Category Archives: Psychological

Sober Inspiration: The Tao of Fully Feeling

So I’m reading a new book that I heard talked about recently by Pete Walker called The Tao of Fully Feeling.  I’m only a few pages in but text is already jumping out at me and screaming to be shared!

Here’s the opening:

Feelings and emotions are energetic states that do not magically dissipate when they are ignored.  When we do not attend to our feelings, they accumulate inside us and create a mounting anxiety that we commonly dismiss as stress.

So, like so many of us, I believed that all those years of pouring wine down my neck to manage ‘stress’ was helpful.  In reality I was busy self-medicating away my feelings and emotions.

I felt that emotions were something to be corralled, minimised, denied even.  In my household growing up we ‘didn’t do’ emotions as we were often reminded.  I now understand that we weren’t allowed to do negative emotions.  I learned very early on to keep my head down, my mouth shut and a smile on my face.  Look happy even if you were dying inside.  No wonder I ended up emotionally constipated and believing that drinking allowed me to express my emotions fully because it was only in that dis-inhibited state that I actually heard them as they roared from their cage inside.  “A drunk mind speaks a sober heart” right?  A saying often attributed to French Enlightenment philosopher Jean-Jaques Rousseau which we know not to be true.

Pete goes on:

We can learn to be emotional in benign ways.  We can have our emotions without holding onto them.  We can soften and relax into our feelings without exiling or enshrining them.  We can let our feelings pass through us when they have fully served their function.  When we learn to experience our feelings directly, we eventually discover that surrendering to them is by far the most efficient – and, in the long run, least painful – way of responding to them.  We realise first-hand that life does not have to be pain-free to be fully enjoyed.  Life is inordinately more painful than necessary when we hate, shame, and abandon ourselves for not feeling ‘good.’

As we become more emotionally whole, our health and vitality naturally improve.  When we disburden ourselves of old unresolved trauma, energy wasted holding the past at bay becomes available for celebrating daily life.  As we learn to befriend our emotions, we suffer less and less from self-damaging flights from feelings.  We gracefully accept the reality that our emotional nature, like the weather, often changes unpredictably with a variety of pleasant and unpleasant conditions.  We realize that a positive feeling cannot be induced to persist any more than the sun can be forced to continuously shine.

And this reflects my experience over the last 3 1/2 years.  Emotions are no longer something to be scared of but welcomed and embraced, whether happy, sad or mad.  My emotional repertoire has grown incredibly as I have allowed my caged and numbed heart to feel what my head was taught to deny for so long.

Welcome to emotional recovery that forms the biggest part of recovery from addiction.  I think I’m going to really enjoy this book 🙂

 

Radical ketamine therapy could treat alcohol addiction

This was featured in The Guardian in January whereby a one-off dose of the drug, ketamine could help alcohol addicts reduce their intake by ‘erasing’ drink-related memories, say psychologists testing treatment.

Ketamine is used as an anaesthetic agent and also in terminal care in my professional experience and as a recreational drug in my personal experience.

Here’s what the researchers say:

Scientists believe that a radical treatment involving the tranquilliser ketamine could help overcome alcohol addiction by “erasing” drink-related memories.

Psychologists based at University College London are testing whether a one-off dose of the drug could help hazardous drinkers who are trying to reduce their alcohol intake. Alcohol addiction is notoriously difficult to treat, and there are few effective therapies available.

Using a recreational drug to treat addiction may sound counterintuitive, but the researchers say there is a growing body of research suggesting that ketamine can be used to disrupt harmful patterns of behaviour.

Ravi Das, one of the lead researchers, said: “There is evidence that it could be useful as a treatment for alcoholism.”

Crucially, ketamine can disrupt the formation of memories, and scientists believe that this property could be harnessed to over-write the memories that drive addiction and harmful patterns of behaviour.

“Memories that you form can be hijacked by drugs in some people,” said Das. “If you were an alcoholic you might have a strong memory of being in a certain place and wanting to drink. Those memories get continuously triggered by things in the environment that you can’t avoid.”

