How to Prevent a Relapse During the Holiday Season

Stress, anxiety, hunger, loneliness, anger, exhaustion, family issues, job loss, death of a loved one, a breakup, divorce…oh…let’s not forget politics and the pandemic. These are just a few of the feelings and stressful events one encounters along the way in this crazy, challenging journey we call life. They are also major triggers for relapse for those in recovery. During the holiday season stress and the temptation to drink or use are often at an all time high when end of year work deadlines and family responsibilities collide with office parties, holiday events and family gatherings. Relapse is often part of the recovery process. But it does not have to be. Read on to learn more about the skills we teach to prevent relapse.

Connection is the Best Prevention
Freedom Institute’s Salah Bustami, LMHC, director, Family Service, states, “I am always so grateful to bear witness to the process of connection that takes place in the groups in our Professionals Program. Clients talk about ‘keeping each other in mind’ throughout the week when they are feeling triggered to use, when they are excited to share with the group ways that they've navigated different challenges, or simply when they've thought about another group member. I am struck by how much the idea of "service" or giving back to the community plays a role in groups, and in recovery in general. Group members talk about ways that they have advocated for others (for example, membership/participation in AA, a post on Facebook) and how that can enrich one's own recovery.” Connection is a key component in recovery and a critical tool in preventing relapse. Early in recovery, it may be helpful to join a support group such as AA. If AA isn’t for you, there are several other support groups, such as SMART recovery, or Women for Sobriety among others.

DBT Skills: Practice Makes Perfect
The foundation of Freedom Institute’s clinical programming is our unique integration of Dialectical Behavior Therapy (DBT) and Relational Family Therapy and we are unique in that we have adapted Dialectical Behavior Therapy (DBT) specifically to treat substance use disorders. Our clients acquire a repertoire of skills in the Professionals Program and learn to generalize those skills to any situation they find themselves in as they return to their lives - job, home, and family - in their first year of recovery. Our Professionals Program is a place to practice these new skills, identify obstacles to using their skills, and to problem-solve with fellow travelers in recovery and a trained, experienced clinician to overcome them. Clients practice asking for help, build a sober network to call upon during vulnerable times, receive validation and encouragement, and give to others. Clients have said the opportunity to share their experiences and hear about others is comforting, normalizing, and makes them feel less alone.

DBT, a therapeutic model heavily backed by scientific research, is central to FI’s renowned Intensive Outpatient Program. DBT focuses on four skill modules - Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.

  • Mindfulness teaches a set of skills to help accept and be present, nonjudgmentally, in the moment, experiencing emotions and senses fully, yet with perspective. The goal is to help maintain a sense of calm, balance, and well-being amid periods of high stress and anxiety.

  • Distress tolerance focuses oncoping with, and moving through, unpleasant emotions. The goal is to become capable of calmly recognizing negative situations and their impact, rather than becoming overwhelmed or hiding from them. Distress Tolerance Skills are designed to get you through suffering when the situation causing it cannot be changed and without making it worse, especially by relapsing. One of the most widely used, fastest, and most popular distress tolerance skills is TIPP as it alleviates distress very quickly. (Check out our videos on FI’s YouTube Channel teaching TIPP.)

  • Emotion regulation is categorized into four modules: understanding and naming emotions, changing unwanted emotions, reducing vulnerability, and managing extreme conditions. The goal is to help people manage intense, negative emotions, and alter past, unhealthy conditioned responses, changing them to healthier ones.

  • Interpersonal effectiveness is essentiallyassertiveness and interpersonal problem-solving skills. It teaches how to communicate with others more effectively and includes strategies for asking for what one needs, saying no, and coping with interpersonal conflict.

Know Your Triggers
What triggers an urge to drink or use is highly individual. HALT, an acronym used in AA, stands for hungry, angry, lonely, tired. These are common feelings most humans feel at any given time, on any day, during normal life. We may not be able to avoid these triggers, but we can be mindful of them, minimize encounters with these states of mind and body, and manage them using skills learned in early recovery. Take care of yourself and eat regular meals. Work on your sleep hygiene, going to bed at the same time each night preferably before 12:00 midnight, getting 8 hours of sleep, and waking up at the same time. Make intense exercise or movement part of your daily routine. Start a mindfulness or meditation practice. There are several apps available to teach this, but DBT’s Mindfulness and DBT TIPPs are skills you learn at Freedom Institute and are among many effective tools to prevent relapse.

Change your routine, (and maybe even your friend group). Avoiding certain situations and behaviors, such as not going to the bar or houses of friends with whom you used to drink or use, minimizes encounters with triggers. Practice healthy coping skills like going to meetings, calling a sponsor, doing yoga, meditating, or other healthy activities and skills you have learned to help you become more resilient. And try the pause and pivot, knowing that the urge will pass. 

Recovery is a lifelong process. While relapses may occur, the best-case scenario in recovery is to avoid them by immediately turning to the skills acquired, asking for help, or joining a support group. If you or a loved one needs help or extra support in your recovery journey, please contact us at Freedom Institute at 212-838-0044 or info@freedominstitute.org to learn more about our programs.

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DBT & DBT PE: The Cutting Edge of Treating Trauma and Substance Use Disorders

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