Tobin Hunt

About Tobin Hunt

A Psychologist trained in Cognitive Behavioural Therapy, specialising in the treatment of alcohol problems, anxiety and depression.

Are you a ‘functioning alcoholic’?

Most of the clients I talk to are not at ‘rock bottom’, to use the AA phrase. Their drinking is not causing many crises in their lives. Sure, there are consequences from their alcohol consumption, but quite often they are manageable. They might be termed ‘high-functioning’ alcoholics.

Do you seem to be getting away with your drinking, most of the time? If you’re feeling a bit below your best at work the next day, does anyone really notice? When you drink, do you tend to be amiable, not argumentative or belligerent? Are you one of those people who would never drive a car once you’ve had more than one drink?

Like most people, you’ve probably never noticed any major health problems due to alcohol, although also like most drinkers, you’re aware of the risks and concerned about them. Maybe you’ve even noticed some subtle costs to your health – weight gain, poor skin condition, troublesome digestion, disturbed sleep? But perhaps you try to ignore those.

Perhaps your partner has repeatedly expressed their concern about how much alcohol you drink? But they haven’t left you because of it, so you dismiss their concerns.

functional alcoholicLots of people drink way more than is good for them, yet manage to deal with the side effects. As such they can convince themselves that their alcohol consumption isn’t out of control, that they aren’t an alcoholic.

But as with most things, alcoholism is not a discrete category that you’re in or not in, it’s a sliding scale, with various degrees along the way from someone who is abstinent at one end, to a dependent alcoholic at the other. A functional alcoholic might be at about 70-80% on the scale, lets say.

Whereabouts on the scale are you?

Ambivalence about Drinking

Pros and Cons of DrinkingFor many people, the decision to change their drinking habits is not clear-cut. The pros and cons of your drinking might seem quite evenly balanced; occasionally the negative consequences might increase, you have a binge and do something embarrassing perhaps; but then at other times those costs can seem more tolerable, more manageable.

When you’re feeling concerned about your alcohol consumption, this back and forth swing of apathy and motivation can go on for years. The truth is, most people find alcohol to be a pleasure, they enjoy the effects, the relaxation of emotional pain, the reduction of anxiety, the dissolving of barriers with those around us, the warm glow of not caring about the pressing issues in our lives. We tend to view many choices about our lives in this way – a simple weighing up of the pros and cons.

When we drink, we just don’t care any more, and that is such a delightful state of being, it seems worth the high price of admission. Most of the time. Until you’re woken by indigestion and anxiety again, until you wake feeling retched again, full of guilt, shame and regret. Many people are aware that their drinking is a problem, but not enough of a problem to do something about it. The idea that we can just force ourselves to change our behaviour, commonly referred to as ‘willpower’ is just not supported by reality – willpower comes and goes unpredictably.

Eventually though, the scales tip slowly but surely towards a point of action. By reading this, does it suggest your motivation is tipping towards making a commitment?

CBT for Alcoholism

CBT for AlcoholismCognitive Behavioural Therapy (CBT) is an effective, practical solution backed by extensive research. It can be used for any number of mental health problems or behavioural issues, including of course, alcoholism.

So how does CBT work in relation to alcoholism, what is the process? And, as you’re probably wondering, how will it help you to solve your own alcohol problems?

Alcoholism is different for everyone; the reasons why you drink are not the same as the reasons someone else drinks. So the first step in solving your issues with alcohol is to explore where your drinking fits into your life, what contributes to it, and what might be maintaining the problem? CBT is a method for helping you to examine your thinking styles, your beliefs, and your interpretations of the various aspects of your life, to see if they are unhelpful for you, and particularly to see which ones are fuelling your alcohol consumption.

Once we’ve established a few priority issues to focus on (like work stress, or relationship problems, worry, or depression perhaps) you can practice some pragmatic changes to see which ones are most effective for you, and which ones help you reduce your alcohol intake. Part of what makes CBT so effective is that it’s individually tailored to you and your specific problems, it’s not just a set of instructions to follow.

Alcoholism is a difficult problem to solve though, so the best intentions don’t always work out as you expected. Dealing with mistakes and learning from them is key to this, without criticising yourself. As such, predicting your most likely triggers for drinking is vital, so plans can be developed for how to handle such situations differently.

Another key difference with CBT for alcoholism is that abstinence is not the only option (unlike AA for instance) – most people find they can successfully cut down how much they’re drinking, once they start handling some other aspects of their lives a bit better. Equally, CBT allows you to learn new approaches to problems, without solutions being ‘implanted’ in you, as in hypnosis.

