Relapse is a holistic process involving negative thoughts, feelings, and behaviors that can lead to a return to active addiction if not addressed. Key factors in preventing relapse include identifying high-risk situations and thoughts, managing feelings in a healthy way with support, changing dysfunctional behaviors, and engaging in recovery-promoting activities. A relapse prevention plan and contract involving supports can help maintain recovery goals.

1. Recovery WellnessRecovery Wellness
Means for SuccessMeans for Success
Relapse PreventionRelapse Prevention
By James D. Amburn CDP, REV.By James D. Amburn CDP, REV.

2. Addiction and RecoveryAddiction and Recovery
• Over the years I have heard many differentOver the years I have heard many different
speakers state that “Spirituality is the absence ofspeakers state that “Spirituality is the absence of
fear”.fear”.
• I personally believe that “Spirituality is theI personally believe that “Spirituality is the
healthy management of fear”.healthy management of fear”.
• When even in fear you can manage the courageWhen even in fear you can manage the courage
to do the right thing then you have become okto do the right thing then you have become ok
with you and your place in the universe. “Awith you and your place in the universe. “A
True Spiritual Being”True Spiritual Being”

3. What is RelapseWhat is Relapse
(How did we get here?)(How did we get here?)
Relapse is a holistic change that occurs in a person;Relapse is a holistic change that occurs in a person;
before they return to active addiction (using).before they return to active addiction (using).
Relapse is a return to old survival skills: Thinking;Relapse is a return to old survival skills: Thinking;
feeling (poor feeling management); and behaviorsfeeling (poor feeling management); and behaviors
that create urges, and if not stopped a return tothat create urges, and if not stopped a return to
active addiction or death.active addiction or death.
Like addiction, relapse is progressiveLike addiction, relapse is progressive

4. Event
Thoughts Feelings Behaviors Urges

5. EventsEvents
• External events cause a chemical response in theExternal events cause a chemical response in the
brain:brain:
• Even though a person may not be cognitivelyEven though a person may not be cognitively
aware; memories are being recalled, memoriesaware; memories are being recalled, memories
retained in nerve cells called dendrites.retained in nerve cells called dendrites.
• The more extreme the event, the longer we stayThe more extreme the event, the longer we stay
in the memories; the greater the urges are.in the memories; the greater the urges are.

6. EventsEvents (samples)(samples)
• Fall in Love (Lust); Fall out of LoveFall in Love (Lust); Fall out of Love
• Get a job; Lose a jobGet a job; Lose a job
• Have money; don’t have moneyHave money; don’t have money
• Music; smells; old friends; old placesMusic; smells; old friends; old places
• Legal issuesLegal issues
• Have a car (broke down, running); don’t have a carHave a car (broke down, running); don’t have a car
• Have my children; don’t have my childrenHave my children; don’t have my children
• Ex-wife/husband; present wife/husbandEx-wife/husband; present wife/husband

7. EventsEvents
Identify events and high riskIdentify events and high risk
situations:______________________________________________________________situations:______________________________________________________________
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
______________________________________________________________________________
Identify means to avoid or minimize events or high riskIdentify means to avoid or minimize events or high risk
situations:_______________________________________________________situations:_______________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________

8. EventsEvents
• Identify who can help you in times of need manage high risk situation orIdentify who can help you in times of need manage high risk situation or
events:events:
Name Phone #Name Phone #
_______________ ______________________________ _______________
_______________ ______________________________ _______________
_______________ ______________________________ _______________
_______________ ______________________________ _______________
_______________ ______________________________ _______________
_______________ ______________________________ _______________
_______________ ______________________________ _______________
_______________ ______________________________ _______________
• ““I will allow them to help me if I call”.I will allow them to help me if I call”.

9. ThoughtsThoughts
• Thought is actually pictures and as our mind seeThought is actually pictures and as our mind see
the pictures we translate them into languagethe pictures we translate them into language
• The first thought process in relapse is a return toThe first thought process in relapse is a return to
denial.denial.
• Then to self-abusive thinkingThen to self-abusive thinking
• Finally our thinking goes to Automatic NegativeFinally our thinking goes to Automatic Negative
Thinking.Thinking.

