Relapse is often a normal part of the recovery process because of the chronic nature of addiction. About 40% to 60% of people in recovery from substance abuse will relapse at some point. Watching a loved one slip back into destructive behaviors after getting sober is a gut-wrenching experience. Anger, sadness, exasperation, disappointment, resentment, fear and helplessness are just some of the emotions you may cycle through. Your knee-jerk reaction might be to unleash all of these feelings upon your loved one. However, to get the end result you desire — helping your loved one get sober again — you may consider taking a different approach. Dr. Ilana Breslau is a New-York based psychologist and educator specializing in addictions, mood disorders and anxiety. She has counseled people struggling with substance use and mental health disorders and their loved ones since 2001. Dr. Breslau shares some valuable advice for helping your loved one, and yourself, through this difficult time.
Communicate Without Confrontation
Confrontation immediately puts your loved one on the defense. It’s hard to have a productive, honest conversation when both parties feel hostile. “If they feel like you’re attacking them, they will likely become defensive and shut down,” says Dr. Breslau. “You want to open up the communication,” she says. Dr. Breslau recommends focusing on evidence in a neutral manner, so you’re more likely to be heard. So, instead of an antagonistic statement like, “I can’t believe that you’re using drugs and drinking again after all of the money we’ve spent on treatment,” you might say something like, “I noticed some empty beer cans outside and I was wondering how you’re doing.” The goal of communication at this point is to just get a sense of what is going on with the person. For the most productive outcome, it is important they feel you are coming from a genuine place of concern, not finger-pointing.
Don’t Blame or Shame Them
People struggling with addiction already have plenty of shame. “Someone who has gotten sober and is using again is probably feeling pretty bad about it and feeling very shameful about it,” says Dr. Breslau. “They’re likely disappointed in themselves for disappointing others.” They’ve probably done a good job of beating themselves up for feeling like they’ve failed themselves and you. In fact, studies support the notion that shaming or blaming family members about their relapse may only compound the situation and cause them to continue to retreat into destructive behaviors to avoid difficult emotions. Instead of a blameful or shameful approach like, “How can you do this? You are tearing apart this family,” try language like, “I see that you’re struggling. Let’s get through this together. How can I help?”
Try to Meet Them Where They Are
Some people may relapse because they don’t feel entirely ready to give up drug or alcohol use. “A big part of treatment is looking at the factors driving substance use,” says Dr. Breslau. “If you can get at those things, it’s much easier to get the substance use under control.” Some people may need to be gently guided to the point where they realize that the positives of quitting drug or alcohol use outweigh the negatives. For example, is their substance abuse really an attempt to regulate untreated or under-treated symptoms of depression or anxiety? Are they trying to numb out past trauma or cope with loneliness? Is the result of using substances to deal with these issues compounding their problems? While these are complex issues that require the help of a trained addiction and mental health professional, you can begin these types of conversations with them.
Provide Positive Reinforcement While Setting Boundaries
One of the most important things loved ones can do for a person recovering from substance abuse is reinforce positive behavior. This means not only providing encouragement and support when they are doing well, but also adjusting your own behavior so it’s not reinforcing their choice to use substances. For example, if your daughter is using marijuana heavily again and cutting school, don’t try to protect her from the consequences of her behavior or yell at her. The latter is not only unproductive, it will likely cause her to shut you out even more and keep her stuck in a defensive position. Dr. Breslau suggests motivating your loved one to reduce their drug use or return to treatment by using positive “I” statements. This demonstrates understanding and shared responsibility. For example, “I know school has been hard for you this year and you’ve been cutting class and not doing schoolwork that I know you’re capable of doing. I’m not going to keep writing late notes for you, but I do want to help. Can you help me understand what’s going on, or would you like to go back to Dr. Smith to talk to her again?” The idea is to build motivation to change and help the substance user be responsible for the negative consequences of their actions so they can take ownership of the problem. At the same time, maintain a positive connection so that interactions aren’t exclusively negative ones focused on what your loved one is doing wrong. Find ways to have positive experiences with them where drug use is not the main focus. For example, ask your daughter out to lunch and keep the conversation around something she enjoys, like a favorite hobby or ask her how things are going with a boyfriend or close friend. “This way you’re not withholding attention and love. The focus is on the behavior, not the person,” says Dr. Breslau.
You can help your loved one by minimizing the triggers in their life. Don’t keep alcohol or drugs in the house. Another way you can help is to be aware of past problematic patterns, and try to alleviate them. For example, if you know that after a stressful day at work, the first thing your wife used to do was make a cocktail, try to support her recovery by guiding her to more healthy coping processes. If she comes home stressed, you might acknowledge that you sense she’s had a hard day at work. Encourage her to go sit outside and read while you tend to the kids or dinner, or suggest another calming activity. After tensions are down, provide encouragement. You might tell her how nice it is to have her sober and fully present at dinner with the kids and how much you enjoy your time together when she’s not drinking. Dr. Breslau says it is important to learn to manage your resentment around these situations. You might have had a stressful day too. It’s natural to feel resentment that your loved one’s needs always seem to come before yours. Remember that by helping them through this period, it will likely improve your relationship and reduce stress in everyone’s lives in the long run.
Take Care of Yourself
Most importantly, take care of yourself. Maintaining your own friendships and support systems and having your own downtime is critical. Loving — and especially living with — someone with an addiction can be an emotionally draining and taxing experience. Dr. Breslau suggests seeing a counselor or attending a support group for loved ones with addictions such as Al-Anon or Nar-Anon. “A lot of people feel like they’ve tried everything and being compassionate when you’re dealing with somebody who you feel isn’t cooperating with the plan is really hard,” says Dr. Breslau. “It is one of the reasons why getting help is critical.” While you can’t do the work for your loved one, you can learn how not to enable them, how to set appropriate boundaries, how to deal with the spectrum of emotions you feel, and how to take care of your own needs.