Drinking guilt and its big brother shame

When I used to drink the drinking threw in a free gift of a helping of guilt and shame on the side – how kind!  Guilt is the emotion that we feel when we have behaved in a way that we perceive to be hurtful to others or as a moral lapse.  Guilt serves a purpose when we recognise, acknowledge and rectify the behaviour, such as apologising if necessary.  The thing is, when I was drinking, sometimes I didn’t remember the behaviour so what I got left with was guilt’s big brother, shame.

Shame is the emotion that we feel when ‘we’ as a person are at fault, not our behaviour.  It is the way we feel if we have fallen short of our own internalised ideals or if there is a public disclosure of a perceived weakness or defect. For me shame was the fast track path to self-loathing, failing self-esteem and crushed self-confidence and it was hard not to feel shame as I felt like I couldn’t control my drinking and therefore my behaviour.  Erik Erikson argued that “shame is blame turned against the self” and Pete Walker writes that “shame is the death of self-acceptance and self-worth.”  If I couldn’t manage this there was something wrong with ‘me’ right?

But if you drink alcohol, which is addictive and designed to make you thirsty (so you drink more) and acts as a disinhibitor (encouraging behaviour that you would not normally engage in) then how is that a weakness or defect in yourself?  Now I’m not handing total responsibility for my actions over to the booze monster as the choice to pick up the first drink was always mine.  What I didn’t fully choose was the addiction created by the substance to go on drinking to the point of total black out, guilt making antics and no memories to attach the guilt to therefore leaving me with an overwhelming sense of shame.  And then I would drink to forget the shame compounding the problem. Shame, drink, shame, lather, rinse, repeat.

The leading expert and queen of shame research is Brene Brown who I love.  Her PhD was studying vulnerability.  You can watch her TED talk on vulnerability here and her follow up TED talk on ‘Listening to Shame’ here.

What her research found was that shame is highly highly correlated with addiction.  Shame is the voice in my head telling me that I’m ‘never good enough’ and I can’t do life sober.  Shame is that same internal critic saying ‘who do you think you are’ to blog about my sober journey thinking people would be interested in what I have to say.

This is the most toxic of emotions and now I don’t drink I don’t really experience it like I used to anymore.  I know that I can do life sober and have done it for over five months. I know that people are interested in what I have to say because they take the time to read my blog and comment.  My internal voice of shame has gone quiet and this gift is perhaps bigger than the gift of no hangover.  The no hangover is the physical gift of not drinking but the diminished feeling of shame is the psychological gift of sobriety.  And the two go hand in hand for me as part of the hangover distress was the angst caused by the shame.  In the words of Brene, for shame to survive it needs secrecy, silence and judgement (of self or of others).  Choosing not to drink and this blog is the answer to resolving my shame and I would chose this option hands down every day over drinking now 🙂

PS My other most popular blog post is my Goodbye Letter to Alcohol which you can read here

Edited to add: I found this brilliant card that summed up how this drinking shame and guilt felt for me so if this is how you feel too then can I recommend this self-compassion break  🙂

Overindulgence Disposal Unit

Sober Inspiration: You are good enough

Words of wisdom from  Marie Forleo and Colleen Saidman Yee and The School of Life. You are enough and good enough 🙂

 

 

 

Just sit. Notice where you feel hard and sit with that.
In the middle of the hardness, you’ll find anger, sit with that.
Go to the center of the anger and you’ll probably come to sadness.
Stay with the sadness until it comes to vulnerability.
Keep sitting with what comes up: the deeper you dig, the more tender you become.
Raw fear can open into the wide expanse of genuineness, compassion, gratitude, and acceptance in the present moment.
A tender heart appears naturally when you are able to stay present. From your heart, you can see the true pigment of the sky.
You can see the vibrant yellow of the sunflower and the deep color of your daughters’s eye.
A tender heart doesn’t block out rain clouds, or tears or dying sunflowers. Allow both beauty and sadness to touch you. This love, not fear.

(meditation from Colleen Saidman Yee)

High ambitions are noble and important, but there can also come a point when they become the sources of terrible trouble and unnecessary panic.

One way of undercutting our more reckless ideals and perfectionism was pioneered by a British psychoanalyst called Donald Winnicott in the 1950s.  The concept of ‘good enough’ was invented as an escape from dangerous ideals. It began in relation to parenthood, but it can be applied across life more generally, especially around work and love.

