Many patients have asked me if I could tell them why so many people relapse. They often quote friends in AA who subscribe to the philosophy that relapse is part of addiction. After so many years in this field, I am reluctant to support that idea. My personal experience tells me that we can change external behaviors. We can encourage and support those who stop participating in negative actions. We can teach patients about triggers, urges and cravings and the journey towards relapse prevention. But the data demonstrates that most will relapse. Why?
My theory is that each person with an addiction has a core issue - usually emerging in childhood and unresolved. It could be abandonment, abuse of some sort, neglect, punishment, gender struggles or a host of other traumas that children are subjected to. Only the person him or herself can identify that issue. Until they recognize and acknowledge that issue and make a conscious effort to deal with it in some therapetic way, they will fall back on what they know - drinking, drugging, gambling or other addictive behaviors. We can put a bandaid on a deep cut and it will heal from the outside. Or we can debris the cut and then bandage it and it will heal from the inside out. Clean up the core issue and the healing will begin.
