Preventing Relapse in Addiction, Anxiety, and Depression

Unlimited CEUs and OPD hours at AllCEUs.com for $59 everybody and welcome to today's  live webinar I hope you are having  an absolutely wonderful week. Its a little chilly here in Middle Tennessee but I'm expecting it   to warm up a lot by Sunday um all right so  without further Ado let's go ahead and get started I'd like to welcome everybody to today's  presentation on relapse prevention for mental   health and addictive issues I'm your host Dr Donal  Snipes in this video we're going to Define relapse   identify relapse warning signs identify strengths  and help people learn about how their issue developed relapse is the return to something that  has been previously stopped and this can be true   for example with psychosis when someone is in  a uh remission period from psychosis or when   their medications are have them stabilized that  is what we would call a um remission period and   then if they start to have symptoms again that  would be relapse and we're going to talk about   a lot of different things that may contribute to  relapse of psychotic symptoms same thing is true   for mood mood disorders addictions and pain  it's important to remember that relapse like   everything else is multi-dimensional we can have  physical relapse where our body starts hurting   more or our body starts feeling more fatigued or  we can't sleep we can have interpersonal relapse   where we start um behaving towards ourselves  and others as we did during the problem or we   start having um relationships that are unhealthy  or unsupportive emotional and cognitive relapse   going back to how we feel and think when  we're in an episode environmental relapse   is surrounding yourself with things that you  typically surround yourself with when you are   in an episode and spiritual relapse really refers  to a lack of a sense of connection meaning and   purpose it's hopefully when you're asymptomatic  or when you're in remission you have a sense of   meaning and purpose and connection to others  but when you go into a relapse phase you may   start feeling disconnected not only from  others but also yourself so a relapse is   when you start returning to any of these  people places things behaviors or feeling   States what's important to recognize is a lot  of times in addictions we talk about relapse   as when somebody started using again relapse  happens long before that when they started   using again is just when they lost complete  control of it but relapse actually probably   started weeks or months before that which is why  it's important to pay attention to all of these   areas where you may be relapsing and becoming  more vulnerable to using or having another episode and vulnerabilities as we've talked about  in other videos are states or conditions in which   a person is more vulnerable to relapse for  example if you're sleep deficient you are   going to probably be more like to be irritable  to be agitated to feel fatigued you may have   more difficulty controlling your thoughts and have  more problems with ruminations which can trigger a   relapse in any of those things that we talked  about whether it's mood disorders addictions   psychosis or even pain nutritional deficits if  you're hangry you're going to be more vulnerable   to reacting stronger to distressful triggers in  your environment pain same way if you're in pain   you're probably going to be more likely you're  already primed your stress response is already   going so you're going to be more likely to  respond with a stronger reaction than you   necessarily would if you weren't in pain so  you're more vulnerable to those triggers in   your environment and then HPA axis disregulation  when your HPA axis isn't working well when it's   disregulated and you go from Flat to Furious  or flat to frantic you can see how that might   contribute to things that increase pain like  muscle tension and uh things that increase   mood disorders when you go from kind of flat  which is no fun anyway to either Furious or   frantic that's not fun either so you can have  an increased sense of helplessness hopelessness disempowerment interpersonally vulnerabilities  tend to uh revolve around feeling insecure in your   relationships and that includes your relationship  with yourself so it's intra and interpersonal and   conflict again with others when you're having  disagreements with your people in your support   system or even with people who aren't necessarily  in your support system but you feel like the world   is antagonistic it can contribute to feeling  stressed which can make you more vulnerable   emotional vulnerabilities include dysphoria and  I'm just kind of lumping everything in there   anger grief guil all that stuff and Euphoria now  Euphoria is more um more of a vulnerability for   people with addictions but it can be true for  people in any area my mother for example she   used to be on anti-depressants and as soon as  she'd start feeling better she'd start feeling   good she'd quit taking her meds and then she'd  very quickly go back into not feeling well again   so Euphoria can be as deceptive in some cases  as dysphoria with addictions when people feel   euphoric it reminds them how they felt when they  were using and they may continue doing things that   give them those adrenaline rushes and stuff which  may be counter to what they need to do in their   recovery process so they start slowly working  away from following good orderly Direction and   back into those old behaviors overconfidence  in your own skills about managing either The   psychosis or the pain or the mood issues can also  can make you more vulnerable if you think hey I   got this I can do these things that I used to do  and yeah it may be stressful but I got this do   you though and a lack of motivation is another  vulnerability