Drinking in pregnancy: where next for preventing FASD in the UK?

My son was conceived on a Bank Holiday August week-end.  Ironically I also attended a Hen Do that week-end where as you can guess much alcohol was consumed despite my trying to conceive at the same time.  So this post today seems fitting.  It is courtesy of a guest blog for Alcohol Policy UK that I read in May called Drinking in pregnancy: where next for preventing Fetal Alcohol Spectrum Disorders (FASD) in the UK?

In this guest blog, Kate Fleming, Senior Lecturer, Public Health Institute, Liverpool John Moores University, and Raja Mukherjee, Consultant Psychiatrist, Lead Clinician UK National FASD clinic, Surrey and Borders Partnership NHS Foundation Trust consider the context and future for Fetal Alcohol Spectrum Disorders in the UK.

A recent opinion piece in The Guardian entitled Nothing prepared me for pregnancy- apart from the never ending hangover of my 20s took a, presumably, humorous take on the tiredness, vomiting, dehydration, and secrecy that so many women live through in early pregnancy, likening this to days spent hungover after excessive drinking in the author’s early 20s.

In an article that was entirely about alcohol and pregnancy there was reassuringly no mention of the author consuming alcohol during pregnancy, indeed quite the reverse “I don’t actually want booze in my body”.  But neither was there explicit reference to the harms that alcohol can cause in pregnancy. 

The harms caused by consuming alcohol in pregnancy

Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term that encompasses the broad range of conditions that are related to maternal alcohol consumption.  The most severe end of the spectrum is Fetal Alcohol Syndrome (FAS) associated with distinct facial characteristics, growth restriction and permanent brain damage.  However, the spectrum includes conditions displaying mental, behavioural and physical effects on a child which can be difficult to diagnose.  Confusingly, these conditions also go under several other names including Neuro-developmental Disorder associated with Prenatal Alcohol Exposure (ND-PAE) the preferred term by the American Psychiatric Association’s fifth version of its Diagnostic and Statistical Manual (APA DSM-V), alcohol-related birth defects, alcohol-related neuro-developmental disorder, and partial fetal alcohol syndrome.

How common is FASD?

A recent study which brought together information from over 300 studies estimates the prevalence of drinking in pregnancy to be close to 10%, and around 1 in 4 women in Europe drinking during pregnancy. Their estimates of FAS (the most severe end of the spectrum) were 14.6 per 10000 people worldwide or 37.4 per 10000 people in Europe, corresponding to 1 child in every 67 women who drank being born with FAS. 

Given the figure for alcohol consumption in pregnancy is even higher in the UK, with some studies suggesting up to 75% of women drink at some point in their pregnancy, conservatively in the UK we might expect a prevalence of FASD of at least 1%.  We also know that it is highly unlikely that anything close to this number of individuals have formally had a diagnosis.  This lack of knowledge of the prevalence in the UK is hampering efforts to ensure the required multi-sector support for those affected by FASD and their families.  

Current policy

For some time a significant focus of alcohol in pregnancy research was to try and identify a safe threshold of consumption, without demonstrable success.  No evidence of harm at low levels does not however equate to evidence of no harm and as such in 2016 the Chief Medical Officer revised guidance on alcohol consumption in pregnancy to recommend that women should avoid alcohol when trying to conceive or when pregnant.  Though this clarity of guidelines has been well received by the overwhelming majority of health professionals there are barriers to its implementation with few professionals “very prepared to deal with the subject”.  In addition, knowledge of the guideline amongst the general public has yet to be evaluated.    

As part of the 2011 public health responsibility deal a commitment to 80% of products having labels which include warnings about drinking when pregnant forms part of the alcohol pledges. A study in 2014 showed that 90% of all labels did indeed include this information. However, it has also been shown that this form of education is amongst the least effective in terms of alcohol interventions, and the pledge is no longer in effect.

Pregnancy is recognised as a good time for the initiation of behaviour change yet in the context of alcohol consumption it is arguably too late. An estimated half of all pregnancies are unplanned and there remains therefore a window of early pregnancy before a woman is likely to have had contact with a health professional and before the guidelines can be explained during which unintentional damage to her unborn baby could occur.  The same argument can be used when considering the suggestion of banning the sale of alcohol to pregnant women – visible identification of pregnancy tends only to be possible at the very latest stages.

How then to address consumption of alcohol during pregnancy? 

Consumption of alcohol is doubtless shaped by the culture and context of the society in which one is living.  Highest levels of alcohol consumption in pregnancy are, unsurprisingly, seen in countries where the population consumption of alcohol is also highest.  Current UK policy that is directed to reducing population consumption of alcohol will likely have a knock-on effect of reducing alcohol consumption in pregnancy.

