A Way Out Addiction Treatment Center Newsletter 04/13
In this edition, we explore the relevant topic of relapse and relapse prevention. We look at the topic of relapse, what it is, how to draft a relapse prevention programme and offer some helpful advice for the family members of addicts.
Lastly, we have some fun stuff and some festive season greetings from the Treatment Team. I sincerely hope that you all enjoy this edition and that you all have a blessed and happy sober festive season.
Greetings in sobriety Welcome to the fourth edition of our newsletter. In this edition we will be looking at relapse, and more specifically relapse prevention planning and will also have a section for family members on how to deal with the addict during this challenging time of festivities. Each newsletter has a specific theme, which is dictated by the professional team at the treatment center. The theme will therefore maintain its relevance in terms of recovery, and will be a theme that is applicable, as dictated by their experiences in the treatment and/or recovery environment. It was with a sad heart that I heard that Hein and Chris had left A Way Out, to embrace new challenges. Both played an integral and important part in my personal recovery, and I will surely miss their presence when I have the privilege of visiting A Way Out again, hopefully in the not too distant future. With that being said Johan has now taken over as the leader of the pack. Well done Johann. Hope all who journey through A Way Out will also have the privilege of sitting through one of your, by now infamous, powerlessness and damages sessions. Hated by me in the beginning, but loved towards the end. Lastly, please share this link with all your friends and family and on social media sites, such as twitter, Facebook, pinterest etc. etc. in an attempt to get the message out to as many people as possible. Hopefully the articles and extracts in this newsletter will be of use to both the addict and the family, and will assist in both parties gaining some sort of clarity as to the feelings and concerns of the other party. We look forward to receiving your suggestions for future articles, and would appreciate your constructive criticisms.
Andrew G
Yours in sobriety
TRIBUTE TO TATA MADIBA
Nelson Rolihlahla Mandela; 18 July 1918 – 5 December 2013) was a South African anti-apartheid revolutionary, politician, and philanthropist who served as President of South Africa from 1994 to 1999. He was South Africa's first black chief executive, and the first elected in a fully representative democratic election. His government focused on dismantling the legacy of apartheid through tackling institutionalized racism, poverty and inequality, and fostering racial reconciliation. Politically an African nationalist and democratic socialist, he served as President of the African National Congress (ANC) from 1991 to 1997. Internationally, Mandela was Secretary General of the Non-Aligned Movement from 1998 to 1999. A Xhosa born to the Thembu royal family, Mandela attended the Fort Hare University and the University of Witwatersrand, where he studied law. Living in Johannesburg, he became involved in anti-colonial politics, joining the ANC and becoming a founding member of its Youth League. After the South African National Party came to power in 1948, he rose to prominence in the ANC's 1952 Defiance Campaign, was appointed superintendent of the organization’s Transvaal chapter and presided over the 1955
Congress of the People. Working as a lawyer, he was repeatedly arrested for seditious activities and, with the ANC leadership, was unsuccessfully prosecuted in the Treason Trial from 1956 to 1961. Although initially committed to non-violent protest, he co-founded the militant Umkhonto we Sizwe (MK) in 1961 in association with the South African Communist Party, leading sabotage campaign against the apartheid government. In 1962 he was arrested, convicted of conspiracy to overthrow the state, and sentenced to life imprisonment in the Rivonia Trial.
Mandela served over 27 years in prison, initially on Robben Island, and later in Pollsmoor Prison and Victor Verster Prison. An international campaign lobbied for his release. He was released in 1990, during a time of escalating civil strife. Mandela joined negotiations with President F. W. de Klerk to abolish apartheid and establish multiracial elections in 1994, in which he led the ANC to victory and became South Africa's first black president. He published his autobiography in 1995. During his tenure in the Government of National Unity he invited several other political parties to join the cabinet. As agreed to during the negotiations to end apartheid in South Africa, he promulgated a new constitution. He also created the Truth and Reconciliation Commission to investigate past human rights abuses. While continuing the former government's liberal economic policy, his administration also introduced measures to encourage land reform, combat poverty, and expand healthcare services. Internationally, he acted as mediator between Libya and the United Kingdom in the Pan Am Flight 103 bombing trial, and oversaw military intervention in Lesotho. He declined to run for a second term, and was succeeded by his deputy, Thabo Mbeki. Mandela became an elder statesman, focusing on charitable work in combating poverty and HIV/AIDS through the Nelson Mandela Foundation. Mandela was a controversial figure for much of his life. Denounced as a Marxist terrorist by critics, he nevertheless gained international acclaim for his activism, having received more than 250 honours, including the 1993 Nobel Peace Prize, the US Presidential Medal of Freedom, the Soviet Order of Lenin and the Bharat Ratna. He is held in deep respect within South Africa, where he is often referred to by his Xhosa clan name, Madiba, or as Tata ("Father"); he is often described as "the father of the nation".
