Your Personalized Recovery Plan
You’ve come a long way since you started this workbook. You have been practicing a lot of skills to help keep you sober and to pave the way to find happiness, pleasure, and emotional balance in your recovery. You understand the way your addicted brain works. You’ve strengthened your rational brain repeatedly with CBT skills, mindfulness training, motivational exercises, new sources of pleasure to replace drugs and alcohol, and a deeper understanding of how your unique relapse triggers lead you to drink or use. In this chapter, we’re going to put all of the skills you’ve learned together into a personalized recovery plan that will help you stay happy, healthy, and sober in the long term.
There are a few ways that you will use the skills you’ve learned to prepare for long-term recovery. First, you will need to be aware of your personal warning signs for relapse, and be prepared with a plan for what to do if you or someone close to you begins to notice these signs becoming apparent. Second, although the hope is that you won’t slip or relapse, given that most people who are in recovery do at one time or another, you will need to prepare for how to handle a slip, to prevent it from turning into a full-blown relapse. Finally, putting all of your hard work together, you will reflect on all that you’ve learned in this workbook and, based on what you’ve observed to be the most helpful strategies, you will put together an integrated, personalized relapse prevention plan that you can use going forward in your recovery process.
Staying One Step Ahead of a Relapse
The great news about where you are now, compared to when you started this workbook, is that you know exactly what triggers you and makes you vulnerable. Equipped with this knowledge, you’re less likely to be blindsided by an urge to drink or use. You just have to pay attention to what’s coming up ahead.
For at least the first six months of your recovery, one of the best ways to stay ahead of a potential relapse is to sit down at the start of each week and take the time to think about the days ahead. Do you know of any risky or potentially stressful situations coming up? (These could be family-related, work-related, or other situations that might result in the urge to drink or use.) If so, you can plan how you’re going to handle them ahead of time. If you feel triggered, will you leave? Will you plan not to stay very long to begin with, so as to avoid getting triggered? Will you use a meditation technique? Maybe you’ll bring someone with you who is sober. Or if it’s possible, you’ll consider avoiding that situation altogether.
These are just a few examples of plans that you can lay out if you take the time to think about what’s coming up for you. It may be helpful to refer back to the Urge Planner in chapter 6. Plan on completing this exercise on a weekly basis for as long as you can (ideally, for the first six months of your recovery). You can discuss it with your counselor or therapist, if you have one, and get some input as to how to plan for potentially triggering situations.
If you think back to the last time that you slipped or relapsed, there were probably warning signs before you entered the situation in which you actually drank or used. Recovery is not just about behaviors (such as avoiding risky situations, or going to therapy or self-help meetings)—as you well know now, it is also a mindset.
As the strength of your motivation for recovery naturally moves up and down, you may find yourself slipping out of the recovery mindset at times. Although this does not necessarily mean that you are headed straight for a relapse, it is best to be aware when it is happening so that you can take steps to renew your motivation and get yourself back on track. In exercise 11.1, you’ll find a list of some common warning signs. These signs can relate to either your mindset or your behaviors. As you look through this list, think about times when you’ve relapsed; in the days and even the weeks before, you probably experienced some changes in the way you were thinking about your recovery, or the way you were acting or feeling emotionally. Maybe you didn’t realize at the time that these warning signs were there, but now as you look back on it, things may become a little bit clearer.
Exercise 11.1: My Warning Signs of Relapse
Look at the list of warning signs below and place a check mark beside the ones that you can identify with, or that you’ve observed in yourself prior to a relapse.
Stopping or cutting back your attendance in therapy or counseling
Thinking about ways that you might be able to drink or use without anyone knowing about it
Fantasizing often about how good it would feel to drink or use, while blocking out or thinking very little about the potential negative consequences
Stopping or cutting back your attendance in self-help groups, such as AA or SMART Recovery
Isolating yourself
Placing yourself in risky situations
Avoiding talking about mixed feelings or doubts you have about staying sober
Starting to use a drug other than your “substance of choice”
Feeling intense negative emotions, such as depression, anxiety, anger, or irritability
Feeling that you don’t fit in with others who are in recovery
Blaming other people for your problems
Having very few activities that are fun or enjoyable in your routine
Not sleeping well or not sleeping enough
Neglecting responsibilities, such as paying bills, doing household tasks, taking care of loved ones, or getting to work or school
Avoiding talking about feelings of unhappiness
Feeling hopeless about your ability to rebuild your life
Keeping alcohol, drugs, or paraphernalia at home
Hanging on to phone numbers of dealers or people you used to use with
Lying
Rejecting help from others
Feeling bored or having lots of unstructured or unplanned time
Spending time with people who drink or use
Acting defensive when others around you express concern about your well-being or recovery
Other relapse warning signs:
Now, looking back at the list, identify which you think are the top three signs that you are at risk of relapse. You will need a plan for what you will do if you or someone close to you points out any of these signs. Here are some examples of potential plans:
You might come up with other ideas. But this list can help you begin to think about how you can respond to your warning signs.
