[Carolyn L. Todd, SELF]
It’s hard to know how to react. These addiction treatment providers can help.
If someone you love is dealing with addiction, you’ve probably experienced a range of emotions from fear to anger to deep sadness and hope. Millions of people are right there with you. In 2017, 19.7 million Americans ages 12 and over met the diagnostic criteria for dependence on alcohol or illicit drugs at some point in the previous year, according to the National Survey on Drug Use and Health. Those people have friends and family in your very shoes.
One tough aspect of this experience is determining how to react if your loved one relapses. While every situation is different, some approaches tend to be more effective—and kinder—than others. Here are three things you should avoid saying to a friend or family member after a relapse and six you should try instead.
Don’t say these:
1. “Why did you screw up your good streak?”
Questions or comments like, “How could you let this happen?” and, “I can’t believe you started drinking/using drugs again” imply your loved one is at fault. It’s critical to understand the true nature of substance use disorders: Addiction is a disease, not a choice. Still, persistent stigma about addiction can misshape the way even the best-intentioned person views relapses.
“So much of the way people conceive of addiction is that it’s some sort of volitional disease,” psychiatrist Timothy Brennan, M.D., director of the Addiction Institute at Mount Sinai West and Mount Sinai St. Luke’s Hospitals and director of the Fellowship in Addiction Medicine Program at the Icahn School of Medicine, tells SELF. “A relapse to many people seems like something somebody chose.” But just like you wouldn’t blame a loved one whose brain cancer returned, it’s not fair to point the finger at someone who relapses, he explains.
2. “I’m so pissed at you right now.”
It’s natural to feel angry when someone you love relapses, and understanding the nature of addiction may help you realize whether or not any of that anger is misplaced. If you’re able to express how your loved one’s actions have affected you without shaming them, that’s perfectly OK. But it’s highly unlikely that expressing any kind of acrimony or rage is going to do any good.
“Many people feel horrible about themselves when they’ve suffered a relapse,” Dr. Brennan says. “Piling on is not likely to be of much benefit [because] we know that people are not motivated by anger or resentment.” You’ll only be adding to the mountain of guilt and self-loathing the person may already be bearing.
If you’re feeling frustrated, Dr. Brennan suggests venting to a third party you can trust, whether that’s a friend, therapist, or people in a support group (more on that later). You could also try journaling, if that’s more your speed.
3. “It’s time to try XYZ treatment.”
Dr. Brennan puts it well: If you polled people about the best treatment for, say, chronic kidney disease, they would probably respond, “I don’t know, ask a doctor.” When it comes to addiction, people usually feel more comfortable offering up treatment advice.
“Oftentimes, a family member will decide, ‘I know what she needs. She needs to go off to rehab.’ And the patient has no interest in rehab,” Dr. Brennan says. “But maybe the patient would be interested in going to an outpatient clinic twice a week.”
Of course, if your loved one is suffering, it’s incredibly tempting to give them advice that you truly believe could help. But try to remember that the type of treatment your loved one and their care team decide to try might be different than what you envisioned. “There's a lot of variability in what treatment plan will work for a person,” Larissa Mooney, M.D., associate clinical professor in the UCLA Department of Psychiatry and Biobehavioral Sciences and director of the UCLA Addiction Medicine Clinic, tells SELF. “Respect their decision about the path that’s right for them.”
Here are some potentially helpful things to say instead:
1. “This doesn’t mean you’ve failed. It just means you might need more help.”
You may have heard the phrase “relapse is part of recovery.” That’s true for many people. “Relapse is not an inevitable component of addiction, but [it is] certainly a very common component of addiction,” Dr. Brennan says. Reminding your loved one that many people relapse before achieving stable and lasting sobriety may make them feel less alone.
Although relapsing doesn’t mean someone is a failure, it does suggest that their current treatment may not be adequate in some way, Dr. Mooney says. Bringing that up may help get your loved one on the path to more effective treatment. John Bachman, Ph.D, a psychologist at the El Dorado County Community Health Center who specializes in helping patients with addiction and substance use issues, suggests saying something like, “Maybe this treatment isn’t all that you need, and maybe this relapse is telling us that. Why don’t we consult your therapist/addiction counselor/other professional, and see what other treatment options might be available?”
2. “I know you didn’t want this, and I don’t hold you personally responsible.”
Even if you don’t express any resentment, your loved one may feel so ashamed that they assume everyone is being as hard on them as they are on themselves. That’s why it’s helpful to explicitly reaffirm that you don’t blame them for their relapse.
