Month: August 2023

Chapter 2 – “Things Can Only Get Better”

This is part of a series called “The Bottled Scream” A Disease of Self – Understanding Addiction and Recovery. To go back to the introduction click here.

Addiction

Chapter 2

Things can Ony get Better

It was only when my wife withdrew from me after she had exhausted all possibilities to try and help me—taking me to mental health professionals but with no success—that I asked her for the first time for help. It was the first time I had directly asked for help. Well sort of asked for help. I was in the bathroom under the pretext of having a bath, something I had not done in many months (I had also developed an actual phobia of water, not uncommon in alcoholics). I stood there in front of her, half naked and asked her if she thought I was a bit jaundiced, in an unusual moment of understatement.

Her face retracted with shock, she hadn’t seen me in many weeks as I lived as a crazy recluse in the attic and we rarely saw each other –  other than talking through doors and written reminders to buy wine and lots of it!  She could hear me clicking bottled wine glass and tins of beer against my teeth as I tried to drink and this had added to her general sense of revulsion and despairing helplessness. Workaholism and fitness addiction had kept her petrified mind together these last months. Most days she would retrun from work wondering if this was the day, the day in which I had finaly killed myself? What unbearable and intolerable strain she must have lived under?

“Jesus, you’re…!” she exclaimed…

“I thought so” I replied. I looked like Homer Simpson with a heavy suntan! With a massive green discoloration snaking around my neck. I already knew I was jaundiced three months earlier when the local shop owner couldn’t contain himself and shouted “look at you, are you ill man!” which is partly why I didn’t go out, the excruciating shame of that and it’s probable repeat and the increasing psychosis, of course. Plus I could barely walk anymore. I knew I was jaundiced  I just wanted Emma to know how bad it was and in realising how bad it was, offer to somehow help in a way that had yet to show itself. Or in a direction we had yet to exhaust. We had already tried various therapists to no avail. I was pretty desperate by this stage. Beyond desperation.

Plus, I also couldn’t rely on my half working eyes anymore and anyway,  I needed absolute verification. God damn it, I needed help! Needed it months ago! Things were very much worse than I thought. Which, somehow, by this stage, seemed impossible. Emma seemed spurred into action and suggested going to the GP tomorrow. The GP? I was still in psychosis and wondered if he could do a home visit?He couldn’t and the next day in the late afternoon we would drive over the surgery. Getting out of the house had become impossible I lived in fear of someone coming to our home and kept a hammer and monkey wrenches by every door and window, proclaiming to my future imaginery intruders that I was ready for them. Paranoid psychosis isn’t a lot of fun. But it is thorough and leaves you well prepared. Emma had even tried to get me sectioned, put into a mental health institution but they only accepted after suicide attempts or attempted murder and given my current weak physical state, these two scenarios seemed remote. Plus all medicines had long since been stored away by Emma, for obvious reasons.

The GP did, however, make allowance for my deteriorating mental health by suggesting I turn up after practice hours and sneak in through the back doors? This was a blessed relief not having to face the public and their horrified looks. I drank two bottles of wine and slurped down a couple of tins of the strong and disgusting German lager in the car, trying not to throw up, as we waited to be sneaked in to the surgery via the tradesman’s entrance. Emma helped me walk to and in through the back of the surgery where the GP met us.

He listened in some incongruity to us explaining how my drinking had got out of hand, probably spurred on by my tough childhood, my mental health problems and so on. He seemed defensive, his arms across his chest. He was resisting our prognosis. He listened but didn’t seem convinced by our reasons for my drinking so much and bluttered out quite brutally.

“You are an alcoholic man! “Plain and simple, and if you keep drinking like this, you will be dead in a few months!”

Emma and I looked at each other. Of course, he was right. It seems so obvious now but at the time it was an epiphany. Of course I was a bloody alcoholic. I was physically addicted to alcohol, for some that would have been a bit of a giveaway but strangely not me, or, even more strangely, not Emma? A strange fog had settled on her thinking too. The panic attacks and the physosis and muddied the water. How come we hadn’t worked this out ourselves? It was now so obvious.