recovery is not always fun and   regardless of what you're recovering from open  heart surgery to addiction it's there are parts   of it that are not fun so it can can be hard to  stay motivated to follow good orderly Direction   and do the next right thing cognitively people  who think with cognitive distortions all or none   thinking personalization mind reading jumping  to conclusions we've talked about all of them   but when you think in um unhelpful ways it tends  to contribute to stress and then stress tends to   contribute to relapse same thing with attention  and problem solving people who are stressed out   um who are having more difficulty with attention  are going to have more difficulty paying attention   to risky situations they may be more on autopilot  and when you're in fight ORF flight when you're   stressed out your exe executive control really  isn't engaged you're in fight ORF flight mode   not problem solve and think about it so when  people start feeling distressed their problem   solving goes down when their problem solving  goes down it makes them more vulnerable to   reacting strongly to stressors environmentally  sensory triggers can make you more vulnerable   I think we've all been in this position where  we've been either hot way too hot or way too   cold or um in an environment that was way too  noisy all the time um or way too busy it's   just people are everywhere all the time moving  around and it's just stressful and when you're   already have that stress response primed it is  going to contribute to feeling more vulnerable   and then spiritual a l lack of connection or  meaning and purpose when you don't know why   you're getting out of bed in the morning when  you don't know why you're doing these things   when you don't feel connected you don't feel  like anybody understands you you don't see   how your behaviors impact anything then it can  be hard to get motivated to do the next right thing one of the things we're going to talk  about a lot in relapse prevention is mindfulness   mindfulness can help people become more aware  of themselves and the current moment to better   understand their vulnerabilities thoughts and  needs in the moment which goes back to that   attention thing again go back to your own  recovery if you've recovered from a muscle   strain or an illness or addiction or depression or  something else you know that early in the process   you're very focused on your recovery and doing  the next right thing and following your plan and   then somewhere along the way you can start sort of  taking it for granted granted and being mindless   in your behaviors and it's really important that  we check in with ourselves even if you've been in   recovery for 20 years it's important to check in  with yourself so anything that can make you more   vulnerable is addressed before it becomes  a relapse trigger evening mindfulness can   also help you reflect on your day identify the  things you did well and learn from the things   that didn't go so well again even if you've been  in recovery for 20 years you probably have days   where something happens and you may hold on to  this resentment for a minute or you may make a   choice that's not in the best interest of your  recovery so being mindful reviewing your day   doesn't have to take long 2 three minutes in  the morning to get your head on straight and   two three minutes at the end of the day to learn  from anything as well as to recognize how well   you're doing to help you feel empowered and safe  in your own skin can go a long way in relapse   prevention physical relapse is characterized by  any of the following fatigue difficulty sleeping   increased pain increased physical symptoms of  stress now I intentionally didn't say anxiety   here because what what we're talking about is  the racing heart the um faster breathing the   sweaty Palms any of those test chest tightness  any of those things can be a potential sign of   impending relapse it can be a potential sign of  activation of the stress response which we know   is pretty much going to underly most of our um  ultimate relapse neglecting physical health such   as your sleep your exercise your nutrition and  your medication can also make you more vulnerable   to overt relapse but it can also contribute  to your symptoms your physical symptoms of   relapse so when you were in an episode psychosis  pain mood addiction whatever that episode is how   did you take care of your physical health most  people with any of those issues probably neglect   their physical health some so we need to look  at that and we say okay your physical health   behaviors have relapsed have returned to where  they were when you were in an episode what do   you need to reinstate in order to get back on  the right track if there was also addiction   the person may experience Cravings drink dreams  about the drug or whatever they were addicted   to and ultimately using um this is full-blown  relapse when somebody goes out and uses again   they are back in a full-blown episode however  again relapse happens long before somebody picks   up relapse happens with pain conditions for  example long before the person is in so much   pain that they can't get out of bed um and we'll  talk about some other examples of that later but   it's important for people to be cognizant to be  conscious of how they're feeling and how these   symptoms contribute to potentially causing  an episode or Resurgence or relapse of their problem encourage people to think about their  vulnerabilities for physical relapse so we'll just   take um mood disorders we'll take depression what  physical vulnerabilities what physical conditions   make you more vulnerable to feeling depressed what  interpersonal situations like feeling unsupported   and low self-esteem may make you more vulnerable  to feeling