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Dealing with Reward-Motivated Behavior: Relapse Prevention (Continued)

Mark Dombeck, Ph.D.

Awareness of your Vulnerabilities. Remember Maslow's Needs Hierarchy? You should not be surprised to learn that people are more vulnerable to relapse when their basic needs are not satisfied. The acronym "HALT" (standing for Hungry, Angry, Lonely, Tired) is a convenient way to remember some of the basic needs that you (and all other people) need to keep met on a regular basis. When basic needs are not met, people tend to start feeling crabby, upset, and uncomfortable, and their ability to tolerate stress decreases. Such people are hungry for comfort, and the "comfort" of the old problem habit looms large at such times.

In addition to increasing your awareness, relapse prevention methods seek to increase your ability to successfully avoid or break out of existing behavior chains as they occur.

Alternative Behaviors Planning. Becoming more aware of your triggers and your behavior chains is a first step but it is inadequate by itself to help you change. You need to recognize trouble when it is happening, but you also need to know what to do differently when trouble occurs. You can help yourself know what to do differently by developing a list of safe alternative behaviors you can engage in when you experience cravings or other triggers, or find yourself starting to make excuses for behaving in bad ways.

Your alternative behaviors list needs to be concrete and specific in nature; and not abstract. Statements like "Do your best to resist" will not be helpful, even though they express a good sentiment. Instead, your list needs to contain instructions like:

  • Call your sponsor now (at this number and then provide the number)
  • Go home (or to a friend's house).
  • Drink water
  • Avoid the people you typically share your bad habit with

The more specific and concrete your list is, the more likely it is to be helpful to you in your moment of need.

Write your list out (or print it out) and carry a copy with you at all times so that you have it with you when you might need it.

Be sure to give yourself a pat on the back every time you pull out your list and successfully avoid acting out your bad habit. Reinforcing your good behavior will help strengthen your desire to do the "right thing" when tempted.

Temptation Prevention. Some of the items for your list will be things you can do in the moment to safely break out of a bad habit chain. Other items you might identify will be things you can do before anything temps you that will help you avoid temptation in the first place.

Let's say that you are trying to break down a long standing pornography habit. You can use what you know about your habit to help protect yourself from that habit.

For example, you know how you access porn, and where. These days, many people access porn through the internet. They do this at home, but might be very shy about doing so at work. If this is the case for you, you can take steps to prevent yourself from accessing porn from home. The extreme but most foolproof method of doing this is to simply cancel your internet subscription (!). If you cannot do that, you can install "net-nanny" software onto your computer that will block you from accessing porn through that computer. If your spouse can install the software and not tell you the passwords necessary to uninstall it (so you don't get tempted to simply turn it off!), so much the better.

Your self-monitoring efforts may reveal that your craving for porn changes over time. It is stronger when you haven't had an orgasm for a while, and weaker after you have. Knowing this, you can implement a regular pattern of sexual contact with your spouse, or with yourself which will keep you having an orgasm on a regular basis, and thus less tempted to act out with porn.

Analysis of Relapse. It is very likely that you will relapse into your bad behavior from time to time, especially when you are first starting a behavior change plan. This is normal enough, so don't worry about it. Many people feel guilty when they relapse, but feeling guilty doesn't undo what has occurred, and it can have negative consequences as well. Some people use their feelings of guilt as an excuse to start back into their bad behavior again. Their thinking goes something like, "Well - I messed up badly and this means that I can't make this change happen, so I might as well keep on behaving badly". Don't make excuses like this! A single relapse is not a problem so long as you pick yourself up out of that relapse as soon as you recognize it is happening and get yourself back on your relapse prevention program.

When you do relapse, the right thing to do is to go over the chain of events and behaviors that led up to that relapse. Figure out what triggered you to start down that road, and what stops you passed along the way (what links in your behavior chain you acted out). Figure out where the opportunities were for you to interrupt the chain of events, and what prevented you from doing so. Perhaps you realized that you were going to relapse, but you didn't care in that moment. That's okay - now you know you need to work on your motivation more. Go back to reviewing the reasons why your habit is bad for you. Perhaps you realized that it was bad, but felt helpless to do anything about it because you were with an old friend who tempted you. Now you know that you need to avoid this "friend" in the future. Perhaps you realized that you were going to relapse, but you didn't have your list with you and didn't know who to call. Now you know that you need to print out a new copy of your list and make sure you don't leave home without it. Figure out the triggers and excuses you make that maintain your habit, and take steps to eliminate them or minimize their impact on you, one by one. Over time, you will weaken their grip on your behavior.