1. Presented by Joan E. Huss; LIMHP, LADC Associate Director of Clinical Services Catholic Charities - JOURNEYS

2.  Relapse is the progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice.  Definition: a reactivation of the symptoms of addiction after those symptoms have gone into remission ◦ Irrational thoughts ◦ Unmanageable feelings ◦ Destructive behaviors

3.  In order to relapse, you first have to be in recovery ◦ Understand addiction ◦ Apply knowledge to self ◦ Accept the painful feelings due to addiction ◦ Stop using ◦ Work a recovery program

4.  Relapse is a process not an event  Relapse is unconscious and automatic  Either relapse or recovery  Relapse is common and predictable  Relapse is preventable ◦ Rule of thirds  Relapse stages are cumulative and progressive

5.  Sobriety vs. abstinence  Brain studies on relapse  Role of choice  Role of motivation  Role of will power and self- discipline  Hitting “rock bottom”

6. 1. Internal Change 2. Denial 3. Avoidance and Defensiveness 4. Crisis Building 5. Immobilization 6. Confusion and over-reaction 7. Depression 8. Loss of Control 9. Realization of Loss of Control 10. Option Reduction

7.  Increased stress  Change in thinking  Change in feelings  Change in behavior

8.  Concern about well-being  Denial of the concern

9.  Believing that I will never use again  Worry about others instead of myself  Defensiveness  Compulsive behavior  Impulsive behavior  Tendencies towards loneliness

10.  Tunnel vision  Minor depression  Loss of constructive planning  Plans begin to fail

11.  Daydreaming and wishful thinking  Feeling that nothing can be solved  Immature wish to be happy

12.  Difficulty in thinking clearly  Difficulty in managing feelings and emotions  Difficulty in remembering things  Periods of confusion  Difficulty managing stress  Irritation with others  Easily angered

13.  Irregular eating habits  Lack of desire to take action  Difficulty sleeping restfully  Loss of daily structure  Periods of deep depression

14.  Irregular attendance at recovery activities  I don’t care attitude  Open rejection of help  Dissatisfaction with life  Feelings of powerlessness and helplessness

15.  Self-pity.  Thoughts of social drinking.  Conscious lying.  Complete loss of self- confidence.

16.  Unreasonable resentment.  Discontinues all treatment activities  Overwhelming loneliness, frustration, anger and tension.  Loss of behavioral control.

17.  Initial use (the lapse).  Shame and guilt.  Helplessness and hopelessness.  Complete loss of control.  Bio-psycho-social damage.

18.  Terence Gorski  GORSKI-CENAPS model  http://www.tgorski.com