completely helpless and hopeless or   depressed what emotional vulnerabilities such  as as holding on to anger and resentment or   a whole lot of anxiety make you more likely to  eventually have a depressive episode cognitively   what thinking uh Styles what attitudes do you  notice that make you more vulnerable to having   a depressive episode and a lot of these  vulnerabilities can also serve as what we   call relapse warning signs when you notice when a  person notices that they are being um less mindful   when they notice that they are using a lot of  cognitive distortions that's a clue that's a clue   that hey something changed and we need to figure  out how to address these things so we're not   vulnerable to stressors and not moving down the  path toward relapse envir mentally what are your   vulnerabilities for physical relapse what are your  vulnerabilities for that fatigue that pain that   dis um physical physical symptoms recognizing what  sort of things if you're in a noisy environment a   lot of the time or when you go to visit X and  so uh relative if you know that that tends to   stress you out and make you more vulnerable to  depression be aware of that and take appropriate   steps and then spiritually what spiritual  symptoms do you have that can make you more   vulnerable when you as I mentioned when you start  feeling disconnected and it feels like nothing you   do ever makes a difference here those cognitive  distortions it can be really easy to slip into a   feeling of helplessness and hopelessness which is  one the core issue what we're talking about with   depression but different from vulnerabilities  are triggers what are triggers for physical   relapse what triggers might make you if you're  physically feeling um pain you know that can be a   vulnerability and a trigger you know all of these  can be um generally both be vulnerabilities and   triggers CU what we find in relapse remember  I said your relapse started long before you   actually have an episode These relapse triggers  these stressors start building up and adding up   and um complicating the picture and leading you  away from good orderly Direction interpersonal   triggers for physical relapse well for example  if you're already feeling like you've got low   self-esteem you're already feeling disconnected  and misunderstood and then you get into a fight   with with your best friend oo that's going to hit  a lot harder probably than if you were feeling   supported and good about yourself and you got  into a disagreement with your friend you're   likely going to perceive it very differently  emotional triggers uh for physical relapse I   know you're like how's that work when you feel  depressed when you feel angry that burns up a lot   of energy and people who feel anxious and angry a  lot burn through a lot of energy they disregulated   their HPA axis which can lead to a whole Cascade  of physical symptoms not the least of which are   sleep difficulties and pain and uh uh well sleep  difficulties and pain cognitively what are your   triggers for physical relapse if you're already  thinking using what we call in addiction Circle   stinking thinking if you're already thinking  in negative terms pessimistic helpless hopeless   terms you've set the stage to feel vulnerable to  any threats that come your way so then your boss   walks down the hall and says I need to see you in  my office in 20 minutes how does that affects you   and how does that affect you physically Al you  know those increased stress symptoms are going   to happen because you were already stressed  out you are already feeling vulnerable and helpless environmental triggers if you have things  that cause you to feel since we're sticking with   depression I've talked about them in a lot  of other videos those ASPCA commercials can't   take them just can't deal uh they make me too sad  and they trigger um my feelings of depression and   hopelessness and helplessness when I see this poor  puppy um so I know in my environment that as soon   as those things come on I'm changing the channel  uh likewise if you're recovering from addiction   if you are putting yourself in situations in  which you're surrounded by that addiction that's   probably a trigger and spiritually if something  happens that makes you feel just suddenly cut off   from your sense of meaning and purpose that can  trigger stress response and that stress response   will trigger those physical symptoms preventing  physical relapse one of the acronyms we use in   addiction recovery is halt there are a lot of ways  to prevent physical relapse but this covers a lot   of them hungry make sure to nourish your body with  proper nutrition if your body is not getting the   nutrients it needs to make the neurotransmitters  and keep everything working well then you know   crap in crap out so it's important that people  pay attention in their relapse prevention plan   to maintaining adequate nutrition I'm not  saying you've got to be you know a foodie I   am just saying you need to make sure that you are  giving your body the building blocks it needs and   nourish your mind with activities and things that  increase your happy chemicals it may not make you   feel elated but it's good to force yourself to  turn your attention to things that are at least   mildly amusing whether it's videos on the Internet  or butterflies or watching Birds whatever it is   for you that promotes a sense of contentment that  helps release Gaba that helps release serotonin   and endorphins in your system even if you're not  feeling giddy it can help you feel more balanced   if you will in terms of angry and anxious reduce  chronic stress stress is a part of life pain is a   part of life but there are chronic stressors that  we can eliminate for example in your environment   you can eliminate uh access to your to your  mobile