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Addictions
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Relapse factors
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Techniques and strategies for addictions
What is addiction?
Do you feel trapped in a cycle of addiction or dependence that is affecting your life and well-being? Addictions and dependencies can manifest themselves in different forms, whether it be to substances such as alcohol, tobacco or drugs, or to compulsive behaviors such as gambling, food, sex, shopping, or technology. These addictions can negatively affect all aspects of your life, including your relationships, your physical and emotional health, and your work or study performance.
It's clear that it’s hard to recognize that you have a problem when you have an addiction and, even harder, go to talk to someone about it. Nevertheless, I offer you a safe and completely confidential space where you can tell about what concerns you without fear of judgment. Remember that you are not the only one who has a problem since problem use have many people but few of them can recognize it and still less ask for help. If you have trouble trusting your secrets or private subjects to a person you don’t know, The Motivational Interview will help us create a therapeutic bond and a certain level of trust.
Normally, many people hesitate about whether they have a problem consuming or compulsive behaviors or not. To clarify the question ask yourself:
Does my consumption or behavior have any negative consequences?
Am I consuming only because I like and enjoy it or because I want to run away from my problems or reality?
Who is in control?
It is crucial to work in a personalized way, adapting the treatment to your individual needs. My holistic approach addresses both the emotional and behavioral aspects of your addiction, helping you identify and modify harmful thought and behavior patterns. We will use different techniques of Cognitive-Behavioral Therapy, Humanistic Psychology and Positive Psychology. We’ll see how we can leverage your resources and strengths to improve your quality of life as much as possible. Together we will set realistic and meaningful goals for you.
Sometimes we are lost and need a guide to show us the way. A ship in the dark sails towards a lighthouse. The ship can pass here and there, through storm and bad weather but it keeps the course towards the lighthouse. If it loses the lighthouse, it's lost...
It is crucial to have goals and illusions in life and move towards them!
Relapse factors in addictions
There are many relapse factors. Among the most important are:
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Emotional imbalances (disbalance). Both highly positive and highly negative emotional changes can lead you to use substances again. Conflicts with others and isolation can be especially relevant here. Try to develop good strategies for managing emotions and aim to find a sense of balance.
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Social pressure. The people you used to consume with often pressure you to continue using. Non-users are often judged or excluded. People who use and those who don’t tend to be on different wavelengths. It’s easy to relapse if you feel like using and someone is pushing you to do it. If your assertiveness is strong, this factor loses significance. Also, observe which of your friends respect your decision.
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Dysfunctional thoughts and self-deception. This is the most powerful factor. It’s common to have thoughts like “I haven’t used in months, I can handle it”, “One time won’t hurt”, “I deserve it” or “I’m not really an addict like my friends”. These thoughts give you permission to use again, which ultimately leads you back to your usual pattern. Boredom can play a significant role here.
In addition, factors such as low self-efficacy, lack of routine, exposure to conditioned stimuli, lack of coping strategies, or a distorted personal narrative that includes addiction, can also be very relevant. Below, I’ll outline some strategies that can help you avoid relapse.
Techniques and strategies for addictions
1. Stimuli control
This technique consists of restricting provocative stimuli and of setting up and helping to limit situations or relationships with other people who incite consumption or certain actions. The performance of this technique depends on the type of addiction. For example:
- if you are addicted to alcohol, you can avoid going through the street full of bars.
- if you are addicted to strong drugs and use in the presence of certain people, you could limit these relationships (ideally, end any relationship with them) and avoid going to places where you take drugs.
- if you play or gamble, do not bring cash and avoid bars with machines, casinos and bingo.
- if you shop compulsively when entering a clothing store, do not carry cards or cash with you or don't even enter the store if you do not need to buy anything urgently. If you see that you need a garment, bring only the money needed to buy it.
- If you use your phone too much, go somewhere without it, for example, leave the phone at home and go to the gym or a class. Analyze the consequences.
Each case and each addiction is different but you can find ways to avoid encountering the stimuli that lead you to consume or to unwanted behaviors. Some people think it is helpful to "tempt the devil", for example, during a few days of abstinence, on purpose, going through an alcohol section in a supermarket, entering a bar with a machine or meeting friends who cannot be without consumption. It’s a silly strategy that what you do is simply increase the likelihood of relapse. Of course, one day you can feel very strong and resistant but in a moment of low emotional level it can be difficult to resist the desire to consume and some pleasant images can come to mind that lead you to return to the previous pattern.
2. Cost of response
Generally speaking, it is a type of negative punishment that leads a person to lose certain reinforcers after engaging in unwanted behavior. In this way the behavior will tend to cease. For example, if we exceed the permitted speed and endanger the lives of others, we will receive a fine. When I lose my points, next time I’ll limit my speed. In general, it works.
In addictions, you can create difficulties for performing certain behaviors like consuming a substance. The idea is to remove everything positive and pleasant from this experience. Again, it’s quite individual and each case can be very different. I leave you a couple of examples of how you could apply this technique:
- If you try to quit smoking, leave your pack of tobacco or other substances in the mailbox or in the car. So you’ll have to leave the house every time you want to smoke. Besides, when you smoke, look at a wall and you can’t talk to anyone, that is, you can’t enjoy views or the company of others. The experience has to become unpleasant.
- If you want to stop drinking, every time for a drink, you go to a bar far away, ugly and where you do not know anyone. Do not have alcohol at home.
