# Coping with a Slip: Getting Back on the Track to Recovery from PTSD



## Daniel (Feb 10, 2009)

Coping with a Slip: Getting Back on the Track to Recovery from PTSD
By Matthew Tull, PhD, About.com
Updated January 27, 2009

Recovery from PTSD can often be a long journey, and it is common for people to slip every now and then. 

People who have a diagnosis of PTSD are at greater risk to engage in a number of unhealthy behaviors in an attempt to cope with their emotional pain, including alcohol and drug abuse, eating disorder behavior (for example, binge eating), and deliberate self-harm. These behaviors are not easy to stop as they are often serving a very important purpose for a person with PTSD. Specifically, in the short-term, they may help a person escape the frequent, intense, and unpleasant thoughts and emotions that occur with PTSD.

Given this, even with the best intentions and coping skills, a person may find that under periods of high stress they may slip and start engaging in one of these behaviors again. However, all is not lost! There are ways of coping with a slip so that you can quickly get back on your road to recovery.
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Stopping the Behavior*
Obviously, this is the most important step and the hardest. It is 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.

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 is 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 early stages of recovery from PTSD.

When you set black and white rules for yourself, you are 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.

If you are in a situation that is promoting your unhealthy behavior (such as in a bar and you are 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 are 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 you and your unhealthy behavior.
*
Learn From Your Experience*
A slip can provide you with incredibly important information that can serve you well in the future. Conduct a chain analysis. What were the factors that led to that behavior? How did you 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. However, 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. What could you have done differently? How early do you think you could have intervened to reduce your 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 it 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.

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

More PTSD QuickTips from About.com


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## ladylore (Feb 10, 2009)

Might want to consider making this into a Sticky. Fantastic article.

One of the most important parts of it for me was: 



> 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 is 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 early stages of recovery from PTSD.



:thankyou:


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## Halo (Feb 10, 2009)

This article is absolutely amazing and I did go ahead and make it a Sticky.

Thanks Daniel, great find


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## Jazzey (Feb 10, 2009)

Thanks Daniel.  I didn't just want to leave it to a button thank you.  This was a great find with a lot of insightful information.  Thank you. 

While I haven't been diagnosed with PTSD, I think a lot of the strategies here apply to anyone who engages in self-destructive behaviours during difficult times.  I know that I have slipped and I like the message in this stickie.


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## texasgirl (Feb 10, 2009)

This really hit home to me..  I find it to be the best one I have seen.  And I agree with you, Robyn, that the section you pointed out is a critical one.  It is also how I hold on when I fall backwards into self-abusive behavior.  

Thanks Daniel!

TG


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## Halo (Feb 10, 2009)

Robyn, I re-read the portion that you had pointed out below and it describes exactly the trouble that I am having now:



> 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 is 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 early stages of recovery from PTSD.



It is encouraging that others have been in this situation, struggled and survived.


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## ladylore (Feb 11, 2009)

I have slipped 2x in that many years and I have been very hard on myself too. So, I understand that point of view. That is when living in the present and going day by day started to make real sense.

One never really knows because we all get curve balls thrown at us once in a while. That's why day by day works best for me because if I do anything else I start doing the what-if thing. That is a real dangerous place for me to go.


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## forgetmenot (Feb 11, 2009)

i will pass this along to my daughter thanks for the infor


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## Halo (Feb 11, 2009)

I keep coming back to this aticle because I can relate to it so much. This is exactly where I am at.



> *Stopping the Behavior*
> Obviously, this is the most important step and the hardest. It is 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.





> When you set black and white rules for yourself, you are 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.



Part of me wants to stop the behaviour but the other hurting part doesn't.


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## forgetmenot (Mar 8, 2009)

When you start setting black and white rules for yourself, now i understand this is.  What i do and when i fail i beat myself up alot. There has to be room for forgiveness to myself so i can try again.

Thanks great article 
Mary


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## Jazzey (Mar 8, 2009)

I do a lot of that myself Mary.  I've now been diagnosed with PTSD.  Which explains so much for me.

Now, when I slip I really focus on this:


> A slip can provide you with incredibly important information that can serve you well in the future. Conduct a chain analysis. What were the factors that led to that behavior? How did you get put into a high-risk situation? Conducting a chain analysis for the unhealthy behavior may help you identify "seemingly irrelevant decisions."



And, as the article suggests, I try and apply 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 it 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.



This one is a little harder for me at least. But understanding why I do what I do makes it a little easier for me...


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## forgetmenot (Mar 8, 2009)

Thanks Jazzey 

It's hard because I do see things as right or wrong, nothing in between. 

As for PTSD, my T says I have this but I don't know really. I just know when I'm in pain it is so hard to deal with it. It's overwhelming to exhaustion sometimes. So today I've kept so busy I haven't had time for it.

Thanks for all your support and suggestions.


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## SoSo (Apr 12, 2009)

Thanks Daniel...just read this post, don't know why, couldn't have come to me at a better time.  I was diagnosed with PTSD a few years back but told there is no 'cure' for it.  For the most part, have learned to control it or the triggers so the episodes have been few, until this month.  It will be a year since my father died, he never spoke a word to me before he died, not a word.  My mother disowned me after assuming something without asking what it was about from an email, hard month for me, also birthday coming up, then on the 21st cancer stuff starts again, etc.  This past week I have had 3 major episodes...awful ones, to do with the folks of course.  I just wanted to do something to make it all stop...go away.  I do not drink but have been binging, to the point I got sick.  I also started some minor SI again but not as bad as before.  Get tired of fighting with this stuff, with myself or my past to try to get better.  But...read this, thanks, realize it is ok to 'slip' or be 'weak' as I have been told over and over.  I will try to do something like I used to like a wear a rubber band to snap me back to the present, etc or do deep breathing, etc.  It just makes me feel like I am not such a darn 'loser' and that there is hope...maybe today I have slipped up...so what, right!  I have tomorrow, the next day and the next to start all over again.  For some reason this post made me very happy.
Feisty:thankyou2:


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## Auburn (May 22, 2009)

Thanks Daniel.   This is a wonderful article.  And, in a very nice way, kind of a kick in the butt!      I am trying to find better coping skills and not beat myself up as much, but that in itself can be a tough job.  I do my best to acknowledge my victories and accept when I slip.  I tell myself to keep fighting, for me and my family.   Thank you again, perfect timing today!


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