Tobin Hunt

About Tobin Hunt

A Psychologist trained in Cognitive Behavioural Therapy, specialising in the treatment of alcohol problems, anxiety and depression.
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Prevent a lapse becoming a relapse

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.

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Alcohol and abusive relationships

alcohol and abusive relationshipsAlcohol is a common feature in abusive relationships, so if your partner is an alcoholic you might have to deal with erratic mood swings and unpredictable behaviour, arguments and aggression, recklessness (DUIs), the risks to your children and so on.

So how do you confront a partner about their drinking? (when it is often a very touchy subject) Usually, people learn to avoid the issue, simply changing the subject when it comes up. And so the situation continues for years, unless you decide to address it.

But quite often each person may be so afraid of loneliness, or have such low self-esteem that they believe themselves unlovable, that no-one else would have them, that they couldn’t survive alone. This co-dependency makes people tolerate more than they should have to, in order to stay together.

The abuse of alcohol might affect your relationships in many ways. But those same close relationships are often the ones that can perpetuate alcoholism. A dysfunctional marriage can be so much stress for anyone involved - if your first choice for coping with that is alcohol, then you can see how some people justify their drinking by blaming it on their husband/wife.

If the extra drinking that arises from relationship problems itself makes those problems worse, then a very messy loop can develop.

Alcohol can serve a number of purposes in a relationship -

  • a temporary boost in self-esteem,
  • soothing anger or escaping from conflict (which often leads to more arguments or even domestic violence),
  • an emotional escape from unhappiness,
  • exerting control through defiance of the partner’s requests not to drink.

Alternatively, if you’ve decided you want to quit drinking, but your partner still drinks heavily, then you might have real difficulty resisting temptation - there you are trying to have a sober day, when your husband is cracking open a bottle of wine for the evening!

This sometimes happens as a form of sabotage too - if a couple both have a problem with alcohol, your partner might not want you to get sober, might not want you to get your confidence back.

This is all sounding rather gloomy, surely there’s a light at the end of the tunnel? Of course, your close relationships can be your biggest source of support and encouragement. Even if you might think you’ve damaged some relationships beyond repair, the people who care about you will still be there if they can see you really want to change.

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The effects of alcoholism on children

effects of alcoholism on childrenYou are probably well aware of the effects of your drinking on your life - hangovers, inability to concentrate, relationship problems, poor health, weight gain etc. However, if you are a parent, have you given enough consideration to the effects of alcoholism on your children?

Primarily of course, when you’ve had a drink you’re not interacting with them in a rational, responsible way, you may be inconsistent with how you were acting towards them earlier in the day, which can be very confusing.

You may be exposing them to arguments with your partner which they might otherwise not have to see. This is really just the tip of the iceberg of the variety of alcoholic behaviour your children might have witnessed on occasion.

One of the recognised effects of alcoholism on children is that they tend to find it difficult to trust others. They also often learn to suppress their feelings, because any expression of them can cause angry outbursts from the drunken parent.

Beyond that though, they’re learning that drinking alcohol is a normal, regular thing to do. They’re learning that it’s something you do to relax if you’re upset, or tired. Eventually the most likely effect is that your children repeat your pattern of alcohol use themselves.

Before that though, your own health might deteriorate sufficiently that you’re admitted to hospital, or you end up there due to an accident. And nobody wants to think about how horrific it would be to injure your children (or worse) from driving whilst drunk. Have you ever done it?

Alcoholism doesn’t just affect you, it’s affecting those around you too, your children probably more than any other.

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What is Cognitive Therapy ?

cognitive therapy for addictionThe cognitive therapy approach to alcoholism treatment is not concerned with analysing your childhood, or finding out if you have an ‘addictive personality‘, nor does it force you into a one-size-fits-all step by step solution, like Alcoholics Anonymous does.

An alcohol problem is not just a habitual behaviour, but also a habitual way of thinking. So the cognitive approach to treatment offers you a way of understanding how your thoughts influence your feelings, and how both of these might cause your problems. You can begin to see what the individual elements are which make up your addiction.

Once you’re more informed about yourself (rather than just acting on auto-pilot - the ‘habit’), then you can make changes in the way you think about your life, about yourself, about alcohol. But only the changes that you choose to make, because at the end of the day you know yourself better than any counsellor or therapist does.

There are many techniques and strategies which have been found to help - ways of changing your habits, and you will be given some suggestions to guide you. But therapy is about helping you develop your own strengths so you can solve your problems. It’s not about being given a set of answers, it’s about discovering your own.

You will probably want to make changes to your other behaviour too - modifications to your lifestyle so that you can deal with anxiety, ease your depression, or cope with stress a bit more easily. So that you can relax without a drink, so you can find healthier, more productive ways to spend your time.

As a combined approach, counselling and cognitive therapy deal with the internal aspects of your addiction and will help you to change your behaviour too.

Get in touch with us now.

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Low Self Esteem

low self esteemDifferent people have different levels of self esteem - some people think they’re wonderful, some people think they’re worthless. Whether other people would agree with either of those judgements is a different matter.

