I was delighted to be asked and honored to take part in one of the excellent “The Hope Interviews” with Steve Jones for the recovery newspaper “Keys to Recovery” – our interview is on page 9 and it was a experience strength and hope type interview from both a 12 step recovery and a neuro-psychological perspective, showing how these perspectives are very compatible and how we need a spiritual solution to a neuro-psychological problem.
Over the next six months I will be blogging about my adventures in coming to terms with my insecure attachments in recovery.
I will blog on how “helping others” helps me (or not) with my insecure attachments.
I do think sitting in a room of recovering alcoholics helps one find a more “secure base” or experience a learnt attachment via recovery groups.
I have always thought 12 step groups seem to be full of people with insecure attachment issues so maybe we can see this in each other and can help each other finding loving bonds with others in “the rooms” or help mend or increase loving bonds in our own private lives too.
We do essentially heal and recover in recovery because of the loving actions of others. It is difficult recovering without deciding to trust at least one other person in recovery.
We have to let someone in to our private selves it seems. We have to bond with another human being!
But then again, do alcoholics have this attachment issue – can I talk on behalf of a whole recovery movement?
And if other alcoholics do suffer from it, can we deduce that these issues were there prior to recovery?
Are they antecedent to alcohol problems, are they part of the pathomechanism that drives additive behaviours?
Is addiction partly driven by attachment disorders?
We will start by looking at alcoholics and then in later blogs look at sex and eating disorders too. I think we may find that insecure attachment to primary care givers has a big part to play in all addictive behaviours.
So is addiction partly driven by attachment disorders?
The study (1) has shown that people with alcohol dependence significantly differ from non-alcoholics in terms of attachment style.
They also received significantly higher scores on insecure attachment style – anxious-ambivalent and avoidant style, and higher scores on attachment dimensions – anxiety and avoidance.
Empirical studies clearly confirm that the history of the attachment relationships significantly affects the shape and quality of interpersonal relationships formed in adulthood, shaping personality and developing a sense of identity, emotional functioning, coping with stress etc
Two distinct dimensions with regards to bonding are: anxiety – corresponding to fear of rejection, and avoidance – referring to avoidance of intimacy (closeness).
Empirical studies confirm that patients addicted to alcohol and other psychoactive substances are very likely to have insecure attachment styles and to display severe anxiety and avoidance in attachment dimensions.
The results of this study confirm our hypothesis that alcohol dependent persons are significantly more likely to exhibit insecure attachment styles (anxious-ambivalent and avoidant styles) than non-alcoholics, and significantly less likely to display secure attachment style.
As indicated by the results obtained, alcohol dependent persons also differ from non-alcoholics in terms of anxiety and avoidance attachment as they received higher scores on these dimensions.
These results are consistent with the results of other studies in which the percentage distribution of the occurrence of the secure style in people addicted to alcohol varies from 5.4 to 40%, while insecure attachment styles vary from 66 to 94.6% [21, 23, 24, 35].
Studies have also shown that among addicts variables such as the avoidance of closeness and fear of intimacy assume much higher values than in patients without addiction .
It seems therefore, that the occurrence of insecure attachment styles and dimensions of such intensity (that indicates feelings of mistrust in interpersonal relationships) is prevalent in patients with alcohol dependence.
Both men and women dependent on alcohol exhibit difficulties in establishing secure, trusting interpersonal relationships and at the same time have an increased tendency to feel anxiety and fear about the stability of the relationship, resulting from the lack of a sense of security and/or actively avoiding forming close, intimate relationships.”
So it seems the prevalence of insecure attachment style is very high from 66-95% in alcoholics which suggests the vast majority of recovering alcoholics know exactly what I am sharing about when I mention my issues around insecure attachment – and are also in a position to help me with these issues.
Wyrzykowska, E., Głogowska, K., & Mickiewicz, K. (2014). Attachment relationships among alcohol dependent persons. Alcoholism and Drug Addiction, 27(2), 145-161.
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.
When I first arrived in AA I was told by a big scary looking man that in AA you will get better.
