Monthly Archives: November 2016

Alcohol Awareness Week 2016

alcohol-awareness-week-2016So it’s Alcohol Awareness Week this week (14-20 November) here in the UK and as a Public Health Nurse I can’t NOT feature a post a day during this time.  My only remaining news source that I subscribe to is the excellent Alcohol Policy UK so I will be reproducing mainly their work here.

Over to James Morris:

Alcohol Concern have announced Alcohol Awareness Week (AAW) 2016 will take place from the 14th to the 20th November, with a theme of “Knowing the Risks”.

The national charity says the aim of AAW is ‘to get people thinking about alcohol – how it affects us as individuals, families, communities and society as a whole’, and is often used by organisations or services to reach out to service users, the public or launch new findings. Social media has also played an increasing role, with #AAW2016 as the Twitter ‘hashtag’. 

The theme follows significant attention of late to the question of what exactly are the risks from alcohol use, particularly at lower risk levels, following the revised consumption guidelines. However both the existence of the guidelines and activity such as AAW raises questions over to what extent ‘awareness’ in itself can reduce harms, as we explored in our review of AAW 2015.

Indeed the Chief Medical Officer accepted that guidelines themselves ‘may not reduce consumption directly’ earlier this year, though informed decision making forms an important basis for drinkers to consider potential consequences of drinking or goals they may wish to aim for.

Alcohol Concern have also increasingly promoted signing up to Dry January as part of AAW activity. Indeed evaluation of Dry January has suggested positive outcomes despite some ongoing questions, whilst more recent research has shown population surveys finding increased attempts to cut down during the month.

Alcohol Concern are also offering local areas the option to order small quantities of alcohol ‘scratchcards’ [see pdf version here] for cost price – download scratchcard pre order form. Over recent years scratchcards based on the AUDIT-C assessment tool have been an increasingly popular in a range of settings. Indeed AUDIT-C is commonly utilised as part of Identification & Brief Advice (IBA), a brief intervention approach typically delivered by health care roles. However concerns that simply disseminating scratchcards may be claimed as ‘IBA’ have been raised previously, rather than as an engagement tool.

See Alcohol Concern’s AAW page for more information, alcohol facts and further links.

Friday Sober Inspiration: Drama to No Drama

karpman-drama-triangleSo I read a Veronica Valli post about recovery red flags recently that really resonated.  And then as happens I was watching a video series from Ruth Buczynski looking at shame, anger and conflict and suddenly I found myself taking a very sharp breath in as the two subjects collided in a way that caused a psychological shift in my thinking.

The expression that Veronica used that has been rattling around my brain ever since I read it is this:

If I’m okay with me, I don’t have to make you not okay

Ouch.  The above image explains it all really well I think.

And then Ruth’s video’s were talking about the Karpman Drama Triangle that Jean over at Unpickled has discussed before here and which I knew about from my time working with families as a school nurse.  And as is the way with the magical internet rabbit hole one thing led to another and I found myself looking at this image.

avoiding-the-drama-triangle So much of recovery from addiction is about moving from fear to love and I am very aware that the Karpman Triangle is alive and well in my way of interacting with others close to me!  So like recovery from booze and reading sober bloggers ahead of me on the path I wanted to know what a healthy way of relating looked like and in my quest I found the work of Tina Tessina 🙂

This is what she has to say:

One profound way to intervene in the Drama Triangle is for family members to learn not to rescue each other. The other is to stop allowing others to rescue you.

Recognize a Rescue While You Are Participating In It

Learn to recognize that you are rescuing when you:
– Do something that you do not want to do because you believe you have to, and feel resentful later.
Do not ask for what you want.
Inappropriately parent another adult (giving unsolicited advice, giving orders, nagging, or criticizing)
Don’t tell your partner when there’s a problem, or when you feel resentful, ripped off, rejected, cheated, depressed, disappointed, or otherwise dissatisfied.
– Contribute more than 50% of the effort to any project or activity that is supposed to be mutual, (including housework, earning income, making dates and social plans, initiating sex, carrying the conversations, giving comfort and support) without a clear agreement between you.
Feel your role is to fix, protect, control, feel for, worry about, ignore the expressed wants of, or manipulate your partner.
Habitually feel tired, anxious, fearful, responsible, overworked and/or resentful in your relationship.
Focus more on your partner’s feelings, problems, circumstances, performance, satisfaction or happiness than on your own.

Whenever you realize you are rescuing, tell the other person what you’re tempted to do or not do for them, (how you want to rescue them) and ask them if they would like you to do that or not. Once you’ve offered and the offer has been accepted or rejected, (even if your partner is not honest about what he or she wants, or makes a mistake) it is no longer a rescue, it is an open agreement, and can be renegotiated if necessary.

