If some of the major causes of relapse after drug rehab is stress, conflict and emotional upset, one of the best ways to resolve this is through improving listening skills. It is actually a skill which can be easily practiced before, during and after rehab. It is a skill we all need work in.

Active Listening

Active, effective listening is a habit and the basis of effective communication
Active listening intentionally focuses on who you are listening to, in a group or one-on-one, in order to understand what the speaker is saying
As the listener, you should then be able to repeat back in your own words what they have said to their satisfaction
This does not mean you agree with, but rather understand, what they are saying
(Active Listening, Study Guides and Strategies, http://www.studygs.net/index.htm)

Prepare to listen with a positive, engaged attitude

Focus your attention on the subject
Stop all non-relevant activities beforehand to orient yourself to the speaker and the topic
Review mentally what you already know about the subject
Organize in advance relevant material in order to develop it further (previous lectures, TV programs, newspaper articles, web sites, prior real life experience, etc.)
Avoid distractions
Seat yourself appropriately close to the speaker
Avoid distractions (a talkative neighbour, noise, etc.)

Acknowledge any emotional state
Suspend emotions until later, or
Passively participate unless you can control your emotions
Set aside your prejudices, your opinions
You are present to learn what the speaker has to say
Your recovery depends on how effectively you can gather information to plan your recovery

If anyone is to change the need to hear new ideas. These can only be presented and understood if you learn to listen without arguing or discounting them immediately in your head. Addictions involving alcohol and drugs involve repetitive thought patterns in your head. Rehab is the best place to break those patterns and and it all starts with improving your listening skills.

The first rule of conflict resolution is that conflict is inevitable

We all have needs which can be in competition with the needs of others.
Even the most compatible people will be in conflict about something.
Badly managed conflict can lead to worse conflicts.
Conflict that is managed well can be potentially constructive.

The Benefits of Conflict

We spend our lives trying to avoid conflicts with others. Why not get better at dealing with it? You can
Become more aware of the barriers to your effectiveness
Become more productive, spending less time brooding and worrying
Experience positive change
Become more knowledgeable and creative as you explore alternatives and points of view
Become more aware of otherâ??s feelings and desires
Become more mature, less self centered, as you focus on the needs of others
Release tension and stress as you solve problems
Become emotionally closer to people
Have fun exploring the intricacies of your relationships
(Page 4-5,Learning to Manage Conflict, Getting People to Work Together Productively, Maxwell Macmillan Canada Inc.,1993, Dean Tjosvold)

By reframing and looking at some of the conflicts in your life in a positive light you may be able to deal with them in a new less stressful manner. Less stress equals less emotion which translates into a decreased chance of relapse. Good advice for those in drug rehab and those leaving or completing rehab.

What is Conflict?

You know. Remember? Thatâ??s the time . . .
You argued with your parents because they wanted you to stop drinking or using drugs
You fought over money with someone
You told your friends there was no way they were going to get you to detox

Remember how it felt?

â??That which is not worked out will be acted outâ??
John Bradshaw

Conflict, Stress and Relapse
Addicts of all types relapse in response to stress related to unresolved interpersonal conflicts.
To prevent relapse conflicts must be identified and resolved .

What conflict in your life needs resolution?

Because addiction dulls awareness and causes people to focus predominantly on their own needs, those who have experienced an addiction have often been involved in situations that have provoked conflict.

With the law
Driving while under the influence
Destruction of property offences
Theft of property
Unpaid fines

With family
Separation or divorce
Estrangement from members of family
Child custody concerns

What other areas of your life might present conflict? When you entered a drug or alcohol rehab program for treatment, there were most likely a lot of conflicts left hanging. While in rehab hopefully different ways of resolving these conflicts were worked out, as if not they must be dealt with upon leaving drug rehab. If the old conflicts draw you back into the old patterns the time spent in rehab may end up being wasted.

The Problem with Anger

Nearly everyone has at some time used anger to defend against painful feelings.
The problem comes when you make a habit of it, when frequency and intensity of your anger begins to affect your health and relationships.
The person who at root feels bad or worthless learns to blow up at the slightest provocation rather than experience a moment of self doubt.
The person who is afraid to feel fear, sadness or anxiety learns to attack and blame rather than endure.

The person whose judgment is clouded by drugs or alcohol turns to anger more frequently.

The first step

To begin to manage your feelings in different ways think about your experience of anger:
How often is anger your first response?
What about your anger works for you?
What about your anger does not work for you?
What does your anger response look like i.e. list the behaviors you most commonly do when you are angry.

What is the difference between when you are angry and intoxicated or angry and clear headed?

If you do the effort to follow through on these questions, the chances of anger getting out of control and leading to relapse and another round of drug or alcohol rehab are greatly reduced. Besides whether you have been in rehab or are just considering rehab, these exercises are good advice for everyone. A lot of most good drug treatment programs are just good advice. Addiction is like a lot of other problems in life, hard work and honesty go a long way towards a successful rehab learning experience.

When looking at how anger can cause stress and lead to renewed drug abuse, you must not only look at the cause, but the intensity as well. What differentiates upsetting traffic that we all face every day from the time that overloads a person and leads to an all out anger fury. It is obviously the later we wish to avoid in the early stages after drug or alcohol rehab. So if we go further with yesterday’s questions, once we know our “hot buttons”, what causes them to grow into the dangerous episodes that can put sobriety at risk? Again this is an important part of drug addiction treatment and would best be started while still in drug or alcohol rehab.

