Holiday Lapses

For people who’ve made positive changes in their lives, holidays can be slippery spots. Individuals who have quit drinking, smoking, or using drugs, people recovering from compulsive gambling or overeating, and people who have been substituting healthier behaviors for unhealthy ones, may be at increased risk of lapses or relapses when holidays approach. Celebrations, added stresses, nostalgia, and disruptions in routine can all increase the likelihood of slips and returning to previous harmful or addictive behaviors.

Alan Marlatt, an expert in relapse prevention, has used the term “abstinence violation effect” to describe a type of “black-and-white thinking” which can turn a slip into a full-blown relapse. People in recovery sometimes refer to this type of dysfunctional thinking as the “f___-it switch,” because it seems to be telling them that everything is ruined once they take the first drink (or take the first hit, or eat the first piece of cake). Sometimes, in fact, the “switch” seems to get flipped even before the first drink or other slip. The individual feels as if on “autopilot,” and has a sense of helplessness while watching himself or herself start to relapse. Treatment professionals should recognize this effect as a type of addictive thinking, a very sneaky trap that the addicted “part” of the person sets for the healthy, recovering “part.” This has been referred to in some recovery circles (like LifeRing) as the “addicted self” taking control while the “sober self” is thrust into the back seat, to watch helplessly.

This idea, that we can each have more than one “voice” operating within ourselves, can be a useful one for managing addictive behaviors. In addition to the “addicted self,” this inner force has been called the “beast,” “Old Lizard Brain,” “base brain,” and “Lloyd the Bartender” (with a nod to Stephen King’s “The Shining”). Of course, we are not composed of different “parts,” but many times we act as if we were. Another way to look at it is that human beings have a tendency to want to have our cake and eat it too. In other words, we want pleasure but hope we can avoid the consequences. We go for the immediate pleasure and don’t think about the long-term costs we incur.

However we conceptualize it, one strategy that our addictive thought patterns use to trick us to returning to unhealthy behaviors, in the pursuit of immediate pleasure, is to play on our emotions. “Any reason and no reason,” as the old saying goes, referring to the fact that celebrating good times – or drowning one’s sorrows in bad times – are flimsy excuses for engaging in addictive behavior. Strong emotions of any kind seem to provoke the urge to drink, smoke, eat poorly, or gamble, even in a person who has abstained for months or years. (Advertisers know this: it’s “Miller Time,” here’s to good friends, and so on). Recovery lore recognizes this in the acronym “HALT” as a reminder of the emotional states that are often triggers for relapse: Hungry, Angry, Lonely, and Tired.

I would add two others that can work the same way: Feeling anxious (or worried), and sulking (that is, feeling sorry for yourself). People in A.A. often speak of “resentment” as one of the “character defects” associated with alcoholism and addiction. I interpret this to mean a range of emotions along with their associated thought patterns, from envy (it’s not fair that others can party without the same negative consequences) to annoyance (I can’t stand hearing and seeing them act impaired). While the Steps of A.A. and N.A. remind the individual to humbly ask for these defects to be removed, cognitive-behavioral techniques actually give us tools to do so.

One tool that we have as intelligent beings is that we are able to “step back” and observe our own reactions, and help ourselves to feel less compelled by them. A specific technique that can help us do this is mindfulness. This includes learning to notice and be aware of states of mind (which can include urges to engage in unhealthy behaviors, as well as the emotional states associated with them), without feeling that we must indulge these states of mind or engage in old patterns of behavior. Marlatt (in the interview linked above) calls the technique “urge surfing,” and it is somewhat like the technique used in EMDR, in which you learn to regard the thoughts and feelings almost as if you had a remote control that can fast forward or change channels. In fact, fast forwarding (to think about the aftereffects of drinking, overeating, or other addictive behaviors) might be the best way to help break the neural ties between happy (or stressful) times and the choice to slip up. At the same time, it might be helpful to “change the channel” and imagine how good we will feel if (for example) we do some exercising instead. William Glasser called this “Positive Addiction” in his 1976 book. Whatever we call it, we can literally rewire our brains to change the associations between emotions and behaviors.

Addictive thinking, being based in our appetites, has little of cause-and-effect thinking in it, and has no sense of time. Our “executive functioning,” which represents our ability to engage in mature planning and think things through, is our best tool to make the choices that will be best for us in the long run. This is not the same as the infamous “will power” of popular (and 12-step) culture. Rather it is an awareness of the discomfort we feel, without any attempt to fight against it (which is not always possible, and can lead to a sense of helplessness when the urges persist).

The goal of mindfulness in relapse prevention is to break the connection between discomfort and helplessness. That way, if a slip should occur (for example, by accepting a glass of wine for a toast with dinner), it may be less of a temptation to say “f___it” and go into a full-blown relapse.

 
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