Recovery

Merry Christmas Everyone!

Hi everyone and thanks for reading my blogs this year. We were getting deep into trauma and co-dependency and then life took over. I ended up on television and then I found out that my anonymous self will be having paper published in an academic journal in January 2016 (the first of many hopefully)!

So I have been having a period of self actualisation which seems to have helped lots with my mental state. I feel strangely less neurotic, more fulfilled and whole and have become much more easy going.

I never thought being published with have such a profound affect.

All my life I have struggled to be heard. Growing up in such a dysfunctional family meant that I often felt unheard, dismissed and emotionally muted.

I now feel that internal voice has now begun to be heard.

I still plan to go into EMDR treatment early January to process the emotional trauma from my childhood.

2016 holds much promise.

All given to me by recovery.

I am so grateful, so so grateful for my recovery that I can’t express it in words.

In four days time i celebrate my tenth year in recovery. Thank God!

God Bless you over this festive period, often a tough period for alcoholcs in recovery.

Surround yourself with those who understand and can support you, that is my solution to this alcohol fueled period of the year.

It is a time for haves rather than have-nots and self pity can often seep into my mind. This year it has been replaced big time with gratitude.

Every moment of every day is precious. It is just realising that. It takes time to realise it takes time.

“We are going to know a new freedom and a new happiness. We will not regret the past nor wish to shut the door on it. We will comprehend the word serenity and we will know peace.”

From

The Promises. (From pages 83-84 of the Big Book of Alcoholics Anonymous).

 

Have a great one!

Santa is almost ready! Have a lovely and merry Christmas everyone!

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It Works, If You Work It!?

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One of this blog’s  original purposes was to inform newcomers to recovery, and their loved ones, what to expect in mainly (but not exclusively) 12 step recovery groups, with the hope that this might help in taking the first crucial step towards recovery.

Not only recovery from alcoholism, addiction or other addictive behaviours but also from codependency, co-alcoholism which loved ones often suffer from too.

In recent weeks we have taken detours to examine other co-morbid or co-occurring conditions which contribute to severity of addictive disorders. Here we return for now to our original intention – to pass on what we have been freely given.

To pass on how you can recover form addictive behaviours and the evidence of the success of 12 step groups in this pursuit.

This interview below is from a expert into the Psychology of Recovery in 12 steps and other treatment modalities like CBT and Motivational Enhancement. His name is Joseph Nowinsky Ph.D.

The language of the interview is not too academic. In fact, it uses pretty straight forward language to explain clearly what happens in 12 step groups and what are the main ingredients in successful long term recovery. 

I have found myself that whatever I put into my recovery I got back in terms of improved emotional well being.

If you put the work in, you will recover just like me.

That is the message of Hope. If you want recovery bad enough, the chances are, you will recover.

This academic and therapist explains why this is the case, citing numerous academic studies which seem to be in line with the experiential and anecdotal wisdom handed down to me via 12 step recovery groups.

It kinda shores on what is known in these groups which is great as it helps dispel any existing doubt about their effectiveness.

Earlier this year, his new book looked at 12 Step outcomes. It’s called, If You Work It It Works! The Science Behind 12 Step Recovery . It is a jargon-free look at how, 12 Step modality help alcoholics/addicts.
Recently a growing chorus of critics has questioned the science behind this model. In this book, Dr. Joseph Nowinski calls upon the latest research, as well as his own seminal Project MATCH study, to show why systematically working a Twelve Step program yields predictable and successful outcomes.
He discusses these in this interview.
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The Roots of All Our Troubles!?

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Most of my distress and emotional pain in recovery comes from wanting stuff, and not getting my way or not accepting things as they are.

As Bill Wilson noted, we seem to get distressed when we don’t get what we want or feel people or trying to take away what we have.

This was his observation after a decade of psycho analysis with the psycho analyst Harry Tiebout.

A decade of therapy also showed Bill Wilson he has two default settings in his relationship to other human beings – he either tried to dominate them or he became dependent on them for his sense of self and emotional well being. In other words, he became dependent on others, on external means for approval and elevating his self esteem.

This is similar to relying on external means, i.e. alcohol, drugs, addictive behaviours to regulate our emotions and bolster our low self esteem.

We are in a sense co-dependent on other people for our sense of esteem.  We rely on others in terms of how we feel about ourselves.

As a result we are guarded against those that we perceive will reject us or be negative to us, harm us in some way and we seek to dominate these folk or we are dependent on those who are kind to us, help us and care for us. We swing at times between these extremes.

Some of us are “people pleasers”, some of us are dismissive towards others. I can be a dismissive person more than a people pleaser. It is all manipulating our interaction with others to our selfish ends.

Some of these tendencies are the result of our childhoods and how closely attached we were to our parents.

Some of us have this knawing feeling of not being good enough, have a hole in the soul which we are/were kinda always unconsciously trying to protect, shield from the world.

It is a strange feeling of not wanting to be found out of being less than, not good enough. “If people realise what the real me is like, they will reject me!” type thinking although a lot of this is unconscious and does not pop in to our minds as thoughts but is an unconscious self schema that shapes our behaviours.

In simple terms we manipulate via people pleasing or we push people away via being dismissive and putting others down, we guard against any threat of perceived rejection or threats to the self via defense mechanisms such as projecting what we do not like about ourselves on to others.

We often do not like traits in others because they somehow mirror traits in ourselves although we are not always conscious of this.

We have difficulties in our relationships with others, these relationships are often unhealthy and ill.

Some of this is touched on in the Big Book of Alcoholics Anonymous, but much of it comes from later observations by Bill Wilson after the publication of the Big Book and my and others’ observations since.

I have seen in myself how fear and shame seem to drive most of my maladaptive behaviour.

My illness of addictive behaviours.

I have an illness of chronic malcontent, things are rarely good enough and I am rarely good enough, according to my “out of kilter”  thinking which  I usually try to ignore, turn over to God or on occasion challenge via reasoning and sharing with other people.

My thoughts are often not my friends, they are often not in the service of my ongoing well being, quite the opposite in fact.

This is how a mental health disorder manifests itself as distorted fear based thinking which appear, if acted upon, to make one’s situation a whole lot worse.

We can not rely on our thoughts and feelings or, in other words, our Self Will. Our self will has become impaired and is no longer in the service of our successful survival.

I have found over the last decade in recovery that when I turn my Will over to the care of the God of my understanding that I am restored to sanity and my thoughts are sound, they are on a higher plane as the Big Book tells me.

I can become the fullest expression of me in the God, not the ill, deluded version while running under my own self will. That has been my experience.

