When a person relapses after a significant period of sobriety, they often find their substance abuse to be as bad as it was when they quit. In some cases, it may even be much worse. There are a few reasons that their use may spiral out of control in a very short amount of time. And these reasons can all be found under the same label: abstinence violation effect. Basically, this is the effect that colors our perception of ourselves when returning to substance abuse. When AVE is in effect, we see little point in stopping immediately. We have already relapsed, so we may as well make the most of it.
This isn’t the only way in which our thinking might become twisted when we experience a lapse in sobriety. Abstinence violation effect fuels our negative cognition, causing us to judge ourselves quite harshly. This is especially true if we are involved in a twelve-step program, as we now realize we must reset our chips. Going to the front of the room to grab a new one-day chip after months or years of sobriety makes us feel like complete failures. We feel ashamed of ourselves, and fear that everybody else must be ashamed of us as well.
Abstinence violation effect greatly twists our thinking. Sometimes, it begins from the very moment we even consider the notion of using again. We must learn to recognize this if we wish to stay on the right track. If AVE sets in pre-emptively, it may actually lead us to the relapse we so desperately fear. And if we do relapse, AVE might prolong the experience. Those who wish to become sober—and stay that way—must therefore learn to identify abstinence violation effect and the dangerous ways in which it might impact our recovery.
Characteristics of Abstinence Violation Effect
As noted above, one possible characteristic of abstinence violation effect is the decision to give up entirely. When our defenses are down, we may not even think about our first drink. But upon realizing what we have done, we feel as if it is too late. We can sober up in the morning, but we may as well get good and drunk now. Drug addicts go through something similar. They may realize instantly after using that they need to get sober again. But if they still have drugs left, they decide to go ahead and deplete their supply before quitting again.
More commonly, abstinence violation effect is fueled by guilt and shame. The weight of this guilt often correlates to the amount of time spent in recovery leading up to the relapse. Those with only a few weeks of sobriety will not feel as bad as those with years under their belt. The concept of now “starting over” weighs heavily on their minds. This may also convince them to give up. Not out of the same warped practicality mentioned above, but because they simply feel as if they are hopeless.
Abstinence violation effect doesn’t necessarily end when we stop using. As we continue to blame ourselves, one question pervades our minds: why? Why did we give up our time in sobriety? What caused us to violate our family’s trust? Is our life in sobriety really so bad that we need to go back? To some extent, these questions are important. We do need to learn which aspects of our program were lacking. But if we obsess too much over these questions, they lose all sense of utility. We become mired in self-pity and depression. It can be difficult to overcome this line of thinking.
If we don’t learn to see the flaws in our thinking, we will collapse under the weight of our own guilt. According to Alan Marlatt, director of the University of Washington’s Addictive Behaviors Research Center:
“People with a strong abstinence-violation effect relapse much more quickly. A single slip solidifies their sense that they are a failure and cannot quit, creating a self-fulfilling prophecy.”
The TIME article in which he is quoted also calls this the “F*** it” effect. It’s not a bad term for a manner of thinking that causes us to give up on recovery. And make no mistake—that’s exactly what AVE will do if we do not defend ourselves against it.
How AVE Affects Our Attempts at Recovery
When abstinence violation effect kicks in, the first thing we often do is criticize ourselves. We view ourselves as weak. Instead of focusing on how to move forward, we continue looking back. This is a problem faced by many addicts and alcoholics, and it actually applies to more than just AVE. When other people get a flat tire, they fix the thing. But when we get a flat tire, we find ourselves practically on the verge of calling a suicide prevention hotline. Obviously this rhetoric is extreme, but that’s the point—we tend to think in extremes.
Looking back does have its benefits in that it helps us identify weaknesses in our program. The problem is that abstinence violation effect magnifies these weaknesses and prevents us from seeking solutions. Our first instinct should be to figure out a relapse prevention plan that addresses the faults we have identified. Instead, we simply stay on the lookout for emotional disturbance. This is an important measure, but it doesn’t do much for relapse prevention if we don’t forge a plan to deal with these disturbances when they arise.
The result of this lackluster planning is that we recognize future disturbances, yet do nothing to truly resolve them. If we feel stress, anger or depression, we do not find healthy ways of confronting these feelings. We instead view these emotions as justifications of the negative cognition experienced under AVE. Our hopelessness and our instinctive desire to give up were spot-on, or else we would be happy all the time. Naturally, we would never say such a thing about anyone else. But when we feel this way about ourselves, it somehow feels rational. We need to learn that it is not. Giving up on sobriety should never feel like a justified response to vulnerability.
Abstinence violation effect may cause us to feel these way about urges and cravings as well. We feel an urge or encounter a trigger, and suddenly we decide that our attempts at recovery have failed. It doesn’t seem logical that we would still experience cravings when we were only just recently hurt by a relapse. We fail to realize that putting drugs and alcohol back in our system was likely what reignited our cravings in the first place. Learning to recognize this will be one of our greatest tasks as we move forward.
Moving Forward in Recovery After AVE
The first thing we must do after a relapse is check our thinking for signs of irrationality. Sometimes we must be hard on ourselves, but we must never view ourselves through a lens of hatred and self-loathing. Marlatt notes that one of the most important aspects of handling abstinence violation effect is the need to develop our coping mechanisms.
“It’s like trying to ride a bike. You make mistakes and learn, and you don’t give up if you don’t immediately find your balance.”
Yes, we will experience cravings. Our mental obsession will sometimes cause us to think in self-destructive ways. But just because we experience the occasional urge does not mean we are failing entirely. It simply means that some of our defenses need to be strengthened a bit. According to Marlatt:
“The urge is like a wave. It goes up and down. You don’t try to get rid of it, but accept it and let it pass.”
He calls this “urge surfing.” Instead of denying our addictive nature or hating ourselves for it, we learn to keep living in spite of it. We remember that our urges do not control us, that we have power over our own decisions. This is easier when utilizing a technique which Marlatt refers to as SOBER—Stop, Observe (our thoughts and emotions), Breathe, Expand (our awareness and our comprehension of potential consequences if we use), and Respond mindfully (make the right choice not to use).
Marlatt’s technique keeps us focused on the present rather than on the past. We can’t keep our urges from occurring, nor can we change past events in which we have acted on them. What we can do, however is learn and grow. We can use our experiences to help others by telling them how relapse and abstinence violation effect caused us torment. If we can keep others from making the same mistakes, our experiences will serve a wonderful purpose. The memories of our slips may always sting a bit, but at least we can sleep easy at night knowing that we used them to do some good. We are not “starting over” in sobriety. We are building on our experiences to become even stronger.
The best plan is to begin practicing these methods pre-emptively. Patients will learn to do this in our programs. Abstinence violation effect can be overcome, but it is far better to avoid suffering AVE in the first place. Enroll in Amethyst Recovery, and you’ll learn the skills you need to practice effective relapse prevention. This is a program of growth and learning. Don’t put off your recovery. Contact us today.