Stages of PTSD – Coping With a Slip in Recovery

You Can Bounce Back After Returning to Unhealthy Habits

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One of the common stages of PTSD is a slip in recovery. Recovering from PTSD can often be a long journey – so don't judge yourself too harshly if you've slipped. Instead, learn how to get back on track.

What Happens When People With PTSD Have a Slip in Recovery?

People who have a diagnosis of PTSD are at greater risk of engaging in a number of unhealthy behaviors in an attempt to cope with their emotional pain. These can include:

These behaviors are not easy to stop because they often serve a very important purpose for a person with PTSD. In the short-term, they may help a person escape the frequent, intense and unpleasant thoughts and emotions that occur with PTSD.

Even with the best intentions and coping skills, a person recovering from PTSD may find that under periods of high stress they may slip and start engaging in one of these behaviors again. Again, slipping back into these behaviors is a common stage of PTSD.

All is not lost! There are ways of coping with a slip so that you can quickly get back on your road to recovery.

If you or a loved one are struggling with PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

How You Can Stop the Behavior 

Obviously, this is the most important step - and the hardest. It's incredibly important to do whatever you can to stop the unhealthy behavior as soon as you catch yourself doing it. This is because it can be very easy to fall back into old patterns of behavior, and the more that you engage in that behavior, the stronger that habit is going to become. Here are strategies that work:

  • View it as a slip, not a failure. One way that might make it easier to stop the behavior is by viewing it as only a slip or a temporary misstep and not an indication of failure or a sign that there is no hope for recovery. During recovery, it's common for people to set hard and fast rules for themselves, such as "I will never have another drink again." This may be a great goal. However, it may not always be realistic, especially for the person who is in the early stages of recovery from PTSD. When you set black-and-white rules for yourself, you're more likely to beat yourself up about a slip, and this is probably only going to motivate the very behavior you are trying to stop. As a result, you may lose control over the behavior and fall farther and farther off track.
  • Avoid your triggers. If you're in a situation that is promoting your unhealthy behavior (for example, you're in a bar while you're trying to stop drinking), get out of that situation as soon as you can. It will be very important to remove yourself from any triggers or cues for that behavior (or the emotions that contribute to that behavior) that are in your environment.
  • Put into action a healthy coping strategy. For example, seek out social support or use distraction. Try some self-soothing exercises or mindfulness. These may be very hard to do during a crisis situation, and you may not feel as though they're working that well. However, it is very important to keep using those healthy coping strategies. The more you do, the more distance you will put between yourself and your unhealthy behavior.

Learning From Your Experience

A slip can provide you with incredibly important information that can serve you well in the future.

When you slip, conduct a chain analysis. Ask yourself: What were the factors that led to that behavior? How did I get put into a high-risk situation? Conducting a chain analysis for the unhealthy behavior may help you identify "seemingly irrelevant decisions."

Seemingly irrelevant decisions are decisions or choices we make that, on the surface, may appear unimportant or insignificant. We may also ignore, deny or explain away the importance of them. But in actuality, they move you farther down the road to a slip. For example, for a person who is trying to stop engaging in deliberate self-harm, a seemingly irrelevant decision might be keeping items around that were once used to self-harm.

Recognizing seemingly irrelevant decisions, as well as other factors or situations that put you at risk for your unhealthy behavior, will help you prepare for future high-risk situations. You can now ask yourself: What could I have done differently? How early could I have intervened to reduce my risk for engaging in the behavior?

Practice Self-Compassion

Changing unhealthy behaviors is not an easy thing to do, especially when you may also be struggling with symptoms of PTSD. Because of this, treat yourself with understanding and self-compassion if you slip. Use the misstep as an opportunity to further build and strengthen your coping repertoire. Doing this can help you get back on track and move you down the road to recovery.

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  • Marlatt, G.A., & Gordon, J.R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York, NY: Guilford Press.