Acceptance is Always the Key!

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Glad to see other people have the same markings on their Big Book too! I have the same fluorescent yellow marker pen scrolls and deep pen lines across the page and under the words.

I was so desperate not to let a word go by, and to understand everything the Big Book of AA has to teach about alcoholism and the solution to it that I tied my developing understanding to the pages with yellow and black ink lines. Often returning to also add these #s and to note well, NB!

Every time I read it I got new understanding. The longer I have gone on in recovery the more I have seen and understood.

Reading the BB over the years help me see how my brain is recovering as I see things more clearly with every passing years. It reminds me of previous times when I have read it, gives me a memory snapshot of where I was at in previous periods of recovery. What I used to think and feel compared to what i think and feel now. What I agreed with then and what I disagree with now.

How I have healed.

It is strange how I see other things, not underlined, as gaining more in importance as recovery goes on.

This excerpt above is from a “share” or a personal story at the back of the Big Book. The story is known by two names, “Doctor, Alcoholic, Addict” or “Acceptance was the Answer” depending on which edition you bought.

It is referred to so often in meetings that it is almost a supplement to the first 164 pages.  It has common sense words of wisdom which can greatly help with your recovery – I keep returning to it over and over again.

Here is a link to it, have a read and hopefully it will help you in the same profound way it helped me and millions of others!

It is the last story in this section –

Here he is speaking at an AA convention. I have found these “shares” crucial to my own recovery in terms of  identifying with other other recovering alcoholics.

It is in listening to their shares that I could see that I am like these people and they act in a way I do, feel in a way I do, think and make decisions in a way I do and even have had experiences throughout their lives and drinking careers which are also so like mine so I guess I figured that  I must be a sort of alcoholic like all these people.

Maybe I was an alcoholic too!?


The journey in recovery often starts with identifying with others, their problems and how they have solved their problems.

I hope it does for you too!

My very first meeting I identified with the AAs talking about how difficult they found living life on life’s terms, their emotional disease etc. It was this that convinced me I was like them. Not the drinking or drugging, but the internal spiritual malady, the ISM that goes with the alcohol to create alcoholism.

Identifying with others like me, saved my life and is the reason I have been recovery ten years.

You are not alone.

How Stories Transform Lives

When I first came to AA, I wondered how the hell sitting around in a circle listening to one person talking, and the next person talking and …. could have anything to do with my stopping drinking?

It didn’t seem very medical or scientific? Did not seem like any sort of treatment?  How could I get sober this way, listening to other people talking?

It didn’t make any sense. Any time I tried to ask a question I was told that we do not ask questions, we simply listen to other recovering alcoholics share what they called their “experience, strength and hope”?

How does this help you recover from one of the most profound disorders known, from chronic alcoholism?

I did not realise  that this “experience, strength and hope” in AA parlance, is fundamental in shifting an alcoholic’s self schema from a schema that did not accept one’s own alcoholism, to a self schema that did, a schema that shifts via the content of these shared stories from a addicted self schema to recovering person self schema.

Over the weeks, months and years I have grown to marvel at the transformative power of this story format and watched people change in front of my very eyes over a short period of time via this process of sharing one’s story of alcoholic damage to recovery from alcoholism.

I have seen people transformed from dark despair to the  lustre of hope and health.

One of the greatest stories you are ever likely to hear and one I never ever tire of hearing.

Through another person sharing their story they seem to be telling your story at the same time. The power of identification is amplified via this sharing.

If one views A.A. as a spiritually-based community, one quickly observe s that A.A. is brimming with stories.

The majority of A.A.’s primary text (putatively entitled Alcoholics Anonymous but referred to almost universally as “The Big Book,” A.A., 1976) is made up of the stories of its members.

During meetings, successful affiliates tell the story of their recovery. In the course of helping new members through difficult times, sponsors frequently tell parts of their own or others’ stories to make the points they feel a neophyte A.A. member needs to hear. Stories are also circulated in A.A. through the organization’s magazine, Grapevine.

But the most important story form in Alcoholics Anonymous describes  personal accounts of descent into alcoholism and recovery through A.A. In the words of A.A. members, explains “what we used to be like, what happened, and what we are like now.”

Members typically begin telling their story by describing their initial involvement with alcohol, sometimes including a comment about alcoholic parents.

Members often describe early experiences with alcohol positively, and frequently mention that they got a special charge out of drinking that others do not experience. As the story progresses, more mention is made of initial problems with alcohol, such as job loss, marital conflict, or friends expressing concern over the speaker’s drinking.

Members will typically describe having seen such problems as insignificant and may label themselves as having been grandiose or in denial about the alcohol problem. As problems continue to mount, the story often details attempts to control the drinking problem, such as by avoid-ing drinking buddies, moving, drinking only wine or beer, and attempting to stay abstinent for set periods of time.

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The climax of the story occurs when the problems become too severe to deny any longer. A.A. members call this experience “hitting bottom.”

Some examples of hitting bottom that have been related to me include having a psychotic breakdown, being arrested and incarcerated, getting divorced, having convulsions or delirium tremens, attempting suicide, being publicly humiliated due to drinking, having a drinking buddy die, going bankrupt, and being hospitalized for substance abuse or depression.

