Using “Opposite Action” To Prevent Relapse

There’s an episode of Seinfeld called “The Opposite,” where one day, single, unemployed, and living-with-his-parents George decides to do the opposite of everything he would normally do. In one episode, he gets a new girlfriend, a new job, and a new apartment. While George’s example is exaggerated, we too can drastically change our lives by changing our actions. Hence the technique of “opposite action” to prevent alcohol relapse.

Navigating recovery from alcohol use disorder (AUD) is a bit like steering a boat through unpredictable seas. Challenging sea swells — or, in the case of AUD, relapses — can make the journey difficult. But what if we had the tools to deliberately change direction and steer against the currents?

“Opposite action,” a dialectical behavior therapy (DBT) tool, can be a crucial navigational tool, much like a rudder that allows us to switch directions and go against the tide of temptation. Let’s learn about how this strategic approach can help us prevent relapse and empower us to chart a course toward navigating recovery with renewed confidence and determination.

Relapses: A Rehearsal for Success

The definition of relapse is returning to a former behavior. In the context of recovery from alcohol dependence or alcohol use disorder (AUD), relapse can mean drinking again after a period of cutting back or abstaining from alcohol. 

It can often be mistaken as a failure or a weakness; it’s anything but that! Relapses are a rehearsal for success and a common part of recovery. The reason? Alcohol’s impact on our brain. Alcohol dependence is marked by neurological changes in our brain. More specifically, alcohol hijacks our “feel-good” hormones, serotonin and dopamine, which give us a temporary sense of calmness and pleasure. But it also keeps us coming back for more. When we stop drinking, cravings and other triggers can lead us back to the bottle — causing relapse. Now that we better understand what relapses are, let’s dive into how “opposite action” helps us prevent them.

A Foundation of DBT: “Opposite Action”

“Opposite action” is a skill used in dialectical behavior therapy (DBT), which is a form of talk therapy that helps us develop acceptance and self-awareness to change our thought patterns and behaviors. Specifically, “opposite action” is a tool for emotional regulation, one of the core components of DBT. It helps us determine whether an action makes sense and encourages us to act against our emotions. 

The “opposite action” skill is based on the idea that our emotions prompt a response. For example, if we’re angry, we might attack and defend. If we’re ashamed, we might isolate ourselves. However, the action might not always be beneficial. For example, if we get angry at someone who is about to punch us, it might make sense to defend ourselves physically, but if we’re angry that a friend showed up late to a gathering, “attack and defend” isn’t an appropriate response. “Opposite action” encourages us to do the opposite of what our emotions are telling us to do when the action isn’t an appropriate one.

“Opposite action” teaches our brain that the action our emotion triggers isn’t an appropriate response; it changes our behavior and thought patterns over time. However, before we use “opposite action,” we need to be able to identify the emotion and unwanted action. 

Identifying Triggers and Urges for Relapse

Before identifying individual vulnerabilities, we can run through the list of common triggers for drinking to help us identify our own.

• Feelings. Strong emotions such as stress, anxiety, and depression are common drivers of drinking to self-medicate. 
• People and places. Factors such as social anxiety, peer pressure, and social drinking are popular triggers. It’s important to not only reflect inward, but to also take a look at who we’re surrounding ourselves with and what situations we may be getting into.
• Objects or moments. Common triggers can include seeing a bottle of alcohol or other substances, important dates and events, or memories.

It’s also important to consider personal triggers and risk factors. Reflecting on our individual histories and patterns helps us identify more specific triggers in these same categories. For example, if the passing of a loved one was a previous trigger for our drinking, the anniversary of their death or people that remind us of them may also be a trigger. 

Now that we’ve taken the time to reflect and identify triggers for our drinking. Let’s explore how “opposite action” can help us overcome them without turning to alcohol.

Relapse Prevention: “Opposite Action” in Action

“Opposite action” involves four main steps:

1. Acknowledge the Urge

In the context of recovery, the urge is our craving for alcohol. However, it’s also important to recognize the emotions or triggers for these urges. Tracking our consumption, as well as the feelings and events before and after, can help us better identify triggers and patterns. 

Let’s say we notice that our alcohol consumption spikes after stressful days at work or when we hang out with a certain group of people. Stress or peer pressure could be the culprit. Now that we’re more aware of our urges and what might cause them, we can be more prepared the next time they come up. But this is just the beginning!

2. Identify “Opposite Action”

The “opposite action” is doing the opposite of what our emotions are urging us to do. Let’s say we’ve committed to quitting alcohol, but when a stressful moment arises, our brain urges us to drink to get temporary relief. The “opposite action” is avoiding alcohol (or reaching for a club soda instead). While it may be easier said than done, practicing finding this opposite action is a helpful step in the right direction.

This “opposite action” can also be sticking to our weekly goals of cutting back or attending a peer support group session when strong emotions tell us otherwise. As we’ve discussed, there are many different triggers for relapse in recovery. Being able to identify the “opposite action” in times of high emotions is a critical step to increasing our awareness — and as a result, changing our habits.