Learn to recognize that you are being rescued if you:
– Think you are not as capable, grown up, or self-sufficient as your partner.
Find that your partner is doing things “for you” that you haven’t requested or acknowledged
Feel guilty because your partner frequently seems to work harder, do more, or want more than you do.
Don’t ask for what you want, because your needs are anticipated by someone, or because your partner will not say “no” if he or she doesn’t want to do it.
Act or feel incapable, childish, irresponsible, paralyzed, nagged, criticized, powerless, smothered, or manipulated in your relationship.
Act or feel demanding, greedy, selfish, out of control, overemotional, lazy, worthless, pampered, spoiled, helpless, or hopeless in your relationship.
Contribute less than 50% of the effort to any project or activity that is supposed to be mutual, (including housework, earning income, making dates and social plans, initiating sex, carrying the conversations, giving comfort and support) without a clear agreement.
Feel your role is to be fixed, protected, controlled, told what you feel, worried about, ignored, or manipulated by another adult.
Habitually feel guilty, numb, turned off, overwhelmed, irresponsible, overlooked, misunderstood and/or hopeless in your relationships.
Focus more on your partner’s approval, criticism, faults, anger, responsibility, and power than on your own opinion of yourself.
Feel controlled, used, manipulated, victimized, abused, oppressed, stifled, limited or otherwise dissatisfied by your partner.

The more familiar these feelings or actions are, the more frequently they occur, the bigger the habit you have of being rescued in your relationship. Rescuing is a habit that you learned early in life that seems “normal” and is habitual, so it is often difficult to be aware of it. Rescues depend on secrecy or ignorance. The antidote to being rescued is making an open agreement. So, if you suspect you are being rescued, suggest negotiating or talking about it, or just say thank you, if the help is truly OK with you.

How to Avoid Rescues
1. Recognize that what’s going on doesn’t feel good. It’s the best indicator of dysfunctional interaction.
2. Stop and Think. Don’t react automatically. If you have a dysfunctional habit pattern, you’ll need to make a different choice than your automatic behavior. Use the following checklist:
a) Does the situation feel fair?
b) Are you reluctant to say what you want?
c) Do you know what the other person wants?
d) Do you feel uncomfortable?
e) Are you resentful, angry, scared or upset?
f) Are you trying to control someone else’s reaction or feelings?
g) Does this feel similar to other interactions that ended badly?
3. After you’ve taken a moment to think about whether you’re rescuing or being rescued, and what clues you are aware of, either ask for what you want, or ask the other person what he or she wants.
4. Offer to work toward a mutual decision.

Taking the rescues out of your relationship removes the drama. Learning to talk about what you want and don’t want, and to offer help instead of just stepping in can make a really big difference in the happiness level of your relationship

Source: Tina B. Tessina, PhD, (aka “Dr. Romance”) psychotherapist and author of The Real 13th Step: Discovering Confidence, Self-Reliance and Independence Beyond the 12-Step Programs

Wow is all I can say.  If I feel like I’m about to say something that I might later regret I now find myself uttering Veronica’s words to establish if it is indeed me who is struggling with something, and therefore not feeling okay, and looking to off-load it onto somebody else to make me feel better and in the process make them not feel okay.  I have said a great deal less and taken responsibility for an awful lot more as part of that process in the few weeks since I made the realisation.

Maybe this work will help you too? 🙂

Soberistas launch new website

soberistas-new-siteSo today is the day that Lucy Rocca of Soberistas launch their new website!  This is a screen grab of the new live site 🙂

This is why:

Hopefully you will be aware that we are currently in the process of having a new website built which will be a much improved Soberistas and result in a better user experience for all our members.

We are aware that the current site is not perfect and there have been issues that will be eliminated in the new Soberistas.

One of the main issues has been the complicated login process. On the new site there will be one simple login process and the site will know if you are a paying member with out having to sign into Tinypass and this can be done on any device.

I’ve always been a fan of the community that Lucy has built because it was one of the first that I discovered.  In fact I talked about Soberistas in my very first blog post which you can read here 🙂  I’ve talked about Soberistas more than once too!  If you want to read all the blog posts where they’ve had a mention you can go here to read them all!

I’m all for supporting other UK initiatives that help us ex-drinkers, alcohol free warriors or recovery folk – whatever you liked to be known as and having met Lucy know that she is doing an amazing job over there in supporting thousands in their sober journey.

