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

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

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

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

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

Like a sponsor for exammple.

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

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

I certainly know I did?

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

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

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

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

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

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

This has been my experience.

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

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

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

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

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

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

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

Alcoholism erodes our self will and choice.

There is nothing so bad that cannot be shared.

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

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

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

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

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

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

It can be viewed as spiritual or an emotional rebirth.

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

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

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

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

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

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

We do fully recover until we do this I believe.

Otherwise we have not really completely treated our alcoholism.

We have simply got sober, sometimes stark raving sober.   

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

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

Because we trusted one person enough.

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

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

It is a former self.

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

I have become me.


The Fanatic in the Attic

When I first came into recovery the thing that really killed me was realising that my thinking was haywire – that I was generally wrong about everything.

My ego was devastated by this newly apparent reality.

I had long prided myself in always being the smartest guy in the room often dismissing other people’s views on things. Generally I always thought I was right about practically everything and what I did know was hardly worth knowing.

I found out my dismissiveness was linked to my insecure attachment. I ended up being intolerant, arrogant and dismissive of others. It kept others at arm’s reach because I didn’t trust them.

The echos of childhood can reverberate for decades afterwards.

So finding out I was often completely wrong about stuff was devastating?

How could I be so wrong about stuff?

Especially I had built up over a life this façade always being right?

My counsellor asked me once “Would you rather be right or happy?

“Right of course” I replied.

I was rarely right about anything in the first months of recovery.

I could not grasp why I was so often wrong, how I kept completely misperceiving events or mistinterpreting people, their facial expressions, their tone of voice.

I would recount something to my sponsor,  he would listen and then give the version of events that actually occurred.

I despaired that I had turned into a cretin somehow?

When at wit’s end, this former intellectual genius was illuminated one day.

One day after group therapy in treatment – where 10 complete strangers take  seeming delight in telling you who are really as opposed to who you think you are – I was walking in a local park when I suddenly had this revelation that my thoughts were always leading me to a place of emotional pain.

It was as if my thoughts were out to get me, had sort of stopped  working for me and had decided to work against me instead.

My thought seemed to blame me for everything as if they were trying to get me to go ”to hell with it, let’s have a drink!”

The thoughts seemed to be the voice of a really negative self schema, mixed with my alcoholic voice that just wanted out of this strange alien world of sobriety and thought it would hassle me until I succumbed.  A world full of people who scared me, whom I did not trust.

I did not know how the hell to cope with this world sober and it scared the hell outta me.

The thoughts were fraught, negative, self loathing, they seemed to contain fragments of the reasons why I drank in the first place and the reasons why I drank years after.

There was a maelstrom of unresolved issues and negative ideas of self mixed up in a strange brew with the motivation voice of my addiction which just wanted to drink.

It was no wonder I drank, with this discordant cacophony of mangled thoughts and harsh voices blaring way.

When I rang my sponsor, with news of this revelation , he was so delighted for me.

At how I had managed to disassociate me from these thoughts. He said these are the thoughts of your illness.

I imagined these voices coming from an alcoholic on a park bench who alone and skint with no means of getting more alcohol. Whinging and criticising, desperate and self loathing, life hating…

This had been my illness constantly jibbering away,  trying to demoralize me..

He told me the 12 steps would help deal with these thoughts although they never go away completely.

It was such a breakthrough in early recovery. It is one of the main reasons I am alive today.

I had realised there was this addicted me, living upstairs like a fanatic in the attic, which was distinct from the new, recovering me that would have to try my best to ignore it.

This has become easier as recovery has progressed.

My illness and it’s lies, it’s quite convincing chatter lives in ME, the parts of my brain that deal with self, especially motivational parts of the brain.

Hence I have to be careful of wanting or desiring stuff as the thoughts and the chatter get turned on again. If I turn my will, my thoughts over to my HP then serenity prevails.

I have to be aware of Me. Me. Me.

I have to be aware of thoughts which have me, mine, or I in them.

If my thoughts have me, mine or I in them then I am lending my ear to my illness again.

This stuff is a difficult thing to come to terms with – it is similar to egodystonic thoughts in OCD sufferers –  thoughts in conflict with a person’s ideal self-image – but when you do grasp this you are well on your way to recovery!





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

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

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

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

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

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

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

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

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


impulse control.preview



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


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


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


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

Predictors of Mortality Risk among Individuals with Alcohol Use Disorders

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

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

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

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

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

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

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


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

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

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

Moderation of the Impulsivity-Mortality Link via the Social Context

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

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

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


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

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.



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.



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.


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 [811]

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.


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.

A Brief History of Controlled Drinking – the Irrationality of Science

In a recent blog a few days ago I challenged some of Gabrielle Glaser’s “evidence” in her article   “The Irrationality of Alcoholics Anonymous “, which purported to demonstrate the so-called effectiveness of “controlling drinking”.

Glaser cited the following in her article

“ To many, though, the idea of non-abstinent recovery is anathema. No one knows that better than Mark and Linda Sobell, who are both psychologists. In the 1970s, the couple conducted a study with a group of 20 patients in Southern California who had been diagnosed with alcohol dependence.