It takes a good deal of bravery and skill to keep even a very ordinary life going. To persevere through the challenges of love, work and children is quietly heroic. We should perhaps more often sometimes step back in order to acknowledge in a non-starry-eyed but very real way that our lives are good enough – and that this is, in itself, already a very grand achievement.

(text from Book of Life)

You Do Enough, You Have Enough, You Are Enough

Happy sober Friday xx

Minimum unit pricing to go ahead in Scotland after 5 year legal battle

MUP is a more effective means of reducing socioeconomic inequalities in health than taxation ( Colin Angus‏ @VictimOfMaths)

From Alcohol Policy UK today:

Today the UK Supreme Court delivered the final verdict on Scotland’s long running legal challenge to introducing Minimum Unit Pricing (MUP). The Scottish Government first passed legislaton in 2012 but a number of industry bodies spearheaded by the Scotch Whisky Association (SWA) forced a series of challenges under EU which some public health figures have described as ‘delaying tactics’.

The legal challenge rested on the argument that MUP contravened EU competition law, arguing instead that taxation would be a more appropriate means of achieving its aims. However the Supreme Court disagreed stating health objectives and the free market were “two incomparable values” and declaring MUP a “proportionate means of achieving a legitimate aim”. The court also rejected the appeal’s claim that the Scottish Government should have committed to going further in assessing market impact as unreasonable, acknowledging its commitments to evaluating the impacts and the five year sunset clause. 

Public health groups and academics involved in MUP took to Twitter to express relief and comment on the judgement and next steps. The SWA have issued a brief statement on the decision whilst a Spectator article by veteran ‘anti-nanny state’ commentator Christopher Snowden says MUP ‘won’t end alcoholism’. However James Nicholls suggested this was a ‘straw man’ argument and has written a response to the ruling outlining MUPs aims and key considerations. The news has also been covered by the BBC, Telegraph, The Scotsman and Guardian, with further coverage and comment likely throughout the week.

Absolutely delighted that minimum pricing has been upheld by the Supreme Court. This has been a long road – and no doubt the policy will continue to have its critics – but it is a bold and necessary move to improve public health.

— Nicola Sturgeon (@NicolaSturgeon) November 15, 2017

Where next?

The Scottish Government will no doubt hope to see MUP come into effect as soon as possible; indeed the likely impact (see latest Sheffield modelling here) of the 50 pence per unit floor price will be significantly lower than had it been introduced in 2012, though its level can be addressed as part of the legislation. Wales and Ireland will also be welcoming the ruling having taken their own legislative steps to introduce MUP.

As for England, further pressure will no doubt be placed on the Westminster Government who, after David Cameron’s infamous 2012 u-turn, have committed only to monitoring Scotland’s proceedings. Watch this space.

Absolutely bloody brilliant news!!!

Alcohol Awareness Week 2017, 13-19 November: ‘Alcohol and Families’

Courtesy of Alcohol Policy UK – Alcohol Awareness Week 2017, 13-19 November: ‘Alcohol and Families.’

Alcohol Concern have announced this year’s Alcohol Awareness Week (AAW) will take place from 13-19 of November on the theme of ‘Alcohol and Families’. The charity, which has recently merged with Alcohol Research UK, has partnered with Adfam, a charity that supports families affected by drugs and alcohol.

As with previous years, Alcohol Concern hope AAW will prompt conversations about the impact of alcohol, this year ‘to help break the cycle of silence and stigma that is all too often experienced by families’. This may also help people access services or support either directly or via signposting from professionals.

Alcohol Concern will release a number of online resources that will be free to download, including:

  • Expert factsheets on various issues associated with alcohol and families
  • An easy to understand, visual depiction of the Chief Medical Officers’ guidelines for low-risk drinking for print and social media use
  • A bank of statistics for you to use

To receive this pack directly to your email, please click here. Alcohol Concern will be sharing information, resources and stories throughout the week on Facebook and Twitter using the hashtag #AAW2017. Family members who have been affected by a relative’s drinking and wish to share their story can get in touch with Alcohol Concern at contact@alcoholconcern.org.uk.

Protecting families and children: more to be done?

Earlier this year a manifesto for action to support ‘Children of Alcoholics’ (COAs) called upon the Government to take ten key actions including a targeted national strategy, local funding to support alcohol services, a plan to change attitudes and action on price and availability.

