This is probably the best video I’ve seen that describes the underlying cause that increases an individuals vulnerability to serious addiction.
George had 12 years of sobriety while focusing on his family and career. Four months ago, he got a promotion to a management position. Mary knew that now George was under much more stress. Secretly, she wondered what effects the stress would have on him. She didn’t wonder long. On a Friday after work, he went for drinks with some of the other managers. He drank more than he intended. George came home late. It was obvious to Mary that he was drunk. She felt irritated, angry and distraught. Twelve years ago, he had promised Mary he wouldn’t drink again, and now this relapse.
In the next 3 months, George had 4 more incidents. Mary had been through this before – too many times. Her anger, distress and worry slowly turned to a melancholy despair. In the privacy of her mind, Mary wondered if George’s drinking was at alcoholic proportions. Is George an alcoholic, or not?
If you’re worried if you’re living with an alcoholic, you’re not alone.
While 17.6 million Americans have a problem with the overuse of alcohol, about half of them are either alcoholic, addicted to alcohol, oralcohol dependent – the medical term. Think how many family members are affected. Although many people use the terms alcohol addiction andalcoholism synonymously, there are slight differences that are best left to a clinical diagnosis. What’s important is to learn some basic characteristics of alcoholism that you can use to help you understand your specific situation.
Alcoholism: Not a black & white science.Drinking alcohol is common in our society. Where most people consume alcohol sparingly or in moderation, others have frequent and excessive use. Over the long term, the latter can become a disease or long-term illness. There has been a lot of research on alcoholism, and we know the causes for some people, but not for everyone. There is still much to learn.
Key characteristics of alcoholism:
- Cravings: A strong urge to consume alcohol
- Loss of control: An inability to stop drinking once started
- Physical Dependence: Rapid discontinuation of alcohol or stopping cold turkey leads to physical symptoms of withdrawal] a withdrawal reaction. Physical dependence starts as a psychological dependence (compulsive need for alcohol)
- Increasing tolerance: Requiring more alcohol to get “high” than previously
Whether or not George is an alcoholic may not be immediately clear. We don’t know if he had cravings in between his 4 drinking bouts in those 3 months. But it’s curious. With 4 incidents of drinking and each one resulting in George being significantly drunk, we can suspect aloss of control and perhaps a psychological dependence. It’s important to note that a psychological dependence can unintentionally lead to a loss of control, physical dependence and increased tolerance.
Why do they do it?
Bob had difficulty walking from the bar to his car. His vision was blurred and when he spoke his speech was slurred. He forgot where he parked after being in the bar for 5 hours. He’d brag to his friends that when he’d find the car, he could drive better drunk than when he was sober.
Distorted thinking and impaired behavior becomes exacerbated.
As with Bob, after an evening of heavy drinking you’d see impairments such as difficulty walking, blurred vision, slurred speech, slowed reaction times, and impaired memory, however, even mild to moderate drinking can adversely affect cognitive functioning. Heavy drinking may have extensive effects on the brain – ranging from simple slips of memory to permanent and debilitating conditions. Exactly how alcohol affects the brain and possibilities of reversing its impact on the brain are hot topics in alcohol research today.
What’s most common?
In adults, the most prevalent brain impairments caused from alcohol are:
- Visuospatial abilities (perceiving and remembering the relative location of objects in a 2 and 3 dimensional space. Examples: blurred vision, difficulty walking, parallel parking or driving a car).
- Higher cognitive functioning (abstract thinking capabilities needed to organize a plan, carry it out, and modify it when needed. Examples: Planning to just have 2 drinks, but 2 leads to more, not planning how they’ll get home before becoming drunk, or not following through with plan).
- Prefrontal Cortex malfunctions: inability to objectively assess oneself, poor judgment, inbility to learn from experience, decreased attention span, becoming easily bored, argumentative, thin skinned, self-centered, and disorganized.
Factors that determine how and to what extent alcohol affects the brain:
- How much and how often a person drinks.
- The age at which he/she first began drinking and for how long.
- The person’s age, level of education, gender, genetic background, and family history.
- His/her general health status.
You may see the drinking problem. You may think you have good reasons to not bring attention to it:
- “It’s not that big of a deal yet.”
