SUNDAY SNIPPET: November 17

Grieving is something in which few aspire to be experts.  Even non-alcoholics are poor performers in accepting and grieving their losses... but an Alcoholic in recovery had better not skip over the grief process. This excerpt from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety shows the vital connection between successful long-term recovery and transcending loss.

You will not find recovery without the process of mourning. Most of us try to pull that off, but we can’t. Period. There is no conceivable scenario to avoid mourning in sobriety. You cannot go from drinking to recovery by skipping the pain of grief any more than you can go directly from Kindergarten to college. “After all, if our life is altered so dramatically by our trauma that we can hardly recognize it as our own, we might think it as a death,” says Kathryn Cramer. (Staying on Top When Your World Turns Upside Down, Penguin Books, New York 1990) “In a small but real way our life as we once knew it has died.” Death and grief go hand in hand.

You have a grievable loss. Failure to grieve, failure to grieve appropriately (e.g. without booze), or failing to even identify our losses as losses, sacks more attempts at long-term recovery than any other stressor. One thing few people respect or even notice about Alcoholics is the upheaval and loss we go through. Instead people seem more interested in the upheaval and loss we create.

Attention in group therapy is showered on abstinence. But look to those who have the most experience in their own recoveries and you’ll see people who have identified their losses, grieved them and transcended them. Every single one of them knows fully what he or she lost and is over it. Grief—the process, not the noun—belongs in treatment for Alcoholism. A full, real grief process. Not the infomercial version. It doesn’t happen in a series of handouts or a couple of DVDs. There are no shortcuts, and because there aren’t it is often overlooked in short-term treatment efforts. Mourning has to be an essential part of recovery’s curriculum. The carnage Alcoholism causes in our lives needs to be seen in the same light as grief counselors view a loss such as a natural disaster or untimely death.
--  Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pg. 72
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

SATURDAY REWIND: Increase in suicide rates, alcohol misuse, depression

Two articles from the alcohol research news archive, published three months apart, demonstrate the complex and deadly interplay between alcohol, depression and suicide.  It's sometimes referred to as a "squirrel cage" in which people use alcohol, a depressant, to treat depression...the alcohol causes more depression... which the person self-medicates with more alcohol.


The U.S. Centers for Disease Control and Prevention (CDC) showed that while suicide rates rose slowly between 1999 and 2007, the rate of increase more than quadrupled from 2008 to 2010. A link between depression and economic recession is assumed in a letter doctors from Britain, Hong Kong and the U.S. wrote on the new data to the medical journal Lancet Nov. 7.

There were 1,500 more reported suicides since 2007 than could have been expected using the suicide rate for the previous eight years. About 25 percent of the increase is attributable to the unemployment rate according to the lead doctor in the Lancet letter.

Alcohol use disorders, either alcohol abuse or the disease of alcoholism, are risk factors for suicide across all demographic divisions. According to the American Foundation for Suicide Prevention, 96 percent of alcoholics who die by suicide continue their drinking right up to the end of their lives.

Alcoholism is a factor in about 30 percent of all completed suicides. Approximately seven percent of those with alcoholism will take their own lives. Alcohol use when accompanied by other disorders, like depression, is one of the AFSP’s top-cited risk factors. Alcoholics, especially those with untreated alcoholism, usually fall into this last group because alcoholics use the depressant alcohol to treat their depression.
-- from examiner.com (see full article)

Bouts of depression are often the direct result of alcohol intake, according to a study in the March issue of the Journal of Studies on Alcohol and Drugs. The researchers linked alcohol abuse and the disease of alcoholism to a third of depressive episodes. These periods of depression are different than depressive episodes caused by other life events.

Experts have long known that heavy drinking can spur temporary episodes of depression while many with alcohol use disorders use alcohol to relieve depression. They self-medicate. "I don't know that the average person realizes that heavy drinking can induce mood problems," said lead researcher Marc A. Schuckit, M.D., of the University of California, San Diego School of Medicine.

Not every doctor might be aware of it, either. But it's important that he or she pay close attention to this problem, Schuckit said, because depression caused by heavy drinking has a different prognosis and is treated much differently from depression not tied to drinking. “Although the symptoms of independent and substance-induced depressions can be identical, if the sadness develops in the context of heavy drinking, the symptoms are likely to lift within several weeks to a month of abstinence and rarely require antidepressants to go away.

“It's important for doctors to consider alcohol use disorders as a possible cause of patients' depression symptoms,” Schuckit said—rather than simply "reaching for the prescription pad" and recommending an antidepressant." The patient needs to be forthcoming with information about alcohol use in order for the physician to properly diagnose the source of the depression.

The 30-year study evaluated nearly 400 men who were 18 years old at the outset. About half were at increased risk for drinking problems because their fathers were alcoholics. Over three decades, about 41 percent of the men with alcoholic fathers developed alcohol abuse or alcoholism, and nearly 20 percent suffered at least one bout of major depression. For men with alcohol problems, though, almost one third of those major depressive episodes were seen only while they were drinking heavily, not depression caused by other life events.

If alcohol is the cause, according to the journal, the depression is very likely to disappear with abstinence.
--from examiner.com (see full article)
www.alcohologist.com

Scroll down for the replay of the Dr. Jeanette Gallagher show feature with Scott Stevens. Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud can be found on www.alcohologist.com, plus the interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.  
 

SAVE THE DATE:  Scott Stevens will be part of the opening night symposium for the REEL Recovery Film Festival San Francisco.

SUNDAY SNIPPET: September 29

Alcoholism is the only disease where successfully getting it into remission relies heavily on paraprofessionals outside the medical community.  When those resources come from within the criminal justice system, the results are statistically below average, as this excerpt from my previous book What the Early Worm Gets begins to point out.

