Monthly Archives: January 2017

Do I Drink Too Much?

So it’s the last day of January and to those of you taking part in Dry January congratulations if you made it this far.  Have you been reflecting on whether you drink too much as part of that month off?  Perhaps on your last night of sipping sparkling water you might want to watch this documentary which aired in December on BBC Wales.  Thanks to my friend Libby for bringing it to my attention!

Lib featured it as part of her News and Update round-up for December on Alcohol Policy UK and if you wish to read all of it you can find it here:

News & updates December 2016: middle-age health, drink-driving, the rise of alcohol-free & the return of benchgirl

Ask your MP to join the alcohol harm debate this Thursday

I’ve just received this email from Liam Byrne and I’m sharing it here in case you would like to write to your MP to urge them to join the debate too.

I feel I don’t have much of a voice on this issue but my MP is my representative so I will be writing to them.

Dear Friend,

Please ask your MP to join the alcohol harm debate this Thursday.

This Thursday we finally bring to the floor of the House of Commons a debate about alcohol harm and the need for a plan from Government to support Britain’s 2.5 million children of parents who drink too much.
Please write to your MP and ask them to join in.
This is a chance for us to make sure the voice and experience of children of alcoholics is heard on the national stage. I’ll be talking about some of the ideas contained in the first ever manifesto for children of alcoholics which we aim to launch the week beginning 13 February – International Children of Alcoholics Week.
If you aren’t sure who represents your local area, visit  They Work for You and ask your MP to join us.

The more who speak, the more we break the silence – and break the cycle of this terrible disease.

Very Best


Liam Byrne MP

Public Health England publish review of evidence on alcohol

Public Health EnglandThis summary report was published by Alcohol Research UK in December.  It looked at Public Health England’s new published review of evidence on alcohol.

Public Health England has published a review of international evidence on alcohol policy and harm reduction.  The new report, based on almost two years of research and analysis, addresses a number of key policy areas.

These include:

  • The price of alcohol and its effect on consumption
  • The impact of both the number of alcohol outlets in a given area, and the times at which they operate, on a range of potential harms
  • The effectiveness of existing controls on marketing, sponsorship and promotion
  • The role of ‘brief interventions’ in preventing harmful drinking
  • The effectiveness of schools-based education programmes
  • The evidence on alcohol treatment in tackling harmful and dependent drinking

We welcome this important contribution to the literature on alcohol harm prevention. It provides both a resource for identifying key evidence and an evaluation of the relative effectiveness of policy interventions based on an extensive process of reflection and review.

Today’s report also provides a new analysis of drinking trends and their economic effects. It confirms that average consumption has been falling in the UK for over ten years, especially among young people. However, it also shows that trends vary between social groups, reminding us that average consumption provides only a rough guide to where harms are concentrated, and that harms can rise even when overall consumption falls.

Importantly, the report confirms previous studies showing that around one third of all the alcohol consumed is drunk by the heaviest drinking 5% of the population.  This demonstrates not only how heavy drinking is concentrated, but the very high proportion of alcohol that is sold to people with serious drinking problems.

The report draws particular attention to the impact of alcohol on economic productivity: suggesting that drinking causes more years of life lost to the workforce than are caused by the top ten most common cancers combined. While the precise social costs of alcohol remain hard to quantify, this report shows clearly that heavy drinking creates an enormous burden for the wider economy.

The PHE report echoes previous evidence reviews in demonstrating that price is a key policy lever in shaping consumption. Its findings suggest that a combination of minimum pricing and more targeted taxation could reduce both harmful drinking and health inequalities (especially the so-called ‘alcohol harm paradox’). Clearly, this is a significant finding as the Scottish Government continues to deal with a prolonged legal challenge to MUP from the Scotch Whisky Association.

The report also argues that while evidence on factors such as outlet density is less compelling than is the case for price, nonetheless limiting hours of sales can reduce antisocial behaviour and drink-driving. While, in the UK, evidence on the relaxation of licensing hours since 2005 has not shown a clear effect in terms of crime, disorder or hospital admissions the authors point to international studies and reviews that show a stronger correlation.