After members relate this traumatic experience, they will then describe how they came into contact with A.A. or an A.A.-oriented treatment facility…storytellers incorporate aspects of the A.A. world view into their own identity and approach to living.

Composing and sharing one’s story is a form of self-teaching—a way of incorporating the A.A. world view (Cain, 1991). This incorporation is gradual for some members and dramatic for others, but it is almost always experienced as a personal transformation.

So before we do the 12 steps we start by accepting step one  – We admitted we were powerless over alcohol——that out lives had become unmanageable –  and by listening to and sharing stories which give many expamples of this loss of control or powerlessness over drinking. .

Sharing our stories also allows us to stat comprehending the insanity or out of contolness (unmanageability)  of our drinking and steps us up for considering step 2 –  Came to believe that a Power greater than ourselves could restore us to sanity – through  to step three, so the storeies not only help us change self schema they set us on the way to treating our alcoholism via the 12 steps.

In these stories we accept our alcoholsimm and the need for persoanl, emotional and spirtual transformation. The need to be born anew, as a person in recovery.


1. Humphreys, K. (2000). Community narratives and personal stories in Alcoholics Anonymous. Journal of community psychology, 28(5), 495-506.




This week saw Alcoholics Anonymous celebrate it’s 80th Birthday.

Many media outlets have stated that AA was founded 80 years ago but this is not correct.

AA was co-founded 80 years ago when Bill Wilson passed on a message of hope to Dr Bob, or Dr Robert Smith to give his full name.

Dr Bob like Bill Wilson had intermittently stayed sober via involvement with the Oxford Group but they had always relapsed back to drinking.

When Bill Wilson first met Dr Bob he convinced him that he had a spiritual malady coupled with a abnormal reaction to alcohol, which meant he could not control the amount he would drink and could not control when he was going to drink, he had, in effect,  become powerless over alcohol and only help from a power greater than himself could help him.

The original power greater than himself, as for millions of alcoholics  over the last 80 years (and for some it stays this way) is another alcoholic. One recovering alcoholic or a group of recovering alcoholics is a power greater than oneself.

The message of recovery is usually from someone who has recovered from alcoholism, this is a power greater than yourself as he/she has used certain tools to recover and this is now being passed on to you, as they were passed onto him or her. The solution to your alcoholism is the same as the solution to their alcoholism.

There are no individualistic programs or people simply doing their own thing, it is a collective program of action.

Thus at the heart of AA is one alcoholic helping another get sober. It is a reciprocal relationship. Helping other get sober helps us stay sober too.

It is the most perfect win-win situation.

The wounded healer principle personified.

Bill Wilson had got this idea of abnormal, or allergic reaction to alcohol, from a physician, Dr Silkworth,  who had treated him at Towns Hospital.  It seemed to account for his uncontrolled drinking.

Dr Bob did however relapse again soon after receiving the message from Bill Wilson, briefly, and this only served to reinforce his view that Bill Wilson was correct about this abnormal reaction to alcohol and his inability  to continue not drinking  under his own steam.

Today this would be termed “despite negative consequences”.

Hence his first day of sobriety is taken as the first day of AA, although the AA organisation as we know it today took longer to come in to being.

It symbolizes that this was the day when one alcoholic helped another alcoholic achieve lasting sobriety.

Dr Bob, it is aid, went on to help over 5,000 alcoholics achieve sobriety and died sober.

The basic tenet of this, is that it takes one alcoholic to help another alcoholic achieve sobriety. This has been borne out in millions of cases around the world.

Millions of lives have been saved not to mention the lasting benefits it has brought to families, and societies once harmed by alcoholism.

When asked what he thought was the greatest accomplishment of the 20th century, Henry Kissenger replied, “Alcoholics Anonymous.”

AA saved my life and I can never put into words the gratitude I have for AA. I cannot express how happy it has allowed my wife, family and friends to become.

I can never properly describe the chrysalis effect it has had on me and on everyone close to me.

The age of miracles is still my us, our recoveries prove that. It is a gift that keeps giving, freely.

Thus my original point is not semantic, AA was not founded by one person, it was co-founded as we alcoholics achieve sobriety with the help of other alcoholics.

It is “we” of Alcoholics  Anonymous, as the very first line of the Big Book of AA states.

In the twelve-step groups the focus is not on the individual self, but on the group or the community. Mutual aid and equality are the core principles of the twelve-step groups. Each member of AA help themselves by helping others who are in the same situation.

Essentially as one academic put it, The «power»
referred to in several of the twelve steps is therefore unrelated to religion; it refers to the potentially healing power inherent in interpersonal relationships based on reciprocity and equality.

Most active ingredients accounting for AA’s benefit are social in nature, such as attending meetings, and the 12 steps mention “we” 6 times but not “I” once.

AA’s 12 steps are a spiritual program of recovery but at the heart of that spirituality is the role of sponsoring.

Sponsorship embodies the fellowship’s  altruistic orientation, reflecting a “helping and helper  therapy principle” . Sponsorship plays an important role in the recovery process.