It is only with God’s help that I get restored to sanity or reasonableness.

When I have a fear of not getting stuff and this is linked to insecurity, as mentioned in the Big Book, it is usually in relation to my pocket book, financial insecurity, personal relationships, self esteem etc.

I will now look at this fear based reaction to my security which is mainly to do with stuff out  there (external) such as work, people and how they affect my sense of self before looking at how my internal sense of self, based on the fear based emotion of shame seems to play a pivotal role in my relationship with others and the world around me.

I am assailed externally by fear of what other’s think about me and internally about what I think of me – when these two line up it can have a powerful and damaging effect on my psyche.

Desiring stuff seems at the root of my fear based stuff – the exquisite torture of desire which soon loses it’s so-called relish and just becomes torturous.

Alcoholics do not seem want stuff like normal folk, but have a pathological wanting, an all consuming need to get stuff regardless of it’s worth or value.

We seem to compulsively seek to relieve an inherent distress of not having what we set out to get. Our decision making seems fueled at times by this need to relieve distress rather than the intrinsic value of what we are seeking.

We seem to become manic in our pursuit of things and end up overdoing whatever we are doing via this stress-based manic activity.

This seems compounded by not always being able to read our emotions or somatic states.

One of my own difficulties is realising I am hungry or tired and I can often end up exhausted by over-doing stuff especially manual work around my house. My stop button broke a long time a ago and probably did not work very well to begin with.

So we have  stress-based compulsive need to do something and very limited brakes in the brain stopping us and very little emotional feedback going on, a limited consideration of  “aren’t we overdoing this a bit?”

Desire obviously runs contrary to the idea of being in God’s will, in fact it is being in Self Will that seems to create distress in many people with addictive behaviours.

I would add to this that I also get distress via fears of rejection from others, I suffer from fear based shame to a chronic extent.

Shame, also the consequence of being in Self Will, was not really mentioned in the Big Book of Alcoholics Anonymous, mainly because it was not really known about as a psychological or psycho-therapeutic concept then.

Much of the Big Book was influenced by  psycho-analysis which did not consider shame, but rather guilt, in psychological disturbance.

In fact, it has only started considering the role of shame in the last few decades.

So I would add fear of not getting what we want or having something taken away is also complemented by shame-based fears of being rejected.

For example there is an undercurrent in fear of things being taken away, of it being because we are not good enough, deserving enough, have failed in some way, which are shame based reactions.

In fact the Big Book gives me a good idea of the “sins” or “defects of character” I have when I have a resentment but does not explain why I have resentments in the first place.

It explains this as selfishness, self centredness… the root of all our troubles.

It does not, for me, clearly explain why we resort to these selfish, immature, emotional reactions or why we persist with resentments?

It does not explain the emotional immaturity at the heart of alcoholism,  this spiritual malady of inappropriate emotional response to the world around us?

Bill Wilson was struck himself, when he started working with other alcoholics, how much they were plagued constantly by various resentments. How they were haunted by memories of situations in the past, how they swirl around and pollute their minds in the present. How they could not let go of events in their past?

For me he was seeing the root of this spiritual malady, this emotional disease.

For me we engage futilely and distressingly in resentment because we have an inability to process and control our emotions, they overwhelm us and we often react by people pleasing (shame) or react via various defense mechanisms (also shame based).

Defense mechanisms are central to psycho-analytic thought – such as projection etc, the idea that we  expel “out of ourselves what we do not like about ourselves onto others.

Sometimes others expel the same negative emotions on to us. I have found this a fairly common trait among male alcoholics in recovery settings and meetings.

I was discussing this with a newcomer last week, how people who seek to “put us down”  do so out of shame and induce in us all the negative emotions they are experiencing themselves!

The newcomer gave me an example of a resentment he was experiencing after this guy at a meeting said “get off your pink cloud” a phrase that refers to the sometimes  mildly ecstatic feelings of early recovery.

This made the newcomer ashamed that he could have been so stupid for being on this pink cloud, as if this was a selfish indulgence!?

I explained to him that his pride had been hurt, he was in shame and his “apparent” depression every since was simply prolonged self pity.

If we leave self pity to fester long enough it becomes depression, that is my experience anyway.

I said the other guy was probably “hurt” to see a newcomer having such a good period of recovery (God does want us to be happy, joyous and free after all) – I said his false pride was hurt too, that he was not having the recovery experience at present of the newcomer (possibly because he wasn’t putting the effort in) and was in shame (not good enough) and self pity. This mesh of negative emotions can link up fairly instantaneously I find.  It is the web my spiritual malady seeks to ensnare me in.

The guy was probably in guilt too as he could been working on his recovery more.

As a result this guy put the newcomer down to alleviate his own sense of self, his low self esteem.

He “had to” react with arrogance, dismissiveness, impatience and intolerance, because his shame, which is a fear based emotion, made him fearful of his own recovery and fear makes one strangely dishonest (at times deluded), This is my experience.

All because a newcomer had the temerity to be enjoying his recovery?

Not completely, this is half the answer.

The other part is that this guy, if an alcoholic like me, has real difficulties accessing in his heart and mind how he actually “feels” at any particular time. Or rather what emotions he is experiencing at any particular time.

This guy could have been experiencing guilt or shame for example.

Instead of saying to himself I am feeling guilt that my recovery is flabby  compared to this newcomer or that I am being an arrogant “know it all”, putting this newcomer in his place because  he had been in recovery longer – although being in recovery and being sober are different things I have found.

Either way, if he could perhaps of had the ability to say this is how exactly I am feeling he could have acted on this emotional information rather than reacted to it.

What do I mean by this?

Well, if I was feeling guilty about this newcomer it would cause a disturbance in me because I have difficulties processing my emotions.

It would have turned up therefore as a resentment of someone having something I do not have and as them taking away the illusion that my recovery was going OK?

I would have found this threatening to my sense of self so I would have reacted via defense mechanisms. I would have strangely blamed this person for making me feel the way I did! Even if this person had no such intention of hurting my feelings I would blame him nonetheless via my defensive reactions.

It is as if my emotional well being is dependent on other people and their behaviours, this is my spiritual malady, my emotional disease.

As I would have had a resentment, it would have had a wolf pack of negative emotions attached.

In this instance I might have have acted differently.

If I had been in God I would have been more sane for a start and had more loving tolerance for a newcomer.

I would have been acting not reacting. I would have had empathy for where the newcomer  “was at in his recovery” as I had been there once too.

This love and tolerance for the newcomer evolves the displaying of virtues (the opposite of defects are virtues).