The report also follows previous reviews in pointing to evidence that exposure to marketing can lead to earlier and higher levels of consumption among young people. It finds no robust evidence that existing marketing controls are effective in preventing youth exposure to marketing, and so will strengthen calls for a reassessment of the current regulatory framework.

It also finds no clear evidence that voluntary industry-led partnerships (including the recent ‘Responsibility Deal’) reduce alcohol harms. This is partly because there are insufficient independent and robust evaluations of such schemes to provide clear evidence of an effect, and also because it has been argued that many of the changes introduced under the Responsibility Deal would have happened anyway.

While the report confirms that, from a public health perspective, price, availability and marketing are key issues, it also addresses questions around treatment and interventions. This is especially important as the impact of austerity continues to be felt in widespread cuts to budgets for treatment services across the country.

The review finds considerable evidence that screening and brief interventions in primary care can help prevent harmful drinking. On a policy level, a key question now is how to support GPs in actually carrying out screening and delivering interventions effectively where there is a need. Currently, delivery of interventions in primary care remains low so work to better incentivise and train GPs is needed. The review, however, also notes that the evidence for the effectiveness of brief interventions in other settings (such as the workplace or local pharmacies) is much less robust..

In line with most previous reviews, the report finds that while education can play an important role in raising awareness and knowledge, the evidence for its effectiveness in changing behaviour is weak. This is not necessarily because schools-based prevention and education is wholly ineffective, but because its impact is inevitably limited (behaviours are driven by far more than simple knowledge of harms) and because the delivery of programmes is often highly inconsistent.

Finally, on drink-driving, the review finds strong evidence that reducing the blood alcohol limit is effective in reducing accidents. England and Wales currently have a BAC limit of 0.8 g/l – the highest in Europe, alongside Malta.

Overall, this report represents a key summary of the available evidence on alcohol. It confirms that there are policy levers available to Government that can have a measurable impact on alcohol harm reduction. Clearly, alcohol policy needs to balance a range of interests, but if the Government is serious about seeking to reduce the health impacts of alcohol then this evidence review is of critical importance.

The PHE report is based on a very wide-ranging analysis of available research and an extensive process of peer review. We hope that it forms a key element in the development of alcohol policies in future.

So 5% of the population equates to approximately 2.6 million people here in the UK …… (source).  And Alcohol Policy UK pose the prompted question which I’d like to know the answer to as well:

PHE evidence review 2016: will Government policy respond?

 

 

Alcohol-related cancers projected to rise – can mass media campaigns help?

cruk-university-of-sheffield-logoThis was published by Alcohol Policy UK in December regarding alcohol-related cancers.

Increasing recognition of the risks of alcohol-related cancer has been a priority for a number of health organisations, with recent research identifying limited levels of awareness and projected rises in incidences.

report released last month commissioned by Cancer Research UK (CRUK) attracted significant media coverage of its findings that alcohol-related cancers could cause around 135,000 deaths over the next 20 years in England. The modelling was carried out by Sheffield University and analysed figures under a number of consumption forecasts, and also provided updated estimates of the potential benefits of Minimum Unit Pricing (MUP). A 50 pence MUP could reduce all alcohol-attributable deaths by 7,200, including 670 cancer deaths over the next two decades, reducing alcohol-related healthcare costs by £1.3 billion.

The report follows findings released earlier in the year by CRUK stating the understanding of the link between alcohol consumption and cancer was “worryingly low”; only 13% identified cancers as a possible risk when asked to identify alcohol-related health conditions associated with drinking too much. Recognition improved when prompted with possible cancer types, but those such as breast cancer had far lower recognition than less prevalent alcohol-related cancers. See here for a CRUK alcohol and cancer page.

Data used from the report though has just been published in BMC Public Health journal revealing significantly higher awareness of the links in the North East region, where Balance North East has been conducting media campaigns including TV advertswww.reducemyrisk.tv and #7cancers Twitter activity.

