Online Alcohol Therapy

“I wish I could quit drinking so much, but I just don’t have enough willpower”.

As a therapist, I hear this quite often, but perhaps we need to explore what willpower really means in order to find a solution to the problem.

The capacity to resist the urge to drink arises initially from various motivations – like the desire to avoid a hangover, or the need to be able to concentrate at work the next day, or the preservation of a close relationship perhaps. If sufficient motivations can be brought to mind, and they feel more compelling than the potential pleasure of alcohol, then a person can exercise self-control and not drink despite wanting one at the time. This is a reasonable definition of willpower.

Some people seem to have more willpower than others regarding their drinking, but perhaps only because alcohol has not taken on so many important functions for them (like stress-relief, confidence boosting, avoiding boredom etc.), or they have found other ways of achieving those results.

People with alcoholism are unable to resist the urge to have a drink, despite knowing that in balance it’s not doing them any good. Partly this is because short term consequences are often more effective at influencing behaviour than long term consequences, and in the short term the pleasure/relaxation of a drink outweighs the negative effects tomorrow or at some indeterminate time in the future (or so it seems to them). A strategy to deal with this tendency of course is to concentrate on the negative effects of alcohol in the short term, rather than the vague long term ones.

People can learn to have more control over their urges to drink, to predict when they are likely to occur so they don’t come as a surprise, to learn to bring to mind all the ‘pros and cons’ rationally, or to address those needs that alcohol has filled some other way – and so they increase their willpower.

A survey by the British Association for Counselling and Psychotherapy (BACP) has found that talking therapies are becoming more acceptable in UK culture, people are less embarrassed to admit they have had counselling, and more would consider it as an option than they used to.

Thankfully it seems our society is changing into one which acknowledges the difficulties we all face with our mental health, and as such does not stigmatise those who decide to seek help in the form of counselling or therapy.

All we need now is sufficient access to these therapies, because at present (and with cuts in public spending under way) there is just not enough capacity to meet demand. The cheaper option of medication is often suggested by GPs with limited funds, which though effective at dealing with symptoms, does not address the underlying issues.

Further coverage in the Guardian.co.uk

A good article on the BBC today about what happens in an AA meeting – well worth reading.

A lot of people consume alcohol as a way to manage stress. How often this is effective as a coping strategy probably decreases as the amount you drink increases. But although alcohol doesn’t really work as a long-term way of handling stressful situations, it does provide relief in the short term. And this is where the problem starts.

Our tendency to consider short-term effects in preference to longer term ones is visible in many areas of our lives. But why can we not more easily use the negative consequences of alcohol in helping us decide how much to drink?

People use the word “stress” quite a lot, but what does it really mean? Do we all use the word to mean the same thing? Everyone perceives different things to be stressful, but a few aspects of our experience are probably universal.

The first aspect is that a feeling of stress arises when we believe situations in our lives require more of us than we are able to give in terms of emotional or mental energy. We become depleted, and our decision-making abilities seem to lessen along with this.

Another aspect of stress is that we encounter events which trigger the ‘fight or flight’ reaction inherited from our ancestors. When we sense threat, or the possibility of emotional pain ahead, or any outcome that might make us anxious at some level, adrenaline is produced to prime our bodies to take action and our blood pressure goes up.

Of course not many stressful situations require physical responses these days, we have to deal with most events through more subtle behaviours than running away or fighting. And yet consumption of alcohol does seem to allow us to effectively ‘run away’ doesn’t it? Maybe this explains it’s popularity.

How is it then that some people seem to manage stress better than others? Is it just their resilience? More likely it depends on our beliefs about ourselves, our estimation of our ability to handle the events in our lives, which is a self-fulfilling prophecy. If we can effectively deal with events, there may be less urge to run away from them, and hence perhaps less urge to drink. If you are drinking less, then undoubtedly your capacity to respond to stress is improved.

We all make mistakes from time to time, it’s inevitable. But how you react to them can make a big difference to your self esteem.

What do you tend to say to yourself when you make a mistake? If you have a judgemental inner voice that says something like “I’m so stupid, I always make a mess of things” or, “why did you do that again, you’re so useless”, then of course you’ll feel bad about yourself as a result.

If you have many of these self-criticisms happening regularly, it tends to lower your opinion of yourself, and can lead to depression, and from there to drinking more.

Similarly, how you respond to your alcohol consumption has an impact on how you feel about yourself. If you drink more than you intended one night, you might judge yourself for it, saying something like “you’re such a loser, you got drunk again”. The consequences of such a thought are probably feelings of hopelessness and low self esteem. Contrast that with a different reaction to getting drunk, like “I wish I hadn’t done that again, I really need to work out what’s going wrong” – there’s no judgement or self-criticism in that, and you’re more likely to feel hope that you can change.

