.....And Then What?

Every addict thinks about relapse. That's an inevitable part of the recovery process. When I counsel people who have addictive disorders, I recommend they keep a three-word question handy whenever they ponder the possibility of relapsing. The question is: ".....And then what?"

Here's an example:

An alcoholic thinks about having just one beer but then asks himself ".....And then what?". (It will taste great.) ".....And then what?" (I'll probably have another.) ".....And then what?" (I'll start thinking I can drink normally.) ".....And then what?" (I'll do OK for a few weeks.) "And then what?" (I'll start drinking every day again.) ".....And then what?" (I'll get depressed because I let myself down.) ".....And then what?" (I'll sink into depression.) ".....And then what?" (Oh man, I don't even want to go there!)

Any addictive or compulsive disorder distorts the ability of the brain to effectively regulate the neurochemicals that are responsible for managing pleasure and survival. This is true whether the emotional dysregulation stems from drugs, lust, gambling, or any other behavior that sets into motion the brain's faulty neurochemical reaction.

One inevitable result is that an abstinent addict is occasionally going to fantasize about reclaiming his or her familiar altered mood. Usually the fantasy is one that stops at the moment of the "high". The cigarette addict thinks about the immediate satisfying relief of that first puff. The crack addict remembers the rush when the hit reaches the brain a few seconds after inhalation. The sex addict's fantasy terminates at the point of orgasm.

In all of these cases the addict doesn't "complete the arc" of the fantasy: he or she doesn't spend much time reflecting on what happens when the rocket invariably crashes (and what comes up always comes down). This is where "....And then what" can be of immense service in connecting the temporary high with the lasting bottom that follows.

There are many other ways an addict can compensate for his or her inevitable central nervous system deficits. Connecting with other addicts, either in group formats such as A.A. or individually with a "sponsor", helps by strengthening the ability of the impaired neocortex to properly evaluate the uncontrolled impulses of the limbic system. No one strategy will be completely successful by itself, but "....And then what?" can be extremely useful in maintaining long-standing success in recovery over addiction.

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