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The Recurrence Response

Issue 15

The question we get asked the most in the work we do with couples in recovery is the dreaded: “What happens if one of us relapses?” A Recurrence can happen to both the person with the substance use disorder as well as the person who loves them and engages in maladaptive behaviors. (Experts in the field prefer to use the word “recurrence” or “recurrence of symptoms”)

What are The Stages of Recurrence?

Recurrence does not start with picking up a drink or drug or engaging in controlling behavior. The process of a recurrence includes emotional, mental, spiritual, and physical aspects, which can occur months before the addictive behavior occurs. This means there is potentially plenty of time for issues to be addressed preventably once one understands and embraces these stages.

What are the Signs of an Emotional Recurrence?

In an emotional recurrence, you are not thinking about the end result but your emotions and behaviors may be setting you up.

The signs of emotional recurrence may include mood swings, anxiety, defensiveness, avoiding meetings, or poor eating and sleeping habits. Recurrence response at this stage means recognizing what is occurring and practicing self-care.

We suggest each partner come up with their own self-care plan before they notice these symptoms, because they are going to come up. Sharing your plan with your partner can build understanding.

Examples of a self-care plan may include going to a meeting, talking to your therapist, exercising, or doing something creative.

What are the Signs of a Mental Recurrence?

In a mental recurrence, there is a war going on in your mind. Part of you wants to engage in the “old” behaviors and there is the part of you that does not.

The signs of mental recurrence can be: negative thinking, glamorizing the past, or predicting the future.

Techniques for dealing with mental urges. Play the tape through. Question your beliefs. Meditate. Share with your thoughts with someone in recovery. Distract yourself for 30 minutes. Again, making a mental recurrence response plan ahead of time and posting it somewhere you can see, is helpful.

What are the Signs of a Spiritual Recurrence?

A spiritual recurrence happens when your behaviors and thoughts do not align with your beliefs and values.

For example, if you find yourself letting your ego take over your behaviors, doing things that do not fulfill you, ignoring your spiritual practices, and moving away from the things that give you value, then your spiritual health is at risk.

Talking with your sponsor about these issues may be a good place to practice being vulnerable and truthful in a safe space. Creating a daily spiritual ritual and setting new boundaries can also be helpful.

What are the Signs of a Physical Recurrence?

The physical recurrence is when one picks up the substance or engages in the maladaptive behavior. It is hard to stop the process once it has begun. However, if you can recognize your behaviors as maladaptive and have a plan in place for recovery ahead of time, you may be able to shorten the duration of the recurrence and continue your recovery process. Sharing these plans with your partner can go a long way to establishing trust and keeping the relationship from derailing.

How Can Co-Recovery Help?

Becoming conscious of your emotional, mental, and spiritual health throughout the recovery process reduces your risk of experiencing a major recurrence. However, when it does happen, our advice to loved ones is to look within, for compassion and empathy. The hardest thing to do is to not take it personally.

Love does come with boundaries however, and if your partner’s recurrence is a threat to your recovery, it may be necessary to separate while encouraging treatment.

It is important for everyone to remember to not live in fear of the future that something bad could happen. If we are living our life in a way that supports our emotional, mental, spiritual, and physical health, then we have nothing to fear.

Recovery is about moving forward, living in the light, and not being afraid of the dark.

Elaine Shamos
Elaine Shamos
Elaine Shamos, MPH, has 30 years experience as a public health professional and is the former director of Dartmouth’s Women’s Health Resource Center. Glenn Simpson, LCSW, CADC, has a private practice specializing in substance use disorder, and couples therapy. They are working together on a book for couples in recovery.

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