Most practitioners recognise this pattern.
Someone finally gets housed. Their substance use reduces. Risk settles. Support is in place. For the first time in a long while, things are relatively calm. And then, almost on cue, everything starts to unravel. Appointments are missed. Use escalates. Engagement drops off. Words like self-sabotage, avoidance, or relapse begin to circulate.
We have explanations for this. We talk about fear of change, poor motivation, difficulty tolerating stability. Sometimes we say people “don’t know how to cope when things go well”. None of these explanations are entirely wrong, but none of them quite explain why this pattern is so persistent, so predictable, and so resistant to even the most well-intentioned support.
For a long time, I tried to make sense of this by thinking about time. Initially, I described what I was seeing as something I called temporal confusion, a way of capturing how the past, present, and future often blur together for people living with distress, substance use, and instability. But the more I sat with it, the less that language worked. Confusion implies misunderstanding, as though people are getting time wrong.
What I’m increasingly convinced of is that many people aren’t confused about time at all. They’re trapped by it.
I’ve started calling this temporal entrapment. By that, I mean situations where certain moments of harm, loss, exposure, or humiliation never fully resolve and continue to shape the present as if they are still ongoing. These moments don’t return as memories. They operate as constraints. They influence what feels safe now and what feels risky in the future. In these conditions, progress doesn’t bring relief. It brings exposure.
To see what I mean, it helps to step out of theory and into practice.
Mark is 42 and has been known to services for years. His notes describe a familiar picture: depression, alcohol use, periods of engagement followed by disengagement, stability followed by relapse. He’s not chaotic in a dramatic sense. He can be articulate, reflective, and polite. At times he works, maintains housing, and reduces his drinking. At other times, he disappears completely. Staff often note that he seems to relapse just as things begin to improve.
When Mark does attend appointments, he frequently returns to the same moments in his story. He talks about losing a job years ago after being confronted by a manager, about feeling exposed and judged, about being made to feel that he had wasted opportunities. These stories are well rehearsed. Practitioners sometimes feel stuck, as though nothing new is emerging. Notes reflect frustration that Mark “can’t move on” or is “stuck in the past”.
Six months ago, Mark was offered a place on a structured therapy programme. At the time, his housing was relatively stable and his drinking had reduced. For a short while, things appeared to be moving forward. Then, two weeks into the programme, he stopped attending sessions. His drinking increased. He avoided phone calls. When contact was eventually re-established, Mark said he had known it would fall apart. As therapy began, he became increasingly uneasy, convinced the therapist would eventually “see through him” and decide he was a fraud.
When asked what actually changed for him, Mark didn’t describe fear of therapy itself. What he described was waiting. When life became quieter, when there was less immediate crisis to deal with, his head became loud. Earlier moments of exposure and judgement replayed, not as memories, but as expectations. He lived with a constant sense that something bad was about to happen, that stability was temporary, and that he was about to be caught out. Drinking, he said, stopped the waiting. It pulled him back into something immediate and familiar, where the future no longer felt like a threat.
From a conventional service perspective, Mark’s behaviour is often understood as avoidance or relapse triggered by progress. The response tends to focus on motivation, challenging beliefs, or encouraging him to tolerate discomfort. None of this is malicious. But each missed appointment and each discharge quietly reinforces the same pattern. Mark ends up exactly where he expects to be: the person who can’t sustain progress, the person who fails when scrutiny increases.
Read through the lens of temporal entrapment, something else becomes visible. Mark isn’t resisting care. He’s protecting himself from a future that feels dangerous. A past moment of exposure and loss of legitimacy is still operating in the present, shaping how he experiences time itself. When the future opens up through therapy or stability, it doesn’t feel hopeful. It feels risky. Alcohol doesn’t help him escape the past. It helps him escape the future.
What’s uncomfortable here is how often systems unintentionally reproduce this loop. Services are built around future-oriented expectations: attendance, engagement, progression. But for someone who is temporally entrapped, progress itself increases vulnerability. Without attention to temporal safety, predictability, and repair, we end up asking people to move forward before time itself has stopped hurting.
I don’t think Mark’s story is about lack of motivation or poor insight. It’s about what happens when unresolved moments continue to organise the present, and when temporal protection is misread as resistance. Temporal entrapment doesn’t remove responsibility or excuse harm, but it does help explain why change so often collapses back into repetition, even when support is available and goodwill is genuine.
Perhaps the question for practice isn’t “Why does this person keep disengaging?” but “What does stability unlock for them?” Or more uncomfortably, “What risks does the future represent?”
Some people don’t relapse because they can’t cope with chaos. They relapse because they can’t yet survive stability. If that’s true, then before we ask people to build futures, time itself sometimes needs repairing first.