That “we will help you by loving you back to health”.
I was quite alarmed by this situation to be honest “loved back to health”? Was this guy some relic from the hippy era?
What he said, was very threatening to me. It suggested unconditional love, a concept that I was only partially familiar with.
I had always knew my father loved my unconditionally but this was less the case with my mother. I knew she loved me in her vague, through a distant Valium haze but part of me was always reaching out, crying out for more. More love.
I found that love in liquid form in alcohol. Or so I felt. Alcohol was constant. It always delivered without fail, transported me to the person I would much rather be. Allowed me to escape the person I did not want to be.
I now accept my mother suffered from addiction just like me and I have immense compassion for her because of that, she did the best she could under the circumstances. I forgive her completely and love her completely.
She was not a bad person she as an ill person just like me.
Did this relationship with my primary care giver have any effect on my teenage drinking and later alcoholism?
Like many alcoholics I have spoken to over the years I too seemed to suffer from the “hole in the soul” they spoke of.
That not feeling whole, like something in you, some part of you was missing.
Having a curious mind, I always wondered what it could be? It must be something that can be discovered? I wasn’t happy to leave it was a vague spiritual condition.
It felt too emotional just to be a spiritual thing, although it is also that.
It felt like I was lacking in something, something in my make up was not there or in diluted measure?
Later I found out that this relationship with my mother was called an insecure attachment and that lots of people in recovery had this insecure attachment with their mothers or whoever reared them.
This insecure attachment they said often resulted in novelty seeking and hunting out some “secure attachment” elsewhere, in a bottle, syringe, sex, a poker machine, food or other addictive behaviours.
It is lonely recently that I found there is a brain chemical linked to this insecure attachment called oxytocin, the “love chemical” which effects all the neurochemical said to be involved in addiction.
Oxytocin is badly affected by the stress reaction to insecure attachment, abuse trauma and a tough upbringing. The oxytocin is then reduced which reduces the other chemicals too and we search for these at the bottom of a glass.
Unfortunately alcohol seems to give us cocktail of these chemicals in liquid form. But never enough.
For a while anyway, it gives us the illusion of attachment, of that fleeting feeling of being part, of being loved.
Through the years all these chemicals start running dry and the drink stops working.
We are then left with the problems we had before we put a glass to our mouths.
So when the drink stopped working and I had to go to AA – not one wants to go there, let’s face it, it’s because we have to!
So the big scary guy may have been right all along. I have found that he is right over the years of attending AA.
I have found a new, surrogate family in AA, a “learnt attachment” within the fellowship of others in the same boat as me, who have felt the same as me. I have found this attachment to others, by being looked after and trying to help others – my oxytocin, the “love chemical” the “cuddle chemical” has gone up dramatically while my stress has plummeted as I have bonded with others in recovery.
This connectedness is my spiritual solution to a neurobiological problem.
I now feel part of for the first time, I have filled the hole in the soul with love given and received.
Like many others in recovery from alcoholism and addictive behaviours I grew up with this really uneasy feeling of “not being part of”, “never belonging anywhere”.
I felt like I did not belong or did not fit in. In fact it was only when I got to AA that I had my first sense of belonging, of being amongst my own kind.
I had found my own recovery family and had this feeling of having gone home in some strange way.
I grew up in a house with three older sisters so thought I did not fit in completely with them because I was a different gender and had my own bedroom.
I also felt warily distinct or different from my parents too. I was always wary of my parents because I never completely trusted them.
Their violent arguments had lead to many traumatic incidents in my early childhood which still scar my psyche to this day. In fact I still suffer from Post Traumatic Stress Disorder (PTSD) today as do about 40 % of alcoholics.
So I felt I never completely trusted and hence never completely attached to my parents, especially my mother. I loved them deeply but there was always this invisible almost unconscious wedge between me and them.
I also grew up in the “troubles” of Northern Ireland. I grew up in the highly usual scenario of being a Catholic in a very predominantly Protestant neighourhood.
This was also traumatic at times so I never attached with the society and culture beyond my home. I also got trouble from Catholic kids at school for coming from this Protestant area. I was always having fights to defend myself. So it was a fairly traumatic upbringing inside and outside the home.