What virtues? Well as the newcomer was relatively new I would attempted to be patient, empathetic, kind, gentle, tolerant, considerate  etc. These prevent the defects occurring I find.

If we practice virtues instead of defects then the brain changes for the better and we recover quicker. Our positive loving, healthy behaviours change us and our brains via neuroplasticity for the better.

Attempting to live according to God’s Will (which is a state of Love) also helps me not react but to act with Grace.

In Grace we can still experience negative emotions but God allows us to see them for what they are and not react. His Grace takes the distress out of thee negative emotions. This is my experience.

This allows me to do a quick inventory of my negative emotions and a prayer to God to have them removed. My experience is that they are always removed and that we are immediately restored to sanity.

I do not necessarily have to react to my feelings of negativity about myself, someone else does not need to experience the consequence of my resentments.

I can manage my spiritual malady or emotional dysfunction, I have the tools to do so.

I also impressed upon the newcomer that what the other guy was experiencing and was reacting is also how he, the newcomer, reacts and how I react too.

It is what our spiritual malady looks like I believe, it is the map of my impaired emotional responding.

I also impressed upon him that mostly I can manage this emotional dysfunction but often I fail to and get into a resentful anger.

This is why I have to forgive the other guy as I have been forgiven but also to forgive myself (or ask God to forgive me my shortcomings) for my reactions.

We are not perfect, far from it. We are far from being Saints but have a solution Saints would approve and achieve a kind of transient sanctity in this 12 step solution of letting go and letting God.

We have to show love and tolerance for each other as we suffer the same illness/malady. Dismissing others like us for having what we have and acting as we do is like a form of self loathing. We have to forgive ourselves and each other for being ill. Self compassion allows us to be compassionate  towards others.

Also we need to be aware what we project on to other alcoholics is the same thing as they project on to use and sometimes we project if back.

So we have two main ailments, distressed based wanting which results in the same negative emotions as being in a shame- based fear of rejection.

I can get out of the distress of wanting/needing stuff by asking God to remove those negative emotions which block me off from Him.

For example, if I really want something and feel someone is preventing me getting that thing or that they are taking this thing away from me I have a hunting pack of negative emotions running through by heart and pulsating through my veins, propelling me to want that thing even more! As if my very life depended on it?

These feelings are translated as “how dare you take that thing/stop me getting that thing” – False Pride – followed by fear of being rejected – Shame (this is because I am not good enough)  and possible Guilt (for something I must have done wrong as usual) – then leading to “poor me” and feelings of Self pity, all because I am in Self, so I am being Self Centred and not considering someone else’s view so I am Selfish.

I retaliate via by “I”ll show you/I’ll get you” emotions of Dismissiveness, Intolerance, Arrogance and Impatience – my “I’ll put you down to make me feel better!”

All because I am fearful that you are taking away something from me or rejecting  me –  Fear and Fear is always accompanied by dishonesty.

I will act out on these somethings, if I do now use my spiritual tools and let Go and Let God, usually by eating too much, Gluttony, having a shopping spree, Greed, engaging  sexual fantasy/activity Lust of “freezing” through fear in the subltle sin of Sloth (procrastination).

A perceived slight or a rejection can have an incredible emotional effect on me

This is all emotion dysfunction and immaturity. I have resentments because they are a true sign of emotion dysfunction.

The mature way to to access, identfiy and label how one is feeling and use this information to reasonably express how one is feeling. This way we do not retaliate, fight, flee or freeze. Instead our emotions do what they are supposed to do. They are suppose the tell the fronts of our brains to find words for our feelings. Not to tell the bottom of our brains to fight back or run or freeze.

Let me use an example.

I had an argument with a guy once who suddenly proclaimed he was upset by what I had said. I was amazed as this guy was reading his emotions, identifying verbalising/expressing them to me in a way I have never been able to do.

My alcoholism is rooted in an impaired ability to read, identify, label and express my emotions (otherwise called emotion processing) – as a result my emotions have always troubled me and been so troubling in their undifferentiated state that I have always either avoided them or ran away from them.

I have sought refuge from my negative emotions in alcohol, drugs and other addictive behaviours. It is this that propelled my addictions, this inability to deal with my negative emotions. I dealt with them externally via addictive behaviours, not internally via emotion processing.

My emotions became wedded in time to being undifferentiated arousal states that prompted me to seek an external way to deal with these troubling emotional/arousal states.

Today when I engage in the above emotion dysfunction, engage in the above web of defense mechanisms it is because I have not been able to locate in me what feeling is disturbing me ?

On occasion it is, as the guy above said, because I am upset. I have not learnt the ability to say that I am upset etc. The words for these feeling states somehow can continue to elude me unless I am in God’s Grace.

God does for us what we can not do for ourselves!

Finding out what is really going on with us emotionally is at the heart of recovery. That is why we have to constantly share how we are feeling with others so that we can find out what we are feeling.

Unless, we let Go and Let God and ask God to remove these negative emotions/sins/defects of character we end up in a futile increasingly distressed spiral of negative emotions.

We end up cultivating much greater misery.

As soon as you can, let Go and Let God.

 

There is a map of Emotional Responding Tattooed on my Heart.

When I was doing my step four inventory as part of my 12 step programme of recovery  I did it pretty much as suggested in the Big Book.

My sponsor at the time asked me to do an additional part that is not explicitly mentioned in the Big Book.

He said to list all the negative emotions (or defects of character) that I had been in the grip of and exhibiting in relation to my various misdemeanors and the resentments I had held against various people and institutions over the preceding decades.

This turned out to be a brilliant idea for two reasons.

First it showed me that  I held a multitude of resentments because I had a problem of emotion regulation.

I did not realise that the engine driving this emotion dysregulation was chronic shame.

I realised when doing my step 4 that that I had not previously been able to leave various supposed slights and abuses from my past in the past because I did not have the emotional maturity to look at these episodes reasonably and objectively.

In other words, I had not processed these episodes emotionally and embedded these events in my long term memory like healthy more emotionally mature people do.

Hence when I came into recovery I had hundreds and hundreds of resentments swirling around my mind, poisoning my thoughts and sending constant emotional daggers into my heart.

My past constantly assailed me emotionally, randomly attacking my mind.

My step 4 and then 5 showed me that I did  not have the natural ability to deal with my negative emotions.

Secondly, listing all the negative emotions I had when I held a resentment against someone was very revealing in that when I held a resentment, any resentment, and against a wide variety of people, the negative emotions listed where generally the same! In fact they were all interlinking in a pattern of emotional reacting, one activating the other. It was like a emotion web that ensnared one in increasingly frustrating states of emotional distress and inappropriate responding.