Media campaigns: a question of behaviour change?

Health groups though tend not to want to see health campaigns in isolation owing to the limited impact on behaviour. Indeed similar debates have taken place with regard to the awareness of the revised drinking guidelines and the limitations of their impact on consumption.

Ealier this year Chief Medical Officer Dame Sally Davies attracted controversy for suggesting drinkers should think ‘Do I want the glass of wine or do I want to raise my own risk of breast cancer?’ each time they drink. Whether any significant number of people have taken on the CMO’s advice – or indeed deliberately rejected it – will remain unknown, but based on the evidence of the complexity of behaviour change it would seem unlikely.

As such health groups, including CRUK, not only wish to see media campaigns and improved information through mandatory labelling, but also action on price, availability and marketing. Such levers have considerably stronger evidence to support an impact on drinking behaviours, but are of course opposed by those who may support informed individual decision making but not the Government in influencing it via regulation.

As for the near future, momentum may continue with a general trend in increasing awareness of alcohol health harms. Whether this will be supported in England by legislation to ensure mandatory labelling on containers, or indeed change environmental influences, is uncertain. In the meantime, alcohol-related cancers are likely to rise before they fall, even should consumption fall further.

estimated-trends-in-annual-alcohol-attritubutable-cancer-deaths-following-reduction-in-consumptionA picture paints a thousand words ……

And edited to add this small celebratory footnote: Voted  Top 100 Addiction Blogs Winner from thousands of top Addiction blogs in Feedspot’s index using search and social metrics.  Ranked 53rd based on Google reputation and search ranking, influence and popularity on Facebook, Twitter and other social media sites, quality and consistency of posts and Feedspot’s editorial team and expert review 🙂

Revisiting my moderation warzone

So Prim & were discussing my recent interview on The Bubble Hour and how she had learned new things about me.  These were primarily to do with my time before I started blogging so that murky past that was my repeatedly attempted and spectacularly failed attempts at moderation.  I think you have a flavour of them from my shared last drunks and final drinking horror but not an appreciation of the total warzone that it was.  I was battling myself and my desire to drink on a daily basis and those internal emotional battles spilled over into external marital discord and parental shame.

We wondered maybe if there existed this perhaps self-limiting belief that those of us who blog out here just decided one day to stop and that was it – bingo, job done – which fails to recognise that there were many quit attempts that preceded that final desperation driven decision and the need to ‘up the ante’ by adding visible social accountability to the mix.  So in an attempt to debunk that potential myth about myself I’m going to provide a brief history of those years of moderation between the end of 2008 and my quit day in September 2013.

To set the scene before we moved to France in early 2008 and up until that point my drinking was problematic but still manageable.  That’s not to say I didn’t do incredibly stupid things when drunk and have many shameful memories of drink-driven drama and mis-behaving.  France changed that and we spent all our time after France trying to regain control and never succeeded.

Because it’s almost 10 years ago and I can’t recall all the details – hangover securely in place – I’m going to do a timeline to paint a broad brush outline:

  • End 2008 returned from France to home county in UK with baby and small toddler in tow.
  • Early 2009 returned to work nursing full-time, MrHOF stayed at home and cared for children.  This was a difficult time for all of us, readjusting to returning to where we grew up, me working, he house-husbanding and not working and two small people in our charge.  Our daily drinking continued unabated and our marriage was showing the strain.  Days of not drinking would follow particularly shaming altercations by way of reparation.
  • 2010 decided to enter London Marathon ballot – started running.  Tried to decrease drinking and smoking as I tried to get ‘healthy’.  End 2010 – lost my maternal grandmother and my step-father became ill.  Was struggling psychologically so started anti-depressants and returned to therapy.
  • 2011 Marathon training in earnest so this is when the stopping and starting drinking started proper.  Gave up for New Years resolution to aid training.  Remember attending 40th b-day party in Feb and had managed 6 weeks.  Mid 2011 – lost my step-father, who was my father from birth in all but genetics.  Two close family deaths meant my drinking spiralled once more (which is the reason for the image at the top of the post, because these types of huge family loss events can be deeply traumatising and can tip us over from coping to not coping).  Remember noticing first Dry January posters for 2012.
  • 2012 did Dry January and carried on to do three months – partly I think to prove to myself that I didn’t have a problem!  Drinking less regularly & frequently but when I did they were spectacular binges.  Trying not to drink in the week so the week-ends were horrendous.  Started my Health Visitor training and gave up smoking for good.  During training was working professionally with families where drink was a problem and the cognitive dissonance created began to become unbearable.  I knew that if I didn’t get this under control I was in danger of visiting my own childhood on my children.