3. Behavioral activation
Behavioral activation is looking for rewarding and enjoyable activities both new and those you liked before. Often, when we have addiction or depression, we tend to stop doing activities. This causes a decrease in pleasure in our lives. If you are trying to quit an addiction, it is crucial to find or re-do these pleasant activities to replace the lack of pleasure hat is produced by stopping to consume a substance or an addictive behavior. Just as we usually mix different substances or addictive behaviors, we can learn to enhance the level of pleasure with different activities. For example, you like going to the movies. But if you go with a couple of friends, it gives you more pleasure. If you also take popcorn or a soda, you will feel more pleasure.
Another objective of the activities is to occupy your free time. We are more likely to fall, relapse, or maintain an addiction when we have a lot of free time or are bored. However, when we are busy, we have more distractors and thus the importance of addiction decreases by paying less attention to it.
Rewarding activities can be very varied. However, try not to make them harmful. For example, it is okay to allow yourself an ice cream or chocolate but in the case of overweight it is better not to abuse. Therefore, it would be better to have more activities. So you can choose which one you want to do at any time. The ideal would be to have in your routine some physical activity and better with other people.
4. Significant persons
1. Sometimes it is important to reevaluate your friendships. At the end of this process, you can reinforce your idea that you want to have certain friends in your life or, on the contrary, come to the conclusion that they do not bring you anything. To do this, you can simply ask yourself different questions, such as:
- What do these friends bring me?
- In what situations are my friends with me?
- What do you know about me and what do I know about them?
- What do we have in common?
If you realize, for example, that your friends are only with you when you consume something and do not help you in staying abstinent, perhaps, they are not so important friendships in your life. It often happens that one addict looks for another one but, despite being in the same context every day, they have very superficial conversations and without any significance. If you have a problem in life, these friends probably won’t show up.
2. Another important aspect: if your friends and family really love and appreciate you, they should support you in deciding to quit and help you. There are people around us who do not give importance to this factor and insist that the problem is not so serious and propose you continue consuming. But you have to stand firm and ask them to respect your decision. In these cases you can see who your true friend is. Moreover, there are very supportive people who, for example, avoid consuming alcohol or another drug in the presence of the person who wants to stop consuming completely.
3. The third aspect relates to the previous one. At times of craving (desire to consume something or perform some action), look for meaningful and trustworthy people to talk to. You can call them on the phone or meet in person to ask for help or talk. Often, with a conversation you get distracted and improve mood as you receive social support. In addition, you can ask your friends/family to spend time with you so that they can keep an eye on you, help control your abstinence, bring economic control, motivate you to continue abstinent etc. Take advantage of your close ties. It’s a very powerful resource.
5. Whys and what fors.
This technique is essential to start moving away from addictions. The reasons (whys) are not always enough to stop consuming. A horrible diagnosis, the fear that our doctor put on us, the advice given to us by family and friends or a scientific research can change little in our attitudes towards consumption. Here the most important role is played by illusions, goals and rewards (what fors). What sense would it have to stop consuming if you have little to live, if you have no illusions in life, if you do not know where you move or if you receive nothing in return when you stop consuming? Therefore, it is essential to find both whys and what fors. Without this deep reflection the probability of stopping consumption is quite low.
To do this exercise take 2 sheets. In one you write down all the reasons to stop consuming, trying to answer the questions :"Why do I want to stop consuming? Why now? What reasons do I have for this?". In the other, all the rewards, goals and illusions, trying to answer the questions: "Why do I want to stop consuming? What goals and illusions do I have in life? What do I get in return if I stop consuming?". This list can be dynamic, that is, over time you can add more information. This last list is crucial to finding a new path forward. If you don't know where you are going, any road will take you there.
Finally, people with addictions have a lot of willpower and will because they go against the current and resist all the advice of the people around. If you manage to redirect this willpower against consumption, you will have the battle won.
6. Economic control
Economic control is a temporary strategy that can be very useful in cases of substance or gambling addictions. It consists of limiting all access to cash, debit or credit cards, and other forms of payment for a specific period of time. This responsibility for managing the expenses of the person with the addiction is taken on by a family member, partner, or close friend. The affected person receives money for a specific purchase — for example, 22 euros for a metro card. Every purchase must be proven with a receipt. In this way, the possibility of spending money on addictive substances or gambling is reduced. While it may seem like a harsh strategy, it is temporary: once the addiction is under control, normal financial access is gradually restored.
In cases of gambling addiction or any form of betting, it is recommended to keep a record of expenses as a self-register, using different columns such as: "date and time", "available money", "money spent", and "money saved". The "money saved" column serves as a motivator because it reflects real savings, even if small, rather than the hypothetical savings or imagined gains created by magical thinking when using slot machines or placing bets.
The saved money is returned to the family or kept by a family member or friend in a designated place for a larger future purchase. For example, in the morning my brother gives me 5 euros in cash for breakfast. I buy a coffee and a croissant, spending 3.80 euros. So, my savings for that morning would be 1.20 euros. That’s what I note in my self-register, and I make sure not to forget to bring the café receipt. Little by little, you’ll see your savings grow. If you want to prove to yourself that gambling or betting only leads to spending, open your bank account or calculate all the money you've invested so far.
7. Mirrow technique / "Today no, tomorrow"
It is described in the page about Self-esteem, technique N1 Version C.