Online Alcohol Therapy

There 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.

Where 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.

Social 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.

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.

Although 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.

Focussing 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.

While this one is written specifically for those of you who have decided you want to totally stop drinking. Again, like his other book, it concentrates on the cognitive aspects of your alcohol problems – what you are telling yourself internally about alcohol.

An interesting study by Hertfordshire University recently discovered that talking about your cravings can actually reduce their power over you.

Although they used chocolate, not alcohol, the principle is exactly the same. The test subjects who were encouraged to talk about their desire for chocolate subsequently ate 50% less than those who were told not to talk about it beforehand.

If you try to ignore your cravings, or suppress them and pretend they’re not happening, then you can end up drinking even more. So if you want to beat your cravings for alcohol, just acknowledge them and talk about it with someone who is supportive.

You’re trying to stop drinking, and maybe you’ve been successful for a while. You’ve managed to control your alcohol intake to reasonable levels, or you’ve managed to stay completely sober for some time.

So then what do you do if you have a lapse? You drink again, far more than you intended to, waking the next morning feeling terrible, that you’ve let yourself down maybe?

How you view this lapse will determine how you react to it. If you see it as a sign of failure, then your self esteem will suffer, you’ll lose hope and end up believing that the changes you’re trying to make are not possible, that you’re simply an alcoholic, you just can’t help it. This sort of belief can then lead you to drink even more – so a single mistake turns into a full relapse.

Or you could look at your mistake as just another occasion where you slipped back into old routines for a while. But that needn’t be a reason for you to give up hope, just a flag to remind you that, for the moment at least, you need to be very vigilant about your behaviour.

Observe your own feelings and thoughts, be aware of when you’re in the sort of mood where you usually want a drink – and do something about it, something different. (See – Dealing with Cravings). Acknowledge that you’re feeling weak or emotional – talk to someone about how you’re feeling generally. Don’t try to struggle through it alone.

Don’t forget, the best way to handle your feelings is to express them – talk about it. That way a lapse can remain just that, something you can learn from rather than an excuse to relapse completely.

The UK National Health Service has officially recognised the effectiveness of online therapy.

Cognitive Therapy is now being offered via private chatroom as part of the NHS services, in an attempt to provide for people who find it difficult to come to a clinic for conventional counselling.

An online chatroom can be used as a private space where a person can get support and therapeutic help from a professional. This is especially useful for people with alcohol or addiction problems, who may be too embarrassed to see a therapist or counsellor face to face. You don’t have to take time to get to someone’s clinic, they can come to you via your computer.

In all other respects, the nature of online therapy or counselling is the same – the same techniques are used, the same issues dealt with. If you’re not sure how this would actually help, read more about how online therapy works.