“The best predictor of a child’s security of attachment is not what happened to his parents as children, but rather how his parents made sense of those childhood experiences” Dr Dan Siegel

  • 2013 more stints of not drinking interspersed with spectacular blow outs.  Early physical signs of damage from alcohol abuse and ongoing symptoms noted with alarm.  Becoming weary of the whole process and drinking was no longer fun in any way, shape or form.  Still in therapy on and off although had never discussed my drinking!  London Marathon running buddy came to stay for week-end and had just mentioned my drinking to my therapist as a ‘door handle moment’ in my final therapy session with her.  Decided to stop for good.  Had night of heavy drinking with her, bought Allan Carr’s book on Kindle, read it all week, final drinking week-end.

So as you can see there was a huge amount of back-story to my stopping which I haven’t fully disclosed here before.  I’m not sure why.  There is a sense that in talking about it I am somehow condoning moderating – which I’m not.  Equally I think we have to acknowledge that this period of one step forward two steps back is part of my story and part of many people’s journey.  So if you’ve read my blog before and thought ‘well she’s different from me because she just stopped’.  I’m not and I didn’t.

As we head into the end of January and you may be considering going back to drinking because you’ve done a month to prove you don’t have a problem I just ask you to pause and think again.  The reason I did all those stop and start attempts is because I started to see the benefits and knew that there was potentially something better on the other side of the difficult first few months if I just stuck with it.  I urge you to consider doing the same because you can always go back to drinking later can’t you?   What have you got to lose? 🙂

A conversation with Jean: Interview on The Bubble Hour

So I have been a long time fan and follower of both Jean at Unpickled and The Bubble Hour.

For those who  haven’t yet discovered the wonderful resource that this is here is how they describe it:

The Bubble Hour is co-hosted by Ellie S., Amanda F., Catherine M. and Jean M. – sober women who are dedicated to breaking down the walls of stigma and denial surrounding the disease of alcoholism. Alcoholism effects more than 50% of American adults, either directly or indirectly, and yet it still remains a “taboo” topic and is still mostly misunderstood by the majority of people (even those effected by alcoholism and their loved ones). The Bubble Hour seeks to inform, educate and help people identify with the stories they hear, the conversations and interviews with people who are just like they are, and let people know they aren’t alone. Nobody can take the first tentative steps towards sobriety without first getting past denial, but even once they are past denial the stigma surrounding alcoholism is so strong that people are reluctant to seek help. The Bubble Hour would like to change that stigma. Our Co-Hosts, and the vibrant community of sober people they know, will be recording and downloading this show for anyone to listen to for information, community, empathy and understanding. We are so grateful for the sober people who came before them to help them find this path; this is one way they feel they can give back. Please help us spread the word about this website and the pod casts; you may be helping someone you know well but don’t even know they have a problem. Alcoholism thrives in the dark. Together, we bring light. And hope.

They have interviewed and recorded over 200 episodes that you can find on iTunes or BlogTalkRadio.

