Psychological Self-Help

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which you give up your controlled behavior and fall back into the old
behavior. (Untrained or unread self-helpers fail about 80% of the time,
usually more near the start than after succeeding. But that is called a
failure, not a relapse.) A slight slip is called a "lapse;" total,
continuous, complete backsliding is called a "relapse." Why do
between 50% and 90% of program successes eventually relapse?
Probably because we don't focus enough on maintaining our gains, but
research is starting to show us how to avoid relapsing. 
First, Marlatt and others (Prochaska, Norcross & DiClemente,
1994) studied the circumstances in which people relapsed, called high-
risk situations. About 35% of the relapses occurred during periods of
negative emotions, such as depression, anger, stress, or boredom. An
additional 16% relapsed while having the same kind of feelings but in
a social situation--a conflict or argument with a spouse, relative,
friend, or co-worker. A health crisis in the family is a common cause.
Here again we find an important relationship between behavior and
emotions. About 20% relapsed under social pressure, either being with
people doing what you don't want to do (smoking a cigarette, using
drugs, eating) or being verbally pressured to participate ("Come on,
John, have a beer with us"). About 10% of the backsliders felt the
forbidden urge or temptation when all alone. None of this is a surprise
but it can help us search for the conditions that might reduce our self-
control. We all have our "weak times." Old temptations may return
months or years later. 
Prochaske, et al, found that certain mental mistakes lead to
relapse: (1) over-confidence ("I've got this drinking problem beat for
sure"), (2) self-testing ("I'll keep a bottle...some candy...some
cigarettes hidden in my desk just to prove I'm cured"), (3) self-
blaming ("My smoking made my kids sick and caused by husband to
start smoking again"). In short, some confidence is needed, but don't
get too much of it, don't get cocky! By denying the risks and
rationalizing one's risk-taking behavior, in effect the relapsing alcoholic
sets him/herself up for another failure (which he/she doesn't feel
responsible for). These cognitions must be attended to... and
challenged by the addict. 
Secondly, Marlatt and his colleagues recommend several methods
for avoiding relapses. Learn to recognize your own high-risk
situations by (a) considering the data above and in the following
paragraphs, (b) self-monitoring (see chapter 11) what's going on when
we are tempted or slip a little or relapse, (c) self-testing in fantasy
how well you would handle several high-risk situations (imagine how
would you respond if a good friend encouraged you to try cocaine?),
and (d) observing your lapse and relapse fantasies or temptations, i.e.
imagine how you might relapse. After identifying your dangerous
situations, you can avoid some and learn to cope with others. Certainly
take credit for avoiding the risky situations. 
But, also admit that getting into high-risk situations are a result of
a series of decisions you have made (without much awareness?),
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