ADDICTION & THE HOLIDAY SEASON
The holiday season typically starts buzzing around the first of November. People put their costumes away and start writing shopping lists and planning for the upcoming family get togethers. A family entrapped by alcohol and drug addiction is forced to write a different story.
Family gatherings are overshadowed by the many consequences of addiction, addicts continue their spiral of abuse, and individuals in recovery flirt with relapse. But, why? The holiday season is saturated with stress from the season’s high expectations. The stress can hinder an individual’s judgment or spark a battle with depression—a common factor in alcohol and drug addiction. In this newsletter we will take you and your family through the different aspects of handling addiction during the holiday season: what to avoid, how to maintain sobriety while surrounded by triggers, etc. Read through each of the articles carefully and print it out for a handy reference. Don’t let alcohol and drug addiction strip away the magic of the holidays. Give the gift of recovery this holiday season. If you or your loved one is struggling with alcohol and drug addiction, don’t hesitate to call A Way Out Addiction Treatment Center on +27 21 864 3773 for support in the process.
RemembeR that theRe is “a WaY OUt”.
FOR THOSE WHO MISSED OUR FIRST EDITIONS Kindly click on the links below should you have missed either of our first editions. In future, ALL past editions will be featured on this page.
Addiction relapse is generally considered to be the return to substance use after a period of abstinence. However, according to James Garbutt, MD, professor of psychiatry at the University of North Carolina in Chapel Hill and a researcher at the Bowles Center for Alcohol Studies, “Relapse has different definitions. Some would say that it is a return to any amount of substance use, while others would say it is a return to heavy use. The medical profession states that a relapse is a return to destructive or heavier use.” It’s an important distinction: If you drink one beer on one occasion, you have had a lapse. But if you are abusing regularly or your alcohol or drug abuse is causing negative consequences in any area of your life, you are having a relapse and need professional help.
Ways to Avoid Addiction Relapse Mental illness can greatly increase the risk of addiction
Addiction Relapse: Why Does It Happen?
“Relapse can occur because an addictive disorder is a chronic disorder. As there is no cure, there is always the potential for relapse,” notes Stephen Gilman, MD, an addiction specialist in New York City. “Anyone can relapse.” Dr. Garbutt agrees, “Addiction is a chronic illness, and like any other chronic illness, it must be managed over time.” Addiction Relapse: What Are the Risk Factors? “There are many risk factors for relapse and they vary from person to person,” Dr. Gilman says. A powerful need to stimulate reward centers within the brain can be the trigger point for an addict who is used to getting a certain drug. Both external and internal factors can create the urge to use drugs or alcohol again. Internal risk factors include a persistently negative mood, feeling stressed or depressed, a genetic predisposition to or family history of addiction, and/or co-existing psychiatric problems like attention deficit disorder, depression, and anxiety disorders.
relapse if left untreated. If other mental health disorders are present, the relapse rate is “significantly higher,” says Garbutt. While significant external psychological or social stressors can play a part in bringing on a relapse, external or environmental risk factors can be as simple as being at a restaurant where other people are drinking, explains Garbutt. Even happy events can be risk factors, such as weddings, New Year’s Eve parties, and other holiday celebrations. Not surprisingly, unhappy events can trigger a relapse as well. “Risk factors are very much individualized,” Gilman says. “When addicts are overwhelmed by external triggers, such as losing a job, problems with their spouse, or even bad weather for a couple of days, they can relapse.” Health-related issues, academic problems, and difficulties with friends or family are all potential risk factors for a relapse.
Addiction Relapse: How to Resist the Urge A person who is tempted to drink or use drugs again sh Anyone who has a relapse should go back into treatment immediately, Garbutt recommends. “In treatment, you can learn to manage negative emotions and your particular triggers for abuse.” Drug and alcohol treatment is critical to learning coping skills that can help you manage relapses. Your therapist may suggest you try constructive activities, like taking a walk, talking with someone you trust, reading, meditating, or exercising instead of using again. “If you do one of these activities for a period of time, you can move into a different state of mind and the addiction urge can pass,” explains Garbutt. If you or a loved one has had a problem with substance abuse in the past, surround yourself with supportive friends and family and rely on guidance and advice from a substance abuse therapist to help reduce your risk of relapsing. And if you do relapse at any point, the best advice is to seek treatment immediately, before the relapse spirals out of control. If you or someone you love has attended a drug rehab program and successfully completed it, it is a huge accomplishment. While in treatment tools were provided to assist in staying clean and sober, relapse prevention plans were developed, and aftercare plans were made. Although successfully completing is a great feat, successfully completing treatment is just the beginning. Working in an inpatient setting, I applaud the accomplishments of patients. It is nice to see progress made, insights gained, and increased awareness of addiction and addictive behaviors. However, I also remind them that remaining drug-free will be a challenge because true recovery is a life-long journey. Some people will remain clean, some will relapse, and some will become what is commonly referred to as “chronic relapsers.” There is no magic wand to help substance abusers avoid relapse; staying clean and sober takes a lot of hard work and commitment. However, there are ways to decrease relapse potential with the hopes of avoiding relapsing completely. 1. Avoid tempting situations. I have often heard patients share that they wanted to prove to themselves or others that they could be around substances and not use. This is particularly dangerous. While one may be able to avoid temptation in that moment, this may not always be the case, especially for one in early
