Why Do People Relapse? An Attachment and Nervous System Perspective on Addiction Relapse

Nearly 40–60% of people in recovery experience at least one relapse, a rate comparable to other chronic conditions like diabetes or hypertension. Many people wonder why they relapse, why relapse happens when things seem to be going well, or why it occurs even after rehab or years of sobriety. Addiction relapse is extremely common, and it often has little to do with willpower or desire for change. Instead, relapse is a nervous system and attachment system response to stress, overwhelm, emotional pain, or unmet relational needs.

When we look at relapse through a trauma and attachment informed lens, shame decreases and clarity increases. Relapse is not a personal failure. It is a signal that the person needs more support, regulation, connection, and safety. Understanding why relapse occurs gives people the tools to respond with compassion rather than judgment.

What Is a Relapse?

A relapse is a return to substance use after a period of abstinence or significant reduction. Clinically, relapse is considered a process, not a single event. This is why a person may ask “Why do I relapse?” long before they actually use a substance.

Research by G. Alan Marlatt shows that relapse begins with emotional and relational disturbances. Emotional distress, isolation, or ignoring needs gradually move into mental conflict and eventually physical use.

Understanding this helps explain why people relapse after rehab, why alcohol relapse happens even after years of sobriety, and why someone might think “Why do I always relapse even when I want to stay sober?”

Relapse is the brain and body attempting to regulate emotional distress. Substances temporarily reduce discomfort, create relief, or mimic co-regulation that was missing earlier in life and currently.

What Triggers a Relapse?

Below are the most common triggers behind addiction relapse, explained through a trauma-informed and nervous-system lens. Relapse is rarely about a single event or choice. It emerges when stress, emotional overload, or unmet attachment needs build up overtime and overwhelm the system.

Being Around Certain People

Spending time with people connected to past substance use can activate powerful emotional and sensory memories. The nervous system learned to associate these relationships with relief, belonging, or escape. Even without conscious intent, proximity to these people can trigger cravings and emotional states that increase relapse risk.

Stress and Life Changes

Stress is one of the strongest drivers of relapse. When experiences push someone outside their window of tolerance, a concept described by Dan Siegel, the nervous system shifts into survival mode and defaults to familiar coping strategies. This window applies to both negative and positive experiences. Even joyful events like promotions, new relationships, or travel can overwhelm regulation capacity, helping explain why relapse can occur when life appears to be going well.

Isolation and Lack of Support

Humans are wired to regulate emotions through social connection. From an evolutionary perspective, isolation has historically been one of the most dangerous conditions a human could face, often associated with injury, abandonment, or death. When someone becomes isolated, the nervous system loses access to co-regulation and relational safety. Distress then intensifies internally, and substances and processes may become a substitute for connection, soothing what relationships are meant to help regulate.

Life Transitions

Major transitions such as divorce, moving, becoming a parent, or changing careers disrupt emotional stability and routines and they also alter brain chemistry and body biology. These shifts affect stress hormones, sleep, and emotional regulation, increasing vulnerability even when changes are chosen or positive. When internal regulation is strained, the nervous system may reach for familiar coping strategies, including substances, in an attempt to restore balance and a sense of control.

Important Dates

Holidays, anniversaries of trauma, or dates associated with past substance use can reactivate emotional memory networks. Even when not consciously remembered, the body may experience increased anxiety, grief, or longing. These physiological states can intensify cravings and raise the risk of relapse.

Overconfidence in Recovery

Feeling “fully healed” can reduce protective behaviors. People may lower boundaries, skip support, or re-enter high-risk environments. Overconfidence often masks subtle dysregulation and increases vulnerability, especially when stress or emotional challenges arise unexpectedly.

Unrealistic Expectations

Believing recovery should feel consistently calm or linear creates shame when difficulty emerges. Shame is a powerful relapse trigger because it activates threat responses and self-criticism. When distress is interpreted as failure, substances may feel like the fastest way to escape internal discomfort.

Ignoring Cravings

Cravings are signals from the nervous system, not signs of weakness. When cravings are ignored or suppressed, they often intensify. Without awareness and regulation, they can build until the system feels overwhelmed, increasing the likelihood of impulsive substance use.

Interpersonal Problems

Conflict, rejection, or emotional distance can activate attachment wounds. These experiences may trigger feelings of abandonment, shame, or fear. When relational distress goes unprocessed, substances can become a way to self-soothe or temporarily escape emotional pain.

Skipping Therapy or Support

Therapy, coaching, and support groups provide structure, accountability, and emotional regulation through relationship. When these supports are skipped, stress and emotions accumulate internally. Without regular outlets for processing and co-regulation, addiction relapse risk increases significantly.

