Relapse is all over the news these days, with the one-two punch of Demi Lovato and Ben Affleck relapsing in such close proximity to each other.

Celebrities who struggle with addiction and talk openly about their recovery face a double-edged sword; the media loves to sensationalize active use and/or relapse, and a celebrity thriving in recovery doesn't get much press. The story just isn't "juicy" enough. But every time relapse is spoken about openly - celebrity or not - it's an opportunity to educate everyone on addiction, relapse, and recovery. 

Demi Lovato and Ben Affleck, due to their celebrity status, are a barometer for the way people respond to relapse. There is a LOT of talk in the media about their struggles, what led to their relapse, even speculation about WHY they relapsed. None of this is worthwhile, and it perpetuates the stigma around addiction and relapse.  They did not fail. They are not weaker than others. They are addicts in recovery who need to get help, make adjustments, and continue on in their recovery. And they are STILL IN RECOVERY. Relapse is only an indication that there are still changes they need to make in their program, their self-care, mental health, and/or environment. There is something about the relationship they have to themselves, and their recovery, that needs to change. It's no more and no less than that. 

What Relapse Is, and What It Isn't

A relapse is a spiral into compulsive behavior and maladaptive coping mechanisms. For someone who has abstained from alcohol and/or drugs for a period of time, the primary symptom of relapse is picking up a substance. While relapse is most commonly spoken of in terms of using a substance, relapse materializes in many forms. Any time we seek to escape our reality though unhealthy behaviors, it can be considered a relapse. It can look like falling back into a codependent relationship, an unhealthy relationship with food, gambling, an active eating disorder, self-harm, and many others. Whatever battle we are fighting, any time we revert back to unhealthy, impulsive, and escaping behaviors, we are in relapse.

A relapse never occurs suddenly.  Let me reiterate that: while it make look sudden, and even feel sudden to the addict, there are always warning signs and other identifiable factors that appear in advance of the physical relapse. This is both the good news and the bad news about relapse. It is a teachable experience, and how we deal with it has everything to do with our ability to continue our recovery. 

Here is what relapse is NOT:

• a moral failing
• weakness 
• a negation of the work someone has already done in their recovery

Unlike the first time someone gets sober, relapse can be devastating to an addict (and their loved ones) because there is a feeling that someone "should know better". Addicts themselves can fall victim to this rhetoric, and experience deep shame that they "did it again", despite all their best intentions and despite working some kind of recovery program. This shame prevents people in relapse from reaching for help, and is - quite literally - killing people as a result. There needs to be more open and honest discourse surrounding relapse to counterbalance this feeling of failure.  Many people who relapse and seek recovery again say they feel like "a bad person trying to get good", instead of the reality which is that they are a sick person trying to get well.  There is no room for moral judgement when it comes to relapse. It simply doesn't apply.

Destigmatizing Relapse 

There is a lot of dialogue now, thankfully, around destigmatizing addiction. Slowly, people are being educated on the fact that addiction is a diagnosable disease that needs to be treated like the chronic and potentially fatal condition that it is. 

Understanding around relapse is slower to emerge, likely because it is often as baffling to the relapser as it is to those around them. The common rhetoric most people in recovery hear is "relapse doesn't have to be part of recovery". This is a noble and worthwhile goal for anyone in recovery, but the reality looks very different. We can't battle the stigma surrounding relapse until we take an honest look at the facts.  According to the National Institute of Drug Abuse , between 40-60% of addicts will experience relapse, many more than once. 

Relapse IS a part of recovery for approximately 50% of addicts. The silver lining is that any relapse is a valuable learning experience and an opportunity to make adjustments to one's program of recovery. A program of recovery is no different than a treatment protocol for a cancer or diabetes patient. If a cancer patient has a recurrence of cancer cells, a physician adjusts the treatment protocols: different chemo, more radiation, etc. An addict who relapses needs to do the same. They can look at what worked, and what didn't, with their recovery program and make adjustments accordingly. 

Relapse Response

When an addict relapses, the objective is to shorten the duration and acuity of the relapse. Instead of a "how could you?", "why did you", or "you know better" responses, the questions to ask are "what kind of help do you need right now" and "what needs to change"? 