- “They’re improving.”
- “If I confront the drinking, it will make it worse.”
- “I can avoid difficult arguments by not talking about it.”
It may seem easier for you when you doubt a drinking problem!
My story of doubting myself
It was early morning. I was driving to the Arkansas River for a quick day long river trip through the Royal Gorge. With a truck full of rafting gear, morning music filling my ears, a smile on my face driving down the highway, enjoying a magnificent Colorado sunrise, and – Bam! I was temporarily jolted and shocked by an incredibly loud noise. But I saw nothing that explained the noise. Was I not quite awake? Had I just imagined a noise? I wasn’t sure.
I couldn’t be sure what had caused the noise and was questioning myself if a noise had even occurred. The rafting gear blocked my back window, so I wondered if the noise was caused by my tailgate falling down. I pulled over and walked to the back of the truck. No problem! Was I going crazy? Where did the noise come from? Was there even a noise? I began doubting that I had ever heard a noise. It wasn’t until I was climbing back into my truck that I noticed cracked glass in the upper right corner of my windshield.
Slowly, my mind attempted to piece things together. I had driven under a bridge. Perhaps someone had dropped a grapefruit sized rock, or was it a meteor that dropped from the sky? Whatever hit my windshield caused the noise. Hmmm. . . I looked back at the bridge I had just driven under. I didn’t see anyone. Although I couldn’t be clear about the noise, it was blatantly obvious I had a freshly cracked windshield.
My mind attempted to take me out. The noise didn’t come out of thin air. But until I saw the cracked window, my mind created stories or rationalizations about whether I heard a noise or not. Doubting or denying can become habitual.
How does this relate to doubting a drinking problem?
The above story indicates how defense mechanisms played a large role in my thinking – doubting a problem (denial) and coming up with stories that explain away the problem (rationalization). Think what happens when a drinking habit is added to the mix. Since drinking causes physical changes in the brain, the potential for denial and other defense mechanisms increase.
The problem drinker or addict can distort the thinking process – use defensense mechanisms – deceive themselves, and others around them.
You may doubt a drinking problem if you are being convinced by an addictive thinker unconsciously or subconsciously utilizing common defense mechanisms.
First: Know what a defense mechanism looks like and sounds like.
Denial – discounting our own (or another’s) thoughts or feelings finding them too painful to consider. This defense distorts reality, keeping us from feeling the uncomfortable truth about things we do not want to face. If we cannot feel or see the consequences of our actions, then we can believe everything is fine when it isn’t.
Rationalization – thoughts or feelings we find unacceptable are explained in a seemingly rational or logical manner. However, the explanation avoids or excludes the thoughts, feelings, or behavior in question. Rationalizations divert attention from what we deny.
Projection – unacceptable or unwanted thoughts, feelings, or behaviors in oneself is seen and attributed to others. This can look and sound like blame. The one blaming, denies his/her own responsibility.
Second: These defense mechanisms operate simultaneously in the same person. Projection and rationalization work together to keep that which is being denied out of awareness. Remember these defense mechanisms are unconscious or subconscious.
Third: Your defense mechanisms are impacted by their defense mechanisms.
Both the drinker and the family members have defense mechanisms that operate around the problem drinking. In a sense, there are unspoken “rules” about whose defense mechanism is going to take precedence when. A pattern develops that works for some things and doesn’t for other things. Add increased drinking to the mix and it becomes clear that the pattern that seemed to work really doesn’t. However, it’s hard to admit.
So, how can you spot defense mechanisms?
When problem drinking activates the defense mechanisms, personal responsibility for drinking decreases and defense mechanisms that deny the problem increases. Since it may be hard to tell, here’s some suggestions:
- If a person is using more than one reason for drinking, you may suspect that a rationalization is present. Beware a rationalization may sound plausible; anyone can be taken in by them.
- If you’re wondering if you’re in the midst of defense mechanisms, you probably are. First, consider your own thinking and to what degree your own defense mechanisms are operating and being affected by the drinker.
Aren’t defense mechanisms operating in most people?