3. Carry Out “Opposite Action”

Now that we’ve identified the “opposite action,” it’s time to carry out this new behavior.

Carrying out the “opposite action” is easier said than done. Most of the time, quitting or cutting back on alcohol isn’t as simple as it sounds. This is where coping strategies can come in handy. Find healthy distractions, have alcohol-free alternatives handy (like that club soda we mentioned!), try mindfulness techniques, and lean on others for support when you need to.

4. Reinforce New Behavior 

Now that we’ve done the hard part, it’s time to reward ourselves. One of the main reasons we become dependent on alcohol is because of how it hijacks our brain’s reward system. 

Well, now that we’re “rewiring” and teaching our brain to engage in a different behavior, it’s important to positively reinforce this new behavior in order to teach our brain that this is how we want to react. We can do this by celebrating even the small wins — extra time to read a good book or a coffee shop latte rather than your usual cup of instant joe. 

This DBT skill is most successful when used repeatedly and to the full extent. This helps us develop more positive habits, leading to many benefits. Let’s take a look at what we have to look forward to.

Long-Term Benefits of Using “Opposite Action”

This DBT tool has many benefits to our recovery:

• Reduced relapse risk. As we continue to teach our brain positive replacement behaviors, we build resilience against triggers, reducing the risk of relapse. 
• Improved health. Aside from the health benefits of quitting or cutting back on alcohol, “opposite action” can enhance our emotional regulation skills. This increases our overall well-being and life satisfaction.
• Positive lifestyle changes. A major component of recovery is growth, which “opposite action” can help facilitate. By acting against our urges to drink, we have more time and energy to pour into our hobbies and interests, as well as our relationships.
• Increased confidence. Overcoming relapse is no easy feat. Developing skills like “opposite action” helps us be more equipped to handle difficult situations, increasing our confidence in recovery and in general.
• Another tool in the toolkit. “Opposite action” is a beneficial tool not only to prevent relapse but also in our day-to-day life. Once we’ve mastered the skill in recovery, we can apply it to strong emotions and unwanted behaviors we want to change. 

“Opposite action” is a powerful tool, but what else can support our journey to recovery? 

Supportive Tools and Resources for “Opposite Action”

Maintaining recovery often requires a comprehensive approach, including tools and resources that support “opposite action.”

• Professional support and therapy options. DBT and cognitive behavioral therapy (CBT) can further support our goals to change our behaviors. We can also explore group therapy and peer support programs, as social connection plays a major role in facilitating change.
• Self-help tools and techniques. Sometimes self-help strategies can work; often their success is short-lived. Fortunately, there are plenty of mobile apps and online resources to help us implement these skills instead of just diving off the deep end. Look up “opposite action DBT worksheet” for step-by-step guidance the next time an urge to drink arises. 
• A supportive environment. The recovery process isn’t always easy, but we don’t have to do it alone. Engage family and friends in the process and turn to community and online support groups for tips to help on the journey.

These additional tools help us practice “opposite action” and navigate recovery successfully. But besides “opposite action,” DBT has more to offer.

DBT in Recovery: Beyond “Opposite Action”

“Opposite action” is just one skill among the four components of DBT. Let’s explore all four components to see how they can aid us in our recovery journey.

• Mindfulness. This core component promotes increased awareness and living in the present moment. Mindfulness skills include practices such as meditation, body scans, deep breathing, intentional pauses, and more. 
• Distress tolerance. This component encompasses the ability to navigate and cope with crisis situations and difficult events. Some distress tolerance skills include TIPP (temperature, intense aerobic exercise, paced breathing, progressive muscle relaxation), distraction skills, and radical acceptance.
• Emotional regulation. This module helps us manage our emotions more effectively. Aside from “opposite action,” other emotional regulation skills include checking the facts, self-soothing, and exploring emotional vulnerability.
• Interpersonal effectiveness. This component targets improved social and communication skills. DBT interpersonal effectiveness strategies include several different acronyms, including DEARMAN, GIVE, and FAST that provide step-by-step guidance on improving these areas. DEARMAN is for expressing our desires and stands for Describe, Express, Assert, Reinforce, Mindful, Appear, and Negotiate. GIVE helps us maintain our relationships and stands for Gentleness, Interest, Validation, and an Easy manner. FAST helps us maintain self-respect and guides us to be Fair, don’t make Apologies, Stick to values, and be Truthful. 

These strategies, along with “opposite action” can help us maintain our journey to a healthier, alcohol-free lifestyle. And don’t forget, Reframe is here to support you along the way!

Flipping the Script

While “opposite action” may seem simple in practice, it’s a powerful tool to help us develop positive replacement behaviors for strong emotions that drive unwanted behaviors. This game-changing helps us prevent relapse and maintain our commitment to recovery. However, it’s just one of many skills that DBT teaches. We can set ourselves up for success in recovery by adding skills like “opposite action” to our toolkit. So, the next time temptation taps you on the shoulder, remember: sometimes, the best action is the opposite action.