Over the course of 17 sessions, they taught the patients how to identify their triggers, how to refuse drinks, and other strategies to help them drink safely. In a follow-up study two years later, the patients had fewer days of heavy drinking, and more days of no drinking, than did a group of 20 alcohol-dependent patients who were told to abstain from drinking entirely.”

I responded to this as follows

” What Glaser failed to mention was that in a subsequent study (4) 10-year follow-up of the original 20 experimental subjects showed that only one, who apparently had not experienced physical withdrawal symptoms (thus possibly not alcoholic), maintained a pattern of controlled drinking;

eight continued to drink excessively–regularly or intermittently–despite repeated damaging consequences;

six abandoned their efforts to engage in controlled drinking and became abstinent;

four died from alcohol-related causes;

and one, certified about a year after discharge from the research project as gravely disabled because of drinking, was missing.

Why did Glaser failed to mention this research, a follow up study to the one she mentions and cites?”

The authors attempted to justify this choice in a statement that seems to clearly demonstrate their bias: “we are addressing the question of whether controlled drinking is itself a desirable treatment goal, not the question of whether the patients directed towards that goal fared better or worse than a control group.. .” (Pendery et al., 1982, 172-173)

The interesting aspect about her article for me (and most worrying) was that it highlighted a controversy that goes back to the 1960s – can alcoholics ever control their drinking?

In this blog we will address the origins of this “controlled drinking debate” and demonstrated how it is a castle built on sand.

The original study which supposedly demonstrated so-called controlled drinking or asymptomatic drinking in it’s alcoholic participants did no such thing.

So we now have an ongoing debate about controlled drinking when it has continuously been based on dubious research, bogus findings and bad science.

It is the researchers that Glaser champions that could be accused of irrationality.

The methodological madness started way back in the 1960s.

 While scattered reports of controlled drinking outcomes had occasionally appeared in the scientific literature before 1962, most commentators date the beginning of the controlled drinking controversy to the publication that year of a paper entitled “Normal Drinking in Recovered Alcohol Addicts.” In this paper, D.L. Davies, a British psychiatrist, reports that, in the course of long-term follow-up of patients treated for “alcohol addiction” at Maudsley Hospital in London, 7 of the 93 patients investigated “have subsequently been able to drink normally for periods of 7 to 11 years after discharge from the hospital.” (Davies, 1962, p. 94).

At least two different studies have challenged the findings of Davies:-

“Evidence suggests that five subjects experienced significant drinking problems both during Davies’s original follow-up period and subsequently, that three of these five at some time also used psychotropic drugs heavily, and that the two remaining subjects (one of whom was never severely dependent on alcohol) engaged in trouble-free drinking over the total period”

“A subsequent follow-up of these cases suggested that Davies had been substantially mislead”

So four decades of research into controlled drinking were inspired by a study which did not actually demonstrate controlled drinking in the first place!

In addition to the Sobells, Glaser also mentioned the Rand Report of the 1970s.

“In 1976, for instance, the Rand Corporation released a study of more than 2,000 men who had been patients at 44 different NIAAA-funded treatment centers. The report noted that 18 months after treatment, 22 percent of the men were drinking moderately. The authors concluded that it was possible for some alcohol-dependent men to return to controlled drinking. Researchers at the National Council on Alcoholism charged that the news would lead alcoholics to falsely believe they could drink safely. The NIAAA, which had funded the research, repudiated it. Rand repeated the study, this time looking over a four-year period. The results were similar.”

The first Rand Report was attacked as being methodologically weak  – e.g  it suffered from sample bias (80% of subject dropped out).

The Rand Corporation did a follow up 4 years later.  This time they reported that a smaller figure of 14% of the sample  continued to drink in an unproblematic manner  but other researchers reanalyzing the data arrived at a corrected estimate of 3-4% of the sample were drinking in a nonproblematic manner.

3% is somewhat less than the 22% – why does Glaser not cite these other follow up studies again?  It is difficult to accept any of her arguments as  she picks only studies that support her biased arguments.


It was also noted that alcoholics can often be expected to drink in a non problematic manner for brief periods. In my own experience, I have often heard of alcoholics share about a relapse and state that they thought they had their alcoholic problem licked as they started off drinking in what appeared to be a controlled manner only to find in a matter of weeks that their alcoholism had progressed far beyond it’s original severity prior to the relapse. In other words it can take a relapse some weeks to kick start into even more profound alcoholism than previously.

Researchers need to spend more time around alcoholics to observe what we have learnt through very painful experience, instead of theorising about this reality from academic ivory towers.

As the Big Book of Alcoholics Anonymous states in Chapter 3  “Most of us have been unwilling to admit we were real alcoholics. No person likes to think he is bodily and mentally different from his fellows. Therefore, it is not surprising that our drinking careers have been characterized by countless vain attempts to prove we could drink like other people. The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death. We learned that we had to fully concede to our innermost selves that we were alcoholics. This is the first step in recovery. The delusion that we are like other people, or presently may be, has to be smashed. We alcoholics are men and women who have lost the ability to control our drinking. We know that no real alcoholic ever recovers control. All of us felt at times that we were regaining control, but such intervals –usually brief—were inevitably followed by still less control, which led in time to pitiful and incomprehensible demoralization. We are convinced to a man that alcoholics of our type are in the grip of a progressive illness. Over any considerable period we get worse, never better.”


