Sober Insights: The Self-Torture Game

So continuing reading Healing the Shame that binds you by John Bradshaw and he talks about a process called the self-torture game.  He says that “it is almost always so habitual that it is unconscious”.  Felt pretty apt so I thought I’d discuss it further here.

It was identified by Fritz Perls as Top Dog-Under Dog Thinking.  Here’s a bit more definition from Wiki:

Topdog vs. underdog is a phrase coined by Fritz Perls, the father of Gestalt therapy, to describe a self-torture game that people play with themselves in order to avoid the anxiety that they encounter in their environment.

The topdog describes the part of an individual which makes demands based on the idea that the individual should adhere to certain societal norms and standards. These demands are often characterized by “shoulds” and “oughts”.

The underdog describes the part of an individual which makes excuses explaining why these demands should not be met. It is often the case that these excuses act as internal sabotage to ensure that the demands are never met.

Gestalt therapists often guide their patients through an exercise where the patients takes on both of these roles. With the guidance of the therapist, the patients can come to gain insight about themselves which can help them have a healthier relationship with their environment.

I think I engaged in this a great deal when I was drinking and it definitely kept me stuck in shame.  My inner critic was my top dog ‘I shouldn’t drink in the week’ or ‘I ought to be able to have a few nights off without it being a problem’ and my drinking behaviour – the victim or underdog.

It’s been happening again recently but I’ve been noticing it.  I injured my back at work a few weeks ago and it has slowed me down and hobbled my usual activities at home, including running.  In my forced resting state I’ve been doing a huge amount of reading and learning and emotional growth which has been both insightful and overwhelming.  I can recommend three books for emotional recovery work: From Surviving to Thriving by Pete Walker, Taming Your Outer Child by Susan Anderson and John Bradshaw’s Healing the Shame that binds you.  I wouldn’t recommend reading the three back to back as I’ve done as I’ve been the instigator of my own emotional overwhelm because of it.  Tread slowly and gently is what I learned!

I noticed this voice pop up around my reduced activity.  It shows up in my thoughts as anxiety related to gaining weight because I’m not running and about being lazy around the home because I’m resting my back.

Perlz argues that the internal conflict speaks to unfinished business.  What I mean by that is, in this scenario the top dog voice is my internalized early parent figure and the underdog is me as a child being chided for being lazy.  By bringing this into consciousness I get the opportunity to finish the unfinished business by acknowledging the dynamic, become more self-integrating (as this is a defensive split in the human personality) and self-accepting, process the emotions attached and thereby facilitate resolution on this specific personal representation of the ‘self-torture’ game.

Is this something that sounds familiar to you too?  Do you recognise this self-defeating thought pattern?

Statistics on Alcohol England 2017

An excellent blog post as always from Alcohol Policy UK in May looking at the latest statistics on Alcohol England for 2017 & Opinions and Lifestyle Survey (OPN) drinking figures.

Over to James:

The annual Statistics on Alcohol for England 2017 has been released, detailing national data for key alcohol-related indicators and health harms.

Mainly bringing together recent alcohol data releases, the overall trend remains one of falls in drinking amongst younger people, whilst many measures of harm including the latest alcohol-related hospital admissions continue to rise, largely driven by heavier drinking mid and older age adults. See here for Guardian and BBC reports.

Key headlines from the release include:

Hospital admissions – broad measure
  • There were 1.1 million estimated admissions related to alcohol consumption in 2015/16. This is 4% more than 2014/15.
  • This represents 7.0% of all hospital admissions which is similar to 2014/15 and 2013/14.
  • Blackpool had the highest rate at 3,540 per 100,000 population. Isle of Wight had the lowest rate at 1,400.

Hospital admissions – narrow measure

  • There were 339 thousand estimated admissions related to alcohol consumption in 2015/16. This is 3% higher than 2014/15 and 22% higher than 2005/06.
  • This represents 2.1% of all hospital admissions which has changed little in the last 10 years.

See here for the LAPE statistical commentary [pdf] on the latest alcohol-related hospital admission figures.

