Dealing With People Who Relapse a Lot

--- In convenors@yahoogroups.com, "fibejebe" charli883@i... wrote:

"...The truth sometimes hurts but it is still better than a load of bullshit. Any comments?" -- Fiona.

Not long ago, on LSRmail, one of our members who's been struggling with repeated day-1's since first becoming involved with LSR late last year, in referring to the response from Ellesarians to his latest slip, put up a post which included this line:

"...When I drank 9 days ago a lot of lsr's said don't worry about it, get back on your feet, move on. Should I still take that attitude?"

My response is copied here:
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What attitude makes the most sense to you, XXXXX? It seems to me that somebody who's made a sincere decision to end the admittedly devastating, suicidal lifestyle of active addiction would not take lightly any episode of drinking, regardless of the circumstances.

Addiction is serious business, and the only known way to arrest it is abstinence. Lapses in abstinence, if dismissed too casually, can become seen as inevitable, or "no big deal". The danger in that attitude, of course, is that the lapses will become more frequent and last longer.

When does one cross the line from being committed to recovery and really making a concerted effort to change, back over to being resigned to a life of struggling with alcohol?

When does a pattern of slips become nothing more than active alcoholism in the form of periodic or binge drinking? I'm not sure there's a clean line there. I'm very sure the danger exists, because that's exactly what I did some years ago.
So, when I hear people suggesting that one "Don't worry about it, get back on your feet, move on...", what I hear is "Don't spend a lot of time wallowing around in guilt and embarassment, by all means stop drinking immediately, and redouble your efforts to attain stable abstinence."

What I don't hear is "Hey, no big deal, forget about it." It is a big deal. It's a failure to achieve what you set out to do. It's a disappointment, a frustration, a bummer. It's an indication that you've more work to do, that there are things you might consider doing differently. It should not be forgotten about, it should be looked at very carefully to see what can be learned to prevent it from happening again.

I guess I'd say the worst attitude one might assume in the midst of, or in the wake of a slip would be, "See? I can't stop drinking. I'm a failure. Screw it, it's too hard, I can't do this, the hell with sobriety." A much better attitude might something like, "See? I'm human, I'm not invincible, I let my guard down and got bitten hard. But I'm not beaten, I'm going to learn what I can from this and do what I set out to do for all the reasons I know in my heart I must, if I'm to live a meaningful life."

I would find it a bit worrisome that after a damn good period of sobriety you drank, then about a week later you drank again...that's a disturbing trend developing. Time to get serious, if you're serious about sobriety. And I believe you are.
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And that about sums up my personal view on the question, except to add that the better I know an individual, the better feel I have for what attitude to take in my support of them. I, personally, am likely to pay more attention and actually think about what's being said if I get some straight, no BS talk (and maybe a slap or two) from someone I trust and respect. At the same time, I realize people react differently, and it takes time to get to know what's the best way to get through to somebody. When in doubt, I'll lean toward the "gentle" approach.
Rick Booth 5/30/03

People Develop Commitment Through Having Choices: A Lesson From Harvard Business Review

Somehow a copy of Harvard Business Review landed in my office and I started reading it on my commute train. The following article caught my eye and I want to pass along some points it makes.

Richard Chase and Sriram Dasu author a cover article titled "Want to perfect your company's service? Use behavioral science." (HBR June 2001, p. 79, click to read it online). They try to apply decades of behavioral research to illuminate what the service experience feels like to the customer. Here are some main points:

(1) People remember the start and the end of the experience more than the middle, but they remember the end most of all. Therefore, to bring customers back, service providers should end on an upnote. Can we learn from this principle in our context? Many of our local meetings end with a round of applause. This is a feel-good experience and provides an upbeat ending. Score one for us.

(2) If there is bad news, get it out of the way early. At a recent meeting it was known that one member had had a relapse. When the opening statement was done, the meeting convenor could have started the check-in ("how was your week") to his left or to his right. Instead he went straight across the room to the member who had relapsed and asked him to start off the discussion. Good move. The meeting processed the bad news early and ended strong.

(3) People desperately want things to make sense and will concoct an explanation when none is available. In the recovery context, the atmosphere is filled with "explanations" derived from the religious/spiritual 12-Step movement. If we don't step in with our own secular explanations, people will fall back on what's available, even if it's counterfactual or meaningless under scrutiny. Lesson: convenors who study and develop a deeper theoretical understanding of secular recovery principles can fill the vacuum and help people make sense of their experience in a rational manner.

(4) People develop commitment through having choices. "A fascinating study found that blood donors perceived significantly less discomfort when they were allowed to select the arm from which the blood would be drawn. The lesson is clear: people are happier and more comfortable when they believe they have some control over a process, particularly an uncomfortable one. Often the control handed over is largely symbolic (as in the choice of arm). In other cases, it's very real: the medical profession has long recognized the value of allowing the patient to make an informed choice about alternative treatments for cancer and heart disease. These are extremely important, high-stakes decisions, and great value is gained by including the patient in the decision. He or she feels less helpless, less hopeless, and more committed to making the process work." (p. 83).

In a nutshell, our approach of telling the person new in recovery that they have a choice and that they have the power to construct their own personal recovery protocol is sound in principle, with clear support in motivational research. The contrary approach -- telling people that they are helpless and have zero power to choose -- is a substandard, unsupportable practice. Our approach develops and reinforces the most important single ingredient in a person's recovery over the long term: the inner commitment to succeed.

It's always good to learn that we're on the right track, even if the stroke comes from such an improbable source as HBR.