Many women will however be familiar with the barrage of questions that they encounter when not drinking on a night out.  From the not-so-subtle “Not drinking, eh… Wonder why that is? <nudge, nudge, wink, wink>” to the more overt “Are you pregnant?”.  The road to conception and pregnancy is littered with enough stumbling blocks and pressures that the additional unintentional announcement of either fact of conception or intention to conceive is an unnecessary cause of potential further anxiety. Until society accepts that not drinking is an acceptable choice, without any need for clarification or explanation, then pregnant women or those hoping to conceive who are adhering to guidelines will continue to identify themselves, perhaps before they want to. 

What next?

The UK’s All Party Parliamentary Group for FASD had its inaugural meeting in June 2015.  This group calls for an increased awareness of FASD particularly regarding looked after children and individuals within the criminal justice system, sectors where the prevalence of FASD is particularly high. Concerted efforts need to be made to identify children with FASD to ensure that the appropriate support pathways are in place. Alongside this, efforts to ensure the best mechanisms for education of the dangers of alcohol consumption in pregnancy need to be increased, including training for midwives, and other health professionals who may be able to offer brief intervention and advice to women both before and after conception.

NOFAS run a national FASD helpline on on 020 8458 5951 as do the FASD Trust on 01608 811 599.

Friday Sober Inspiration: Reasons to Stay Alive

So I read the book by Matt Haig Reasons to Stay Alive quite early on in my recovery.  It was published in December 2015 and it was Bryony’s interview with him on the MadWorld podcast series that reminded me of what a great book this is.

You can read an extract from it here.

And here’s an interview with Matt from The Guardian when it was published:

Why did it take you 15 years to get the courage to write about depression?
I was meant to be writing a blog for the Books Trust, as their writer in residence, about novel writing but ran out of things to say and was starting to repeat myself. So I thought: OK, I’ll write about depression, this thing I had always had inside me and wanted to get out. And I got an incredible response, not because the blog was great but because I’ve noticed when anyone talks honestly about depression, it breeds a warm, sincere response from people. Everybody has a story about depression yet, for decades, we have been silent about it.

Is writing a way out of depression?
Writing is not the way but it helps. In February 2000, I was in the depths of depression. I was 24 and back from Ibiza, living at home in Newark [Nottinghamshire], in my childhood bedroom. I started writing bits and pieces – unreadable, angsty stuff. Articulating what is in your head is therapeutic. Words are a shared thing – depression lends itself to melodrama: you believe you’re going through something no one else has been through. At 31, Abraham Lincoln wrote: “I’m the most miserable person now living.” That is the drama of being a young man. That is the drama of depression.

How did you recover?
I still get bouts of depression but I am a lot better than I was. Staying sane and well is a complicated, never-ending process. The critical thing was that I had people I could talk to around me. My solution was never medical. What ultimately helped me was time. Depression told me I wouldn’t make my 25th birthday, then I made my 25th … and then I made my 30th.

One of the surprises is how speedy you make your experience sound, saying that adding anxiety to depression ‘presses fast-forward’?

Most people have depression with anxiety. They overlap in complicated ways. Mine trickled over into OCD and panic disorder. One of the main symptoms of anxiety is racing thoughts.

Why were you living in Ibiza?
I was a party person at university. I went to Hull, then Leeds. I used to drink a lot. (In one fell swoop, I gave up drinking and smoking. I became scared of anything that could alter my brain chemistry). Anyway, I met my partner, Andrea, early on and we went on holiday to Ibiza. After another winter in Hull, we thought it would be nice – probably against our parents’ wishes – to try and get work in Ibiza. I was selling tickets, doing a bit of PR. Andrea got the good job – running the office for the island’s largest party. Ibiza contributed to depression in that I was run down: we weren’t eating well, there had been heavy drinking, no sleeping, a lot of unhealthiness.

How worried were your parents when depression struck?
It happened suddenly so they had to be aware of that. I wasn’t mad or delusional but I was worrying about things too much. I knew who I was. I could hold a conversation, there was nothing obviously wrong with me. My mother had experienced postnatal depression but that made it harder for her because it brought it all back. Unlike with physical illnesses, there is always with depression, I believe wrongly, guilt and blame attached.

Your dad is quoted telling you to pull yourself together …
I feel guilty about that but you can’t write what is vaguely a memoir without betraying someone. I wanted the main person I betrayed to be myself. My mum has only just read the book…

How did she react?
Long, emotional texts that said it was hard for her to read but she thought it was brilliant and that it made her understand depression better.

Is depression different for each person who experiences it?
I don’t know. I’ve only ever been me.

Is it safe to generalise?
It is dangerous not to – despair is universal.

