Abstinence Violation Effect: what it is and how it is expressed
The Marlatt and Gordon relapse prevention program is aimed at treating addiction to alcohol. It talks about the Abstinence Violation Effect, which implies the fact of relapsing into the addictive behavior within a cessation or detoxification treatment.
Relapses have an important influence on the evolution of a person who is in the process of recovery. In this article we will see what the Abstinence Violation Effect consists of; We will know how it appears and the repercussions it entails for the person with an addictive disorder.
- Related article: "Addiction: disease or learning disorder?"
Relapse Prevention Program
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 own name indicates, is aimed at preventing relapses typical of each addictive disorder. Marlatt and Gordon argue that three cognitive factors interact in relapse:
- Self-efficacy: perceived ability to cope with situations.
- The expectations of the results of the behavior of consumption.
- The attributions of causation.
The Relapse Prevention Program talks about the Abstinence Violation Effect (VAE) as the emergence of a new addictive behavior on the part of the patient (i.e., the patient starts drinking again, relapse); 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, we are going to know its characteristics in more detail.
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 the desire to abstain from it.
The Abstinence Violation Effect is about a thought pattern that appears after drug use. It is often 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 taking the first drink; This desire entails a series of physiological manifestations in the organism.
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.
- You may be interested in: "How to prevent drug use in young people? 8 tips"
EVA Components
The Abstinence Violation Effect It is composed of two cognitive-affective elements, and appears based on the two of them. In addition, these components are the ones that will trigger the aforementioned unpleasant emotional state associated with EVA. These components are:
1. A cognitive dissonance effect
Cognitive dissonance occurs because the addictive behavior of “drinking again” does not fit the person's desired abstinence self-image.
This dissonance or "incompatibility" is then produced for the patient between what they want (to drink) and what they know is "correct" or what they want in the long term (not to drink and continue with abstinence).
- You may be interested in: "Cognitive dissonance: the theory that explains self-deception"
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 to say, the subject attributes the occurrence of his relapse behavior to stable, global and internal factors, and this decreases the resistance to future temptations (and therefore more likely to relapse in the future, thus creating a kind of "circle vicious").
What factors influence relapses?
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 he does not have sufficient coping skills to know how to expose oneself to such a risk situation and/or high levels of emotionality (pleasant or unpleasant).
All these factors make it difficult for the person to reason and will lead to a loss of control (or self-control) in the person; eventually, the person would develop the Withdrawal Violation Effect, going back to drinking and therefore relapsing.
In other words, it could be said that the fact of relapsing makes it more likely that one will relapse in the future. In other words, the Abstinence Violation Effect translates into a situation of high risk for relapse (no fall or punctual consumption).
The role of relapses
The fact that consumption occurs again, punctual and concrete, would imply relapse. Throughout the 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 is finally achieved.
As we have seen in the Abstinence Violation Effect, when relapses appear during treatment, there are also a series of emotional and cognitive changes in the person, which will affect their state and their evolution within the treatment.
EVA treatment
Within a broader psychological and behavioral treatment, one of the possible techniques to be used 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.
Bibliographic references:
- Echeburua, E. (1999). Addictions without drugs?: the new addictions: gambling, sex, food, shopping, work, Internet. Desclée de Brouwer.
- Pereira, C. (2007). Relapse prevention and other psychotherapeutic or psychosocial approaches in the management of alcoholism. Evidence-based Alcohol Clinical Guide.
- Perez, M.; Fernandez, J.R.; Fernandez, C. and Friend, I. (2010). Guide to effective psychological treatments I: Adults. Madrid: Pyramid.