device or to your computer or something   in the evening when you're more likely to start  Doom scrolling when you don't have something   else calling your attention away um whatever it is  that people can do to reduce unnecessary stress is   going to be helpful people who have chronic pain  are likely experiencing chronic stress well you   can't get rid of that chronic pain but developing  tools to deal with that chronic pain is going to   help the person feel more empowered and may help  buffer against the stress response so the brain   gets the message all right this sucks but we are  not super vulnerable right now so we don't need   to trip off the stress response encourage people  to develop distress tolerance skills so they can   downregulate when they start getting stressed  out they can downregulate their stress response   and get into their wise mind so they can better  problem solve remember that for a lot of people   whether it's mood addictions pain or psychosis  stress is a huge underlying factor that starts   throwing the endocrine system all out of whack  and can lead to lead to at best breakthrough   symptoms at worst a full-fledged relapse so  all of these things reducing stress physical   um interpersonal emotional cognitive environmental  spiritual reducing stress in each of those areas   is essential for relapse prevention now how  each person goes about that is going to be very   individualized and proove problem solving skills  is another aspect for angry and anxious a lot of   people I've worked with over the years um have  struggled with problem solving skills especially   surrounding their their issue but for people with  uh depression we're sticking with depression here   uh they may feel helpless and hopeless well the  opposite of that is empowered and looking at what   do I have the power to solve what skills and tools  can I use a lot of people who are struggling with   addictions and mood disorders um and even to some  extent pain uh chronic pain conditions may just   simply not have the skills to handle that they  may not have any clue what a cognitive distortion   is or the inner child or any of those things  that we talk about helping people identify the   thoughts and things that trigger their anger or  their anxiety and then help them figure out okay   how can you best deal with that in the moment  what is the best way to use your energy to deal   with that lonely we're designed to be interactive  we're designed we we've got a bonding hormone for   a reason encourage people to nurture social  supports including with themselves to buffer   stress and that's a radical notion here uh for a  lot of people they don't have any clue who they   are and they certainly haven't been their own best  friend but that's part of the recovery and relapse   prevention process not relying on other people to  build you up now yeah it's great to have support   but it's also important to feel like you know what  I deserve to be happy I deserve to be treated with   respect and hey I'm going to treat myself respect  with respect imagine that and being willing to   ask for help a lot of people not all but a lot of  people who are in an episode whatever that episode   is may feel like they're a burden may feel like  it is shameful to ask for help there's a lot of   reasons people don't ask for help however asking  for help help can actually increase oxytocin   providing help can increase oxytocin levels  and when one person's oxytocin levels are up   the other person's oxytocin levels tend to respond  in kind so it's good in in many ways to be willing   to ask for help there are people out there who  have been down that road before or who may have   skills that you don't have and typically when  people are nurturing those social supports and   willing to ask for help they feel less isolated  they feel less lonely and tired well of course   get sufficient quality sleep if your pain if the  hallucinations if your mood if your um intrusive   thoughts are keeping you from getting sufficient  quality sleep then that's going to be a problem   and we need to figure out how to address it but we  also know that if you don't get sufficient quality   sleep all of those things can increase and address  issues such as sickness and pain that prevent that   quality sleep this is true even when if you're  just having a moment maybe you've got a virus   four six 10 days of not getting good sleep can  have a significant impact on mood and cognitive   control and a whole bunch of other things so it's  important for people to not minimize what's going   on and and be more mindful of how is this  impacting me and how can I be compassionate   with myself today interpersonal relapse you've  returned to the old people and places who co-sign   on your BS let's go with anxiety for this one or  addiction likely you nurtured a uh peer group or   a set of relationships that thought similarly  to you so if you were uh if you're recovering   from having a lot of anger or anxiety chances  are you're probably you've probably surrounded   yourself with people who also feel a lot of anger  and anxiety and so they cosign they they actually   rein force your beliefs in addictions people do  a lot of minimization justification denial and   they surround themselves with other people with  addictions who will uh validate their minimization   justification and denial so they don't have  to face it recognizing if you're withdrawing   from people who tell it like it is and going  towards those people who are going to nurture   the negative stuff paying attention other symptoms  of interpersonal relapse you've withdrawn from   your social supports you felt vulnerable um you  started wanting to withdraw into that that known   even though depression is exceedingly painful  sometimes it feels more comfortable and and I   know some