This was quite a revelation!? That I respond in exactly the same way to my sense of self being threatened?

That there was a map of emotional responding tattooed on my heart.

I was drawing up a web of my emotional dysregulation, a route map of all the wrong ways to go, to emotional cul de sacs.

It was a list of the negative emotions which appear always when I felt anger and resentment against someone for hurting me and my feelings.

Just as revealing where the negative emotions listed which clearly showed how  I react, and can still react to people who I believe have caused my hurt or rejection.

In fact it seems now that I treat all insult, intentional or otherwise, in a very similar way.

I have spent years trying to work our why?

I got as far as deciding it was an inherent problem with processing negative emotions, which it is.

However, there seems to be a problem specifically with a patterned mesh of negative emotions which are activated when someone upsets me.

In fact I think this pattern of interlinked negative emotions occurs simply because of inability to identify, label and share the simple fact that I have been upset  by what someone has said or acted towards me.

“Shame is a fear-based internal state being, accompanied by beliefs of being unworthy and basically unlovable. Shame is a primary emotion that conjures up brief, intense painful feelings and a fundamental sense of inadequacy. Shame experiences bring forth beliefs of “I am a failure” and “I am bad” which are a threat to the integrity of the self. This perceived deficit of being bad is so humiliating and disgraceful that there is a need to protect and hide the flawed self from others. Fears of being vulnerable, found out, exposed and further humiliated are paramount. Feelings of shame shut people down so that they can distance from the internal painful state of hopelessness.”

“… unacknowledged thoughts and feelings become repressed and surface later through substitute emotions and dysfunctional behavior. Other emotions are substituted to hide the shame and maintain self esteem. Anger, exaggerated pride, anxiety and helplessness are substituted to keep from feeling the total blackness of being bad. The buried shame is expressed through defense mechanisms that shield negative unconscious material from surfacing.

Anger responses are modeled and learned in some families. The anger response is more comfortable than feeling the shame for some individuals. Families where coercive and humiliating methods of discipline are used develop children who are shame prone. Behavior become driven by defenses that function to keep from feeling bad. Reality becomes distorted to further protect the self from poor self esteem. The transfer of blame to someone else is an indicator of internal shame.

Children who live with constant hostility and criticism learn to defend against the bad feelings inside and externalize blame on others. External assignment of blame is a defense against shame. People who are super critical have a heavy shame core inside.”

I was working with someone last year and we had a disagreement and this guy said to me “I am upset” and “You have hurt my feelings” I was taken aback. I thought I never say things like that. This guy was an Olympic champion at expressing how he feels compared to me. I never say I am upset because it also seems to be an undifferentiated emotion that I have trouble accessing, mentalising and expressing.

I have not been taught as a child or since to simply say I am upset.

Instead of acting on my upset by saying to someone,  you have hurt my feelings  I do the opposite,   I react and attack them in my head, my thoughts, my words and sometimes in my actions. Sometimes I “get them back” somehow. I make them pay in some way.

Honesty is the heart of recovery and I am being honest. The years of recovery reveal many different things, some of them not so palatable.

I grew up in a family that did not express emotions like the ones I had mentioned. We reacted via anger and put downs hence I have grown up to be dismissive.

My dismissiveness and my arrogance are parts of defence mechanism against rejection, they guard my inherent sense of shame. I am full of shame, more so than fear, although these two overlap. Shame is in fact fear evoking.

I hide my shame away under an anger of emotional hostility, stay away or else! I will get you back somehow. Sometimes I am in shame and offend via my attitudes.

I also have other ways of reacting in an emotionally unhealthy way that my step 4 showed.

If someone hurts me, according to my step 4, my angry resentment of what they have said or done makes me ashamed. This can quickly prick my sense of self pity (uselessness and hopelessness) which is something I have always rage against (rage is an essential part of shame plus I rally against this feeling of powerlessness) and I retaliated via excessive pride (I am better than you, I will put you down and see how you like it!) I put you down in my mind or through the words uttered from my mouth by arrogance, dismissiveness, impatience and intolerance.

I do so because I am being dishonest and fearful.

I do some because I am self centred and selfish.

These are all parts of my emotionally entangled web that is spun when I react to some sense of rejection.

Sometimes the shame persists for some time and I try to relieve it by behavioral addictions, too much shopping, too much eating, too much objectification of the opposite sex.

Not enough action, or effort to change my feelings in a healthy manner.

My step 4  showed me this is the unhealthy fruit of my greed, gluttony, my lust, my sloth.

My spiritual malady.

Add in perfectionism because that is the quick way to do nothing, a fear of failure  that paralyses.

These are my main negative emotional  reactions to the world that often scare me and make me feel ashamed.

I have felt powerless via your comments so try to to steal some power back by making my self seem more powerful over you.

I respond to feelings of humiliation by humiliating you, I react to my chronic shame by attempting to created shame in you.

Some days I react more adversely than others.

For example, this family have just moved into my neighbourhood, they seem wild and out of control.

I am not only fearful (leading to dishonesty in my thinking, catastrophizing, intolerance of uncertainty about how they will behave etc) I have reacted to their arrival via shame based defence mechanisms and reactions. I am shamed and disgusted that my neighourhood has come to this. I am dismissive of them, intolerant, impatient and arrogant towards them. All shame based reactions.

Last night the police were called to their home and one of them was handcuffed and put in the back of the police van.

My head went “I told you so!”

It was a very shameful scene for the whole family.

When things had died  down and calm restored I spent the evening not in my fear or shame but in empathy and compassion.

How embarrassing for them how shameful.

I relate to them as they are out of control, my family was at varying times completely out of control too, traumatic and this is what has created a chronic shame in me, even still now after 10 years of recovery!

My shame responded and related to their shame.

Nobody wants to be out of control, to be teetering on the verge of the next disaster, the next moving of home, the next calling of the police,  the next swirling carousel of unmanageabiilty.

No one.

I related and all my negative emotions retreated to source like a evening tide on a beach.

I relate to my fellow human beings when I am not in fear or shame.

When I am in fear and shame the same pattern of negative reactions entrap my heart in its’ poisonous grip and I react in a way I would not choose to, if more reasonable.

This is what the heart of my alcholism looks like. Not a pretty sight some days.

The most beautiful thing about me most days is the fruits of my recovery.

Now at least I can see how I react and can take steps to deal with it.

I have a spiritual tool kit that deals with this emotional disease.