So how excited was I to be interviewed for their 202 episode!  We had a wonderful conversation and it felt like two old friends catching up.  As I say in the discussion Jean was one of the first sober blogs I discovered in my very early days and I am so grateful to her for leading the way for me 🙂

If you want to hear me talk about my drinking (we lived in France for 6 months not 1 year – nervous brain fart moment!), my recovery and all the things I’ve been up to since I stopped 1214 days ago you can do so here:

http://www.blogtalkradio.com/bubblehour/2017/01/17/a-hangover-free-life-author-louise-rowlinson

Supplementary links to the discussion should you be interested to read further:

The Conscious Parent is written by Dr Shefali Tsabary, Clinical Psychologist.

Attachment theory where I talked about secure and insecure attachment and omitted a very important word in the insecure categories! I should have said insecure anxious-avoidant and insecure anxious-ambivalent.

Alexithymia which I described as emotional constipation!

The groundbreaking work of Dr Dickon Bevington and team: Adolescent Mentalization Based Integrative Therapy (AMBIT)

Thank you so much Jean for hosting me and I hope you enjoy listening in 🙂

Edited to add: 20th January 2017.  I didn’t mention running in my conversation with Jean which I should have done as part of my sober toolbox.  It set me on the road to sobriety when I trained for the London Marathon in 2011 and has been a vital decompression tool ever since.  Which ties in nicely with this clip from T2 Trainspotting which is released next Friday and boy I can’t wait to see this film.

Renton is so right – be addicted to something else ……

Guest Post: Finding the Link Between Substance Abuse and Schizophrenia

pt_figure_dopamine-pathways-in-schizophrenia_53127-pngI was contacted on email by Justin in November who said; “I am a recovering addict and content writer interested in providing a guest post article.  In my path to recovery I’ve taken to writing content about addiction, recovery and substance abuse through my treatment program.”  Here’s what he wrote about substance abuse and schizophrenia:

New studies have found a link between substance abuse and schizophrenia.  While the relationship between mental health and substance abuse is an incredibly complex one, a group of Denmark researchers have determined that abuse of virtually every type of drug can contribute to mental deterioration and eventual, schizophrenia.

A common misconception about schizophrenia is that those afflicted have split personality disorder or multiple personalities.  However, this has been determined false, as most people suffering from schizophrenia are non violent and lead fairly normal lives, posing no immediate threat to others. Per the National Institute of Mental Health:

“Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.”

Rather than split personality disorder, which is a separate diagnosis, those suffering from early onset schizophrenia can experience a decrease in mental processing, rational thinking and general mental well being.  Furthermore, in can take years for schizophrenia to fully develop and during this time, can manifest itself as more common mental health disorders like depression and anxiety.

So what environmental and societal factors can worsen these symptoms into full blown schizophrenia?

The new Denmark study has determined that substance abuse can not only trigger schizophrenia in people genetically at risk, but also increase the chances of developing schizophrenia by up to six times.

While the direct cause and effect relationship between substance abuse and schizophrenia is tremendously complex, the study found the following increases in risk:

  • Cannabis: 5.2 times
  • Alcohol: 3.4 times
  • Hallucinogenic drugs: 1.9 times
  • Sedatives: 1.7 times
  • Amphetamines: 1.24 times
  • Other substances: 2.8 times.

The study notes, while the effects are not often immediately noticed, symptoms of schizophrenia as it relates to drug abuse, often surface later in life: sometimes ten to fifteen years after the substance abuse diagnosis.

Mental health and substance abuse treatment centers often offer dual diagnosis programs for this exact reason, noting that symptoms of schizophrenia can be coupled with drug use.

A particularly worrisome finding of the study is the risk found with two of the most prevalent substances, marijuana and alcohol.  While marijuana is federally illegal, it is used medicinally and recreationally in many stages, including California.  A large factor in the correlation found between cannabis and schizophrenia is due to the fact that people can be exposed to it second hand.  That is to say, unlike most other substances (not smoked), marijuana can be introduced to people’s systems indirectly, simply by being in close proximity of someone that is using the drug.

Alcohol on the other hand, tops the list, as it’s the most socially acceptable and easily obtainable substance given it’s legal place in American media and culture.

