February 15th - 20th, 2011: Skill of the week

Thank-you for your gracious patience with my weekly skills post. I know I said that I would do it on Monday, but you know life happens and I really wasn't feeling all that well. It makes me wonder, which is the lesser of the two evils? The pain meds or the pain? Well, I suppose that would be different for each individual person.

Last weeks skill we discussed self-monitoring. There is an area that is very important to monitor: our relapse. Each of us will eventual relapse. We are not perfect and for us to consider it a failure to relapse would be short sighted.We need to understand how to fail well. Once we have come to grips with the reality that a relapse will happen the next step is to do everything in our power to avoid it and prepare for it. 

Each of us should have a Relapse Prevention Plan. This plan should be kept with your Crisis Plan, Recovery Plan, and your assessments of your progress worksheets. It needs to be handy. I would recommend studying it on a regular basis. It is good for us to keep it close in mind as to what happens to us as a relapse is building up. It gives us many more opportunities to stop the relapse in its tracks. We will get more adept at stopping this relapse mid-stream the more familiar we are with the process and the more comfortable we are with the concept of failing well.

We should consider these aspects when developing our plan:

1. List three warning signs of relapse that apply to you.
2. What steps can you take to prevent a return to your self-destructive/impulsive behavior once you have become aware of the relapse symptoms?
3. What are the three personal danger situations where you are most likely to act-out self-destructively or impulsively?
4. What prevention steps can be taken to either avoid the above situations or reduce the change of making a bad situation worse?
5. What changes have you made in your day-to-day life during your treatment that will help prevent a relapse or help you recover from a possible relapse?

Be aware of the many relapse triggers that are out there. Some have found the following to be especially difficult:

• Coping with negative emotions: anger, frustration, fear, anxiety, tension, depression, loneliness, sadness, boredom, worry, apprehension, grief, loss and other distressing states.
• Coping with negative physical/physiological states: pain, illness, injury, hunger and fatigue.
• Enhancement of positive emotional states: pleasure, joy, fun, freedom, celebration.
• Coping with interpersonal conflict: fights, disagreements, discord, hassles.
• Minimizing: minimizing the potential negative consequences of engaging in target behavior, rationalizing why it is OK or not so bad. 
• Testing personal control: going to high-risk places. Thinking you can "do it just once" or somehow do it differently, or have different results this time.
• Social pressure: direct or indirect (observation of others) social pressure. Associating with people who are "high risk" for you.
• Not working your program: not using skills, procrastinating, not practicing, skipping group or not participating when you do go.

Take a mindful approach and seriously meditate on these points. Which are you more susceptible to? Which are more dangerous for you? Then write it in your plan on what you will notice and what you can do about it.

Enjoy writing this plan. A lot has to do with your frame of mind. Don't begrudgingly do this, consider it a pleasure to set-up safety protocols. Cover the material with a safe support person, get their input and then put this plan in an easy to reach location and cover it often. Be very familiar with its content. 

MJ