Drinking resumption: problematic alcohol use relapse after rehabilitation. A phenomenological hermeneutical perspective

Abstract

The majority of patients being treated for alcohol abuse disorders experience one or more relapses after treatment. The fact that people use this inebriant in a way leading to so much harm and suffering might seem a conundrum. Therapists, family and others might find the person's relapse to be dramatic and upsetting, and one might question whether the person has the sufficient will or motivation to change. However, few previous studies have explored relapse from the patient's perspective. The aim of this study was to illuminate the patient's lived experience of relapse and to develop a deeper understanding of this phenomenon. The study consisted of qualitative interviews using a phenomenological hermeneutical approach. Three main themes emerged from the analyses: 'craving', 'self-image' and 'time'. The findings were discussed in the context of phenomenological literature. Cravings could occur unpredictably; nevertheless, craving was a common experience for the patients and signified a risk of relapse. Bodily experiences of craving were frequently mentioned, and alcohol addiction could be understood as to be a disease or a learned habit. Self-image was, at times, adversely affected by relapse episodes. Therefore, feelings of shame, self-respect and recognition were significant concepts. This study found that the perception of time as past, present and future greatly influenced the participants' experiences of relapse and rehabilitation. Thus, relapse was an upsetting and dramatic experience that could cause great discomfort and sometimes life-threatening situations. However, relapse could also be viewed as a planned event. This study highlights important truth and reality about alcoholism and relapse grounded in people's lived experience.

‘The rollercoaster of follow‐up care’ after bariatric surgery: a rapid review and qualitative synthesis

“…Those who had begun to find it difficult to maintain weight loss and behavioural changes expressed feelings of shame, similarly to those expressed in other patient groups experiencing behavioural relapse, e.g. in alcohol misuse . These feelings of shame could lead to non‐attendance at follow‐up, which could then extend to appointments for unrelated medical problems.…”

Outpatient Addiction Treatment for Problematic Alcohol Use: What Makes Patients Who Dropped Out Different from Those Who Did Not?

“…Additionally, craving, as a conscious expression of desire directed toward the use a substance (Tiffany & Wray, 2012), is a key factor when studying patterns of substance use and trajectory in care (Morgenstern, DiFranza, Wellman, Sargent, & Hanewinkel, 2016;Witkiewitz, 2011). Alcohol urges are known to take a variety of form and intensity, and are particularly unpredictable for the user (Kvamme, Asplund, & Bjerke, 2015). The most intense experiences of craving can overwhelm any intention to change (Bradshaw, Shumway, Wang, & Harris, 2014;Browne, Wray, Stappenbeck, Krenek, & Simpson, 2016).…”

Alcohol Effects on Stress Pathways

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