recovery. If possible, steer clear of any situations that may place you in the way of temptation. These situations can be either physical or emotional. Try to avoid going places where there will be substance use or where there will be reminders of times you used. Also try to avoid people or situations that can be emotional triggers. 2. Develop a positive support network. Often, addiction social circles consist primarily of “using buddies,” with supportive family and friends being distant outliers. Surround yourself with positive people who do not engage in substance use and who are supportive of your substance-free lifestyle. It is important to have healthy people who will be able to support you in your times of need. Sever unhealthy relationships and ties to unhealthy people. If necessary change your number, delete their numbers, block or delete them from social networking sites, and work on creating a new and healthier support network. 3. Create a healthy schedule. I often encourage patients before leaving treatment to create a daily schedule. This schedule usually includes times for treatment and meetings, necessary activities such as work or family time, activities of daily living, and free time. Creating a schedule is a great way to develop a new and healthier routine. In treatment, patients are required to follow some type of schedule as a part of learning structure. By creating a schedule for when treatment has ended, the patient is able to continue that structured living. When scheduling for free time, it is important to find constructive activities to fill that time. The key is not allowing for time for frequent boredom. 4. Don’t get complacent. When I speak with patients following relapse, one of the most common reasons I hear is “I got complacent.” Complacency is dangerous. Many are highly motivated after completing inpatient treatment to continue with an aftercare program or 12-step meetings. They also develop their support network and make other strides in their recovery. However, this motivation starts to dwindle over time. As progress continues, they no longer deem all of the recovery efforts necessary. I am not saying that one has to stay in treatment or attend meetings forever. Everyone has to find what recovery program works for him or her. However, when you find what does work for you, stick with it and continue to make it work. 5. Don’t view relapse as a failure. If you relapse, don’t view it as the ultimate failure. It is this type of thinking that will keep you sick. If you were able to stay clean and sober before, you will be able to do it again. Reach out to others and seek help. Begin working your recovery program again. Process the events and emotions that led to relapse so that they are not repeated. By processing these situations, you can learn from your mistakes. This will only help you in your journey in recovery.
WHICH CATEGORY DO YOU FALL INTO?
ATTITUDES THAT LEAD TO RELAPSE The moral inventory will become a way of life based on the courage to be honest with yourself. If you need support or help, ask for it! The attached list of personality traits is a guide to the areas to be examined. Relate to them your behavior and feelings as they honestly existed or which you still experience. The list is only a guide. Search fearlessly for other personal areas that you are aware caused yourself or others emotional unmanageability that could lead to relapse. Describe positive characteristics that can be developed. This self-assessment may very well be one of the most courageous acts of your life. Tackle it honestly and willingly. False Pride What we mean is excessive pride, being so thick – skinned that we have trouble admitting any human weakness at all. Another word for this kind of pride is grandiosity. Describe how your pride has kept you from looking at your own behavior. Humility Now that you are learning that it is safe to admit your powerlessness and unmanageability do you find it easier just to be human? Being humble doesn’t mean weak. It means accepting ourselves – our strengths as well as our weaknesses. Do you know something now about what humility really means? Are you able to be less defensive? To enjoy the peace that comes with genuine humility? Explain. Perfectionism Too often we are unwilling to accept human mistakes, our own or those of others. When we are afraid of criticism, we set unrealistic standards for ourselves, and we are frustrated if we can’t meet them. When we are felling this way, we are impatient with family members and friends and co-workers when they are imperfect too. How has your need to be perfect hurt you? How have you made others unhappy by insisting that they be perfect?
Admitting Mistakes Most of us have not had much experience in admitting when we are wrong. We seem to give ourselves only two choices; being absolutely perfect or totally worthless. What a relief it is when we can admit we’re human. Can you think of examples of you being in the wrong and admitting it? Is it OK to make mistakes? Selfishness “I want what I want when I want it” Think about that. Do you spend a lot of time worrying about your own needs? Maybe you don’t get what you want. But what about all the energy you put into trying, one way or another, to please yourself, to get your own way? How have you hurt others by putting your own needs first? Impatience When impatience gets the better of us, not only do we want what we want, but also we want it right now. When we are feeling like this, and things don’t work out the way they should, and on just the timetable we set, our blood pressure rises and we can be really miserable. Describe some situations in which your impatience caused damage to you and to others. How does your impatience get in your way right now?
Self – Pity This is hard to recognize, and it’s something no one likes to admit. It’s a matter of feeling sorry for us. Maybe because we feel people just don’t understand us. Or maybe it’s feeling that people don’t respect us or don’t love us enough. It means feeling hopeless, feeling like a victim of circumstance. Have you ever-felt self–pity? Do you feel sorry for yourself right now?
