Structuring Life and Lowering Risk
The first step in relapse prevention is designing a lifestyle which reduces risk of relapse. This is accomplished first by setting up a good support system in the way of sober friends, supportive family members and involvement in support groups (e.g. NA, AA, or SMART recovery). Having strong supports in place allows the freedom to work towards identifying “Pairings”, or as most people know them, “Triggers”.
Triggers
The most commonly taught triggers in recovery are people, places, and things. But what makes these particular triggers so special? People, places, and things are common objects to be “Paired” with substances and therefore act as triggers when in our presence. For instance, substance use is likely to occur with specific friends, in a particular setting. Additionally, substance use is ritualistic and involves objects or “things” such as drinking glasses, bottles, lighters, and money. The psychological principle behind triggers is process called “Classical Conditioning”. Classical conditioning tells us that when two object are “paired” together on multiple occasions that one takes on the property of the other. This pairing elicits responses such as cravings, withdrawal symptoms and relapse behavior. An example of classical conditioning is when money is used to purchase substances enough times that money itself brings about similar cravings responses. When unconscious pairings result in withdrawal symptoms, this is known as post-acute withdrawal symptoms (PAWS). One of the best ways to build an awareness of pairings is to create a “Pairing List” of people, places, and things that have been paired with substances of choice.
Acceptance, Change, & Wisdom
Creating awareness provides the opportunity for choice, where choice is unavailable if one is unaware of their options. Being aware of pairings allows opportunity to change one’s lifestyle in a manner which reduces vulnerable to relapse. However, it may not be easy to avoid exposure to certain pairings. During these times we accept the things we cannot change, change the things we can, and have the wisdom to know the difference.
CBT for Emotion Regulation and Cravings
Managing triggers and making wise choices can be difficult when negative emotion and strong cravings overwhelm the system. Several therapies including cognitive behavioral therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based treatments help with effectively managing thoughts, emotions, and cravings. Having a psychologist who is proficient in these therapies is critical for making choices guided by wisdom rather avoidance. Dr. Berman and Cognitive Behavioral Counseling will work with you to put a strong support system in place, identify your triggers (pairings), and work through emotions/cravings using the most effective therapeutic interventions available.