In 2014 a report from the Children’s Commissioner looked at the number of children affected by parental alcohol misuse and at the help available to them, calling for further action by services and local authorities. An Alcohol Hidden Harm Toolkit was also released to support managers, commissioners and practitioners involved in designing, assessing or improving Alcohol Hidden Harm services for children and families. Many will bee hoping AAW 2017 helps not only raise awareness of the issue, but also prompts further attention and resources for prevention and support

Links to all #AAW2017 content

Resources

Case studies

And this valuable research was released recently too:

Drugs for the treatment of alcohol dependence: insufficient evidence?

Plus this was published yesterday – more support for MUP when the Scottish decision is finally announced:

The killer on Britain’s streets – super-strength alcohol 

And an update from Alcohol Policy UK today (14th Nov):

Alcohol Awareness Week 2017 kicks off in week of MUP decision

It’s a big week!

New drug strategy prompts calls for clear national alcohol policy

Another great post from Alcohol Policy UK regarding the Govt’s 2017 Drug Strategy released in July.

The release of a new national drugs strategy for England and Wales has prompted revised calls for a new national alcohol strategy that includes minimum unit pricing (MUP).

The last national alcohol strategy was released in 2012 promising MUP, followed by an infamous U-turn. MUP has of course still yet to be implemented in Scotland, though a final legal ruling is expected this month following a drawn out legal challenge, with Ireland and Wales also committed.

MUP aside, alcohol objectives feature across several other policy domains, including as part of a Modern Crime Prevention Strategy, various PHE guidance and a national CQUIN incentivising brief intervention delivery across hospitals.

The new drugs strategy though refers to drugs and alcohol throughout, thus in the context of treatment for alcohol problems it may be seen as reflecting national alcohol ambitions for treating and preventing all substance dependence. Indeed a section on alcohol states:

While the focus of this Strategy is on drugs, we recognise the importance of joined-up action on alcohol and drugs, and many areas of the Strategy apply to both, particularly our resilience-based approach to preventing misuse and facilitating recovery. Alcohol treatment services should be commissioned to meet the ambitions set out in the Building Recovery chapter that are relevant to them, and in line with the relevant NICE Alcohol Clinical Guidelines. Commissioning of alcohol and drug treatment services should take place in an integrated way, while ensuring an appropriate focus on alcohol or drug specific interventions, locations, referral pathways and need.

In addition, local authority public health teams should take an integrated approach to reducing a range of alcohol related harm, through a combination of universal population level interventions and interventions targeting at risk groups. The Modern Crime Prevention Strategy 2016 highlights alcohol – as with drugs – as a key driver of crime and sets out a range of actions to tackle alcohol-driven crime.

The strategy though is not titled a ‘drug and alcohol strategy’, and some argue that there are many issues with providing alcohol treatment – or indeed strategies – under the same roof. Until April 2019 the ring-fenced but still shrinking Public Health Grant to local authorities will require local authorities to ‘have regard to the need to improve the take up of, and outcomes from, drug and alcohol services’, but not thereafter. The strategy also highlights the UK devolved administrations have ‘their own approaches to tackling drug and alcohol misuse and dependence in areas where responsibility is devolved’. 

Where next for national alcohol policy?

Calls for a single national alcohol strategy seem logical, if not at least to make clear the Government’s ambitions across the wide range of areas where alcohol harm and policy can reach. As well as a national drug strategy, a new tobacco control strategy has also been released, further highlighting an apparent gap. From a political perspective however, a lesson from the 2012 alcohol strategy appears to be not to commit to ambitious policies with powerful opponents; at least not until the path is clearer. Indeed since the MUP U-turn, Ministers have said on MUP they would be waiting to see what happens in Scotland.

Other alcohol policy areas are seemingly in an ongoing state of political bargaining. Marketing and availability are hotly contested areas, with health groups calling for the adoption of key approaches including taxation and effective levers identified in the recent PHE evidence review. Translating such calls into action is of course complex and faced with opposing voices, as debates over licensing policy have recently demonstrated.

The drug strategy though has received some praise for highlighting the need for evidence based approaches to prevention and treatment, and the need for addressing multiple-needs and overlapping issues including mental health. Others have argued it as the ‘same old rhetoric’, particularly when treatment budgets are ever shrinking.