Drinking Prevalence

  • 57% of adults reported drinking alcohol in the previous week in 2016 which is a fall from 64% in 2006.
  • This equates to 25.3 million adults in England.
  • Those who drank more than 8/6 units on their heaviest day in the last week fell from 19% to 15%.

Deaths

  • In 2015, there were 6,813 deaths which were related to the consumption of alcohol. This is 1.4% of all deaths.
  • The number of deaths is similar to 2014 but is an increase of 10% on 2005.

[NB Age standardised death rates show a relatively stable trend since 2012].

Prescriptions

  • The number of prescription items dispensed in 2016 was 188 thousand which was 4% lower than 2015 but 63% higher than 2006. This breaks the recent trend of successive year on year increases.
  • The total Net Ingredient Cost (NIC) was £4.87 million. This is 24% higher than in 2015 and more than double the level ten years ago.

Consumption confounders?

The national statistics release includes the latest Opinions and Lifestyle Survey (OPN) data on alcohol consumption, albeit that Heaviest Drinking Day (HDD) in the last week is not well regarded as an accurate indicator of consumption. Health Survey for England (HSE) data may be considered better for consumption trends as it also includes questions on mean weekly or daily consumption.
Recent sets of both data though show similar findings in terms of identified trends and socio-economic or geographical variations. However a small decline in the OPN’s proportion of adult drinkers in Britain to 56.9% based on reported drinking in the last week is the lowest since 2005 when the survey began. This time point has however been described as ‘peak booze’ following several decades of steep increases before the turn of the century. As well as the many important demographic differences behind these overall trends in reported consumption, more detailed research has continued to highlight the ‘rich tapestry’ behind the various drinking groups and the extent of under-estimation in self-report data.
Prescriptions: an unexpected drop?
Whilst the ten year trend for prescriptions to treat alcohol dependency has risen significantly, a 4% drop on 2015 may be notable, though largely due to a significant fall in Disilfiram prescriptions. The release however notes a sharp rise of £22 for the Net Ingredient Cost for Disilfiram giving a likely indication as to why. Also of interest, prescription items for Nalmefene fell by 1,000 from 4,400 in 2015 to 3,400 in 2016 which may reflect the apparent decision by its producers Lundbeck ceasing promotion activity in the UK, but also potentially linked to questions raised over the evidence and licensing process.
Alcohol-related cancers: a further harm measure
The latest LAPE statistical commentary [pdf] also includes estimates of alcohol-related cancer based on the six cancer types which are known to have an alcohol link; mouth, throat, breast, stomach, liver and bowel cancer. The release suggests approximately 19,000 new cancer cases each year attributed to alcohol. Since 2004 these rates have been rising, but a recent small drop in alcohol-related cancer rates for men has not yet been followed by the rates for women.
Looking ahead: sales and pricing?
For those keen on assessing the potential future for harm and consumption trends, interest will no doubt be focused on forthcoming sales data which indicated a return to rising total UK alcohol consumption last year, largely driven by the continued growth in off-sales. As such, health advocates wish to see Minimum Unit Pricing (MUP) to curb the availability of the cheapest alcohol – a final conclusion to Scotland’s long running bid is expected imminently.
There has been a great deal of talk recently about JAM (just about managing) or “squeezed middle” in the UK and this share of expenditure being spent on booze can’t be helping financially or otherwise.

A Tunnel That Wakes You – Dear Sugar (Cheryl Strayed)

Dear Sugar

I think (know) I have a serious problem with alcohol.  It freaks me out; it even wakes me up in my sleep because I am terrified of this tunnel I keep going further into.  No one has ever said anything to me about it, because I’ve always been professional, calm, laid-back and in control.  I don’t think I have control anymore, and it seriously scares me.  I drink before work, when I wake up, drinking during lunch, and drink as soon as I get home to fall asleep, when no on can see me doing it.

But I also drink out socially, with my friends, and they are impossible NOT to drink around, and they actually prefer to see me “on”, which is the only state I seem to be comfortable with now.  I don’t think I can give up drinking out socially, because without my friends, I would probably just end up drinking more at home alone.