This is just one small example, but the important point is to listen out for the content of your inner voice, and notice when it’s being harsh or critical, then stop to consider what you could say to yourself instead that would be more understanding and caring.

And before you reject this idea, saying “but that’s just how I am”, these self-statements are not a fixed part of your personality, they are just habitual, so they can be changed.

You can start by making yourself more aware of what you habitually tend to say to yourself. Write it down when you notice you’re being self-critical, then you can begin to challenge such thoughts when they pop up next time, maybe something like “hang on a second, I’m not useless, I just made a mistake, that’s all”. No judgement, no labelling yourself as faulty, just an acknowledgement of human error, and maybe some forgiveness too.

As if you needed another excuse to have a drink. Now researchers in Spain have conducted a study of 40 000 people and found that those who drank alcohol regularly tended to have a lower risk of a heart attack than those who were teetotal (particularly for men over the age of 40). And the more you drink, the greater the protective effect.

Don’t forget of course that all the other health risks still apply – so you might not have a heart attack, you’ll just get liver cirrhosis instead, or pancreatitis, a stroke perhaps, or you could develop diabetes, or stomach cancer. So don’t take this as an excuse to have a drink after all.

The Independent

A recent research study published in the Lancet has demonstrated the effectiveness of online psychological counselling for mental health problems. The study followed a group receiving therapy over typed internet chat (or instant messaging), and found it more than doubled their chance of successful recovery from depression when compared to a control group just taking anti-depressants.

The study director Dr David Kessler said these results are comparable with those seen in face to face therapies. Clearly, some people find it useful to write down their thoughts as a way of talking through them.

If you think you might want to give it a try to help with your alcohol problems, get in touch with us here.

Many of you will say that you need a drink in order to sleep, that alcohol actually helps you sleep better. While it may be true that drinking will get you off to sleep quicker, unfortunately the quality of your sleep will be much worse overall.

Alcohol inhibits the brain from entering REM stage sleep, which is when we do most of our dreaming, and prolongs the initial stage of deeper sleep. So when you wake up, you will probably not have dreamt enough – and dreaming is an essential component of sleeping. That or you wake up early once the alcohol has worn off.

Alcohol also inhibits your kidneys from absorbing water, so you tend to urinate more, and end up dehydrated. This further disrupts the quality of your sleep, and often produces a headache by morning. As such you end up feeling tired and unable to concentrate for the rest of the day. If you drink every evening, then you may be chronically sleep deprived, even though you might sleep all night, the quality of your sleep is not what it should be.

Making the transition to drinking less is often marked by a difficulty in falling asleep however, so you’ll have to readjust to dropping off naturally again. Getting regular, strenuous exercise is a good idea then – if you’re physically tired you’re much more likely to be able to sleep without needing your usual ‘knock-out drops’.

An important factor in solving your problems with alcohol is talking to other people who understand what you’re going through, who won’t judge you for it, and who will genuinely share their experience without just trotting out the old clichés about drinking. I’m sure you’ve heard these many times from friends or family, like – “oh you don’t need to worry about it, you don’t have a drink first thing in the morning do you”, or “I don’t understand why you can’t just have a couple like I do” etc.

Of course most people immediately think of Alcoholics Anonymous meetings when they consider getting support from a group of people with drink problems. But again, many people are intimidated by the doctrine of AA, as the 12-step model it follows has certain expectations for you to fit into (though not all AA meetings strictly adhere to these principles). Similarly, some people are so uncomfortable and embarrassed about their drinking that they don’t want to admit it face to face with others, even if they are strangers.

Luckily there is now the option of communicating online, where the computer screen can grant you that cloak of anonymity (much like a catholic confessional, but without the “forgive me Father…”). As such you can exchange comments with others on any of the posts on this site, or more effectively you can join our alcohol support forum – day or night there will always be a wide range of people logged on who can give you feedback, support or advice about your drinking and an idea of how to make some changes. Check it out and if you like what you see, register for an account (free of course).

According to figures released today by the NHS:

• 1 in 4 adults are drinking at hazardous levels,
• 1 in 10 men are on the verge of alcoholism,
• 1 in 6 women drink at levels sufficient to damage their liver or lead to depression,
• 1 in 10 men and 1 in 25 women are approaching alcohol dependence (admittedly rather vague terminology).

We have to ask ourselves why people in the UK seem to be developing more problems with alcohol, and what can be done about it. The cost to the health service alone is staggering – presently some £2.7 billion. That’s before we even consider the personal and social costs involved.