Resentment Resentful people hang on to angry feelings. Angry feelings toward our families. Angry feelings about how we live and where and when. Hanging on to bad feelings can make us really miserable. Resentments are always a good excuse for our irresponsible behavior. Talk about resentments you have right now. Do you hang on to angry feelings because you feel your angry is justified? Forgiveness And Understanding Learning how to accept situations we cannot change and how to understand those people we think have wronged us are marks of personal growth. What do you know about forgiveness and understanding? Has the ability to accept the things you cannot change become a part of your life now? Intolerance Intolerance can grow from self-pity and resentment. Once we learn how, it becomes easy to blame others for the way we feel. Being intolerant is especially easy when others have different ways of thinking or living. However, it’s also easy to be intolerant of those people who are close to us and who are important in our personal lives. How were you intolerant of others in the past? Think hard about this one: are you still intolerant of others? Alibis How much have we invested in justifying and explaining our behavior to others? Sometimes the explanations are true, sometimes they are partly true, and often they are purely fiction. Can you think of ways you alibi for yourself? How do you feel about yourself when you did alibi? Do you catch yourself making up alibis now? Being Honest How do you feel about your new way of life? Do you show your gratitude to those who helped you build a new life? What are some of the ways you could express your gratitude right now? Can you see how feeling grateful can influence you in a positive way, and help you avoid the pitfalls of complacency, boredom and depression? Dishonest Thinking This happens when we begin making alibis to ourselves and believing them. When we really begin to believe our resentments. When we actually feel abused and misunderstood, the danger is that we will loose contact with reality. How were you deceiving yourself in the past? How could you deceive yourself now about important matters in your life?
5 DEADLY MYTHS THAT SABOTAGE RECOVERY What do we mean when we talk about myths? Often people think we are talking about lies. Lies are simply something that is not true, whereas a myth is a reality, which we construct which may be based in truth – or it may not. Generally myths refer to a reality greater than ourselves. E.g. Christmas is a reality around which certain myths are constructed. There are symbols and tokens e.g. trees and gifts, or if you are religious, cards, nativity scenes, etc. Recovery is also a reality bigger than ourselves which has its own set of myths and symbols e.g. tokens awarded for progress in AA/NA, the big book, etc. Some of the myths that are associated with recovery which are true and positive are: - “One day at a time” – which Myth No.2 means, “Take it slowly” Don’t think about staying clean forever, do it for today. “Others should really be grateful for my recovery” - “Let go and let God” – means we can’t do it by ourselves, that there is a power greater than ourselves that we can turn Which means, “I am the most important person around”. The fact is that it isn’t other people who were to. responsible for you drinking and drugging. Our drinking/drugging has caused problems for other These myths, or construction of reality, work, because they are true, tried and trusted and are pegs around which we can people. Our sobriety is about fixing our own mess. Hopefully, others close to us will be glad, but not organize our reality. grateful. We are not doing them a favor; we are not the only ones who have suffered and who are Similarly, these are 5 myths, which can jeopardize our damaged. We often hear from family members who recovery. cry “what about us”, the addict is in a treatment program receiving counseling and attention and very Myth No.1 often the family is ignored. So, no, other people are not and should not be grateful for our recovery. We in “When I get sober/clean, life’s problems are over” fact, should be grateful if they are still around.
E.g. my financial, relationship, work, family problems will be a thing of the past. The truth is that chemicals medicate the pain; they help us avoid pain and therefore dealing with reality. Once sober and clean our problems are still there. The benefit of sobriety is that we can deal with our problems with a clear head. For some folk in recovery as soon as a problem arises, they doubt their recovery, they doubt their program. “I didn’t have problems until I got into recovery”. Not true – they didn’t feel the reality of their problems through the drug induced haze.
Myth No.3 “Recovery should be easier – if I go to a treatment program, go to my groups, I should sail through this – it should be easy”. If we look at Step Two – “we came to believe that God could restore us to sanity”. The phrase restore us to sanity implies that the alcoholic/addict is insane, i.e. lost grip of reality. That is serious business. It means that there is a difficult task ahead – why should it be easy. The damage done is usually deep and there is usually a long history of damage to yourself and others. You often hear “this is hard, this hurts” The only thing that hurts more is if you don’t want this road of recovery. The journey of recovery never ends. The capacity for recovery is endless and it keeps getting better.