High sponsor involvement over time has been found to predict longer recovery .

Although social support is key to early engagement in the Twelve-Step membership, over time, spiritual issues emerge as increasingly important and helping others achieve recovery is at the heart of this.

The spirituality of AA is exemplified in helping others, it creates a feeling of wholeness and connectedness with others.

This is why we celebrate this great anniversary, this co-founding of AA, as it is the start of this therapeutic and spiritual connectedenss with other alcoholics needing help and giving help and with the wider world.

Thank God For AA!



Helping Others Helps Us.

In AA they say people who engage in service, i.e. helping out at meetings, sharing, making the tea and coffee, sponsoring others, helping on A A telephone helplines, inter group etc  have a much greater chance of staying sober and in recovery  long term than those who do not.

Although I was scared of my own shadow when I came into recovery and my brain was still incredibly scrambled and disorientated, I believe doing service in AA is one of the main reasons for me still being in recovery nearly 10 years later.

It helped me become part of AA not just someone who turned up and hung around on the periphery. 12 step recovery is a program of action not self absorbed introspection. The spiritual and therapeutic aspect of 12 step recovery is connectedness with others who have the same condition and share the same common purpose of wanting to remain sober and in recovery.

Doing service is an outward sign of one taking responsibility for their own recovery and declaring it too others in the meetings via service. When I see a newcomer to recovery start to do service it gladdens my heart as I know they have dramatically increased their chances of remaining sober and in recovery long term.

This has been my experience.

A reality, however, seems to be that most people are very anxious, lacking in confidence and fearful when they reach the rooms of AA.

When you have spent a long time drinking in increasing isolation, suddenly being at a meeting among strangers can have it’s problems.

When we go to meetings, to begin with, we are often unaware that we are actually in the company of people just like us, sensitive souls. Most have at some time at issues around social anxiety.

It is often said that this social anxiety is linked to the not belonging” feeling that many alcoholics experience throughout their lives prior to drinking.

Some have said it can be traced to insecure attachment to a primary care givers or to trauma or abuse in childhood.

Equally I have known many alcoholics who had idyllic childhoods who also have this feeling on not belonging socially, not fitting in, so I suggest that this social anxiety or not fitting in may be the result of some genetic inheritance which gets worse via the adverse effects of abuse or insecure attachment.

The vast majority of alcoholics I have met over the years have this sense of not belonging, having a “hole in the soul”.

I believe it is some neurochemical deficit, such as oxytocin deficit that has a knock-on effect on other brain chemicals, that decreases our feelings of belonging,  which  we all inherit and which can be made more severe via stressful adversive childhoods.

It often leads to isolation, being a loner, not only in adolescence but sometimes in recovery too. We seem to often like our own company but equally it is something to be wary of.

I have often heard of people relapsing after becoming isolated from 12 step fellowships. They stopped doing service, then reduced meetings and then disappeared off the scene, locked away in isolation.

So we seem to have a tendency to isolate and this may be due to many of us having social anxiety issues. Social events often seem like too much effort and this can be a dangerous thought.

So who do we cope with a room full of people?

I just came a cross a study recently which addressed how AA is almost perfect for dealing with this issue of social anxiety.

I will use some excerpts from it. It relates to youths in recovery but is applicable to all people in recovery or seeking recovery.

“In treatment, youths with social anxiety  disorder (SAD) may avoid participating in therapeutic activities with risk of negative peer appraisal.

Peer-helping is a low-intensity, social activity in the 12-step program associated with greater abstinence among treatment-seeking adults.

The benefits from helping others appear to be greatest for individuals who are socially isolated.

Helping others may benefit the helper because it distracts one from one’s own troubles, enhances a sense of value in one’s life, improves self-evaluations, increases positive moods, and causes social integration.

The myriad of existing service activities in AA are readily available inside and outside of meetings; are low intensity; and do not require special skills, prior experience, time sober, long-term commitment, transportation, insurance, or parental permission.

Peer-helping in AA, such as having the responsibility  of making coffee at a meeting, empathetic listening to others, reading inspirational meditations to others, or sharing personal experiences in learning to live sober, may have the effect of greater engagement in treatment and improved outcomes due to patients’ active contributions.

Learning to live sober with social anxiety is a challenge in society where people can be quick to judge others

Coping with a persistent fear of being scrutinized in social situations often requires learning to tolerate the opinions of others, feeling different, appropriate boundary setting, and enduring short term discomfort for long-term gain—skills that are in short supply among adolescents and those in early recovery.

The low-intensity service activities in AA offer youths—and those with  social anxiety in particular—a nonjudgmental, task-focused venue for social connectedness, reduce self-preoccupation and feeling like a misfit, and transform a troubled past to usefulness with others.

AA should be encouraged for socially anxious youths in particular.

As stated by a young adult, “I wanted to be at peace with myself and comfortable with other people. The belonging I always wanted I have found in AA. I got into service work right away and really enjoyed it”


1. Pagano, M. E., Wang, A. R., Rowles, B. M., Lee, M. T., & Johnson, B. R. (2015). Social Anxiety and Peer Helping in Adolescent Addiction Treatment. Alcoholism: Clinical and Experimental Research, 39(5), 887-895.