While the newly discovered findings presented by the Denmark study do not provide us with a black and white relationship between schizophrenia and substance abuse, the evidence is undeniable: The prolonged abuse of illicit drugs and alcohol increases the risk of developing schizophrenic tendencies and symptoms later in life.

Article courtesy of the team at Muse Treatment

Thank you Justin!

Friday Sober Jukebox – Ghosts in the Machine

ghosts-in-the-machineSo this feels like a timeless sober jukebox tune for a timeless post.  I’m actually writing this at the end of October 2016 because I have been struggling with some recurring demons – my ghosts in the machine as it were.

Coming from the family experience that I do I struggle with fear and anxiety pretty regularly and it settles for long periods of time and then flairs up again.  Invariably I think that I have more power than I do and that everything is my fault, everything will fall apart and it will all be my fault.  I listened to a Yoga Church podcast last night called ‘Step Out of Your Past and Into Your Now’ that got me thinking about this again as I struggle to get on top of another bout of raging anxiety and fear.

shadow-dancerMeadow and Laura McKowen were talking about the words that define their past and for me those two words, fear and anxiety, express it pretty succinctly.  They discussed coming up with an image that portrayed this and pretty similarly to Laura the one I landed on was shadow dancer.  I spent my entire life dancing to the tune of others to dodge the shadows of fear and anxiety – either my own or those of others around me.  No wonder I ended up in the bottom of a bottle!

This image and these words must then be honoured and let go in a ritual of some kind of your making.  To me it felt like I had to sit with them and not dance myself away from them and my shadow side.  To be honest the trigger events have prompted a great deal of soul searching and somatic discomfort so I feel like this has been part of the process and hence why it is time to move on from being stuck in these feelings.

explorerHaving created the image and words that defined the past the task was then to create ones to replace these for the future.  My brain was pretty fried by this point (or I was simply disassociating under the stress of it!) but with the help of MrHOF we came up with calm and fearless as the words and the image was explorer.

This image seemed fitting in terms of my internal exploring of more positive feelings and our external plans for travel as a family too 😉

This is an ongoing process and I continue to have waves of emotional upheaval but like the waves of craving to drink they come less often and are less intense and I see them build to crescendo and break now so I’m making progress.  I recommend you give it a try what with the heralding of a new year not that long ago.

And now to one of my favourite albums 🙂

Back to life, back to reality … Women closing the drinking gap on men

women-closing-the-drinking-gap-on-menIt’s the end of the Christmas and New Year break and most of us head back to work or school, hence the Soul II Soul lyrics in the blog post title.  And part of that reality is that women are closing the drinking gap on men as reported by the Institute of Alcohol Studies in October 2016.  Over to their analysis:

Trend most evident among young adults, international analysis shows (25 October)

Women are catching up with men in terms of their alcohol consumption and its impact on their health, finds an analysis of the available international evidence, spanning over a century and published in the online journal BMJ Open.

This trend is most evident among young adults, the findings show. Historically, men have been far more likely than women to drink alcohol and to drink it in quantities that damage their health, with some figures suggesting up to a 12-fold difference between the sexes. But now evidence is beginning to emerge that suggests this gap is narrowing.

In a bid to quantify this trend over time, a research team pooled the data from 68 relevant international studies published between 1980 and 2014. The studies calculated male-to-female ratios for 3 broad categories of alcohol use and harms (any alcohol use, problematic alcohol use and alcohol-related harms) stratified by 5-year birth cohorts ranging from 1891 to 2001, generating 1,568 sex ratios (see above data table).

Sixteen of the studies spanned 20 or more years; five spanned 30 or more. All the studies included explicit regional or national comparisons of men’s and women’s drinking patterns across at least two time periods.

Results:

The pooled data showed that the gap between the sexes consistently narrowed across all three categories of any use, problematic use, and associated harms over time.

Men born between 1891 and 1910 were twice (2.2) as likely as their female peers to drink alcohol; but this had almost reached parity among those born between 1991 and 2000 (1.1, illustrated). The same patterns were evident for problematic use, where the gender gap fell from 3 to 1.2, and for associated harms, where the gender gap fell from 3.6 to 1.3.