I wondered why the Drug and Alcohol Centre hadn’t released this too? I had turned up to the noon meeting having drunk two bottles of wine? Some would have seen this as a clue to potential alcoholism? More important than those underlying conditions, they kept talking about. Or the two therapists I had seen over the last three years. One who had seen me for two years and then when I returned subsequently for therapy, told me I didn’t have enough brain left to continue therapy (and how later would say me in recovery if I had suddenly decided to be a good boy when she learnt of my recovery!) and another who insisted I listen to white noise around the clock to treat the trauma that was obviously leading to my excess drinking. Obviously, it increased my drinking. Didn’t people know anything about alcoholism or addiction? How could the therapeutic world be so ignorant. Almost willfully ignorant!

Another terrible irony of this whole scenario, is that the GP I saw was only filling in for my usual local GP, who had failed in seven years to realise I was alcoholic, choosing instead to treat me with anti depressants for my depression and anxiety! If he had been there that day, I wouldn’t be here today. That is the terrible truth! He would not have said what this GP had just said, that I was an alcoholic! He probably would have tried to give me more medication. In the months that followed, he would try to dissuade me going to a local 12 step facilitated treatment centre because he thought it was too draconian. Not as draconian as chronic alcoholism though!? He, like most of the so-called professionals I saw, would treat me for something other than alcoholism, wondering if my drinking was linked to some other mental health issue.

They all failed to see that the mental health issue that I was suffering from, and that was going to kill me quicker than any other possible disorder, was my chronic alcoholism, my chronic addiction. I wouldn’t have any chance of treating any other mental health issue unless I dealt first with my addiction to alcohol. I still contend today that those individuals with addiction do not get any less addicted when they have treated other co-occurring conditions. The severity and complexity of their addiction may alter but they will remain addicted people in recovery.

As I show later treating these other conditions helps tremendously with recovery form addiction. I hope to explain, one condition feeds into another and they all have to be treated in the whole. Starting with addiction first! Start with the condition most like to kill you, and work backwards from there!  

Chapter 1 “Rock Bottom”

This is part of a series called “The Bottled Scream” A Disease of Self – Understanding Addiction and Recovery. To go back to the introduction click here.

Addiction

Chapter 1

Rock Bottom

My alcoholism almost killed me. I had spent the last nine months in alcoholic psychosis, the so-called DTs (delirium tremems) hallucinating, drinking and vomiting, repeat.

I could hardly get the drink to my mouth with my violently shaking hands. Tin and glass, cracking against my teeth. I was so jaundiced my neck had turned a dark sickly shade of copper green! My eyesight deteriorated to such an extent, that it was about like straining to see through scratched plastic glass. Eyesight is linked to liver and my fatty liver had reduced by eyesight by half.  

I was so weak from drinking, not eating, a 8 and half stone weakling, who had to stop on the stairs, every three steps, to rest and start again. Sleep had been replaced by twenty minute snoozes, awoken by terror and the dripping sweats. How the hell had it come to this?

I had planned none of it. I thought of death and of suicide. There was a place worse than dying and I had somehow ended up there. All plans on killing myself foundered on my angrily held assertion to myself that I hadn’t asked for any of this. None of this was my fault! That indignation was as close as I could get to hope, which had recently left home. I drank because of my bloody tough upbringing, didn’t I, and that wasn’t my fault either? Many had had similar upbringing and they weren’t slipping down the plughole along with my stomach-heated up wine? Why me? Why the hell was I in this hellish hole of despair and utter defeat?

Worse still the drink had stopped working, only staving off the full horror of the hallucination and preventing me from having the alcoholic fit that would kill me.My wife would travel to the shops, reluctantly buy grates full of cheap Spanish wine and almost undrinkabe German lager that tasted like liquid Gorgonzola, unwittingly keep me alive. We were both ignorant of the reality that any prolonged period without drink could have killed me. That a diversion from the straight road home, after shopping , or a car accident,  or some other unavoidable occurrence that slowed the delivery of my alcohol, could have killed me via an alcoholic seizure.

My wife hated spending all that money on drink that rarely stayed long in my stomach. People would shout over to her as she waited at the till “Having another party!?” Little did they ever know how far they were from the truth.