Is technology a contributing factor?
I became ill in 1999 and didn’t even have a mobile phone. Facebook and Twitter provide a Samaritans culture: people are there to chat to 24/7. That said, the addictive aspects of the internet, comparing yourself against other people, is negative for mental health.

Your most unexpected message is that depression can be a force for good?
If you took away all pain, if everyone lived for ever, everything would be bland, flat and boring, there would be no reason for art, music, newspapers, love because we would all be in a mono state of happiness. You cannot belittle depression yet a lot of people would not undo that side of themselves because it changes your thoughts. It makes you appreciate things you would not have appreciated before: like just being alive. Thinking about death makes you analyse what life is. Anxiety makes you curious and curiosity leads to understanding. I wouldn’t be a writer without depression.

Did becoming a published author boost your self-esteem?
It gave me a sense of identity. I had the confidence to write a novel and send it off which I wouldn’t have had before. We were in debt which gave me this ridiculous drive. I wrote a book about talking dogs – a reworking of Henry IV Part 1 – and ended up in more debt! Being published gave me that sense of: that is what I am here for.

What does Andrea make of your writing about depression and her role in helping you?
She is a shy person and we are both a bit antsy because it is your life and people are going to be disbelieving. She and I used to write side by side. Her books were – she hates the word – “chick lit”. When we had kids [now 5 and 7], she stopped but is now writing again, she has some ideas for children’s books.

Do you worry about your children inheriting the depressive gene?
Yeah. It is a confidence thing – if there is a link between how you raise a child and the adult. We try not to be unreasonably critical but I’m of the grim belief that each generation corrects its parents’ mistakes and then makes new mistakes of its own.

You once worked in a cabbage factory warehouse. That could bring on a depression?
Strangely, I don’t get depression in adverse situations. Hard work can be therapeutic. I hated the cabbage factory but it wasn’t capital D depressing.

You suggest we’re losing sight of what matters in over-affluent lives?
Yes, absolutely. I’d feel worse in shopping centres. Adverts, designed to make you feel bad, depressed me – they create a void. It’s easy to lose your priorities and think: I’ve got to have this sort of job or earn this amount of money. It would be lovely to live in a culture where calmness was the aim.

What is the single most important thing to tell someone depressed?
However much in the foreground depression feels, you are separate to it. This is going to sound cheesy but I’d say: You are the sky. A cloud comes and dominates the sky. But the sky is still the sky. Depression tells you everything is going to get worse but that’s a symptom. Don’t give depression power – constantly discredit it.

Giving up alcohol was a major part of Matt’s recovery in the earlier years and you can hear him talk about it with Bryony here:

https://bryonysmadworld.telegraph.co.uk/e/mad-world-matt-haig/

Like Bryony I loved his lists in the book.  Although this is written about depression it could so easily be about alcohol dependence too (excerpt taken from his blog):

7. Ignore stigma. Every illness had stigma once. Stigma is what happens when ignorance meets realities that need an open mind.

My alcoholic daughter, 26, must leave home – or I will

This was a Guardian Dear Mariella letter in June that garnered almost 600 comments so clearly it is a subject that hit a collective nerve that prompted people to offer advice and share their perspective.  An alcoholic daughter cared for by ageing parents who have had enough and write in asking for help.

The dilemma I’m a 69-year-old retired engineer with two children; one who lives abroad and seems to be doing well, and the other, my 26-year-old alcoholic daughter.

She appears incapable of holding down a job, is a strain on our resources and frequently goes on binges during which she might fall and get bruised.

I am her enemy, it seems. Today she told me she wishes I had died when she was 15. Yesterday the police called because she had gone to the local shop, bought cheap spirits, and was outside in a stupor.

I want her out of my house. I am depressed by the constant arguments between her and her boyfriend (a decent sort of guy), her and her mother, her and me. She behaves like a devious psychopath, manipulating others.

Unfortunately my wife keeps enabling her behaviour. I think I am going to have to leave to preserve my sanity. I hate to seem as if I am attacking my wife, but I can’t see any other way.

Mariella replies How sad. Your daughter is an addict plain and simple, but it’s not just her own life she’s destroying. One of the frustrating aspects of addiction is how useless it can make those around feel, even when they are doing their utmost to be helpful.

Your daughter needs professional help, ideally a clinical stay, but as you’ll be all too aware you can’t force her to seek that out. You can, however, make it less easy for her to dodge the fact that she is making a problem for all of you.

All addicts become adept at manipulation, as deluding others is often their only way of maintaining their habit. Lying becomes their lifeline. It’s easy for me to say this, but you must try – no matter how terrible the things she says – not to confuse your daughter with the creature her addiction makes her.

The day she liberates herself from her dependency on alcohol she will be an altogether different human being, so please don’t abandon hope for the return of the girl you once knew. Insisting, if she’s to remain living with you both, she attend AA meetings would be a step forward, but you would have to be prepared to go through with the alternative of her leaving the house.

