3.6 Managing Risk Factors to Prevent Relapse

Lapse Versus Relapse Versus Prolapse

It’s important to remember that sometimes it’s just not possible to avoid the occasional setback, also referred to as a slip or lapse. Lapses lead individuals to two potential outcomes: relapse or prolapse. Relapse is returning to old behavior following an initial setback. A lapse could lead to relapse, or it could lead to prolapse which means the lapse is instead set right and the desired behavior reinstated.

At times there may be a specific reason for a lapse, such as a change in routine, an upsetting event, stress, or diminished motivation. Lapses are normal and should be expected. Preventing relapse involves reducing or managing internal and external risk factors and anticipating triggers.

Managing Internal Risk Factors

Internal risk factors are aspects of your physical or mental condition that reduce your motivation or interrupt your plans. An example is feeling tired from sleeping less than usual; this, in turn, could lead to not having the energy to meet a workout goal. Going to the grocery store when you’re tired or hungry or stressed can get in the way of choosing nutritious foods or working toward nutrition goals.

Becoming aware of these internal risk factors is the most important step. Once you notice them, you can manage better by saying to yourself things like, “Whenever I skip breakfast, I feel tired earlier in the day and tend to drink caffeinated beverages to get through, which keeps me up later at night. What could I do differently next time?” Self-care can go a long way when it comes to internal risk factors.

Managing External Risk Factors

External risk factors are ongoing situations that can lead to increased stress and therefore, hinder motivation or action toward change. Examples could include ongoing family circumstances, unhealthy or stressful relationships, financial strain, chronic pain, or a difficult living environment.

Sometimes we can recognize and reduce external factors, but sometimes we cannot. External risk factors might be out of the individual’s control or may require some creative thinking to work around. Utilizing their support system and community resources can also help an individual manage external risk factors. For example, if an individual lives in an environment with few outdoor spaces to engage in physical activity or where outdoor physical activity is not appropriate or acceptable, they may need to think through ways to get around this external risk factor by using stairs, guided YouTube videos, or other means to fit activity into their week. To provide another example, if an individual is short on time due to work demands, they could consider asking a roommate, family member, or neighbor to trade off meal preparation week-to-week to align with goals around eating habits.

Anticipating Triggers

Triggers are more immediate events that contribute to a setback. Some triggers are practical problems or barriers, for example falling out of your usual sleep routine because family is visiting from out of town. Others are more internal and affected by our physical or mental state. An example of this might be feeling self-conscious about your new cooking methods if a partner doesn’t understand your new behavior or isn’t supportive of you in making nutritious food choices.

Sometimes you can anticipate triggers and plan ahead for them. If bad weather might interfere with your plans to fit physical activity into your week, for example, you may need to do some research and plan ahead about how you can fit this in, in other ways.  Being aware of multiple means of achieving a goal allows us to be more resilient against setbacks (Carver & Scheier, 1982; Kruglanski et al., 2002). At the same time, some triggers happen unexpectedly and don’t allow for planning ahead, making problem-solving in the moment an important skill for staying on track. Getting into the habit of anticipating triggers and planning ahead in the situations when you can will not only make you less likely to experience a relapse, but will also help you be more practiced and prepared to think of a solution when faced with unexpected triggers.