I know you are not a psychologist, but I would like to get some unbiased advice about this.  I have tried to approach some people about this before (including therapy), but it has proved fruitless, and also really embarrassing.  I guess I am hoping you have the magic, easy solution to this, and I am going to assume there probably isn’t one.

Thanks, Drinker

Dear Drinker,

My unbiased advice is that you know you’re addicted to alcohol and you need help.  You’re right that there is no “magic easy solution” to this, sweet pea, but there is a solution.  It’s that you stop using alcohol.  Privately.  Socially.  Morning.  Noon.  Night.  And probably forever.

You will need to do this when you’re ready to do this.  To be ready you need only the desire to change your life.  To succeed, most people need a community of support.  Alcoholics Anonymous is a good place to begin.  There, you will find those who struggle in the same ways you do; people who once told themselves the same lies about what was “impossible.”

Addiction is a tunnel that wakes you up in the middle of the night.  Everything else happens out here in the light.

Yours, Sugar

Taken from Tiny Beautiful Things by Cheryl Strayed.

Commons alcohol policy briefings

Thanks once again to Alcohol Policy UK for this information shared in April.  A spate of alcohol research briefings produced by the House of Commons Library have recently been released, suggesting continuing Government interest in alcohol’s impact on society.  An expectation of the need to tackle alcohol harms now seems further embedded amongst the general population.

The recent House of Commons Library briefings include:

Alcohol: minimum pricing

The recent Minimum Unit Pricing (MUP) briefing [pdf] sets out a brief history of MUP in the UK, highlighting:

‘The Government has said that MUP “remains under review pending the outcome of the legal case between the Scotch Whisky Association and the Scottish Government, and the impact of the implementation of this policy in Scotland”.

The Coalition Government introduced a ban on the sale of alcohol below cost price from 28 May 2014. This is one of the licensing conditions of the mandatory code of practice that applies to licensed premises.

The Coalition Government’s alcohol strategy (March 2012) had included a commitment to introduce MUP. A consultation (November 2012) on the strategy recommended a price of 45p per unit. The commitment was dropped in July 2013 – the then Government claimed that its analysis of consultation responses showed there was not enough “concrete evidence” that MUP would be effective in reducing the harms associated with problem drinking without penalising responsible drinkers.’

The briefing further review the details of recent policy developments, including the long-running Scottish Government’s effort to implement MUP in face of successive legal challenges and appeals by sections of the alcohol industry. A final conclusion to the saga is expected this year, which should it result in implementation will be likely to increase pressure on any Government in Westminster to make commitments pending  positive outcomes. Wales and Ireland meanwhile take the view the evidence is already conclusive enough and are seeking MUP irrespectively.

Alcohol taxation and the pub trade

Often tied in with MUP debates, debates over the potential for taxation as a pricing lever can be equally hard fought. A newly released briefing on taxation and the pub trade [pdf] extensively details some of the key issues including the way alcoholic drinks are taxed, Labour’s introduction of a ‘duty escalator’ in 2008, and reported concerns in the pub trade over the impact of the policy. It further considers the Coalition Government decision to remove the duty escalator in two stages in 2013 and 2014, and the current Government’s approach to the taxation of alcohol.

Indeed the growing price gap between off and on-trade sales has been charged with the shift towards home drinking and continued decline in pubs. Whilst multiple factors are likely to be at play, many are concerned that cheap off-trade sales fuel heavy drinking in unregulated environments and ‘pre-loading’. A current consultation on changes to white cider may have some effect down the line, but will not address many of the broader public health concerns.

Alcohol: mandatory licensing conditions

A briefing on the mandatory licensing conditions [pdf] has also been released, detailing the amendments made to the Licensing Act intended to address ‘irresponsible drinking’. A mandatory condition in 2014 introduced the controversial ‘below cost ban’ – an alternative price floor following the MUP u-turn, but in reality thought to affect few if any drinks on sale to the public.