Looking back I had more than enough reasons to feel not part of.
It wasn’t until I came to AA that I found a whole bunch of people who had also felt the way I did – they also felt they never belonged.
I was suddenly struck with a choice – either I felt I never belonged because of various circumstantial factors (which quite frankly did not help) to do with my upbringing or because I was an alcoholic?
As I feel completely at home with other alcoholics this seemed to be the reason I felt that I had never belonged.
If you feel that you do not belong it may be because, like me, you haven’t found your society of like minded people.
People just like you. People who do not fit in naturally with the so-called “normal” world?
In fact when I look back on my early drinking at about 14 or 15 years old I remember alcohol giving me that warm euphoric glow which felt like someone had poured “love chemicals” into my blood.
I had a “spirit awakening” if you like, whereby I felt so much more comfortable in my own skin, relaxed, expansive, acting spontaneously without fear, connected more with other people, felt the warmth and camaraderie of my fellow human beings.
Alcohol allowed me to more fully join the human race.
I allowed myself via alcohol to belong temporarily, to attach to the warmth of others.
Then in cold sobriety these feelings would shrink and recede – until the next time.
But was the illusion.
For me the so-called euphoric recall contains that feeling of belonging, or not being desolately alone. But connected. In fact the spirituality of 12 step groups is about the connection with others in the same boat as yourself..
In later years when asked by my wife why I drank, I would answer “to get away from myself”; to escape me!
I found a surrogate home in AA, a learnt attachment. Like my own family it can be far from perfect at times, but it is here I belong ultimately, with my own.
Accepted completely for who I am.
Where I am free to be me.
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!
In our previous blog we wondered if some commentators, who have co-occurring disorders may be puzzled at how having a “spiritual malady” could be related in any way to have a co-occurring condition?
This is a pretty valid question?
In fact this may be at the heart of the issue in many cases of feeling the need to take medication for so-called co-occurring conditions?
Seeing alcoholism as partly the product of a spiritual malady, instead of the affective disorder I believe it to be, may influence certain AAs to seek additional help for supposed additional conditions when the manifestation of these conditions may actually be part of the emotional disorder of alcoholism?
It is at least worth considering?
For me sometimes there is a confusion with what is perceived to be a spiritual malady?
I do not believe I have the same type of spiritual malady as my wife for example who is an normie, earthling, normal person (whatever that is?) I believe, if any thing I have a super enhanced, at times turbo-charged, spiritual malady, often fuelled by stress/distress, as the result of my alcoholism.
I do not believe I have the same spiritual malady as other normal people such as those people who were in the Oxford Group.
That is not to say that normal people cannot be full of sin – a cursory look around the work and it’s events will soon confirm this is the case. What I am saying is that they do not have the emotion dysregulation or fear based responding that I seem to have which often prompts “sin”.
By sin I mean negative emotions that cause distress to me and others.
For example, false pride, intolerance, impatience, arrogance, shame, lust, gluttony, greed. Yes these all create distress.
The spiritual principles of AA and the 12 steps in particular were drawn from the 4 absolutes of the Oxford group, via initially the 6 steps and the idea of a spiritual malady is also borrowed from the Oxford group.
I have for several years wondered if the spiritual malady described in the Big Book adequate or accurate enough in describing what I suffer from.
I believe others have difficulties in reconciling the spiritual malady of the Big Book with their own alcoholism, addiction and co-occurring conditions?
Part of the problem may lie in not being specific enough about what alcoholism is.
It may be that research and the world have not progressed far enough to give a comprehensive account of what alcoholism is. Also the spiritual malady concept of AA has for 80 years helped millions of people recover from this most profound of conditions? So why change it if it’s not broke?
That is a good point? I am not advocating changing anything, I hope AA recovery remains as it is for 80 more years and much more years. I would not change one word in the first 164 pages of the BB.
However, many AAs ignore the spiritual malady thing completely, or do not do the steps, so, in my opinion, they often do not properly understand what they suffer from?
