SUNDAY SNIPPET: December 1

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

 

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: Shaming leads to poor outcomes, relapse

Shaming someone with the disease of alcoholism or another substance abuse problem is a centuries-old practice that does nobody any good (except maybe the shamer, in a warped sort of way).  Science backs that up now, too, as this piece from the alcohol research news archive points out.

To predict whether an alcohol abuser or someone with the disease of alcoholism will hit the bottle again, ignore what they say and watch their body language for displays of shame, a University of British Columbia study finds. The University introduced its research in a news release February 4 in advance of publication in Clinical Psychological Science journal.

The study, which explored drinking and health outcomes in newly sober recovering alcoholics, is the first lab work to show that physical manifestations of shame – from slumped shoulders to narrow chests – can directly predict a relapse in people who struggle with substances.

“Our study finds that how much shame people display can strongly predict not only whether they will go on to relapse, but how bad that relapse will be – that is, how many drinks they will consume,” says UBC Psychology Prof. Jessica Tracy, who conducted the study with graduate student Daniel Randles.

Forty-six drinkers completed questionnaires about their physical and mental health while Tandy and Randles assessed their body language — finding unconscious physical mannerisms are a powerful sign of future relapse, while the written expressions of shame offer almost no clues. Tracy says the amount of shame displayed was directly tied to the number of drinks an alcoholic will have on that first binge after giving up sobriety.

The issue of shame is one of the four largest emotional situations tied to relapse. This may be the first scientific study to empirically link shame and drinking, however the concept has been around a long time, dating back to the work of psychologist John Bradshaw in the 1980s in his Healing the Shame that Binds You. According to the new relapse book, Every Silver Lining Has a Cloud, “The inability of an alcoholic to deal with the social stigma attached to the disease of alcoholism can be countered by group counseling and group self-help, e.g. Self-Management and Recovery Training (SMART) or 12-step groups, such as Alcoholics Anonymous. In any of those group environments, those attempting recovery see and accept they are not alone, that others feel the shame, too, and by talking through the emotional stressor they can stay sober.”

The UBC findings have important implications for people struggling with addictions, their friends and families, and researchers and clinicians who study emotion and addiction, the researchers say. “The research is also important in light of the fact that some policymakers and judges have argued for the use of public shaming as a punitive measure, or treatment, against crime. Our research suggests that shaming people for difficult-to-curb behaviors may be exactly the wrong approach to take,” Tracy and Randles argue. “Rather than prevent future occurrences of such behaviors, shaming may lead to an increase in these behaviors.”
-- from examiner.com (see full article)
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. 

SUNDAY SNIPPET: November 24

Alcoholics drink that first drink for many of the same reasons non-alcoholics do: among the reasons is to relieve stress. Non-alcoholics can stop, alcoholics cannot, after the first drink. Chapter Two covers stress and cortisol and their relation to relapse, plus the new research revealing how the stress hormone alters the perception of and reaction to stress in those with the disease of alcoholism.


"The stressors some Alcoholics pile up over periods of sobriety aren’t the small day-by-day stressors like coffee spills on new carpet. They’re the four major category stressors covered in chapters four through seven.  The longer you spend in prolonged stress with the cortisol rioting through you, the more intense your feelings of helplessness and, sometimes, emotional numbness. You at times feel like you’re just going through the motions. Things “normal” people drink to forget. 

 

Adrenal glands secrete the stress hormone cortisol and, like the rest of the body, are not designed for prolonged stress according to Dr. Aphrodite Matsakis (I Can’t Get Over It, New Harbinger Publications, Oakland, CA 1992). “The adrenals can be permanently damaged leading to overfunctioning during subsequent stress. If you were subjected to repeated or intense trauma or stress, certain biochemicals may have been depleted.”

 

In a famous series of experiments conducted by Martin Seligman in the 1970s, animals were subjected to electrical shocks they could not flee no matter what they did or did not do (Helplessness: On Depression, Development and Death, W.H. Freeman, San Francisco, CA 1975). They fought at first. Later the animals became listless when shocked. This was phase one. In Seligman’s second phase, the animals were shocked again but could prevent the zap by pressing a button. They didn’t. They were too changed biochemically to take a simple action to end their suffering. Bessel van der Kolk (in Journal of Traumatic Stress, Vol. 1, 1988) followed up the Seligman work and concluded the shocked creatures had the same biochemical imbalances as humans enduring prolonged exposure to stressors.

With people though, human nature dictates that we try to avoid or escape anything to do with the stressor. Someone might, for example, avoid driving a car after the stress of a car wreck. That is a single, short-duration stressor. An Alcoholic, like Seligman’s experiment subjects, has multiple stressors of long duration. And you can’t run from them all. Like the two experiments convincingly demonstrated, there’s a point at which we don’t even save ourselves. Alcohol becomes a cheap, fast, easy, available escape.