If you’re curious about how CBT can help you, make an initial enquiry with our contact form in the top menu.

Are you ashamed of drinking?

ashamed by alcohol bingeUnfortunately, drinking too much alcohol can make people feel ashamed, especially if you believe that drinking excessively suggests there is something defective about you. Or you believe it is something that needs to be hidden from other people, as you fear their judgement. This is the nature of shame, it is a particularly negative feeling, and is often a factor in depression. It is usually tinged with regret of course, at having done things while drunk that we would never do sober – perhaps hurting other people or behaving inappropriately.

How can we reduce the effects of shame then, or minimise it’s impact? How can you feel less ashamed of drinking alcohol? The first thing to consider is compassion. These are the feelings of nurturing, caring and forgiveness that we normally feel towards a child or a loved one, but we also need to apply to ourselves. Most of us are our own harshest critic, and when feeling ashamed about drinking that tendency can go into overdrive.

So forgiving yourself is an important aspect of reducing shame. Some will have concerns here, that if they forgive themselves then they’ll lose control of their drinking entirely. But this is not to suggest that the behaviour itself is forgiven, just the person is forgiven; “I did something I regret, but that does not make me a bad person”, for instance – taking responsibility for your actions, rather than berating or blaming yourself. Many people find the idea of self-compassion awkward, it’s not something we’re accustomed to, but most therapeutic approaches recognise the importance of it for mental health.

Some might say that the easiest way to avoid feeling ashamed is to stop drinking so much. But that is overly simplistic, because many people find they cannot do that easily, they may have tried many times, but without success. A vicious circle can develop, whereby someone feels ashamed of their drinking, becomes self-critical and starts to feel depressed as a result. This can then be a trigger for further drinking, as alcohol often lifts your mood. But again, the important thing to distinguish is that drinking too much is a regrettable habit, not a sign of a personality defect.

Harmful Drinking in the over 50s

Research just published in the journal BMJ Open, studied the alcohol consumption levels of UK residents over the age of 50.

Overall, levels of drinking in this age group are increasing, the report concludes (although binge drinking has reduced, suggesting more regular drinking patterns). Although for men, the peak is at 60, after which their drinking tends to diminish. They found that higher income is associated with more harmful levels of alcohol consumption in women, but strangely not so with men. Those who smoke, and those more educated also tend to drink more, for both genders.

Unfortunately the harmful effects of alcohol on our health are more pronounced the older we get, so these results have some alarming implications.

How Mindfulness can help with your alcohol problems

Mindfulness for alcohol problemsThere’s been a lot of media attention on Mindfulness lately, but not so much on how useful it is for dealing with an alcohol problem. So how does mindfulness help us deal with mental health problems generally, and with alcohol issues specifically?

There is very little research into how it achieves its effects, however my own mindfulness practice leads me to believe that one of the main mechanisms by which it is helpful is the development of an ‘observer view’ on your own mental processes.

This observer view occurs largely as a result of focusing on clearing the mind and concentrating on the breath. When the mind inevitably wanders off this focus, a key part of mindfulness is to notice that you have started thinking about something, then calmly return to focusing on the breath again. It’s the ‘noticing’ what the mind is doing that is helpful I believe. From that we can learn to observe our own thoughts more generally, when we’re going about the rest of our day, not practicing mindfulness necessarily. If we can be more aware of when patterns shift in our inner landscape, it can only be a good thing. If we therefore become more self aware, rather than reacting automatically to our thoughts, we can have more choice in how we respond, in whether we have a drink, or choose something more helpful for us.

Another effect of mindfulness, or meditation as it used to be called, is in allowing the ever-active mind to take a break. To just perceive and be aware, without any labeling or inner commentary on what’s happening, even if it’s only for a few seconds at a time. A pause for breath, in both a figurative and literal sense. This allows certain neurons to rest and re-balance their associated neurotransmitters (the chemicals which our brain cells require to communicate with each other). If this allows us to de-stress, or for the mind to cope with stress more effectively, then again we can be less likely to reach for alcohol.

If you are drinking as a reaction to anxiety or worry, you can easily see how having a moment to step away from those concerns could be very calming, and potentially help to avoid the urge to calm yourself with a drink instead.

Many people are put off the idea of mindfulness practice because they believe it requires long sessions of sitting cross-legged in front of a candle, chanting certain special phrases. That’s more like the traditional form of meditation, whereas modern mindfulness can be practiced for 1 minute at a time, several times during your day, even while you’re sat at your desk working perhaps. The key is to allow your mind to focus on the breath, or a pleasing view perhaps, and try to just perceive it, without discussing it in your mind. You might only be able to sustain that for a few seconds at first, but that’s fine.