The magic of the the steps is that they seem to reveal the patterns of behaviour that our actions have prompted over the course of our lives. Maladaptive behaviours I should add. It helps us see ourselves and our condition of alcoholism and how it effects us and others.
It shows the areas of behaviour and attitudes that can be treated by working the steps. It shows us how our approach to life can possibly be transformed for the better.
For me personally it often showed a pattern of emotional responding to events that do not go my way!!?
As Bill Wilson once wrote we suffer when we cannot not get what we want or others seem to prevent us getting what we want.
My inventory of steps 4/5 showed me that my long lists of resentments were mainly the product of emotional immaturity and responding in an immature manner to not getting my way.
My inventory showed me also that I did not seem to have the facility previously to emotionally respond to the world in a mature way. As the world dominated me.
My recovery has thus since been about “growing up” a bit, however unsuccessful I am in this pursuit on occasion.
I have often written that this inherent emotional immaturity may even be linked to the possibility that the areas of my brain that regulate emotions have not matured properly as alcoholic seem to have different connectivity, functionality and morphology (size/volume) in this emotion regulation circuit/network to healthy normal people.
Alcoholics seem not to be able to fully process emotional information externally, i.e reading emotion expression of faces accurately, or internally reading what emotions we are having, or even whether we are hungry or tired!
So we have issues with emotions and somatic/body feeling states. This is perhaps compounded by most of us having experienced abuse or maltreatment which can also lead to alexithymic characteristics such as not being able to label or describe, verbally, emotional states we are experiencing – although we can be good at intellectualising these emotions – which is not the same as processing them.
Alcoholics and children of alcoholics have a tendency to avoid emotions (use avoidant coping strategies) in fact and to use emotional reasoning when arguing a point.
These emotion processing deficits also appear to make us more impulsive, and to choose lesser short term gain over greater long term gain in decision making. It can lead to a distress feeling state that can make us fear based, perfectionist, have catastrophic thoughts, intolerance of uncertainty, low frustration and distress tolerance, be reactionary, moody, and immature in our emotional responding.
But how has any of this got anything to do with the so-called spiritual malady we are suppose to suffer from?
I believe the spiritual malady mixed with the ancedotal evidence throughout the BiG Book hints at these emotional difficulties as being an intrinsic part of our alcoholism, “We were having trouble with personal relationships, we couldn’t control our emotional natures, we were a prey to misery and depression, we couldn’t make a living, we had a feeling of uselessness, we were full of fear, we were unhappy…”
It was 80 years ago, so our knowledge base has moved on greatly from when the Big Book was written. Hence I believe we should appreciate that this definition of our condition has been updated by research into emotions especially in the last 20 years.
I am happy to say a spiritual malady is what we suffer from, as the steps provide a solution to my emotion disorder by treating it as a spiritual malady but I do not think it is the straightforward spiritual malady adopted by AA from the Oxford Group, mainly because in the majority of situations I do not choose to sin, the sinning seems to happen to me. In other words it is the consequence of my fear based condition, this affective disorder.
The Oxford Group explain a general spiritual malady that all people can have. I do not think alcoholics are like all people. We are human beings, but extreme versions of human beings. I believe, even when I try my best to be virtuous and holy, I could sin at the sinning Olympics for my country. I am that naturally good at it!
I sin so naturally, effortlessly and usually without even trying. I believe my so-called defects of character are linked to my underlying emotional disorder of alcoholism.
Sins I believe are the poisoned fruit of fear, often helped along in alcoholics by false pride, shame and guilt. These defects are related to me being an alcoholic, they are intrinsic to my condition.
In order to illustrate how I believe my spiritual malady is the consequence of my emotional disorder, called alcoholism/addiction first let’s go back to where this idea of spiritual malady came from.