Read more about Rock Bottom in my earlier Blog Post from 2016 “Do we Really have to Hit Rock Bottom to Recover?” here

“The Bottled Scream” A Disease of Self – Understanding Addiction and Recovery

Introduction

Getting To the Root of All Our Troubles

I was born into trauma and know no different.

Trauma, with a helping of genetic disposition, gave birth to addiction and alcoholism which it then used to try and kill me. It led be to a place that I strongly believe was worse than dying. Eventually it has led to a place, and a way of life, which I would have scarcely believed existed.

This is a book about my journey though alcoholism, addiction, complex PTSD ( and related OCD) and my continued recovery from these conditions, via 12 step recovery and treatment centres, neuroscientific research and trauma therapy. It is about how I have survived addiction and, at times, recovery.

Recovery can kill you too; other peoples’ views and understanding of alcoholism has a bearing on whether you live or die. Their lack of understanding about co-occurring disorders can too. This may be unpalatable to some but it doesn’t make it less true. These people can include fellow recovering people and recovery groups (while acknowledging their crucial role in recovery), medical professionals, those working in treatment, your loved ones and many other professionals who deal with addicted individuals on a daily basis and the media.

The more each of these groups know more precisely the nature of addiction, what caused it and how this can be recovered from, via specific and appropriate, sometimes individualised, treatment, the better they can help people in recovery.

We tend to blame addicted individuals for not recovering rather those helping to treat them or giving medical advice.  Or those whose responsibility it is to provide clear understanding into the nature of addiction. Society continues to create stigmas in the absence of a common knowledge about these conditions. Stigmas blossom in ignorance.

Clarity of understanding leads to a compassion that simply wilts in it’s absence.

I have experienced much of this ignorance in my own recovery and have been moved to challenge it now in this book. I have found medical and treatment professionals and those in recovery to be lacking in precise definitions and the consequences are profound. It seems that the precise definitions of other chronic diseases, seen elsewhere in medicine, is somehow not as important in addiction, a condition that remains one of the worst killers.

So let’s start here with a clear definition of addiction and what causes it and then show how this manifests in the life of one alcoholic/addict.

Addiction is the progressive impairment of self control (regulation). This can be mapped in the brain and addiction has a brain signature.

It is driven, to endpoint addiction, by the effects of emotion/stress dysregulation (which itself is often prompted and often sustained by negative self schema, often post traumatic ) on reward (motivation) dysfunction.

In simple terms, most addicted individuals cannot process emotion properly and this causes them to flee feelings by substituting unpleasant, undifferentiated, feeling states with more controllable feelings of pleasure and relief from aversive feeling states. It represents the “fixing of feelings” externally, outside of self, as opposed to emotions being processed internally, in the brain . This is negative and positive reinforcement combined at the very onset.

This represents a defective and disordered survival network, an embryonic neurobiological disease state, as it represents a disorder of function, emotion processing, which will eventually create  a distinctive group of neurobiological changes, and thus, unwittingly, create the fertile ground for later addictive behaviour.

As emotion/stress dysregulaton escalates, the inital prompting of impulsive behaviour increasingly becomes compulsive addictive behaviour as increasing and continual levels of distress increase reward dysfunction and a patholical wanting (needing) results.

At the endpoint of addiction, the rewarding and relieving effects of addictive behaviour diminish in relation to chronic distress levels and even increasing levels of addictive behaviour no longer have sufficient effect on what often becomes compulsive behaviour; this automatic behaviour to relieve chronic distress yields increasingly diminished returns.

The addictive behaviour as “solution” profoundly diminishes while the “problem” of chronic emotion/stress dysregulation escalates.

Recovery is often particularly viable at this point and needs to address the cessation of the former “solution” with treatment of the underlying problem – emotion/stress dysregulation, the pathomechanism of this addictive behaviour.

This emotion disorder and thus impairment of self regulation, often born out of genetic disposition and/or environmental trauma, is the pathomechanism that drives addictive behaviour, not only in substance addiction but also in behaviour addictions. It can be diagnosed, it can be tested for. It need not be shrouded in mystery.

It need not be endlessly argued over. It is inherent in most addictive behaviour and it can be easily treated.