Do go check out the new platform and raise a cuppa in thanks.  I will be 🙂

Well done and good luck Lucy with the continued growth of Soberistas <3

PS Apologies for posting this up this morning and then taking it down until this evening.  The new site launched this afternoon so I was a bit premature in my announcement earlier!

Friday Sober Inspiration: Date with Destiny

date-with-destinySo recently I watched Tony Robbin’s documentary film ‘I am not your Guru’ because I’d read some of his books and have always been curious about his seminars and conferences.  So this documentary follows him during one of his 6 day Date with Destiny seminars.  It was fascinating to watch and he certainly has a unique coaching approach!

What I didn’t know is that he was, and continues to be, driven by a desire to both progress within his own life and help others as part of that process because of his own childhood.  His mother was both an alcoholic and addicted to Valium and he talks about this briefly during the film.  And there was much about the seminar programme that resonated with our sobriety journey hence why I’m talking about it here and now.

The 6 day event is both long and intense and the format runs:

  1. Preparation
  2. Evaluation – push will wear you out
  3. Discovery – we all get what we tolerate
  4. Relationship
  5. Transformation
  6. Integration

He understands the human condition because of his own experience.  He asks great questions such as what are the beliefs, behaviours, emotional habits, story you tell yourself or conflict inside of you that stops you living your best life?   And there were some great take aways such as:

Stay in your head and you’re dead

Another of his quote’s in Fortune that I read and really liked was:

‘Be in charge of your life. You’re going to have reward and risk wherever you are, but be authentic to what you want to be and what you want to do. Don’t be worrying about what somebody thinks about you. Don’t flatter yourself. They’re really not thinking about you.’

All of these stages and questions fit the drinking and sobriety conundrum really well and he acknowledges that people who attend his days are looking to change a behaviour or way of thinking which again fits our battles with booze perfectly!

And wouldn’t you know he’s one of us 🙂

He’s also fastidious about his diet. Robbins doesn’t drink alcohol or caffeine, or eat red meat or chicken (source)

Here’s a TED talk given by him where he motivates in 20 minutes:

PS The second trailer for T2: Trainspotting is out and you can watch it here – can’t wait for January!

You’re an addict so be addicted, just be addicted to something else – choose the one’s you love, choose your future, choose life” 😉

 

Who needs a drink when you’ve got the Feel Stress Free app?

feel-stress-free-appSo managing all feelings, and particularly difficult feelings like depression and anxiety, was a big part of the early days and months of getting sober for me.  Even now I’m always on the look out for new sober treats and self-care tools to make this easier for all of us.  The new Feel Stress Free app released this year, is the second mindfulness app I have tried as I have talked on the blog before about Headspace.

For me psychological self-care and fitness is as important as physical fitness and self-care so this was a great addition to my sober tool-box particularly on the go when life gets tricky.  As you know I’m a District Nurse and some patient visits can be emotionally difficult so having an app in my pocket that I can tap into, potentially between patient visits if needed, is a much welcomed respite.  The apps image and sounds of a desert island, lapping waves and seagulls with background calming music was lovely every time.

This above image is the first screen that greets you once you have downloaded for free the Thrive’s Feel Stress Free Mobile App which is available for iOS and Android.  It works on a subscription basis,which can be purchased for one month, three months or a year. For one month it will set you back £4.99, for 3 months it will cost £3.33 each month and for a year it’s £1.99 each month.  I was lucky enough to get a month’s free trial from the developers 🙂

This is what their website says:

Be Stress Free has been created over two years of development and research to pro-actively prevent and manage stress and anxiety.

  • Keeps track of your mood over time
  • Enables you to train your thoughts so you can manage how you feel about different situations
  • Trains you in 4 relaxation techniques that give you control over your stress

Stressed or anxious? We can help! Using evidence-based techniques, we help you learn to relax and build your resilience to these common—yet hard to conquer—problems. Featuring our thought trainer, zen garden, and unique ‘message in bottle’ social feature, there’s plenty to explore!

I loved the zen garden and ‘message in a bottle’ social feature (that enables you to send a message of encouragement to others using the app) and fed back to the developers:

“Have recently spent a year training part time to be a child and adolescent psychotherapeutic counsellor at the University of Cambridge and one of the therapeutic tools we used was a sand tray!  It was lovely to be able to immerse myself in that way again and very valuable.”

I wasn’t the only reviewer who really liked this as Moonlolly in the City agreed: ‘If you swipe left, you go to a second island called the ‘Zen Garden’, a virtual Japanese rock garden used to aid meditation. Here you can design your own space and save your best designs.  I loved this part, probably because I’m a big kid – it was one of those absorbing exercises akin to adult colouring books. Totally on board with this.’