Love is the Drug!

Science as we have shown in many blogs has given us unprecedented insight into brain mechanisms implicated in addiction. It has shown us how various neural networks governing reward/motivation, memory, attention and emotions seem to be usurped in the addiction cycle.

Important aspects of “the self” are taken over in other words. It has shown how those vulnerable to addiction seem to have decision making deficits, suffer impulsivity, choose now over later, do not tolerate distress or negative emotions etc. Over react to life!!

It shows how addicts have difficulties in  regulating stress, and that stress systems in the brain are altered to such an extent that they rely for brain function on allostasis not homeostasis.

They show us that various neurotransmitters are also reduced in the addict’s brain such as GABA, the inhibitors or brakes of the brain. We are deficient in natural opioids, dopamine, serotonin etc. Our brains are different to “normies” to “earthlings.

Science suggests the majority of addicts have had abuse or trauma, neglect or adverse experiences while in childhood and this too contributes to addiction vulnerability via stress and emotion dysregulation and a heightened sensitivity to the stimulating effects of drink, drugs and certain behaviors such as eating, sex, gambling, gaming, internet use  etc.

Science also offers suggestions on treatment. It offers the use of chemicals or antagonists to reduce “carving” and it suggest the effectiveness of CBT, Mindfulness and DBT but it seems to know little about how or why 12 step programs work.

Science can’t quite bring itself to believe that laypeople, fellow addicts, can help solve each others’ problems. It scratches it’s head about “spiritual maladies” and “spiritual solutions”; how the 12 steps could bring about such a cathartic change in personality to change someone from a hopeless addict to a person in recovery.

It wonders how helping others and taking fearless and honest inventory can bring about the psychic change sufficient to help some with addiction recover. To be restored to sanity.



In various blogs we have suggested the spiritual malady can also be viewed as a emotional disease and that the 12 steps also allow us to process emotions and regulate feelings in a way we could not before.

It helps us process the many negative emotions of the past via steps 4-9 and sets us free by consigning these emotions to long term memory instead of having them swirl around forever in explicit memory, forever tormenting us.

For us, 12 step programs offer a workable definition of the addict. The “spiritual malady” mentioned in the Big Book does however refer to all people, not just alcoholics/addicts, and is borrowed directly from the Oxford Group.  But reading around this, there are many examples of emotional and stress dysregulation in the BB, some 70 plus examples in the first 164 pages  of  how our emotions dominated us and how we were shot through with fear.

It is the description of alcoholics in the BB that highlights we have an emotional as well as spiritual  disease. What is a spiritual disease if not manifest in negative emotional states such as resentments, false pride, anger, jealousy, and so on. The need to control, to be better than, to know best, all also signs of emotional immaturity.  The BB clearly show us alcohol(ism) has made us very emotional irresponsible. We step on the toes of our fellows and they retaliate.

We have a spiritual malady but, from descriptions of ourselves, it seem more extreme than normal people. It is not only in terms of alcohol that “the delusion that we are like other people, or presently may be, has to be smashed.”

The definition is thus workable because it allows one to act in relation to it. For example, if I am aware of the nature of my defects of character I am in effect aware of what cuts me off from the “sunlight of the spirit”, aware of what keeps me spiritually and emotionally ill, what keeps me in a state of unprocessed emotions, of emotional dysregulation, of undealt with distress. Of what keeps me in resentment in a viscous circle of unprocessed negative emotions.

It shows me how this dysregualtion effects other people and gives me the tools to correct my mistakes, to make amends for the mistakes I have made. To relieve distress. It gives me a framework, a program of action which allows me to live with others, on life’s terms, although I might not immediately agree with those terms, which is often the case!

It gives me a choice that I never had before. It says to me you can live with unregulated negative emotions and cultivate your misery or you can choose to use the program to free yourself from these negative unregulated emotions and by processing them be restored to to sanity. It can help me get out of the past/future and into the now, the present.

The solution to my spiritual and emotional malady is this simple. Identify, label, verbalise either to God or to another human being the nature of these wrongs/sins/defects/shortcoming/negative emotions – those factors that trapped me in self propelled distress – and they are quite simply removed. That is my experience. Honesty, openness, willingness, the how of getting out of self. Repeatedly during the day. When I do not do this I suffer emotionally, and others suffer too.

The steps allow me to reduce my distress and this control of distress and stress via the cultivation of serenity, balance, selflessness deactivates my illness for a while allows me to be happy, joyous and free as this appears to be the state of freedom from self, in my experience, this seems to be a state of Grace in other words. The sunlight of the spirit that Bill W mentioned.

It is the solution. I drank to get away from myself. To exhale some air and go “phew!”  I do not not have to even consider that now because I can do that via the steps, by simply taking inventory and letting go. It is our emotions that hold on to negative thoughts, that grow them in the dark shadow of our souls like fungus. Honesty is a light that extinguishes them. By letting go, by allowing my emotions to lower in intensity, to label and identify them and thus allow via, God’ loving Grace, for them to be removed (and stored away where they belong in long term memory).

