The Four Ds – a Simple Relapse Prevention Strategy

You can (and should) try to avoid cues and triggers but there’s no way to dodge them all; if you’re in recovery – and you want to stay in recovery – you need to learn to cope with cravings.

Cravings come in waves. They feel like they’ll last forever but if you can endure for 20 minutes or so, they always dissipate into nothingness.

And fortunately, the more often you resist those cravings, the weaker they get and the less frequently they bother you.

If you can hold on for just a few minutes, you can almost always overcome your cravings. To help you with this, here’s an easy-to-remember coping strategy (The Four Ds) to get you safely past the 20 minute danger zone.

The Four Ds

This is a classic relapse prevention technique. The Ds stand for:

1. Delay – Since cravings rise and fall like waves, if you can delay a relapse decision for 20 minutes you’ll generally find the cravings dissipate on their own.
2. Distract – Craving time passes more quickly when engaged in a distracting activity for a few minutes.
3. Deep breathing (De-Stress) – Deep breathing exercises help you maintain calm and purpose when cravings hit, keeping you from making rash decisions.
4. De-Catasrophize - In the midst of a craving it's easy to get caught up in panicky 'end of the world' type thinking, like "I can't take it any longer." Or, "I'm never going to succeed so I might as well get high now." Don't let inaccurate catastrophic thoughts guide your actions. Challenge your thoughts and when necessary, reframe them into more accurate notions, like, "This is really uncomfortable, but at least my withdrawal symptoms will go away within a few days."
   

Also try - Drink a glass of water – Drinking a glass of water relaxes you and sets your purpose. Imagine your cravings as like a runaway train gathering momentum to a disaster. Simple activities like taking a moment to drink a glass of water are like brakes that slow that train!

So the next time you feel a craving, remember The Four Ds and avoid a permanent mistake caused by a temporary urge.

Here are 20 solid distraction ideas that will keep you occupied just long enough. Try any or all that make sense to you, or better yet, come up with a list of your own.

You may want to write down a few go-to distraction tasks and keep them on your person (see the example chart at the end of this article). This way you won’t be left scrambling for distraction ideas when already struggling with cravings – you’ll have your ideas planned out and ready to go.

20 Distraction Ideas for Cravings

1. Take a shower, even if you don’t need one. Scrub hard and turn the water as hot (or cold) as you can stand it. Let it soak into you for a few minutes and by the time you towel dry 20 minutes later you’ll probably feel a lot less tempted to fold.
2. Wash and wax the car
3. Call a friend and talk about their problems (not yours)
4. Clean the fridge, the bathroom or the garage – cleaning anything provides just the right amount of physical exertion and mental distraction – and as an added bonus you feel better after getting it done.¹
   
5. Walk the dog (or just take a walk around the block)
6. Go jogging
7. Do a quick home work-out
8. Meditate or do yoga
9. Play a musical instrument
10. Do a progressive muscle relaxation exercise or write in a journal
11. Catch up on work for a few minutes
12. Prepare an interesting snack, and then enjoy it
13. Do a crossword or Sudoku puzzle
14. If you’re tempted to drink or use at home, then get out of the house and go for a drive. This can be a risky. Don’t get in the car if you’ll steer by autopilot to the nearest bar or drug dealer
15. Play a challenging video game
16. Do bicycle maintenance
17. Cut the grass
18. Walk out and get a coffee
19. Fix that thing that needs fixing – replace burnt-out light bulbs or dead batteries, etc.
20. Water all the plants or groom your pet
    

The next time you feel a craving coming on, take a moment to feel it in your body, and then tell yourself that it’s going to pass if you can just wait it out – and then use one of the 20 methods listed above (or any others you can think of) to distract yourself while you wait for that urge to disappear.

And since the more tools you have at your disposal the better your odds of success, learn how to urge surf as well – it’s a fantastic mindfulness technique that lets you glide with attention right over the peak of a craving.

Make a Relapse Prevention Card to Take with You

OK, you’ve read this far, and if you think the 4 Ds make sense, take 5 minutes to write a relapse prevention card to carry around with you. Do it right now (before you get distracted :) and you maximize your odds of having it ready when you need it.

Instructions

Fold a paper into four squares:

1. On on the first square, write out The Four Ds
   
2. On the second square, write out 5 or 10 personally relevant distraction ideas
3. On the third square, write out 3 or 4 of your most significant reasons for wanting to stay clean and sober
4. On the fourth square, write out some negative expectations - accurate predictions for what will happen if you slip and use or drink.

Negative Expectations – When you’re about to relapse you tend to focus on positive expectations and gloss-over negative expectations.

Some examples of positive expectations are:

•  “I’d have such a good time if I did a few lines and went out dancing.” Or “I am so stressed right now – a few drinks would really relax me…”

Some examples of negative expectations are:

• “If I drink tonight I will feel hung-over and ashamed tomorrow.” Or “If I start doing cocaine I won’t stop until all of my money is gone.”

By writing down accurate negative expectation statements you provide a counter-balance for the positive expectation statements your addicted mind manufactures all on its own.

An Example Relapse Prevention Card