How is it that those behaviors which have kept one sober and stood the test of time are known clearly and then forgotten immediately when one's spiritual condition suffers and the addictive mind kicks in? Call your sponsor, get to a meeting, pray, ask for help. How can one read/do the same thing over and over and know it works—and then throw it aside in favor of some lame excuse? When we think of relapse prevention, we need to look at how habitual recovery behaviors are established and reinforced, especially those which build a spiritual life of meaning. Forming a habit is a three-step process: Cue/Reminder: the trigger that initiates the behavior; Routine: the behavior itself; and Reward: the benefit gained from doing the behavior It should be a simple matter of substituting a new routine in response to a cue; i.e.: instead of drinking in response to stress, I call my sponsor, go to a meeting, or take a bubble bath. The reward, of course, is peace and serenity—or at least not using. Sometimes it happens just this way. However, human memory and motivation often fail. One cannot will themselves into new routines or even to consistently remember to do new routines. Ambivalence seems to be the norm for human beings ("On the one hand this, and on the other hand that"). Another way to build self-efficacy would be if I set the new routine next to something I always do. Maybe then I'll be able to establish new habits. Maybe I put the floss next to my toothbrush and I am cued by brushing my teeth (something I do daily) to flossing my teeth (something I am trying to establish). Or when I sit down to eat, I say something I am grateful for; in order to build a spiritual condition. To implement this idea I could make three lists: Those activities I do daily without fail; The things that happen to me each day without fail, and All the recovery behaviors that will build a spiritual life. Then I start pinning desired behavior/routine for an increased spiritual life to activities I always do, so I have that daily reprieve the Big Book speaks about. Patterns of Thought that Lead to Relapse Chapter Three of the Big Book, titled, "More About Alcoholism," describes a number of people exhibiting behaviors the book calls "curious mental phenomenon," or mental blank spots. Three examples from that chapter were people who had established sobriety. They each held common beliefs that lead to relapse: One had "failed to enlarge his spiritual life," believing a textbook understanding was sufficient; another thought his long period of sobriety meant he could control his use; and another had a great deal of willpower. Al Tighe, in his book, Stop the Chaos, describes a four-stage relapse process that is clearly understood and to the point. The first stage begins with a change of attitude that others may be aware of before we are. Stage two continues with a re-emergence of old behaviors and thinking. Stage three manifests a physical and/or emotional withdrawal from AA/NA and other people. Stage four would be a behavioral or an emotional crisis where return to use happens unconsciously. It is true that one's addiction cannot be reduced to just a bad habit, and the true biological, psychological, social components cannot be addressed fully by developing new habits. We have the Twelve Steps and the Principles set down in the Big Book to reveal the need for spiritual development, the fellowship of recovery, and education regarding the disease; but when it comes to a relapse prevention plan, I believe habit formation is key. What I do in any given situation is about the cue, the response/routine, and the reward. The relapse prevention workshop, offered twice per year at the Dan Anderson Renewal Center (see? We even made the workshop a habit), looks at habits and building a relapse prevention plan that is concrete and specific for the individual. Hope to see you there. Jay Stackhouse, LADC, is a licensed alcohol and drug counselor who has worked at the Hazelden Betty Ford Foundation in a variety of positions since 2004. He lectures regularly on the disease of addiction, symptoms and phases of the disease, and Chapter 3 from the Big Book. His retreat, Preventing Relapse will be held in March and November at the Dan Anderson Renewal Center in Center City, MN.