It’s easy to conceive of relapses as one-time events that occur during times of weakness. If you’re like me, you may have recently watched the Netflix show, Cheer, and thought, “I’ve got to start working out more…” But surely that isn’t the first time you’ve told yourself that. From New Year’s resolutions to the start of a new school year in September, we seem to be obsessed with clean, fresh starts where we can completely transform ourselves and our habits. However, this mentality may be just the thing that keeps us from achieving our goals. These patterns can be actively identified and corrected, helping participants avoid lapses before they occur and continue their recovery from substance use disorder.
Marlatt notes that one of the most important aspects of handling abstinence violation effect is the need to develop our coping mechanisms. The result of this lackluster planning is that we recognize future disturbances, yet do nothing to truly resolve them. If we feel stress, anger or depression, we do not find healthy ways of confronting these feelings. We instead view these emotions as justifications of the negative cognition experienced under AVE. Our hopelessness and our instinctive desire to give up were spot-on, or else we would be happy all the time. Giving up on sobriety should never feel like a justified response to vulnerability.
As such, these cognitive constructs have both a stable and enduring effect emanating from the individual’s general cognitive beliefs as well as a malleable and plastic effect emanating from upon the individual’s moment-to-moment experiences. The AVE was introduced into the substance abuse literature within the context of the “relapse process” (Marlatt and Gordon 1985, p. 37). Relapse has been variously defined, depending on theoretical orientation, treatment goals, cultural context, and target substance (Miller 1996; White 2007).
In this model, treatment success is defined as achieving and sustaining total abstinence from alcohol and drugs, and readiness for treatment is conflated with commitment to abstinence (e.g., Harrell, Trenz, Scherer, Martins, & Latimer, 2013). Additionally, the system is punitive to those who do not achieve abstinence, as exemplified by the widespread practice of involuntary treatment discharge for those who return to use (White, Scott, Dennis, & Boyle, 2005). By the end of treatment, most gamblers will have experienced a prolonged abstinence from gambling. Marlatt & Gordon’s (1985) approach to relapse prevention with alcoholics provides a very useful framework https://ecosoberhouse.com/ within which to prevent relapse with gamblers (for a full discussion see Marlatt & Gordon, 1985).The most important aspect of this is to have gamblers understand that a lapse is not equivalent to a relapse. This realisation reduces the abstinence violation effect and ensures that patients no longer adhere to the “one drink, one drunk” mentality which leaves them at risk for relapse. The abstinence violation effect (AVE) occurs when an individual, having made a personal commitment to abstain from using a substance or to cease engaging in some other unwanted behavior, has an initial lapse whereby the substance or behavior is engaged in at least once.
A common pattern of self-regulation failure occurs for addicts and chronic dieters when they ‘fall off the wagon’ by consuming the addictive substance or violating their diets . Marlatt coined the term abstinence violation effect to refer to situations in which addicts respond to an initial indulgence by consuming even more of the forbidden substance . In one of the first studies to examine this effect, Herman and Mack experimentally violated the diets of dieters by requiring them to drink a milkshake, a high-calorie food, as part of a supposed taste perception study .
The second is assessing coping skills of the client and imparting general skills such as relaxation, meditation or positive self-talk or dealing with the situation using drink refusal skills in social contexts when under peer pressure through assertive communication6. One of the most critical predictors of relapse is the individual’s ability to utilize effective coping strategies in dealing with high-risk situations. Coping is defined as the thoughts and behaviours used to manage the internal and external demands of situations that are appraised abstinence violation effect as stressful. A person who can execute effective coping strategies (e.g. a behavioural strategy, such as leaving the situation, or a cognitive strategy, such as positive self-talk) is less likely to relapse compared with a person lacking those skills. Moreover, people who have coped successfully with high-risk situations are assumed to experience a heightened sense of self-efficacy4. Marlatt, based on clinical data, describes categories of relapse determinants which help in developing a detailed taxonomy of high-risk situations.
The AVE occurs when the person attributes the cause of the initial lapse (the first violation of abstinence) to internal, stable, and global factors within (e.g., lack of willpower or the underlying addiction or disease). The abstinence violation effect, described by the famous substance abuse researcher Alan Marlatt, occurs when someone who was made a commitment to abstinence suffers an initial lapse that they define as a violation of their abstinence. This perceived violation results in the person making an internal explanation to explain why they drank (or used drugs) and then becoming more likely to continue drinking (or using drugs) in order to cope with their own guilt. An individual who feels guilt often uses substances to ease their guilt, which can lead to AVE. Guilt is a difficult emotion for someone to bear, one that can constantly replay in their minds, leading them to use substances again.
In psychology, relapses are seen as the result of an accumulation of events, not a single event. They are the result of a series of events occurring over the course of time, explains psychologist Alan Marlatt, Ph.D. Abstinence is complete and total avoidance of an activity such as drinking, sex, shopping, or gambling.
In addition, many individuals in recovery consider a single slip as a full-blown relapse. When one returns to substance use after a period of abstinence, they experience a negative cognitive and affective reaction known as an abstinence violation effect in psychotherapy. An individual may experience uncontrollable, stable attributions and feelings of shame and guilt after relapsing as a result of AVE. Oxford English Dictionary defines motivation as “the conscious or unconscious stimulus for action towards a desired goal provided by psychological or social factors; that which gives purpose or direction to behaviour.