But there are so many more reasons why 12 step programs work! If the majority of us have had abusive upbringings then it suggests perhaps that there are attachment issues present in many of us. For me my insecure attachment to my primary care giver, my mother, may have caused an insecure attachment which has certainly kick started my later addictions. In fact some observers have gone so far as to view addiction as an attachment disorder.

I will blog on this in the next weeks or two. I will blog on this attachment disorder as perhaps causing that “hole in the soul” that many addicts talk about in meetings.

That not belonging, being separate from. That isolation – these may all stem from insecure attachment. Insecure attachment can shape the brain in a way that makes it difficult to regulate stress and emotion and thus contribute to later addiction. It may cause the differences in emotions mentioned above. It may also point to heart of the problem and why 12 steps groups work in treating addiction.

12 step groups seem to directly treat the “Hole in the soul” by instantly giving an addict a sense of belonging which is particularly powerful after many years in the desolation of addiction. I know that I stayed in AA because I have finally found the club, the tribe, that I belong too. This   like other families is a group of people I love, but sometimes have problems with, fall out with, return to and see in a new light. It is an organic relationship. It has never been wonderful at all times but that says as much about me and my distrust of others, my insecure attachment as it does AA.

I had grown up not even feeling part of my family. The required psychic change happened to me in my first meeting I believe.  Others have commented on how I walked into the meeting a different person from the person who left the meeting. I had a spiritual experience of some sort in my first meeting, purely through identifying with the other recovering alcoholics in the meeting. Not about their drinking, but by identifying with their spiritual malady. I identified with there emotional disease and I realised that if they could find a solution then there was a chance, however small, that I could too. The first flickers of hope happened in that very first meeting.

I knew in my heart I had somehow returned home in a strange way. I had found my surrogate family, those who would help love me back to health and recovery.
Perhaps this is what Science is generally not getting about 12 step groups, the powerful therapeutic tool of talking with someone who has been where you have, who shares your disease and who can help you recovery, as they have. Even now sitting in an AA meeting is the most spiritual thing I do. More so that attending Chapel, visiting monks in isolated monasteries.

Identification with those in the same boat as you is profound. It tells you are not alone. It tells you I need to help you to help me. We are in this together, not you and I. Us, together.

It accepts you as you are, at your lowest ebb, at your rock bottom, your most degraded self. It offers your affection when you are your most unlovable, most wretched.

This for me was the key, being accepted into a group I knew I belonged in. My new home. My new secure attachment. I believe this secure attachment and the love you have for fellowships, sponsees and the love you can now show yourself and your family and friends and people in your life is that solution. To Love and be loved.

I felt in my active addiction I was not deserving of love, that you shouldn’t give me your love. I didn’t know how to give you mine. Now I have so much love inside of me. It is this love that has filled up the hole in my soul.

Okay, it has also increased my natural opioids, raised my dopamine via belonging, raised the GABA brakes in my brain. It has also increase my serotoninergic well being and happiness, it has lower my excitatory glutamate. It has restored more neuro-chemical balance in my head. By prayer and mediation and helping others it restores sanity, fleeting periods of homeostasis, balance, serenity. It most importantly reduces stress/distress, silences my addiction, long enough for me to think of others, help others. And there is not greater buzz that helping others. Love is the drug that I have been thinking off. Love is the solution.

Trust someone enough so that you can begin to allow them and God to love you and you will eventually love them back. A whole new world, full of love and being whole awaits.

The journey is from the crazy head to the serene heart. 

Getting out of “self” via Prayer and meditation

When I first came into recovery I constantly heard the refrain about “getting out of self” – in fact steps 10-12 help one do so. Step 12, by helping others in recovery and step 11 which encourages prayer and mediation.

Can we get out of “self” by prayer and mediation? I will be dedicating a number of blogs to mediation so will just briefly consider prayer here.

In one study Franciscan nuns had their brains imaged via SPECT which looked at blood-flow in their brains while they were engaged in a type of mystic union called  ‘centring prayer’ which involves opening themselves to being in  the presence of God (and not in “self”).

In centring prayer the nuns had a “loss of usual forms of space  During prayer there was demonstrated increase in blood flow in the PFC inferior parietal and inferior frontal lobes  and a decreased flow in the superior parietal lobe, which is related to feelings of “self”.


I mention this type of meditation, also because it is a meditation/prayer that I do myself. Click here for more information on this wonderful prayer technique and how it is used by Fr Frank Keating and 12 step groups  –

I alternate with this and vispassana meditation

which also makes one feel like they are no longer in “self”, that the self is an ephemeral reality, always changing so not static, fixed – the self is thus an illusion in a sense as it is constantly changing. Regardless, of their different origins, both when practiced can transport one to a place seemingly beyond feelings of being in self. The self seems to blend into a widen sense of consciousness without parameters or boundaries such as limited by self.

In this state of being, one can view the fleeting images  of the self dispassionately, not being moved by them or reacting to them. Images of the self dissolve like into snow flakes in snow.

As we we will see in other blogs, meditation also reduces stress, improves neurotransmission in neurostransmitters effected by chronic addiction, e.g. GABA and strengthens neural regions of the brain that are very important to recovery.