Have you tried family counselling? It can be a helpful step towards getting the person to realise that they need to look to themselves instead of attacking those trying to firefight for them. At present she’s casting you as a demon, but that would be much harder if you and your wife built up some solidarity. Parenting in partnership is one of the most constructive things you can do with children generally. Speaking in one voice is one of the toughest collaborations to maintain, but it’s indispensable when dealing with an addict. A united front helps to create a sense of security, offers less chance to indulge manipulative tendencies and presents a clear idea of where the boundaries lie. Your daughter is over-stepping every one of those lines and it may be that things have to get worse before they can improve. What would be really destructive would be allowing your daughter’s behaviour to drive a wedge between you and your wife.

Don’t underestimate the immense strain you are both under, which is clearly having an impact on you both in different ways. Your wife’s enabling of your daughter’s behaviour puts her in a majority. There are very few parents who come around easily to abandoning their child in the hope of them hitting rock bottom – it’s an incredibly hard choice to make.

However, your girl needs to see that there are expectations and consequences, and the life you are all enduring is unsustainable and damaging. If you haven’t tried family counselling it’s worth investigating. There’s no downside to having an honest discussion and there can be surprises for all concerned. No amount of therapy, however, will cure her addiction – she is an alcoholic and needs to understand that whatever is at the root of her problems her addiction to alcohol is only exacerbating it.

Maybe her dependable boyfriend can help convince her of the invaluable support available at her local AA meeting. This is an issue for expert advice, not just an email to an agony aunt, so do ensure you’re in touch with the organisations whose expertise has helped many a family, including Al-Anon Family Groups (020 7403 0888) and adfam.org.uk.

Ultimately, the best I can offer is my certainty that you won’t be able to make changes until you and your wife find common ground. Leaving won’t cure the problem and removing yourself will be a temporary respite at best. Refraining from calling the family home “my house” as you do in your letter is one small correction to your own approach that you might make. The way forward will take compromise and a willingness to accept change from all concerned to dig you out of this dark hole.

I liked her advice and thought it was sound – what did you think?

Sober Inspiration: Stepping away from Self-Improvement

So I seem to be getting the same message from different sources and in different mediums.  I’m guessing I need to take note!  This also mirrors a conversation I had with Prim about how I’d overdone it somewhat in the self-help reading and had emotionally overwhelmed myself in the process 🙁  So in a direct snapback to that I then read the book Stand Firm: Resisting the Self-Improvement Craze (see image) and then serendipitously listen to a podcast interview with Danielle LaPorte where in discussing her new book White Hot Truth – she hits upon similar themes 🙂

His book’s premise is this:

The pace of modern life is accelerating. To keep up, we must keep on moving and adapting – constantly striving for greater happiness and success. Or so we are told. But the demands of life in the fast lane come at a price: stress, fatigue and depression are at an all-time high, while our social interactions have become increasingly self-serving and opportunistic.
 
How can we resist today’s obsession with introspection and self-improvement? In this witty and bestselling book, Danish philosopher and psychologist Svend Brinkmann argues that we must not be afraid to reject the self-help mantra and ‘stand firm’. The secret to a happier life lies not in finding your inner self but in coming to terms with yourself in order to coexist peacefully with others. By encouraging us to stand firm and get a foothold in life, this vibrant anti-self-help guide offers a compelling alternative to life coaching, positive thinking and the need always to say ‘yes!’

It introduces 7 steps:

  1. Cut out the navel gazing
  2. Focus on the negative in your life
  3. Put on your No hat
  4. Suppress your feelings
  5. Sack your coach
  6. Read a novel – not a self-help book or biography
  7. Dwell on the past

He espouses the Hellenic tradition of Stoicism:

Stoicism is predominantly a philosophy of personal ethics which is informed by its system of logic and its views on the natural world. According to its teachings, as social beings, the path to happiness for humans is found in accepting that which we have been given in life, by not allowing ourselves to be controlled by our desire for pleasure or our fear of pain, by using our minds to understand the world around us and to do our part in nature’s plan, and by working together and treating others in a fair and just manner.

“Will-power is like muscle strength, the Stoics believed: the more we exercise it, the better and stronger it becomes.  No matter how silly such innocent examples might sound, it isn’t so stupid to practice turning down a dessert, a glass of wine or a lift in a car.  Self-control is one of the absolutely key virtues for the Stoics, albeit one that encounters a degree of adversity in our accelerating culture, with its penchant for ‘living in the moment’ and its exhortations to ‘Just Do It!’ as the ad says”.