How to stop worrying

stop worryingWorry is a normal human activity – we all do it from time to time. But for some people, it dominates their life. So how can you stop worrying? The initial answer is that it’s unlikely you’ll be able to stop completely, but you might be able to reduce it. Before we proceed, lets define what worry is.

Worry is a mental activity where we speculate about potential negative outcomes in our future; those outcomes feel threatening, which produces anxiety. This speculation often arises from uncertain or unpredictable situations in the present day, anything we might feel is out of our control.

That lack of control or predictability is very uncomfortable for some people, so they attempt to reduce the uncertainty (and increase control) by speculating about what might happen.

If you speculate about what positive things might happen, then you’re lucky, because most people are drawn to speculate about the negative possibilities, the threatening or unpleasant outcomes which they would rather avoid. If your thoughts often begin with “What if…(something negative) happens?” then you’re probably a worrier. The common themes for worrying are almost universal – family, relationships, work, health, finances or being negatively evaluated by others, for instance.

Some forms of worry are about planning strategies to avoid these potential negative outcomes, or how to deal with them if they’re unavoidable. But quite often people are so anxious about the imagined outcome that they don’t even get to the planning stage, they just turn away from the unpleasantness, and try to avoid thinking about it. This is where alcohol comes into the picture for a lot of people – it is very effective at silencing worries (in the short term at least).

Now we’ve got a working definition of what it is, so how do you stop worrying?

People who worry excessively tend to make threatening interpretations of ambiguous circumstances – and unfortunately life is full of ambiguity, uncertainty and unpredictability. Additionally, worriers often lack confidence in their decision-making or problem-solving abilities, which can lead to doubt about their own ability to cope. As such, an objective evaluation of your coping ability might be helpful – if you think back to a few crises you’ve experienced in your life, ask yourself how you managed to cope with them, did you work out a solution to the crisis, did you get through it eventually? You might be able to recall a few situations where you didn’t handle things so well, but it’s probable that overall, you’ve managed to deal with everything in your life thus far. This suggests you’ll be able to handle everything else that might happen too, doesn’t it? That’s not to say that you can avoid all unpleasant situations in your life, but that you’ll be able to deal with them when they occur, you will cope. This could mean that speculating about hypothetical outcomes is unnecessary.

How could you learn to tolerate uncertainty better? How could you reduce the need to control your life so rigidly? Is it possible to accept that the future is unknowable, unpredictable, and be ok with that? In fact, is uncertainty unavoidable in life? Ask yourself if there are certain scenarios you never worry about. For instance, some people worry about paying for their children’s education, yet they don’t worry about war breaking out. Why is that? Why don’t you worry about nuclear war? The answer to that question might provide useful insights about the issues you do worry about.

We need to look at what processes maintain your worry, what beliefs you hold which give your worries strength. What purpose do you think your worrying serves? Why do you do it? What might potentially go wrong if you didn’t worry? Does worrying help you in any way at all? Does being a worrier say something good about who you are even? These are important questions to consider, because these beliefs may be unhelpful for you, and may need some adjustment if you want to stop worrying.

If you’re someone who avoids thinking about solutions for imagined negative outcomes, then those outcomes remain threatening, and continue to pop into your mind to make you anxious. A way to deal with this is to actively imagine the unpleasant scenarios occurring, and then consider how you would react, how you would deal with the situation, what support you would call on, and what options you might have available. It’s not a pleasant exercise to engage in, for sure, but the idea is to expose yourself to the imagined threat, and then imagine yourself solving the problem, coping with the situation somehow.

Again, you probably won’t be able to stop worrying completely, but it might be possible to reduce the amount you worry to a more tolerable level.

Treatment of Depression

treatment DepressionTreating depression takes a long time, as it requires various long-standing patterns to be changed.

Lets begin at the level of your moment-to-moment thoughts; a vicious circle often develops, where as a result of low mood your style of thinking will automatically tend towards negativity and over-generalisation. These thoughts will maintain or exacerbate your already low mood. So you need to learn how to identify your negative automatic thoughts, and practice challenging them when they occur. Lets look at an example:

Imagine something goes wrong during your day, and you think to yourself “I always make mistakes, I’ll never be successful”, which obviously makes you feel low. Those two words, ‘always’ and ‘never’, are examples of over-generalisation, so those thoughts would be more helpful if they were more specific, like this – “I’m making a few mistakes at the moment, I wonder what needs to change so I can solve this?” – such a re-framing might help you feel a bit better about your situation. You may have picked up certain unhelpful styles of thinking which are holding you back, which you could benefit by altering; or some of your beliefs about yourself may need adjusting to be more adaptive.