The findings of these and other studies of prayer bear some similarity to studies in meditators such as on Tibetan Buddhist meditators (1) so I would not get hung up on the apparent religiosity  or non-religiosity of these ways of meditating. to me they achieve something very similar. It they work they Work!

The meditative and spiritual experiences are partly mediated through deactivation of the superior parietal lobe which normally helps to generate the normal sense of “self” (2)


A  beautiful and enriching respite from self regulation and a profound sense of wholeness, and connection with something beyond self whatever that being beyond self is.  Therapeutically we have to somehow move beyond a reactionary self to a mindful one. From an emotional distressed one to a serene one. The brain is healthier after mediation than before.


As mentioned in other blogs, without emotional distress this condition can be quite dormant.



1.  Newberg, A. B., & Iversen, J. (2003). The neural basis of the complex mental task of meditation: neurotransmitter and neurochemical considerations. Medical hypotheses61(2), 282-291.

2. d’Aquili, E. G., & Newberg, A. B. (2000). The neuropsychology of aesthetic, spiritual, and mystical states. Zygon®35(1), 39-51.

From Hijacking the Brain

Maintaining emotional sobriety (and sanity) via Steps 10-12

When I have did my steps 4-7, noting the situations, the people, the institutions  that have caused persistent resentments in me, then examining what parts of my self have been affected,  I also, thanks to one sponsor was asked me to,  put down exactly what “sins” or defects of character I also experienced during these resentments. This jotting down of the exact sins I was in during these resentments  has proved to be very useful in my recovery ever since.  What I noticed was that I had the same array of sins or negatively (immaturely) expressed emotions in relation to all resentments regardless of the situation or the person I had the resentment, the same web of sins was weaved in every situation.  For me this shows clearly how I do not process and regulate my emotions properly, how it has a canalized form of reaction.

I have found increasingly in recovery that when I want someone or something to be the way I want it and it doesn’t go that way or I want something to stay a certain way or I believe someone is threatening to interfere or take away something that I have (when I am controlling basically), I find I respond by either being dependent or dominating of the person or situation. This is what Bill Wilson also found out in ten years or so of psycho-analysis with Harry Tiebout.

Immature emotional response I call this, followed by emotional reasoning. I rarely react in a balanced manner to these prompts. The situations invariably provoke a fear based response in me which somehow also leads to me suddenly becoming dishonesty in my thinking. It is as if this self centred fear as cut me off from the truthful sunlight of the spirit and I am suddenly in the dark shadow of dishonesty. In fact, according to Father Ralph honesty comes from the Greek to be at one with God funnily enough.

Then I feel shame as the result of my pride being hurt, which can lead to self pity it if I let it. I may also feel guilt. Then I may decide to strike back via being arrogant, impatient or intolerant, in behaviourally expressed sometimes as putting others down to elevate one self. Again immature emotional response. I am obviously also being self centred and selfish while in this process. I can also be envious or jealous of others in the midst of this for taking what I wanted or threatening what I have, like a child in the park or playground with friends. Other ways of fixing my feelings rear their heads and I can be gluttonous as a reaction or become greedy. Eat too much or go on a shopping frenzy. All instead of processing the emotions which are driving this behaviour I react, act out of distress based impulsivity. I can be so distressed that I can tend towards procrastination, which is sloth in five syllables. These sins or negatively expressed emotions truly grip me and these sins seem to  hunt in packs.

I found this fascinating when I first discovered this during my steps. It seemed to map the reactions of my heart when I react via resentments to the world. They describe accurately how I relate to the world especially when the world does not give me what I want or I have stood on it’s toes.

What else is this but an immature emotional reaction based not just on me being the same age as I started drinking  but also on the fact that the regions of the brain which govern emotional regulation in the brain of the alcoholic are immature, are smaller, not connected as well or do not function as well as healthy folk.  This is according to many academic studies and also seen in the brains of children of alcoholics, so our emotional brain regions may never have worked properly and thanks to years of alcohol abuse have gotten a whole lot worse.

When I am not in charge of my emotions they are in charge of me, in other words. They are controlling me and not the other way around. This type of emotional immaturity happens throughout the day sometimes. So there is no point waiting to the end of the day to do a step 10, to see when have I been fearful, dishonest, resentful or selfish. I have to do it continuously throughout the day to maintain my spiritual and emotional equilibrium, because it needs constant attention and maintenance, because I have no naturally maintained balance. I have to manage it. I impose homoestasis to an allostatic system. There is not naturally resting place. I am in charge of my serenity.

So I spot check continuously to ensure my emotional sobriety. Another word for sober is sane. I ike this because  while I am in emotional dysregulation or immaturity, I am far from sane. In fact, I am strangely deluded, distinct from from any reasonableness. I need to do my step ten to be restored to sanity.

The other problem with this emotional lability and dysregulation is that it send streams of distorted thinking into my head. I remember ringing my sponsor in early recovery, a few months in, with the startling relevation, to me,  that my thoughts were all leading me to a place of emotional pain. My emotional dysregulation leading to cognitive distortions which leads to further emotional dyregulation etc.  Spot the negative emotions underpinning these thoughts and they disappear like wispy evaporating clouds. This has similarities here with the practice of mindfulness.