“Unburdening them from the idea that they have gone out and done this of their own will is really empowering,” Dr. Brennan says. This doesn’t mean not holding the person accountable for the consequences of their actions or acting like they don’t require treatment, he notes, but this show of empathy could mean the world to them.
3. “I’m here for you through thick and thin.”
Expressing your unconditional love and support may be one of the kindest things you can do. Let them know that you are there for them—relapse or not, three days sober or 300. Dr. Brennan suggests something like, “Just like I was there for you before, I’ll be there for you for this. I was there for you in the good times, and [I’m] also going to be there in the bad times.”
This might be especially powerful if the person lied to or otherwise hurt you during their relapse, Dr. Mooney says, because it can relieve them of the fear that they have irreversibly damaged your relationship. “They may know that they’ve broken some trust. I think what people are often seeking is an opportunity to rebuild that trust,” Dr. Mooney says.
The major caveat here is that you should only say this if you mean it. Depending on your relationship with the person and the circumstances of their relapse, you may feel you need to institute some boundaries or can’t have them in your life right now. Talking with a therapist or addiction counselor can help you determine how to go about this in the most constructive and compassionate way possible. We’ll get into how to find that kind of support in a bit.
4. “Did you learn anything about your addiction or sobriety from this relapse?”
Discussing a relapse with a supportive listener can be a valuable learning experience for someone with an addiction, Bachman says. For example, they might be able to pinpoint triggers that prompted them to engaged in substance use again.
Like everything else, it’s important to ask this question without judgment, Dr. Brennan says. If you’re concerned about sounding patronizing, you can say something like, “I don’t mean to sound preachy—has this relapse given you any insight into your addiction? I’m wondering if you’ve discovered something that can help as you get back on this path.” You can also encourage them to discuss this question with their therapist or addiction counselor.
5. “What’s the best way for me to support you right now?”
Given that everyone experiences addiction and relapse differently, it’s never a bad idea to ask what the person needs from you instead of assuming, Dr. Mooney says. Dr. Brennan suggests something like, “Is there anything I can do to help you in this period? Because I want to make sure we get you back to a place of happiness and security.”
It may be emotional support in the form of lending an ear or expressing encouragement. Or it may be something practical, like not keeping wine in the house or driving the person to their therapist, treatment center, or group meeting.
6. “You’ve been sober before, and I believe you can get there again.”
It’s not uncommon for a person who’s relapsed to feel discouraged and get into a pattern of negative thinking. Shifting the focus to their successes in the past and the potential for success again can be helpful, Dr. Mooney says. She suggests something like, “I know you can do it because you’ve done it before.”
This reminds the person that they do have the capacity to be sober, even though it may feel impossible in the moment. “Those days of sobriety happened. They matter. They mean something,” Dr. Brennan says.
One way to help them find a realistic sense of optimism is to tap back into their motivations for getting sober, Bachman says. Ask what inspired them to seek treatment before. Maybe it’s being a better parent, taking care of their health, being a role model for their little sibling, or running a marathon. Whatever the response, reiterate how valid those reasons are.
Through it all, remember that you are ultimately not responsible for another person’s wellness.
“At the end of the day, the person has to want [sobriety] and take the steps to reconnect with their treatment providers,” Dr. Mooney says. This is something you can support with your words and actions, but the tough reality is that making it actually happen is out of your hands.
Just as you can’t blame the person for their relapse, you can’t condemn yourself, either. “We see this time and again with family, where some family members blame themselves for a patient’s relapse,” Dr. Brennan says. “Don’t [believe you must] be their therapist, their psychiatrist, and their [Alcoholics Anonymous] sponsor. That support exists.”
Finally, don’t forget to take care of yourself, too.
It’s important to reach out for help if it feels like it’s all getting to be too much, Dr. Mooney says. This may take the form of individual counseling, like speaking with a therapist who specializes in addiction and recovery. There are also support groups you can join, such as Al-Anon (for people whose loved ones are addicted to alcohol) and Nar-Anon (for people whose loved ones are dealing with addiction in general). Resources such as the Substance Abuse and Mental Health Services Administration’s 24/7 helpline (1-800-662-4357) can point you toward local support groups and helpful organizations.
“There’s a long tradition of support networks for people who are dealing with family members and loved ones with addiction,” Dr. Brennan says. “These can be helpful because you realize how many other people are feeling the same way.” It might seem like you’re alone in this, but people out there want to help you—even if you haven’t met them yet.