people are really going to argue with  that but having dealt with depression throughout   my life I can tell you there are times where  it just seems easier to be depressed than to do   what you got to do and you may withdraw from your  social supports that are saying come on you got   to get up you got to get showered you got to do it  uh so that's also important to notice if you start   shutting people out uh that are good for you if  you become self-centered it's all about me and I   don't care about anybody else that can be another  sign of relapse because you're trying to control   other people you're trying to um make them if you  will focus on you You' be become disconnected from   yourself and started acting on autopilot you're  not even in a relationship with yourself anymore   you're not being being mindful you are just going  through the motions based on if you're not mindful   then you're going on urges and that is a recipe  for disaster in terms of relapse and sometimes   people become more suspicious or argumentative  during interpersonal relapse why well let's go   back to that stress response some situations  occurred that made you more vulnerable able you   you already felt a little stressed when we feel  vulnerable it primes that stress response and then   you were triggered by something that caused you to  feel really vulnerable caused you to feel a threat   well how do we respond when we feel threats  we become suspicious and argumentative so or   you know we fight or flee so it makes sense that  people who are struggling um May be withdrawing   it makes sense for a lot of people when they  are in recovery if it just doesn't seem like   things are moving fast enough or it doesn't seem  like it's doing well even though objectively an   outsider might be able to say yeah I've seen some  changes if the person's not feeling that they may   not be motivated to continue to do that hard stuff  which can mean they want to withdraw they don't   want to have that shoved in their face Behavior  communication when we start withdrawing from   people that are good for us surrounding oursel  with people that um bring out the problems then   we need to consider what is that behavior saying  and and why is it that I don't want to why is it   that I'm not motivated to do the next right  thing to give myself that love and respect so   again asking people what are their vulnerabilities  for interpersonal relapse physically if you feel   you know those stress feelings the racing heart  and all that okay if you're in pain it can cause   you to feel hopeless and helpless if you're  fatigued you know it's really hard to want to   engage with others when you're exhausted and it's  even hard to tolerate something that they may do   that you feel is uh threatening in some way inter  or intrapersonal so again your relationships what   vulnerabilities in your relationships make you  more vulnerable to worsening those relationships   make you more vulnerable to disconnecting from  the healthy supports emotional and cognitive What   feelings and thoughts tend to be more prominent  when you decide that people are just they're not   safe and the Situation's not safe and I just don't  want to hang out with them I want to go back to   the old to the old peer group or I want to go back  to being all by myself because people are just   people environmentally are there vulnerabilities  for interpersonal relapse um when you're feeling   um stressed environmentally it can be really  tempting to withdraw from others and going through   the same thing with the triggers for interpersonal  relapse um what physical things might happen that   make you withdraw from from others if you used to  go out with your friends and go rock climbing all   the time and you're having an episode of pain  or you get diagnosed with fibromyalgia and you   just can't do that anymore then when they go out  rock climbing um because your your pain is too   bad and you can't go then you may feel depressed  you may feel hopeless you may feel helpless and   you may decide that you know what I don't want  to hang around with them anymore um they go do   stuff without me and that's not okay I'm going  to go over here but going through each of these   things preventing interpersonal relapse practice  daily mindfulness both in the morning and in the   evening what is it that you want how are you're  going to use your energy to move towards your   rich and meaningful life and in the evening how  did I use my energy well today and what can I   learn address insecure attachment issues when  people are insecurely attached they are almost   always uh triggering that stress response they're  almost always a lot more vulnerable to stressors   that come their way in any of the areas Define  and develop skills to maintain boundaries here's   the kicker without guilt oh my so many people  have been taught that guilt is or boundaries   are not okay it's not okay to say I'm too tired  right now or I don't want to do that so this is   a learning process and it's a stressful learning  process setting boundaries especially initially is   a change in the Dynamics of your relationship and  a lot of times there's some turmoil before things   settle out and it's important for us to make sure  that people understand that so they go into it   under with with their eyes wide open encourage  people to contact their social support or social   supports on a daily basis for the first three  months whether that's your sponsor your coach   your uh best friend whoever it is reaching out  with regularity starts establishing that habit   keep a business card in your wallet with the names  and numbers of three social supports one can be   your therapist one can be the crisis hotline and  one can be a friend if you know have three people   that you would consider social supports but