He goes on to say: “As an ‘anti self-help philosophy’ I definitely think it’s useful, partly because it emphasises self-control, a sense of duty, integrity, dignity, peace of mind and a willingness to come to terms with (rather than find) yourself.”

Quite.  Practical pragmatism if you will.

And Danielle is riding the same vibe too it would seem as a reflection of the backlash against the self-improvement movement.  Her book asks:

Has your self-help become self-criticism?

White Hot Truth is a wise and often (hilariously) relatable exploration of the conflicts between spiritual aspiration and our compulsion to improve, from Oprah SuperSoul 100 member, Danielle LaPorte.

Danielle cheerleads seekers to fully own their wisdom by having a good laugh (and maybe a good cry) at all the ways we’ve been trying to improve on our self-improvement.

I’ve enjoyed reading and listening to these and hope you do to 🙂

Being drunk in charge of a child can get you arrested

So this was featured in The Independent in July and was picked up by Alcohol Policy UK.   After a Russian heiress was found guilty of being drunk in charge of a child, the Independent dug out the 1902 licensing act.

The Summer’s social calendar is already in swing events from family barbecues to village fetes already lining up. However, while drinking when in charge of children at family events is common practice, it is also actually a breach of the law.

With even David Cameron leaving his eight-year-old daughter behind at a pub back in 2012, parents drinking while looking after their children is an everyday occurrence. But a century old law forbids the behaviour.

Being drunk while in charge of a child under the age of seven is illegal according to the 1902 licencing act. The law states that a fine or up to a month’s imprisonment would result if “any person is found drunk in any highway or other public place, or on any incensed premises, while having the charge of a child.”

“The threshold would be whether the child was compromised. If you’re having lunch with a couple of glasses of wine, you probably wouldn’t be considered drunk in charge of a child,” solicitor advocate Joy Merriam tells The Sun.

Being alert and capable of safeguarding your child are the key responsibilities that could be compromised by drinking irresponsibly. If parents are unable to look after their children and protect them from physical harm they could be committing the offence.

“There is no fixed amount under the current legislation, but it could certainly be argued that if you are an adult solely responsible for a child, it is better not to drink alcohol at all,” family lawyer Jo Shortland tells The Independent. 

However, Ms Merriam adds that in cases of this type where parents are arrested on suspicion of the offence, prosecutions are infrequent and most commonly passed on to social services.   

“Those responsible for children need to consider their own limitations and take a sensible approach to alcohol consumption,” family lawyer Deborah Heald tells The Independent. 

The charity Drinkaware also released the following advice for parents: “Drink within the low risk alcohol unit guidelines of not regularly drinking more than 14 units per week for both men and women, and spreading them evenly over three days or more. This shows your child that adults can enjoy alcohol in moderation.”

Edited to add: I suspect this includes if you are drunk on a plane!

Revealed: The growing problem of drunk and abusive fliers – and the worst routes for bad behaviour

Panorama: Plane Drunk (BBC One Panorama 8.30 pm tonight)

 

Friday Sober Jukebox: Humour as a defence (Lit)

humourThere were so many gems in Sally Brampton’s book ‘Shoot the Damn Dog‘ that I have already shared here before.  This is also utterly true and resonated for me – humour as a defence.  I’m a nurse – gallows humour is our professions stock-in-trade.

First Sally’s words:

They don’t like jokes in group therapy.  Humour is a defence.  I am in denial, they say, which is just another word for smart ass.  I use humour to hide behind, because I cannot bear to feel my feelings, cannot face the truth.  I use too many words, they say.  I hide behind language.  I intellectualise my feelings and then explain them away.

‘Stop using your head, Sally.  How do you feel?’.

‘How can I tell you how I feel if I don’t use words?’

They sigh.  I can see the word ‘difficult’ captured in bubbles above their heads.

‘Feel the feelings’ they say, again.

And then what? My feelings are stuck in my throat.  The feelings that I can’t, actually put into words.

Once again, she nails me, completely.  Yes, yes, yes.  Thank you Sally 🙂

And this is what Psychology Today says:

This may explain why some psychologists classify humour as one of the “mature” defense mechanisms we invoke to guard ourselves against overwhelming anxiety (as compared to the “psychotic,” “immature,” and “neurotic” defense mechanisms). Being able to laugh at traumatic events in our own lives doesn’t cause us to ignore them, but instead seems to prepare us to endure them.

Perhaps laughter could be most properly considered as a weapon against suffering and despair. If we can joke about a disappointing or traumatic event, we’ll often find ourselves feeling that what’s happened to us isn’t so bad and that we’ll be able to get through it. This expectation serves two vitally important functions:

  1. It diminishes or even eliminates the moment-by-moment suffering we might otherwise experience as a result of a traumatic loss, which
  2. Actually makes it more likely we will make it through a trauma unmarred and flourish once again

So back to gallows humour then.  This is what Wiki says:

Sigmund Freud in his 1927 essay Humour (Der Humor) puts forth the following theory of the gallows humor: “The ego refuses to be distressed by the provocations of reality, to let itself be compelled to suffer. It insists that it cannot be affected by the traumas of the external world; it shows, in fact, that such traumas are no more than occasions for it to gain pleasure.”