Last year a small drop in the number of people accessing alcohol treatment was seen, though unlikely to be linked to the downturn in overall consumption since 2004. Other alcohol trends present a complex picture yet overall alcohol-related hospital admissions are still rising. Regardless of the various trends, many consider the scale and reach of alcohol problems deserve a single national policy for England and Wales. Given that no alcohol strategy will be universally praised or indeed gain much in voter popularity, some may consider its absence suggests political expediency has come first.

I know I sound like a stuck record about MUP but it’s because I agree with those who keep proposing it!

Sober insights: Happiness Problem?

Another month another book.  This time I’m inspired by by Mark Manson and his book (see left).  The 2nd chapter of his book looks at the happiness problem – and yes happiness comes from solving problems 😉  I’m going to quote a small section that discusses our favourite subject – addiction.

Over to Mark:

Highs come in many forms.   Whether it’s a substance like alcohol, the moral righteousness that comes from blaming others (yep, ouch!), or the thrill of some new risky adventure (ouch again!), highs are shallow and unproductive ways to go about one’s life.  Much of the self-help world is predicated on peddling highs to people rather than solving legitimate problems.  Many self-help gurus teach you new forms of denial and pump you up with exercises that feel good in the short term, while ignoring the underlying issue.  Remember, nobody who is actually happy has to stand in front of a mirror and tell himself he’s happy.

Highs also generate addiction.  The more you rely on them to feel better about your underlying problems, the more you will seek them out.  In this sense, almost anything can become addictive, depending on the motivation behind using it.  We all have our chosen methods to numb the pain of our problems, and in moderate doses there is nothing wrong with this.  But the longer we avoid and the longer we numb, the more painful it will be when we finally do confront our issues.

The path to happiness is a path full of shitheaps and shame.  You can’t have a pain free life.  It can’t all be roses and unicorns all the time.  Our problems birth our happiness.

Amen brother, completely agree!  It took me till the age of 44 to finally confront the issues and yep it involved a whole lot of pain that might have been avoided if I had only tackled them sooner! That said having resolved the alcohol addiction issue I’m still working on the moral righteousness and thrill of risky adventure addictions …..

How bout you?  Does this ring true for you too?

 

The Head-Heart-Gut Check

So this infographic came though in an email from Melli over in Australia in July.   She is the genius behind The Mindfulness Summit that I attended virtually last year and this Head-Heart-Gut Check is a great tool.   I love her work and it felt like a bit of a birthday present to share it here with you when it was my belly-button birthday yesterday! Another year older, another year sober 🙂

Over to Melli:

We make a lot of decisions every day and these decisions are what determine the direction and quality of our lives. Some are little. Some are completely life altering. All of them matter as you steer the course of your life at each little juncture.

Any time you’re at a decision point you can use this mini-meditation to respond (and not react)  to what is arising with wisdom and intelligence, making more mindful choices leading to a fuller happier more authentic life.

Step 1: Take three deep slow conscious breaths as a way of gathering your awareness to the present moment.

Step 2: Bring your awareness to your head
With your awareness in the head acknowledge what kind of thoughts are present in relation to the current situation.

Step 3: Drop awareness down to the heart
Place a hand over the heart and take a moment to attend to what values you have in this situation, what you care about and what your deepest intention is.

Step 4: Drop awareness down to the gut
Place a hand over the abdomen. Tune into any hunches, intuitions or emotions that are present in relation to the current situation.

Step 5: Collect all this information
Take one deep slow conscious breath in and out as you have a sense of collecting all this information from the body and mind. Then mentally ask yourself this question “what shall I do now?” Listen for the answer.

The Head-Heart-Gut Check meditation can be done in as little as 30 seconds when you need to make a quick decision or you can do a longer version that takes up to five minutes when you have more time. This simple powerful mini meditation will help you make more mindful decisions and will be an ally in times when you need mindfulness the most. May it serve you well

The ‘Head-Heart-Gut’ Check In Meditation

You may also listen to the head-heart-gut check in meditation by clicking on the video below:

You can also listen on SoundCloud

Thanks Melli! 🙂

1500 days!

Well how about this for kismet?  Tomorrow is my belly button birthday and today I hit 1500 days sober!  Thank you Universe for tying that up so neatly 😉

Wow – just wow.  Such a big number and yet day 1 doesn’t feel that long ago.  So much has happened, so many friendships made, so much gratitude.  Who knew that such a small change could make such a big difference to my life and the lives of those around me?

