About Recovery and Relapse!

An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates

Volume 9, Number 5

For 65 years, May has been designated Mental Health Month. Perhaps now more than ever, the importance of maintaining good mental health is vital. As the internet makes our world smaller and as anxiety and stress increase in our society, we should not take good mental health for granted. The media, which bombards us, is replete with stories of tragedies and violence that are often caused by people with mental health problems. Unemployment, financial problems, the increase in hate and terrorism, and the breakdown of the traditional family unit all try our ability to cope and remain optimistic. It may very well “be a jungle out there” and we need to be mentally healthy to survive.

We recommend the following to maintain good mental health:
• Have and maintain a system of values to live by
• Eat well and regularly
• Exercise at least 2 times a week
• Relax, meditate, practice yoga, etc.
• Socialize with friends and family; do not isolate
• Get enough rest and sleep
• Do not abuse drugs, cigarettes, or alcohol
• Seek professional help if needed.

Do not take good mental health for granted. In these times, it takes effort.

This month’s E-letter focuses on Recovery and Relapse. Our email of the month is about
Paraprosdokians and our Ask the Doc question is about gaining cooperation. We hope you find the enclosed information helpful. As always, we appreciate your questions and comments are welcome.

Practice News

Depression group. A weekly depression therapy group has been meeting regularly for the past few weeks in our office. This group is run by Dr. Jim Kaikobad and meets for one and one-half hours. The group is educational, supportive, and confidential and is limited to 8 people. If you are interested in attending, please contact Jillian at 954 755-2885.

Research Study. If you are overweight, you might consider participating in a research study. Our practice has been asked by Life Extension Institute to participate in conducting research assessing the effects of cognitive therapy, nutritional supplements, and medications on weight management in overweight individuals. Informal results continue to show success for those subjects who are in the study. For more information about the study, contact Jillian, at 954 755-2885.

Parent Education and Family Stabilization Course. Our practice is one of the few offices certified to provide the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, it is required by the State of Florida for all parents divorcing or separating even if not legally married. We have provided this course many times and have designed it as a 4-hour, one-session presentation that focuses on ensuring that parents protect their children from the effects of divorce or separation by setting aside their differences and focusing on the children’s need for both parents in their lives. The course also provides information about divorce as loss, gives an overview of the Florida laws and statutes related to divorce and custody issues, and offers information on how children react to divorce based on their ages.  The course is offered live on a flexible schedule, based on the availability of those attending the course.  Please contact our Administrative Assistant, Jillian, at 954 755-2885 for additional information.

Handouts from previous E-Letters can be found on our website, www.KimmelPsychology.com.  We invite you to read and download them if desired.


Our E-Letter this month focuses on recovery and relapse, specifically to drugs and alcohol. While recovery is also important for mental health, there seems to be a lot of misunderstanding about relapsing and recovering. We have had several patients recently who have had difficulty trying to be clean and sober. Even though they may not have used for months, they have relapsed and gone back to their using. Fortunately, they are again struggling not to use. For those of us who have not had an addiction, it may seem difficult to understand. But for those with addictions, it is a struggle.

Relapse can be defined as a return to use of a substance after a period of non-use. It starts days or weeks before actual use. Before even thinking about using, behaviors and feelings are moving towards eventual using. Signs to look for include isolation, anger, depression, mood swings and intolerance. As time goes by, one starts to think about using and often deludes themselves into believing that they can use only once or every so often. They may be giving into their urges and rationalizing their substance use. Finally, they actually use with the old addictive behaviors returning.

Recovery does not involve just the cessation of using drugs or alcohol. Recovery involves creating a new life where it is easier not to use. Most people use to escape, to relax, or to reward themselves. After all, alcohol and drugs are easy, are plentiful, and are cheap. Yet to an addict, they can destroy their lives, their health, and their family. To recover from an addiction, the user must practice HOW. That is, being Honest, being Open minded, and being Willing to change. People who use cannot recover for others; they have to recover for themselves and be willing to do all that it takes to get healthy. The first critical decision is for the addicts to be willing to change their life and to be honest with themselves. They must get sober by being abstinent from alcohol and drugs. They also must take care of their personal health including learning to relax, eating healthy, and exercising. Finally, they must practice good citizenship where they give back to the community and show regard and respect for others.

Support programs and groups can be a source of guidance, assistance, and encouragement in recovery. 12 step programs have been shown to be an invaluable part of the recovery process. They are quite effective and are available all around the world. In a 12 step meeting, attendees can hear others tell their stories of their addictions and then can decide if they are an addict or not.

At a meeting, you can meet others who are going through the same thing as you. You can hear from others in recovery and recognize that recovery is possible. You can learn how they recovered and what tricks and techniques they used. You won’t be judged and you can learn that addiction is a disease and not a moral failing or lack of will power. If you decide to attend 12 step meetings, be active and tell your story. Be committed to a new life, use the support of others who have been there, and do community service to give back and to show gratitude.

