The Warning Signs and Phases of Relapse

Literature can be vague about the process that unfolds before the addict picks up substances and sets of the cycle of destruction in theirs and their families lives. Below are the 10 Phases that addicts will typically go through before attempting controlled use again.

The process is not always as simple as "the thought crossed my mind, and I used". Most addicts who begin recovery don't intend to pick up substances again. Many are genuinely baffled when they find themselves in an active addiction episode again. With the right insight and relapse prevention strategies, these phases can be identified and arrested.

Phase 1: RETURN OF DENIAL

During this phase the dependent person becomes unable to recognize and honestly tell others what he or she is thinking or feeling. The most common symptoms are:

1. Concern about well being. 2. Denial of the concern.

Phase 2: AVOIDANCE AND DEFENSIVE BEHAVIOR

During this phase the dependent person doesn’t want to think about anything that will cause painful and uncomfortable feelings to come back. As a result, he or she begins to avoid anything or anybody that will force an honest look at self. When asked direct questions about wellbeing, he or she begins to become defensive. The most common symptoms are:

1. Believing “I’ll never drink again.” 2. Worrying about others instead of self. 3. Defensiveness. 4. Compulsive behavior. 5. Impulsive behavior. 6. Tendencies toward loneliness.

Phase 3: CRISIS BUILDING

During this phase the dependent person begins experiencing a sequence of life problems that are caused by denying personal feelings, isolating self, and neglecting the recovery program. Even though he or she wants to solve these problems and work hard at it, two new problems pop up to replace every problem that is solved. The most common symptoms are:

1. Tunnel vision. 2. Minor depression. 3. Loss of constructive planning. 4. Plans begin to fail.

Phase 5: IMMOBILIZATION

During this phase the dependent person is totally unable to initiate action. He or she goes through the motions of living, but is controlled by life rather than controlling life. The most common symptoms are:

1. Daydreaming and wishful thinking. 2. Feeling that nothing can be solved. 3. Immature wish to be happy.

Phase 6: CONFUSION AND OVERREACTION

During this phase the dependent person can’t think clearly. He or she becomes upset with self and those around her or him and is irritable and overreacts to small things.

1. Periods of confusion. 2. Irritation with friends. 3. Easily angered.

Phase 7: DEPRESSION

During this phase the dependent person becomes so depressed that he or she has difficulty keeping to normal routines. At times there may be thoughts of suicide, drinking, or drug use as a way to end the depression. The depression is severe and persistent and cannot be easily ignored or hidden from others. The most common symptoms are:

1. Irregular eating habits. 2. Lack of desire to take action. 3. Irregular sleeping habits. 4. Loss of daily structure. 5. Periods of deep depression.

Phase 8: BEHAVIORAL LOSS OF CONTROL

During this phase the dependent person becomes unable to control or regulate personal behavior and daily schedule. There is still heavy denial and no full awareness of being out of control. His or her life becomes chaotic and many problems are created in all areas of life and recovery. The most common symptoms are:

1. Irregular attendance at AA and treatment meetings. 2. Development of an “I don’t care” attitude. 3. Open rejection of help. 4. Dissatisfaction with life. 5. Feeling of powerlessness and helplessness.

Phase 9: RECOGNITION OF LOSS CONTROL

The dependent person’s denial breaks and suddenly he or she recognizes how severe the problems are, how unmanageable life has become, and how little power and control he or she has to solve any of the problems. This awareness is extremely painful and frightening. By this time he or she has become so isolated that it seems that there is no one to turn to for help. The most common symptoms are:

1. Self-pity. 2. Thoughts of social drinking. 3. Conscious lying. 4. Complete loss of self-confidence.

Phase 10: OPTION REDUCTION

During this phase the dependent person feels trapped by the pain and inability to manage his or her life. There seem to be only three ways out–insanity, suicide, or drug use. This person no longer believes that anyone or anything can help him. The most common symptoms are:

1. Unreasonable resentment. 2. Discontinues all treatment and AA. 3. Overwhelming loneliness, frustration, anger and tension. 4. Loss of behavioral control.

THE RELAPSE EPISODE

During this phase the dependent person begins to use alcohol or drugs again, typically struggling to control or regain abstinence.

Some people, especially those who have developed an emergency plan to stop relapse should it occur, are able to quickly reach out and get help before catastrophic consequences occur.

The struggle to control use, however, often leads to shame and guilt when the attempt ultimately fails. Eventually all control is gone and serious bio-psycho-social problems develop and continue to progress. The most common symptoms are:

1. Initial use (the lapse). 2. Shame and guilt. 3. Helplessness and hopelessness. 4. Complete loss of control. 5. Biopsychosocial damage.