According to a wonderful pamphlet “What is the Oxford Group” written by The Layman With a Notebook ” Sin can kill not only the soul but mind, talents, and happiness as surely as a malignant physical disease can kill the body…
Sin is a disease with consequences we cannot foretell or judge; it is as contagious as any contagious disease our bodies may suffer from. The sin we commit within this hour may have unforeseen dire consequences even after we have long ceased to draw living breath…
…Like physical disease Sin needs antiseptics to prevent it from spreading; the soul needs cleaning as much as the body needs it…
Unhappiness to us and others, discontent, and, frequently, mental and bodily ill health are the direct results of Sin.
…Morbidity of mind must affect the physical health. If we can be absolutely truthful to ourselves we can analyse our sins for ourselves and trace their mental and physical effects. Sins can dominate us mentally and physically until we are their abject slaves. We cannot get rid of them by deciding to think no more about them; they never leave us of their own accord, and unless they are cut out by a decided surgical spiritual operation which will destroy them, roots and all, and set us free from their killing obsession, they grow in time like a deadly moss within us until we become warped in outlook not only towards others but towards ourselves….”
One can see how this concept of sin disease or in other words spiritual malady could be and was applied to early AA and incorporated into the Big Book of AA.
However, it is equally stating, I believe, that alcoholics suffer from the same spiritual malady as other people but our spiritual malady has led to chronic alcoholism, this is the manner in which sin has dominated “mentally and physically until we are their abject slaves”.
In fact the Big book’s first chapters look more at the manifestation of this malady, problem drinking, than the malady. It suggests that there is more than this malady, there is also a physical reason for alcoholism- an allergy (or abnormal reaction) to alcohol. So this is a departure from the Oxford Group as it clearly states that alcoholism is more than a spiritual malady. It is not simply the consequence of this spiritual malady although this malady may contribute. So is this saying some of us are spiritually ill while also having an abnormal reaction to alcohol?
In the foreword The Doctor’s Opinion suggests that “the body of the alcoholic is quite as abnormal as his mind.” and a first mention of a disorder more than “spiritual” is suggested, “It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact, to a considerable extent with some of us. (my emphasis)
“The doctor’s theory that we have an allergy to alcohol interests us…as ex-problem drinkers, we can say that his explanation makes good sense. It explains many things for which we cannot otherwise account.”
“the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker.”
Here we have an abnormal reaction to alcohol and for some alcoholics a maladjustment to life.
For me this maladjustment to life is not exactly the same as the spiritual disease mentioned in the Oxford Group pamphlet.
All of my academic research in the last 6 years has explored the possibility that this “maladjustment to life” is more than a spiritual malady, i.e. it is not simply the consequence of Sin but the result of abnormal responding, emotionally (which has obvious consequences for sinning) to life.
This emotion dysregulation, as I name it, has consequences for how we feel about ourselves, how we interact with people, how much we feel we belong, how rewarding alcohol and drugs are, how much these substances make us feel better about ourselves (fix our feelings ) and how they turn off the internal critic of maladaptive and negative self schemas.
In fact our first “spiritual” wakening was probably the result of drinking as it transformed how we felt about ourselves and the world in which we lived. I know it did for me. In fact, I felt “more me” when I drank, it was like I escaped a restrictive sense of self to be a more expansive, people loving self. I had a connection with the world I could not generate myself, when sober.
I was a “spirit awakening” if nothing else? It is interesting that a common definition of “spiritual” as it relates to AA, is a sense of connection with others.
As the BB states “Men and women drink essentially because they like the effect produced by alcohol. The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one. They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few drinks—”
For me this section is saying our emotion dysregulation leads to feelings of being “restless, irritable and discontented” which prompt a return to drinking.
The Doctor’s Opinion even offers some classifications of alcoholics “The classification of alcoholics seems most difficult, and in much detail is outside the scope of this book. There are, of course, the psychopaths who are emotionally unstable… the manic-depressive type, who is, perhaps, the least understood by his friends, and about whom a whole chapter could be written.”
This section would appear to be stating clearly that there alcoholics who have other (co-occurring) conditions or conditions appearing as co-occurring?
I contend that alcoholism is an emotional disorder which results in chemical dependency on the substance of alcohol. However in order to treat it we have to first contend with the symptomatic manifestation of this disorder, chronic alcohol use, as it is the most life threatening aspect of this disorder when we present our selves at AA.