After taking account of potential mathematical bias in the calculations, the gender gap fell by 3.2% with each successive five-year period of births, but was steepest among those born from 1966 onwards.

Associated health harms fall disproportionately on female drinkers

The calculation used was not designed to address whether alcohol use is falling among men or rising among women, the researchers caution.

But among the 42 studies that reported some evidence for a convergence of drinking levels between the sexes, most (n = 31) indicated that this was driven by greater use of alcohol among women, and 5% of the sex ratios were under 1, suggesting that women born after 1981 may actually be drinking more than their male peers, the researchers claimed.

Conclusions

The researchers wrote: “Findings confirm the closing male–female gap in indicators of alcohol use and related harms. The closing male–female gap is most evident among young adults, highlighting the importance of prospectively tracking young male and female cohorts as they age into their 30s, 40s and beyond.”

While they did not set out to explain the reasons behind their observed findings, they emphasised that their results “have implications for the framing and targeting of alcohol use prevention and intervention programmes.”

They concluded: “Alcohol use and alcohol use disorders have historically been viewed as a male phenomenon. The present study calls this assumption into question and suggests that young women in particular should be the target of concerted efforts to reduce the impact of substance use and related harms.

“These findings (also) highlight the importance of further tracking young male and female cohorts as they age into their 30s, 40s and beyond”, they added.

Institute of Alcohol Studies director Katherine Brown said: “The findings from this study illustrate a trend that has been in the making for decades. Women are increasingly subjected to heavily targeted marketing practices by alcohol companies enticing them to drink more. This is a global phenomenon, with drinks manufacturers producing sweet, often pink, fizzy alcoholic beverages that appeal to young women, with glamorous advertising campaigns.

“Another major driver of alcohol consumption is price, with very cheap products commonly on sale for as little as 16 pence per unit in shops and supermarkets. We are no longer a nation of pub goers, with two-thirds of all UK alcohol drunk at home. Pre-loading on cheap shop bought alcohol before a night out is common practice and police have reported strong links to crime, disorder and vulnerable behaviour in towns and city centres.

“Alcohol places a huge strain on our NHS and emergency services, with the total costs to society at £21 billion each year. We need to take this issue seriously and introduce evidence-based measures such as minimum unit pricing and marketing restrictions in order to protect out future generations and improve the health and wellbeing of our most vulnerable communities.”

Coverage from Alcohol Policy UK:

‘Women have caught up with men’ in alcohol consumption levels, headlines reported across the media. According to international research the gap between men and women is closing rapidly when it comes to use and alcohol-related harms, though in the UK men still drink more. See NHS behind the headlines analysis or BBC, The Sun and Guardian reports.

To act as a counter-balance to this view here is a recent article from the Guardian citing another BMJ study:

Female binge drinkers unfairly stigmatised by media, says study

It’s worth a read and has an interesting conclusion that begs the question: who is funding this research?

Further evidential data:

(taken from HSE 2015)

Health Survey for England 2015: latest consumption figures

Eight in 10 middle-aged Britons ‘are overweight or exercise too little’ (oh and drink too much!)

Ladies it’s the beginning of January and it’s not too late to join us for Dry January.  You can start the clock today and not become part of these statistics of the future.

Shame Backdraft

OLYMPUS DIGITAL CAMERA

So once again I’m listening to a Ruth Buczynski seminar about shame featuring Peter Levine, Ron Siegel, Kelly McGonigal and Bill O’Hanlon where I learn something new that feels very familiar.  It’s called ‘backdraft’ and is about the backlash that can happen when someone is feeling ashamed and is met by compassion.  It reminds me of that moment when I am close to tears and someone moves into hug me to which I respond “please don’t”.  It is almost a warning that you are in danger of killing me with kindness.  Sound familiar?

