What happens when we drink too much? Firstly there is the pleasant rush of intoxication, the relaxation of anxiety and inhibitions, and a generally pleasant effect. then as more alcohol goes in, a number of things can happen. Mostly nothing major happens, and the night passes off well enough. But with increased drunkenness, a lot more bad stuff can happen. Emotions can run riot, people can get argumentative, even belligerent, and fights can occur. That might end up as a few bruises, or even a visit to A+E; but occasionally, it can end up in a serious injury or even death. As inhibitions get shed, people can act in ways unthinkable when sober; “truths” that are best unsaid get said; opinions that should be kept quiet are shoved in others faces; and impulses best left under control get unleashed. All can have massive consequences. Friendships can get destroyed, spouses can get attacked and battered, and sexual assaults can occur. If someone has a depressive tendency, then depression can get much more intense, and suicidal ideas can emerge. Disinhibition can lead to those suicidal ideas getting acted upon, and so there can be rash suicidal acts that can end up in death. So much can be unleashed by the power of alcohol that it is a wonder that it is permitted at all. You can argue that it all laid under the surface anyway, and that everything that happens is just an expression of what lay underneath. But the reason we have layers as humans is that we have discovered ways of judging situations, of controlling impulses, and putting conscience into play. Indeed it is arguable that the main thing that distinguishes as humans is all those factors we inhibit in our daily lives, and not all the things we push for. Neandrethals had much smaller inhibiting frontal lobes in their brains than us humans, and we all know what happened to them. For better or worse society exists on the basis of suppression of desires and impulses, and alcohol lets us know what would happen without civilization. We possible might have a good time initially, but without controls we would probably end up injured, depressed and possibly dead. That is as good an argument that you can find for the controlling of the uncontrolled substance. Unfortunately there is no sign that alcohol will be controlled in any meaningful way in this country or any of our neighbours in the near future. The consequences will continue, and the cause will remain the same. No change there!
Death is not necessarily the worst outcome for the struggler with an addiction, at least from their perspective. Death for some is an escape from turmoil, trouble and suffering. If someone is in the throes of an addiction, depressed to boot, and suffering both craving for a substance, and the guilt that comes from inflicting suffering on loved ones, then death may seem like an easy option. It however is not an easy option for those left behind. Death because of an addiction, from an overdose of alcohol like Amy Winehouse; from a slow death from a disease like cirrhosis of the liver, or the worse of all by suicide, leaves loved ones bereft and correspondingly guilty as well. For with an addiction there is always the question: what if I had done something differently, what if I had intervened earlier, what if I had enabled less, what if I had tried harder to do something for the addict? Who knows, maybe something that someone else does or says could turn a situation around; maybe a kind word here or an sharp-turned phrase there could make the difference between life and death. It is hard to say, but when an addict dies, the question dosen’t die, it just becomes unanswerable. I cant say what works and what doesent in relation to turning a particular addiction situation around. Not everybody has to reach rock bottom; but sometimes it is all that works. When there is life, even in the middle of an addiction, there is hope. Sometimes it does take the 4th or 5th rehabilitation for someone to really get the message, sometimes it does take 2 or 3 failed relationships to help someone gain insight; maybe it takes being fired numerous times to really get the motivation to stop. But there is no opportunity to change when death is chosen, there is no possibility for an alternative outcome, there is no other path in the woods. And all that is left behind is the grief, guilt, and sense of “what a waste of a life”. Ultimately there has to be a better way, and that way is recovery.
What happens if a loved one is developing an addiction problem, and no one is letting them know what is happening? Most people who go on to develop a full alcohol dependence are not aware of it as it is happening. If the road to hell is paved with good intentions, then the road to alcohol misuse is paved with good blinkers. No one sets out to become an alcoholic, but they have a right to be informed about it if it is happening. So those closest to the “alcoholic in training” need to let them know what they are seeing, as they are seeing it. That does not mean a shouting match at 3 am, that means a careful and measured conversation after the alcohol has had a few days to get out of the system. Careful, measured but forcefully stated comments by a loved one are the most powerful methods of real commounication with a budding alcohol abuser. Not that a response or a change is guarenteed, of course, but they do deserve an opportunity to get the message. A lot of alcohol misusers can reverse a pattern of excessive drinking, by just having a simple effective warning or two at the right time. Research suggests that 20% of alcoholics can reverse track with such a kind of warning, if given early and effectively enough. In a rehabilitation setting, the most powerful force for change is a loved one’s opinion; a therapist can’t get under an alcoholic’s skin quite like a spouse or partner. And you never know when an addict is ready to change, or ready to hear a message then haven’t been able to hear previously. All a loved one can do is give that message, clearly, soberly and directly, and sometimes it pays off. It is the least the alcohol misuser deserves.