Whether  I stay in fear or shame is now my choice. A choice I once did not seem to have.

This is what recovery has given to me.

I do not have to cultivate my own misery through blind reaction.

Via an Amazing Grace I can now see what ails me.

Via AA I now have the tools, never taught to me in my family or in my troubled home environment.

I have gone home in AA. I learnt an attachment to those in AA and others.

I share my feelings of shame with those who know what that feels like.

Together we share our pain and we recover.

Reference

1. http://www.angriesout.com/teach8.htm

 

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.

sharing 82a62c4e060569b3dedb0dc7e4c6c438

 

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.

Reference

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

 

 

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!

Life In Recovery (Part 3)

“This story is only starting to be told.

We have much work to do … to challenge the stereotypes of both the general public and our own professionals.

Addiction may well be a chronic, relapsing condition but people can and do recover.

They can change and that change is not only personal but social and societal.”

COMPARISONS:

US & AUSTRALIAN LIVES IN RECOVERY

In the US, a total of 3,228 people completed the online survey and as in the Australian survey just over half of the sample was female.

The samples were also very similar in that the mean length of the substance using career was 18 years in the US and 18.6 years in Australia. The average ages of recovery initiation were also very similar – 34.8 years in Australia and 36 years in the US.

While 75.2% of the US sample described themselves as being ‘in recovery’ and 13.7% as recovered, this was true for 79.8% and 6.3% respectively in Australia.

In terms of problem profile, primary alcohol was the problem for 29% in the US and 35% in Australia, drugs only for 13% in the US and 11% in Australia, and both alcohol and drugs for 57% in the US and 54% in Australia.

In terms of their pathway to recovery, 70.5% of the US sample had received formal treatment, compared to 69.8% in Australia; 94.6% of the US recovery group had attended 12-step meetings compared to 82.0% of the Australian sample. Although a wide range of other mutual aid groups was reported, there was much less frequent use of mutual aid groups other than 12-step in Australia.

There is a higher rate of lifetime mental health problems in Australia – while 62.4% of the US sample had been treated for a mental health condition, 91.5% of the Australian sample reported lifetime mental health problems and 56.8% reported current involvement with mental health services. In the US, 55.6% had a bachelor or graduate degree, while this was true for 41.4% in Australia. At the time of the survey, 70.8% of the US sample was employed compared to 68.2% of the Australian participants. Thus, it is reasonable to conclude that the histories and careers of the Australian sample were very similar to their American counterparts.

THE IMPACT OF RECOVERY IN THE US AND AUSTRALIA

The most dramatic and powerful findings of the US survey, that addiction involves “many heavy costs … to the individual and to the nation” and that “recovery from alcohol and drug problems is associated with dramatic improvements in all areas of life” (FAVOR, 2013, page 1) are clearly replicated in the Australian context.

As in the US, where 4 out of 10 individuals experienced financial problems while in recovery, this was also the case for around one in 3 in Australia who owed back taxes and / or had bad debts. However, there were dramatic effects in Australia as in the US of family functioning with significant reductions in domestic violence.

The Australian study also successfully replicates the US findings around health and criminal justice – with marked improvements in positive health markers such as regular exercise, registering with a GP and regular dental check-ups and significant reductions in negative health factors such as ED attendance and untreated psychological problems.

As in the US sample just over half of the Australian sample had a lifetime arrest history (although significantly fewer Australians in recovery had been incarcerated following sentence), the reduction in arrests and in any involvement with the criminal justice system was even more dramatic – around 40% of the US sample and 90% of the Australian sample had no criminal justice system involvement while in recovery.

There were similarly positive differences in work and study – showing the same overall pattern of reduced burden to the taxpayer and the same improvement in personal, family and community wellbeing and connectedness.

CONCLUSIONS

Similarly, there is a dramatic reduction in involvement with the criminal justice system from around half to less than one in ten, particularly involving the areas of drink-driving and criminal damage. There is also a dramatic improvement in both employment and education, and in successful engagement and retention of jobs. This is a story of overcoming adversity and transforming lives to make a significant and positive contribution in their families, in their communities and to society. These results are consistent with the findings of the US Life in Recovery Survey (Laudet et al, 2013) in showing dramatic reductions in pathology and improvements in wellbeing from active addiction to recovery. This is the first attempt at undertaking a recovery survey in Australia and the results are unequivocal in showing that there is an accessible population of Australians who will classify themselves as being in recovery or recovered and who are willing to complete a survey about their experiences.

There is a critical message here for policy makers and treatment providers – that people in Australia can and do recover from addiction problems.

However, there are two nuanced factors that are important to emphasise.

The first is that this is a long and challenging journey for many people and that there will still be residual and ongoing problems for many throughout the recovery journey.

However, there are two nuanced factors that are important to emphasise. The first is that this is a long and challenging journey for many people and that there will still be residual and ongoing problems for many throughout the recovery journey

The findings also emphasise the fact that those in recovery are a very diverse population and that there is no single road to recovery, with a proportion of those participating describing themselves as in ‘medication-assisted recovery’ and a much larger population having ongoing contact with specialist services for addiction or mental health issues.

Nonetheless, the transition reported from active addiction to recovery is a dramatic one.

This is particularly striking in key areas around social and family functioning where the rate of involvement in domestic violence decreased from more than 50% to less than 10% and in volunteering where participation increased from less than 20% to more than 50%.

Similarly, there is a dramatic reduction in involvement with the criminal justice system from around half to less than one in ten, particularly involving the areas of drink-driving and criminal damage. There is also a dramatic improvement in both employment and education, and in successful engagement and retention of jobs.

This is a story of overcoming adversity and transforming lives to make a significant and positive contribution in their families, in their communities and to society.

These results are consistent with the findings of the US Life in Recovery Survey (Laudet et al, 2013) in showing dramatic reductions in pathology and improvements in wellbeing from active addiction to recovery

Those in recovery for the longest term report markedly higher levels of psychological wellbeing and quality of life and much lower levels of need for professional support for emotional or mental health issues.

The other more surprising domain of consistency with the US results is around the demographics and career factors of those who took part. Average age at time of survey completion, average duration of recovery and average length of addiction career are all markedly similar across two countries with differing cultures, treatment systems and philosophies around addiction and recovery.

RECOMMENDATIONS

POLICY RECOMMENDATIONS

It is critical that the implications from the Australian Life in Recovery survey are acknowledged and addressed at a federal, state and local level to ensure that the achievement of recovery is extended across families, communities and professional settings (such as health and legal systems).