10. ThoughtsThoughts (examples)(examples)
• Self- abusive thinking:Self- abusive thinking:
• Putting one-selves downPutting one-selves down
• Cussing one-selfCussing one-self
• Calling one-selves names (stupid, crazy, retarded,Calling one-selves names (stupid, crazy, retarded,
or dumb, comparing one self to another.or dumb, comparing one self to another.

11. ThoughtsThoughts (examples)(examples)
• The language of denial that stops forward progress:The language of denial that stops forward progress:
• If only, I don’t, should have, could haveIf only, I don’t, should have, could have
• Denial is also the thinking that minimizes, rationalizes, intellectualizes,Denial is also the thinking that minimizes, rationalizes, intellectualizes,
justifies, and personalizesjustifies, and personalizes
• If only my PO would stopIf only my PO would stop
• If only my ex would let meIf only my ex would let me
• I should have been able if onlyI should have been able if only
• I could have if onlyI could have if only
• I can have one hit no one will knowI can have one hit no one will know
• No one really stops usingNo one really stops using
• Everyone does itEveryone does it
• They’re out to get meThey’re out to get me

12. ThoughtsThoughts (examples)(examples)
• Automatic Negative ThinkingAutomatic Negative Thinking
Concrete thinking (My way or No way, right or wrong)Concrete thinking (My way or No way, right or wrong)
• Victim stance thinking;Victim stance thinking;
It wasn’t my fault, blamingIt wasn’t my fault, blaming
• Vindictive Thinking;Vindictive Thinking;
I’ll show themI’ll show them
• CriminalityCriminality
• For every negative thought towards self it takes two-hundredFor every negative thought towards self it takes two-hundred
positive thought to counter act.positive thought to counter act.

13. ThoughtsThoughts
• Identify denialIdentify denial
thinking:_____________________________________________________thinking:_____________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________
• Identify self-abusiveIdentify self-abusive
thinking:_____________________________________________________thinking:_____________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________
• Identify myIdentify my
ANT:_______________________________________________________ANT:_______________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
__________________________________________________________________________

14. FeelingsFeelings
• Feelings are neither good nor bad; they are just feelings.Feelings are neither good nor bad; they are just feelings.
• In addiction, extremes and intensity are the norm.In addiction, extremes and intensity are the norm.
However in reality extremes and intensity areHowever in reality extremes and intensity are
infrequent.infrequent.
• In relapse a person will attempt to regain the addictiveIn relapse a person will attempt to regain the addictive
norm. Thoughts create feelings. So negative thinkingnorm. Thoughts create feelings. So negative thinking
creates feelings such as anger, resentment, depressioncreates feelings such as anger, resentment, depression
and loneliness.and loneliness.

15. FeelingsFeelings
• In recovery it is learned that healthy feelingIn recovery it is learned that healthy feeling
management is needed. The formula E/I ismanagement is needed. The formula E/I is
used for addiction Emotion over Intellect.used for addiction Emotion over Intellect.
When entering into recovery the formulaWhen entering into recovery the formula
changes to I/E, Intellect over Emotions. Whenchanges to I/E, Intellect over Emotions. When
entering into relapse the formula again changesentering into relapse the formula again changes
back to E/Iback to E/I

16. FeelingsFeelings
• Identify feeling I have when inIdentify feeling I have when in
relapse:____________________________________________relapse:____________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
________________________________
• Identify means to be ok with myIdentify means to be ok with my
feelings:____________________________________________feelings:____________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
______________________________

17. FeelingsFeelings
• Identify who can help you to express and manage feeling in a healthy wayIdentify who can help you to express and manage feeling in a healthy way
• Name Phone #Name Phone #
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• ““I will allow them to help me if I call”.I will allow them to help me if I call”.

18. BehaviorsBehaviors
• From the “Sanskrit”; “All that we project onFrom the “Sanskrit”; “All that we project on
the outside is but an inner reflection”.the outside is but an inner reflection”.
• Behavior is where most people start to realizeBehavior is where most people start to realize
that they are in relapse. Unlike thoughts orthat they are in relapse. Unlike thoughts or
feelings; behavior is easily identified asfeelings; behavior is easily identified as
appropriate or inappropriate.appropriate or inappropriate.