Existing mandatory conditions introduced in 2010, which too may have been of questionable impact or unknowns over national levels of adherence, include:

  • ban irresponsible promotions
  • ensure free potable water for customers
  • ensure that small measures of beers, wine and spirits are offered and that customers are made aware of them
  • ensure that all those who sell or supply alcohol have an age verification policy in place requiring them to ask anyone who looks under 18 for proof of age

Children in pubs

A new briefing relating to children in pubs [pdf] sets out the various legal and policy considerations for this rather complex area. Whilst the Licensing Act includes the protection of children as one of its four main objectives, children can attend most pubs if accompanied by an adult and within certain hours. However certain other laws and circumstances exist, as well as important considerations around age checks, employment and other issues.

Alcohol: drinking in the street

A recent briefing on issues pertaining to street drinking highlights that whilst consuming alcohol in public places is not illegal per se, a range of legislation and controlled zones exist which can authorise confiscation or arrest related to public space consumption. Since their introduction, powers of confiscation, dispersals or penalty notices have been significantly utilised and are likely to have contributed to falls in arrests for drunk and disorderly or being drunk in a public place. Street drinking however remains a concern in many areas; a toolkit for ‘Tackling street drinking’ was released last year, intended to help ‘reduce the incidents of, and burden from, street drinking and to improve the interventions provided to street drinkers themselves.’

Let’s see if what they said is followed up with actions ….

20 things to replace 2!

So I’ve been having a massive clear out following stumbling across the blog of Be More With Less.  As part of that I was having a good old sort through of my office and came across this list that was clearly written back in the days of my drinking and smoking because of what I called it!  Its ‘replace’ sub-heading was healthy relaxation methods as I was desperately looking for ways to relax that didn’t include booze and fags.

The reason for writing this post is two fold.  Firstly to share the list so here it is:

  1. Aromatherapy
  2. Acupuncture
  3. Hot stone massage
  4. Reflexology
  5. Flotation tank
  6. Reiki
  7. Meditation
  8. Swedish massage
  9. Exercise = running
  10. Music
  11. Chocolate
  12. Mindfulness
  13. Diet + increased water intake/Less caffeine and sugar
  14. Bath
  15. Scented candles
  16. Cup of herbal tea
  17. Reading
  18. Sleeping
  19. Cinema
  20. Yoga

If you’re looking for even more inspiration how about this:

The Mayo Clinic say to get the most benefit, use relaxation techniques along with other positive coping methods, such as thinking positively, finding humor, problem-solving, managing time, exercising, getting enough sleep, and reaching out to supportive family and friends.  They go on to say that by practicing relaxation techniques we can reduce stress symptoms by:

  • Slowing your heart rate
  • Lowering blood pressure
  • Slowing your breathing rate
  • Reducing activity of stress hormones
  • Increasing blood flow to major muscles
  • Reducing muscle tension and chronic pain
  • Improving concentration and mood
  • Lowering fatigue
  • Reducing anger and frustration
  • Boosting confidence to handle problems

And secondly I am pleased to say that I have finally signed up for the one thing on my list I’ve avoided up until now – the body technique at no 20!  I’ve been resisting it because I have sensed it is going to engage me to work on some somatic elements of my recovery that I know is going to potentially be hard so I’ve been procrastinating.  I know how beneficial others have found it and that many in the recovery community are big advocates of it so I’m finally diving in and I’ll let you know how I get on.  If you want to share your experience of yoga in the comments along with any hints and tips please do 🙂

Depression in Recovery


So I’ve talked before about depression and drinking here so this is not a new topic.  However I’ve not really discussed it in recovery.

Often our drinking is a self-medication for depression and keeps us stuck in a place where we don’t look at the underlying driver to our drinking.  However when we stop we remove that coping strategy and also the distraction and suddenly our underlying low mood comes fully into view.  This can be disconcerting when we’ve achieved so much in stopping and are hoping for pink clouds and get dark skies instead.  This is something I’ve experienced in recovery so know you are not alone.

If you’re struggling with low mood can I recommend listening to the brilliant podcast featuring Mandy Stevens which was featured on Bryony Gordon’s MadWorld podcast series in April.

