I’ll never get used to how strange it feels to introduce myself to a group of strangers at a 12-step meeting. “Hi, my name is T, and I’m an addict,” is how I usually start talks. This is something that other people in recovery are used to. It’s one way we show that we’re all in the same situation. It’s a way of saying that we all face the same problems, no matter how different we are.
People who aren’t in the recovery community might think it’s weird or like a way to hurt yourself. No matter how far we’ve come as a society in making addiction less of a taboo, the stigma is still very strong, and it sticks to words. When I start talking about addiction, most people who don’t know much about it look away. They often feel awkward or try to make up for what they think is a shocking statement by adding more pleasant details. “You’re more than that,” they might say, and then list what they think are my good qualities.
This is nice, but it doesn’t always help because “I’m an addict” is sometimes just the start of a line. I need to tell the people who care about me that I’ve recently slipped back into old habits. Most people who say they have a problem with drugs will know that the landscape of return is vast and wide, but for the rest of the population, or “normies,” relapse means failure, financial ruin, overdose, and death.
During my most recent episode, I realised that the people who love me don’t really know what it means. And even though they sometimes want to be kind and helpful, they don’t know what to do.
When most people think of return, they either get scared that I’m going to die soon and need to be watched, or they don’t think it’s that big of a deal because I’m still doing yoga and going to work. Most of the time, the truth is somewhere in the middle. I probably need a little more attention than usual, but please don’t help me tie my shoes.
Even among people who work in the field of addiction recovery, there isn’t a clear meaning of what “relapse” means, so it makes sense that the general public would be confused. For this piece, I asked more than 20 people who study addiction how they would define relapse. I got more than 20 different answers. Most professionals are well aware that return can mean many different things.
Steven Hall, a therapist and head of a recovery centre in Maryland, says, “In the recovery sense, a relapse is when someone has been clean for a long time and then started using drugs again.” “In a clinical setting, a relapse is any time a person with a disorder goes back to a bad behaviour pattern, such as using drugs again after they have stopped for a while.” I like the second meaning better because it describes what relapse feels like to me: going back to a bad habit. It means, “I used to do crazy things that were bad for me as a way to deal with things. After a while, I stopped doing it, but then I started doing it again.”
For me, relapse means going back to old ways of thinking and acting that were bad. I think this is something that everyone can understand. Even if you’ve never abused drugs or done something you can’t stop doing, you know what it’s like to deal with life in a healthy way for a while and feel good, strong, and maybe even happy, but then something happens and you stop doing the healthy things. And life no longer seemed so good. When you put it that way, most people know right away how bad that feels, even if it’s not life-threatening.
The relapse experience is marked by a return to old ways of thinking and acting.
When we do something we swore we would never do again, what really bothers most of us is how bad we feel about it. “Regret is one thing, but shame is destructive,” says Jeff Chervenak, a therapist and recovery guide from Connecticut. Chervenak also says, “Shame is more likely to cause relapse than to stop it.” In other words, the shame that comes from relapsing can start a loop that leads to more relapsing. Ouch.
To be clear, most of the shame people feel after relapsing is not because of what other people think of them. “Most of the time, the person who relapses is the one who feels bad about it,” says Hall. “It’s not something that other people in recovery fellowships shame or look down on in the same way that the person who chose to use does on the inside.”
No one in a treatment group or someone I care about has ever made fun of me for relapsing. But because the shame of addiction still exists, how can I not internalise it when I am weak? Who among us can?
The truth is that shame is an obstacle that makes you feel weak. “In many ways, reducing shame is the biggest challenge we face as treatment professionals,” says Joseph Volpicelli, a psychiatrist who specialises in addiction and runs the Institute of Addiction Medicine in Pennsylvania. One thing that can make a person feel ashamed during a relapse is the idea that the relapse somehow takes away all the good things they have learned in recovery. “When relapse is thought of as all or nothing, it makes people feel hopeless and ashamed,” he says.
So, if you or someone you care about is having a relapse, it’s important to think of healing as a process, not a goal. This way, a return can be seen as a normal part of the process, not as a loss. “There’s no way you can tell me that someone who’s been clean for 10 years and then used for a month or a few years lost all the growth and experience that came with being their true selves,” says Hall. This is true, but it’s hard to remember when I’m hurting and feel like I’ve let myself and other people down.
When dealing with return, it’s important to find a balance between acceptance and responsibility. Hall says, “If someone who has been sober for a long time relapses, they probably do need to do some work to figure out what went wrong, but that’s not starting over; it’s continuing.” Sometimes, we all need to be reminded that one mistake doesn’t make or break our lives and relationships, and someone going through a return needs both themselves and the people around them to be aware of this. This, a plan, and a way to get help.
It’s also important for the people who care about people who are getting better to take care of themselves.
When someone you care about relapses, it can be easy to give up and say, “Leave it to the professionals,” or to try to save them. Nope. “It’s important to hold your loved one accountable and not take on all the consequences of a relapse,” says Volpicelli. “It’s also important to avoid blame and judgement.” Instead, he says, you should try to figure out what led to the return and offer to help them in ways you know how. You cannot become your bestie’s drug abuse counsellor. Full stop.
It’s also important for the people who care about someone who is getting better to take care of themselves. This means you have to face the fact that you may have feelings about their return that need to be dealt with. “Don’t think that everything is either all good or all bad. Instead, look for signs of progress to give yourself and a loved one who is having trouble hope,” says Volpicelli.
Try to keep in mind that this is just a small part of your relationship, and that it doesn’t have to make or break it. Even though we talk about our addictions when we present ourselves at meetings, no one wants to be known only for them. You don’t love a person because they are a junkie. You love them as a whole person. It’s easier to love someone who seems to have their life together than someone who seems like a shame-filled mess. That’s not true, but it’s real. The truth is that relapses often only last for a short time. So, if someone you care about is relapsing, try to think about both the problem and the person as a whole.