For instance, seeing a glass of beer, hearing the clinking of glasses or even arriving home from work may trigger memories of the rewarding sensation of taking a drink – and might prompt a person to follow this urge.

“The main problem is the really high relapse rate after treatment,” said Das. “People can successfully quit using over the short term while they’re being monitored in the hospital … but when they return home they’re exposed to those environmental triggers again.”

There is increasing evidence, however, that memories are less stable than once assumed and may be open to manipulation.

Each time our brain accesses a memory, the neural connections that encode it are temporarily destabilised, meaning that our recollection can be slightly altered before it goes back into storage. This is one reason why, in everyday life, people can recall wildly different versions of the same events.

In the clinic, scientists believe this short period of instability, represents a window of opportunity. Ketamine blocks a brain receptor called NMDA, which is required for the formation of memories. So the logic is that giving someone the drug just as a memory has been destabilised could help weaken the memory, or even erase it.

A similar approach with a different drug was shown to eradicate people’s phobia of spiders. And research in rats that were made to be addicted to cocaine showed that the memories underpinning their addiction could be completely wiped out using a similar strategy (although this involved injecting a chemical into the brain).

In the UCL trial, the scientists will intentionally trigger alcohol-related memories by placing a glass of beer in front of the participants, who are all heavy drinkers. They will then disrupt the memory, by surprising the participant (the team is not disclosing the exact details as this could bias the results).

Participants will then be given either a ketamine infusion, with a concentration equivalent to a high recreational dose, or a placebo. The team will follow up the people for a year and monitor whether their drinking has changed and by how much.

In total the scientists are aiming to include 90 people in the trial and more than 50 have already taken part. It involves people who drink harmful quantities of alcohol, but excludes anyone who meets the clinical criteria for alcoholism. The participants were drinking at least 40 units for men (equivalent to four bottles of strong wine) and 28 units for women, and drinking on at least four days.

Nikki, 31, who works as a consultant in London said she decided to take part in the study when she had some time off between jobs and realised she was drinking more than she wanted to. “It’s just in the culture, that’s what all my friends are like. Everyone drinks to excess,” she said.

She described the experience of being given the ketamine as “overwhelming and intense”, but not unpleasant. “My body felt like it was melting away,” she said. “It was quite psychedelic, I felt untethered from my body.”

In the week after the session, she said, she felt in an “incredibly positive mood” and that since taking part she has been more conscious about deciding whether to have a drink, although said this could also be linked to starting a new job and taking up meditation. “In the past, there were occasions where I would be drinking and I’d be on autopilot ‘Let’s get another drink’,” she said.

If the trial yields promising results, the team hope that the approach could form the basis for therapy sessions targeted at alcoholics and people who are drinking unhealthily. However, they acknowledge that there may be resistance to the use of a recreational drug to treat people with addiction.

“There’s just the general social attitude that everything that’s illegal is terrible. There will obviously be that kind of narrow-sighted pushback,” said Das. “But if it’s safe and effective enough it should be recommended.”

Andrew Misell, a spokesman for Alcohol Concern, said: “The researchers have quite rightly highlighted what a lot of people in recovery from alcohol problems know from experience, namely that cues or triggers like the smell of beer can cause a relapse even after long periods of abstinence. Any work looking at how people can overcome these pitfalls is going to be useful.”

However, he added, no drug-based therapy is risk-free “and that certainly includes ketamine”.

Professor Michael Saladin, of the Medical University of South Carolina, is looking at similar approaches to help people quit smoking. “There is a vast animal research literature that suggests memories can be manipulated following reactivation,” he said. “I am convinced that there is sufficient evidence to believe that memory reconsolidation can be harnessed for clinical purposes.”

The Evening Standard also picked up on the research:

Researchers at University College London are trialling the use of ketamine, a powerful anaesthetic used in the NHS and on animals, to block or dismantle the “alcohol reward” memories that cause cravings and addictions. It is hoped the drug, known as ‘Special K’ on the party scene, will help drinkers “reboot” their brain and get their habit under control.

Well I’m all for research and trying new things if it will potentially help.  Although I’d be slightly concerned about cross-addiction because if it is a very pleasant experience people may wish and seek to repeat it and ketamine is available as a street drug.