If you wish to read Mandy’s story you can do so here:

From NHS Director to mental health inpatient in 10 days

The podcast is superb because she talks so eloquently about her depression and suicidal thoughts as one with the insight of both mental health professional and also client struggling with this debilitating mental health illness.

Her words:

As I have worked in mental health services for 29 years, one would think I would be immune to mental illness. I am a Registered Mental Health Nurse with 15 years experience as a clinician and latterly 14 years as a manager and then Director. But there is no immunity; mental illness can come out of nowhere and affect anyone at any time.

From initial symptoms of depression to admission to a mental health unit 10 days later via the Crisis Team, depression ripped the rug out from under my feet and emptied my whole being. I have been completely disabled and incapacitated by this illness.

If I had been in hospital with a broken leg, or a physical problem, no doubt I would have been sharing amusing photos of my drip stand, the signed plaster cast and the hospital food; laughing with my family, friends & extended Social Media community. Instead I have hidden myself away, scared of my own shadow and told very few people. Sad to say, I have also been embarrassed, shy, suicidal, phobic, anxious and scared of everything.

She also in the podcast shares some superb resources including:

The Beck Depression Inventory

This is a free self-scoring resource that you can complete, print out and take to your GP to start a discussion with your healthcare professional should you find yourself struggling.

GO HERE TO ACCESS THE TEST

She also shares many tips including those for managing panic attacks and some excellent mindfulness resources.  It is well worth your time and I thank her for it.

As she advocates if you are struggling please reach out to someone – anyone be it family, friend or supportive stranger.  You can find a supportive stranger at the Samaritans here 🙂

 

Friday Sober Insight: The Addiction Game

So continuing on reading John Bradshaw he discusses Transactional Analysis and mentioned a Life Script I’d not heard of: the ‘no feel’ (addiction) script also described as Joyless.  In deeper exploration I found further talk of the addiction game.  The image to the right explains the script types further and this excerpt below from the core Transactional Analysis text explains the Addiction Game:

The drama triangle can be illustrated with the Addiction Game. (I’ve discussed the Karpman Drama Triangle before here.)  In the Addiction Game, the addict playing the role of the Victim of addiction, humiliation, prejudice, medical neglect and even police brutality seeks and finds a Rescuer. The Rescuer plays the role by trying to generously and selflessly help the addict without making sure that the addict is invested in the process of giving up drug abuse. After a certain amount of frustrating failure the Rescuer gets angry and switches into the Persecuting role by accusing, insulting, neglecting or punishing the addict. At this point the addict switches from Victim to Persecutor by counterattacking, insulting, becoming violent and creating midnight emergencies. The erstwhile Rescuer is now the Victim in the game. This process of switching goes on endlessly around the Drama Triangle Merry-go-Round.

To avoid the drama triangle in psychotherapy, transactional analysts insist on establishing a contract in which the person specifically states what he/she wants to be cured of. This protects both client and therapist: the therapist knows exactly what the person wants, and the person knows what the therapist is going to work on and when therapy is to be completed. In any case, the best way to avoid the Drama Triangle is to avoid the roles of Rescuer, Persecutor or Victim by staying in the Adult ego state.

SCRIPTS: Transactional analysts believe that most people are basically OK and in difficulty only because their parents (or other grown ups and influential young people) have exposed them to powerful injunctions and attributions with long-term harmful effects.

People, early in their lives come to the conclusion that their lives will unfold in a predictable way; short, long, healthy, unhealthy, happy, unhappy depressed or angry, successful or failed, active or passive. When the conclusion is that life will be bad or self damaging this is seen as a life script.

The script matrix is a diagram used to clarify people’s scripts. In it we see two parents and their offspring and we can diagram the transactional messages–injunctions and attributions–which caused the young person to abandon their original OK position and replace it with a serf-damaging not OK position.