it's  important to have options if you have an addiction   or you were surrounding yourself with people who  are just really unhealthy consider changing your   phone number and if possible destroy contact  information for people who might trigger a   relapse some people are going to be willing to get  with the ball game and respect your move toward   health and happiness great the people who refuse  to respect that are the ones you need to consider   do I really want to maintain contact and where  do I need to set those boundaries and find at   least one pro-social activity to do each week and  I emphasize the social part because we're talking   about interpersonal relapse where you're around  other people you don't have to be spending a lot   of time talking to them you can go volunteer to  clean up a trail at a state park or something um   but just being around others and doing something  positive increases oxytocin for some people going   to church or synagogue for others just going to  the gym being around other human beings um can be   very helpful in emotional relapse people's  emotions and behaviors become negative and   unpleasant this is true in addiction or mental  health issues or overconfident and driven   to maintain Euphoria and like I said earlier  this is more common in addiction than anything else encouraging people to be aware of their  vulnerabilities for emotional relapse all right   I can be you know doing fine something happens  that um causes me to feel anxious or angry or   depressed and I can roll with that I can be  resilient to that but what vulnerabilities   exist in me physically interpersonally emotionally  mentally environmentally or spiritually that would   actually knock me on my butt if that same thing  happened I'm just I'm already depleted I can't   do it and it triggers that emotional relapse  remember with pain for example pain is in many   cases um triggered and can trigger the stress  response increases in pain are associated with   disregulation of the HPA axis and um stress when  we feel stressed we have tension when we have   tension it tends to throw things out of whack  and can cause increased pain it also impacts   stress also impacts the levels of inflammatory  cyto kindes and other um biological processes   that can make pain worse so recognizing that  and recognizing how when you're depressed for   example or you're anxious how does that impact if  you're recovering from Pain how does that impact   your pain when you are depressed or anxious  how does that make you more likely to start   feeling helpless and hopeless and distressed and  then know what your triggers are for emotional   relapse and this is probably the easiest one  for people to fill out what are your triggers   for depression anxiety hopelessness anger uh  physically if something happens like you are   are an avid Fitness person and you break your  leg so you know you can't work out for 3 months   while your leg heals that could be a trigger  for feeling hopeless and helpless um when you   are over tired and I know that's a big one for  me if I don't get enough sleep I am much more   vulnerable to making mountains out of proverbial  mole Hills and being more um uh sensitive so if   I'm exhausted already and then I don't get a  good night's sleep or something happens um I   can feel overwhelmed really easy interpersonal  and intrapersonal triggers for emotional relapse   triggers for distress what triggers your distress  and again go back to the vulnerabilities my um I   I have a relative who um has some in-laws that  are extremely stressful now this is not mine   my my mother-in-law is about the next thing to a  sayane but um I I do have a relative who has some   in-laws that are extremely critical and extremely  stressful and they know that pretty much every   time they interact with their in-laws they are  going to have a flare of their fibromyalgia it's   almost a one toone correlation and it also is  affected by how long if they spend a meal with   their in-laws it may be a day or two before they  get their energy back and they can get their pain   under control if they have to spend the weekend  with them they may be in bed for a for a month   um with pain and it's it's such an intensely  direct correlation um but recognizing that and   then making a decision how do I handle this in in  a way that makes sense for myself as well as my family addressing emotions help people develop  emotional intelligence identify the emotion   explore why they're feeling that way and take  steps to fix the problem now the first thing   people have to do before they identify the  emotion a lot of times is to downregulate   use those distress tolerance skills so then they  can more effectively observe and describe what's   going on people can be stuck in an emotion  nurturing it or blowing it out of proportion   have you ever had a situation where you were  already irritable and something else happened   and it just made you more irritable and you just  kept getting more and more irritable and you   started seeing the whole world as or everybody  as just just a stressor it's like I can't take   anymore y'all just go away um compounding it  with other emotions like anger and guilt we   talked about this in acceptance and commitment  therapy if you're feeling depressed and then   you start feeling guilty about being depressed  and you get angry that you're woke up and you   were depressed that drains even more energy  that turns the stress response on even more   which is going to be more likely to lead to  a backwards Cascade personalizing things and   trying to escape from feelings feelings are like  your body's smoke alarm and if you try to escape   from it it's not going to do any good it's your  those feelings are trying to tell you something   sometimes those feelings are saying all right  this