Here are some other unhelpful thinking styles to watch out for in your thoughts

Moving on to the level of behaviour, depressed people often find the pleasure they feel from their normal activities becomes diminished, and so you end up doing less and less, getting less pleasure and less sense of achievement. Part of the treatment thus involves increasing the number of activities you are doing, building up a range of things which might be rewarding or pleasurable. Depressed people often become accustomed to procrastinating however, you may find ways to delay or avoid activity. So you might need to evaluate some of the things you’re saying to yourself whenever you put-off doing things.

Depression itself causes some problematic ideas about the likelihood of successful change – two very common thinking styles are helplessness –  e.g. – “I can’t do anything to solve these problems” and
hopelessness – e.g. – “what’s the point in trying, nothing will change?”

Next time we will continue with more issues in the treatment of depression.

What causes depression?

There is often some misunderstanding of what it really is, so we should perhaps briefly describe what the medically agreed symptoms of depression are:

  • causes depressionlow mood most days (feeling sad or empty)
  • lack of pleasure in activities
  • low motivation
  • irritability
  • inability to concentrate & poor memory
  • lack of activity and energy generally
  • feelings of guilt & worthlessness
  • appetite changes
  • sleep disturbance

The causes of depression are different for each person, of course, but certain similarities occur:

Early life events:
Some people are more predisposed to depression than others, as a result of their life experience – certain events may cause the development of low self-esteem, poor problem-solving skills or hopelessness.

Beliefs:
Depending on what messages people have been given in life (by peers or parents for example), they may develop a range of dysfunctional, rigid beliefs about themselves, other people, or life generally, for example –

  • “I’m weak”,
  • “I’m unloveable”,
  • “if other people don’t approve of me then I’m worthless”, or
  • “if I need people they won’t help me”, or
  • “I’m not strong enough to cope if unpredictable things happen”.

Thinking styles:
How we make sense of our life has a big influence on how we feel. An example of this is ‘attributional style’. For instance:

  • If a negative event occurs, perhaps a mistake with significant consequences, and you attribute it to an internal, enduring cause (e.g. considering yourself useless), then of course it would tend to make you feel low.
  • If you attribute the same event to an internal but transient cause (“I wasn’t paying attention right then”), then you might feel less depressed about it.
  • Were you to attribute the event to external factors beyond your control (“anyone would make mistakes under this sort of work stress”), then you might barely feel down about it at all.

This is a simple example of the many attributions we make for what happens in our lives, all of which are just opinions, subjective views, not facts. Depressed people might counter “yes, but I AM useless”, but again this is only an opinion, not a fact.

Current events:
If, on top of these predisposing vulnerabilities, current life events occur which deplete emotional energy or make coping difficult, then depression can develop. Some examples of such events might be:

  • A loss of some sort (not just of a loved one, but perhaps a loss of some important aspect of life such as status or health for instance).
  • Prolonged stress – the perception that the demands being made of you exceed your available resources; if this is chronic then a state of helplessness (“I’ll never escape”) or hopelessness (“what’s the point”) can develop.
  • Periods of anxiety can also precipitate depression, as the feelings of vulnerability, unpredictability and lack of control can create pessimistic beliefs about the future.

Once depression develops, what maintains it?

depression symptoms

Another aspect of our selves is our moment-to-moment stream of consciousness; the linguistic content of our thoughts. These have an immediate effect on our mood, so depression can be maintained by ‘Negative Automatic Thoughts’ which take the form of unhelpful styles of thinking.

There are three main themes: –

  • the self (eg. – I’m defective or inadequate)
  • the future (eg. – it’s hopeless and pointless)
  • the world/life (eg. – it’s difficult, uncaring, cruel)


Some common unhelpful thinking styles include:

  • Over-generalisation (using words like: always, never, everyone, no-one, everything, nothing)
  • All or nothing, categorical thinking (if you’re not perfect then you’re a failure)
  • Negative filter (only seeing negative evidence about yourself, ignoring any positives)
  • Mind reading (“I know they don’t like me”)
  • Catastrophising (“that’s it, I’ll never succeed at this now”)
  • Labeling yourself based upon your behaviour (“I did something stupid, therefore I am stupid”)

Self blame:
Lack of compassion for yourself is often a factor in maintaining low mood – even if we are capable of being compassionate and caring towards others, we believe that we don’t merit the same compassion or forgiveness for ourselves. Thus guilt and self-recrimination can become entrenched.

