Online Therapy Articles

Mental Health & Alcoholism

Therapy becoming less stigmatised

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

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

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

Further coverage in the Guardian.co.uk

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.

Alcohol makes your heart healthier

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

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

The Independent

Online Psychological Therapy Proven Effective

online-therapyA recent research study published in the Journal of Technology in Human Services has demonstrated the effectiveness of online psychotherapy for mental health problems.

The meta-study reviewed 92 different studies of online counselling or therapy (a total of 9,764 clients), and found no difference in effectiveness from usual face to face therapy.

The studies involved clients with a wide range of mental health problems, including addiction, anxiety and depression.

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

Effects of Alcohol on Sleep

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

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

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

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

For a deeper exploration of the interactions between sleep, alcohol and Melatonin, have a look at this interesting article over on Sleepyhood.com

Group Support for Alcohol Problems

support-groupAn important factor in solving your problems with alcohol is talking to other people who understand what you’re going through, who won’t judge you for it, and who will genuinely share their experience without just trotting out the old clichés about drinking.

I’m sure you’ve heard them many times from friends or family, like – “oh don’t worry about it, you don’t have a drink first thing in the morning, do you”, or “I don’t understand why you can’t just have a couple like I do” etc.

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

alcoholic-helpLuckily there is now the option of communicating online, where the screen can grant you a cloak of anonymity. As such you can join our alcohol support forum – day or night there will always be a wide range of people logged on who can give you feedback, support or advice about your drinking and an idea of how to make some changes. Check it out and if you like what you see, register for an account (free of course).

Dangerous Levels of Drinking

hazardous-drinkingAccording to figures released today by the NHS:

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

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

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!

What type of Drinker are you?

types-drinkerThe Department of Health has released research where they have identified nine different types of person who drinks alcohol to excess (their definition of excess being double the recommended weekly amount or more).

It might be useful to see if you can recognise which type you are. The types they defined are –

  • Depressed drinker
  • De-stress drinker
  • Re-bonding drinker
  • Conformist drinker
  • Community drinker
  • Boredom drinker
  • Macho drinker
  • Hedonistic drinker
  • Borderline dependent

It’s a fairly comprehensive list, but if you’re not sure which category you might fit into, have a look at the list of criteria for each type of drinker on the BBC

Of course it would seem to suggest that people who drink fall into one type or another, whereas experience would suggest that the same person could be defined under many of the categories, depending on what is going on for them that day.

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.

How to Cure a Hangover

how cure hangoverEveryone has their own little hangover cure don’t they. There must be thousands of them out there, but how many actually work? The truth is different people probably need different things to help them, depending on their individual constitution.

However there are a few reliable cures that seem to work for everyone. One of the main causes of a hangover is dehydration (largely responsible for your headache), so clearly the best thing to prevent or cure them is rehydration – plenty of water or fruit juice (as that often contains anti-oxidants too).

Sugar filled soft drinks like cola are NOT a good idea, because although they’ll make you feel good temporarily by boosting your blood sugar, you’ll very quickly feel even worse again as you suffer from the insulin crash afterwards.

Having said that, caffeine can often help with a headache and get you feeling sharper again, it depends on your preference. Unfortunately most caffeinated drinks are also diuretic, meaning they will dehydrate you even more. Part of your rehydration might perhaps include essential electrolytes too (Calcium, Potassium, Sodium, Magnesium etc).

Another cause of hangover is acetaldehyde, the toxic chemical produced when alcohol dehydrogenase breaks down alcohol in the liver. This is what causes the ‘poisoned’ feeling. There are a couple of things which work quite well to mop this up – the first is an amino acid called cysteine, which is found in large quantities in eggs. So that’s breakfast sorted out. You can also buy N-acetyl cysteine as a supplement in health food shops. The second thing which mops up acetaldehyde quite well is probiotics – the healthy bacteria found in yoghurt. However perhaps the best way to take this is in capsule form where it’s far more concentrated. A few of these before bedtime can really help you.

Most alcoholic drinks will leave you with low blood sugar (hypoglycaemia) by morning, so its important to get that back up again in a slow, stable way. Which means complex carbohydrates as opposed to simple ones. What I mean is whole grains, like wholemeal bread or muesli, vegetables and fruit (particularly bananas to boost your potassium levels again). Carbs like simple sugars, white pasta or potatoes will not help.

The nausea can be eased very effectively with ginger or peppermint tea, and again with those rehydration salts (or electrolytes).

Painkillers are obviously quite tempting, but paracetamol causes further toxic strain on the liver and kidneys, and ibuprofen can irritate the stomach. So aspirin is probably the safest analgesic for a hangover.

Finally you might well benefit from some B vitamin supplements – to calm your central nervous system (responsible for the tremors, sweats and anxiety), but these will tend to have a more long term effect rather than being a short term cure.

No doubt you’ve got plenty of suggestions for your own hangover cures too, so lets hear what works for you in the comments…

Drinking diaries show an excess is often normal

alcohol journalThis week the BBC monitored the drinking diaries of two typical professional people in their late twenties – both considered themselves to be health conscious and fit.

What emerged was a picture of what many people might consider ‘normal’ patterns of drinking in our culture. However, when their level of alcohol consumption was broken down into units it became apparent that both of them were drinking way in excess of recommended guidelines – 37 units for the woman and 112 units for the man.

They also demonstrated a significant level of ignorance about their drinking, and about the implications for their health. One of them actually said – “I don’t like getting drunk…” yet had consumed over 15 units per session on five days that week, and 25 units (as far as he could remember) on the Saturday! That’s about 8 pints of strong lager or nearly 3 bottles of wine. But he doesn’t like getting drunk – yeah, right!

However, a survey by YouGov also found that many people have no idea what the recommended safe alcohol consumption levels actually are (14 units per week for women and 21 for men), and very few were aware of the units of alcohol present in common drinks.

[Here’s a very handy units of alcohol calculator]

The thing which strikes you when you read the two diaries is that there are many people around drinking exactly the same amounts, yet believing that they don’t have a problem with alcohol.

Are you an alcoholic?

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.

Increased arrests of drunk & disorderly women

woman arrested for being drunk and disorderlyOh dear, the BBC reported today that UK police crime figures have shown a 50% increase in arrests of women for being drunk and disorderly over the past five years.

In certain areas of the country this rate was even higher – a 1200% increase in the West Midlands, and a 700% increase in South Wales.

Some people are blaming this on cheap alco-pops, while others suggest the opened up licensing laws. It seems to be more to do with our culture, women drink as much as men do now.

Where is this trend going, and what effect is it having on the health of the women in this generation?

Allen Carr – Easy way to Control Alcohol

There is no doubt that the most popular self help book for people with alcohol problems is this one by Allen Carr.

He achieved his deserved reputation with his initial book about stopping smoking, and such was its success that he’s now written two books dedicated to drinking. This one is for those who want to regain control, but don’t want to stop completely.

If you don’t want to buy the book, but are interested in the cognitive approach that it uses, try having a read through our articles and worksheets on relapse prevention.

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.