Daily Archives: 14/09/2014

Abstinence violation effect

This is something I’ve been thinking about for a while and thought it was about time I wrote a blog about it.  With just a week to go until I hit one year sober I’ve been thinking about what would be the impact of having a drink.  Now don’t get me wrong I am not thinking about having a drink I’m just interested in the whole counting days thing and how it differs to when I gave up smoking.

When I gave up smoking if I lapsed I would think of it as a slip and get back to not smoking.  I didn’t consider it going back to day 1 – I saw my quit attempt and stop date intact with a small blip.  But in the world of giving up booze it is very different and I don’t know where that comes from.  If anyone can share what the source is of this much more ‘all or nothing’ view I’d love to know.  This difference in view between a lapse and relapse has consequences for how we see ourselves and our actions about further drinking moving forward.  If I lapsed and had a drink now it would feel like the whole year had been wasted as I would have to go back to day 1 and that would probably lead to me thinking “well  I’ll keep drinking then”.

It is recognised and called the ‘abstinence violation effect’ (AVE) which is defined as “what happens when a person attempting to abstain from alcohol use ingests alcohol and then endures conflict and guilt by making an internal attribution to explain why he or she drank, thereby making him or her more likely to continue drinking in order to cope with the self-blame and guilt”

The problem with this way of thinking is that a lapse has the potential to become a relapse and then a collapse.  That moment of yielding fully to addiction is what Alan Marlatt, director of the Addictive Behaviors Research Center at the University of Washington, describes as “a form of black-and-white thinking,” says Marlatt. “You blame [your failure] on internal factors that you consider beyond your control.”

Those factors, such as a belief that addiction is a disease that robs you of free will are what derail thousands of quitters and abstainers. You could also call it the “f___ it” effect, the idea that once you cheat, you’ve blown it, so you might as well binge. In traditional 12-step programs for addiction, that line of thinking is encapsulated in the slogan “A drink equals a drunk.” But understanding and overcoming AVE, says Marlatt, is crucial to conquering a problem behavior or dependency in the long term. You have to know what to do when you fall off the wagon to learn how to stay on it.

And this is where my ponderings and Marlatt’s article in Time magazine come together:

While studying cigarette smokers who were trying to quit in the 1970s, Marlatt discovered that people who considered the act of smoking a single cigarette after their quit date to be a complete defeat and evidence of an innate and permanent lack of willpower were much more likely to let a momentary lapse become a full-blown relapse.

Most people who try to change problem behaviors will slip at least once. Whether that slip provokes a return to full-blown addiction depends in large part on how the person regards the misstep. “People with a strong abstinence-violation effect relapse much more quickly,” says Marlatt. A single slip solidifies their sense that they are a failure and cannot quit, creating a self-fulfilling prophecy.

So I guess the question becomes is counting days helpful?  If I was to consider a one off return to drinking as a slip rather than a relapse would it help me get back in the saddle quicker after the event?  This will remain a hypothetical question of course but do we need to change our perspective on counting days and moments of lapse?

7 days to go

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