When life is guided by a script there are always periods in which the person appears to be evading his or her unhappy fate. This seemingly normal period of the script, is called the counterscript. The counterscript is active when the person’s unhappy life plan gives way to a happier period. This is, however, only temporary and invariably collapses, giving way to the original scripting. For an alcoholic, this may be a period of sobriety; for a depressed person with a suicide script it may be a brief period of happiness which inevitably ends when the script’s injunctions take over.

In the Script Matrix of Joseph, a drug addict we see that the script injunction “Don’t think, drink instead.” goes to Joseph’s Child from his father’s Child. This powerful message influences Joseph’s life dramatically, when he follows his father’s injunction with drugs instead of alcohol causing him repeated drug abuse episodes through his young life and adulthood. The counterscript message “You should not  drink to excess,” motivates him to make repeated but ineffectual efforts to cut down on drug abuse and it goes to Joseph’s Parent from his mother and father’s Parent.

The Script message: “don’t think, drink instead” delivered from Child-to-Child-is more influential than the Parent-to-Parent counterscript message to abuse moderately: that is why the script messages will usually prevail unless the person changes his or her script. When scripts are not changed they are passed down the generations, like hot potatoes, from grown ups to children in an uninterrupted chain of maladaptive, toxic behavior patterns.

You can read more about TEN CONCEPTS IN TREATING ALCOHOLICS WITH TA written by Stephen Karpman:

10Alc

I’ve been wondering to myself whether the “hot potato” of the no-feel script, leading to addiction issues, is present in the UK because of our cultural tendency to a “stiff upper life” approach to life.

From Wiki:

One who has a stiff upper lip displays fortitude in the face of adversity, or exercises great self-restraint in the expression of emotion.[1][2] The phrase is most commonly heard as part of the idiom “keep a stiff upper lip”, and has traditionally been used to describe an attribute of British people in remaining resolute and unemotional in the face of adversity.[1]

And it’s not just me who’s been questioning the value of our stiff upper lip approach to life recently either:

The stiff upper lip: why the royal health warning matters

Just a thought.

Guest Post: Recovering from Your Alcohol Addiction

More guest content this time courtesy of James and image courtesy of www.pixabay.com about recovering from alcohol addiction.

What’s the first thing that comes to your mind when you hear the word addiction? I mean, there are different types of addiction. There are people who are addicted to reading. Others are addicted to the internet or computer games. There are even people who are addicted to studying. Well, the thing is, they’re not all the same.

Different types of addiction have different degrees. Some people might even argue that other types of addiction can be a good thing. Let’s say, for example, is being addicted to studying. How can too much studying be a bad thing? But, reality strikes again.

There are bad sides to studying too much. One example would be not having a social life. When you’re too engrossed on academics, not having enough time for your friends, then you might find yourself at the mercy of a mental illness called depression anxiety.

So, what’s my point? What does it have anything to do alcohol addiction? Well, everything. I mean, when you’re addicted to studying, you don’t really see anything wrong with it. Good grades make you happy, but pretty soon you are going to have your sessions, and then suddenly being too engrossed in studying wasn’t such a good idea after all. Well, it’s pretty much the same with alcohol addiction. Drinking is a social activity. At first, you don’t see anything wrong with it. I mean, if drinking makes you happy, it can’t be that bad, right? But apparently, at some time of your life, the negative sides of being addicted to alcohol starts to show, and you’re going to wish you were never addicted to it in the first place.

But the thing is, just like any other addiction, getting through it is hard. It’s not an easy feat. It’s not something you can do overnight. It’s going to take time. You need to familiarize yourself with all the correct steps in order to overcome it, and in this article, you’re going to find out just how by answering the following questions:

What do you get out of it?

Try to list down all the benefits that you get out of drinking alcohol. It’s not just about getting to know the benefits. It’s also about trying to think up alternatives. I mean, if drinking makes you feel better about your problems, this could be a phase where you’ll be writing down possible alternatives. Get to know other hobbies that will give you the same benefits.

How much does it cost?

Now that you have a list of all the things that you get out of drinking alcohol, you can now begin to ask yourself, if it’s all worth the cost.

I mean, if you’re drinking to forget about your problems, perhaps, you’ve to find a different hobby that helps you do the same. Perhaps, reading on your spare time would also help you forget your problems.