Lack of activity:
Once low mood sets in, energy levels and motivation drop, and as a result people do less. Their opportunities for having fun, for feeling a sense of achievement, for sharing experiences with friends, all diminish. Thus a feedback loop is established, potentially leading to further drops in mood.

Alcohol:
And finally of course, alcohol is a well-known depressant, a substance which many people turn to in times of difficulty, thus compounding the problem.

In the next article, we’ll look at the treatment of depression based upon the causes we’ve identified here.

Social Anxiety

social anxietyThere are several factors which contribute to social anxiety, and each of them needs to be addressed for the whole problem to be dealt with.

Lets look at them in turn – firstly there is your belief that other people are highly likely to reject you or judge you negatively, when in fact this is probably an overestimation on your part. People are more forgiving than you think.

So you need to test out how likely this is with some experiments. Start with a situation that’s fairly non-threatening (you’ve probably got some scarier situations you could imagine, but we don’t need to jump in at the deep end). When you’ve thought of a slightly anxiety-provoking social scenario, predict how exactly you think others will judge you, and how will they demonstrate their judgment? What evidence can you gather that they have judged you? Then conduct the experiment (expose yourself to the situation) and compare the results with what you predicted would happen. What can you conclude from this? Most likely it will be that other people aren’t quite as judgmental as you believed them to be, and that in fact it’s almost impossible to tell if they are or not – because you are not a mind-reader.

So this brings us to another aspect of social anxiety disorder – that you accept the judgments you imagine other people are making of you, and you predict that this situation will be intolerable, so much so that you want to avoid it at all costs, which is where the fear and anxiety arise. The truth of the matter is that occasionally people are judgmental, but when they are, although it’s unpleasant, it is tolerable and need not be avoided, hence some of the fear and anxiety associated with it can reduce. However, you will only fully accept this once you’ve experienced it several times without avoiding the situation.

During social interactions, you’ve probably developed several ways in which you try to reduce your anxiety, or make yourself feel safe. These range from the obvious ones (like alcohol), to the more subtle (like rehearsing what you’re going to say beforehand), or more common ones (such as pretending to look at something on your phone). These ‘safety behaviours’ are counter-productive, because they reduce the opportunities for you to learn that social situations aren’t really so threatening. What things make you feel calmer in a social situation? You believe these things ensure your safety, when in fact you’re safe without them.

social anxiety disorderWhere you focus your attention is another important factor in reducing social anxiety. You probably pay close attention to the bodily symptoms of your anxiety when you experience it – you become self-conscious, and this acts as a feedback loop because you judge your own anxiety symptoms, making them seem more alarming to you, and so they get worse.

All the while, you are not focusing on the social situation, not engaging fully in the conversation, thus it becomes harder to read the cues other people are showing you, which can lead you to make further mistakes (stuttering, not understanding what someone said, forgetting their name etc.) It’s important therefore to remind yourself to focus your attention outwards, not on your body.

Evaluate the negative thoughts you’re having at the time which might contribute to your fears. Such thoughts may view the situation as catastrophic, or in ‘black or white’ terms (ignoring the grey areas), and may tend to overgeneralise – for example:

If I get anxious — then I’m a failure

If I blush — people will think I’m weak

If I stumble over a word — I’m a loser

If I act differently to other people — I must be weird

If I lose my train of thought — it shows I’m stupid

Such thoughts need to be challenged and replaced with more helpful, rational alternatives. This takes practice though, as these thoughts are quite automatic and habitual. Taking the examples above;

“If I get anxious — that’s acceptable

“If I blush — people will feel compassion

“If I stumble over a word — I’m normal

“If I act differently to other people — I’m not one of the herd

Essentially you need to learn that social situations are not as threatening as you imagine them to be, social mistakes you might make are not as catastrophic as you believe they are.

The goal is not to eradicate anxiety altogether, as that would be abnormal, but to reduce it to tolerable levels. Because actually you can learn to tolerate the discomfort that these situations create for you, and such tolerance can be improved with practice.

Anxiety is not a helpful measure of your social performance. You can feel anxious, and other people will still accept you. Imagine for a moment that you encounter someone who is obviously anxious when they are speaking to you – would you reject them and judge them negatively? No, of course not, and neither would most of the people who meet you.

Other people are not as critical towards you as you are yourself. Hence what you believe people will think about you is more likely to be a reflection of your own self-critical beliefs. And changing that is the subject of another article.