People with alcohol problems often have low self-esteem. They judge themselves negatively - not just for their addiction, but also for other parts of their behaviour or their personality.

These beliefs or views about the self may have been picked up as far back as childhood, from parents, siblings, or friends -

  • “you’re not good enough to deserve that treat”,
  • “you don’t measure up to our expectations”,
  • “you don’t deserve love and affection”,
  • “we don’t accept you for who you are”,
  • “why are you so much trouble, what’s wrong with you”.

Of course such things may not have been said literally, but that may have been the message being conveyed. These messages become incorporated into our beliefs about ourselves, and affect our self esteem. As such they can be quite difficult beliefs to change.

When you have such negative thoughts about yourself, you probably won’t be very capable in dealing with life or coping with the difficult feelings that we all have. So you might then tend to turn to something which does deal with those feelings, if only temporarily. From there you can come to rely on those things - alcohol, drugs, food, whatever it might be.

Then of course, the dependent use of alcohol can further damage self esteem and reinforce those negative beliefs. “I’m an alcoholic now too - so I must be really useless then”. Alcoholism or addiction can lead to social isolation, or uncontrolled behaviour, alienating those around you and maybe removing any possible positive feedback or encouragement, making it even more difficult to improve your confidence again.

However, what often happens with friends and family, is that the issue of concern for them becomes the alcohol use itself, rather than the lack of self esteem that’s causing it in the first place.

Try our self esteem test if you’d like.

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Relapse Prevention

relapse preventionSo you’ve stopped drinking, or maybe you’re just not doing it every day now, and you want to know how to prevent yourself from relapsing, or (if you want to keep it simple) how to make sure you don’t drink today.

Relapse prevention requires some planning, specifically -

  • what situations might I encounter that could make me want a drink? (my triggers)
  • how might I deal with my feelings sober?
  • what action can I take instead?

You need to identify your internal triggers (like boredom, frustration, loneliness, anxiety etc.), and your external triggers (like arguments, bars, other people drinking etc.). Can any of these triggers be avoided? If so, plan how to do that. For those that can’t be avoided, you’ve got to learn to deal with them some other way.

So, what do these triggers mean to you? What beliefs do you hold about them that lead you to drink? A few common beliefs might be -

  • “drinking helps me get rid of stress”,
  • “drinking makes me more confident”,
  • “some people drink more than me, so that makes it ok for me to drink as much as I do”.

What thoughts go through your head when you’re exposed to these triggers? You may not even be aware of these thoughts, they’re so habitual, so you’ll have to listen carefully to your internal dialogue here.

Once you’ve got an idea what some of your automatic thoughts are, you need to learn to challenge them. So for example, the next time you’re feeling stressed and you think “a drink would relax me” you might then say to yourself “yes, it does, but it’ll make me even more nervous and stressed tomorrow”.

Relapse prevention is just knowing about your habits

Of course by the time you’ve got to this stage, you’re probably craving a drink, and you’re thinking about how to get some. You might be arguing with yourself - part of you doesn’t want to get drunk again. You’ve told yourself you’re not doing it any more (or today at least). So here’s when you might start looking for permission, to make it ok:

  • “just this time won’t hurt”,
  • “I’ll be able to hide it, so no-one will know”,
  • “I’m not at work tomorrow, so it doesn’t matter if I’m hungover”
  • “I can’t cope with this craving, so I might as well just get on with it”

As far as behaviour goes, we’ve already mentioned avoiding triggers, but another option is distracting yourself (look at our earlier article on ‘how to cope with alcohol cravings‘). Other things you might do are more general - make some new friends, find new things to do with your time, get into the habit of some exercise. Most importantly - find some support, people you can talk to about what’s troubling you.

Try going through our worksheet on Relapse Prevention Strategies.

Remember though, a binge does not mean failure, you just made a mistake, try not to think “oh well, I’ve failed, so obviously I’ll never beat this, I might as well just keep drinking…”

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How to stop drinking alcohol

Are you trying to decide if you should stop drinking alcohol? Maybe you’ve already tried a few times to just cut down, and drink more sensibly like other people seem to.

There will be many different factors which contribute to your alcohol consumption, so in order to stop drinking so much, you might need to address some of these.

how to stop drinking alcohol

It may be stress or anxiety, depression or boredom, perhaps social pressure or relationship problems. If you can identify that you often drink alcohol in response to some of these, then your first step is to look for different solutions to these issues.

So how do you stop drinking? The first thing to look at is:

Consider your motivation for stopping

Why do you actually want to stop? What are the consequences of your alcohol consumption? Weigh up the pros and cons of your drinking, the costs versus the benefits (write them down here if you like).

  • What are the negative effects of your drinking? Be honest here - look at your relationships, your health, job, self-esteem, depression etc.
  • Next what are the good things you expect to happen when you stop drinking, how will your life be better?
  • Finally what are the negative aspects of quitting? What is putting you off the idea? This is important because you will have to find some way to solve these concerns.

You need to be reminding yourself about this list of your motivations every time you think about having a drink. The next stage is to find out:

Are you physically dependent on alcohol?