My Top Three Warning Signs of Relapse:
Warning sign #1:
Plan if I notice this sign:
Warning sign #2:
Plan if I notice this sign:
Warning sign #3:
Plan if I notice this sign:
You might remember our discussion about the difference between a “slip” and a relapse. To review here briefly, the first time you drink or use after a period of being sober or abstinent, it is called a “slip.” Although you may be committed to abstinence, and it might be hard to imagine that you’d slip, studies of addiction have shown that the tendency to return to substance use after a period of sobriety is part of the illness (NIDA 2010). So it is best to be prepared for the possibility that this could happen.
The important thing to remember is that your response to a slip makes all the difference in terms of the impact it has on your recovery. A slip doesn’t have to set you back tremendously, if you’re willing to address it immediately by: (1) talking about it with a counselor, therapist, or sponsor; (2) figuring out what went wrong; and (3) putting safeguards into place to prevent it from progressing into a relapse. A relapse happens when you allow a slip to lead to an extended period of days, weeks, or longer during which you actively drink or use drugs. Here are some things that you can tell yourself to prevent a slip from heading in the relapse direction:
Another important thing to remember is to catch yourself if you find that you are getting into the spiraling lapse mindset. In chapter 5, we discussed how sometimes when you experience a slip or a lapse, it can trigger dysfunctional thoughts like, I’ve blown it. I’m a total failure. I’ll never stay sober. I have nothing to lose by continuing to drink (or use). Beware of the spiraling lapse frame of mind; it is a sure pathway from a slip to a full-blown relapse. You can avoid it by recognizing it for what it is, and intentionally bringing your thoughts into a more CBT-oriented mindset, in which you view the slip as a learning opportunity that you can quickly move past.
Once you’ve preserved your recovery mindset, brought yourself out of the spiraling lapse mode, accepted that the slip happened, and decided that you are ready to put it behind you, there are a few more steps you can take to prevent any further drug or alcohol use:
Your Personalized Relapse Prevention Plan
Now that you’ve worked your way through all of the chapters and the exercises in each one, you are well positioned to manage your recovery both now and in the long term. In each of the chapters, you’ve been trying new skills and, hopefully, making mental notes about which of them have been most helpful to you.
In this section you’re going to revisit these skills and mark off the ones that you think you’d like to use, going forward in your recovery. Some of the skills are general recovery lifestyle behaviors; they keep you feeling happy and balanced, reducing your risk of a relapse. (Examples include doing pleasant activities, exercising, and communicating effectively with others.) Other coping skills that you’ve learned are more specific to risky situations (like surfing the urge, the mindfulness-based SOBER breathing exercise, and challenging red flag thoughts). Reflecting on the skills you’ve learned in this program, place a check mark beside those that you found helpful:
Motivation Enhancing Skills
General Wellness Skills
Alcohol- and Drug-Specific Coping Skills
Mood and Anger Management
Now, you will list the skills in each category that you plan to use as your “go-to” strategies in your personalized relapse prevention plan. Think about which exercises have spoken the most to you and your personal experience. Also think about which of the techniques you have found yourself using when you were not reading this workbook, but just out living your life and navigating challenges in your recovery.
When I need to enhance my motivation for recovery, I will use the following techniques:
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The general wellness skills that I plan to continue using in my recovery include:
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The alcohol- and drug-specific coping skills that I plan to use when I am tempted to drink or use are:
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People I can call if I am tempted to drink or use include:
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The mood and anger management techniques that I will continue to use include:
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Other skills I plan to use going forward in my recovery:
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Congratulations on your hard work and persistence throughout this workbook. You’ve taken in a lot of new information about the science of addiction, and you’ve tried out many different types of coping skills. In doing so, you’ve laid the essential groundwork for your ongoing recovery.
You now have a range of evidence-based therapy techniques that are used in addiction treatment at your fingertips, and you have the flexibility to choose which ones you’d like to use, based on the relapse prevention plan that you’ve laid out in this final chapter. You’ve made great strides in developing the tools that you need to live a well-balanced and happy life in your recovery. Keep up your hard work; you are well on your way toward rebuilding a satisfying and rewarding life, free from alcohol and drugs.