In order to  fully  recover from alcoholism, addiction and addictive behaviours, we find we have to trust at least one other human being.

This might be easy for some, to trust, but for me it was very difficult.

Considering my upbringing, this was a big step but as I had little choice…

I am not talking about trusting my wife, loved ones, family etc.

I am talking about trusting someone in recovery. A practical  stranger. Someone who is the same boat as you. Who has been where you have been, felt how you have felt.

Like a sponsor for exammple.

Someone you are going to open up to and discuss intimate stuff with, someone who will ultimately know the shameful secrets that can keep a person spiritually and emotionally sick and will continue to do so until we share this stuff and let it all go.

It chains us to the past and endangers recovery because we drank on shame and guilt.

I certainly know I did?

Sorry for being so direct in this blog, it is a message of hope, there is a way to completely turn your life around.

Shameful secrets can fester in the dark recesses of our minds and inflame our hearts with recrimination and resentment.

They  can have constant conscious and unconscious effect on our behaviors, how we think and feel about ourselves and how we interact, or not, with others.

Due to the nature of frequent episodes of  powerlessness over our behavior,  attached to addiction and alcoholism, we often  acted in a way we would never act in sobriety. We had limited control over behaviour at times due to intoxication  and acted on occasion in a way that shames us today.

Most of us were determined to take these secrets, these “sins” to the grave.

We often take them to grave sooner rather than later unless we  decide to  be open and share our secrets with another person.

This has been my experience.

Everyone in recovery has secrets they would rather not disclose,  but there are not many “original” sins as one suspects and that haven’t been shared in 12 step recovery.

Almost disappointingly I found some of my sins were quite tame when compared to other people I have spoken to in recovery.

That is not to say I did not frequently hurt others, especially loved ones,  but under examination they were not as monstrous as my head made them out to be.

These secrets are the emotional and psychic scars of our alcoholic past and they need to be exposed in order for us to fully heal.

In steps 4 and 5 we listed wrongdoings to others and although initially petrified to share them with another, found that it wasn’t as  difficult as we thought it would be, once you wrote down the worst top ten. There was an immediate release in fact. A sense of cleansing almost.

Sharing them was obviously awkward but a good sponsor shares his at the same time.

It is therapeutic exchange and shame reducing to know someone else has committed similar sins or has acted for similar reasons; they were powerless over their behaviours.  Just like me, just like you.

Alcoholism erodes our self will and choice.

There is nothing so bad that cannot be shared.

The 12 steps were influenced  by the Oxford Group who said sins cut a person off from God, and that there was such a thing as sin disease.

This sin disease had very real psychological, emotional and physical and physiological effect on the mind and body. Sins were a contagion that mixed with the sins of others and the sins of  families, groups, societies, cultures and countries.

The sin disease  idea became the “spiritual malady” of AA.

We can also see this as years of not being able to regulate our negative emotions properly, if you wish to see them as sins.

I see these “sins” also, and perhaps alternatively, as hundreds of unprocessed negative emotions from the past which were never consigned to our long term memories, so they just swirl around our minds for decades shaping how we think about ourselves and the world around us.

Steps 4 -7 and the amends to those people wronged in steps of 8 and 9 allow us to be completely free and in a sense reborn.

It can be viewed as spiritual or an emotional rebirth.

Isn’t this rebirth, catharsis, renewal, a becoming free from the old self, which was kept us ill in our shame and guilt about the past?

We have the chance to be free from the sick version of our real self, the self that has been in bondage, in addiction.

It is almost miraculous, the sudden transformative effect it can have on us.  I have seen it many times with my own eyes.

By freeing ourselves from the past,  we become who we really are.

We have a sea change in how we think and feel about ourselves and the world around us.

In fact we never become who we really are until we have examined our past and consigned it to the past.

We do fully recover until we do this I believe.

Otherwise we have not really completely treated our alcoholism.

We have simply got sober, sometimes stark raving sober.   

We are not bad people getting good but ill people getting well.

All this because we plucked up enough courage to ask someone we barely knew to be our  sponsor.

Because we trusted one person enough.

In reality we asked a fellow sinner to hear our sins and through God’s help have them taken off us, or if one prefers, have had the past finally   processed and consigned to long term memory where it will take only a special and quite frankly bizarre decision and effort to go rooting around and digging it up again.

I look at the past fleetingly sometimes to help others but I never stare at it too long.

It is a former self.

I have been reborn, I have become who God had intended me to be.

I have become me.


Who Wants to be an Alcoholic?

The social stigma of being an alcoholic prevents many from coming into recovery and treating their illness. And it is an illness but it takes time to realise that – a physiological, psychological, emotional, cognitive, behavioural and spiritual disease. It is as profound an illness as one can have.

It is the only illness that actively tells you that you do not have it!

How cunning, baffling and powerful is that!?  

In fact stigma, particular prevalent in the UK as compared to the US, helps kill alcoholics.

We all have ideas of tramp on park benches supping on bottles of alcohol when we think of alcoholics.

