Some Sure-fire Causes of Relapse

Version H 7/5/2000

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>We have heard them called "slips", "falls", "relapses" and you-name-it. The import is that the alcoholic—usually having achieved some sobriety —returns to the bottle. Lest we allow newcomers to think they can get drunk again by stepping on a banana peel, it is advisable to label these regressions as "leaps" or, at least "relapses" to convey the certain message that we are always aware that we are taking that next drink. It doesn't just happen to us. At some point in the process we have invariably said "Yes".

The Dictionary on RELAPSE 

1. To slip back into a former condition after a change for the better;
specif., to become ill again after convalescing, to revert to evil
habits after amendment, etc.

2. To sink; lapse; as, to relapse into a stupor.


Our goal here is to explore the causes of alcoholic relapse, specifically, the causes set forth by the Big Book, Alcoholics Anonymous. You may also wish to take the Bottle Inventory , which analyzes the allure of the bottle's contents.

Before looking at causes, though, it will be enlightening to see some of the consequences of relapse. We know an old codger who always asks recent slippers what happened as a consequence of their drinking. He points out that they have been out scouting for the rest of us, and he volunteers to count their arrows with them—the ones they got shot with, that is. He suggests that his newly injured friend label each arrow and that he fasten it to a wall at home, when it's finally pulled out, as a reminder of his spree. If a museum is ever stocked with these trophies, the show-case might have Relapse Trophies with labels such as: Jail, Homeless, Broke, Hospitalized, Fired from job, Divorced, Rejected, Despondent, etc..

Causes of RELAPSE
(as offered in AA meetings)

1. Failure to go to AA meetings.
2. Failure to take the 12 steps.
3. Involvement in an emotional relationship.
4. Association with the old crowd.
5. Failure to get a sponsor.
6. Failure to read the Big Book.
7. Failure to get a job.
7. Desire to achieve oblivion.
8. etc.

Causes of Relapse we hear in meetings. It is also interesting to think of the causes most frequently offered in AA meetings by those just returning from scouting research, or from those who tried to steer them away from it.

We think most would agree that the conventional wisdom concerning relapse as contributed in AA meetings has real value. However, not a single one of the causes in the list above is presented explicitly in the Big Book as a cause of relapse.

Causes of Relapse in the Big Book. Some 22 Big Book statements have been extracted. These are quoted later. We have left out the traditional must statements, and we have included only clear cut assertions that the alcoholic will get drunk if he does (or doesn't do) that which is described. [Actually, we did slip up by including two additional statements that just had to be in our list.]

Here is a distillation of Big Book causes of relapse:

Causes of RELAPSE
(according to the Big Book)

  7 .. a. Failure to grow spiritually
  4 .. b. Fighting with or harming others.
  3 ...c. Failure to work with other alcoholics
  2 .. d  Failure to take step 5.
  2 .. e. Attempt to shield from alcohol.
  2 ..  f. Failure to make amends.
  1 .. g. Selfishness.
  1 .. h. Resentment.

( 22 examples of relapse causes selected)

We had some thoughts as to why the 'Big Book list seems to differ from that heard at meetings.

The Big Book items reflect the founder's concentration upon, "...the mental states that precede a relapse into drinking, for obviously this is the crux of the problem." [Big Book, page 35, line 1]

The Big Book items can be restructured within the twelve steps without much reshaping or cramming. We have listed them in such a step orientation in the pages that follow.

Our efforts to select and categorize 22 causes of relapse from the Big Book can certainly be improved upon. Perhaps a more capable person, such as yourself, might get and present a different and better set. Go for it!

22 Causes of relapse from the Big Book

(numbered in the order in which they appear in the book)

STEP 2—Failure to keep on believing

3) Faith has to work twenty-four hours a day in and through us, or we perish. [Big Book page 16, line 12]

STEP 3—Failure to maintain the Decision

22) Whether the family goes on a spiritual basis or not, the alcoholic member has to if he would recover. [Big Book page 135, line 1]

STEP 5—Failure to make confession

9) We will be more reconciled to discussing ourselves with another person when we see good reasons why we should do so. The best reason first: If we skip this vital step, we may not overcome drinking. Time after time newcomers have tried to keep to themselves certain facts about their lives. Trying to avoid this humbling experience, they have turned to easier methods. Almost invariably they got drunk. Having persevered with the rest of the program, they wondered why they fell. We think the reason is that they never completed their housecleaning. They took inventory all right, but hung on to some of the worst items in stock. They only thought they had lost their egoism and fear; they only thought they had humbled themselves. But they had not learned enough of humility, fearlessness and honesty, in the sense we find it necessary, until they told someone else all their life story. [Big Book page 72, line 28]

10) He trembles to think someone might have observed him. As fast as he can, he pushed these memories far inside himself. He hopes they will never see the light of day. He is under constant fear and tension—that makes for more drinking. [Big Book page 73, line 19]

STEP 7—Failure to remove Our Shortcomings

6) So our troubles, we think, are basically of our own making. They arise out of ourselves, and the alcoholic is an extreme example of self-will run riot, though he usually doesn't think so. Above everything, we alcoholics must be rid of the selfishness. We must, or it kills us! [Big Book page 62, line 14]

7) But with the alcoholic, whose hope is the maintenance and growth of a spiritual experience, this business of resentment is infinitely grave. We found that it is fatal. For when harboring such feelings we shut ourselves off from the sunlight of the Spirit. The insanity of alcohol returns and we drink again. And with us, to drink is to die. [Big Book page 66, line 13]