Why Do People Relapse When Things Are Good?

One of the most confusing and common questions in recovery is why relapse happens during positive periods. People often ask, “Why do I relapse when life is going well?” or “Why do alcoholics relapse when things are good?” From a trauma-informed and nervous-system perspective, this pattern is understandable.

When life slows down and stress decreases, the nervous system finally has enough space for previously suppressed emotions to surface. Unprocessed grief, fear, loneliness, or unresolved trauma that were held at bay during crisis can rise into awareness. Without strong regulation skills, these emotions may feel overwhelming.

There are several trauma-informed reasons this happens:

• When life calms down, buried emotions and unresolved trauma rise to the surface.
  Crisis can keep difficult feelings contained. Calm removes that distraction.

• Stability can feel unfamiliar or unsafe for people with insecure or disorganized attachment histories.
  Emotional ease, closeness, or dependence may trigger old protective responses.

• Reduced external accountability creates vulnerability.
  Therapy may feel less urgent, routines loosen, and support decreases.

• The brain may shift into bargaining mode.
  Thoughts like “I can handle just one drink” become more convincing during good periods.

• Success or closeness can activate old protective patterns.
  The nervous system may attempt to prevent disappointment, loss, or emotional exposure.

For many people, emotional ease is more dysregulating than chaos. Substances then become a familiar way to manage vulnerability and regain a sense of control.

What Are the Stages of a Relapse?

Emotional Relapse

During emotional relapse, a person is not actively thinking about using substances, but their nervous system is becoming increasingly dysregulated. Common signs include irritability, anxiety, emotional numbness, poor sleep, and difficulty concentrating. The person may begin withdrawing from others, avoiding support, or suppressing emotions rather than expressing them. Self-care routines often decline, and stress builds internally without relief. At this stage, the body is signaling overwhelm, not failure. Because the distress is subtle and often unrecognized, emotional relapse is frequently missed. Early intervention through connection, regulation, and support can prevent progression into later stages.

Mental Relapse

Mental relapse is marked by internal conflict. One part of the person wants to remain in recovery, while another part begins thinking about using substances as a way to cope. Thoughts may include bargaining, minimizing risks, or remembering past substance use as comforting or manageable. The individual may test boundaries, revisit high-risk environments, or reduce engagement in therapy or support. Cravings often intensify during this stage. Mental relapse reflects growing nervous system strain and unresolved emotional needs. Recognizing this stage early and reaching out for support can interrupt the relapse process before substance use occurs.

Physical Relapse

Physical relapse occurs when a person returns to substance use. This may happen impulsively or after a period of mental preoccupation. Once use begins, shame, guilt, and fear often follow, which can prolong the relapse if left unaddressed. Many people isolate at this stage, believing they have failed. From a trauma-informed perspective, physical relapse is a signal that the nervous system became overwhelmed and defaulted to a familiar coping strategy. Immediate support, compassion, and stabilization are essential. Reaching out quickly helps shorten relapse duration and prevents escalation into longer periods of use.

Myths About Relapse and Addiction

Many people believe relapse means failure, weakness, or a lack of motivation. This belief is deeply stigmatizing and inaccurate. Relapse is not a character flaw. It is a stress and trauma response that reflects nervous system overwhelm rather than a lack of commitment to recovery.

There are several common myths about relapse:

• Relapse means someone is “back at zero.”
  In reality, recovery skills, insight, and growth remain intact even after a relapse.

• Relapse is inevitable.
  While relapse is common, it is not unavoidable. With the right support, structure, and regulation skills, many people maintain long-term recovery.

• A person relapsed because they did not want recovery enough.
  Motivation alone does not regulate the nervous system. Trauma, stress, and emotional overwhelm drive relapse far more than desire or willpower.

In truth, relapse occurs when the nervous system becomes overwhelmed and defaults to familiar coping strategies. It does not erase progress or invalidate the work already done in recovery.

What To Do Right After a Relapse

1. Reach Out for Connection

Connection is one of the most effective ways to regulate the nervous system after a relapse. Contacting a therapist, coach, sponsor, or trusted loved one helps reduce isolation and shame. Co-regulation calms emotional flooding and restores a sense of safety. You do not need to explain everything. Simply being heard and supported can significantly shorten the duration of relapse.

2. Stop the Shame Spiral

Shame is one of the strongest drivers of continued substance use. After a relapse, self-criticism often intensifies emotional distress and cravings. Instead of judging yourself, normalize relapse as a signal that more support or regulation was needed. Self-compassion helps stabilize the nervous system and creates space for clear thinking and constructive next steps.