As the Psychology Today article continues: Laughter is a powerful means by which we can encourage ourselves. That when confronted with setbacks, adversity, trauma, or terrible news, even if it may seem socially inappropriate, we should reach toward humor. We should try to find a way to make light of whatever circumstances make us afraid. Because if instead of focusing on the negative impact of an adverse event or experience we focus on simply laughing about it, actively and consciously pursuing a perspective that makes it funny, we just may be able to activate the most under recognized but powerful weapon we have against suffering.

MrHOF asked for this to be the Friday Sober Jukebox and the video made me laugh 😉

PS Don’t forget that this Sunday London hosts its first Mindful Drinking Festival!

Guest Blog Post: Mindful Drinking Festival & Alcohol Free Drinks In Recovery

So this is a quick plug for my friends over at Club Soda and a guest blog post they have written in support of their upcoming Mindful Drinking Festival (see details to the left)

Over to Jussi:

Alcohol-free beers and wines can be a controversial topic for people in recovery. Many feel that they should be avoided completely. Why keep drinking something that reminds you of alcohol? Won’t they just lead you back to the full-strength stuff eventually? These are all valid points, coming from years of experience by many people.

Club Soda is a Mindful Drinking Movement, which means that we support people whatever their drinking goals are. Some want to quit completely, some want to take a temporary “sober sprint”, some want to cut down in some way. We believe these are all valuable goals – any reduction in alcohol use is good news.

Alcohol-free beers and wines is a topic that comes up regularly in our online community. There are strongly held views both for and against them. It was never our aim to promote any particular drinks. But we have heard from so many of our members how swapping their usual beers and wines to a non-alcoholic or even a lower alcohol version has helped them to dramatically change their habits.

But we also believe that only you can decide for yourself. If you don’t think a non-alcoholic beer is right for you, then absolutely do not try them. We do always say that if you find a drink a “trigger” for alcohol, then it is best to stay away. There are plenty of soft drinks to drink which will not remind you of alcohol.

A further interesting twist to this discussion took place recently on our Facebook Group: how does people’s relationship with AF drinks change over time? This is what Ellen wrote:

“At 8 months sober, I can really take them or leave them. However in early sobriety, especially over Christmas, I TOTALLY depended on them. There was a time I could drink a whole AF wine fairly fast and open another. Now though, I honestly hardly even want a bottle.”

Melanie responded in a similar way:

“I’m at 8 months and like you drink a lot less af drinks now than I first did. A weekend treat or if the girls are over. They have their uses but I guess I’ve now broken the habit!!”

Many others added comments on the same lines: used to drink more or less the same amount of AF drinks as they used to drink alcoholic drinks in the beginning of their sober journey, but have reduced their consumption over time. Many of the people with a few sober months under their belt said they only drank AF drinks on special occasions: most often when out in a pub. Partly to “blend in”, partly to have something “grown up” to drink, rather than a sugary lemonade.

The good news is that there is a real revolution going on in the drinks industry. There are more and more good quality non-alcoholic beers and wines available both in shops and bars. And many other new drinks are also making an appearance, from craft sodas to fermented tea drink kombucha.

Many of the new drinks can still be difficult to find though. That is why Club Soda is organising the UK’s first ever Mindful Drinking Festival – bringing together all the best alcohol-free drinks (0.5% and below) in one place: not just wines and beers, but also soft drinks, kombucha, mocktails, fine teas and much more. The event is free to attend, and lets you taste all the best new drinks, and find some new favourites for every occasion!

The Club Soda Mindful Drinking Festival is on 13th August, from midday to 6pm, at Bermondsey Square, London SE1 3UN. Entry is free, and you can RSVP online at mindfuldrinkingfestival.com.

We would love to see you there and hear your views.

I would love to be there that day but sadly will be working my day job 🙁  If you go do drop me a comment here to tell me what you sampled!

Sober inspiration: Co-dependency vs Self-Love Deficit Disorder

I’m currently reading Melody Beattie Co-dependent No More and that prompted me to dust off this post which has been in draft format for over 2 years!! :O So on my day 600 I shared a video that looked at co-dependency that carried a warning and I know from feedback that it caused a few wobbles.  Well imagine my delight when I watched this Jason Silva Shots of Awe where he says ‘what’s wrong with co-dependence?’.  Obviously we’re talking healthy rather than unhealthy co-dependence  here but just the same relying on other human beings is not in and of itself a bad thing!