I know I did. When I went to my first meeting I thought I would be greeted by park tramps with strings holding their trousers up with food encrusted beards, no teeth and hygiene problems.

I wasn’t greeted by anyone like this.

I was greeted by a teacher, a lawyer, a counsellor, a business man, a builder, a nurse, an actress, among others.  Alcoholism effects every area of life, no strata of life is immune, there are recovering alcoholics everywhere.  The second man to have stepped on the moon is in recovery for alcoholism!

These shiny AA people were not drinking and some had not drank for decades!

Imagine not drinking for ten years and more? I could not imagine ten minutes…but now I am coming up to my tenth birthday in AA.


“Most of us have been unwilling to admit we were real alcoholics. No person likes to think he is bodily and mentally different from his fellows” (1)

Neuroscience has demonstrated repeatedly how the brain is taken over by the actions of alcohol and other substances which leave the brain severely restricted in it’s choice of behaviours. Self will has become so compromised we barely have any!?

We become so comprised in our own ability to make decisions that we are often “without mental defence against” drinking.

Alcohol via the alterations in stress and reward (survival) systems in the brain means our illness has literally taken over our brain and calls the shots, does the thinking which leads to the drinking.

We have a thinking disease as well as drinking one by the time we get into recovery.

It is the thinking of this illness, which we mistake for our own, quite understandably, as these thoughts are happening in our own head, that tells us we do not have an alcoholic problem, we do not need to go to an AA meeting, or when we have gone, that we do not need to stay, that we are different to the people at the meeting – that they need this recovery thing not me. I can work this out myself.

Why does it do this?

Why is it constantly chittering away between our ears. It has to be us, surely? Our thoughts can’t have been taken over like some 1960s episode of Star Trek where Captain Kirk and crew are struck down by some thought virus??

If you are new to recovery don’t bend your head over this stuff!

All you have to do is twofold. Get to a meeting and see if your experience of drinking tallies with those there and two, watch out for that motivational voice of alcoholism trying to get you far away from these people.

This is my test to see if you are alcoholic.

This voice of the illness is similar to the voice of OCD and other anxiety disorders which talk to us in thoughts which are contrary to our well being and health. Why?

Because our survival networks in the brain have gone so haywire that these conditions think they are helping us survive by suggesting certain actions which we previously used to reduce distress, i.e.compulsive behaviours, but which take us increasingly into even greater emotional distress and unhealthy behaviours.

They are like an Olympic coach training us to get chronically unwell.

They persist because they have ingrained in our brains unfortunately, possible forever. They are the torturous whispers of our neural ghosts!

They refuse to die but in time these voices become more manageable, the volume on them can be turned down or ignored altogether.

Turning down the distress signal that feeds them is at the key.

You are not alone – “Every natural instinct cries out against the idea of personal  powerlessness.” (2)

This powerlessness led me to surrendering. Paradoxically to win this war we must first surrender.

Surrendering to the idea that I may, possibly, be an alcoholic.

Acceptance of this possibility is the first step.




  1.  Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York: A.A. World Services.
  2. Twelve steps and twelve traditions. (1989). New York, NY: Alcoholics Anonymous World Services.


You are Not Alone!

In the final months of my active alcoholism I was living in the attic room of my house.

I drank about 6 bottles of cheap Spanish wine plus a dozen cans of strong German beer every day.

The alcohol had little effect on me by this stage. I only drank to dampen the delirium tremens, the violent shakes. I often could not control my hand enough to get alcohol into my mouth, holding my wrist steady with my other hand to raise the drink to my mouth.

Usually  cracking the bottle or tin can against my teeth.

I was no longer getting drunk anymore.

You know you are fully addicted to alcohol when it does nothing intoxicating any more.

I slept in 5-10 minute fits and busts. I did not eat for months. The television told me to kill myself and voices not belonging to me talked insistently in my head.

Alcohol-related Psychosis it is called.

No one told me this would happen when I bought my first alcoholic drink when I was fourteen years old. There was no health or warning label saying “Could lead to Psychosis and Premature Death!”

Maybe there should be.  Or at least alcohol can be addictive for some.

Anyway there is more to alcoholism than alcohol.

In the depths of this alcohol induced madness, I rarely saw my wife, who could not bring herself to look at me and what I had become.

If I could have got it together I might have killed myself.

But I couldn’t get it together. Psychosis is all involving, doesn’t leave much time for planning anything.



So I staggered on. When I say staggered, I could not actually walk more than a few yards or climb more than a few stairs.

By  the time I reached my first AA meeting

1. the alcohol had stopped “working”.

2. I had surrendered.

Regardless of these two factors, I could not admit I was alcoholic. My pride and it’s best friend shame were still talking away to me.

I was willing to admit I was addicted to alcohol and that I was about to die from it.

But alcoholic?

We often wonder why some people don’t accept their alcoholism?

How did I start my journey to acceptance?

My wife came to my first meeting of AA, she practically carried me in!

The Chair of the meeting was a person I had drank with before – I though how come he is here?

I spilled more drink than he ever drank?

Then it dawned on me that maybe I should have come here before?

Especially when he shared that he had been trying to get sober and recovered for ten years!?