I just spent a part of my holidays reading Keith Richard’s autobiography, Life. In
Is this a "real" life?
it he details his rise in the 1960′s as guitarist in the Rolling Stones. He charts his musical interests, his part in the band’s success, his marriages and relationships, and his relationship with Mick Jagger. He also details in pretty intense detail his “struggles” with multiple addictions over 40 years. He describes multiple drunken episodes, his dependence on heroin for many years, and how his addictions affected those around him, his girlfriends, and his children. It makes for pretty harrowing reading, were it not for one thing: he dosent express any regret for any of the damage he has done. Bizzare episodes where he abandones his eldest child to live with his drug addicted partner, his previosuly estranged father and a slighlty mad alcoholic minder are described and then passed over. His friendships with many musicians appear fuelled by drugs and alcohol, and then their deaths listed as if part of some terrorist campaign between them and reality. He seems impervious to the feelings of others, including Mick Jagger, and accepts without remorse all the efforts to help him achieve sobriety. He credits himself a survivor because he knows how not to go too far in his addiction, he was always moderate. He uses the words of recovery, without acknowledging the emotion nor the effort that must be behind those words. In short, he refuses to acknowledge the emotional responsibility for the effects of his addiction upon those around him, and he seems to feel that putting words upon paper absolves him from his evil deeds. It is uncertain if he is currently sober, but there is no doube that he is not in recovery. It seems such a shame that such a talented and indeed really dedicated musician can do such damage to those around him, and not see that for himself. No only does he not see that, he dosen’t evey try to see it. He makes the excuse that this is the territory that goes with being a member of the Rolling Stones, as if that is a justification. He is to be credited with a kind of superficial honesty that hides more than it reveals. As with a lot of addiction, the people close to him suffer most, and he simply refuses to see that. I hope that he will write a second book, “New Life” in which he charts his revised understanding of his addicted life. I somehow doubt it.
When someone enters into recovery, their ambitions may be very modest. They may think, I would like to give up the booze for a while, or I would like to get the wife back, or I would like to get out of debt. they may look upon the exercise as a very limited method of achieving one single end, of getting the monkey of alcohol of their back. But soon into the pathway of sobriety, they discover that there is a lot more to it than simply giving up alcohol. In fact giving up alcohol is just the start of recovery, it is saimply step one on a very long journey. If the cliche is true, then stopping drinking is the easy part, but staying stopped is the hard part. Staying stopped off alcohol involves broadening ambition to many aspects of life. Since addiction to alcohol takes up a large part of life, in fact the major part of life, staying off alcohol involves redirecting all of those parts of life. So that means looking at all aspects of life that were in any way associated with alcohol, looking at friends who were drinking companions, looking at jobs or passtimes that were associated with alcohol, looking at the times of day that were spent drinking. All of these need to be looked at, and if necessary changed. A life without alcohol is a very different from a life built around it. Pride has to be rediscovered, and reasons for pride found in a sober life, and not a drinking one. It is wonderful when a major source of pride is the achievement and maintenance of sobriety; it is much healthier when the source of pride moves beyond that into the achievement of many things that could not be done while drinking. Recovery allows the rediscovery of personal pride, because at the bottom of a drinking life, it is very hard to be really proud of anything. In the cold light of a sober morning, almost nothing achieved during a drinking period is worthy of pride and very little is of value during that time. The greater purpose of recovery is the reestablishment of the foundations of self esteem and personal worth. Those foundations may be hard to define, and harder to actually find, but they are the things that make recovery not only possible but worthwhile. Sobriety is but the gateway to a much broader and worthwhile way of living.
The bigger picture
We all have dark days, days when we can’t seem to shake a sense of forboding, of feeling flat and low. For most of us it is only an occasional feeling; there is some reason or other for it, and it dosent last more than a few hours or days. For those suffering from depression, this period of feeling flat is much more intense, much longer lasting, and dosen’t fade with time. Such a feeling or set of feelings is an experioence to avoid at all costs. It effects all aspects of life, robs us of pleasure in life, and can even be life threatening if it reaches an extreme. Most of us would do anything to avoid such a feeling, and would do anything to make that feeling go away if it began to linger in our lives. And there can be many causes of such a feeling, ranging from unfortunate genetic loading, recent trauma or loss, medical disorder, or even childbirth. What most people don’t realise is that it can also be caused by alcohol. Alcohol is a downer, and half of alcohol addicted people entering treatment have significant depressive feeling that are primarily caused by the alcohol. Of course alcohol isn’t a downer all the time, for most people alcohol produces the pleasant buzz of intoxication, and then a period of disinhibition, and then some drowsiness. However for a significant number of people, depression intervenes, and the feeling of mild intoxication is followed by a distinct downturn in mood, overpowering all other sentiments. This feeling can last hours, days or even weeks, and it can outweigh and outlast rational explaination. You don’t have to be addicted to alcohol to get the depressed mood from alcohol, you can even get it after an occasional binge, or just heavy drinking. The tragedy is that most people suffering from an alcohol induced depression don’t even know that their depression is caused by alcohol, they think it has some other explanation. They assume it is a recent life event, or even a past trauma that is the explanation, and they look no further. The big deal is that this degree of depression can lead to suicidal thoughts, and for some even suicidal acts. The good news is that alcohol induced depression can be eliminated with one simple act: ceasing alcohol. For someone suffering from depression, the chance of eliminating it in one simple move, through stopping drinking, should prove to be a wonderful opportunity to control a most uncontrollable disorder. Most people suffering from a severe depression would give their right hands to get rid of it; and some can absolutely get rid of it with no cost, no effort, and no difficulty. Stop drinking and then see what happens. For about 80%, the depression disappears altogether, and that isn’t a bad percentage. For them, one simple act means the dark days are over. A nice way to exercise control over an uncontrollable suffering.