Here’s his video:

And then consider this also as pioneered by Ross Rosenberg:

Men and women always have been drawn into romantic relationships instinctively, not so much by what they see, feel or think, but more by an invisible and irresistible relationship force. “Chemistry,” or the intuitive knowingness of perfect compatibility, is synonymous with the Human Magnet Syndrome.

He has 18 guiding principles of Self-Love Deficit Disorder and The Human Magnet Syndrome which you can read in full here, but below is a taster with the first principle outlined.

1. “Codependency” is an outdated term that connotes weakness and emotional fragility, both of which are far from the truth. The replacement term, “Self-Love Deficit Disorder” or SLDD takes the stigma and misunderstanding out of codependency and places the focus on the core shame that perpetuates it. Inherent in the term itself is the recognition of the core problem of codependency, as well as the solution to it.

Above is his Self-Love Abundancy Pyramid where the goal of SLDD recovery, or “The Codependency Cure”™ is the healing the trauma responsible for one’s self-love deficit (SLDD) and the acquisition of self-love or “Self-Love Abundance” or SLA.  

I’ll drink a sparkling water to that! 🙂

Hidden Signs Of Alcoholism – Interactive Priory Awareness Campaign

So it is the second week of the summer holidays and for many of us with children this can be a trying time as we juggle work, childcare and the family holiday.   We might drink more to cope or we might drink more while celebrating the relaxing of rules because it is the school holidays.  We might be trying to keep our drinking hidden so they don’t notice or we may just give up entirely and not care at all.  I swung between every one and all of those positions and feelings back in the day!

I’ve had the interesting experience this last week of my children going away on holiday for a week with their grandparents leaving us footloose and fancy free for the first time in 11 years!  In the past this would have been a green light to an absolute booze fest – no kids for a week would have mean’t the brakes were well and truly off with no one watching us so it’s been valuable to see how far I’ve come since 4 years ago.  It’s been pub lunches with lovely AF drinks, cake and tea out, cinema & chocolate, nice meals at home but no late nights getting shitfaced and days wasted in bed with a hangover – and no noise generators but ourselves, how lovely 😉

So recently The Priory contacted me about their new interactive awareness campaign and I thought I’d share it here.  Over to them:

I am writing to make you aware of an educational campaign that we are running to educate the public on the often hidden signs of alcohol addiction, through the use of an interactive web page.

Alcohol dependency is a condition that over a million people deal with in the UK (NICE). In fact, the NHS estimates that 9% of men and 4% of women in the UK are dependent on alcohol – however most don’t seek help.

Alcohol has also been identified as a causal factor in more than 60 serious medical conditions including heart disease and liver disease, various cancers and mental health problems (Public Health England).

With this in mind, we have developed an interactive campaign for interested parties to link to from their websites.

As one of the UK’s leading independent providers of alcohol rehabilitation and support services, we are committed to helping people overcome their addiction to alcohol and start their journey towards recovery. Our consultants treat people from all walks of life – often it is those you least expect who are struggling.

Our campaign is based on helping people to spot the signs of alcohol addiction, and we thought your audience might find it a useful support should they be worried about a partner’s, friend’s or relative’s drinking.

We would be delighted if you would add the item to your website:

www.priorygroup.com/the-addiction

Disclaimer: I have no vested interest in The Priory Group and have received no payment from them for sharing this email nor is this a recommendation from me to use their services.  It is purely just help to spread the word of their most recent campaign.

What do you think of their interactive web page?

Sober Inspiration: How to Be a Little Less Certain of Yourself

I’ve been reading this book over the summer and really like Mark Manson’s writing.  Thought I’d share his wisdom about how being less certain of ourselves can be valuable in terms of personal growth and insight.  This excerpt is based on his blog post that you can read in it’s entirety here: https://markmanson.net/wrong-about-everything

Over to Mark –

Questioning ourselves and doubting our own thoughts and beliefs is one of the hardest skills to develop.  But it can be done.  Here are some questions that will help you breed a little more uncertainty in your life.

Question 1: What if I’m wrong?

As a general rule, we’re all the world’s worst observers of ourselves.  When we’re angry, or jealous, or upset, we’re oftentimes the last one to figure it out.  And the only way to figure it out is to put cracks in our armour of certainty by consistently questioning how wrong we might be about ourselves.

“Am I jealous – and if I am, then why?” “Am I angry?””Is she right, and I’m just protecting my ego?”

Questions like these need to become a mental habit.  In many cases the simple act of asking ourselves such questions generates the humility and compassion needed to resolve a lot of our issues.

But it’s important to note that just because you ask yourself if you have the wrong idea doesn’t necessarily mean that you do.  The goal is merely to ask the question and entertain the thought at the moment, not to hate yourself.

