The video for this presentation is available on our Youtube channel: https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c= We review signs of relapse in the following areas: emotional, mental, physical, social. We explore triggers and how to eliminate negative triggers and add triggers for recovery behaviors.

1. Relapse Prevention Part I
Dr. Dawn-Elise Snipes PhD, LMHC, LPC, NCC

2. Objectives
 Define Relapse
 Identify Relapse Warning Signs
 Identify Strengths
 Learn about how your issue developed

3. Relapse Definition
 Relapse is the return to something that has been previously
stopped
 Relapse is multidimensional
 Emotional
 Mental
 Physical
 Social
 Review your Distress vs. Happiness worksheet.
 A relapse is when you start returning to any of these people,
places, things, behaviors or feeling states.

4. Emotional Relapse
 In emotional relapse, your emotions and behaviors
become negative and unpleasant.
 You start finding it difficult to experience pleasure
 What triggers your negative emotions
(Anger/resentment/jealousy/guilt; anxiety/fear/stress;
depression)
 Things/Media
 People
 Places
 Events

5. Emotional Relapse
 Negative emotions make us uncomfortable
Identify the emotion, explore why you are feeling that way and take
steps to fix the problem
You can become stuck in the emotion, sometimes
 Nurturing and blowing it out of proportion
 Compounding it with other emotions like anger and guilt
 Personalizing it
 Trying to escape from it
Remember that emotions are just cues like a stoplight.
You feel how you feel in the moment
You can choose to change or improve the next moment

6. Preventing Emotional Relapse
 Practice mindfulness
 Increase positive experiences (real and guided imagery)
 Keep a gratitude journal
 Avoid personalizing something that may not be about you
 Remember that…
 Negative emotions are the mind’s way of telling us to get off our butts
and do something—Like our car’s idiot light or hunger pangs
 Dwelling on, nurturing, avoiding or hiding from negative emotions
never makes anything better
 You can *choose* to feel and fix, or relapse and repeat

7. Activity
 List 10 things that you chose to get anxious or angry about over
the last week
 Why did you get upset? (What was your mind telling you needed
to be fixed)
 Did holding on to the upsetness do any good?
 What was your initial reaction, and was it helpful?
 What could you do differently next time to either
 Change/fix the situation (Improve the next moment)
 Change how you feel about the situation (Walk the middle path)
 Let it go (Radical Acceptance)

8. Mental Relapse
 In mental relapse there's a war going on in your mind.
 Part of you wants to stay positive, but part of you is struggling
with tolerating the distress.
 The signs of mental relapse are:
 Focusing on the negative
 Having a pessimistic/helpless/hopeless attitude
 If you had an addiction, you may also be:
 Thinking about people, places, and things you used with
 Glamorizing your past use
 Lying to yourself and others
 Justifying your behaviors
 Minimizing the impact of one (drink/hit/bet etc.)
 “Screw It” attitude

9. Mental Relapse
 What types of things trigger negative thoughts?
 Things/Media
 People
 Places
 Events
 What thoughts do you have that make you feel
 Angry/irritated/resentful
 Guilty
 Envious
 Scared/Anxious/Worried/Stressed

10. Identifying Unpleasant Thoughts
Loss of Control/
The Unknown
Failure Isolation/
Rejection
Death
Angry/
Irritated
/Resentful
Guilty
Envious/
Jealous
Scared/
Anxious/
Worried/
Stressed
Identify and address the thoughts that trigger the emotions related to each
fear/threat

11. Preventing Mental Relapse
 KISS: Keep It Simple Stupid
 Trying to change too many things at once can lead to failure
 Often some of simplest things can have the greatest impact
 Prevent and address vulnerabilities that can make you
focus on negative or have a strong, negative emotional
reaction
 Good Orderly Direction
 Your life is a road map
 The destination is recovery and happiness
 Before you act, think whether that keeps you on the right road, or is
an unplanned detour
 Maintain Head-Heart-Gut Honesty (Rational, Emotional, Wise Mind)

12. Social Relapse
 Symptoms
 You have returned to the old people and places who co-sign on your
b.s.
 You have withdrawn from your social supports
 You have become self-centered
 You have withdrawn
 What triggers your social relapse
 People
 Places
 Things
 Events

13. Preventing Social Relapse
 Contact your social support(s) on a daily basis for the first
3 months
 Keep a business card in your wallet with the names and
numbers of 3 social supports
 Change your phone number (if possible) and destroy
contact information for people who might trigger a relapse
 Find at least one prosocial activity to do each week ---
volunteer, church, go to the gym

14. Physical Relapse
 Physical relapse is characterized by:
 Fatigue
 Increased anxiety
 Difficulty sleeping
 Neglecting physical health (sleep, exercise, nutrition, medication)
 If there was also addiction…
Cravings
Dreams about the drug

15. Preventing Physical Relapse
 HALT
 Hungry
Nourish your body with proper nutrition
Nourish your mind with activities and things that increase “happy chemicals”
 Angry/Anxious
Reduce chronic stress
 Lonely
Nurture social supports to buffer stress
Be willing to ask for help
 Tired
Get sufficient quality sleep
Address issues such as sickness and pain that prevent quality sleep

16. Review Strengths
 What is life like when you are happy?
 What is different?
 What is the same?
 List three ways you cope with stress.
 What activities do you like to do?
 What are your positive qualities and strengths?

17. Review Prior Relapses
 What was happening before the relapse?
 What triggered the relapse?
 Relapses occur when old behaviors are more rewarding or
stronger than new ones.
 What became more rewarding than your recovery program?
 Before you relapse, what changes in
 Your emotions
 Your thoughts
 Your behaviors
 Your interactions with others?
 What have you learned?

18. Relapse Prevention Planning
 Include time in the morning and at night to use
mindfulness skills to “get grounded”
 Identify and prevent or mitigate vulnerabilities each day
 Avoid alone, idol time if your mind tends to wander to dark
places
 Incorporate positive experiences each day
 Set realistic daily goals
 Give yourself credit for positive accomplishments

19. Summary
 Relapse triggers can be emotional, mental, physical or
social
 For each trigger you identified, describe at least 1 way you
can deal with it
 Practice mindfulness each day can help you become aware
of your personal, daily vulnerabilities for relapse
 For each general category, identify 3 things you can do to
continue on your journey toward happiness