On a journey to sobriety

Tue, Mar 15, 2011

A new book aims to bring alcohol misusers, their family members and friends on a day-by-day journey through the first 28 days of rehabilitation, writes MICHELLE McDONAGH 

IN THE movie, 28 Days , Sandra Bullock plays a newspaper columnist who is given a choice between jail or 28 days in a drug and alcohol rehab centre after ruining her sister’s wedding and crashing a stolen limousine. She chooses rehab and over the next month, she begins to re-examine her life while she tries to get sober and come to terms with her alcoholism.

In his new book, consultant addiction psychiatrist at St Patrick’s University Hospital, Dublin, Dr Conor Farren, brings alcohol misusers, their family members and friends on a day-by-day journey through the crucial first 28 days of rehabilitation – the typical length of a rehab programme.

He has used his experience in treating thousands of patients for alcohol and addiction problems over the years to create a clear, concise and caring guide to sobriety entitled Overcoming Alcohol Misuse – A 28 Day Guide.

The book, which was launched yesterday in Dublin, seeks to demystify the common disease of alcoholism and the recovery process. Crucially, the information given is not just based on the personal experience of sufferers or Farren’s astute observations about what really works, but also on the most up-to-date scientific research on the treatments of alcohol misuse.

Farren says: “The book is essentially a mixture of two things. Firstly, it’s therapy in a book designed for somebody who is looking at whether they [or a loved one] might have a problem with alcohol misuse and it gives information about how to identify if they do have a problem. It shows you how to begin to tackle the issue and move forward towards recovery.”

The guide has been written from the point of view of somebody going on a journey and is designed to provide help and support every step along what the author acknowledges can sometimes be “a very bizarre and unusual journey”.

The hard science content is interspersed with real-life personal case studies and at the end of each chapter, there is an instalment of Joe’s Story, which is the day-to-day experience of one person as he journeys into sobriety over those initial 28 days.

The book contains practical, user-friendly information on the causes of alcohol misuse, health risks, effects on loved ones, associated conditions such as depression and anxiety, how to increase an alcohol misuser’s insight, and how they can utilise the various tools available to them for recovery.

“Before I wrote the book, I went through what was available out there in terms of the literature and I found two types. There is the ‘My Story’ personal account of overcoming addiction, which is often wonderfully expressed but not necessarily helpful for somebody trying to figure out their own journey. The second type are densely scientific tomes for people working in the field,” explains Farren.

From listening to patients over the years, Farren has developed a unique understanding about what they are going through in terms of suffering and how to go about the journey towards overcoming addiction. “I am absolutely aware of what works and doesn’t work in terms of therapies, medication and self-help and, up until now, no book has combined this all together.”

As he points out, quite often the sufferer is lost and family members are equally lost and do not know where to turn. Medical and therapeutic professionals can also use the book to evaluate their patients and help guide them, he says.

Indeed, the book has already been endorsed by a number of eminent academics and research colleagues from around the world, including the universities of Yale and Harvard and the Mayo Clinic in the US. Although the book is only being launched in Ireland at the moment, Farren is hopeful that it may be taken up abroad in the future.

“Overall, the book’s message is hopeful. People can and people do recover from addiction to alcohol, and their personal and professional lives can be not only repaired but even enhanced,” Farren says.

ROAD TO RECOVERY: WHO WILL SUCCEED?
 
The list below is not exhaustive, nor is it in any particular order. It is based on research as well as the personal experience of Dr Conor Farren.

The following people are more likely to succeed in recovery:

Those who persist in treatment over time.

Those who exhibit a readiness to change.

Those who have a caring but non-enabling support group (family, friends, fellow addicts).

Those who are a bit older; recovery is more difficult in adolescents or young adults. Those who engage in recovery groups such as AA soon after discharge from rehabilitation, rather than those who leave it for a number of months.

Those who suffer from an anxiety, depression or bipolar disorder, where that disorder is effectively treated. Those without major health problems such as brain damage or liver disease.

Those who have one addiction, such as alcohol, rather than multiple addictions.

Those who relapse but re-engage with treatment quickly, either in rehabilitation or in supportive therapy.

Those who use sobriety to engage in a full recovery and not simply to stand still.

Dos and Donts: for misusers partners  

Dos: 

1. Engage in a self-help group for partners such as Al-anon.

2. Regard the problem as a behavioural one – the alcohol misuser’s behaviour must be encouraged to change.

3. Continue to express affection for the person, and dislike for the disease.

4. Analyse the situation and gain an understanding of what is taking place.

5. Gather evidence about the extent of the problem.

6. Maintain a critical eye on your own behaviour: “Am I supportive or am I enabling?” “Am I just venting my anger, or am I trying to effect change?”

7. Gently confront the alcohol misuser about the consequences of their drinking, but only when they are sober.

8. Formulate a plan of action that you intend to follow.

9. Establish a series of escalating negative consequences for the alcohol misuser if they don’t seek help or cease drinking.

10. Establish an appropriate time frame in which the alcohol misuser must seek help or do something about their drinking.

Don’ts:
 
1. Avoid screaming, shouting and throwing abuse at the alcohol misuser; it is counterproductive.

2. Don’t confront them when they have been drinking or are drunk – they will not be able to listen and probably won’t remember what you’ve said.

3. Don’t hate the alcohol misuser – the problem may not be their fault, but the cure is certainly their responsibility.

4. Don’t say one thing and then do another.

5. Don’t use the children as bargaining chips, but do point out how they might be suffering as a result of the alcoholism.

6. Don’t enter into a Faustian pact: “I’ll let you drink, if you let me sleep around/spend your money/beat you up/or do something nasty to you in revenge”.

© 2011 The Irish Times