Sober Inspiration: Dan Siegel Wheel of Awareness

drdansiegel_wheelofawarenessSo the further into recovery I’ve got the more mindful and conscious I have become and in fact my awareness continues to deepen all the time.  With that in mind I wanted to share with you Dan Siegel‘s work on the Wheel of Awareness.  The reason I’m posting this today is because yesterday he led a meeting in LA to mark the beginning of his ‘Wheel of Awareness Community’.

Here is an image of “The Wheel of Awareness.” The hub represents the experience of awareness itself — knowing — while the rim contains all the points of anything we can become aware of, that which is known to us. We can send a spoke out to the rim to focus our attention on one point or another on the rim. In this way, the wheel of awareness becomes a visual metaphor for the integration of consciousness as we differentiate rim-elements and hub-awareness from each other and link them with our focus of attention.

I attach below a presentation on the subject that Dan has shared on SlidePlayer:

Mindsight Presentation by Dr Dan Siegel

And now a Youtube guided meditation that he has created:

And then finally the pdf handout that was created by him to support our further understanding of the Wheel of Awareness:

wheelofawareness-guided-meditation

The total package free on the internet from him – how wonderful is that? 🙂

For me this is what it is all about now.  Deepening my  understanding and integration of my sixth, seventh and eighth senses – so my somatics and my ability to perceive my mind by reflecting on my experience.  As Dr Siegel says:

“When we carry out a mindfulness practice of focused awareness, we develop mindsight”

Here’s to that and me finally acting on all the universes hints that I need to start a yoga practice to compliment my running!

NICE guidance on dual diagnosis 2016

This is not the first time that Dual Diagnosis has been discussed on this blog (you can read them all here).  However we now have official guidance from the National Institute of Clinical Excellence (NICE) on the issue.

My lovely friend Libby Ranzetta did an excellent synopsis that garnered praise on Twitter from the NICE guidelines chair themselves no less! 🙂

Over to her summary detailed over at Alcohol Policy UK:

New NICE guidance on dual diagnosis was released in November 2016: Coexisting severe mental illness and substance misuse: community health and social care services.

The guidance and supporting tools and resources sets out how services for those dually diagnosed aged 14 and above should be improved to ‘provide a range of coordinated services that address people’s wider health and social care needs, as well as other issues such as employment and housing.’

NICE has also produced a guideline on coexisting severe mental illness (psychosis) and substance misuse: assessment and management in healthcare settings.

Context and definitions

NICE contextualises the guidance by stating that adults and young people with coexisting severe mental illness and substance misuse have some of the worst health, wellbeing and social outcomes (details here). It is not clear how many people in the UK experience dual diagnosis issues, partly because some people in this group do not use services or get relevant care or treatment (see previous post).

The Department of Health’s Refocusing the Care Programme Approach identifies people with dual diagnosis as one of the groups in need of an enhanced Care Programme Approach. That is because they are not being identified consistently and services are sometimes failing to provide the support they need. The policy highlights the need for a whole systems approach to their care, involving a range of services and organisations working together. This guideline, NICE claims, aims to address this need.

In announcing the guidance, Professor Alan Maryon-Davis, chair of the guideline committee, spoke frankly about the challenges coexisting substance misuse and mental health problems pose for patients and practitioners alike.

“People with dual diagnosis almost always have multiple needs – often with physical health and social issues as well as their dual mental health and substance problem. They are often unemployed or struggling to hold onto a job. They may be in debt, homeless or poorly housed. They could even be in an abusive relationship.

To add to their woes, they are also more likely to be stereotyped and stigmatised. They are often regarded as unreliable, feckless, difficult to engage, aggressive or abusive.

As a result, they tend to get shunted around the various services they need support from with no-one wanting to take responsibility for them. This can all too easily lead to a downward spiral and sooner or later a crisis – perhaps forcing them into A&E, or on the streets. They may even find themselves in the magistrate’s court.

This is why our NICE guideline is so desperately needed.”