I then listened to the other alcoholics sharing their stories.

The stories mentioned the progression of the alcoholism, which I obviously identified with.

They also mentioned how they, even now in recovery, struggled with their emotions and anxieties, how they found living life difficult.

They talked about issues which had bedevilled them and me since childhood, this  spiritual malady they talked of was like the emotional disease I had  suffered from all my life, whether it was depression, panic attacks, anxiety disorders, PTSD, etc.

They had used alcohol to self medicate these conditions, especially as alcohol for them had felt like an elixir for them as it had for me.  We all had all dealt with our negative emotions since adolescence in the same way.

Now a new way had to be found.

When we left the meeting my wife had a psychic change similar to the one I had.

She said these people are just like you. They can help you, I can’t.

A week before I had heard a voice in my heart, through the psychosis, saying  to go down stairs to my wife and ask her for help. I asked her for help in that round about alcoholic way of “do you think I look a bit jaundice (I actually looked like Homer Simpson with a heavy sun tan!)?

The help I asked for was not to come directly from my wife but she led me to where I could get it. In a room, full of people just like me, suffering the same illness as me.

I will be forever eternally grateful for it being there for me. For them being there.

We will be there for you too!

The Power of Identification!!

The main reason I am alive today, sober and have recovered from a seemingly hopeless condition of alcoholism is simple!

Or rather the first step can be simple.

The first step on my recovery journey was to identify with the life stories of other recovering alcoholics.

Not necessarily with where they grew up, or the damage alcoholism had inflicted on their lives. Although many alcoholics talk themselves, or their illness talks them, out of the possibility of recovery by saying I am not as bad as that guy, or that woman.

You may not be as bad “YET!” – the “yets” are often talked about in AA – you may not have done the damage others have, yet? Keep drinking and you are bound to. You, like them, will have no choice.

Alcoholism increasingly takes away choice.

It takes over your self will.

Your self will, your self regulation, is a combination of your emotional, attentional, memory and reward/survival/motivation networks.

Alcoholism takes over these networks, progressively, over time.

Neuroscience has shown this, over the last twenty odd years.

A superb longitudinal study, “The Natural History of Alcoholism” by George Vaillant  clearly showed this progression in six hundred alcoholics over a 60 year period!

In my own research and in articles, with two highly respected Professors at a UK University, I have shown how the alcoholic brain progressively “collapses inwards” to subcortical responding.

In other words, we end up with a near constant “fight or flight” reaction to the world,  with alcoholism causing distress based compulsion at the endpoint of this addiction.

All the above neural circuits become governed by a region of the brain which deals with automatic,  compulsive behaviour. All the self regulation parts of the brain progress to an automatic compulsive behaviour called alcoholism and we are then often without mental defence against the next drink!

I identified with this one simple fact – the progression of this neurobiological, emotional, and spiritual disease state called alcoholism. I saw it in my own life, this progression over years of drinking.

The “invisible line” that is crossed, according to AA members, can be viewed on a brain image, I believe.

Can you see it in your life?

Like these recovering alcoholics I had not taken my first drink hoping to end up an alcoholic

It was something that had happened to me,  happened despite my very strong will not because my will is weak. I am as wilful a person as you would hope to me. How come I became an alcoholic then?

I did also relate to other things these people shared.

I identified with the damage caused by alcoholism  in their lives and the lives of their family.  How this illness affects everyone in the immediate and even extended family.

I had never considered the effect on others, apart from me?

I listened and identified with how they talked about a “hole in the soul”, how they never felt part of, felt different from others, detached. I related to this. That was me too.

Alcohol made me feel more me! I became attached to it and grew to love it like someone would love another person, more so perhaps? Alcohol came first, loved ones second.

Alcoholism takes away all the good things in life and then your life too.

All of this was the case with me too.

I identified with all this.

I identified too with their solution.

I identified with and wanted what these now happy people in recovery had.

I decided to take the same steps as they had towards this happiness.

There is a solution.

We do recover!

Self Diagnosing Alcoholism

For those reading who feel they may a problem with alcoholism I will attempt to help you self diagnose.

I personally came into recovery via AA after my local doctor/GP, stated quite unequivocally that he thought I was an alcoholic. I was with my wife at the time.  The scales fell from our respective eyes.

Oh that’s it!? It wasn’t my troubled childhood, the premature death of my parents, my various difficulties with anxiety, depression, panic attacks, etc etc. It was because I was an alcoholic!

I have no doubt that the above factors contributed to the severity of my alcoholism but the other psychiatric issues I now consider to have been substance induced disorders which have either dissipated in recovery or have been treated in some way by a 12 step recovery?

Regardless of GP’s diagnosis of alcoholism I still need to self diagnosis.  I could not recover from alcoholism based on someone else’s diagnosis, however helpful. I had to identify myself as an alcoholic. Acceptance of this condition was the first step in recovery for me and countless others.

In the early days acceptance is based on acceptance of a destructive relationship with alcohol.

How do we define this relationship, this alcoholism?

There are various definitions of alcoholism mainly centring on  continued use of alcohol despite negative consequences. The Big Book of Alcoholics Anonymmous (1) simply states  “If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, you are probably alcoholic.  “.