So you may have noticed that my post frequency has reduced again as I enter my fifth year sober to once a week.  The fire in my belly doesn’t burn so fiercely for me now on this issue.  I’ve realised that I can’t change the world of public health and alcohol single handedly – no matter how loud I shout or how many words I expend in effort.  So I’ve contented myself on changing the lives of those who matter to me most – my family and to end the intergenerational transmission of alcohol dependence here.  I have above my desk a note that reads:

A hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove, but the world may be different because I was important in the life of a child.

That was reason enough for me to stop drinking and remains reason enough to never start again.  And to support that reasoning is new research from the Institute of Alcohol Studies

Download “Like sugar for adults: The effect of non-dependent parental drinking on children & families” [pdf]

and as reported in The Guardian last week reads:

At least 30% of parents admit being “tipsy” or drunk around their children, a study has found, prompting calls for a national conversation about alcohol consumption and the harm that exposure can do to youngsters’ emotional development.

Such behaviour can trigger family rows or leave children anxious, embarrassed, worried or disrupt their bedtime, according to research by the Institute of Alcohol Studies (IAS). The findings include that 15% of children have asked their parents to drink less, and 11 to 12-year-olds think adults drink to “solve their problems”. There are now calls for the government to strengthen official warnings about how much it is OK to drink, and when.

“All parents strive to do what’s best for their children, but this report has highlighted a troubling gap in their knowledge,” said Katherine Brown, the IAS’s chief executive. “Parents who have a glass or two of wine in the evening deserve to understand how this might affect their children and the steps they can take to minimise this impact.”

Alison Douglas, the chief executive of Alcohol Focus Scotland, said: “As well as the negative impacts on children’s wellbeing, seeing how adults drink can have a big influence on our children’s future drinking habits.” Jon Ashworth, the shadow health secretary, who has spoken about his father’s death as a result of drinking, said: “Children are incredibly perceptive of their parents’ drinking habits and this analysis must serve as a wake-up call to the government.”

So news continues to present itself as the battle rages for our hearts and minds on the subject of alcohol and addiction.  We still await the outcome of minimum unit pricing (edited to add: although Wales announced Minimum Unit Pricing today!)

PHE continue to produce resources to support alcohol awareness:

PHE ‘All Our Health’ alcohol resource

The alcohol industry continue to try to subvert the public health message:

Drinkers’ Voice Vs ‘anti-alcohol’? Guidelines, pregnancy & cancer risk messages

Drinkers’ Voice labels itself as a consumer organisation and says ‘the anti-alcohol lobby has dominated the conversation on alcohol and your health, resulting in misleading statistics and scaremongering news headlines’

And so it was ever thus …….

Unbelievably this blog has now had over 500,000 views.  Who’d have guessed that when I started it back in October 2013?  Thank you to all of you for being here, for reading, for commenting, for supporting me in my journey from terrified, reluctant ex-drinker to relaxed, contented ‘not interested even if you paid me’ non-drinker and proud member of the soberocracy! 🙂

Edited to add: Plus an extra 1500 day gift of a mention in Single and Sober My Top 20 Recovery Blogs and Sites

 