For Guideline 58 the age cut-off for young people has been set at 14 to reflect the small numbers affected below this age and the fact that many early intervention services usually start at age 14. ‘Substance misuse’ refers to the use of legal or illicit drugs, including alcohol and medicine, in a way that causes mental or physical damage.

‘Severe mental illness’ includes a clinical diagnosis of:

  • schizophrenia, schizotypal and delusional disorders, or
  • bipolar affective disorder, or
  • severe depressive episodes with or without psychotic episodes.

NICE Recommendations

The guideline is arranged as series of detailed recommendations on the following:

  • first contact with services
  • referral to secondary care mental health services
  • the care plan: multi-agency approach to address physical health, social care, housing and other support needs
  • partnership working between specialist services, health, social care and other support services and commissioners
  • improving service delivery
  • maintaining contact between services and people with coexisting severe mental illness and substance misuse who use them

Drug and Alcohol Findings Bank has provided a summary of the key recommendations here.

Professor Maryon-Davis summed up two main messages from the recommendations:

“First, there has to be much wider recognition that this group of people, despite their complexities, have as much right to dedicated care and support as anyone else. They should not be turned away or left to flounder. Every effort should be made to help them benefit from the services they so badly need. Crucial to this is a non-judgmental, empathetic approach and the building up of mutual respect and trust.

And secondly, good communication is key! Staff working in mental health, substance misuse, primary care, social care, housing, employment, benefits, criminal justice and the voluntary sector need to have strong leadership to ensure that they are all working together as best they can. We recommend that this can be best achieved by having a dedicated care coordinators.”

What happens next

Substance misuse practitioners could be forgiven for saying they have heard these messages before; messages which have not made much difference to the way mental health services respond to dual diagnosis. Last year the Recovery Partnership’s Review of Alcohol Treatment Services found a clear failure of services to meet the needs of people with dual diagnosis, summarising the policy context for such failure as follows:

“National guidance on the management of this [dual diagnosis] group was first published by the Department of Health in 2002. NICE published further guidance on psychosis with coexisting substance misuse in 2011.

However, the… situation has not improved and may be worsening because budgets have been cut in mental health services, and because mental health services are now commissioned by a separate body (Clinical Commissioning Groups) from alcohol services (Public Health). This represents a real blockage in the pathway of care for problem drinkers (and drug users), a blockage that cannot be easily resolved at the local level.”

Other questions may relate to possible missed opportunities to address low level mental health problems and substance misuse. For instance Improving Access to Psychological Therapies (IAPT) services – which exist for those mild to moderate mental health difficulties, such as depression, anxiety and phobias – are not mentioned within the guidance. IAPT though may be considered an ideal setting for brief intervention given the link between alcohol misuse and problems such as anxiety and depression, yet few IAPT services appear to routinely deliver IBA (although guidance was released for IAPT roles in 2012).

In 2014 an analysis suggested cognitive based therapy (CBT) and/or motivational interviewing (MI) for comorbid alcohol use disorder and major depressive disorder produced small but robust beneficial effects on both depression and alcohol consumption – regardless of whether delivered by mental health or subtance misuse roles.

Commissioners and service providers though will now be expected to use Guideline 58 to improve the quality of care given to people with dual diagnosis involving severe mental health problems. The Care Quality Commission (CQC) use NICE guidelines and quality standards as evidence for inspections, to inform the award of good and outstanding ratings. CQC’s inspection regime and associated powers may well provide the impetus needed for real change to happen this time.

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 🙂

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? 🙂

 

 

 

 

2017: Freedom & Liberation

Firstly Happy New Year to you from me! 🙂 What does one write about on the first day of a new year that holds so much promise and optimism?  I think the best place to start are with my words for 2017 which are freedom/liberation.  I think they stem from the discoveries I made as I approached 3 years sober.

Perhaps to appreciate my sense of freedom & liberation I have to revisit the life I left.  Once more Sally Brampton in ‘Shoot the Damn Dog‘ describes it more eloquently than I so I’m going to quote a passage from her book here.  The conversation between her and a friend could have been my ‘now sober self’ talking to my ‘old still-drinking self’ and so it feels really fitting for today and this post.