I do this all in a very simple way – I simply ask God to remove my sins, which are usually fear, dishonesty, pride, shame,guilt, self pity, leading to intolerance, arrogance and impatience and so on, warmed in a dendritic spreading across my heart and polluting of my mind with stinking thoughts.

It is interesting that in the 5th century a religious man called Evagrius Ponticus suggested that one gets rid of troublesome thoughts by pinpointing the negative emotions which were somehow underpin then and weight these thoughts in one’s mind, like anchors weighing down lassoed clouds. I do the same effectively.

I ask God to remove these emotions after I have first identified them and offered them to Him for help in removing. What I am doing, in a sense, is also identifying, labelling and letting go (processing) of the negative emotions that have kept these thunderous grey black clouds of thoughts in my head, and striking my heart with forked pain. I am asking God to help me do what I cannot do for myself it seems; namely emotional regulation.

People outside AA often wonder how this spiritual program can help people recover. As  I blogged about recently recently it does so, I believe partly, because it helps us learn how to practice identifying, labelling  and processing emotions (often by verbalising them to someone or via step 10)  in a way that is not only healthy and adaptive but in a way I was seemingly never able to do prior to coming into AA.  Or had never been taught to do.

I have learnt all these development skills not in my childhood but in my surrogate home of AA.  How many of us have come home in AA?

Processing the Past via the action steps, 4-12!



Processing the Past via the actions steps, 4-12!

by alcoholicsguide

How The Alcoholics Anonymous’ program of action helps with emotional dysregulation.

When I first came into recovery I was surprised how much more time I spent embroiled in thinking about past incidents and how I had numerous murderous resentments  about people who had supposedly done me wrong, than I did thinking about drinking.

The thought of drinking terrified me rather than enticed me. Fortunately it also made be nauseous and fortunately still does. A full year of vomiting on an empty stomach, throughout each and every interminable day and night, has had some aversion like effect.

I had literally hundreds of thoughts and negative emotions about the past streaming through and around my aching head and piercing my heart. They were like toxic mind darts that flipped my guts and almost made me physically ill. Even thinking back now makes me feel queasy.

It was a constant state of emotional distress, those early days of recovery.

I was shocked as the weeks trudged on painfully that I seemed to have problems other than the drink. I was reassured by many other AAs in meetings when they shared about how difficult life was on life’s terms – how they struggled with resentments and fears and their “emotional disease”. I was was glad it wasn’t just me.

I had finally found a club where I fitted in! After all these years. In fact most people I drank with were also alcoholic! So I have always sought the company of my own. I thought we could only be found in pubs! And here we had rooms of them talking about trying to stay “emotionally sober”. It wasn’t just sobriety it had to be emotional sobriety. I was, through my fading eyesight and mercifully abating alcoholic psychosis, greatly intrigued by this. My life, and their lives, had become unmanageable, they said,  not just because of the drink, but because of some underlying condition.

I was especially interested in why I was so cursed by memories of my past. Why hadn’t they gone away? Why had they come back so prolifically in early recovery. The alcohol must have keep some of them suppressed, at bay. Now they were teeming through, poisoning my mind just as effectively as any alcoholic withdrawal or rattling hangover ever did. It was difficult not to somehow see these rampant, rampaging negative thoughts and emotions as akin to a disease. When they spoke of spiritual disease, it seemed to describe what was happening in my head.

I have “done” the steps three times and each time has offered more insight into this spiritual malady which I call an emotional disease. Why? Well because the sure sign of a spiritual malady, I believe,  is the expression and lack of control over negative emotions. The emotional lability and volatility. The bad temperedness, the indignition at life’s flaws, the perfectionism, the need to control, the righteous anger. We sin via these negative emotions. Have you ever heard of someone sinning via positive emotions? “Yes he wronged me by being so kind and generous, thoughtful and loving, to hell with that man!” So why are we so scared of the e word, emotion.

We sin via, or have defects of character which are, negative expressions of emotion. Intolerance, or impatience, selfishness, fear based dishonesty and so on. All expressions of distress. A fear based illness?  I like the term defect of character because it suggests sometime intrinsic to alcoholics. I call this inherent aspect of this condition called alcoholism, emotional regulation and processing difficulties.

In this blog I will attempt to explain how the 12 steps of AA, principally the action steps 4 through to 12, have not only connected me with a power greater than myself  but they continue to treat, on a daily basis, my unmanageability.  An  unmanageability caused inherently by my difficulties processing and regulating emotions.


12 steps pic


I have looked hard for supporting evidence to substantiate what I am about to write and found this link to an interesting piece on the use of EMDR and other therapies in treating the unprocessed emotions caused by emotional dysregulation in those who suffer from trauma. I have used aspects of this to make it applicable to alcoholics. I believe profoundly that steps 4-12 facilitate a profound alteration in our ability to regulate and process emotions.

Steps 4 -7,  in particular help us to embed the numerous unprocessed memories from childhood onwards, that all seem to have been tied together in a terrible mnemonic mesh by aspects of emotional dysregulation such as resentments.  It is in addressing all these that we finally process these associated negative emotions in our memory banks and finally embed all these memories in long term memory.

