Addiction and recovery
Lisa Arrigo on coming back after relapse without drowning in shame
A 2022 cocaine relapse after long-term recovery taught trauma therapist Lisa Arrigo that shame, not the substance, is what keeps people from finding their way back.
You Are Not Starting Over: What To Do After A Relapse
Video from The One Day At A Time Recovery Podcast.
Generated from the canonical interview transcript and validated against source data by Guests on Air.
How do you come back after a relapse in long-term recovery?
Lisa Arrigo says the way back starts with the shame, not the substance. A relapse does not erase the work already done; it is a communication from a part of the self that needs attention. Acknowledge the shame and pride, reach out to one person who understands, find trauma-informed support, and treat the relapse as a teacher rather than a verdict.
In 2022, Lisa Arrigo had long-term recovery, decades of work as a trauma-informed therapist in private practice, and a memoir under way. Then a makeup artist getting Arrigo ready for a fundraising event offered a couple of lines of cocaine before the night began. The yes came out easily, and three months of full-blown addiction followed.
Speaking on The One Day At A Time Recovery Podcast, Arrigo described how that relapse ended with an overdose and a hospital bed. The first thing Arrigo saw on waking was a yellow wristband reading fall risk, and Fall Risk became the title of the memoir. The episode turns that experience into practical guidance for anyone trying to come back after a relapse.
The core message is that shame, not the drink or the drug, is what keeps people stuck. Arrigo argues that a relapse does not wipe out years of growth, and that people who understand how trauma shapes the nervous system can meet a slip with curiosity instead of self-punishment, then find the support that genuinely fits them.
Key takeaways
- A relapse is not failure; the shame people feel usually predates the drink or the drug by many years.
- Knowledge alone does not protect recovery, because trauma lives in parts of the brain that insight cannot easily reach.
- Emotional relapse can come first, as loneliness, overwork and emptiness quietly open cracks long before any thought of using.
- Coming back starts small: acknowledge the shame, contact one person who understands, and find trauma-informed support that fits.
1. Why knowledge did not prevent the relapse
Arrigo is clear that expertise is not armour. After years of trainings, certifications and deep personal work, the relapse showed that some places inside had never been reached. As Arrigo put it, a person can have all the knowledge in the world and it still may not translate into the subcortical parts of the brain that keep someone on high or low alert.
At the time, Arrigo was not thinking about using at all. A relationship was failing, loneliness and emptiness had set in, and overwork had become a way to cope. Looking back, Arrigo calls this an emotional relapse that went unnoticed, a fragile state hidden behind a busy, functioning life that looked perfectly fine from the outside.
So when the offer came, an old addicted part took over in seconds. Arrigo describes getting the dealer's number before the makeup artist left, then spending the fundraiser in the bathroom trying to reach that dealer. Once cocaine was back in the system, the old neural circuits reconnected as if they had never gone, and the brain, in Arrigo's words, was no longer a friend.
2. Shame is the real barrier to coming back
Asked why it is so hard to return after a relapse, Arrigo answered with one word: shame. Relapse sends people straight back to old places of wounding and to the feeling of having failed. Nobody plans a relapse, Arrigo notes, and the experience itself can be traumatic, which makes reaching out feel almost impossible for someone already flooded with self-blame.
The reframe at the centre of the conversation is that the shame is not really about the substance. Arrigo encourages people to ask when they first felt shame, because a relapse often triggers wounds that are far older. Left unexamined, that shame locks people into isolation, and Arrigo sees it as the biggest killer of people with long-term recovery who never make it back.
Arrigo also questions how labels can deepen the problem. All addictions start as coping strategies, Arrigo says, and nobody wakes up wanting to become an alcoholic. Twelve-step meetings offer community and a spiritual practice, but the model is not trauma informed, so a comment meant kindly can land badly on someone whose history includes violence, mistrust or religious trauma.
3. How to come back without starting over
The first step Arrigo describes is to acknowledge and validate the shame and any pride standing in the way, and to meet those feelings with compassion. Next comes contact with one person who knows what it is like to be back in that place. Trauma-informed therapy is another route, along with groups and communities where people can tell the truth and feel seen.
Crucially, a relapse does not erase the work already done or the lessons already learned. Arrigo describes it as a block on the access route, not a reset to zero. Stepping out of what Arrigo calls a shame bath takes personal responsibility, even while the shame still feels heavy, but the tools and growth from earlier years are still there to reclaim.
For people with complex trauma, Arrigo draws on internal family systems and structural dissociation work to help them unblend from the addictive part. The relapse becomes a communication from one part of the self rather than a verdict on the whole person. That shift opens room for curiosity, and Arrigo now calls the relapse the biggest teacher of all.