19. BehaviorsBehaviors (examples)(examples)
• Language: Comparing one-self to others;Language: Comparing one-self to others;
Victim speech; they have all the luck, if I only hadVictim speech; they have all the luck, if I only had
the breaks they have, they aren’t really clean.the breaks they have, they aren’t really clean.
Cursing self or others, systems, threats towardsCursing self or others, systems, threats towards
people or places.people or places.
Disorganized speech; idea’s going in everyDisorganized speech; idea’s going in every
direction, fantasizing.direction, fantasizing.

20. BehaviorsBehaviors (examples)(examples)
• External actions:External actions:
Pacing, isolating, aggressive actions, slammingPacing, isolating, aggressive actions, slamming
doors, throwing things, self-harm, higherdoors, throwing things, self-harm, higher
pitched voice; short choppy speech, clenchedpitched voice; short choppy speech, clenched
fist, jaw, fast tense movement, or inability tofist, jaw, fast tense movement, or inability to
sleep.sleep.

21. BehaviorsBehaviors
• Identify behaviors I have when inIdentify behaviors I have when in
relapse:____________________________________________relapse:____________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
________________________________
• Identify means to change myIdentify means to change my
behaviors:__________________________________________behaviors:__________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
__________________________________

22. BehaviorsBehaviors
• Identify who can help me manage my behaviors in a healthy wayIdentify who can help me manage my behaviors in a healthy way
• Name Phone #Name Phone #
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• ““I will allow them to help me if I call”.I will allow them to help me if I call”.

23. Activities to Help Break the Cycle ofActivities to Help Break the Cycle of
RelapseRelapse
• Working out with a friendWorking out with a friend
• Go to a meetingGo to a meeting
• Call a friend, sponsor, mentor, elderCall a friend, sponsor, mentor, elder
• Volunteer Oxford presentations, H & I (12Volunteer Oxford presentations, H & I (12
step ) presentationstep ) presentation
• Help someone who is having problems withHelp someone who is having problems with
their own recoverytheir own recovery

24. Personal Activities that PromotePersonal Activities that Promote
RecoveryRecovery
• To help me change my thinking and behaviors I can;To help me change my thinking and behaviors I can;
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
________________

25. Relapse Prevention ContractRelapse Prevention Contract
• As a Recovering person I;_______________________. I willAs a Recovering person I;_______________________. I will
allow others in recovery to help me manage my thinking,allow others in recovery to help me manage my thinking,
feelings, and behaviors in a healthy manner.feelings, and behaviors in a healthy manner.
My main purpose is to develop a health life style that will let meMy main purpose is to develop a health life style that will let me
remain in recovery.remain in recovery.
I no longer want to live in my past, allowing my addiction toI no longer want to live in my past, allowing my addiction to
jeopardize my; life, freedom, friends, family, income, or spiritualjeopardize my; life, freedom, friends, family, income, or spiritual
growth.growth.

26. To achieve this goal I will allow;To achieve this goal I will allow;
• Name Phone #Name Phone #
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• _______________ ______________________________ _______________
• ““I will allow them to help me even if I do not believe I needI will allow them to help me even if I do not believe I need
help”.help”.
• Signature of Sponsor ___________________.Signature of Sponsor ___________________.
• Signature of Recovery Friend ___________________.Signature of Recovery Friend ___________________.

27. Resources'Resources'
• Terence T. Gorski:Terence T. Gorski:
• Staying Sober; Relapse Prevention CounselingStaying Sober; Relapse Prevention Counseling
Workbook; Relapse Prevention Therapy withWorkbook; Relapse Prevention Therapy with
Chemically Dependent Criminal OffendersChemically Dependent Criminal Offenders
• Dr. Darryl Inaba:Dr. Darryl Inaba:
• The Evolving Science of Relapse and RecoveryThe Evolving Science of Relapse and Recovery

28. Resources'Resources'
• Dennis C. Daley:Dennis C. Daley:
• Relapse Prevention WorkbookRelapse Prevention Workbook
• Ernie Larson;Ernie Larson;
• Stage Two RecoveryStage Two Recovery
• My mind is not my friend. When I am aloneMy mind is not my friend. When I am alone
with my thinking I’m in the wrongwith my thinking I’m in the wrong
neighborhood and hanging with the wrongneighborhood and hanging with the wrong
person.person.