What to Say to Someone Who Relapsed

What Is Relapse?

Relapse is when a person in recovery stops abstaining from alcohol or other drugs after a period of sobriety.¹ Alcohol relapse or drug relapse have three stages, and they can be hard to identify at times. If you have a loved one in recovery, learning more about the stages of relapse can help you keep an eye out for any changes in behavior that may put your loved one at risk.

Relapse consists of the following stages: emotional, mental, and physical.² The physical stage is when one has started using a substance after remaining sober. The emotional and mental stages can be picked up on, though, and can assist loved ones in identifying and potentially preventing a physical relapse. It is important to remember that relapse can occur in any person, no matter how long they have been in recovery.

What Causes People to Relapse?

Relapse happens often in the recovery process for several reasons. Just like any habits we work to form, there are often unforeseen elements that cause changes in our lives. In recovery, one will often hear the phrase “people, places, and things” referred to as potential triggers.³ It rings true; any potential life influence can be identified as a trigger depending on the person.

Reasons that people might relapse include:

• Changes in relationships
• Familial concerns
• Stagnation in one’s recovery program
• Moving to a new place
• Medical issues
• Occupational changes
• Celebration of life events
• Losing a loved one

Signs of Relapse

It is important to be able to identify signs of relapse before the physical stage of relapse occurs. As a person in recovery, or a loved one of a person in recovery, it can be helpful to look out for emotional and mental changes. When the emotional stage of relapse occurs, the individual is not thinking about using substances. A large part of this stage is denial.³

The next stage of relapse after emotional relapse, is mental relapse. During this stage, one will experience internal discord and remain aware of it. This looks like not wanting to physically use, but thinking about how using may decrease their emotional disturbances. It is important to note that thoughts of using while in recovery is common, but in mental relapse, these thoughts are more consistent and include planning to physically use.²

Signs of relapse include:

• Isolating
• Avoiding meetings
• Changes in eating and sleeping habits
• Cravings
• Bargaining
• Lying
• Minimizing consequences of past use

What to Say to Someone Who Has Relapsed

What to say to someone who relapsed might include: You are not alone in this. Relapse is a common part of the recovery process. Individuals who suffer from addiction issues often feel isolated or that no one can relate. Reminding them that they are not alone can provide comfort and support through this difficult time.

Additionally, relapse rates in the recovery process are more common than you may think. In fact, roughly 85% of individuals relapse within the first year after completing treatment.⁴ Discussing the prevalence of relapse during recovery can provide comfort to individuals who may be judging themselves harshly for misstepping in their sobriety journey.

Sharing Your Concerns

Relapse can be an emotional journey for both the individual seeking sobriety and the support system for that person. When sharing concerns with a loved one regarding their relapse, it is important to do so from a place of support without judgment or criticism. Talking with a loved one on how to re-engage with their goals can be a difficult conversation to navigate.

It is essential to remain authentic and honest when communicating these concerns. Coming from a place of love and support is key, but these conversations are more beneficial when one can remain genuine and empathic. It is also beneficial during these discussions to provide unconditional positive regard. This means loving and supporting someone for who they are, not what they do.⁵

Expressing Empathy

In order to express concerns effectively, we must utilize an empathic approach. This means putting yourself in someone else’s shoes and attempting to see the situation through their eyes. This can look like, “I know this must be really difficult for you right now.” Validation and empathic understanding can open the doors for deeper communication.

Asking How You Can Help

Another way to connect with someone who has relapsed is to ask what they need. Oftentimes, when a loved one has relapsed, they are told what they need in harsh or heated contexts. Attempting to start the conversation about help can be an arduous task. Asking someone, “How can I be there for you?” or “What kind of help or support do you need?” can assist in getting back into a recovery mindset.

Suggesting Treatment

When an individual in recovery has relapsed, they may need to see treatment to help get back on track with their sobriety. Treatment comes in many different forms, ranging from weekly outpatient therapy, to inpatient detox and rehabilitation programs. When attempting to suggest treatment, one may consider the length, severity, and substance of the relapse to inform what pathway is most appropriate.

How to Help Someone Who Has Relapsed

To help someone who has relapsed requires an individual to ensure they remain in the supportive role. A person in relapse often feels guilty and isolated, and connection and encouragement can be the perfect antidote. It is important to reflect personally on how to intervene with a person in relapse.

Ways to help someone who has relapsed include:

• Offer Support: Communicate to the person that you are there for them and ask what support they need in the process of getting sober.
• Discuss Strengths: Remind a person of all the qualities and characteristics they possess that make them a strong and lovable individual.
• Be present: Stay focused and use active listening when having difficult conversations.
• Remain authentic: Part of recovery is honesty and genuineness. Model this behavior by remaining authentic when interacting with them.
• Stay compassionate: Come from a place of compassion rather than judgment to make the person feel heard and cared for.
•  Join a support group: Support your loved one by supporting yourself. There are support groups available to those who care for people in recovery, including Al-Anon and Nar-Anon.

What Not to Do When Someone Has Relapsed

A person who is going through a relapse can experience a range of negative emotions. This holds true for a person who is supporting a loved one in relapse. When remaining in the emotional mind, people can stay reactive rather than responsive. This can lead to hurt feelings and violated boundaries during emotionally tender times.

What not to do when someone has relapsed include:

• Blame or shame: blaming or shaming a person for their actions or relapse can amplify the presence of those feelings and elongate the relapse period.
• Enable: Though based on good intentions, enabling a loved one can ultimately lead to a negative impact on their recovery.
• Take it personally: It can hurt when a loved one relapses, but taking it personally adds another layer of shame to the person in relapse.
• Be controlling: Telling a loved one what they have to do, or forcing them into treatment when they are not ready can sever strong relationships and cause breaks in communication.

Treatment for Substance Abuse

There are several different options when it comes to treatment for substance use. There are different levels of inpatient care based on a person’s use history, including detox, rehab, residential, and partial hospitalization programs. Additionally, there are outpatient options to include intensive outpatient and weekly therapy sessions. Another important factor is the type of therapy utilized by the clinician.

Treatment options for substance abuse include:

• Cognitive behavior therapy (CBT): CBT for substance use could help because this clinical intervention assists in establishing healthier thought patterns. CBT can assist in identifying irrational thoughts and replacing them with rational ones.
• Motivational interviewing: the purpose of motivational interviewing is to assist one in identifying their goals and how they impact actions. Helping someone in relapse find their “why” can put meaning behind their sobriety.
• Acceptance and commitment therapy (ACT): ACT can assist in identifying values and applying action and acceptance in maintaining those values.
• Person centered therapy: Person centered therapy is a theoretical orientation that provides a basic understanding of how to support an individual through a growth phase, including authenticity, empathy, and unconditional positive regard.
• Solution focused therapy: Solution focused therapy can assist in treating addiction through identifying problematic behaviors and creating a plan of how to manage impulses.
• Support Groups: Working in a program has consistently fostered sobriety and acceptance for individuals who suffer from addiction. These can include alcoholics anonymous, Narcotics Anonymous, SMART recovery, dharma recovery, and several other programs.

When to Seek Professional Help

There are often signs associated with the early stages of relapse. If you or a loved one is experiencing a combination of these warning signals, it would be beneficial to seek preventative help. This can be completed through an online therapist directory or online therapy platform, where one can search for a helping professional who specializes in addiction and recovery.

If one continues to experience more severe mental health or psychiatric symptoms, searching for a psychiatrist may be a good next step. These professionals can assist in medication management for persistent and invasive mental health issues. One can look at online psychiatrist options, or can ask for a referral from their therapist or primary care physician.