16) In our belief any scheme of combating alcoholism which proposes to shield the sick man from temptation is doomed to failure. If the alcoholic tries to shield himself he may succeed for a time, but he usually winds up with a bigger explosion than ever. We have tried these methods. These attempts to do the impossible have always failed. [Big Book page 101, line 16]

17) After all, our problems were of our own making. Bottles were only a symbol. Besides, we have stopped fighting anybody or anything. We have to! [Big Book page 103, line 18]

19) We never, never try to arrange a man's life so as to shield him from temptation. The slightest disposition on your part to guide his appointments or his affairs so he will not be tempted will be noticed. Make him feel absolutely free to come and go as he likes. This is important. If he gets drunk, don't blame yourself. God has either removed your husband's liquor problem or He has not. If not, it had better be found out right away. Then you and your husband can get right down to fundamentals. If a repetition is to be prevented, place the problem, along with everything else, in God's hands. [Big Book page 120, line 22]

STEP 9—Failure to make amends

11) Arranging the best deal we can we let these people know we are sorry. Our drinking has made us slow to pay. We must lose our fear of creditors no matter how far we have to go, for we are liable to drink if we are afraid to face them. [Big Book page 78, line 12]

12) After consulting with his wife and partner he came to the conclusion that it was better to take those risks than to stand before his Creator guilty of such ruinous slander. He saw that he had to place the outcome in God's hands or he would soon start drinking again, and all would be lost anyhow. [Big Book page 80, line 21]

STEP 10—Failure to make daily Inventory & Amends

8) Suppose we fall short of the chosen ideal and stumble? Does this mean we are going to get drunk? Some people tell us so. But this is only a half-truth. It depends on us and on our motives. If we are sorry for what we have done, and have the honest desire to let God take us to better things, we believe we will be forgiven and will have learned our lesson. If we are not sorry, and our conduct continues to harm others, we are quite sure to drink. We are not theorizing. These are facts out of our experience. [Big Book page 70, line 5]

15) After they have seen tangible results, the family will perhaps want to go along. These things will come to pass naturally and in good time provided, however, the alcoholic continues to demonstrate that he can be sober, considerate, and helpful, regardless of what anyone says or does. Of course, we all fall much below this standard many times. But we must try to repair the damage immediately lest we pay the penalty by a spree. [Big Book page 99, line 9]

20) In the first flush of spiritual experience they forgave each other and drew closer together. The miracle of reconciliation was at hand. Then, under one provocation or another, the aggrieved one would unearth the old affair and angrily cast its ashes about. A few of us have had these growing pains and they hurt a great deal. Husbands and wives have sometimes been obliged to separate for a time until new perspective, new victory over hurt pride could be rewon. In most cases, the alcoholic survived this ordeal without relapse, but not always. So we think that unless some good and useful purpose is to be served, past occurrences should not be discussed. [Big Book page 124, line 25]

STEP 11—Failure to engage in Prayer & Meditation

5) All went well for a time, but he failed to enlarge his spiritual life. To his consternation, he found himself drunk half a dozen times in rapid succession. [Big Book page 35, line 27]

13) It is easy to let up on the spiritual program of action and rest on our laurels. We are headed for trouble if we do, for alcohol is a subtle foe. We are not cured of alcoholism. What we really have is a daily reprieve contingent on the maintenance of our spiritual condition. Every day is a day when we must carry the vision of God's will into all of our activities. "How can I best serve Thee-Thy will (not mine) be done." These are thoughts which must go with us constantly. We can exercise our will power along this line all we wish. It is the proper use of the will. [Big Book page 85, line 13]

18) Perhaps your husband will make a fair start on the new basis, but just as things are going beautifully he dismays you by coming home drunk. If you are satisfied he really wants to get over drinking, you need not be alarmed. Though it is infinitely better that he have no relapse at all, as has been true with many of our men, it is by no means a bad thing in some cases. Your husband will see at once that he must redouble his spiritual activities if he expects to survive. [Big Book page 120, line 6]

STEP 12—Failure to have Spiritual Experience

1) the sense of ease and comfort which comes at once by taking a few drinks—drinks which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to drink again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery. [Big Book page xxvii, line 1]

STEP 12—Failure to Practice These Principles

4) Most of us sense that real tolerance of other people's shortcomings and viewpoints and a respect for their opinions are attitudes which make us more useful to others. Our very lives, as ex-problem drinkers, depend upon our constant thought of others and how we may help meet their needs. [Big Book page 19, line 30]

2) My friend had emphasized the absolute necessity of demonstrating these principles in all my affairs. Particularly was it imperative to work with others as he had worked with me. Faith without works was dead, he said. And how appallingly true for the alcoholic! For if an alcoholic failed to perfect and enlarge his spiritual life through work and self-sacrifice for others, he could not survive the certain trails and low spots ahead. If he did not work, he would surely drink again, and if he drank, he would surely die. Then faith would be dead indeed. With us it is just like that. [Big Book page 14, line 28]

STEP 12—Failure to Carry the AA Message

14) PRACTICAL EXPERIENCE shows that nothing will so much insure immunity from drinking as intensive work with other alcoholics. It works when other activities fail. [Big Book page 89, line 51]

21) ...let him go as far as he likes in helping other alcoholics. During those first days of convalescence, this will do more to insure his sobriety than anything else. Though some of his manifestations are alarming and disagreeable, we think dad will be on a firmer foundation than the man who is placing business or professional success ahead of spiritual development. He will be less likely to drink again, and anything is preferable to that. [Big Book page 129, line 30]

1) the sense of ease and comfort which comes at once by taking a few drinks—drinks which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to drink again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery. [Big Book page xxvii, line 1]

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