This useful useful article (2) discusses the “loss of control over drinking” concept, which academic studies have failed to prove or disprove in laboratory settings.

I believe this loss of control can occur spontaneously or over several drinking episodes. It is not an all or nothing phenomenon like the “allergy” concept of the Doctor’s Opinion in the Big Book. It is variable.

The return to uncontrolled drinking can take one drinking session for some or a number of drinking sessions for others.

“The loss-of-control phenomenon is the essence of any addiction and certainly of AD.

This refers to the inability of the AD person to predict with any degree of certainty how much he or she will imbibe from one drinking episode to the next.

Clinically, once the drinking episode starts, the AD person will be unable to stop in the middle of the episode without a very great struggle. Useful questions at interview include asking 1) whether patients feel compelled to continue drinking or find it very hard to stop drinking; 2) once they start, whether they find themselves drinking more than they wanted to or had planned to; and 3) whether they make rules to attempt to control their drinking through external means.

It is important to distinguish the loss-of-control phenomenon from craving. The former has to do with the inability to stop drinking once started.

The loss-of-control phenomenon occurs within a drinking episode. Forms of craving occur between drinking episodes. The loss-of-control phenomenon continues to be a scientific puzzle.

Despite ongoing research inquiry over many years, neuroscience has yet to define the CNS changes underlying the loss-of-control phenomenon that characterizes dependence.

Clinically, however, longitudinal studies of abstinence make it clear that once the control of drinking behavior departs, it does not return in most cases (3).

It cannot be relearned or reconstituted. In this sense, a diagnosis of dependence signals a permanent condition—including a permanent risk of uncontrolled drinking. “



  1. Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York: A.A. World Services.
  2. Beresford, T. P. (2007). What is addiction, what is alcoholism?. Liver Transplantation13(S2), S55-S58.
  3. Vaillant GE. The Natural History of Alcoholism, Revisited. Cambridge, MA: Harvard University Press; 1995.

Impulsivity is an Independent Predictor of 15-Year Mortality Risk among Individuals Seeking Help for Alcohol-Related Problems

In yesterday’s blog we looked at how AA membership and the 12 step program of recovery helped reduce impulsivity in recovering alcoholics.

We mentioned also that impulsivity was present as a pathomechanism of alcoholism from vulnerability in “at risk” children from families, were there was a history of alcoholism, right the way through to recovering alcoholics in long term recovery (i.e. many years of recovery).

We cited and used excerpts from a study written by the same authors as the study we cite now (1).

This study shows and highlights how, if untreated, by recovery programs such as AA’s 12 steps, that “trait” impulsivity can lead to increased mortality in alcoholics.

This study interestingly shows there is a difference from “state-like” impulsivity in early recovery when recovering people are still distressed and “trait-like” which is after Year 1 of recovery when some of the severity of withdrawal from alcohol has long since abated and some recovery tools have been learnt.

The fact that this impulsivity continues to contribute to relapse and mortality may suggest it is a trait state in alcoholics and possibly a vulnerability to later alcoholism also.

In effect, it illustrates the role impulsivity plays as a pathomechanism in alcoholism, i.e. it is a psychological mechanism that drives addiction and alcoholism forward to it’s chronic endpoint.

Again research shows us how we can learn about a pathology from the recovery from it!


impulse control.preview



Although past research has found impulsivity to be a significant predictor of mortality, no studies have tested this association in samples of individuals with alcohol-related problems or examined moderation of this effect via socio-contextual processes. The current study addressed these issues in a mixed-gender sample of individuals seeking help for alcohol-related problems.


…higher impulsivity at baseline was associated with an increased risk of mortality from Years 1 to 16; higher impulsivity at Year 1 was associated with an increased risk of mortality from Years 1 to 16, and remained significant when accounting for the severity of alcohol use, as well as physical health problems, emotional discharge coping, and interpersonal stress and support at Year 1. In addition, the association between Year 1 impulsivity and 15-year mortality risk was moderated by interpersonal support at Year 1, such that individuals high on impulsivity had a lower mortality risk when peer/friend support was high than when it was low.


The findings highlight impulsivity as a robust and independent predictor of mortality.


…personality traits related to impulsivity (e.g., low conscientiousness) have been identified as significant predictors of poor health-related outcomes including mortality (Bogg and Roberts, 2004; Roberts et al., 2007). Although there is a well-established association between disinhibitory traits and alcohol use disorders (AUDs) (Labouvie and McGee, 1986; McGue et al., 1999;Sher et al., 2000), to our knowledge, no studies have tested these traits as predictors of mortality among individuals with alcohol-related problems or examined moderation of this effect via socio-contextual processes.

Predictors of Mortality Risk among Individuals with Alcohol Use Disorders

Relative to the general population, individuals with AUDs are more likely to die prematurely (Finney et al., 1999; Johnson et al., 2005; Valliant, 1996). Accordingly, several longitudinal studies have aimed to identify the most salient risk factors for mortality in this population (for a review, see Liskow et al., 2000)

…more reliance on avoidance coping, less social support, and more stress from interpersonal relationships increase the risk of mortality among individuals with AUDs (Finney and Moos, 1992; Holahan et al., 2010; Mertens et al., 1996; Moos et al., 1990).