Probably! Although, having defense mechanisms is not the issue. The issues are:
- Problem drinking (or any substance abuse) can over-employ the defense mechanisms, limiting one’s own ability to be aware of the problem.
- Family members can swing between making excuses for and defending the problem drinker, to avoiding the problem (rationalizing), or blaming and escalating arguments with the problem drinker (projection).
- Defense mechanisms have a tendency to increase with continued substance abuse.
How can you tell to what degree your own defense mechanisms are operating?
First, I want to be clear that when our defense mechanisms are operating it’s not a sign of weakness or failure; it’s not a diagnosable condition to cause worry. However, it is important to understand our own defense mechanism and how it works; when we don’t, we are limited by them. Our defense mechanisms limit what we will accept, what we think we deserve, what we think we can do, and what we think we can have. To grow, we constantly challenge our own defense mechanisms. When we stretch from our own limiting thinking, the world around us expands creating options we never considered.
Betty made some changes (not her real name)
Betty and Bill had been married for 19 years when they went through recovery together. They both know the walk and talk of using and sobriety, not just intellectually, but experientially. Betty and Bill had a fantastic recovery story and fulfilling life. They were successful in many ways – a successful business, 2 children, and a lavish life. About 2 years ago, Betty states, “Bill started changing” (pulling away emotionally, staying out all night, responsibilities at work went undone). Initially, Betty took over more responsibilities at work. Eventually, she noticed other changes (phone calls at odd hours then Bill would have to leave for a while, drug paraphernalia in his jacket pocket and in his car). Clues to Bill’s behavior would keep presenting themselves; Betty minimized the problem to people at work and to her friends.
Her defense mehcanisms played off Bill’s defense mechanisms – denying the problem. Eventually, she admitted it to herself. Eventually, she came into counseling, increased her strength and confidence, and coordinated an intervention for Bill to go into treatment.
Bill’s out of treatment. It’s not a silver bullet absolute solution for the future. However, Betty is getting clearer about her needs in the relationship and her future. Betty took a very difficult action out of love to support her husband’s sobriety from drugs.
You can do this too! Read more here
Maybe you’re not sure if drinking is a problem in your family. Alcohol can be in our lives without it being a problem. But can you tell when it goes from “no problem” to “problem”?
What’s the Cat in the Hat got to do with warning signs of problem drinking?
I remember when the ‘Cat in the Hat’ was at home with the kids when the mom was out. He used the bathtub only to have an unimaginable bathtub ring appear. Do you remember the strategy he used to attempt to remove this bathtub ring? He’d have a “brilliant” idea to remove the bathtub ring, at first the kids were excited with the “brilliant” ideas, but then after each attempt left more of a bathtub ring, the kids got a little more suspicious, concerned, and nervous because their mom may come home and they’d get into trouble. But they went along with it, each time with a little more hesitation.
It’s like the kids saw these warning signs, felt concerned, but because of the fast-talking of the ‘Cat in the Hat’ the kids were hesitant to trust themselves and instead trusted the that the ‘Cat in the Hat’ would fix the problem. It’s a funny kids story. But put this logic onto warning signs of problem drinking and the humor wanes.
What’s the point?
1) The problem will not magically go away like the story of the ‘Cat in the Hat.’
2) The fast-talking of the ‘Cat in the Hat’ (Problem Drinker) may sway you from trusting your own feelings about warning signs.
3) You may be so close to the situation that it’s hard to tell if there’s a problem.
4) It’s important to spot warning signs and take action to solve the problem.
What are the warning sign of problem drinking?
- Is the drinking causing or exacerbating a persistent or recurring social, work, financial, legal, or health problem?
- Has the drinker tried to cut down unsuccessfully, or once started drinking he/she sometimes loses control over the amount consumed? (Both are indicators of alcohol dependence).
- Do they continue drinking when others stop?
- Do they drink alone?
- Do they drink before a social engagement?
- Do they drink to “relax” prior to social engagements?
- Do they ever drink first thing in the morning as an “eye-opener?”
- Do you hear statements like, “I can drink a lot without it affecting me”?
- Do you suspect they use alcohol to cope with life’s problems?
- Has there been a recent increase in their drinking? (may signal other problem issues).