Myth No.4 “Recovery should be faster – in 6 months it should be licked” Why should it be? It has taken 20 years to develop the problem – it takes almost that long to make it right. Yes, you are going to be frustrated. You have a life time what’s the rush. The addict has a character defect – impatience. You need to remember – “easy does it”. Myth No.5 “There should be no shoulds” Addicts are generally people who have difficulty with structure and authority. Recovery requires structure and discipline – not imposed by others (external) but by oneself (internal) e.g. if you wanted to build a skyscraper these are the rules, safeguards, disciplines, plenty of ‘shoulds’. Another example is the comrade’s marathon – if you want to be sure of completing this mammoth task you have to do all the right things, train regularly and accordingly to experts recommendations, eat right, etc., etc. I call obeying the rules of recovery ‘working a safe, solid program or sitting in the middle of the bed’. If you sit in the middle of the bed, you can’t fall off! If you sit on the edge, you could. ACCEPT YOUR ADDICTION (if you want to recover) Nobody wants to be chemically dependent or addicted and it is easy to refuse to look honestly at your problem rather than accept your problem as the absolute, unpleasant reality. MAKE CHANGES (if you want to recover) An unchanged addict is almost always an active addict. Changes in feelings, attitudes and behavior are necessary.
PAIN IS A NECESSARY PART OF RECOVERY Face it and don’t try drink/drug it away. One little drink/drug WILL hurt you, remember? RECOVERY CAN BE FUN Make changes to have more fun and enjoy a sober, clean life. LEARN TO ASK FOR HELP No man is an island – we cannot do this alone. Expect help from others. Use the phone. Write down the names and numbers of several group members and call one every day. If you are suffering and we don’t know about it we cannot help you. CREATE A GRATITUDE LIST To avoid the P.L.O.M. Syndrome (Poor Little Old Me).
tiPs FOR the FamiLY
According to one of the many definitions of holiday, "it is a day designated as having special significance for which individuals, a government, or religious groups have deemed that such observation is warranted." To some, the preparation of Christmas, New Year or whatever special holiday you may observe is as joyous as it gets and an opportunity to be and feel festive. Family and friends come together to celebrate taking out the old and bringing in the new. Hmm... a lovely thought, but what if there is an alcoholic/addict in your life, and you both desire to spend all or part of the holidays together, yet maybe you are both anxious nonetheless? The desire to have the family together can be a strong pull for any parent, spouse, sibling or friend, and even with the hopes, desires and promise that everything will go as planned, it is that wise parent, spouse, sibling or friend that presents a clear head as to how they would like to see the festivities gel as it pertains to the involvement of their loved one, the alcoholic/addict. For healthy openers, you will be more comfortable and confident if you keep in mind that you are in control, not the alcoholic/addict. This active role on your part has you establishing fair yet concrete boundaries and keeping your expectations to a minimum. In one of our previous newsletters we dealt with boundaries and expectations, but since they are the cornerstone for you in dealing with the alcoholic/addict in your life, they are worth repeating.
Here are a few concepts that, if implemented, could make the difference between a successful holiday experience or a disaster: 1.
Pick boundaries that are important to you and must be adhered to by the alcoholic/addict in order to be welcomed to participate in the family festivities. Such boundaries include arriving at the designated time, being well groomed and dressing appropriately; being clean and sober (this is paramount to participation: if you smell alcohol on their breath or they act intoxicated or high, you will not let them in, or if they live there, you will ask them to stay away from the festivities until the event is over); and maintaining a cheerful and kind demeanor (this is also an entry ticket, as anger or a woe-is-me, chin-on-the-buttons attitude is not welcome).
9.
2.
Keep your boundaries simple, doable, short and to the point.
3.
Discuss these boundaries at least a week before the holiday activity is happening.
4.
Don't defend yourself regarding your decisions. If you don't engage and stay neutral, you will be perceived as having a plan that is well thought-out and smacks of self-respect.
5.
Please don't bring up old examples of how the alcoholic/addict let you down in the past, as doing 10. so might provoke an argument, which serves no purpose.
6.
Have clear ramifications if your conditions are 11. not met.
7.
Make sure that you both understand what those consequences are so that no one can dispute a misunderstanding or feign ignorance as to the intention of the plan. This is important!
8.
If the alcoholic/addict doesn't like your holiday 12. rules and regulations, be committed to a response like, "That makes me sad that you won't be joining us, but that's your choice." They now have to shoulder all the responsibility for their decision even though they may try to blame you.
Don't let your boundaries be built on quicksand, where you acquiesce because the alcoholic/addict spins an excuse as to why he or she has not lived up to his or her end of the bargain, or because he or she resorts to tugging at your heartstrings by yelling and screaming. Please don't fall prey to thinking, "Oh well, I'll overlook this because it's the holidays," or, "It's the holidays and I just don't want to be unhappy or make my loved one unhappy." This will turn out to be a lose/lose scenario all around. Tell the other family members what that arrangement is so that everyone is on the same page and there can be no surprises. Keep an open mind. If your loved one opts out of the family festivities for one reason or another (e.g., he or she doesn't care for someone who is going to be there, or isn't ready for a public appearance, etc.), respect that with no guilt, judgment or cajoling placed upon them. Keep your expectations in check. Realize that you are dealing with someone who might not be as true to their word as you would like them to be. Though you might be disappointed, you won't be surprised.