As such, the following policy recommendations are suggested for consideration:

1. Policy makers should acknowledge and recognise in drug and alcohol commissioning the key role that recovery organisations play in the initiation and sustaining of recovery journeys that benefit wider society and challenge stereotypes and stigma around addiction

2. Greater policy and funding commitment to recovery support services to ensure that those who initiate recovery journeys are supported to maximise their own wellbeing and their contributions to family and community

3. That greater funding is provided for alumni and aftercare organisations to enable the informal community support that is essential to build recovery capital and recovery communities

This story is only starting to be told.

We have much work to do – and we hope to do this through academic publications and presentations – to challenge the stereotypes of both the general public and our own professionals.

There is one core message that the data presented here in Australia and by FAVOR in the US

Addiction may well be a chronic, relapsing condition but people can and do recover.

They can change and that change is not only personal but social and societal.

The next step on this journey is to repeat and augment this work. At the date of publication this survey has already been approved and will be conducted in the UK and we we await the survey outcomes with great interest.

This survey has already followed in the footsteps of the FAVOR survey with almost no resources and supports and we should aim both to do this in more countries and to continue to repeat the surveying to allow us to map global changes and implications in recovery pathways (see final recommendations below).

LIFE IN RECOVERY SURVEY RECOMMENDATIONS

1. That the ‘Life in Recovery survey’ is undertaken in other countries to increase the comparability and so that a shared evidence base can be generated.

2. That repeat surveys are undertaken in Australia to assess change in the nature of the recovering population and in the journeys and stories they provide.

3. That the results from this survey are widely distributed and used to contribute to the policy debate about recovery in Australia.

4. That the results from the current survey are used for academic journal publications to augment the empirical evidence base around recovery.

http://www.southpacificprivate.com.au/sites/default/files/2015%20Australian%20Life%20In%20Recovery%20Survey.pdf

 

Life In Recovery – Australia (Part 2)

“After over five years of intermittent relapses and struggling to re-invent myself, I can safely say that I feel at ease in my own company for the first time in my life. I trust that I will do the right thing by myself and my family”.

 

“…all levels of government need to stop focusing on the policing of drug use and distribution, and invest more in recovery services.

That would slash health care, child care and criminal justice system costs racked up by addicts, while drastically cutting crime rates and creating more valuable contributors to society, the Life in Recovery report says.

The survey, by the South Pacific Private and Turning Point treatment centres, suggests addicts in recovery are 75 per cent less likely to drive while under the influence, 50 per cent less likely to get arrested and 40 per cent less likely to perpetrate or be a victim of family violence.

They’re also 40 per cent more likely to volunteer in a community group, and tend to make more significant contributions to the community than the average person, according to the report’s author, Associate Professor David Best.

Government funding is provided for detox services but virtually no money is spent on the difficult recovery process that follows, despite relapse rates of between 50 and 70 per cent in the first year of recovery, he said.

The focus needs to switch to funding support groups and programs that help addicts get back on their feet, like finding jobs and accommodation, he said.

“None of the treatment services are sufficiently well-funded but the complete neglect of after care and recovery services is both inconsistent with the evidence and counter-productive, because it just puts people into this spiral of relapse,” Prof Best said.

from

http://www.sbs.com.au/news/article/2015/05/05/govt-policy-addicts-wrong-report

reported in

http://www.southpacificprivate.com.au/Life-in-Recovery-Survey-first-of-its-kind

Infographic  of some of the Survey Findings

 

 

 

RECOVERY STATUS There was considerable variation in how people described their recovery:

• 79.8% described themselves as ‘in recovery’

• 6.3% described themselves as ‘recovered’

• 4.5% described themselves as in ‘medication-assisted recovery’

• 3.7% reported that ‘they used to have an AOD problem but don’t any more’

• 5.7% used other ways of describing themselves

Thus, for the vast majority of participants, recovery is seen as an ongoing process.

The majority (69.8%) reported that they had accessed alcohol and other drug (AOD) treatment services meaning that 30.2% had never done so. Of those who had, 36.6% had taken medications prescribed by a health care professional to help them deal with their drug and alcohol problems.

At the time of the survey, 41 individuals (7.2% of the total sample), were currently receiving prescribed medication to deal with their drug and alcohol problems.

A higher proportion (82.0%) had attended a 12-step meeting, with 68.8% attending 12-step meetings at the time of the survey. Current 12-step group attendance involved Alcoholics Anonymous for 57.1% of the sample, Narcotics Anonymous for 24.6%, Gamblers Anonymous for 2.3% and Crystal Meth Anonymous for 1.0%.

11.3% were currently attending Al-Anon (as a loved one or family member) and 6.8% reported that they were currently attending other 12-step groups that included Sex and Love Addicts Anonymous, Overeaters Anonymous, GROW (for co-morbid alcohol and mental health problems) and Adult Children of Alcoholics. SMART Recovery was being attended by 0.5% of the survey participants.

 

1. FINANCES

Changes in financial situation from active addiction to recovery There were marked improvements in paying bills on time, in having your own place to live, in having a good credit rating and paying taxes from when participants were in active addiction to when they were in recovery.

WELLBEING & LIFE

2. FAMILY AND SOCIAL LIFE

…  there were marked reductions in the experience of family violence from around half of the participants during active addiction to less than 10% in recovery, that were accompanied by positive improvements in participation in family activities and planning for the future. There was also a clear improvement in children returning from care and a massive increase in participation of community and civic groups.

3. HEALTH

There are marked differences in health functioning as reported by participants with clear improvements in a range of self-care activities – improved engagement with GPs, regular dental check-ups, improved diet and nutrition and regular exercise. At the same time there is a clear reduction in health service utilisation indicated by marked reductions in the frequency of use of healthcare services and emergency department attendance and improvements in the rate of smoking. There is also a significant reduction in experiencing mental health side effects.

4. LEGAL ISSUES

Changes from active addiction to recovery in offending and criminal justice system involvement There are very striking transitions in involvement with the criminal justice system and overall offending with the most marked transition from 82.9% reporting driving under the influence while in active addiction to fewer than 5% while in recovery. Likewise, while more than half of the sample had been arrested in active addiction, this dropped to around 2% in recovery, leading to significant reductions in family disruption as well as significantly reduced costs to society. This is also reflected in the more than 90% reduction in imprisonment from active addiction to recovery, while there were considerable improvements in re-obtaining both professional registration and the right to drive once in recovery.

5. WORK AND STUDY

Missing work and being fired or suspended, which had been frequent occurrences in active addiction, were extremely uncommon in recovery, as was dropping out of school and university. In contrast, there were clear improvements in positive job appraisals, in further education and in remaining in steady employment.