Over to the experts:

Most clinicians have witnessed how difficult memories resurface when a client feels truly seen, heard, and loved in therapy. A metaphor for this process is “backdraft.” Backdraft occurs when a firefighter opens a door with a hot fire behind it. Oxygen rushes in, causing a burst of flame. Similarly, when the door of the heart is opened with compassion, intense pain can sometimes be released. Unconditional love reveals the conditions under which we were unloved in the past. Therefore, some clients, especially those with a history of childhood abuse or neglect, are fearful of compassion (Gilbert et al., 2011).

It is related to trauma and the belief held by the person that they are undeserving of kindness but in fact it is more than that.  They are perhaps so unused to compassion that they find the experience unsafe, threatening and dangerous.

Childhood trauma survivors may also equate self-compassion with self-pity or self-centeredness. They may have been told as children to “get over yourself” when they suffered and complained. It is important to understand that by entering into our emotional pain with kindness, we are less likely to wallow in self-pity. The reason is that self-compassion recognizes the shared nature of human suffering and avoids egocentrism. Sometimes only a few minutes is all that is needed to validate our pain and disentangle ourselves from it.

Self-compassion is often confused with narcissistic self-love, although research indicates that there is no link between narcissism and self-compassion (Neff, 2003; Neff & Vonk, 2009).  Victims of childhood trauma often do not have enough narcissism, feeling that meeting their own basic survival needs is a forbidden indulgence. Anxiety may arise from the looming possibility of breaking an invisible bond with a primary caregiver who thought the child should suffer for his or her misdeeds or bad nature. Self-deprivation becomes “safety behaviour” (Gilbert & Proctor, 2006). It is a necessary compromise made by an abused child in order to survive, so the client becomes frightened, viscerally and unconsciously, when he or she breaks the contract. For this reason, sincere efforts by therapists to help abused or neglected clients may be met with resistance. These clients first need to contact their emotional pain, see how it originated through no fault of their own (“you’re not to blame!”), and then gradually bring the same tenderness to themselves that they are likely to give to other, vulnerable beings.

Three symptom clusters commonly found in post traumatic stress disorder (PTSD) are (1) arousal, (2) avoidance, and (3) intrusions. Interestingly, these three categories closely correspond to the stress response (fight–flight–freeze) and to our reactions to internal stress (self-criticism, self-isolation, and self-absorption) mentioned earlier (see below).

PTSD symptom Stress Response Reactions to internal stress
Arousal Fight Self-criticism
Avoidance Flight Self-isolation
Intrusion Freeze Self-absorption

Together they point toward self-compassion as a healthy, alternative response to trauma. Self kindness can have a calming effect on autonomic hyperarousal, common humanity is an antidote to hiding in shame, and balanced, mindful awareness allows us to disentangle ourselves from intrusive memories and feelings. Research shows that people who lack self-compassion are likely to have critical mothers, to come from dysfunctional families, and to display insecure attachment patterns (Neff & McGeehee, 2010; Wei, Liao, Ku, & Shaffer, 2011). Childhood emotional abuse is associated with lower self compassion, and individuals with low self-compassion experience more emotional distress and are more likely to abuse alcohol or make a serious suicide attempt (Tanaka, Wekerle, Schmuck, Paglia-Boak, & the MAP Research Team, 2011; Vettese, Dyer, Li, & Wekerle, 2011).

These quotes are taken from a chapter of a book by Christopher Germer & Kristen Neff that you can read here:

germer-neff_-trauma

I found an excellent blog post about it here:

Mindful self-compassion and backdraft

So there you have the connection between shame and booze once again.  Low self compassion, higher emotional distress and greater levels of self-medication with alcohol.

If you are unsure of how self-compassionate you are you can score yourself here:

Test how self-compassionate you are

Unsurprisingly my score was low to middling but not as low as it used to be when I was drinking!  So how do we work on improving our low self-compassion?

The response is to teach ourselves how to take a self-compassion break

If you start to do this even if you are still drinking, the shift in self-perception may be enough to get you started on thinking about cutting down or stopping.  Give it a try – what have you got to lose? 🙂