Do I think like you? Alcoholic Personality

The Betty Ford Clinic maintains there is an alcoholic personality which they describe below:
The first is a low frustration tolerance. Alcoholics seem to experience more distress when enduring long-term dysphoria or when tiresome things do not work out quickly.  Alcoholics are more impulsive than most.
Secondly, alcoholics are more sensitive. This sensitivity relates especially to nuances of interpersonal relationships. Alcoholics have a “low rejection threshold.” They feel more apart or left out. Incidentally, a drink or two “works wonderfully” to deal with this feeling. Yet, it is known that sensitive people are often especially creative. Alcoholism seems to selectively strike gifted people. Most American Nobel Prize winners in literature suffered from alcoholism.
Another trait found in excess in alcoholics is a low sense of one’s own worth. Then there is isolation. Alcoholics are loners. It is with most difficulty they are able to share innermost thoughts and concerns with anyone.
Although they may be articulate, charming and very persuasive, they operate behind an armor or shell that keeps the world out. They are afraid of intimacy.
So let’s dissect and analyze:
Low frustration tolerance (LFT), or “short-term hedonism” is a concept utilized to describe the inability to tolerate unpleasant feelings or stressful situations. The feeling that reality should be as wished, insisting that everything that a person dislikes should be resolved quickly and easily, and if it’s not, it leads to emotional disturbance.[1] Behaviors are then derived towards avoiding frustrating events which, paradoxically, lead to increased frustration and even greater mental stress. *Check*
Are your own feelings easily bruised and do you worry endlessly about hurting other people’s? Do you well up when watching charity adverts for illness or animal cruelty, dislike scary films or feel bothered by loud or irritating noises (think music coming from somebody’s earphones) in a way that those around you don’t? Then you could be a Highly Sensitive Person, or HSP, a condition that’s common but until now rarely understood. *Check*
Fear & Anxiety are the cornerstones of low self esteem (Low self worth and low self esteem are synonyms; they mean virtually the same thing). Those who suffer from low self-esteem experience extreme fear and anxiety frequently. Believing that there is something innately wrong with themselves, these low self esteem sufferers experience self-esteem attacks (often called panic attacks) when they do something they deem to have been stupid, something they think others have noticed, and something that confirms their own feelings of inadequacy, incompetence, being undeserving or unlovable. During these attacks they may attack or withdraw and isolate while feeling embarrassed, humiliated, devastated, depressed, even despairing. Depending on how seriously they perceive their “mistake” they may not recover for minutes, hours, days, or longer. They are often too fearful to ask for help, thinking that needing help is an admission of inadequacy. *Check*
So that’s three out of three for me and yes I isolate too.  Do these traits and descriptions resonate for you too?

MDMA used in world’s first trials to treat alcohol addiction

This was a news piece in The Independent in July looking at MDMA being used in trials to treat alcohol addiction.

In a world first, scientists in Bristol are using the psychoactive drug MDMA as part of a treatment programme for addicts and alcoholics.

The study was created by a research team at Imperial College London, and involves giving doses of MDMA – known by the street names Molly or ecstasy – to help patients battling addiction. They claim this could be more effective than conventional methods. Those on the trial will also be put on a course of psychotherapy.

“We know that MDMA works really well in helping people who have suffered trauma and it helps to build empathy,” said Ben Sessa, a clinical psychiatrist on the trial and senior research fellow at Imperial College London.

On his website, Sessa stated: “3,4-methylenedioxymethamphetamine is a remarkable substance. Forget what you know about the popular use of this compound in the context of the recreational drug ecstasy.

“MDMA is a medical drug that started its life in the clinical setting. It has a unique receptor profile that makes this drug, when combined in a supervised clinical setting with experienced psychotherapists, the perfect tool to enhance trauma-focused psychotherapy.”

Participants on the trial are all heavy consumers of alcohol, typically drinking about five bottles of wine per day. They were chosen through the alcohol services in Bristol and have undergone repeated treatments for alcoholism.

After going through a detox period, those on the trial receive two therapy sessions, followed by a day where they receive a capsule of high-dose MDMA.

The drug has shown promise in treating those with post-traumatic stress disorder (PTSD). At the Psychedelic Science 2017 conference in Oakland, researchers showed that after more than one year after two or three sessions of MDMA-assisted therapy, about 67 per cent of participants no longer had the condition.

However, experts warn that recreational use of the drug can cause harm. “I’ve seen people in my practice who took MDMA at a party and weren’t prepared for the memories that came up, and it was really harmful for them,” Michael Mithoefer, a psychiatrist and a principle investigator in the MDMA trials said in a Nature report.

Alcohol-related deaths have increased by 13 per cent over ten years, according to the report Statistics on Alcohol: England, 2016.

I will be greatly interested in reading the research papers following this trial to see what the outcomes were from this experimental process.

Alcoholism continues long after you stop drinking: my 15 years sober

This exceptional piece of writing comes courtesy of Tanya Gold featured in The Guardian earlier this year.  Beautiful writing about alcoholism and how for many of us it is but the symptom of much deeper issues.

It is easy to get morphine in University College hospital, London, if you are a good liar. It hurts, you tell the midwife, although you can’t feel anything, being so high on morphine already that someone could hit you with a sledgehammer and you would only laugh: what else you got? It was close to midnight on 13 August 2013, and I was on medical-grade opiates; nothing else can make you forget you are about to give birth. Eleven years without alcohol or drugs, and I fell, complete, into the waiting groove. I loved it. I was having a party in the high-risk maternity ward and they didn’t even know it. I lay back on my pillow and gurned with joy: oh, Morpheus, god of dreams.