 

THE SOCIAL NETWORKS AND SOCIAL IDENTITIES OF ACTIVE ADDICTS AND PEOPLE IN RECOVERY

Here the position is even more dramatic with the vast majority of participants reporting no contact with people in recovery while they were active addicts, but that this situation is reversed to the extent that 36% of people in recovery have a social network made up only of people in recovery.

This is reflected in ‘qualitative social capital’ – in other words the number of people individuals can rely on. At the peak of their addiction, 38.3% of participants reported that they had nobody they could discuss important things with compared to 2.0% who reported the same in their recovery. By contrast, while 8.6% of participants reported that they had four or more people they could discuss important things with in active addiction, this increased to 65.9% in their recovery. This is reflected in changes in social group membership – a proxy for connectedness and wellbeing.

…our participants’ social identification with addiction had not diminished but their social identification with recovery had grown enormously.

 

PERSONAL ACCOUNTS OF RECOVERY

THE EXPERIENCE OF ADDICTION

he pain and trauma of addiction is clearly illustrated in the reports of participants. Active addiction is seen as having destroyed the person’s own lives and taken many of the lives of their peers.

“Active addiction completely destroyed any semblance of normality in my life. Everything was reduced to absolutes: the need to get drugs so I could not feel sick, and the use of drugs to numb any emotional or physical pain”.

“Ruined my life in all areas, physically, mentally, emotionally and spiritually”

“I am alive, none of my peers from that time are alive. Only 5 of the 33 people I was in rehab with are still alive”.

THE JOURNEY TO RECOVERY

This journey is not perceived as a quick or easy journey by most of the participants. Many recognised that they have had persistent problems long into their abstinence. However, for most people it is a generally positive transition.

“After over five years of intermittent relapses and struggling to re-invent myself, I can safely say that I feel at ease in my own company for the first time in my life. I trust that I will do the right thing by myself and my family”.

 

“Addiction was part of my journey, I don’t regret it but recovery is so much more comfortable”.

THE EXPERIENCE OF BEING IN RECOVERY

Building on the previous section, this was generally very positive and the following examples illustrate the perceived benefits. Many people spoke of what they had achieved since starting their recovery journey.

“I am a productive member of society today: a good partner, parent, employee, daughter, sibling and friend, and I was not any of those things before”

“I experience long periods of peace of mind. I can manage problems really well. I am less inclined to react negatively to adverse events. I have recovered from Hepatitis C. I have deep and meaningful relationships with friends and family. I feel a wide range of emotions and can (mostly) sit with them. I have experienced 15 years of being engaged with and liked by the community instead of being a pest to society and that is absolute gold”.

POSITIVE ROLE OF TREATMENT OR MUTUAL AID

There were a striking number of comments supportive of 12-step groups, as illustrated by the following:

“AA saved my life because I gradually changed and got my self-respect back”

“AA saved my life; I would be dead without AA”

“I have a brand new life thanks to AA. For me, my children and my grandchildren. I am responsible at work and pay my bills”

“In nearly 30 years I have literally witnessed many hundreds of people turn their lives around from chaos and mayhem to lead similarly fruitful lives to the one I live today, overwhelmingly through the agency of their involvement in 12 step programs”

“I could not stop drinking on my own. AA has shown me a new way of living. Life is not perfect but I can now live like a ‘normal’ person. I have self-respect and dignity and I am a good worker and mother”

COMBINED APPROACHES Furthermore, as is consistent with the literature, a number of respondents talked about the benefits of bespoke and blended support from both mutual aid groups and professional treatment services.

“I am an active participant in the AA program – the 12 steps are my program for recovery. Putting the 12 steps in my life and putting the skills I learned at South Pacific Private into my life have given me a life that is full of understanding, patience, great relationships and love”.

“Detox set me on the path to recovery and AA helped me to sustain my recovery”, while a third respondent reported that “recovery through detox, rehab clinic, 12 step program with AA has completely changed my life and my attitude to life. I feel free and have choices and I am happy for the first time in years”

The overall conclusion by the majority of participants is that recovery is experienced as liberation and is an opportunity not just for a normal life but a meaningful and fulfilling one. That does not mean recovery is without regrets or without problems :

“My addiction was hell, my recovery has been amazing. I will be forever grateful for the second chance I was given. It took a long time to feel a part of the world when coming out of addiction. It was so hard to fit in with a world I felt so uncomfortable in. But now I love every day. I suffer with depression, and it has been harder than active addiction was but it is in remission and I have learned to live with it. My children are my greatest blessing and I have been able to break the cycle”.

 

Alcoholics Anonymous and Reduced Impulsivity: A Novel Mechanism of Change

Impulsivity or lack of behaviour inhibition, especially when distressed, is one psychological mechanisms which is implicated in all addictive behaviour from substance addiction to behaviour addiction.

It is, in my view, linked to the impaired emotion processing as I have elucidated upon in various blogs on this site.

This impulsivity is present for example in those vulnerable to later alcoholism, i.e. sons and daughters of alcoholic parents or children  from a family that has a relatively high or concentrated density of alcoholics in the family history, right through to old timers, people who have decades of recovery from alcoholism.

It is an ever present and as a result part of a pathomechanism of alcoholism, that is it is fundamental to driving alcoholism to it’s chronic endpoint.

It partly drives addiction via it’s impact on decision making – research shows people of varying addictive behaviours choose now over later, even if it is a smaller short term gain over a greater long term gain. We seem to react to relieve a distress signal in the brain rather than in response to considering and evaluating the long term consequences of a decision or act.

No doubt this improves in recovery as it has with me. Nonetheless, this tendency for rash action with limited consideration of long term consequence is clearly a part of the addictive profile. Not only do we choose now over then, we appear to have an intolerance of uncertainty, which means we have difficulties coping with uncertain outcomes. In other words we struggle with things in the future particularly if they are worrying or concerning things, like a day in court etc. The future can continually intrude into the present. A thought becomes a near certain action, again similar to the though-action fusion of obsessive compulsive disorder. It is as if the thought and possible future action are almost fused, as if they are happening in unison.

Although simple, less worrying events can also make me struggle with leaving the future to the future instead of endless and fruitlessly ruminating about it in the now. In early recovery  especially I found that I had real difficulty dealing with the uncertainty of future events and always thought they would turn out bad. It is akin to catastrophic thinking.