One of the things I liked about this app is it is designed by clinicians:

Dr Andres Fonseca – CEO, is a psychiatrist with almost 20 years of clinical experience. He believes the way mental health services work at the moment is very broken. Services are focused on intervening when people are in crisis, which is already too late. He believes therapeutic software that is fun to use is the way to help people Thrive.

A bit more detail about some of the key features:

Mood Meter

Start every day tracking your mood to receive the best recommendations to get through it. Based on your results the Mood Meter will recommend different activities. It will record your results on your progress so you can look back and see what works for you. It will learn itself what you find helpful and get better at advising you over time.

Thought Trainer

Our cognitive behavioural therapy based thought trainer is how we help you to re-frame your negative thoughts. We all have negative thoughts at times, but is there a better way we can think about things? That is what the thought trainer is here to do. It tracks how you feel, giving recommendations and helping you to see a positive in the negative. With everything tracked in Progress and the app learning more about you as you use it, the Thought Trainer will soon personalise itself to your experiences.

The evidence

Computerised Cognitive Behavioural (cCBT) therapy has accumulated 10 years of evidence. It has been shown to work as a self-directed treatment without intervention from a therapist. In 2016 Jill Newby and colleagues from St Vincent’s Hospital in Australia undertook a review of all the evidence of cCBT used for depression and anxiety showing it is a very effective technique and comparable to face to face therapy. Here is a link to the study.

Calm Breathing

This is the simplest technique, one that you can learn in the app and practice anywhere you are. It is based on the fact that increasing chest pressure by taking very slow and deep breaths, and then reducing by slowly breathing out, triggers a reflex. This reflex slows down your pulse and gives you a relaxed feeling in your body. As body and mind are connected this then results in relaxation in your mind. Give it a go for 3, 5, 7 or 10 minutes!

The evidence

Deep slow breathing is an essential technique incorporated in many relaxation exercises. It has been extensively examined in the literature in different setting. A good review of the evidence behind it and its uses can be found in General Principles and Empirically Supported Techniques of Cognitive Behavior Therapy, Chapter 14 by Hazlett-Stevens and Craske. You can read a preview of the chapter here.

Progressive Deep Muscle Relaxation

In this technique we also take advantage of the mind-body connection. We will teach you to contract and relax various muscles progressively allowing you to enjoy the difference between the tense sensations in the muscle and the relaxed sensations that come after you have let the tension go

The evidence

Since its description by Jacobson in 1938 this technique has a record of proven efficacy. There is a 2007 review of the literature that summarises all the available evidence up to that date which you can find here.

Self Hypnosis

Not for everyone but those of you who are able to reach a state of hypnosis can benefit greatly from this technique. We will try to teach you to put yourself into a hypnotic trance. If you are able to achieve it, he will help you teach yourself a word of phrase that will quickly bring you back to that state of relaxation whatever your circumstances.

The evidence

It has proven efficacy in anxiety related to many situations. It has been particularly studied in people going through different medical treatments like dialysis, chemotherapy, surgery and dentistry. There is a 2010 review that goes through all that evidence. The main issue with hypnosis is that the person must be suggestible to benefit from it. Here is a recent study on how suggestibility influences outcomes in using hypnosis to manage pain.

Meditation

Simple to learn but hard to master this is quite a powerful technique for relaxation.  It requires dedication and practice but if you persevere it can bring about the most benefits. You will need a quiet space and to achieve a sensation of comfort. You will be able todevelop a passive attitude that allows you to just watch your feelings, sensations and thoughts as they pass through your mind. You will also use word or phrase to help you refocus.

The evidence

This is probably the technique that has received the most attention recently. It requires practice to master but everyone can use it if they devote the time to learn it and practice it. There is a complete review and meta-analysis of all the evidence of meditation in the management of anxiety published in the British Journal of Psychology in 2012.

And you can track your progress:

Progress keeps track of everything you do in the app. It is what the app uses to give you better and better tips. If you are working with a therapist you can use Progress as your full-fledged therapy journal.

You can choose how long you want to do each exercise for, from a quick 3 minutes of deep breathing to 25 minutes of meditation, which is great if you want to fit a session into a busy day.  The app also remembers which exercises you’ve done before and how many times, encouraging regular use and making the whole experience feel very personalised.

Echoing the words of Moonlolly: if you’re going to invest in a mindfulness app, it’s worth bearing in mind that this is one of the first to have actual CBT therapy incorporated and be officially ‘clinically proven.’

So next time you’re feeling stressed or anxious rather than reaching for a drink, or thinking that a drink would help, why not try this?