When the morphine ran out, I had a baby. He was very small and handsome, and he was an imposition. I could say I was frightened, but that would be self-serving. It is possible, even likely, that I was afraid. I was definitely high.

I stared at him and thought: I am more vulnerable than you, even if you are a baby. Then I told the midwife: my husband is trying to kill me. My evidence was that he had brought me a tin of biscuits. This, then, was the comedown, and I was at the bottom of the curve. I must have said that the baby was not important to me, because my husband became angry and I became angry, and I told him I hated him and had never loved him. I considered walking out into the traffic, or throwing myself under a train, and that was our baby’s first night on Earth. We went home and I locked myself in my bedroom, without the baby, and looked at photographs of him on Facebook, and ate a ham.

Strange things can bring you to a crisis, like realising that you cannot read Dickens out of jealousy. Or more obvious ones, like thinking: the baby should live with my sister, she will do this better than me. Or, when he was two months old: when is he going to university? In my history of alcoholism, I have been at my most healthy when I knew that I was ill. If you remind yourself that you are ill, you can do better. Now, in my son’s room, wishing his childhood away because I did not know how to care for him, I knew I was ill. I was not drinking or using drugs, but I was as lonely and frightened as I had ever been. I was back where I had started.

***

Alcoholism is a strange condition. If you survive the drinking stage, and many don’t, it has relatively little to do with alcohol, which is merely the drug with which the alcoholic treats herself. It is, rather, a way of thinking, and continues long after you have stopped drinking. It is a voice in the head: a malevolent voice that wants you to die. I certainly see it that way: it makes it easier to pick my way through the days if I know what, exactly, I am dealing with. Is this the voice speaking, or not? Which one made a decision, and which one doubted it? To discover the true root of any plan can require forensic vigour, and much time. It is perpetual inner warfare.

The party in the maternity ward aside, I have not taken drugs or alcohol for 15 years. You might think I would be better by now, but for the alcoholic there is nothing as prosaic as “better”. There is only a daily remission, based on how you deal with the voice in your head. (“Hello, monster. Where have you been?”)

One morning in early 2002, at perhaps 5am, which is, as all addicts know, when the night breaks, leaving you with mashed lips and mad eyes, I stood in front of the mirror in my mother’s house. I had been drinking alcoholically – that is, without stopping – for almost nine years, and I was very near the end. I pointed at myself – I remember myself as a very attractive drunk, red-lipped and irresistible, but this is the voice again, for I was nothing of the sort – and I said, very clearly, “I hate you and I wish you would die.” I knew then what the voice in my head wanted, and how powerful it was. It made a mistake by being honest and, because it made a mistake, I lived.

I could no longer blame circumstances or others; I would have to do something about it myself. It is frightening, seeing yourself wish death on yourself in a mirror, and – because you are full of cocaine, as well as alcohol – being able to remember it. Alcohol shrouds itself in blackout, and you wake to a queasy blank; but cocaine is very bright, and pointed – it is almost telescopic. I was frightened enough to attempt one year without alcohol.

I was prepared to be conscious (I loved the WH Auden line “But who can live for long/In an euphoric dream?”) but I was under the delusion I was a literary genius, even though the only job I could get at the time was as a freelance reporter for a now defunct Daily Mail showbusiness column called Wicked Whispers. Wicked Whispers was so awful that, occasionally, the subs forgot to put it in the paper and no one would notice. If the celebrities I stalked stared at me, and asked, kindly, about my pitiful excuse for a career, I was stunned. Looking askance at Gillian Anderson when she, clearly and without malice, pities you, is, for me, a definitive act of insanity.

I was too scared to drink alcohol, but I couldn’t do anything else about a condition I barely understood. I went to self-help groups in gloomy church annexes, which seemed as despairing – though less vivid – as what I had left behind, and heard people talk about “spiritual growth”. I missed my near-death, for it had not been boring. I did not know what they were talking about. I could not hear them. I said I was an alcoholic, because I supposed I must be, but I didn’t really know what it meant.