Impulsivity and Risk for Mortality: Relevance for Individuals with Alcohol Use Disorders

Despite the litany of variables that have been examined as predictors of mortality among individuals with AUDs, tests of the significance of individual differences in personality are noticeably absent from this literature. In the clinical and health psychology literatures, however, personality traits have long been identified as possible risk factors for mortality (Friedman and Rosenman, 1959), with low conscientiousness emerging as one of the most consistent, trait-based predictors of poor health and reduced longevity (Kern and Friedman, 2008; Roberts et al., 2007). Conscientiousness is a broad domain of personality reflecting individual differences in the propensity to control one’s impulses, be planful, and adhere to socially-prescribed norms (John et al., 2008).

(previously) no studies in this literature have tested impulsivity as an independent predictor of mortality in a sample of individuals with alcohol-related problems. This is a surprising omission, given that impulsivity is a well-established risk factor for alcohol misuse (Elkins et al., 2006; McGue et al., 1999; Sher et al., 2000) and therefore may be an especially potent predictor of mortality among individuals with AUDs. Furthermore, the role of impulsivity as an independent predictor of mortality risk among individuals with AUDs is relevant from the standpoint of the stage of the alcohol recovery process.

Thus, we sought to examine the impulsivity-mortality link at baseline and one year after participants had initiated help-seeking for their alcohol use problems. At baseline, participants were in a state of distress due to their problematic alcohol use, whereas at Year 1 most participants had obtained help for their alcohol-related problems and reduced their drinking (Finney and Moos, 1995).

Given prior research on acute clinical states and self-report assessments of personality (e.g., Brown et al., 1991; Peselow et al., 1994;Reich et al., 1987), we hypothesized that individuals’ self-reports of impulsivity at Year 1 would be less a reflection of their alcohol problems – and therefore more likely to be independently linked to mortality risk – than their reports at baseline, which may be more closely associated with concurrent alcohol use and problems (i.e., state effects).


…impulsivity at baseline was a significant predictor of mortality risk from Years 1 to 16; however, this effect was accounted for by the severity of alcohol use at baseline. In contrast, impulsivity at Year 1 was associated with an increased risk of mortality over the subsequent 15 years…

In addition, a significant interaction was observed between impulsivity and peer/friend support at Year 1, which suggested that, among individuals high on impulsivity, the mortality risk may be reduced for those high on support from peers/friends. Collectively, these findings highlight impulsivity as an independent risk factor for mortality in AUD samples…

…It is also conceivable that, given participants were in a state of crisis at baseline, their reports of their impulsive tendencies at that time partly captured “state” effects (e.g., psychiatric distress from concurrent substance use; withdrawal symptoms) and therefore were less an indication of their typical or “characterological” pattern of impulsivity, independent of alcohol use. However, at Year 1, most participants had reduced their drinking and were not in a state of crisis; thus, their reports at that time may have been a better reflection of their “trait-like” pattern of impulsivity, which in turn may be a more robust independent predictor of long-term outcomes such as mortality. Accordingly, future studies that seek to test impulsivity as an independent predictor of mortality among individuals with AUDs should consider the stage of the alcohol recovery process.

Moderation of the Impulsivity-Mortality Link via the Social Context

The results of the moderator analyses suggest that the effects of impulsivity on mortality may become manifest through interactions between traits and socio-contextual process (Friedman, 2000). That is, the dire effects of impulsivity on risk for mortality may not reach fruition for individuals who are able to maintain a strong peer support network. Conceivably, by virtue of their strong bond with a high-risk individual, such peers may have sufficient leverage to discourage expression of the individual’s impulsive tendencies and encourage consideration of the long-term consequences of his/her actions.

Such a perspective is consistent with evidence from the AUD treatment-outcome literature that social support networks are a key mechanism by which Alcoholics Anonymous (AA) and other psychosocial treatments can improve long-term drinking-related outcomes (Humphreys and Noke, 1997; Kaskutas et al., 2002).

Furthermore, from the standpoint of treatment, the present findings suggest that interventions for AUDs may benefit from an ecological perspective that considers the contexts in which dispositional tendencies, such as impulsivity, become expressed in individuals’ everyday lives. Notably, based on prior work with this sample, longer duration in AA and alcohol treatment was associated with a decline in impulsivity (Blonigen et al., 2009). In combination with the present findings, it appears that formal and informal help for AUDs may include “active ingredients” that can help curtail expression of impulsive tendencies (e.g., social integration, peer bonding; Moos, 2007,2008) and buffer the otherwise deleterious impact of such tendencies on health and longevity.


1. Blonigen, D. M., Timko, C., Moos, B. S., & Moos, R. H. (2011). Impulsivity is an Independent Predictor of 15-Year Mortality Risk among Individuals Seeking Help for Alcohol-Related Problems. Alcoholism, Clinical and Experimental Research, 35(11), 2082–2092. doi:10.1111/j.1530-0277.2011.01560.x