Learning to recognize and manage this effect is crucial in eating disorder recovery to promote self-compassion, resilience, and sustainable progress. After a period of success in your recovery, you may think you can control your drug or alcohol use again. Even though you may think this time is different, if your drinking and drug use has gotten out of hand in the past, it is unlikely to be different now. While this might seem counterintuitive, it is a common thought that many people need to recognize if they want to avoid a relapse. While celebrating victories is important, you should also find constructive ways to acknowledge your sobriety.

Who might experience the AVE?

Marlatt and Gordon (1980, 1985) have described a type of reaction by the drinker to a lapse called the abstinence violation effect, which may influence whether a lapse leads to relapse. This reaction focuses on the drinker’s emotional response to an initial lapse and on the causes to which he or she attributes the lapse. People who attribute the lapse to their own personal failure are likely to experience guilt and negative emotions that can, in turn, lead to increased drinking as a further attempt to avoid or escape the feelings of guilt or failure. In contrast to the former group of people, the latter group realizes that one needs to “learn from one’s mistakes” and, thus, they may develop abstinence violation effect more effective ways to cope with similar trigger situations in the future.

A Lapse Vs. A Relapse

The desire for immediate gratification can take many forms, and some people may experience it as a craving or urge to use alcohol. Although many researchers and clinicians consider urges and cravings primarily physiological states, the RP model proposes that both urges and cravings are precipitated by psychological or environmental stimuli. Ongoing cravings, in turn, may erode the client’s commitment to maintaining abstinence as his or her desire for immediate gratification increases. This process may lead to a relapse setup or increase the client’s vulnerability to unanticipated high-risk situations.

What experiencing the AVE may feel like

Covert antecedents and immediate determinants of relapse and intervention strategies for identifying and preventing or avoiding those determinants. If stressors are not balanced by sufficient stress management strategies, the client is more likely to use alcohol in an attempt to gain some relief or escape from stress. This reaction typically leads to a desire for indulgence that often develops into cravings and urges. Two cognitive mechanisms that contribute to the covert planning of a relapse episode—rationalization and denial—as well as apparently irrelevant decisions (AIDs) can help precipitate high-risk situations, which are the central determinants of a relapse. People who lack adequate coping skills for handling these situations experience reduced confidence in their ability to cope (i.e., decreased self-efficacy). Moreover, these people often have positive expectations regarding the effects of alcohol (i.e., outcome expectancies).

Urges and Cravings

• In the absence of other non-drinking pleasurable activities, the person may view drinking as the only means of obtaining pleasure or escaping pain.
• This aspect of relapse prevention can be beneficial to those in addiction treatment or contemplating treatment since it is not necessarily a failure to exercise self-control or abstain from using a substance of abuse.
• The cognitive-behavioral model of the relapse process posits a central role for high-risk situations and for the drinker’s response to those situations.
• The abstinence violation effect (AVE) describes the tendency of people recovering from addiction to spiral out of control when they experience even a minor relapse.
• In conclusion, the abstinence violation effect is a psychological effect that impacts those in recovery, as well as those who are focused on making more positive behavioral choices in their lives.

Although specific intervention strategies can address the immediate determinants of relapse, it is also important to modify individual lifestyle factors and covert antecedents that can increase exposure or reduce resistance to high-risk situations. Global self-control strategies are designed to modify the client’s lifestyle to increase balance as well as to identify and cope with covert antecedents of relapse (i.e., early warning signals, cognitive distortions, and relapse set-ups). Although the RP model considers the high-risk situation the immediate relapse trigger, it is actually the person’s response to the situation that determines whether he or she will experience a lapse (i.e., begin using alcohol).

• The results of recent research, particularly the RREP study, likely will lead to modifications of the original RP model, particularly with regard to the assessment of high-risk situations as well as the conceptualization of covert and immediate antecedents of relapse.
• The term “reliability” refers to the ability of a test or method to provide stable results (e.g., when different patients are compared or different investigators rate the same patient).
• Instead of surrendering to the negative spiral, individuals can benefit from reframing the lapse as a learning opportunity and teachable moment.
• Additionally, individuals may engage in cognitive distortions or negative self-talk, such as believing that the relapse is evidence of personal weakness.
• For example, someone who has been on a diet might have a small slip-up and then binge on unhealthy foods.

Asking clients questions designed to assess expectancies for both immediate and delayed consequences of drinking versus not drinking (i.e., using a decision matrix) (see table, p. 157) often can be useful in both eliciting and modifying expectancies. With such a matrix, the client can juxtapose his or her own list of the delayed negative consequences with the expected positive effects. Another efficacy-enhancing strategy involves breaking down the overall task of behavior change into smaller, more manageable subtasks that can be addressed one at a time (Bandura 1977). Thus, instead of focusing on a distant end goal (e.g., maintaining lifelong abstinence), the client is encouraged to set smaller, more manageable goals, such as coping with an upcoming high-risk situation or making it through the day without a lapse. Because an increase in self-efficacy is closely tied to achieving preset goals, successful mastery of these individual smaller tasks is the best strategy to enhance feelings of self-mastery. It is not even on your mind to relapse at this point because of stress, high-risk situations, or inborn anxieties.

Countering The Abstinence Violation Effect: Supporting Recovery Through Relapse

But more schools are seeing visas stripped from students with no known connection to protests. The Institute for Research, Education and Training in Addictions (IRETA) is an independent 501(c)3 nonprofit located in Pittsburgh, PA. Although the benefits of 12-step participation may (and quite often do) outweigh the added AVE risk, clinicians should be aware of this particular risk and take steps to counteract it. This is an open-access report distributed under the terms of the Creative Commons Public Domain License. You can copy, modify, distribute and perform the work, even for commercial purposes, all without asking permission.

Understanding the Abstinence Violation Effect in Eating Disorders

Twelve-month relapse rates following alcohol or drug cessation attempts can range from 60 to 90 percent, and the AVE can contribute to extended relapses. Learning healthy coping mechanisms can help you manage stress, cravings, and triggers without resorting to substance use. When people don’t have the proper tools to navigate the challenges of recovery, the AVE is more likely to occur, which can make it difficult Alcoholics Anonymous to achieve long-term sobriety.