Relapse Is a Part of Recovery

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Clients and loved ones often come into therapy wanting to end their compulsive behaviors, but few recognize the realization of what that encompasses. People will swear to never go back to their "drug of choice" and I will acknowledge their steadfast commitment while giving them an understanding that recovery should be likened to a marathon and not a sprint.

People enter addiction recovery after years of engaging in their destructive behaviors, and I let everyone know that it's going to take patience and understanding for true recovery to take hold.

Clients can "white-knuckle" through the early stages (from a few months to a year) and find other means to distract and avoid the compulsive behaviors that got them into treatment in the first place. But more times than not, there will be what we call a slip or relapse. While it may feel discouraging to the patient and their family members, I try to see this through the prism of harm reduction.

For example, if problematic drinking is the issue, I would like to ensure clients never go back to their past ways of hiding, secrecy, and lies. This means having clients agree as a goal to not drink during the entire time they're in therapy. But this agreement doesn't mean they won't have a slip or even a full-blown relapse. What we do, though, is process what occurred and find new ways of shoring up their defenses so they're more aware of the triggers (emotional, physical, relational), stressors, and high-risk environments that led to the slip in the first place.

Therapeutically, addiction is such an insidious issue and I require clients to get into some group or community that can address their drug of choice. This often means joining a 12-step program or being in group therapy run by a therapist for their specific problem (e.g. eating disorders, alcohol, sex, etc.). The group aspect is significantly more important than individual therapy, in my opinion. This is because a group offers identification, advice from peers, accountability, and hope that is harder to generate in individual counseling.

While no one wants a slip or relapse to occur, we'd be foolhardy to say it can't or shouldn't occur. What's important is not whether a relapse occurs or not but the time between them. For example, clients initially struggling with daily, compulsive porn use who get better in recovery and are slipping monthly are praised for their work and gradual improvement.

There's another saying in recovery, "progress not perfection," as we want clients to see this process is one of grace and not shame. Perfection in early recovery is unreasonable, but as clients become healthier and develop a new lifestyle, they can be encouraged to know that many people in recovery have years and decades worth of sobriety that is achievable—but not until they learn how to first love themselves, even in their struggles, slips, and relapses.