13.Try not to involve the family too much in your jubilant desire that the whole family will finally 13. Try not to involve the family too much in your jubilant desire that the whole family will finally all be together. Conversely, help them to keep their expectations curbed as well. all be together. Conversely, help them to keep their expectations curbed as well. 14.
If your expectations are not met, please remember that this is not an affront to you. It's not personal; it's just the nature of their disease and what they may be struggling with at this particular time.
Boundaries and expectations are extremely hard to implement and curb, respectively. I know this all too well, as I have struggled with them while dealing with my own substance abuse issues. This will be, God willing, the second sober Christmas and New Year in many years that I will spend together with my family. I don't know what the boundaries will be this year around, but boundaries there will be – and that’s cool. I have agreed to abide by them whatever they may be. I must be true to the boundaries set and leave my expectations in the trunk of the car. Please remember that you, too, deserve a fulfilling and memorable holiday.
Building a Relapse Prevention Plan Think of a relapse prevention plan like you would think of building a house. First you lay the foundation, hopefully something strong, with pieces you can build upon. From there you add elements stone by stone that as a whole create the building that will shelter you and keep you safe. Your relapse prevention plan is just like that house, from the moment you make a decision to start your journey of recovery, you are laying the foundation for that house. Every day you spend in a drug or alcohol treatment program, every meeting and every time you learn something about yourself and your own unique path to recovery, you are assembling the tools and materials you need to build a relapse prevention plan that will shelter you from a storm. Even relapse itself can be used as a building block for that shelter, for each time you take a step back followed by two steps forward, you are moving ahead in your recovery. Many people ask what the elements of their relapse prevention plan should be. Without a doubt your plan should include a support system of friends, family and loved ones who will be there for you even in the most difficult of situations. It should include tactics and strategies for avoiding difficult situations and fall back plans for when a situation becomes too much for you to handle. It should also include certain factors that only you yourself can bring to the table. It should include respect, trust and love for yourself. You should respect your decision to live a sober life, your choice and trust yourself enough to know that this journey is worthwhile to be seen through. You should love yourself enough to push ahead even when relapse prevention seems too difficult to continue and above all you should give yourself the space to say that sometimes it is going to be difficult and hard, but that is ok. Forgiveness is something many people don’t think of as a building block for their relapse prevention plan. However, forgiving yourself at the very outset of your recovery is an essential gateway for continuing down the path to recovery. You will find the gate of forgiveness appears several times along your journey. Recognize that you may have to forgive yourself for thoughts, actions and behaviors many, many times along your journey. No journey is without bumps or mistakes, don’t expect your behavior to be perfect. Forgiveness is a key element to rebuilding that house of recovery. It is a critical element to correcting past mistakes and improving your future. A relapse prevention plan without forgiveness is a plan that is set up to fail from the beginning. Give yourself and those you love the space to admit their mistakes, seek forgiveness and move on with their recovery.
Chilled bottles of fancy champagne to toast the New Year; elegant wines from all over the world meant to satisfy the most sophisticated palate at each holiday feast; open (and well-stocked) bars at holiday parties; and creamy eggnog decadently spiked with brandy… Drinks, anyone? Yes, the holiday season is upon us. Anyone who’s ever struggled with alcoholism knows all too well that the nearly 7 week period of holiday “cheer” and festivities – which commences just before Christmas and continues until New Year’s Day has come and gone – can be one of the most challenging times for staying sober. It can feel as if the whole world is trying to entice you to relapse. After all, what’s the harm in having just one drink? Everyone else is celebrating, so why shouldn’t you join in? The holiday season can wreak havoc on emotions. For many, it elicits bittersweet and often this difficult memories and emotions. As a result, the temptation to drink – for pleasure as well as a means of selfmedication – seems to lurk around every corner. If you’re a recovering alcoholic (or someone who’s prone to over-indulging but determined to refrain), then the following tips and tricks will help you get through the season without any slips or regrets: Always be prepared. This succinct Boy Scout motto will serve you well during the holidays. While you don’t need to carry a pocket knife and piece of flint everywhere you go (unless you’re spending the holidays camping in the wilderness), you do need to always have a game plan to counter the endless parade of alcoholic temptations. Your family and close friends (hopefully) know and respect the fact that you have a history of alcoholism and are in recovery; however, there’s always going to be a few who don’t know – or don’t care – and will insist that you have a drink. Have 2 or 3 polite, brief responses ready to use. Don’t feel obligated to tell anyone (unless you really want to or feel it’s necessary) that you’re recovering from alcoholism. That’s personal and private. It’s okay to simply say, “No thank you, I’m good”. You don’t owe anyone an explanation for why you choose not to drink. Keep a non-alcoholic beverage in your hand. One of the best ways to avoid unwanted drink offers (and to avoid feelings of deprivation – at least to some degree) at holiday social gatherings is to keep a non-alcoholic beverage in your hand. Whether it’s sparkling water, soda, or apple juice, others won’t be inclined to push drinks on you constantly; you’ll have something delicious to sip on as well.