I did know I needed a new soul, the old one having broken, and I chose to build it with ink. I thought that I should be a famous journalist, so I stood outside the Daily Mail building and offered up a prayer, like Salieri: Lord, make me a great short-form showbusiness columnist, and then, if you think it right, Lord, may I progress to features. I got a job on the features desk, a job I called “Idiot Girl”. I was required to report in fancy dress – Saxon peasant, old woman – and I loved it. It was evidence of my survival: she mugs, she pratfalls, she lives! The voice was impressed, and temporarily silenced. (I believe everyone is a secret Daily Mail reader, even the voice.)

I built a career in journalism but I felt, always, that the person in print had nothing to do with me. She looked like me, but she was my ghost, and she was not reliable. I could never stop working, but I could never stay in any job; as soon as I arrived, I yearned to leave. I became marvellous at being fired and learned to soothe, and even thank, the person who was firing me, the better to start again at the beginning. It was a game I played with myself. I would procrastinate over my work to stoke the fear, but I was not lazy. I met a sensitive, clever man and married him, but I worked on my wedding day. I worked on my honeymoon. I worked in the labour ward, until I was offered the morphine. I was terrified of losing things and I would try to lose them so I could be, momentarily, at peace. My husband, at least, knew that, which is probably why I chose him. I am not a complete idiot.

I was, for a while, a columnist, but that was no good, either. To write a good column, I had to work myself into such a state of rage that the week was empty of anything else. I had a schedule of rage, which I followed dutifully; if I wrote on Wednesday, I would be numb on Thursday and would then stoke the rage over the weekend. On Monday, the rage would ebb, to be replaced by terror, which would reach a pitch on Tuesday night, after which I would write what seemed to me not sentences, but tiny, insistent stabs. That is not a job; it is a condition.

I was still at the mercy of the voice, but she had regressed to sludge. She manifested as a cloud of anxiety that travelled with me and occasionally mutated, helpfully, into dread, and then back to anxiety. I was a cartoon character with a personal cloud, Charlie Brown with a mood disorder.

Late summer in 2013, I was sitting in a self-help group. This one was surrounded by a very fine, old graveyard, like a metaphor, with many famous intellectuals in fabulous tombs; we sat calmly with the dead, as if we belonged there. The baby was at home in the cradle. I always said the same thing at this self-help group, and they were very patient with me. If I had published a good article in the previous 24 hours, I was happy because I existed in a form with which I was comfortable, and which other people could recognise and approve of. If not, I moped, and complained that I was not happy. I avoided self-help groups where they talked about their gratitude. I did not believe them.

I listened and thought about how much, then, I hated being an alcoholic. I mourned the lives I could have lived if I had not been cursed with this condition. I could have been an MEP! I could have been a chef! I wondered, in a broad way, what had happened, and what I could do. I became aware, quite suddenly in the quiet by the graveyard, of the constancy of the voice. I had waited, every day for 15 years, to wake up and find she had gone, and that was my error.

I knew then that she has always been there. When I was five, she told me my parents didn’t love me. I remember repeating, very insistently, to my parents that I knew they did not love me, because she had told me so. Evidence doesn’t matter to the voice; she kicks it away. She cherishes a passing piece of thoughtlessness, nurtures a harm. She lives in the small places beneath my conscious mind.

When I was 10, she said I was friendless at a noisy suburban school. When I was 12, and mooching about the dull streets of Kingston upon Thames, she said I was alone, and probably always would be. For the nine years of my active alcoholism, she told me to drink, first because it wouldn’t harm me – and what else was there? – and then because I couldn’t be saved.

She says only what she can get away with. She could never, for instance, convince me that my sister doesn’t love me; instead, she tormented me, when I was drinking, with the possibility that my sister might die. She wants so much to be believed, this voice, and is almost as pitiful as the other me, which is the one that is writing this story: the one that wants to live. I am quite aware how mad this sounds, but it is the truest narrative of my alcoholism that I can offer. Perhaps in 15 years I will have another one.

We coexist uneasily, today, the voice and I; she tells me to procrastinate over my work, to start fights, to give up. If I am unwary, she can plunge me into the deepest despair, and I have learned to construct an obstacle course to thwart her. It is made only of ordinary human love. Nothing else works.

My son helps me. His is three now, and knows what is important. “I must teach you to play, Mummy,” he says, and invites me, without irony, to pretend to be a monster. Then, of course, the voice whispers, “You have made him a parental child”: a creature who will care for me and not himself. I try to ignore her, because I cannot send her away. But I wonder now if it is she who is afraid, and not I.

As so many of the comments said too – thank you Tanya.