In short, the Steps allow us to adaptively and healthily process our disturbed pasts. They also allow us to maintain a health and adaptive emotional regulation  on a daily basis and via steps 10-12 in particular allow us to greatly improve our emotional regulation.

I am not rewriting the Big Book of AA here, only to add another angle to understanding it and how it works, so that others in related therapeutic fields can have some insight into how it may work and those who need help feel more inclined to come to AA for help.   – Refer also to the work of Francine Shapiro (1) and her work which shaped development of the EMDR therapy which treats trauma (PTSD) and other disorders. I know it works for PTSD as my wife suffered PTSD after a car accident, and was greatly helped by this type of treatment. It is Shapiro’s insight into the role of unprocessed emotions in causing emotional volatility and a “volcano of unresolved distressing effects” (2) and that  chronic dysfunctional perceptions, responses, attitudes, self-concept, and personality traits are all symptoms of unprocessed memories (3) that shapes my thinking, partly, on how the steps allow us to put the past to bed.

I have to add also that I believe myself to be a sufferer of PTSD also. I have stressed that alcoholism is a psychiatric disorder in it’s own right but would never be silly enough to suggest it does not have co-occurring disorders such as PTSD, as the result of abuse and trauma in earlier life experience. Especially as there as up to 2/3s of dependent people may have had abuse in their early lives and that PTSD sufferers have up to a 50 % co-morbidity with alcoholism and addiction. Perhaps this is why this work by Shapiro strikes a cord with me. I think it is naive to say that abusive early life does not play a role in alcoholism and addition and that this environmental influence on genetic inheritance (alcoholism has a a generic heritability of some 50 – 70% making one of the most inheritable disorders). In other words, some 50 – 70% of alcoholics have alcoholism in their genes.

Throughout our lives, we all experience significant events that impact our perceptions of the world and determine how we interpret and respond to future experiences. These moments represent painful experiences so severe that they overwhelm our ability to cope with the rush of thoughts and feelings they elicit and If left unresolved, these feelings can persist for years in unprocessed emotions.

As a general rule, anything destructive that is left untreated — disease, trauma, stress, psychological disorders, addiction — can become progressively worse over time. Coming to terms with the past is often referred to as “integration,”  of these errant unprocessed emotions and achieving resolution. One way this resolution can be accomplished is by verbally and somatically (by being aware of how they affect one bodily) reprocessing these, like in step 5 when discussing one’s inventory, and the rewards can be transformative.

Mental networks contain visual images of the previous experiences  as well as related thoughts, emotions, and sensations. Previous experiences — including every physical sensation, every emotion, and every perception or interpretation — are encoded and stored in the brain and throughout the body. The processing of information about previous events may be incomplete, perhaps because the person has not developed the emotional or mental faculties to effectively manage or correctly interpret the situation (often the case with children who have faced abuse, trauma, insecure attachment to caregivers) or because processing is hindered by strong negative feelings (such as shame, helplessness, and denial) which I believe may be the consequence of emotional dysregulation.

images (3)


The memory of the previous experiences can  therefore be improperly stored without appropriate associative connections and with many elements still unprocessed. This incomplete processing prevents the forging of connections with more adaptive information or new learning which might help the person release the abusive, traumatising, misrepresented, resented, emotionally dysregualted and unprocessed experiences from the past. Finally when we do process these experiences then we can consign them to, embed them, happily in long term memory.

In a previous blog we say how one maladaptive emotional regulations strategies that of self elaboration, where one regulates a negative emotional experience by filtering in through the self and then elaborating on this in a ruminating manner, i.e. only seeing an event in relation to themselves, in self- reference (similar to a resentment)  and that our minds in early recovery are thus filled with these unprocessed memories as the consequence of this type if emotional dysregulation which filtered everything through a self centredness. In many cases we began to see in our step 4 inventory that it was often our emotional dysregultation that caused others to act in certain ways which we interpret, whether for valid reasons or not, in a self centred and distorted way which was base on emotional reasoning. These unprocessed emotions and memories thus lingered on in our minds for decades, festering as resentments and fuelling our drinking and drug use.

Doesn’t Step 4 allow us to record these unprocessed memories, get them down in black and white, with the unprocessed emotions, the resentments and other negative unprocessed emotions, such as anger, fear, selfishness, self-centredness, dishonesty and son on.  Doesn’t it let us use our proper reasoning to see through our purely emotional reasoning?

Don’t we start to process these emotions and thus the attached memories by verbalizing them in a therapeutic sense to our sponsors, mentors, respected religious or spiritual guides, counsellors etc? Don’t we learn to see what has kept us enslaved in feelings of injustice, resentment, of being wronged? Doesn’t it help us see how our emotional dysregulation distorts our perception of reality, and leads to a negative bias in our thinking about life and the people in it? Doesn’t it show us our underlying problem, our underlying psychiatric condition, which the steps helps us then to manage, to help us become manageable. We are not powerless over alcohol when we manage our negative emotions.

The Steps 6 and 7 allow us to have these removed. I believe God remove my many previous unprocessed emotions and memories, helped me consign then to the past and my long term memory. They did not go into ether as i fist thought, but into were processed in long term memory. This is no way lessens the Grace of God or his mercy.  He helps me do what i cannot, He goes deep! Steps 8 and 9 process these emotions even more via making amends for our wrongdoings and getting rid of the potential distress associated with unresolved situations from our past.  The final recognition of the effects our emotional dysregulation has had on our wider community.