If a thought of a drink entered into my head it was so distressing, almost as if I was being dragged by some invisible magnet to the nearest bar. It was horrendous. Fortunately I created my own thought action fusion to oppose this.

Any time I felt this distressing lure of the bar like some unavoidable siren call of alcohol I would turn that thought into the action of ringing my sponsor. This is why sponsees should ring sponsors about whatever, whenever in order to habitualize these responses to counteract the automatic responses of the addicted brain.

I think it is again based on an inherent emotion dysregulation. Obsessive thoughts are linked to emotion dysregulation.

My emotions can still sometimes control me and not the other way around.

Apparently we need to recruit the frontal part of the brain to regulate these emotions and this is the area most damaged by chronic alcohol consumption.

As a result we find it difficult to recruit this brain area which not only helps regulate emotion but is instrumental in making reflective, evaluative decisions about future, more long term consequence. As a result addicts of all types appear to use a “bottom up” sub-cortical part of the brain centred on the amgydala region to make responses to decisions instead of a “top down” more cortical part of the brain to make evaluative decisions.

We thus react, and rashly act to relieve the distress of undifferentiated emotions, the result of unprocessed emotion rather than using processed emotions to recruit the more cortical parts of the brain.

Who would have though emotions were so instrumental in us making decisions? Two parts of the brain that hold emotions in check so that they can be used to serve goal directed behaviour are the orbitofrontal cortex and the ventromedial prefrontal cortex.

120px-Orbital_gyrus_animation_small2

 

These areas also keep amgydaloid responding in check. Unfortunately these two areas are impaired in alcoholics and other addictive behaviours so their influence on and regulation of the amgydala is also impaired.

This means the sub cortical areas of the amgydala and related regions are over active and prompt not a goal directed response to decision making but a “fight or flight” response to alleviate distress and not facilitate goal directed behaviour.

128px-Amyg

 

Sorry for so much detail. I have read so much about medication recently which does this or that to reduce craving or to control  drinking but what about the underlying conditions of alcoholism and addictive behaviour? These are rarely mentioned or considered at all.

 

We always in recovery have to deal with alcoholism not just it’s symptomatic manifestation of that which is chronic alcohol consumption. This is a relatively simple point and observation that somehow alludes academics, researchers and so-called commentators on this fascinating subject.

Anyway that is some background to this study which demonstrates that long term AA membership can reduce this impulsivity and perhaps adds validity to the above arguments that improved behaviour inhibition and reducing impulsivity is a very possible mechanism of change brought about by AA membership and the 12 step recovery program.

It shows how we can learn about a pathology from the recovery from it!

Indeed when one looks back at one’s step 4 and 5 how many times was this distress based impulsivity the real reason for “stepping on the toes of others” and for their retaliation?

Were we not partly dominated by the world because we could not keep ourselves in check? Didn’t all our decisions get us to AA because they were inherently based on a decision making weakness? Isn’t this why it is always useful to have a sponsor, someone to discuss possible decisions with?

Weren’t we out of control, regardless of alcohol or substance or behaviour addiction? Isn’t this at the heart of our unmanageability?

I think we can all see how we still are effected by a tendency not to think things through and to act rashly.

The trouble it has caused is quite staggeringly really?

Again we cite a study (1) which has Rudolf H. Moos as a co-author. Moos has authored and co-authored a numbered of fine papers on the effectiveness of AA and is a rationale beacon in a sea of sometimes quite controversial and ignorant studies on AA, and alcoholism in general.

“Abstract

Reduced impulsivity is a novel, yet plausible, mechanism of change associated with the salutary effects of Alcoholics Anonymous (AA). Here, we review our work on links between AA attendance and reduced impulsivity using a 16-year prospective study of men and women with alcohol use disorders (AUD) who were initially untreated for their drinking problems. Across the study period, there were significant mean-level decreases in impulsivity, and longer AA duration was associated with reductions in impulsivity…

Among individuals with alcohol use disorders (AUD), Alcoholics Anonymous (AA) is linked to improved functioning across a number of domains [1, 2]. As the evidence for the effectiveness of AA has accumulated, so too have efforts to identify the mechanisms of change associated with participation in this mutual-help group [3]. To our knowledge, however, there have been no efforts to examine links between AA and reductions in impulsivity-a dimension of personality marked by deficits in self-control and self-regulation, and tendencies to take risks and respond to stimuli with minimal forethought.

In this article, we discuss the conceptual rationale for reduced impulsivity as a mechanism of change associated with AA, review our research on links between AA and reduced impulsivity, and discuss potential implications of the findings for future research on AA and, more broadly, interventions for individuals with AUD.

Impulsivity and related traits of disinhibition are core risk factors for AUD [5, 6]. In cross-sectional research, impulsivity is typically higher among individuals in AUD treatment than among those in the general population [7] and, in prospective studies, impulse control deficits tend to predate the onset of drinking problems [8–11]

Although traditionally viewed as static variables, contemporary research has revealed that traits such as impulsivity can change over time [17]. For example, traits related to impulsivity exhibit significant mean- and individual-level decreases over the lifespan [18], as do symptoms of personality disorders that include impulsivity as an essential feature [21, 22]. Moreover, entry into social roles that press for increased responsibility and self-control predict decreases in impulsivity [16, 23, 24]. Hence, individual levels of impulsivity can be modified by systematic changes in one’s life circumstances [25].

Substance use-focused mutual-help groups may promote such changes, given that they seek to bolster self-efficacy and coping skills aimed at controlling substance use, encourage members to be more structured in their daily lives, and target deficits in self-regulation [26]. Such “active ingredients” may curb the immediate self-gratification characteristic of disinhibition and provide the conceptual grounds to expect that AA participation can press for a reduction in impulsive inclinations.

…the idea of reduced impulsivity as a mechanism of change…it is consistent with contemporary definitions of recovery from substance use disorders that emphasize improved citizenship and global health [31], AA’s vision of recovery as a broad transformation of character [32], and efforts to explore individual differences in emotional and behavioral functioning as potential mechanisms of change (e.g., negative affect [33,34]).

Several findings are notable from our research on associations between AA attendance and reduced impulsivity. First, consistent with the idea of impulsivity as a dynamic construct [18, 19], mean-levels of impulsivity decreased significantly in our AUD sample. Second, consistent with the notion that impulsivity can be modified by contextual factors [25], individuals who participated in AA longer tended to show larger decreases in impulsivity across all assessment intervals.

References

Blonigen, D. M., Timko, C., & Moos, R. H. (2013). Alcoholics anonymous and reduced impulsivity: a novel mechanism of change. Substance abuse, 34(1), 4-12.