If someone in relapse feels they will be shamed or shunned for reaching for help, they stay in relapse. If they feel they will be met with support and an action plan to help them, they are much more likely to reach out for help. In some recovery circles, there is a "back to day one" notion, meaning that if you relapse your counter resets to absolute zero. While this may be true in the actual number of days someone has abstained from using, it is NOT true when it comes to the progress they have made in their recovery so far. Everything they learned in recovery - including what didn't work - is of value. 

There is an analogy for this that is poignant: if you were driving to Los Angeles from Boston and you got lost in Chicago, would you drive all the way back to Boston and start over? No. You would reroute, consult people who know how to get to Los Angeles, adjust your path, and continue on. 

The same is true of recovery. If relapse happens we can get help, make adjustments, regroup, and keep moving forward. 

What to Do If You Relapse

• Ask for help: it is very, very difficult to pull yourself out of relapse. Ask a safe person for help, whether it is a friend, recovery coach, loved one, spiritual adviser, or therapist, the first step is TALKING to someone. Getting honest with another person helps you get honest with yourself. 
• Get Honest: Asking for help and getting honest go hand-in-hand, because people can only work with what you tell them. Resist the urge to minimize and/or justify. Simply saying you're in relapse and need help is enough. You have time to figure out what happened and what you need to adjust later. 
• Come Up with a Plan of Action: Do you need a physical detox? Do you need inpatient or outpatient help? Perhaps you need to address something in your life that continues to undermine your recovery, like a stressful job, toxic relationship, and/or other unhealthy behaviors that keep you off balance. The idea is to get support and be safe while you work through what needs to change.
• Tell People What is Helpful, and What Isn't: In other words: advocate for yourself. You may be experiencing shame (due to the judgement, or perceived judgement, of others) but don't let this keep you from speaking up for what you need. If someone isn't being helpful, or is unable to be objective in some way, move on. Your life depends on your ability to get the help you need, so it is fruitless to waste valuable time explaining yourself, trying to make others feel better about your relapse, and/or minimize your pain to placate others. 
• Be Proud of Yourself: You may be shaking your head at this one, thinking "relapse is AWFUL, what is there to be proud of?" Relapse is what it is, and it is treatable. It is hard to ask for help, make changes, and get honest. It takes courage to reach out for help. Dwelling on shame and self-deprecation keeps you stuck. Cultivate pride and self-worth, because you deserve to be healthy, balanced, and whole. 

What To Do If Someone Asks You For Help

• Be Kind: This can be very challenging if you feel angry or disillusioned by a loved one's relapse.  What this person needs right now is your support and a plan of action. There will be time to work through how you feel, and if you need immediate help with your emotions around a loved one's relapse go get help for yourself. Asking the person causing your pain to help you fix it is not helpful for anyone. If you feel you are too angry and/or upset to help, be honest about that. You can help direct them to someone more objective, like a therapist or other loved one, but the immediate wake of a relapse is not the time or the place to subject them to your feelings.
• Listen: Listening without judgement helps the relapser get honest, and allows them to feel safe opening up to you. Even if you aren't sure yet what the plan of action will be, you can simply listen and be there for them. You may not understand, or know what to do, but allowing them a safe space to talk is an important first step. 
• Don't Fix/Ask for Help: Just like the relapser can't fix themselves, you need a support system as well. There are 12-step communities for loved ones of addicts, as well as a multitude of other communities and counselors who can give you the support you need. You can walk alongside someone as they get help after relapse, but you cannot fix them on your own. Marshall the resources you need to take care of yourself, so you are on steady ground to help the ones you love.
• Detach with Love: If you have a loved one who relapses and they are not seeking help, detach with love. Prioritize your own self care without shaming the relapser. Stay neutral and take care of yourself. If and when they are ready for help they may turn to you, but if you shame them or react in anger/resentment, you will make things worse for them AND for you.
• Be Honest: Just like the relapser needs to get honest, so do you.  Be honest with yourself about how you feel, and what you're able to do to help.  As the prior points emphasize, you can't help anyone if you struggle yourself. Talk to people who can understand how you feel, and find a support system of your own which does NOT include the relapser. You are not alone. 

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Significant progress has been made de-stigmatizing substance use disorder, but it remains difficult for many people to ask for help. People often go to great lengths to avoid actually asking another human being for help for a variety of reasons, including the fact that as children we were not taught how, nor is asking for help modeled often in modern-day society. 