You can now evaluate if you’d rather spend for alcohol or just read for free, in order to forget about your problems.

Set goals

Getting over your alcohol addiction doesn’t start when you say so. It starts when you decide. Action can only start when you have goals. So, starting today, you should list down some of your goals. These are the goals that you should list down:

  • The date when plan to launch your call to action
  • Whether you’re going to eradicate drinking completely or just regulate it

Remove temptations from your life

Abstain from everything that reminds of drinking.

All the planning would be of no use if one beer poster is just going to tempt you back to being a drunkard.

Tell your friends about your goal

No matter what you do there will always be temptations all around you. Self-control won’t always be enough. There will be times when you’ll fall into the pit.

So, what now? Do you just quit? Well, of course not. What you should do is to tell your friends, family, and everyone you know. That way, you’ll have all the support you can get. When you have the entire family or friendship circle rooting you to get better, it’s impossible for you to not abstain from alcohol.

Author Bio

James R. Robinson is an essayist for hqassignments.net. Needless to say, he has a passion for words. Most of his relatives are quite obsessed with science. His family is a streak line of businessmen, architects, doctors, and lawyers. He, on the other hand, chose art. He chose to write. Even so, he doesn’t think he’s that far off. Being a writer isn’t all art. It’s a part science and half art. So, he’s sort of in between them.

Thank you James!

Friday Sober Inspiration: Shame and The Squirrel Cage

So I’ve been reading John Bradshaw’s Healing The Shame That Binds You and oh my goodness when I read the section on Shame as The Core and Fuel of Addiction I almost fell off my chair!  It’s called The Squirrel Cage and is so reminiscent of this post I wrote it is spooky …..

I’m going to quote this section from his book but will share a series of Youtube video’s you can watch where he speaks about shame and this book’s premise.  There are 5 video’s in total and I’ll link the first one below.

Over to John:

Neurotic shame is the root and fuel of all compulsive/addictive behaviours.  My general working definition of compulsive/addictive behaviour is “a pathological relationship to any mood altering experience that has life-damaging consequences.”

The drivenness in any addiction is about the ruptured self, the belief that one is flawed as a person.  The content of the addiction, whether it be an ingestive addiction, or an activity addiction (such as work, shopping or gambling), is an attempt at an intimate relationship.  The workaholic with his work and the alcoholic with his booze are having a love affair.  Each one alters the mood in order to avoid the feeling of loneliness and hurt in the underbelly of shame.  Each addictive acting out creates life-damaging consequences that create more shame.  The new shame fuels the cycle of addiction.

The image at the top of the post is taken from Dr Pat Carne’s work, giving you a visual picture of how internalized shame fuels the addictive process and addictions create more shame, which sets one up to be more shame-based.  Addicts call this the squirrel cage.

I used to drink to solve the problems caused by drinking.  The more I drank to relieve my shame-based loneliness and hurt, the more I felt ashamed.  Shame begets shame.

The cycle begins with the false belief system shared by all addicts: that no one could want them or love them as they are.  In fact, addicts can’t love themselves.  They are an object of scorn to themselves.  This deep internalized shame gives rise to distorted thinking.  The distorted thinking can be reduced to the belief, “I’ll be okay if I drink, eat, have sex, get more money, work harder, etc.”  The shame turns one into what Kellogg has termed a “human doing” rather than a human being.

Worth is measured on the outside, never on the inside.  The mental obsession about the specific addictive relationship is the first mood alteration, since thinking takes us out of our emotions.  After obsessing for a while, the second mood alteration occurs.  This is the “acting out” or ritual stage of the addiction.  The ritual may involve drinking with the boys, secretly eating in one’ s favourite hiding place or cruising for sex.  The ritual ends in drunkenness, satiation, orgasm, spending all the money or whatever.