Avoid salty foods and snacks. Salty foods are going to make you thirsty, and that thirst will make it more difficult to resist something alcoholic to wash them down. Avoid them altogether if possible (eating something beforehand will help curb your appetite), or make sure you’ve got a non-alcoholic beverage in hand before you indulge in sodium-laden hors d’oeuvres or snacks. Remind yourself often why your sobriety is important to you. Without a solid “why” it can be next to impossible to hold onto your resolve when temptation abounds. You made a decision to do the hard work involved in recovery; if you’re feeling the urge to drink, remind yourself why you chose to recover from alcoholism. Write it down and put it in your purse or pocket if needed. Sometimes all we need is to remember why we’re doing something in order to resist the temptation to throw in the towel. Go to a meeting. If you’ve found 12-step groups or similar meetings to be beneficial, be sure to make time to go to as many as needed during the holidays. Not only will you benefit from the support of other group members, you’ll also feel comforted by the fact that you’re not alone – that others are also struggling with very similar issues, urges, and emotions. If you have a sponsor, stay in close with him or her as needed via phone, text, or email. Believe in yourself. Just the fact that you’re in recovery and have been sober for as long as you have (whether it’s been just 2 days or 25 years) speaks volumes about your courage and strength. It takes a lot to stop drinking. Don’t lose site of the powerful, determined, and amazing person you are. No one can knock your down or cause you to fail without your permission. Don’t hesitate to pray. If you’re a spiritual or religious person, reach out often in prayer to whatever Higher Power you believe in. Prayer can bring tremendous comfort and strength during times of temptation. Talking to God, the Universe, or whatever Higher Power you believe in will help you feel less alone and more empowered to stay sober. Surround yourself with supportive loved ones. Even if those closest to you don’t understand the challenges of recovering from alcoholism, they’ll most likely want to be there for you and cheer
you on. If you doubt yourself or feel like you might give in, reach out. Sometimes all it takes is a few words of encouragement or just knowing that they’re there for you to get over the hurdle and feel empowered again. And if you’re doing well in your recovery and kicking temptation to the curb, share your victory with them and let them celebrate it with you. Focus on the true spirit of the season. Regardless of your faith or spiritual beliefs, the holidays are really about two things: giving and gratitude. The temptation to drink is usually the greatest when we wallow in negative feelings, such as resentment, worry, sadness, selfloathing, disappointment, or anger. But when you truly focus on giving and gratitude, you won’t have room for those feelings. So many things of life are really about perspective more than anything else. Focusing on gratitude and giving – the true spirit of the holiday season – you’ll likely find that those negative feelings show up far less often, and when they do, their power is greatly diminished. Have a blessed, safe, and joyful holiday season.
Holiday Relapse Risk Self-Test Whilst doing my usual research for this topic I came across this interesting “test” to assess your risk of relapse. I must however mention that the results are in no ways substantiated with conclusive facts, but thought that it would be a good measuring tool for addicts to use to alert us to possible dangerous behavior traits. The holidays likely up your relapse risk. Find out how much more risk you’re facing by answering the following 14 questions honestly. Over the holiday season: 1.
Will you be exposed to more alcohol and drugs at parties etc. than you normally would?
2.
Will holiday events and pressures significantly interrupt your normal routine?
3.
Will extra time commitments keep you from attending as many counseling sessions/ meetings as you normally would?
4.
Will extra time commitments keep you from attending as many 12 step (or other recovery support group) meetings as you normally would?
5.
Will you experience financial stress due to the extra expenses associated with gift buying, traveling etc.?
6.
Will the hustle and bustle of the holiday season keep you from exercising as frequently as you normally would?
7.
Will you feel stressed out by the crowds or pressures of the season?
8.
Are you going to be in more frequent contact with family members than normal?
9.
Will you get caught up in the general party vibe of the season?
10.
Will the season provoke difficult family or holiday memories?
11.
Will you feel extra anxiety as you try to cope with additional exposure to triggers?
12.
Will you feel frustrated if/when you can’t find as much time as you need to take care of all of your responsibilities during the holiday season?
13.
Will New Year’s Eve be a difficult day to stay clean and sober?
14.
Will you have a lot of extra free time over the holiday period?
SOME FUN & FOOD FOR THOUGHT
Now page over and assess your risk.
REMEMBER IF YOU CHEAT – YOU’RE ONLY FOOLING YOURSELF
Relapse Risk Scoring Self-Assessment •
If you answered yes to 1 to 3 questions, the holidays cause a small increased risk of relapse.
•
If you answered yes to between 4 and 6 questions, you have a moderately elevated risk of relapse. You should prepare yourself for the extra stress of the season and be prepared to meet the challenges to your recovery that you may face.
•
If you answered yes to 7 or more questions, the holidays present a serious risk to your recovery. Plan to make full use of any and all relapse prevention methods you’ve learned to get through this difficult period.