In this book, I will show how I came to be in recovery after almost dying from alcoholism. I will show my struggles in recovery and with the recovery programmes I have followed.

Leaving the 12 step recovery that saved my life, and which still offers me a template of recovery today, was very frightening but I felt I had no choice. Through neuroscientific research and, eventually, trauma therapy, I have been like a detective piecing the clues together to better understand my condition. To understand how I ended up the way I did. It has not only helped me more clearly understand my addiction, and the trauma that partly underlies it, but it has often saved my life.

The outside help I received in addition to 12 step recovery has not been an adjunct to addiction but has shown me the fertile soil in which my addiction grew. It showed me what partly fuels my addiction today, seventeen years into recovery. It shows me why my addiction still continues to be progressive, even in recovery.

Recovery has been discovery, often thrilling, often terrifying. It continues to be so today. Let me take you on that journey from despair to hope, from ignorance to understanding.

Let me take you through my traumatic childhood and life, through alcoholism and addiction to recovery. Through 12 step recovery and treatment to the research and trauma therapy to a new understanding that reconciles all treatment and arms it with greater clarity and understanding.

Structure of this project This book is split into three distinct parts – Addiction, Trauma and Recovery. These can be read separately, in order, or not, or concurrently. They interweave in their influence on my addiction and recovery. One feeds into the other, as in real life. In both parts I will marry my anecdotal and neuroscientific research into the nature of my addiction.

In this first part I will share my journey into recovery from chronic alcoholism, looking at what happened to bring me into recovery and what has happened in the seventeen years of my recovery

In recovery, I have journeyed through six years of 12 step recovery and AA anecdotal wisdom about addiction and recovery to twelve years of neuroscientific research into understanding how the brain changes as a result of addiction and what, in addition to substances, accounts for this dramatic change in how the brain controls our behaviours. 

Via this research where early understandings of addiction have been both complemented and challenged, resulting in a clearer insight into how addiction can effectively be treated.

Although this research gradually saw me gradually move away from 12 step recovery (although I still follow the steps on a daily basis) , my research also shows, in a more profound way, how this type of recovery is key to helping addicted individuals recover.

Finally the experiential wisdom of 12 step recovery has become more effectively married to the most recent neurosicentific research so I believe it is time, as Bill Wilson, co-founder of Alcoholics Anonymous, once declared, to be “friends with our friends”.

In fact, Bill Wilson has been a constant inspiration for me in my research, he was constantly striving learn more about addiction via his work with academics and would be, no doubt, fascinated by what neuroscience has unearthed about this strange illness of mind and body. He was also worried that 12 step recovery was based on a book “frozen in time”; I hope to unfreeze some of our understanding in this book. In the Big Book of Alcoholics Anonymous it also suggests people in recovery should get “outside help” for conditions other than alcoholism, or co-occuring conditions as they are called today.

After ten years, I found that I needed to get treatment for Complex PTSD and attachment trauma as they were threatening my recovery. Thus the second part of this book is dedicated to Trauma and starts with my experience of trauma from childhood onwards until I started treatment for it at the age of 48 years old, ten years after seeking recovery from chronic alcoholism.

I will then explain the treatment I had before taking you on part of the actual therapeutic journey I undertook to get more healed. This is the part of my “experience , strength and hope” sharing how trauma, in the fertile soil of family addiction, led to my later chronic alcoholism. The complexity and severity of my alcoholism was caused by Complex PSTD and it’s treatment has greatly reduced the severity and complexity of my alcoholism while in recovery.

Although alcoholism and trauma are two tributaries running into the same river, I hope by clearly delineating them, the reader, and those who suffer from similar co-occuring conditions, can more clearly see how they influence each other and how they may need, at times, separate, and common, treatment in recovery. The treatment of one affects the recovery of the other has been my experience. This is my message of hope to you.

This is a work in progress and I am adding chapters all the time. I’m afraid that my chapter numbers might change or just be plain wrong as I revise the text. I will try an keep up double checking the indexing but organisation is a weak point of mine, so please bear with me!

Here a few links to posts on the following:- Addiction, Trauma and Recovery.