What follows is shame over one’s behaviour and life-damaging consequences: the hangover, the infidelity, the demeaning sex, the empty pocketbook.  The meta-shame is a displacement of affect, a transforming of the shame of self into the shame of “acting out” and experiencing life-damaging consequences.  This meta-shame intensifies the shame-based identity: “I’m no good; there’s something wrong with me,” plays like a broken record.  The more it plays, the more one solidifies one’s false belief system.  The toxic shame fuels the addiction and regenerates itself …..

I would really recommend the book but if you’re a visual and auditory learner instead watch here:

Changing Scotland’s Relationship to Alcohol

Coverage from Alcohol Policy UK of the new report from Alcohol Focus about changing Scotland’s relationship to alcohol and recommendations for further action.

A new report has been released by Alcohol Focus Scotland (AFS) calling for bold action by the Scottish Government as it prepares to refresh its national alcohol strategy.

Download Changing Scotland’s Relationship with Alcohol: Recommendations for further action (PDF)

The report is intended to inform the next phase of the Scottish Government’s alcohol strategy and was developed with the BMA Scotland, SHAAP and Scottish Families Affected by Alcohol & Drugs. It outlines a comprehensive range of actions that it wishes to see the Government prioritise, including a target to reduce national consumption in Scotland by 10%. It argues the fall in consumption could potentially deliver a 20% reduction in deaths and hospital admissions after 20 years, based on University of Sheffield modelling.

The report’s recommendations include:

  • Implementing a 50p minimum unit price as soon as possible
  • Developing a strategic approach to reducing the availability of alcohol, and improving existing licensing regulation
  • Reducing exposure of children to alcohol advertising and sponsorship
  • Protecting every child’s right to an alcohol-free childhood
  • Clearer information for consumers about the health risks associated with drinking
  • More investment in alcohol prevention, treatment and support services

The report states that whilst per capita alcohol consumption in Scotland declined by 9% between 2009 and 2013, since 2012 the amount of alcohol sold and number of people dying as a result have increased. In 2015 the amount of litres of pure alcohol sold was 10.8 per adult in Scotland; equivalent to 20.8 units per adult per week. Alcohol misuse is stated to cost £3.56 billion a year in health, social care, crime, productive capacity and wider costs, whilst the cost to the NHS in Scotland is £267 million. The cost of alcohol-related crime in Scotland is £727 million a year, and the total costs to society equate to £900 for every adult in Scotland.

Alison Douglas, Chief Executive of Alcohol Focus Scotland said Scotland was “awash with alcohol” and that “widespread availability, low prices and heavy marketing are having a devastating effect.” Dr Peter Bennie, Chair of BMA Scotland said doctors see “the first-hand the damage that alcohol misuse does to patients and their families” and that the country could not afford the costs of alcohol upon the health service.

Health Secretary Shona Robison welcomed the report and said the government would consider all of the recommendations. Last year the final Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) report was released, indicating the Scottish Government’s alcohol strategy has had a positive impact over the past 5 years despite minimum unit pricing (MUP) not having been implemented.

Scotland: evidence first?

In 2015 a report was released exploring the extent to which alcohol policies across the UK nations were evidence-based. The report rated Scotland as having the strongest approach based on policy detailed in ‘Health First’, an independent alcohol strategy proposed by a coalition of independent health bodies in 2013. Scotland’s main weakness was rated as its involvement of alcohol industry in policy decisions – public health groups argue industry should only be involved as producers, retailers and distributors, and not be permitted to influence policy.

Meanwhile Scotland’s infamous long running effort to implement MUP has been repeatedly challenged by sections of the alcohol industry led by the Scotch Whisky Association. The most recent appeal was described as amounting to ‘delaying tactics’ by AFS and others who remain hopeful that MUP will finally be authorised to commence this year.

Certainly it appears the Scottish Government support an alcohol policy approach that public health groups deem largely evidence based. Many including PHE suggest the same approach is needed in England, albeit that MUP has not technically been ruled out. However given the broader political context, those wishing to influence alcohol policy may feel now may not be the most opportune time. Equally, alcohol and related health policy debates may still be considered relatively high profile and with many MPs now routinely involved in a number of alcohol-related issues.

We are cheering you along from down here Scotland!!