Is Social Anxiety making you drink?

shyness-social-anxietySocial anxiety is a common problem, characterised by being apprehensive and nervous about potential rejection or humiliation by other people.

If you find yourself getting worried about upcoming social events, and imagining how uncomfortable they’re going to be, or how other people will notice your anxiety, then you might well get into the habit of drinking alcohol in order to calm your nerves.

You might believe that you will behave in an unacceptable way, which will result in other people making an unfavourable evaluation of you, and this feels very threatening. You might believe that people will think you are weak, crazy, stupid or boring, and as such you might find it very difficult to engage in conversation or eat a meal.

Sometimes social anxiety escalates to include a panic attack, which can then fuel further anxiety, as you become worried that another panic will occur next time you socialise.

As such you might often find yourself preoccupied with thoughts about your visible symptoms of anxiety (sweating, blushing etc.), and how other people might be viewing them. You really want to make a good impression, but you’re worried that you’re just not able to. Social phobia like this can simply be described as a fear of being embarrassed.

As such, the consumption of alcohol can become an easy solution for people finding themselves in this position – drinking quickly and easily reduces the anxious feelings, boosts confidence and aids conversation. However, many people find that they end up binge drinking, and thus embarrassing themselves in exactly the way they were hoping to avoid.

Next week, we’ll look at how this problem can be overcome.

Do you need willpower to quit drinking?

 

will power“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.

Alcohol Consumption as Stress Management

stress-managementA 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 better at stress management 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.

Self criticism causes depression

self-criticismWe 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.

depressionSimilarly, 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.

Is Your Drinking Just a Habit?

alcohol-habitAlthough it may seem like ‘just a habit’, you are making a choice to have a drink each and every time. That choice involves many components – your beliefs about alcohol and yourself, your thoughts (your inner dialogue), your feelings and your behaviour.

Your wish to not drink so much (because you can recognize the negative consequences) will translate into action depending on your motivations. Partly you are motivated to have a drink because its pleasurable, it helps you relax etc, and at the same time you’re motivated not to drink because you know about all those negative consequences. So you’re in a dilemma. The strength of your different motivations will determine how easy you find it to choose not to have a drink.

Lets take an example to illustrate this – there is something happening at work which you find very stressful, so you get home feeling frustrated and edgy. You believe the stress at work is not going away soon, and perhaps you also blame yourself for some aspect of the situation. You have a belief that you can’t handle this stress well naturally, and you believe that alcohol removes it very effectively. So you want a drink. But of course you know you shouldn’t, because you’ll be hungover again tomorrow, and that will leave you feeling worse. So your inner dialogue, your thoughts, might be something like – “well I haven’t had a drink for a couple of days, so I deserve it.” or – “I just don’t want to feel stressed like this, I want this feeling to stop NOW”.

However, emotional pain and difficult feelings are a part of life, there’s no escaping them, but alcohol deals with them so effectively, that its easy to develop a reliance on it to take away all your painful feelings. In order to cut down or stop drinking therefore, you have to accept that painful feelings must be dealt with sober, just as you are. You can deal with life, but you are choosing not to experience discomfort, because it can so easily be tranquillised with alcohol.

Its a common thing to drink because you feel “I can’t cope” – but what does that actually mean? Whatever is happening in our lives, however painful it is – we get through it, we survive, and that is coping. So the belief that we can’t cope makes us give up trying, give up hope. And again, alcohol is there to take away that hopeless feeling, to take us to that dream-world where things are fluffy and safe.

To get through life being generally sober, we have to accept that painful feelings can be handled naturally. Not rubbed out, but acknowledged, truly felt. You’re stressed? So see how it feels for it to just subside naturally with time. You feel bored? So just sit with that and examine what it really means to you. What could you actually do to remedy that feeling? Again, explore it and see what needs or thoughts are associated with the feeling. Then you might realise a different solution or two, whatever they might be.

Or perhaps you just don’t think you’re a particularly valuable person? Any mistake, any difficult situation can be attributed to your own failure or lack of some quality. Again, alcohol makes you feel good about yourself, temporarily anyway. And then it bites back with a vengeance. So to an extent, the solution might also be about healing that relationship with yourself. Your beliefs about yourself can often be a sort of self-constructed fiction. That constant inner commentator is so detached from the world, in many ways. So you may believe yourself to be inadequate because that’s how you’ve been affected by life, but of course its a subjective opinion, its not a fact, just a viewpoint.

The point here is to make yourself aware of the various elements that make up your drinking habits, then you can try to solve each part, rather than just relying on will power to not drink, which as you’ve probably discovered by now, isn’t that effective.