 

Initially as we begin abstinence, we’re told to save ourselves from triggers. People. Places. Things. And the things in slogan-happy and acronym-rich rehab we call HALT: being Hungry, Angry, Lonely or Tired. Research demonstrates that those triggers lead to lapse because you are not thinking your clearest thoughts. When your stomach growls the oldest parts of the brain focus your body’s resources on food. If you’re focused on food, you’re not focused on sobriety, the thinking goes. You’re juggling sobriety’s apples and hunger throws you a chainsaw. When you’re tired, your thinking is blunted by your need for sleep. When you’re angry or lonely, you may prioritize resolving those emotions rather than concentrating on sobriety. HALT is a good starting point. The objective is to stay out of harm’s way. Avoid. But the four major stressors knocking our cortisol out of whack and leading to lapse, you cannot avoid. We need to instead alter our reactions to them.”

– from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pages 29-30

 

The first drink is the ESC key for the big stressors in the book, even for infrequent drinkers.  Alcohol has managed to remain popular for millennia for that reason despite troubling social or physical outcomes from alcohol misuse. For non-alcoholics, stopping after that first drink, after hitting the ESC key, isn't an issue.  All bets are off for the Alcoholic after the first drink to break the stress.  That isn't to say violence or illness is inevitable for that episode, just that stopping at one drink is not an option.  Many drinkers have tried and failed that simple test.  After the first one, it's like trying to slam a revolving door.
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: Understand relapse, because it's not at all uncommon

A man I've come to admire in recovery, Bill, relapsed four times in 22 months. It's part of having a chronic disease as this article from the alcohol research news archive points out.  However, so is bouncing back from relapse part of having a chronic disease.  Bill relapsed four times, but gave sobriety a fifth try.  His name: Bill Wilson, one of the founders of the 12-step group Alcoholics Anonymous. Whether or not you subscribe to AA's methods, here is some of the science behind relapse.

Ozzy Osbourne recently suffered a relapse and has admitted to drinking alcohol and taking drugs in the last 18 months. The solo artist and Black Sabbath frontman confessed on his Facebook page April 15 that he was “in a very dark place” and has apologized to his family for his “insane behavior.” He reports he has now been sober 44 days since ending his relapse.

Relapse – a return to a pattern of drinking – is very common among those with the disease of alcoholism. Relapse is considered by most counselors to be part of the recovery process, yet some cynically state that relapse isn’t part of recovery it’s part of drinking.

Terence Gorski, author of Staying Sober, notes “you cannot experience recovery without experiencing a tendency toward relapse.” Louise Bailey Burgess, author of Alcohol and Your Health adds, “Unfortunately, despite desperate determination, the depressing fact remains that not more than 50 percent of those who decide to quit, manage to attain sobriety for the rest of their lives.”

Neuroscientist George Koob of the Scripps Research Institute, in the public TV special "Close to Home: Moyers on Addiction," puts the number at 80 percent of those who have detoxed relapsing within the first year. Yet another expert, Michael Dennis of Chestnut Health Systems says in HBO's, "Addiction: Why Can’t They Just Quit?" “Seventy percent of patients relapse after the first time getting help. It’s not like fixing a broken bone.”

The 2013 book Every Silver Lining Has a Cloud puts the number at nine of 10 sober alcoholics returning to alcohol at least once, noting relapse isn’t even unique to alcoholics. "People with chronic depression have a relapse rate also at 50-80 percent. High blood pressure patients only have to keep taking their meds—a really simple task compared to staying clear of alcohol—and their rate of non-compliance is as high. Patients with seizure disorders: Same thing. Diabetics? Ditto . . . high rate of relapse/non-compliance. Asthmatics are even worse. Relapse is a part of having a chronic disease."
-- from examiner.com (see full article)

Studies completed in 2012 and reported in my book point to an elevated level of the stress hormone cortisol in practicing and recovering alcoholics are a key part in relapse.  Too much cortisol creates an exaggerated startle response, confusion and mood changes like irritability. These non-physiological reactions to cortisol have a direct connection to lapse/relapse and are to what I’m referring when I use the term Symptoms of Sobriety.

Ironically, research from the University of Chicago showed conclusively what does block cortisol. Alcohol. “Alcohol can decrease the cortisol the body releases to respond to stress,” says Emma Childs, a research associate at the university quoted in Alcoholism: Clinical and Experimental Research, October 2011. That’s one of the many paradoxes of alcohol and the Alcoholic: The quick, easy solution to cortisol giving you the Symptoms is to drink. After all, relieving stress is the number one or two reason most people, including non-Alcoholics, drink. Lapse or relapse is, obviously, a ridiculous alternative that only makes the stress—and the cortisol—worse in the long term. In the hand of an Alcoholic alcohol is no answer, it is a question: “What do you feel like losing today?”
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. 

Purple with a Purpose: Alcohol misuse ups pancreatic damage, especially in men

People wearing purple Nov. 22 are doing so in support of Pancreatic Cancer Awareness Month. One of the easiest ways to reduce the risk of pancreatic disease and cancer is to cut back on the alcohol or stop all together. Alcohol abusers and those with the disease of alcoholism are 1.6 times more likely to develop pancreatic cancer, the most fatal of cancers and one of the hardest to detect.

Pancreatic cancer is currently the fourth leading cause of cancer death in the United States, but is expect to become the second in 2020. According to the Pancreatic Cancer Action Network, 45,000 Americans will be diagnosed with the disease this year alone.

