It arises when a person starts to feel that when a lapse occurs, it is indicative of a moral failure, loss of hope for continued recovery, or proof that recovery is ultimately not possible. This is a common risk factor, but psychologists, rehabilitation professionals, and treatment centers work hard to combat it because it’s generally not constructive for the individual’s future success. Once relapsed, this strongly held belief increases the likelihood of relapse. 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. 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.
For many with serious substance abuse problems, any drug or alcohol use can be problematic. If they drink or drug again, they can slip into full-blown relapse, even after months or years of abstinence. For some, even a brief lapse may generate so much self-doubt, guilt, and a belief about personal failure, that the person gives up and continues to use. The AVE in addiction is systemic, and some experts believe that too few treatment modalities identify both the mechanisms that lead to addictive disorders and the ones that keep them in place, even years after a client abstinence violation effect seems to have recovered. Focusing on recovery as a continual path of growth, learning, and changing can be one of the most important ways that clinicians and individuals with substance use disorders can counter the inaccuracies present in the way we think about addiction.
After 5 years of sobriety, someone had a glass of champagne at a wedding and then felt that they had wasted their 5 years of sobriety and would have to start over anyway, so they ended up going on a binge for the next 18 months for fear of having to “start over”. If you view your lapse as a mistake and as a product of external triggers, rather than as a personal failure, research shows that you will have a much better chance of return to abstinence quickly. Your lapse becomes a tool to move forward and to strengthen your motivation to change, your identification of triggers and urge-controlling techniques, your rational coping skills, and the lifestyle changes needed to lead a more balanced life. I’ve heard of AA meetings where a member with over 10 years of sobriety ends up drinking (let’s say as an attempt to cope with the loss of a loved one or other tragic event).
You don’t have to wait until a relapse occurs to seek help if you are concerned that you might be headed for a relapse. There are some common early psychological signs that you might be on the way to a relapse. Advocates of nonabstinence approaches often point to indirect evidence, including research examining reasons people with SUD do and do not enter treatment. This literature – most of which has been conducted in the U.S. – suggests a strong link between abstinence goals and treatment entry. The study was especially notable because most other treatment readiness measures have been validated on treatment-seeking samples (see Freyer et al., 2004).
In a similar fashion, the nature of these attributions determines whether the violation will lead to full-blown relapse. In conclusion, the abstinence violation effect is a psychological effect that impacts those in recovery, as well as those who are focused on making more positive behavioral choices in their lives. By reframing lapses as learning opportunities and teachable moments, cultivating self-compassion, and seeking support, individuals can navigate these challenges more effectively, increasing their chances of leading a healthier lifestyle. Self-efficacy is defined as Alcoholics Anonymous the degree to which an individual feels confident and capable of performing certain behaviour in a specific situational context5. Although many view recovery as a static state that must be achieved, practitioners and individuals working to combat the AVE recognize that recovery is a spectrum, and that lapse and relapse operate on that spectrum.
Taylor uses an app to watch her intake of calorie limit and does see positive outcomes to her new lifestyle. One night, she craves pizza and wings, orders out, and goes over her calories for the day. CP conceptualized the manuscript, conducted literature searches, synthesized the literature, and wrote the first draft of the manuscript. SD assisted with conceptualization of the review, and SD and KW both identified relevant literature for the review and provided critical review, commentary and revision. Set realistic expectations for your recovery journey, understanding that progress may not always be linear. Depending on the substance used, addiction may also have the potential to damage the brain itself.
Taylor may think, “All that good work down the drain, I am never going to be able to keep this up for my life.” Like Jim, this may also trigger a negative mindset and a return to unhealthy eating and a lack of physical exercise. The abstinence violation effect is a complex phenomenon that usually needs to be approached from several different directions to be handled effectively.