Cutting Down or Giving Up Drinking

giving-up-drinkingDo you need to give up drinking completely if you have a problem with alcohol? There are conflicting opinions on this. The AA approach says that abstinence is the only way that works for sure.

But being abstinent is no guarantee against a relapse, and some would say that it is just avoiding the problem, not dealing with it. So how about learning some new habits around alcohol instead – because you have learnt how you behave towards alcohol already, so surely those habits can be changed?

Giving up for a while could be a useful exercise though – it doesn’t have to be forever. In fact the thought of it being a lifetime commitment prevents some people from even contemplating a period of sobriety. Why not try a month of no drinking at all, just to see how it feels? Then if you can manage that ok, you can decide whether to keep going with it, or not, the choice is yours.

The difficulty with cutting down of course is that all your best intentions tend to dissolve after the first few drinks – so a self-imposed limit is easily ignored with a slightly inebriated justification (‘oh I’ll do it tomorrow instead’, ‘I had a really hard day today, I deserve another one’, ‘oh he’s opened another bottle, it would be rude of me to refuse’ etc.)

Delaying the time you allow yourself to start drinking is one way to make cutting down easier. If you have less time for drinking, then perhaps you’ll drink less quantity (that’s the theory). A drinking diary can also help you keep track of how much you’ve actually had over the week.

How much you drink also tends to be a product of how much alcohol you purchase. So one obvious step is to not buy quite so much. Make sure you don’t keep any drink in the house – just buy it as you need it. That way the choice to drink has to be a conscious decision. Don’t forget, for this to really work you’ll need your partner to agree on the plan, so they don’t buy any either, unless you both decide to.

There’s a third option too – a combination of cutting down and giving up – just staying sober for a day or two at a time every week. It’s better than nothing, and you’re getting used to dealing with life without drinking. Try and plan which days you’re going to do it in advance, and plan to do something else incompatible with drinking perhaps. But be careful of the trap of rewarding yourself for your two days of sobriety with, you guessed it, a binge!

Stages of Change in an Alcohol Problem

stages-of-changeAs you’re reading this website, then you might be thinking that you need to change your habits around alcohol. This means you’re in a stage called ‘contemplation’.

The Stages of Change model is a well established and useful way of considering different people’s levels of motivation to change their behaviour. This is how it applies to alcoholism:

Stage 1: Pre-contemplation –

Someone who drinks alcohol but doesn’t consider that they have a problem with it, or that they need to do anything about it. Other people around them might disagree however. Occasionally they might regret drinking too much, have an accident perhaps, but they still don’t feel their drinking needs to change.

Stage 2: Contemplation –

Possibly where you are now – you might have realised that your drinking is causing more problems than it’s worth, and that you’re probably drinking too much. You’ve noticed your health is suffering, or your closest relationships have been affected. Maybe your work is not up to scratch because you’re always hungover. But then on occasion you switch back to thinking it’s not such a problem after all, and you get drunk again.

Stage 3: Decision –

You realise that you do need to do something about this, so you decide to seek help, or talk to someone professionally, join a support group, maybe check out AA, or start looking online for some possible tips to cut down your drinking.

Stage 4: Action –

You start to reduce your alcohol consumption, you set yourself limits and you achieve them. You start talking about the problems in your life that might be causing your drinking, maybe to a counsellor or another mental health professional. You might well announce your decision to cut down or quit drinking to your partner or family members.

Stage 5: Maintenance or Relapse –

Your new pattern of drinking is becoming a habit, your alcohol consumption is back to acceptable, healthy levels again. Or maybe you haven’t had a drink for a couple of months, and you’re feeling comfortable with your sobriety. You can feel the benefits of not drinking so much – you’re healthier, happier and functioning better.

There is always a possibility that future circumstances might take a turn for the worse, and you end up drinking again. Maybe you go right back to stage 1, or one of the other stages instead. The important thing is to learn from this process, not to blame yourself for it. If you see this set-back as a ‘failure’, then you’ll just feel more depressed about it. You’ve made a mistake and had a relapse, that’s all, but you can get back to where you were again.

If you think you’re ready to take action about your drink problems, contact us to arrange an online therapy session with a professional alcohol counsellor.

Beat Alcoholism with Positive Thinking

beat alcoholism with positive thinkingFocussing on negative thoughts as opposed to positive ones leaves you feeling depressed and unmotivated.