sucks we're not in a lot of danger right   now but just letting you know that this sucks  okay um other times it's saying this sucks and   is dangerous so you need to fight or flee but  trying to escape from it just trying to ignore   it and avoid it and make it go away that doesn't  address the underlying issue you've still got the   little control guy in your brain going um  I'm trying to get you to pay attention to something remember the emotions are like cues  you feel how you feel in the moment so unhook   I feel I notice I feel angry all right so I feel  angry what's that about what's triggering my anger   you know I'm unhooking from it and I'm trying to  figure out what's causing this to happen what's   triggering my anger right now and what can I do  to address the problem evaluate the situation   based on fitkat the facts in this context at  this time and then choose to change or improve   the next moment in order to prevent emotional  relapse practice mindfulness we can we're we're   programmed to focus more on the negative than on  the positive because we want to be more aware of   the Vipers than the bunny rabbits to to survive  so it's important to practice mindfulness so we   can see the big picture and not just what's going  crappy increase positive experience es both in   real life and using guided imagery going to your  mental happy place keep a gratitude Journal avoid   personalizing things that may not be about you  remember that negative emotions are the mind's   way of telling us to get off our butts and do  something to evaluate the situation and figure   out if there's a threat it doesn't mean there's a  threat kind of like a smoke alarm doesn't always   mean the house is on fire and a smell of poop  doesn't always mean that the dog went in the house   dwelling on nurturing or avoiding or hiding from  negative emotions doesn't make anything better I   I tell my clients don't marry it don't say to  have into hold from this day forward to death   do us part no those feelings are transient  states that are designed to motivate you to   do something and then move on and remember that  you can choose to feel and fix or relapse and repeat encourage people to list 10 things that  they chose to get anxious or angry about over   the last week why did they get upset what was  their mind telling them needed to be fixed what   vulnerabilities did they have that made it more  difficult to deal with that situation did holding   on to the upsetness do any good what could they  do differently next time to either change or fix   the situation which is improving the next moment  change how they feel about the situation instead   of feeling that it's the end of the world feeling  that it's unpleasant but manageable um and and in   linan C calls this walking the middle path or  letting it go sometimes it is what it is and   there's nothing I can do to change it so I'm not  going to continue to to throw my energy at it in   cognitive relapse there's a war going on in your  mind part of you wants to stay positive but part   of you is struggling to tolerate the distress  signs of mental relapse are focusing only on   the negative or mainly having a pessimistic  helpless blaming or hopeless attitude just   giving your giving your power away difficulty  problem solving difficulty concentrating   and using those nitive distortions the extreme  language like jump and jumping to conclusions or personalizing if you had an addiction signs  of relapse may also include thinking about   people places and things you used with you start  having these intrusive thoughts glamorizing or   romanticizing your past use lying justifying  and minimizing the impact of that substance   or just adopting a screwd attitude you know  whatever I'm going to do what I want when I   want cuz I want to like everything else help  people identify what makes them more vulnerable   to having those negative attitudes or to  reacting in a pessimistic way and what are   their triggers for cognitive relapse a lot of  us have difficulty thinking clearly when we're   in pain pain or we exhausted um when we are in  a bad mood our brain is actually kind of wired   to think pessimistically so if you are already  distressed in some way then it may make it harder   to adopt that cognitive restructuring and adopt  that healthy thinking [Music] style in terms of   addressing cognitive relapse what types of things  trigger the negative thoughts for the person this   can be things and the media people places events  sights sounds and smells um just thinking very   holistically about what may trigger them to have  negative thoughts and what thoughts do they have   that make them feel so this is kind of another  way of addressing it what thoughts do they have   that make them feel um angry or irritated  guilty envious scared anxious worried or stressed one chart that I have people use is  this one to help them identify their unpleasant   thoughts a lot of our unpleasant thoughts can be  traced back to four basic fears loss of control   or the unknown and whenever something's unknown  with then we don't have control so they kind of   go together failure isolation and rejection or  death so when you think about things that cause   you to feel angry irritated or resentful  what do they have to do with being out of   control failure uh fearing that you're going to  be rejected or death if somebody does something   that could threaten your life yeah you're  probably going to be a little bit poed um   encouraging people to evaluate these things so  they can understand what is my body telling me   when this happens and how accurate is it if I  get angry about something because I fear that   it's going to leave people to reject me okay  that's a feeling and that's a valid feeling   but let's look at the facts facts in this context  at this time is this whatever