It’s worth remembering that for any change to happen in your life, you must be wrong about something.  If you’re sitting there, miserable day after day, then that means you’re already wrong about something major in your life, and until you’re able to question yourself to find it, nothing will change.

This was me when I was drinking.  I KNEW something was wrong and I was unhappy but this thought was cognitively dissonant to my belief (beliefs drive values) that my life was not worth living if I couldn’t drink alcohol (my addict voice could be really melodramatic!!)

Question 2: What would it mean if I were wrong?

Many people are able to ask themselves if they’re wrong, but few are able to go the extra step and admit what it would mean if they were wrong.  That’s because the potential meaning behind our wrongness is often painful.  Not only does it call into question our values, but it forces us to consider what a different, contradictory value could potentially look and feel like.

Aristotle wrote, “It is the mark of an educated mind to be able to entertain a thought without accepting it”.  Being able to look at and evaluate different values without necessarily adopting them is perhaps the central skill required in changing one’s own life in a meaningful way.

Probing questions are necessary in order to get at the core problems that are motivating our dickish behaviour.

So the contadictory value I needed to consider was that a sober life or a  life was worth living if I couldn’t drink alcohol.  I had to consider the possibility – which is where sober blogs and communties are so powerful!  Here’s an excerpt of a recent post of Prim’s saying pretty much the same thing!  Thank you Prim 🙂

“If you are in the early days of sobriety – which I would classify as at least the first 200 days – then you may well have taken that decision because all the evidence has been proclaiming to you that your belief that consuming alcohol is an enjoyable and vital part of life is NOT TRUE, at least for you. and after decades perhaps of drinking, and social conditioning, that is an immensely hard belief to back away from, to challenge, to change.

one of the reasons I blog is to try to help those who HAVE identified they have an issue with alcohol, and to offer hope and example that life without alcohol is not lesser, but vastly more. that it is not a case of not being able to drink, but not having to drink. which is something I am still thankful for, every day.”

Question 3: Would being wrong create a better or a worse problem than my current problem, for both myself and others?

This is the litmus test for determining whether we’re got some pretty solid values going on, or we’re totally neurotic fuckwads taking our fucks out on everyone, including ourselves.

The goal here is to look at which problem is better.  Because after all, as Disappointment Panda said, life’s problems are endless (but equally happiness comes from solving life’s problems).

With drinking my options were – Option A continue drinking or Option B mistrust my  (addiction driven) belief that my life is not worth living if I can’t drink alcohol and remain humble and open to the idea that a life without booze might very well be the better problem to have.

Option A felt easier for sure at the time and Option B appeared hard and painful so it felt like the more difficult choice.

I try to live by a few rules, but one that I’ve adopted over the years is this: if it’s down to me being screwed up, or everyone else being screwed up, it is far, far, far more likely that I’m the one who’s screwed up.  I have learned this from experience.  I have been the asshole acting out based on my own insecurities and flawed certainties more times than I can count.  It’s not pretty.

That’s not to say there aren’t certain ways in which most people are screwed up.  And that’s not to say that there aren’t times when you’ll be more right than most other people.

That’s simply reality: if it feels like it’s you versus the world, chances are it’s really just you versus yourself.

It was me versus myself – well actually me versus my addiction.

Our most radical changes in perspective often happen at the tail end of our worst moments.  It’s only when we feel intense pain that we’re willing to look at our values and question why they seem to be failing us.  We need some sort of existential crisis to take an objective look at how we’ve been  deriving meaning in our life, and then consider changing course.  You could call it “hitting bottom” or “having an existential crisis”.  I prefer to call it “weathering the shitstorm”.  Choose what suits you.

If you’d like to read my answer to Question 3  I was recently a featured Sober Story on Living Sober: http://www.livingsober.org.nz/sober-story-lou/

Learn to sustain the pain you’ve chosen.  When you choose a new value, you are choosing to introduce a new form of pain into your life.  Relish it. Savour it, Welcome it with open arms.  Then act despite it.

I won’t lie: this is going to feel impossibly hard at first.  But you can start simple.  You’re going to feel as though you don’t know what to do.  But we’ve discussed this: you don’t know anything.  Even when you think you do, you really don’t know what the fuck you’re doing.  So really, what is there to lose?

LIfe is about not knowing and then doing something anyway.  All of life is like this.  It never changes.  Even when you’re happy.  Even you’re farting fairy dust.  Even when you win the lottery and buy a small fleet of Jet Skis, you still won’t know what the hell you’re doing.  Don’t ever forget that.  And don’t ever be afraid of that.

If you’re certain about your drinking not being a problem  – maybe it’s time to ask yourself these questions?  And if you’ve hit bottom please reach out.