Suddenly she said, ‘Tell me about the drinking too much’.  I shrugged. ‘I drink too much, end of story’.  ‘Shall I tell you about my drinking? Would that help?’.  ‘If you like’.  I was awkward, unused to somebody being open about drinking.  I kept mine secret, even from my closest friends.  I liked to drink alone.  That way, I could drink as much as I liked.  That way, I was the only witness to my shame.  And I was ashamed.  Alcohol does that to you

Lulu said, ‘Every night, I promised myself that I wouldn’t drink the next day and every morning, when I woke up, I promised myself that I wouldn’t drink that day.  As I left the house to go to work, I promised myself, again, that I wouldn’t drink that day’….  I said nothing.  Those promises were familiar territory.  I had made them to myself, countless times. 

‘I’d get through the rest of the day somehow, but my mind was always fixed on alcohol.  Perhaps if I just had one drink, after that I stop completely.  Just one couldn’t hurt, could it?  Then I would decided that, no, I would be good.  I would go home, have a bath, make myself something nice to eat and have an early night so I’d be fresh for work the next day.  She looked at me, her eyes clear. ‘I knew that was what I was going to do.  But I still stopped at the off-licence and bought myself a bottle of wine and got straight into bed without washing or eating and I drank until I passed out.’  She grimaced at the memory.  ‘I don’t even like the taste of alcohol’.

Nor did I.  In fact, I’d come to hate it.  But I loved the effect, the way it stopped the pain, stopped me feeling.  She said, as if reading my mind, ‘I drank to change the way that I feel.’.  I wanted, right then, to change the way I felt, or how she was making me feel.  Even thinking about it made me want a drink.  What could be the harm in having one drink, to make me feel better? Perhaps she didn’t know what she was was talking about.  After all, it wasn’t as if she had been drinking that much.  I knew people who drank far more and they didn’t think they had a problem.  ‘It doesn’t sound too much’.

‘It’s not how much you drink.  It’s how you drink and why.’

‘I only drink because of the depression*.  If it wasn’t there, I wouldn’t drink, I laugh nervously.  ‘Or I wouldn’t drink so much’. [*You could change the word here to stress, anxiety, debt, work, family, children, boredom, need to get things done, all my friends do/partner does, insert your word(s) of choice].  ‘Seriously though, a drink doesn’t make it better.  It only makes it worse.  How much are you drinking?’  ‘A bottle of wine, perhaps two a day’.  ‘Can you stop?’  ‘Yes, no,’ I sighed.  ‘I don’t know …. No.  Well, I find it hard to stop.  But I’m not an alcoholic’.  Lulu’s smile curved.  ‘What’s an alcoholic?’  ‘Someone who sleeps on a park bench? Who passes out? Who gets violent? Who can’t hold down a job?’  Lulu’s smiled curved even higher.  ‘I am an alcoholic.’  I looked down at my hands.  Her voice was gentle.  ‘Sal, I know exactly how you feel.  I tried to do it on my own too, and it doesn’t work.  We need help.  We cannot do it on our own.’  ‘But you look so well, so happy.’  I shook my head.  ‘I don’t know.  Maybe I can stop on my own.  I’ve done it before’.

Lulu got up and hugged me.  ‘We’ve all done it before.  We’ve done it so many times we’re sick and tired of feeling sick and tired.  We all think we can do it on our own.  It’s just that we don’t have to.  We don’t have to be alone.’

I nodded.  For some reason, I wanted to cry. ‘OK’.

If this resonates for you too, know that you are not alone and if you are looking for freedom and liberation from booze you can always reach out and email me at ahangoverfreelife@gmail.com.  Or if you would like help to cut down or quit drinking I run an online course and you can use the link here to get a 25% discount 🙂  

If I can do it, you can do it …….

 

 

Shoot the Damn Dog

shoot-the-damn-dogBack in June I blogged about the sad death of Sally Brampton and at the time added her book to my reading wish list.  ‘Shoot the damn dog‘ finally arrived from the library and oh my goodness what a beautiful book.  It should be mandatory reading for each and every one of us depressed, drinker or otherwise.

