He may at times be aware of the circumstances that led him to slip, while being offered a drink or some cocaine. By the time of the next encounter with his therapist, however, the addict will have long since denied or lost touch with the cues that precipitated drug-taking. He will talk about the consequences of the slip, attributing them to some other available cause, perhaps blaming it on family or circumstance. Such misattribution is expected in the face of unexplained and unsettling experience. The addict in relapse will not spontaneously offer an understanding of how the slip came about, unless the cues precipitating it were so glaring that awareness breaks through a cloud of forgetfulness.
A therapist must elicit lost or forgotten information relating to a relapse, and encourage patients to become aware of the cues to which they are subject, so they can avert the consequences in the future. The therapist will have to enter areas that often have no compelling emotional content for the patient. Using an approach I call guided recall, a patient must be asked questions about locations, casual companions, seemingly unrelated events that were associated with the time when conditioned cues were first encountered.