Pancreatic cancer is more common in men than women, however it has recently moved from the tenth to the ninth most common cancer in females. As an additional shot across the bow for men: University of Pittsburgh School of Medicine researchers isolated a gene variant in men that puts those who drink heavily at risk for pancreatitis. While painful and treatable, long-term pancreatitis has been linked to cancer of the pancreas.

The researcher’s report, online in the journal Nature Genetics, found the genetic defect in half the men with chronic pancreatitis.

Pancreatitis is a disease in which the pancreas becomes inflamed. Acute pancreatitis occurs suddenly, with severe upper abdominal pain and can be a serious, life-threatening illness if not treated. The most common symptoms of pancreatitis acute abdominal pain, pain radiating into the back, nausea, vomiting and fever. The symptoms may last for a few days then disappear off and on.

Alcohol abuse and alcoholism are risk factors for developing the disease of pancreatitis, but the new research shows men with a flaw on the X chromosome are more likely to have pancreatic troubles if they drink heavily. Women with the same flaw were not as likely to get the disease. The study suggests the second X chromosome in women protects them, while men have only one X chromosome and a Y.

The gene doesn’t cause pancreatitis but increases the risk in drinkers.

“The discovery that chronic pancreatitis has a genetic basis solves a major mystery about why some people develop chronic pancreatitis and others do not,” study lead author Dr. David Whitcomb, professor of medicine, cell biology and physiology, and human genetics, said in a university news release.

“We also knew there was an unexpected higher risk of men developing pancreatitis with alcohol consumption, but until now we weren’t sure why,” he said. “Our discovery of this new genetic variant on chromosome X helps explain this mystery as well.”
(from examiner.com -- see full article)
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.

Five considerations about alcohol and the holidays

For those in recovery, sober is the only way to do the holidays.  For non-alcoholics, here's some food for thought...

Nearly half of annual domestic sales of wine and roughly 40 percent of higher-priced spirits are sold in the final three months of the year as consumers tend to drink more and buy alcoholic beverages as gifts or to bring to holiday parties and other special occasions. Then there are the office parties and gatherings of family and friends.

For many, abstinence is a year-round plan, and for those who may be concerned about their drinking, here are five fast facts about the season of drinking that demonstrate the value or moderation or abstinence.

Parents, not peers, set drinking examples. Much of parental alcohol abuse or the disease of alcoholism is only occasionally visible to the world outside the family. However, children get their attitudes toward alcohol by observing how the adults around them behave while drinking. Christmas can be stressful. Getting home, complaining to our partner and having a drink seems normal. But stop and think what that might be teaching your children – that alcohol is a coping mechanism.

Drink responsibly – you don’t have to finish the bottle just because it’s open, or even drain your glass. Know your limit. Once you’ve reached it, set the example. Also, when planning a family celebration where teens might be present, try to reach an agreement on rules for them beforehand. Don’t feel pressured to let your teen drink if you’ve already decided they shouldn’t drink before a certain age. And don’t feel hypocritical for drinking when you’ve told your kids they can’t. Explain that alcohol is for adults because their bodies have finished growing, and even then, there are laws about drinking and driving. (See nine more alcohol tips for holiday parenting.)

Alcohol adds calories. Many Americans worry about the extra calories from that green Jello stuff or slab of pumpkin pie. Put down the extra glass of wine and save yourself about 200 calories. If you drink a glass of wine before dinner, another glass with dinner and a sweet wine for dessert, that’s more than 400 calories in addition to the meal. If three beers help that dry turkey seem more palatable, that will add an extra 450 calories. (See more in this related examiner.com article.)

Company parties are back. A recent survey by executive search firm Battalia Wilson found that 91 percent of the companies polled will have holiday parties this year, a significant increase from last year’s low of just 74 percent. If you’re a business owner hosting a party, you have liability. For a former drinker struggling with sobriety, there is no shame in skipping a bash. Otherwise, if you’re an attendee, ginger ale looks just like a cocktail and may keep you from legal trouble on the roads, because…

More people get in collisions during the holidays. Twenty-five people die on an average day in alcohol-related crashes. Between Thanksgiving and New Year’s, the average spikes to 45 alcohol-involved traffic deaths daily. December is Drunk and Buzzed Driving Month to emphasize the dangers of drinking and driving during the travel- and celebration-intensive season. Motor vehicle violations involving alcohol increase an average of 54 percent after Thanksgiving. Twelve hundred Americans will die on the roads this month from intoxicated driving crashes. The numbers are higher in years when Christmas and New Year's land on a weekend, which they won’t this year.

Alcohol-related violent crime increases in December. The Department of Justice reports alcohol-related violent crime is highest in December compared to the rest of the year except July – which is a statistical tie. One-third of state prisoners and one-fifth of federal prisoners report alcohol use at the time of the offense. Twenty-one percent of federal prisoners serving time for a violent offense reported alcohol use at the time of the offense. An earlier study in 2008 by Pew Research revealed that 25 percent of state prisoners given a standard questionnaire to screen for the disease of alcoholism tested positive.
--from examiner.com (see full article)
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. 

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.