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Relapse Recovery

Lukenotes, Summer 2016

When a priest or religious completes residential treatment at Saint Luke Institute, the achievement is celebrated with a commissioning liturgy.

Though this may seem like a conclusion, it is more like the end of a chapter than the end of a book.

Successful recovery is an ongoing journey that requires vigilance and care. In fact, an important part of commissioning is the signing of a contract that outlines goals and action steps developed by the individual with his or her therapists and agreed-upon with his or her contact person or superior.

For someone living with addiction, the contract usually includes participation in 12-Step programs, therapy, use of a support network, medication, and other strategies to implement the skills and knowledge developed in treatment to be stable and able to self-regulate.

Risk of Relapse

Some studies have suggested the risk of relapse for an alcoholic can be 40 percent or more, and relapse may occur more than once over a person’s life. For a priest or religious, relapse can bring feelings of shame and a sense of personal and vocational failure. This shame then becomes part of the relapse cycle, as it can be not only the result of relapse, but also a cause.

Relapse is “the process of becoming dysfunctional in recovery, which leads to a return to chemical use, physical or emotional collapse, or suicide.” (www.SAMHSA. gov, TAP #19, 2016)

It is important to understand relapse not as a person’s failure, but potentially as part of the normal recovery process. An addiction is a chronic disease and, like other diseases, needs to be monitored and treated based on the stage and symptoms present at a particular time.

Triggering Relapse

Relapse occurs when a person minimizes triggers, engages in solitary problem solving and delays in sharing his fragility with others.

Triggers that can undermine the stability of a person’s recovery include stress, grief, an unexpected loss, news of a serious health issue, or even a ministry reassignment or retirement. A person also may experience increased cravings when encountering people, places or things he or she associates with prior addictive behavior.

Warning Signs

Someone who is relapsing may not be aware of what is occurring. It is important for the person’s close friends, support group and superior to pay attention to early warning signs, such as:

  • abrupt mood swings and increasing periods of isolation
  • “too busy” for 12-Step meetings or therapy
  • minimizing the emotional impact of an unpredicted life event
  • failing to plan for mood swings that may come at a holiday or significant anniversary of loss
  • avoiding close friends and family who may challenge behavior
  • decreased involvement in much-loved pastoral work and favorite leisure activities
  • increased tendency to intellectualize feelings and make impulsive unilateral decisions (“I quit the committee because no one wants to implement my idea”)
  • reluctance to discuss feelings of frustration or disappointment about a change in ministerial role (e.g., not being named a pastor or not being elected to a leadership team).

Early intervention by a close friend and/or superior who calmly challenges the person’s behavior often can be very effective, especially in the early stages. An important part of healthy recovery is being able to speak openly with colleagues and friends about cravings and triggers. Support can be very effective in stopping the slide into further relapse.

Sometimes, however, a person is not able or motivated to take the steps necessary to stop the process. A more formal intervention and treatment are necessary. Consultation with a mental health professional and a person’s support team can help guide the next steps, which may include additional treatment.

Treating Serious Relapse

The goals of relapse treatment are to identify and retool a person’s knowledge of and response to triggers so he or she may return to stability and recovery, and identify and address co-occurring conditions. For example, a person in recovery who also has depression may self-isolate and return to self-medicating through alcohol or a narcotic.

The components of relapse recovery treatment – daily group therapy, intensive individual therapy and 12-Step programs – are designed to:

  • develop a thorough understanding of one’s particular relapse process in order to be proactive
  • cultivate confidence in sharing with others the emotional triggers for addictive behaviors
  • enhance one’s ability to ask for support and to identify sources of resistance to receiving help
  • address co-occurring conditions such as an addiction and a mood issue (anxiety or depression)
  • explore other significant elements for further healing: addressing significant personal issues, growth in the spiritual life and eventual reintegration.

Successful treatment focuses on identifying what happened, why the process of recovery failed and then adjusting a person’s skills and knowledge to the situation, similar to the approach followed with other chronic diseases.

Stephen Carroll, Ph.D., LCPC, is a member of the clinical staff of Saint Luke Institute.