What we used once to regulate negative emotions and a sense of self has eventually come to regulate our emotions to such an extent that any distress leads to the compulsive response of drinking. Alcoholics had become a compulsive disorder to relief distress not to induce pleasure.
The “spiritual malady” of the Oxford group seems enhanced in me, I believe I sin more than normal people because of my emotional immaturity and reactivity. My “loss of control” over drinking is also linked to emotion processing difficulties as it prompted impulsive, uninhibited drinking.
This emotional immaturity is referenced throughout the Big Book I believe.
“… He begins to think life doesn’t treat him right. He decides to exert himself more. He becomes, on the next occasion, still more demanding or gracious, as the case may be. Still the play does not suit him. Admitting he may be somewhat at fault, he is sure that other people are more to blame. He becomes angry, indignant, self-pitying. ”
“Whatever our protestations, are not most of us concerned with ourselves, our resentments, or our self-pity? Selfishness—self-centeredness! That, we think, is the root of our troubles. Driven by a hundred forms of fear, self-delusion, self-seeking, and self-pity, we step on the toes of our fellows and they retaliate. ”
“So our troubles, we think, are basically of our own making. They arise out of ourselves…”
“…Our liquor was but a symptom…”
“Resentment is the ”number one“ offender. It destroys more alcoholics than anything else. From it stem all forms of spiritual disease, for we have been not only mentally and physically ill, we have been spiritually sick.”
For me this is saying that out of my emotion dysregulation “stem all forms of spiritual disease”.
It then talks of the fear that “was an evil and corroding thread; the fabric of our existence was shot through with it. ”
The list of emotional difficulties continues throughout the Big book’s first 164 pages.
One of the earliest studies on AA members concluded that they were linked in commonality by two variables, emotional immaturity and grandiosity! I would contend that grandiosity is a part of emotional immaturity. I also contend that our “maladjustment to life” is based on emotional immaturity which is in itself a function of emotion regulation and processing deficits.
A book titled Matt Talbot by Morgan Costelloe has cites this reference – “American authorities on alcoholism hold that the following psychological traits are commonly found in alcoholics:
> 1. A high level of anxiety in interpersonal relations
> 2. Emotional immaturity
> 3. Ambivalence towards authority
> 4. Low frustration tolerance
> 5. Low self-esteem
> 6. Perfectionism
> 7. Guilt
> 8. Feelings of isolation”
The list is almost word-for-word identical with one in Howard Clinebell’s
“Understanding and Counseling the Alcoholic” p 53 of the revised edition of 1968 (the original edition appeared in 1956), the only difference being that Clinebell included grandiosity and compulsiveness.
Years after the Big Book Bill Wilson wrote about this emotion immaturity in the guise of discussing emotional sobriety, for me what he is saying that our emotional difficulties are present in long term recovery and need to be addressed – in other words there is more to alcoholism than sinning and drinking. What we are left with after the steps is ongoing and underlying difficulties with living life on life’s terms because we are emotionally immature. This I believe also preceded our drinking, for many of us anyway?
For many recovering alcoholics this may be another unpalatable truth, that they have issues with emotional responding, with being emotionally mature. If further validation is required I suggest a frank conversation with a loved one, wife, husband, child, parent, etc.
Here is what Bill Wilson wrote ” Those adolescent urges that so many of us have for top approval, perfect security, and perfect romance—urges quite appropriate to age seventeen—prove to be an impossible way of life when we are at age forty-seven or fifty-seven. Since AA began, I’ve taken immense wallops in all these areas because of my failure to grow up, emotionally and spiritually”. (my emphasis)
Bill continues “Suddenly I realized what the matter was. My basic flaw had always been dependence – almost absolute dependence – on people or circumstances to supply me with prestige, security, and the like. Failing to get these things according to my perfectionist dreams and specifications, I had fought for them. And when defeat came, so did my depression.”
” Emotional and instinctual satisfactions, I saw, were really the extra dividends of having love, offering love, and expressing a love appropriate to each relation of life… I was victimized by false dependencies… For my dependency meant demand—a demand for the possession and control of the people and the conditions surrounding me.”