Do you feel like this?
The trouble about an addiction is that it never goes away. Of course it goes away from the front of your mind, but an addiction is your friend for life. It is impossible to get rid of it, so there is no point in trying to pretend it is gone ‘cos it ain’t. However just because it hasn’t gone away, doesn’t mean that it has to dominate your life anymore. An addiction is not cured, it is just managed. Management of something takes care and some attention, but after a while it may not need as much attention, but it always needs some attention, like a pet. Whatever your addiction needs to be managed into quiesence, that’s what you have to do, no more no less. If it rears its head again, it needs more management; if it is not making your life or the lives of those around you a misery and if it ceases to be a behavioural part of your life, then you are probably managing it adequately. However ignoring it is not the same as managing it. It always requires attention, if only a small amount of attention. Not bothering to give it any attention is the same as asking it to dominate your life again. Your addiction’s response to being totally ignored is guarenteed: it will come back again, it’s return is a certainty. And that is the message you need to hear every day: if I don’t pay attention to my addiction, it will pay attention to me. So find a way to get your self that message every day, through a self help group, like AA, through talking to a sponsor, through prayer, through a counsellor, through an online forum. Every day should involve some effort at being reminded at what a full addiction is like. A gentle easy reminder can be as effective as a big reminder, but you must make some effort to be reminded. An effective reminder will provide motivation to remain abstinent. Motivation is not acquired in single large dolops, it is acquired in daily small reminders. A daily small effort can provide a lifetime of benefit. Persistence is a gentle small effort that can pay big dividends. Every day.
This can produce craving
Kermit the frog said “it’s not easy being green”. He might have well have said “it#s not easy being sober”, and it isn’t. No matter how someone says that life is better without alcohol, and it is; no matter how the quality of almost every aspect of living goes up, and it does; and no matter how much any tells themselves that things are looking up, and they are: sometimes you just want a drink! That feeling dosent go away, it just fades over time. It can take months, or even years for the feelings or thoughts about alcohol to fade completely. Some people are luckey, and the thoughts and cravings fade almost immediately. The majority of people, if they are truthful to themselves, will admit that it takes time for the alcohol to disappear from prominence. What is suprising is that eventually the obsession with alcohol does completely go away, if it is let. If an awareness of the possibility of craving is adopted to, and all situations alcohol related are avoided, and all associations are revoved from daily life, and all the places and people avoided, then craving simply dissapears. If however no changes are made, the same associations left in place, and the effort is only partial, then craving can refuse to go away, and indeed can even grow. No everyone who continuously craves eventually drinks, but it certainly has an influence. Remember the fact that it can be unconscious as well; and that’s why there must be eternal vigilence to prevent it coming back. Avoidance of life must be replaced with avoidance of all things alcohol: it really works.
What its all about.
Wanting to drink is a funny kind of thing. Its not necessarily very strong, it can be just a passing fancy: “Oh wouldn’t it be nice to have a beer, it a lovely hot day”. Or “Gosh look at everyone having a glass of wine with their dinner, I would love one too”! It seems such an innocent, background thought that no harm could come of it. And of course it could be the most deadly thought of a lifetime, it could literally mean the difference between life and death, between having a family and losing everyone, and between having a job and getting fired. It is very difficult when having a passing thought that there could be a whole history of addiction behind it; there could be a whole force of an alcohol dependence driving that thought; there could be years of build up to make a passing thought. Scientists have identified major changes in the base of the brains of those who become alcohol dependent, their whole brain architecture and chemistry is changed. They may not be aware of those changes, but they certainly need to be aware of the consequences. Each passing fancy of a thought could be the precursor of a major relapse, a major binge, a major bender. Each relapse is a risk, something awful could happen during it; no one can predict what could happen. So each passing fancy could have a major cause, and a major consequence, if it is acted upon. If you cant prevent the thought, you can at least prevent the consequence. The aim is to recognize the thougt for what it is, a significant episode of craving, and act as if it could be the kiss of death. Only through the understanding of what the origin of the passing thought is, can you stop yourself from acting on it, taking tht first drink, and ending up God know where, in God knows what state. Beware what is behind that thought.
It has been great to have the queen here in Ireland. The visit has been wonderful, uplifting, healing and magnificent. It has felt like growing up, leaving home after years of rows, and then visiting the family home as an adult, and not a child. The relationship is now of equals. But whay did she have to visit Guinnesses, and make it look that drink was the major part of Irish culture she could not miss. There are many more things that that to Ireland, and yet that is the message going out to the world, alcohol is a vital part of being Irish. There should be more to us than that, and at least she didn’t touch the stuff. We have so much more to celebrate than booze; maybe she should have visited the best rehabs in the country instead. We may have grown up in our attitude to our neighbour, but we have yet to grow up in our attitude to alcohol.