Aren’t the steps, primarily to help us manage our emotional dysregulation?

Isn’t this what was unmanageable? Wasn’t it this which gave King Alcohol power over us? Doesn’t the AA program of action help us in a similar way EMDR does with trauma victims?

Step 10 helps us on a daily basis look out for manifestations and examples on how we hurt others with our lack of control over our negative emotional response, our dysfunctional emotional response. It gives us a way to examine and process these emotions and to take action to apologise to those who experienced this emotional volatility. It helps encourage positive, healthy, adaptive emotional expression.

Step 11 helps us self soothe and this helps our emotional regulation, meditation improves  and strengthens the very brain areas which regulate emotion, the dlPFC and ACC, which help control our anxious amygdala, the very the heart of all distress.  And via Step 12 we regulate our emotions in one of the most profound ways possible by helping others. By showing love. There is little dyregulation in love, the most healthy of human  emotional expression. ..and in all our affairs! We do not become intolerance of other is upholding “Principles not personalities”

Love contains the positive assets hopefully also listed in your inventories; selfishness, consideration, patience, tolerance etc  – the aspects of healthy emotional being. Perhaps this is another reason why Step 12 is so profound in helping us manage the unmanageability of our emotional dysregulation.

And fellowship itself, gives us an “earned attachment” especially when many of us had insecure attachments with our parents, grew up in dysfunction, disrupted families, in abuse or trauma. It helps us finally “belong”.  Fellowship  allows us perhaps to express our emotions fully for the first time, allows us to verbalize our concerns and feelings, label them for the first time, regulate and process them. Provides a safe environment in which to emotionally mature. The list goes on and on. AA gives us loving feedback, nurtures us, nourishes us.  Home groups with regular members over many years obviously aid this process of caring and mutual self growth.

It has become more clear while writing this how AA manages this emotional disease we call alcoholism.

The AA program of action helps us change how we feel and think about the world.


1. Shapiro, F. EMDR Therapy: Adaptive Information Processing, Clinical Applications and Research Recommendations.

2. Courtois, C. A., & Ford, J. D. (Eds.). (2009). Treating complex traumatic stress disorders: An evidence-based guide. New York, NY: Guilford Press.

3  Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York: A.A. World Services.

Some references to follow.

Getting “out of self” through prayer and meditation?

When I first came into recovery I constantly heard the refrain about “getting out of self” – in fact steps 10-12 help one do so. Step 12, by helping others in recovery and step 11 which encourages prayer and mediation. Can we get out of “self” by prayer and mediation? I will be dedicating a number of blogs to mediation so will just briefly consider prayer here. In one study Franciscan nuns had their brains imaged via SPECT which looked at blood-flow in their brains while they were engaged in a type of mystic union called  ‘centring prayer’ which involves opening themselves to being in  the presence of God (and not in “self”). In centring prayer the nuns had a “loss of usual forms of space  During prayer there was demonstrated increase in blood flow in the PFC inferior parietal and inferior frontal lobes  and a decreased flow in the superior parietal lobe, which is related to feelings of “self”.


I mention this type of meditation, also because it is a meditation/prayer that I do myself. Click here for more information on this wonderful prayer technique and how it is used by Fr Frank Keating and 12 step groups  – I alternate with this and vispassana meditation which also makes one feel like they are no longer in “self”, that the self is an ephemeral reality, always changing so not static, fixed – the self is thus an illusion in a sense as it is constantly changing. Regardless, of their different origins, both when practiced can transport one to a place seemingly beyond feelings of being in self. The self seems to blend into a widen sense of consciousness without parameters or boundaries such as limited by self. In this state of being, one can view the fleeting images  of the self dispassionately, not being moved by them or reacting to them. Images of the self dissolve like into snow flakes in snow. As we we will see in other blogs, meditation also reduces stress, improves neurotransmission in neurostransmitters effected by chronic addiction, e.g. GABA and strengthens neural regions of the brain that are very important to recovery. The findings of these and other studies of prayer bear some similarity to studies in meditators such as on Tibetan Buddhist meditators (1) so I would not get hung up on the apparent religiosity  or non-religiosity of these ways of meditating. to me they achieve something very similar. It they work they Work! The meditative and spiritual experiences are partly mediated through deactivation of the superior parietal lobe which normally helps to generate the normal sense of “self” (2)


A  beautiful and enriching respite from self regulation and a profound sense of wholeness, and connection with something beyond self whatever that being beyond self is.  Therapeutically we have to somehow move beyond a reactionary self to a mindful one. From an emotional distressed one to a serene one. The brain is healthier after mediation than before.   As mentioned in other blogs, without emotional distress this condition can be quite dormant.   References 1.  Newberg, A. B., & Iversen, J. (2003). The neural basis of the complex mental task of meditation: neurotransmitter and neurochemical considerations. Medical hypotheses61(2), 282-291. 2. d’Aquili, E. G., & Newberg, A. B. (2000). The neuropsychology of aesthetic, spiritual, and mystical states. Zygon®35(1), 39-51. From Hijacking the Brain