For me this is emotional immaturity, regulating ones emotions and distress via external dependencies on others, demanding in an immature manner that others do one’s bidding?
I would suggest in relation to the issue of co-morbidities that one try to deal with these alcoholism related issues and then see if there are any other to deal with afterwards. For me, as someone who has been treated for anxiety and depression prior to recovery the 12 steps appear to have treated these as emotional consequences of my underlying condition of emotion dysregulation which I call alcoholism.
I think part of the issue is whether doctors, who know in my experience often know next to nothing generally about alcoholism, can always properly diagnose depression and anxiety in someone suffering from alcoholism?
I also think the issues are complicate because alcoholism have some many similarities to GAD, MDD, OCD, and so on. They all may be similar but different.
This is why we need a satisfactory definition of what alcoholism and addition is? Rather than describing these conditions in terms of the manifest symptoms, i.e chronic substance abuse or, at times, vague “spiritual maladies”.
For example, one variable I believe is slightly different in alcoholism to other affective disorders is distress based impulsivity which leads to maladaptive decision making, it leads to always wanting more of that…that anything.
These may be specific to addictive behaviours.
It may also be that we feel we have a co-occurring disorder because the underlying distress states prompt similar reactions in various differing disorders.
My distress feeds perfectionism, and catastrophic thinking as with other anxiety disorders like OCD, does that mean I have OCD too?
Maybe or maybe not? My tendency to not regulate emotions has caused a distress state since childhood, it feeds into perfectionism and many other manifestations like always wanting just one more…?
It is the always wanting one more that makes my affective disorder that of addiction and not another disorder.
My affective disorder via various neural and cognitive – affective mechanisms leads to chronic substance use and dependency of these substances.
GAD, MDD, OCD have different manifestations and different mechanisms.
If we start by trying to recover from alcoholism and addiction and find we still have other issues then obviously address these with outside professional and specialist help.
I believe we can unwittingly complicate our treatment of alcoholism by believing we have (and treating) other conditions we see as distinct from alcoholism but which are in fact part of this condition called alcoholism.
I never fully knew what alcoholsim was until I did the 12 steps. Only then did it become clear what I suffered from?
I have suggested clearly in previous blogs how I think AA’s 12 recovery programme helps specifically with problems of emotion dysregulation.
These illustrate how the 12 step programme can help with an emotion dysregulation disorder.
I end, however, with some words from a doctor who seems to be suggesting that AA works because it makes us more emotionally healthy. For me she is saying how AA treats emotional illness.
An article by Dr. Jacqueline Chang’s paper given to the National Workshop for Health Liaison in York in 1998 and published in the Winter 1999 edition of the AA News suggests that
“The principles of the programme of Alcoholics Anonymous are scientific and closely follow all the helping therapies which lead people to emotional well-being.
AA proposes living “ One Day at a Time”. It is emotionally healthy to live in the day … in the here and now. Professional therapists teach people to live in the present. AA encourages members to share their experience, strength and hope with other members. It is emotionally healthy to accept our past experiences, however painful, as past events and move on to a richer, more fulfilling future.
Step 1 in the AA programme is “ We admitted we were powerless over alcohol – that our lives had become unmanageable”. It is emotionally healthy to surrender and accept things over which we have no control.
“God grant us the serenity to accept the things we cannot change, courage to change the things we can and the wisdom to know the difference” is the Serenity Prayer used at every AA meeting. It is emotionally healthy to prioritise problems. The Serenity Prayer is the greatest exercise in prioritisation.
It is emotionally healthy to accept that we cannot change a particular situation but we can change the way we react to it.
It is emotionally healthy to accept yourself as you are.
It is emotionally healthy to recognise your environment and interact with it as it is, not as you wish it would be. It is emotionally healthy to associate or be in contact with other human beings.
It is emotionally healthy to be altruistic – to help others without question or expectation.