3. Identify the Trigger

Take time to gently reflect on what led to the relapse. This might include stress, emotional overwhelm, loneliness, conflict, or exposure to high-risk environments. Understanding the trigger helps transform the relapse into useful information. Awareness allows you to interrupt the same pattern in the future rather than repeating it automatically.

4. Rebuild Structure Quickly

Structure provides containment and safety for the nervous system. Returning to daily routines, therapy sessions, group support, regular meals, sleep hygiene, and grounding practices helps restore stability. Even small, consistent actions reduce emotional chaos. Reestablishing structure quickly can prevent a brief relapse from turning into a prolonged period of use.

5. Create a Short-Term Safety Plan

A short-term safety plan helps you navigate the next seventy two hours, which are often the most vulnerable. Identify who you can call, what environments to avoid, how to regulate emotions, and where to go if urges increase. Having a clear plan reduces decision fatigue and increases the likelihood of reaching for support instead of substances.

Long-Term Relapse Prevention

1. Avoid High-Risk People and Places

Certain environments, relationships, or routines are strongly linked to past substance use and can activate cravings automatically. Reducing exposure to these triggers protects the nervous system from unnecessary stress. This does not mean avoiding all discomfort, but rather creating boundaries that support safety and stability while new regulation skills are still developing.

2. Create a Daily Routine

A consistent daily routine helps regulate the nervous system by reducing unpredictability. Regular sleep, meals, movement, and rest create a sense of safety in the body. Structure lowers stress levels and makes emotional states more manageable, reducing the likelihood of turning to substances for relief.

3. Strengthen Social Support

Recovery is not meant to happen in isolation. Supportive relationships provide co-regulation, accountability, and emotional attunement. Regular connection with trusted people helps regulate stress and reduces the need for substances as a coping strategy. Community is one of the strongest protective factors against relapse.

4. Develop Emotional Regulation Skills

Learning how to stay present with difficult emotions reduces relapse risk. Practices such as mindfulness, breathwork, somatic regulation, and grounding exercises help calm the nervous system before distress escalates. These skills increase tolerance for discomfort and create alternatives to substance use during challenging moments.

5. Heal Underlying Trauma

Unresolved trauma often sits beneath addiction. Therapies such as EMDR, somatic approaches, Internal Family Systems, and attachment-based work help process traumatic experiences and restore nervous system regulation. Healing trauma reduces the intensity of emotional triggers that drive cravings and relapse.

6. Engage in Meaningful Activities

Purpose and fulfillment play an important role in long-term recovery. Activities that align with personal values, creativity, or service help rebuild identity beyond substance use. Meaningful engagement supports emotional balance and decreases the pull toward substances as a source of relief or stimulation.

7. Attend Therapy or Support Groups Regularly

Consistency in therapy or support groups provides ongoing structure and accountability. Regular check-ins allow emotions to be processed before they accumulate and overwhelm the system. Even during stable periods, continued support helps maintain regulation and resilience over time.

8. Track Early Warning Signs

Relapse rarely happens suddenly. Paying attention to early signs such as irritability, isolation, fantasy thinking, avoidance, or emotional overwhelm allows for timely intervention. Recognizing these signals early makes it possible to adjust support and coping strategies before relapse occurs.

Relapse as a Signal for Healing

Addiction relapse is not a personal failure or a lack of commitment to recovery. It is a signal from the nervous system that something needs attention, support, or regulation. When viewed through a trauma-informed and attachment-based lens, relapse becomes understandable rather than shameful. It reflects overwhelm, unmet emotional needs, or old protective strategies resurfacing under stress.

Sustainable recovery is built through connection, structure, emotional regulation, and healing the underlying wounds that drive substance use. With the right support, relapse can become a moment of learning rather than defeat. Each step toward greater awareness, self-compassion, and co-regulation strengthens resilience and supports long-term recovery. Healing is not linear, but it is possible, especially when people are met with understanding rather than judgment.

References and Influences

• Bowlby, J. Attachment and Loss (Vols. 1–3). Basic Books.

• Brown, D. P., & Elliott, D. S. Attachment Disturbances in Adults: Treatment for Comprehensive Repair. Norton.

• Flores, P. J. Addiction as an Attachment Disorder. Jason Aronson.

• Marlatt, G. A., & Donovan, D. M. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press.

• van der Kolk, B. The Body Keeps the Score. Viking.

• Siegel, D. J. The Developing Mind. Guilford Press.

• Schore, A. N. Affect Regulation and the Origin of the Self. Routledge.

• Porges, S. W. The Polyvagal Theory. Norton.

• Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders. American Journal of Psychiatry.

• Substance Abuse and Mental Health Services Administration (SAMHSA). Trauma-Informed Care in Behavioral Health Services.