12 step programs are not the only resource for recovery. Working with drug counselors, mental health professionals, and other support groups can also help you to live a clean and sober life. We offer the following information on Recovery and Relapse:

We offer the following information on Recovery and Relapse:

“Fall seven times, Stand up eight”— Japanese Proverb


  • People basically use drugs or alcohol to escape, relax, or reward themselves and can develop “chemical thinking” which reinforces their use
  • Recovery is a commitment to changing one’s life in order to not be dependent upon drugs and alcohol to achieve relaxation and fulfillment
  • Recovery is not just not using, but involves additional social and health aspects
  • Recovery has been defined as a voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship
  • sobriety refers to abstinence from alcohol and drugs
  • personal health refers to improved quality of physical and psychological life
  • citizenship refers to living with regard and respect for others and includes such
    concepts as giving back to the community
  • A key element in recovery is the voluntary willingness and acceptance of certain behaviors that constitute recovery
  • In recovery, addiction is seen as a disease and not a moral failing or lack of willpower
  • In recovery, addiction cannot be cured but can be managed by a healthy lifestyle
  • Relapse is a return to the use of substances after a period of non-use
  • Relapse starts weeks or even months before the actual physical relapse and can be a three step process:
  • Emotional relapse where one is not thinking of using, but behaviors and feelings, such as anxiety, anger, isolation, not going to meetings, etc. lead to use
  • Mental relapse where thinking about using becomes predominant and includes lying, idealizing past use, hanging out with old friends in old places
  • Physical relapse includes the actual use of drugs or alcohol
  • Relapse occurs frequently during recovery and is an opportunity to learn from mistakes and change the direction of recovery
  • To achieve recovery, avoid situations of HALT: being Hungry, Angry, Lonely or Tired
  • The recovery movement believes that you recover by creating a new life rather than by just stopping your use
  • In recovery, it is critical to be honest with oneself and also others
  • 12 step groups are an important resource for recovery although not the only one
  • 12 step groups have been shown to be very effective and occur all over the world
  • 12 step meetings help one see that addiction affects everybody, help break through denial, help one get support from others, and help one to see that recovery is possible


  • To start recovery, make a voluntary and conscious commitment to change
  • Get support through 12 step programs, sober friends, and other recovery programs
  • Make relaxation part of your life through meditation, yoga, deep breathing, etc.
  • Build a sober life to include community service, new friends, new hobbies, and goals
  • Avoid old friends, old places where you used, and old things associated with your use
  • If you go to 12 step meetings, become active, be committed, use the support of others, find a sponsor, work the steps, and give back to the community
  • Seek professional help if you have difficulty beginning recovery or to resolve mental health issues that may impair your recovery

We Can Help!

Call us at (954) 755-2885 or email us at drkimmel@kimmelpsychology.com

Joel I. Kimmel, Ph.D., P.A. and Associates
5571 N. University Drive, Suite 101
Coral Springs, Florida 33067

As always, we would like to welcome new readers to our e-Letter. We hope that you find it informational and enjoyable. We invite you to share this e-Letter with others. If you have received this from a fellow reader, please send us your email address to include you on our list.

Ask the Doc

RL writes: I read your newsletter last month about sleep apnea and was very interested. For years, my sister has been complaining about her husband’s snoring. He is over 45 and overweight. I think he may have it. I spoke with my sister who has done more research. She agrees with me. However, the problem is he won’t consider the possibility. In fact, every time we bring it up, he dismisses it, tells us to leave him alone, and walks out of the room. He really doesn’t understand or believe the potential medical problems. She won’t ignore it. What can we do?

Dr. Joel Kimmel replies: This is a difficult situation as it really is not a question of sleep apnea but your brother-in-law’s cooperation. I don’t think using a scare tactic such as sleep apnea can be fatal is going to work to get him to comply. Rather, you need to find a way for him to be part of your team rather than to brush you off. From your knowledge and past experience, what seems to work with him to get him to go along with the group? Is it some type of reward? Is it doing an activity he enjoys? Is it some kind of bargaining such as if you do it, I’ll do it? Everybody has something that motivates him and this is what you need to find. Nagging as you have already seen does not work.

I suggest that you talk with your sister and try to identify what motivates him. If you can identify something, use it on the condition that he gets a sleep study. You can also try an intervention approach where you set up a meeting of those who care about him and express your concern lovingly. He will find it hard to deny or walk away if there are several loving people in the room. A third approach, although negative, would be to refuse any interaction or activity with him until he gets the sleep study. The last approach I would suggest would be to negotiate with him. Tell him that you will do what he has been after you to do if he goes for the sleep study.

Good luck and let me know how it works out.

Email of the Month

We would like to thank Bob S.for the following email:


Paraprosdokians – are figures of speech in which the latter part of a sentence or phrase is surprising or unexpected; frequently humorous.
1. Where there’s a will, I want to be in it.
2. The last thing I want to do is hurt you. But it’s still on my list.
3. Since light travels faster than sound, some people appear bright until you hear them speak.
4. If I agreed with you, we’d both be wrong.
5. We never really grow up, we only learn how to act in public.
6. War does not determine who is right – only who is left.
7. Knowledge is knowing a tomato is a fruit. Wisdom is not putting it in a fruit salad.
8. To steal ideas from one person is plagiarism. To steal from many is research.
9. I didn’t say it was your fault, I said I was blaming you.
10. In filling out an application, where it says, ‘In case of emergency, Notify:’ I put ‘DOCTOR’.
11. Women will never be equal to men until they can walk down the street with a bald head and a beer gut, and still think they are sexy.
12. You do not need a parachute to skydive. You only need a parachute to skydive twice.
13. I used to be indecisive. Now I’m not so sure.
14. To be sure of hitting the target, shoot first and call whatever you hit the target.
15. Going to church doesn’t make you a Christian any more than standing in a garage makes you a car.
16. You’re never too old to learn something stupid.
17. I’m supposed to respect my elders, but it’s getting harder and harder for me to find one now.

Please continue to send us your comments, questions, and favorite emails for our e-Letter.

Till June…

The information provided in this electronic newsletter is not a substitute for professional treatment. It is the opinions of the writers and is provided solely for educational purposes. For mental health care, seek a qualified professional.

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Copyright © 2014 by Joel I. Kimmel, Ph.D., P.A. and Associates.