Familial and Societal Influences 

If the messages you received as a child, directly or indirectly, taught you that reaching out for help was weak,  unacceptable, futile, or embarrassing, it makes sense that you would avoid doing so whenever possible. It's human nature to fear rejection, and if you have a history of reaching for help - even for simple things - and being ignored or shut down, asking for help will be even more difficult as an adult. 

Society bombards us with images of 'perfection' - in mainstream media, social media, television, and magazines. Everywhere we look, especially as impressionable young adults, we are imprinted with the way things "should" be, and this leads us to compare and not identify with others. 

Human beings are social animals, and there is an evolutionary component to why it's so hard to ask for help. To ensure we will always be welcome in our communities we develop responses, like fear and pain (physical or emotional), that let us know when we risk alienation. When our social standing in the community feels threatened, these responses are triggered. We fear losing status, being treated unfairly, facing uncertainty, and rejection. When we experience all or some of these things, it creates deep distress and our brain signals that we need to modify our behavior to community norms and get back within the fold.

This deep fear of being ostracized is based in our primal longing for connection.  

One of the hallmark symptoms of substance use disorder is that it tells us we are all alone, that we are weak, immoral, or broken, and that we are the only ones struggling the way we do.  As much as we ache to break free from the grip of drinking or drug use, we look around at society and it seems like everything comes so much more easily to other people. Our disease, coupled with our instinctual fear of rejection, can prevent us from reaching out for help.

The Role of Denial 

Denial is also a major obstacle to asking for help. As our drinking or drug use progresses, we justify and minimize our behaviors, making it harder to see the truth of how much trouble we're in. When actively drinking or using drugs, there is also a part of our brain that doesn't want the help - that feels like drinking or drugs is the only thing holding us together (even though the opposite is true) - and wants to cling to our substance of choice like a life-raft. 

Asking for Help is Connection 

The irony is that asking for help is the opposite of alienation; it is a powerful form of human connection. If you are having trouble believing this, think about how you feel when someone asks you for help. Knowing someone loves and trusts you enough to ask you for help feels amazing, doesn't it? Would you ever reject or ignore a loved one asking you for help? Treat yourself with the same kindness you would someone you love. 
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Asking for Help is Brave

If you were raised to believe asking for help is weak or wrong, remind yourself that peoples' inability to ask for help is based in fear. Facing any fear involves courage and bravery, which is the opposite of weakness. Not everyone can understand substance use, but everyone can understand the bravery it takes to reach out to another human being for help. Focus on the ways people are identifying with your strength, as opposed to listening to the narrative in your head that wants to silence you. 

Five Ways to Ask for Help with Substance Use Disorder
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• Find a Real-Life Community Who Understands:  Nobody can provide insight, empathy, and assistance like someone who has been through a struggle similar to yours and has come out the other side. They likely remember what it was like to be where you are, and will do what they can to help. They can talk to you about what they did that helped them, and can introduce you to other people who will also understand. Look for 12-step meetings in your area, as you are assured that everyone at the meeting is there for the same reason you are, and can help. Look online for local resources, groups, and communities and reach out to them. The important first step is connection, and getting out of your own head. 
• Talk to Someone You Trust: Most people have someone in their life that they know they can talk to about anything. If you know someone like this, turn to them. Even if they have no personal experience with substance use disorder, they love you and can help you make sense of what is going on. They can walk side-by-side with you through the next steps so you aren't alone.
• Talk to a Professional and/or Expert: There are counselors, psychologists, recovery coaches, and therapists who specialize in substance use disorder who can help, and who are bound by confidentiality. These professionals are experts in the field of substance use and recovery, and can give you advise on next steps and walk with you through your journey. It's important to be completely honest, too, as they can only be as helpful as you are truthful. 
• Start Online:  While the ultimate goal is to find real-life people who can help, looking online is can be a good start. Sometimes, it’s easier to admit to struggling from the safety of a computer rather than face-to-face with someone. Find addiction/recovery blogs you can identify with, but be careful. It's important to find reliable/legitimate resources when looking online (there are many chat rooms, help lines, and websites that are thinly disguised marketing sites). 
• Write it Down: If you can't bring yourself to talk to another person, at least not yet, start by keeping a journal where you write honestly about how you feel and what you're going through. There is a power to the truth, and it helps break down the difficult obstacle formed by denial. Treat yourself with compassion, and pay attention to the language you use about yourself. Get honest, and speak to yourself like you would someone you love. Shame fuels isolation and fear. Remind yourself that you are strong, brave, and worth it.