- Is there a family history of alcohol abuse?
All of these are warning signs to take seriously. Isolating any one of these alone or as an isolated incident doesn’t signify a problem, however put several of these warning signs together and you have a problem.
From the perspective of a concerned family member:
- Do you notice a lack of emotional intimacy or connection in the relationship?
- When you express concern does it lead to arguments?
- Are you or someone else in the family covering up for the problem drinker?
- Do you feel controlled by the situation or that your choices have been limited?
A frog will leap from a pan of hot water, but if the water is brought to a slow boil, the frog will remain until its demise.
Now that I have sufficiently terrified my animal-rights friends, let me create a deeper context for the above metaphor.
When does drinking become a problem?
Drinking becomes a problem when it negatively effects our functioning (business or employment opportunities, family, and social relationships). It’s a simple definition. But what’s not simple is defining what “problem” means. Is it black or white, where it is either a problem or it’s not? Remember the problem drinker will tend to see things in black or white – black and white thinking may be a clue.
But messages of “enjoyable” drinking saturate us from television, radio, and newspapers. It is common for many social functions to have alcohol available. Depending on the people you associate with the alcohol at social functions may be excessive or just readily available. But how do you discriminate?
Too easily discerning problem drinking becomes like the frog in the pot of water slowly coming to a boil.
Without realizing it, you are at problem levels without a reality check on the water temperature.
It’s the degrees that matter
With drinking being prevalent in our culture it’s difficult to determine the matters of degrees. There is a continuum of risk associated with different levels of drinking. Like the frog metaphor, it can be difficult to discriminate degrees of change until we’re boiling to death.
Here’s a useful model from the National Institute of Health:
At Risk (Risky Drinking)
- Currently, no negative consequences have been identified
- The risk for potential adverse consequences seems low
Mild to Moderate (Problem Drinking)
- One experiences an adverse consequence due to drinking behavior but continues anyway
Moderate to Severe (Alcohol Abuse)
- Role impairment (the drinker is having trouble fulfilling his or her responsibilities and roles as parent, worker, spouse, or other)
- Hazardous use (drinking is paired with driving, operating machinery, reckless sporting activities or something that creates an additional hazard)
- Recurrent legal problems related to alcohol
- Social or interpersonal problems due to alcohol
Severe (Alcohol Dependence)
- Increased tolerance (have to drink more to have the same subjective effect)
- Signs or symptoms of withdrawal (nausea, anxiety, sweating, paranoid, loss of memory, hand tremors)
- Drinking more or longer than intended
- Unsuccessful attempts to control use (especially when one has tried)
- Decreased activities due to alcohol (social, work, recreational)
- Drinking continues despite knowledge of physical or psychological consequences
Recognizing a family drinking problem is not always easy. When you see a problem, there’s a tendency to want to fix it. Perhaps you have already tried to fix the drinking problem. How’d it work out? As you probably know, it’s not an easy fix!
Sometimes you may think you can make someone change. You really want them to change; you may think life in the family would improve if they changed. You may be right. But fighting to “be right” may not contribute to change. If “being right” increases the level of tension and conflict, well, you may want to rethink it. I know this terrain.
A story about taking responsibility
In the middle of my life, I went back to school for a master’s degree. I remember the first assignment – writing a specific kind of academic paper. Although I knew the material well and I did enjoy the writing process, I wasn’t clear about how the professor wanted the structure of the paper.
My attempt at remedying the problem was to write the majority of the paper and send it to the professor for feedback. I emailed it to her three weeks before the paper was due. After two weeks without a response, I asked her about giving me feedback. She said she hadn’t been able to get to the paper, and probably wouldn’t. I felt jarred. My expectation was that she would help.
I finished the paper and turned it in. A couple weeks later when the papers were returned, the professor pulled me aside and said, “You need to rewrite your paper.” I was shocked. I reminded her that I had asked for feedback early; I reminded her that I didn’t get a response from her. I wanted her to assume some responsibility. I asked her to change her mind. From my perspective, she didn’t do anything I had requested. I interpreted this as her not taking responsibility. I was pissed. Despite my frustration, I needed to rewrite the paper or my grade would suffer. Read more here