She was the most eloquent of writers and this book is poignant, honest, heartbreaking and brave.  She does for depression what we try to do out here about booze – tell our story in the hope that it helps someone else who recognises themselves in our words.  I saw myself in Sally’s experience and I could quote huge swathes of this book exclaiming ‘me too!’

I shall desist apart from to share brief excerpts as to why she wrote the book, her experience with booze and therapy.

So why am I writing this book?  I’m writing it because although I dislike the confessional, I was (and continue to be) so repulsed by the stigma around depression that I determined I must stand up and be counted, not hide away in shame. …… I wish I could say it was bravery that drove me to pin myself like a butterfly to the pages of a national newspaper, but it was actually anger.  I admit that my anger took me by surprise.  But then, so did depression.  I had never thought about its implications, or its consequences.  The more I inhabited it, the more I came to see the fear and shame surrounding it.  The more depressives I met, the more I came to understand  that we are not simply fighting an illness, but the attitudes that surround it.”  Replace the word depression with alcoholism and all of that could have been said by me, here.  I share her anger at how those of us who become alcohol dependent can at times feel stigmatised and ashamed.

I am drunk, I think, because I learned to use alcohol to try to crush my pain…… I learned that alcohol is the best anaesthetic in the world.  If I drank, I did not feel……. And I knew, in that part of my brain that was still robustly sane, that alcohol would not free me from the pain, except temporarily.  I knew that alcohol was a depressive, that I was taking an anti-depressive pill with one hand and a bottled depressive with the other.  And I also knew that I was trying to kill myself.  Alcoholism is a slow, ugly form of suicide.

As my shrink explained, ‘ You have to find your way into alcoholism which means drinking sufficient amounts to develop a dependency.  Why you do that is open to interpretation.  But once you have developed a dependency, you have an addiction not only to alcohol but also to a pattern of behaviour.  The only way out of addiction is to stop the substance abuse, and to learn new ways of behaviour.’  Shrinks call depressive drinking, ‘self-medication’.  I could stop for a day, a week or a month.  I could stop drinking for 3 months or even six.  Stopping is easy.  Staying stopped is overwhelmingly difficult if you are drinking to stop pain.”

Every addiction is a manifestation of emotional distress.  Nobody becomes an alcoholic or a binge eater because they love alcohol or food, they simply use excess alcohol or food to dull the pain that they are unable to express in words.  Most of this, of course, is unconscious.  If I am in emotional pain, my instinct is to take it away.  My way of doing that is to drink, as I have learned that it relieves (if only temporarily) my pain.  I have learned a disorderly habit of behaviour, that, once learned, is difficult to dismantle.  It is a condition, an emotional illness or a behavioural disorder.  It is, if you like, an inappropriate response to difficulty or pain.  It is the messenger, not the message.  Now that I am well again, perhaps I could drink again.  It is simply a risk that I am not prepared to take.

Yes to all of the above.

Looking at our own selves is horribly difficult to do, requiring a level of honesty and humility that can at times feel unbearable.  Few people are prepared to engage with it fully but without it, I truly believe that we cannot be happy…..  Therapy helped, but it is not magic.  It does not change our thoughts and behaviours.  It only teaches us what they might be.  It does not work unless we take from it what we have learned and put it into action.  So it is not, as so many people seem to think, a piece of indulgent navel gazing.  Nor is it about blaming the parents.  It is, I’d say, quite the opposite.  It is about understanding and accepting our parents.

There is a saying, ‘it’s never too late to have a happy childhood‘.  I’d rephrase that.  I’d say, it’s never too late to stop a difficult childhood from turning us into unhappy adults.  A difficult childhood may have set up a series of behaviours and responses that leads us to repeat those same patterns in our adult lives.  That does not mean that we have to continue those patterns.

I was given a birthday card with those exact words on during the first years of my recovery not just by one person but two – MrHOF and my sister.  The identical card by two different people, who are both very close to me and know me very well, on the same birthday!  It is on the wall above my desk …..

There is so much wisdom in this book I really do urge you to go read it in it’s entirety .

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? 🙂