Abstinence Violation Effect: What It Is And How It Is Expressed
Marlatt and Gordon’s relapse prevention program is aimed at treating alcohol addiction. It talks about the Abstinence Violation Effect which involves the fact of relapsing into addictive behavior within a withdrawal or detoxification treatment.
Relapses significantly influence the evolution of a person who is in the recovery process. In this article we will see what the Abstinence Violation Effect consists of; We will learn how it appears and the repercussions it entails for the person with an addictive disorder.
The Marlatt and Gordon Relapse Prevention Program (1985) is aimed at people with a substance-related addictive disorder. Specifically, it is usually used in patients with alcohol addiction.
The program, as its name indicates, is aimed at preventing the relapses typical of each addictive disorder. Marlatt and Gordon maintain that Three cognitive factors interact in relapse :
The Relapse Prevention Program speaks of the Abstinence Violation Effect (VAE) as the appearance of a new addictive behavior by the patient (that is, the patient starts drinking again, relapses); It is therefore about an emotional and cognitive consequence that arises in the addicted patient after a period of abstinence and commitment to treatment.
Abstinence Violation Effect: characteristics
Now that we have seen a little about what the Abstinence Violation Effect consists of, let’s learn more about its characteristics.
The Abstinence Violation Effect involves a loss of control in the drinker, which leads the subject to a new relapse This effect produces in the person a negative emotional state of guilt and internal conflict between the incompatibility of the addictive behavior carried out and their desire for abstinence.
The Abstinence Violation Effect is about a thought pattern that appears after drug use It is usually used for cases of alcoholism.
There are authors who maintain that this effect appears as a result of the intense desire to drink, which appears after having the first drink; This desire entails a series of physiological manifestations in the body.
For their part, Marlatt and Gordon believe that it is due more to a belief or the existence of expectations of the “self-fulfilling prophecy” type, rather than to underlying physiological mechanisms.
EVA components
The Abstinence Violation Effect It is composed of two cognitive-affective elements , and appears based on the two of them. Furthermore, these components are what will trigger the aforementioned unpleasant emotional state associated with the EVA. These components are:
1. A cognitive dissonance effect
Cognitive dissonance occurs because the addictive behavior of “drinking again” does not fit with the person’s desired self-image of abstinence
This dissonance or “incompatibility” then occurs for the patient between what he wants (to drink) and what he knows is “correct” or what he wants in the long term (not to drink and continue abstinence).
2. A personal attribution effect
On the other hand, once the drinking behavior has been carried out, the patient makes an internal, stable and global attribution of the addictive behavior (for example: thinking that one has used because he is a disaster and that he will not be able to recover from his addiction).
That is, the subject attributes the occurrence of his relapse behavior to stable, global and internal factors, and this decreases his resistance to future temptations (and therefore makes him more likely to relapse in the future, creating thus a kind of “vicious circle”).
But what factors influence the person to use again and therefore relapse?
On the one hand, the fact that the person is exposed to a situation considered high risk without having previously detected it, added to the fact that they do not have sufficient coping skills to know how to expose themselves to such a risk situation and/or high levels of emotionality (pleasant or unpleasant).
All these factors will hinder the person’s reasoning and will lead to a loss of control (or self-control) in the person; eventually, the person would develop the Abstinence Violation Effect, returning to drinking and therefore relapsing.
That is, you could say that the fact of relapse makes it more likely that you will relapse again in the future. In other words, the Abstinence Violation Effect translates into a high-risk situation for relapse (no fall or occasional use).
The role of relapses
The fact that consumption occurs again, punctual and specific, would imply relapse. Throughout detoxification treatment, it is preferable that relapses do not occur. However, the fact that they occur It does not have to prevent you from continuing with the treatment and that abstinence and recovery are finally achieved.
As we have seen in the Abstinence Violation Effect, when relapses appear during treatment, a series of emotional and cognitive changes also occur in the person, which will affect their condition and their evolution within the treatment.
EVA treatment
Within a broader psychological and behavioral treatment, one of the possible techniques to use to reduce the probability of the Abstinence Violation Effect occurring, consists of training in different cognitive strategies
These strategies include cognitive restructuring, focused on modifying errors associated with the abstinence violation effect or apparently irrelevant decisions.