Christmas “Mocktails” for the Non-Drinker Christmas can be a difficult time of year for non-drinkers and especially for those who have just come out of rehab. There are not only potentially difficult family reunions and the stress of preparing a meal and buying presents for the big day, but also the fact that alcohol seems to play a huge part in how we celebrate Christmas, especially in S.A. So I have come up with a few winter “mocktails” to help the non-drinker through the festive season – just one warning: make sure you make enough because you’ll probably find that everyone else wants some too! A note to hosts: As with any food or drink, presentation makes Spicy Tomato all the difference. Prepare non-alcoholic drinks as you would alcoholic drinks – don’t offer a can of coke; instead make the 300ml tomato juice non-drinker feel special by serving the drink in an attractive 1 lemon, juiced glass with ice and lemon. ½ tsp. Tabasco sauce 1 desert spoon Worcestershire sauce Pinch of salt Vanilla Eggnog (Serves 6) Celery stick Ice cubes There are lots of different ways to make this winter warmer. Mix the tomato juice, lemon juice, Worcestershire We have taken one recipe and replaced the alcohol with vanilla sauce, Tabasco sauce, salt and ice cubes. Taste and and nutmeg/cinnamon for added flavour. add any additional seasonings. Pour into a tall glass and garnish with celery stick. 1 liter milk 260 grams sugar Castle Craig’s Christmas Punch (Serves 6) 12 large egg yolks 200ml chilled double cream 1 liter apple juice Whole vanilla pod 500ml orange juice Grated nutmeg/cinnamon 200ml water In medium saucepan, whisk milk and sugar over medium heat until sugar is dissolved, 1 to 2 minutes. In a large bowl, whisk egg yolks. Whisking constantly, pour hot mixture into yolks in a slow and steady stream. Add the vanilla pod. Return mixture to pan; cook over medium-low heat, stirring often, until thick enough to coat back of spoon, 20 to 25 minutes; do not let simmer. Quickly strain into a bowl. Stir in the cream. Cool completely; cover with plastic wrap; refrigerate until chilled. Dust with nutmeg/cinnamon.
A good slug of ginger cordial (enough to make it fiery) Slices of orange 16 whole cloves 2 cinnamon sticks 1 desert spoon sugar Place all ingredients in a saucepan. Heat the mixture and simmer gently over a low heat for about 10 minutes (do not boil). Allow to cool a little and pour the warm punch into warm glasses or cups, making sure everyone gets a slice of orange.
ONE DAY AT A TIME
Just for today I will try to live through this day only, And not tackle my whole life problem at once. Just for today I will be happy. This assumes to be true what Abraham Lincoln said, that "most folks are as happy as they make up their minds to be." Just for today I will adjust myself to what is, And not try to adjust everything to my own desires. I will take my "luck" as it comes, and fit myself to it. Just for today I will try to strengthen my mind. I will study. I will learn something useful. I will not be a mental loafer. I will read something that requires effort, thought and concentration. Just for today I will exercise my soul in three ways; I will do somebody a good turn, and not get found out; if anybody knows of it, it will not count. I will do at least two things I don't want to do - just for exercise. I will not show anyone that my feelings are hurt; they may be hurt, but today I will not show it. Just for today I will be agreeable. I will look as well as I can, dress becomingly, talk low, act courteously, criticize not one bit, not find fault with anything, and not try to improve or regulate anybody but myself. Just for today I will have a programme. I may not follow it exactly, but I will have it. I will save myself from two pests: hurry and indecision. Just for today I will have a quiet half hour all by myself, and relax. During this half hour, sometime, I will try to get a better perspective of my life. Just for today I will be unafraid. Especially I will not be afraid to enjoy what is beautiful, and to believe that as I give to the world, so the world will give to me.
CONCLUSION This Editions Poem I Bleed Behind these eyes; My entire soul cries; Pieces of my heart; Unfold under hurt; All I have left to hold; Is myself, behold; Empty and broke; CONCLUSION This particular edition was extremely interesting for me. I have had my personal battles with low selfesteem and frozen feelings, and it has taken many years and many hours of carefully examining myself to evenly begin to scratch the surface. I am however constantly reminded, mostly by my sponsor, of the obvious, which is the easiest for me to forget namely that we are works in progress and that it’s about progress NOT perfection. My thanks to Hein and his team for checking through what I sometimes believe to be mindless babbling, and for pointing me down the right path in researching for the articles included. Until next time, let’s keep on One Day At A Time remembering that recovery is possible.
A WAY OUT ADDICTION TREATMENT CENTRE
Listen, my words are spoke; Screaming from within; I want out of my skin; Feelings of abandon; Bearing the scars of years I branded; Into my veins; Evil spirits remain; Fighting for freedom; I hold on longer than most; Tired and sick I feel within; Needles and poison heal the webs I spin; Surrender I must; I come to the trust; Take away my pain I plead; I'm just like you, We are the same; I've cut my ties and here I bleed.
NOVEMBER 2013
VOL 1 ISSUE 4
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A WAY OUT ADDICTION TREATMENT CENTRE
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