If you concentrate on how many mistakes you’ve made, or how you haven’t managed to stop drinking like you wanted to, maybe how you’ve ‘failed’ yourself and those around you, then of course you won’t feel good about yourself. Notice when you’re thinking these thoughts, and take control of them. Here’s where you need to make a choice to –

Concentrate on positive thoughts instead :

  • What will improve in your life when you’ve cut down or stopped drinking?
  • How much better will you feel?
  • What improvements have you already made?
  • Have you managed some slight reductions already?
  • If so, what benefits have you started to notice because of that?
  • Are you still essentially a good person, even though you’ve made mistakes?

The theory of ‘negative suggestion’ warns that if you focus on NOT doing something, it’s more likely that you’ll end up doing it, than if you were focussing on something else entirely. So if you find yourself thinking, “I must not drink, I must not drink” it’s a warning sign that you need to start concentrating on something else instead – distract yourself with another task, something absorbing. Just telling yourself “I mustn’t think about not drinking” is clearly still in that loop.

Likewise if you need to quit for a while, but you’re thinking, “Oh no, I’ll never be able to drink again“, then that will undoubtedly keep you focussed on the negative. Maybe you can drink again in the future; you don’t need to decide that now, focus on the present moment, and how good you feel about not drinking today.

Is alcoholism a disease, or is it just a drink problem?

alcoholic disease or drinking problemSometimes the terminology used when talking about alcohol problems can be quite unhelpful.

In fact, when using the terms ‘alcoholism’ or ‘alcoholic’ (which everyone does, including this site), the emphasis can be that the problem is with the alcohol itself.

But the problem actually stems from the state of mind that the alcohol gives you, not from the chemical as such. The importance that this state of mind takes on for you, the preferability of it despite the huge costs to other parts of your life, that is actually where the problem lies.

Similarly, people often refer to alcoholism as a disease. But what actually is a disease? Well, it is

“an abnormal condition that causes discomfort, dysfunction, distress, social problems, and/or death to the person afflicted, which is associated with specific symptoms and signs”.

The symptoms of the condition ‘alcoholism’ are generally agreed on as:

  • tolerance – the need to consume more in order to achieve the same effect,
  • withdrawal – the experience of unpleasant physical effects upon stopping drinking,
  • craving – a preoccupation or prolonged urge to have a drink,
  • loss of control – the inability to stop drinking at a sensible level once you have started.

You may have periods when you experience all four of these symptoms, and therefore you could be classified as an alcoholic. There may be other times when you’re not experiencing all of them, so you merely have ‘problems with alcohol’. But do you have a disease?

A disease is something over which you would have very little choice – “I don’t want this disease any more, I’m going to make some changes” would seem slightly ridiculous. So the way you view your alcohol problems, what terminology you use – will determine what you feel you can do about them.

If you view it as a set of problems, you will be motivated to solve those problems, but if you say to yourself “I’m an alcoholic, its a disease, it can’t be cured” then what are you likely to do about it? Not that much, I would suggest. Some people seem to have more control over their alcohol problems than others, so perhaps it is not a black or white condition, but one with varying shades of grey in between.

There are many different factors involved in an alcohol dependency, from genetic predispositions, or inherited behaviour from parents, perhaps learnt behaviour from society, to our beliefs about ourselves, our coping strategies, our self worth, our levels of anxiety and the stability or instability of our moods.

Different people will have different causes for their alcohol problems. The way to solve them is therefore to make yourself more aware of what factors are involved in your personal problem. Then you can go about making some changes to those underlying issues.

Self Acceptance

Accept your self and your feelingsMany people do not accept their own feelings – especially the negative ones. When you feel angry, you might tell yourself, “oh no, I shouldn’t feel angry about it”, or maybe “why do I feel so lonely, what’s wrong with me” ?

But the key to mental health (or suffering a bit less at least), is accepting your own feelings as they are, and not judging yourself for having them. That doesn’t mean they’ll suddenly go away, but just that you realise that its OK to be feeling them, there’s nothing wrong about them.

You need to recognise that you feel a certain way for a reason, so your feelings are valid. Most of the time we have very little (if any) control of our emotions – they appear within us without our choosing them, they are not our creations. So we cannot really judge ourselves as ‘bad’, or stupid for having them.

Nor can we judge ourselves if we’re finding it hard to deal with those feelings – we often think “oh why can’t I cope with this, I’m useless” etc. Well there’s not many people who can easily handle their emotions all the time. The truth is, we’re all struggling with our feelings, few of us really feels in control of them.

So there’s no easy solution for coping, but accepting who you are and what you’re feeling (however painful that might be) is a good start. There’s nothing wrong with you for feeling like you do.