Some Underlying Drivers of Chronic Relapse

There are many reasons I love working with people in recovery who struggle with ongoing slips and relapses. First of all, everyone who has come to me for help is committed to sobriety and desperate for the right type of help. By the time they get to me, there is no ambivalence left. They WANT to make a new life work for them but simply haven’t found the right key. Some people have given up trying by this point because no matter what they try, it doesn’t seem to work. They have been taught all the skills, they go to several meetings a day, and they revolve in and out of treatment programs but they still find themselves regularly using. And no one can explain why! This can lead to profound shame, despair, and anger at the system that keeps letting them down. 

So, when I help them identify the underlying drivers of cravings and relapse that have been missed, my clients are excited, hopeful, and bewildered that no-one had ever explained this to them before. In years past, many of the missing pieces had to do with untreated trauma and a lack of emotional management skills. Fortunately, the treatment world is catching up here. There are much more trauma-informed treatment and powerful trauma treatment strategies that didn’t exist before. Now, the danger can be that clinicians encourage their clients to engage in trauma recovery before the necessary sobriety and emotional management skills are in place. Proper timing is crucial here. 

Now, what I keep seeing time and again, is a big difference in eating behavior between those people who have an easier time successfully utilizing treatment and other recovery support, and those for whom it doesn’t seem to be enough. We need a BIG, formal research study around this observation. People who consistently eat healthy, protein-rich food seem to do much better than those who have never cared about what they feed themselves and frequently skip meals or eat a lot of non-nutritive food. This makes sense when we realize that human beings need a well-fed brain to function optimally. We all know what happens when we get “hangry”! 

Unfortunately, treatment providers haven’t been trained to help their clients connect the dots between emotional dysregulation, cravings, slips, and having skipped 1 or more healthy, protein-rich meals. I strongly believe that once this connection is understood and taught well, the relapse rate will significantly drop. The challenge is now to make nutrition part of the conversation. Many people seem to think that it is silly to think that what we eat matters to our recovery.  I don’t understand this. We don’t think it’s silly to feed our 5-year-old children nutritious food; why should adults deserve less?