We can’t predict what’s going to happen throughout the day, and sometimes distressing thoughts, feelings or situations will come up. We may receive bad news about something that meant a lot to us, we may feel a sudden mood shift or our thoughts and feelings may stem from a spontaneous trigger. There are so many questions we could answer about when and where these feelings occur, and, for those in addiction recovery, these distressing sensations could lead to relapse. Relapse is a common fear for many in recovery and, although it’s a normal part of the process, those who relapse tend to view it as a major setback. Relapse is defined by the National Institute on Drug Abuse (NIDA) as a “return to drug use after an attempt to stop”. If you’re in recovery, how can you effectively work through both distress and relapse, should it arise?
Types of Triggers
First, it’s important to have a clear understanding of what can trigger us. The Fix highlights two main types of triggers: external and internal. External triggers are what happens outside of us. These are things we can’t control. Here are some examples:
External Triggers
- People – running into someone whom you used to abuse substances with, receiving a phone call from someone who used to sell drugs to you, etc.
- Places – passing by a house you used to get high in, attending a club you used to get drunk at, sitting in your living room where you used to use drugs, etc.
- Things – finding a bottle of wine in the fridge upon your return home from treatment, noticing some unused painkillers in your significant other’s medicine cabinet, seeing smoking-related objects in a store, etc.
- Events – holidays, birthdays, times of the day when a person used to abuse substances, etc.
Now that you know more about situational occurrences, you can become more familiar with internal triggers – or, in other words, what happens inside of us. Internal triggers
Internal Triggers
- Physical sensations – feeling pain, exhaustion, stress, etc.
- Thoughts – ruminating, holding onto harsh beliefs, etc.
Triggers and Distress Tolerance: Working Through Difficult Emotions
In psychology, distress tolerance is a person’s ability to work through difficult or “impossible to change” situations. Negative (and otherwise unbearable) emotions can make life seem unbearable; and if we’re not careful in managing distress, we may find ourselves in the throes of even more painful emotions. In early recovery, this is especially important as a person is still becoming accustomed to a life of sobriety.
In a 2017 study, published in the journal Addiction Biology, researchers sought to explore how distress tolerance related to relapse when it came to those in the early stages of recovery. They concluded that low distress tolerance is associated with drug-related reward seeking behaviors – which could lead to relapse. One person shared their story of how external triggers led them to relapse after 3 weeks of sobriety. Here is an excerpt from their story, as stated on aagrapevine.org,
“On my third week I relapsed and drank for several days in a row. The final day was a work event. At the end of the event the company provides wine and beer and everyone parties.”
When we’re faced with these tempting circumstances, how should we handle them? It can feel so hard to ignore the cravings to use substances, especially if they seemed to abate some of your distress before – even if only temporarily. What you must remind yourself is what happens after you relapse. How do you feel? What happens around you? For many people in recovery, this alone is a strong motivator to continue on the path of recovery – because to go back would be too painful.
Tools for Recovery
With so many opportunities for distractions, we must balance ourselves with tools that we’ve gained in treatment. Therapy is a strong component of recovery because it allows you to work through some of the things that have been holding you back with a professional who understands which tactics can help reduce your distress. Cognitive behavioral therapy (CBT), for example, is an excellent approach to recovery because it helps us change our thought processes.
12-Step programs, such as Alcoholics Anonymous (AA) are great additions to treatment because they promote structure in recovery, as well as connect you with others who are working towards recovery as well. A 2016 study published in the journal Teaching and Learning in Medicine further suggests the following approaches that have helped many in recovery:
- Mindfulness and meditation
- Yoga
- Breathing exercises
- Guided imagery
- And more
In recovery, you have to rely – and use – the tools you’ve been given. It may seem uncomfortable at first, but you will only become more confident in your ability to work through triggering thoughts, feelings and sensations by practicing them when it’s necessary. If you’ve been struggling with triggers, you’re not alone – yet there are many people out there who have strengthened their recovery by getting actively involved in treatment, support groups and more.
Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.