What intensifies the anger response?

Hot buttons: each person has their individual triggers e.g. weaknesses in others remind us of weaknesses in our self so we get angry with others, pain in others makes us afraid and we get angry. Underneath anger are often other causes.

Family or personal history: Children tend to repeat behavior they have seen modeled. Adults tend to repeat behavior they have seen as effective when others use it e.g. in military.

Preconceived cognitions: certain thinking habits intensify anger e.g. all offenses are deliberate.

Excessive self-focus: perceiving all events as about you.

inadequate rest
inadequate recreation
poor physical or mental health
poor nutrition
the influence of alcohol or drugs

All of the above can ultimately increase anger and aggression(Pg. 12 - 13 â??The Anger Management Sourcebook,â?? Glenn R. Schiraldi, Ph.D., & Melissa Hallmark Kerr, Ph.D., Contemporary Books, New York, 2002)

Substances that increase stress and the anger response

Alcohol is the most dangerous legal drug available
Drinking one or two drinks will bring on euphoria and general good feelings
Drinking more leads to the second stage characterized by depression, fatigue, nausea and general bad feelings
Alcoholic hangovers are a major source of irritability which can lead to rage and physical aggression
72% of male batterers are abusing alcohol or drugs
Nicotine and caffeine increase insulin secretion which causes swings in blood levels, resulting in irritable moods

So go through the list you created yesterday and look and see if any of the above items may pertain to you. Are there intensifiers that may comprimise your sobriety. When looking at the list above also note that while in rehab treatment most of the above factors are removed. That is why it is neccessary to have a plan on how to deal with them when you leave rehab to have the greatest chance of success.

If anger has the potential to trigger relapse during drug treatment of after drug and alcohol rehab it would be wise to discuss the common sources of anger. Learning better ways to handle these either while in rehab or as soon as possible after rehab is the safest course.

What triggers anger?

Stressors, triggers or hooks that â??get you to respond with angerâ??.

Others: when they hurt us or donâ??t do what we expect of them.

Situations: such as traffic jams, getting lost, a computer glitch, losing something, frustrated goals, interruptions or an injustice.

Self: failing to meet personal goals, not acknowledging our realistic limitations â??I canâ??t believe I did that. Iâ??m so stupid. Why canâ??t I do that?â??

Which is the greater threat, the trigger or your reaction to it?

What causes anger?

We care

People who become angry reflect a will to live, to grow and to protect self-interests

If we did not care we would cease to react

There are ways to channel caring with less anger or no anger at all

A sense of lost power

Anger attempts to restore lost power by taking temporary control of the situation and temporarily numbing the pain of self â?? diminishment ( When you are yelling no one else can speak, you appear to be in control)

Self-diminishment

It is very painful to feel rejected, disrespected, powerless, like a nobody

It is very painful to be reminded of our own inadequacies or unworthiness

Unrealistic expectations

Failing to accept the way things truly are

Expecting too much,

expecting other drivers to be more perfect than they are,

expecting your family to be more perfect than they are

expecting to have more control than you do

(Pg. 10 - 11 â??The Anger Management Sourcebook,â?? Glenn R. Schiraldi, Ph.D., & Melissa Hallmark Kerr, Ph.D., Contemporary Books, New York, 2002)

Please go through this list of ideas carefully and see if any of them have been sources of anger in the past that have lead to instances of drug or alcohol abuse. It is also obvious that it is our responses to the situation that creates the stress and also creates the danger of relapse. However either in rehab or after rehab you can develop ways to handle these situations in ways that don’t increase the stress your life. The big point of drug or alcohol rehab is change. Finding new ways to respond to old situations and taking the time to practice them so that you can actually use them in day to day life, is the goal of any addiction treatment or any residential rehab stay. See if you can find some new ways to respond to anger inducing situations that lead to resolution instead of escalation and more stress.

I have repeatedly said that one of the major causes of relapse after drug or alcohol rehab treatment is uncontroled stress or emotional upset. Anger then if not handled properly would be an emotion of high risk after rehab. For any rehab program to be successful there would logically be some components about anger and how to handle it.

What is Anger?

Anger is an unpleasant and uncomfortable feeling arising from an event that is perceived to be an injury, a mistreatment or an opposition to oneself usually showing itself as a desire to fight back at the supposed cause of the feeling.

Anger involves:

Thoughts that trigger and/or maintain anger. Anger is likely to be greater if one presumes oneâ??s anger is justified.

Physiological arousal such as a flushed face, increased heart rate, and blood pressure, sweating, and the release of various stress hormones.

Behaviors or tendencies that are culturally influenced, such as yelling, clenching fists or pouting.

The apparent purpose of protecting or furthering our self interests, which might include loved ones, or causes or cherished principles.(Pg. 3, â??The Anger Management Sourcebook,â?? Glenn R. Schiraldi, Ph.D., & Melissa Hallmark Kerr, Ph.D., Contemporary Books, New York, 2002)

Firstly it might be wise to spend some time and look at how anger has fit into your life in the past. You would want to consider frequency, intensity and duration when considering how “normal” your responses have been in the past. Has bouts of anger lead to drug or alcohol abuse in the past? How is anger viewed in your family? As always it is best to spend some time figuring out where you are before you decide on where you want to go. Over the next few days I will try to give you information about anger and how to handle it, especially in the light of post drug rehab and preventing relapse.