For the sake of safety, if you are drinking all day from the moment you wake up in order to avoid your hangovers, then you will need some sort of medical supervision to help you through the detox. So if you’re drinking this much you should see your doctor before you plan to stop drinking alcohol. If you won’t do that, then you MUST try and cut down a bit before you stop completely.

So you’ve worked out why you want to stop, and if you can stop safely. Now what? You need to:

Develop a plan for how you can avoid those urges to drink.

Read our earlier article on coping with alcohol cravings first. It will give you a few techniques to help you. One thing’s for sure, will-power alone is not enough to stop you from drinking.

You need to work out what are your ‘high-risk’ situations, what are your ‘triggers’ that make you want to drink? Some of these can be avoided, so make plans as to how you can avoid them. For those that clearly can’t be avoided, you have to start thinking about how you can deal with them differently. Make your own relapse prevention strategy.

But what if things go wrong?

Ok, so it might not be as easy as all that (of course not), you may well slip and have a drink when you weren’t planning to. You haven’t failed, it’s just a mistake, you let that old habit sneak up and catch you unaware.

This obviously isn’t going to change over night. And realistically, this is where you might need the help of a professional. You will need to replace all that drinking with other activities, which means you need to set yourself some achievable goals.

The same goes for your feelings, learning how you can cope with difficult feelings without alcohol will take some time. Alcohol has been your way of dealing with everything difficult in your life, so you are going to have to find some other ways to cope, basically.

You should regularly review what is working and what’s not, what things are still tripping you up and most importantly, what benefits you are seeing. Remind yourself of your original reasons for wanting to stop drinking alcohol. And of course, if you find that you need some help, try a therapy session.

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The Addictive Personality

addictive personalityFor most people with some sort of alcoholism, their over use of alcohol has arisen from too many unpleasant emotions in their lives.

As such, understandably they yearn for the good feelings usually associated with positive life experiences. These feelings are immediately available through alcohol, so excessive use can take hold. As many an alcoholic has said -

“I just wanted to feel normal…”

The important thing here is that most of the time alcoholics do not feel normal, they feel like something is wrong. Sometimes it’s because a part of their personality is not being expressed fully, they are suppressing a part of themselves which may have been buried for years, for so long they have probably forgotten it was a part of them.

What often happens though is that when drunk, these suppressed or forgotten parts of us come out to play - sometimes this is enjoyable, and sometimes not. But the way people behave when they are intoxicated can be very informative. It can tell us a lot about the ‘how’ and ‘why’ of the addiction.

These two aspects of an addict’s personality - ‘the straight’ and ‘the addictive’ are very often in conflict with each other. They don’t like the other part, they don’t trust them and they fear each other.

To move forward, there has to be a truce. An acceptance and understanding of both parts of the self. You need to recognise what the positive qualities are about both. Then maybe some of the guilt and self-blame can subside…

» Read this related article on Addiction and Mental Health.

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Coping with Alcohol Cravings

coping with alcohol cravingsCoping with cravings is the key to tackling alcoholism. If you can manage to not give in to your cravings, or you can adapt so that you don’t get so many cravings in the first place, then there is no more addiction is there?

How you view your own cravings will determine how much power they have over you. If you believe that a craving won’t naturally go away once it has started, or if you think that the only way to deal with a craving is to drink, then of course you will be fairly powerless over them. This is the cognitive component of your addiction.

Making yourself aware of what things in your life tend to give you cravings, and therefore how you might avoid those situations, becomes a vital skill. For those ‘triggers’ that you can’t avoid, you can learn how to deal with them differently.

Lets say there are four types of cravings:

  • a reaction to withdrawal symptoms
  • escaping from unpleasant feelings (boredom, depression, anxiety etc.)
  • a response to a learnt association (people, places etc)
  • enhancing a positive mood

Each type requires a different approach to deal with it. And each person’s approach will be unique to them.

There are six recognised methods for dealing with cravings when they occur:

(more…)

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Abstinence or Control?

This is a decision which many alcoholics struggle with, and some try both approaches at different times. It is of course tempting for anyone who drinks alcohol problematically, to think that they can just regain control and drink more sensibly. And of course this is possible, but it is also very difficult. But then achieving total abstinence is not exactly easy either.

Realistically, there is no way of knowing if you are able to change your addiction into healthier patterns of use, or if you must become abstinent, the only way to know this is to find out. Many people go around this cycle many times - achieving a certain time of abstinence, then trying to drink socially or sensibly again, only for this to spiral out of control back into alcoholism. But there are those who do successfully manage their addiction and achieve healthier patterns of drinking.

The 12-step (AA or NA) philosophy is unequivocal on the matter - “abstinence is the only way”, but more modern approaches are adapting to the fact that there are other options. Similarly, if you are trying to achieve abstinence and you slip, or relapse, then the 12-step crowd would have you believe that you’ve failed, and that you need to start again from the beginning (back to step 1). But of course this just increases a person’s sense of shame and failure, which can itself make even more drinking or using a possibility.

It would seem far healthier to look at relapses as an opportunity to learn from mistakes, and try to do things differently next time.

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