It is emotionally healthy to anticipate – to plan for future discomfort or crises. This is the function of the AA Step programme. ”
AA provides many ways of becoming more emotionally well, which ultimately means more emotionally mature.
INTERNET ADDICTION has become a prevailing problem in the modern wired society. One important line of research has examined the relationships among Internet abuse, social anxiety, and interpersonal relationships. Several studies have identified that people who are shy, have poor social skills, or experience a high level of interpersonal anxiety may be drawn to cyberspace relationships.
The social anxiety this study describes seems very similar to the “not being part of” or “not belonging to” that alcoholics and addicts frequently talk about. Many addicts say they never had the manual to know how to deal with other people hence it seems they had some form of social anxiety as the result of insecure relationships with primary care givers. Hence they found “friends” via the mediation of alcohol and drugs and these substances suddenly seem to endow them with the “chemical keys” to unlock the ability to act socially with other people, to be part of or “to act extemporaneously” to quote Bill Wilson, to act spontaneously, to act as if we had shed our anxiety straight jacket. We all felt more social, wittier, etc even if we were not in reality.
I felt I was “more me” when I started drinking initially, that this was the “real me” not the grey version of me when sober!
Alcohol had boosted my neurobiology in some way, my blood flowed better around my veins, my stress chemicals reduced, the neurotransmitters that were reduced seem to be repleted. I seemed to grow more into my body, be more alert, be more loving to my fellow human beings. I liked me more when drinking just as others seemed to.
I preferred this me, more than my sober me. Fact. Alcohol gave me something I could get by myself. This was my first “spirit awakening” in a sense. I could transform my self in minutes via substances and via certain behaviours. Spirit transformation.
Wears out. Drastically. Leaving me chronically addicted to everything.
I often wondered if I would be an internet addict myself if an adolescent now? The answer would be yes as I am an internet addict now!!
I use the internet so much it would be considered, by diagnostics, as internet addiction. I use it to write blogs, research, run my own business rather than to find cyber “love” but…I use it 7 hours or more every day! Is this internet addiction to add to my alcoholism, substance addiction, behavioural addictions, insecure attachment issues , PTSD etc.
When I engage in any behaviour I have to be aware of doing that behaviour way too much. If I want to do something, there is a sure fire guarantee that I will really, really want to do it more and more and….
This study (1) suggests “that the quality of parent–child relationship is indeed positively correlated to the quality of our participants’ interpersonal relationships and that frustrating interpersonal relationships may raise the level of social anxiety. In addition, interpersonal relationships, the parent–child relationship, and social anxiety all influence Internet addiction… Finally, the more social anxiety and discontent with their peer interactions the participants experienced, the more addicted they were to the Internet.
Other studies have explored whether the cyber-relationship substitutes for an unmet need in an actual relationship.3–5 Together, these studies indicate that cyber-relationships can provide a sense of belonging, warmth, and well-being.
A study by Bell et al. revealed that the parent–child relationship was a primary experience of the child, as parents retained a substantial influence on the development of adolescent social relationships outside the family (8).
Feldman and Wentzel also found that parental child-rearing style and social support from the family were positively associated with whether the adolescent was trusted or liked by his or her peers (9). These studies collectively suggested that warmth, support, acceptance, and love in the parent–child relationship are directly related to the child’s closeness to peers, satisfaction with peer relations, and acceptance by peers.
In this study, we identify predictors of Internet addiction by constructing a model from elucidating the linkages among Internet addiction, parent–child relationship, interpersonal relationships, and social anxiety. This finding is consistent with the positions of Suler and Young, who have said that addiction to the Internet is a reaction to poor adaptation in the real world (5,14).
Most individuals who are addicted to the Internet experience more social anxiety because of bad social skills and frustrated personal companionship, which in turn may be shaped by qualities of the parent–child relationship. Anxiety picked up from caregivers or parents in the early stages of development, however, can be overcome and social skills can be improved if people develop good relationships during adolescence(6).
1. Liu, C. Y., & Kuo, F. Y. (2007). A study of Internet addiction through the lens of the interpersonal theory. CyberPsychology & Behavior, 10(6), 799-804.