"The professionals and paraprofessionals handling the treatment are critical to the success. And to build that success you need credibility, especially because there are so many paraprofessionals affiliated with recovery. It’s their duty to adhere to a code of ethics simply not embraced in a correctional environment. Knowledge and competence—not necessarily a degree—are required, and trust. Where do those with alcohol problems place their trust? Others who have walked a mile in their shoes. Because you really don't know how it feels to be alcoholic unless you are alcoholic.  A mechanic isn’t a metallurgist even though the material with which he works with is metal. You still need a multi-disciplinary team including medical doctors or psychotherapists, however having someone who is in recovery helping facilitate the recovery process gets better results.

The most important facet of good treatment is alleviating guilt, shame and grief. We look through life’s window which can get coated with a grime of guilt and shame and grief. Those are precisely the three features the criminal justice system uses in its programs to make sure you’re sorry, make sure you know you’re sorry and won’t do it again. Positivity and attitude are the window cleaner that can clean the window of the grimy shame. The criminal justice system doesn't do windows.  They put bars on them. They will work to make sure you don’t forget your shame.

Recovery can be spontaneous. It does happen. However, true rehabilitation is based on Opus Contra Naturam—working against what comes easily— and few people are successful working against what comes easily without help.  Few people are successful for long when that help comes from a corrections environment designed to warehouse people, not provide meaningful treatment."
--from What the Early Worm Gets, pg. 73

www.alcohologist.com

 

SUNDAY SNIPPET August 25

Former boxing champ Mike Tyson's admission that he's struggled with grief and forgiveness in part of his ongoing alcohol rehab points to two of the four key stressors Every Silver Lining Has a Cloud notes as potential barriers to long-term sobriety. Of course everyone, Alcoholic or non-Alcoholic, faces these stressors.  Most handle it swimmingly well, others not so well, masking them with alcohol.  When someone with the disease of Alcoholism encounters something so strong it triggers the stress hormone cortisol, relapse is a possibility.

 

"For those on the outside of the disease, in a way, dealing with a drinking Alcoholic is easier than dealing with a sober one because with a drinking one you know what the problem is. The conversations I had with more than 200 men and women in recovery reveal what the sober Alcoholic’s problems are.

 

When the Symptoms of Sobriety appear, know they are normal responses to cortisol increase traced to these four things we struggle with in sobriety:

Guilt (Chapter Four)

Shame (Chapter Five)

Forgiveness (Chapter Six)

Grief (Chapter Seven)

 

When you take away alcohol, you still have problems—problems that non-Alcoholics sometimes use alcohol to relieve, “treat” or cover up. In an Alcoholic, these four cause relapse. They are the cloud to sobriety’s silver lining. They aren’t simply squishy, intangible emotional qualities for Hallmark cards or spiritual books. Science shows they’re states that have a concrete and measurable effect on our biochemistry.

 

Every Alcoholic has manifestations of these four and needs treatment geared toward these stressors or the treatment fails. No treatment will have lasting success without addressing what causes the Symptoms of Sobriety. To put it another way, it’s well known that high cholesterol levels increase coronary heart disease—heart trouble. Those who have a genetic predisposition for difficulty handling cholesterol frequently can forestall heart trouble with careful eating habits. A person who doesn’t have the problem handling cholesterol doesn’t have the same urgent need to restrict his diet. Eating ice cream or gorging on fries isn’t much of an issue for him but it is for the man who does have the genetic predisposition. And so it goes with Alcoholics who are stuck with a problem handling cortisol. Guilt, shame, forgiveness and grief are a threat to recovery trouble like cholesterol is a threat to heart trouble."

--from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pgs. 33-34

www.alcohologist.com

SUNDAY SNIPPET, May 19

Denial is a word tossed around liberally when it comes to the disease of Alcoholism. It's most often a reference to the very early phases of the drinking when the drinker denies (to himself) he has a problem when it is obvious to those around him he does have a problem. To get to any level of sobriety, an Alcoholic has already tackled that form of denial. What this excerpt from Every Silver Lining Has a Cloud addresses is a different form of denial that rears its head during recovery: The denial that life has, or has to, change because we lost something. It is a stage of the grief process.

 

 

“Alcoholics have a tendency to cling to their denial of their losses, not of their problem. By lingering in the stage, it only makes the cortisol worse. Even though the reason we linger in denial is simply that we don’t want to feel worse, we’re actually feeling worse because of the cortisol. To move away from more of continued Symptoms, the denial evolves into anger. Ashley Davis Prend identifies it as going from “Not me” to “Why me?” and it takes a long time.

 

“On average it takes one to three years to work through the disorganization and anger stage. That’s because you need to process the grief repeatedly so it can sink in, settling on deeper levels of consciousness over time.”

 

Simply put, you’re not going to be pissed off one time for one day, but you’re entitled to it and it is a healthy part of what comes naturally during mourning and recovery. Different anniversaries rekindle the anger. Social losses and financial ones have long tails and breed anger over and over. Impatience sparks the anger, too, because all of us Alcoholics have a little control freak in us.

 

Unfortunately, some of us never get past the anger because that’s where we lapse. We drink at the anger. Or if we don’t drink, we become what’s known as a dry drunk, a bitter and angry person who doesn’t and won’t drink. The dry drunk won’t find recovery, but will maintain sobriety because they cling to the anger. They become dry drunks because of a false sense of power anger provides. It does beat being sad. Sad feels so broken, anger feels powerful, but sadness is the next stage. Rather than moving forward, the dry drunk chooses the power of anger rather than feeling like the ornament at the bottom of the Christmas storage box. They’re usually more of a pain in the ass than they were when they were drinking.”

– from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pg. 79

www.alcohologist.com