happened is this um   does this make me more likely to be rejected by  people or is that just a feeling do I have facts   to support it preventing cognitive relapse  keep it simple silly uh try to change don't   try to change too many things at once or it's  probably all going to go to crap um often some   of the simplest things can have the greatest  impact like getting enough sleep or spending   10 minutes with um looking outside and enjoying  the to day regularly practice fit cat mindfulness   prevent and address vulnerabilities that can make  you focus on the negative and Trigger the stress   response and remember good orderly direction  is a shortcut for saying this is your plan   for getting to your rich and meaningful life  your life is a road map with the destination   being hopefully recovery and happiness before  you act think whether whatever you're getting   ready to do keeps you on the right Road or is an  unplanned detour and Main maintain head heart and   gut honesty my heart can lie to me my head can  lie to me but rarely do all three of them lie to   me so if they're not in alignment if your Spidey  senses say it's okay your heart says it's okay and   your head says it's okay you're probably in the  in a good place and environmental relapse this   is when you start reintegrating things that  trigger your problem if you are recovering   from alcoholism keeping alcohol in the house or  hanging out at bars probably a problem if you   are recovering from depression spending two hours  each night on Twitter Doom scrolling probably not helpful encourage people not only to review their  vulnerabilities but also to review their strengths   what is life like when they are happy what's  different from when they're unhappy okay so   let's look at what changes you're happy one moment  then something changes and then you're unhappy   what happened what changed and what is the same  what things do you have that actually make your   life feel rich and meaningful and what in those  areas of your life physically interpersonally   um emotionally cognitively environmentally  spiritually what is the same that helps you feel happy what people things and experiences are  important in your rich and meaningful life and   how many of them are going okay how many are  crap and how can you best use your energy to   nurture the things that are going okay and  address the things that aren't going so good list three healthy ways that you cope  with stress having people look because   they've been surviving until now so what  are three healthy ways they've dealt   with stress in the past that work for them  and what are their positive qualities and strengths review prior relapses what was  happening before the relapse again pain   psychosis mood addiction it doesn't matter what  was happening before the relapse in what ways   were you vulnerable to relapse at that point  in time what were you doing or what was going   on that made you already more vulnerable you  were already stressed what actually triggered   the relapse what was that straw that broke the  camel's back relapses occur when old behaviors   are more rewarding or stronger than new ones so  what became more rewarding than your recovery   program and this is important as we watch people  you know start slipping down that slope to relapse   their old behaviors are becoming more rewarding  and these new behaviors that may not be quite   as fun or pleasurable are less um rewarding so we  want to help people recognize uh what was pulling   them back towards that relapse before your relapse  what changes occurred in your physical functioning   interpersonal and intrapersonal self relationships  your emotions and your emotional control the your   cognitions the way you were thinking about  things and your ability to solve problems   your environment and your sense of connection  meaning and purpose once you've reviewed that   relapse think about what you've learned what  can you take away from that to prevent the next   relapse what weaknesses do you see in your plan  or in what you were doing that may have caused   you to start slipping down that relapse slide  include time in the morning and at night to use   mindfulness skills to get grounded identify  and prevent or mitigate vulnerabilities each   day each day you're going to wake up you may have  slept well one day not the next you may you know   don't skip breakfast all those things eliminate  unnecessary stressors that are going to make you   more vulnerable avoid alone idle time if your  mind tends to wander to Dark Places incorporate   positive experiences each day set realistic  daily goals and remember to give yourself   credit for your accomplishments relapse triggers  can be emotional mental physical social or even   spiritual for each trigger the person identifies  describe at least one way to deal with it practice   mindfulness each day to become more aware of  personal daily vulnerabilities for relapse and   for each General category of vulnerabilities  and relapses identify three things things or   relapse triggers identify three things that  can be done to continue on the journey towards happiness are there any questions Al righty everybody have an absolutely  wonderful day and I will see you next week where   we're actually I'm doing a brand new video on  the importance of hydration for mental health   remember your neurotransmitters com communicate  through synapses in a fluid environment so when   we're dehydrated you can see how that might throw  a wrench in the in the works have a great day

Channel: Doc Snipes

Views: 2,805

Keywords: yt:cc=on, doc snipes, relapse prevention, relapse prevention in addiction recovery, addiction recovery, cbt, anxiety relief, depression recovery, recovery is possible

Id: 3Np1xhc5k_k

Length: 60min 46sec (3646 seconds)

Published: Tue Apr 16 2024