egodystonic thoughts | The Alcoholics Guide to Alcoholism

Powerless over Thinking!

Posted on June 24, 2015 by alcoholicsguide

When I first came into recovery I would be plagued by intrusive thoughts about drinking, I would have thoughts about drinking, at certain times of the day in particular, on sunny days etc.

These thoughts used to greatly distress me and I would end fighting with these thoughts which only seemed to make things worse, the thoughts seem to increase rather than decrease and I got increasingly distressed.

I had no control over these thoughts and would get into a terrible emotional state over this. All before I decided it was now a good time to ring my sponsor. I always waited until I was in as much emotional pain as possible before ringing my sponsor!

I thought I could go it alone – that I did not need any help. I was in control of this.

Geez, surely I could control my own thoughts for flips sake!

Hmmm…afraid not!?

In early recovery I was as powerless over thinking as well as my drinking.

It was obvious I had lost control of my thinking like my drinking – it took a lot longer (and I still forget this even today!) to realise I have no control over my thinking.

It chatters away regardless of my will, my wishes. It I have found is not usually a friend.

So like everything else in recovery I decided to research this! To find out why my thinking seemed out to get me, to negatively affect my recovery. To find out why my thinking did not seem to help me in recovery.

I found out that the idea that abstinence will automatically also decrease alcohol-related intrusive thoughts had been dismissed by research and vast anecdotal evidence.

Practically all therapies for alcoholism e.g AA, SMART and so on suggest that urges create automatic thoughts about drinking.

This has been demonstrated in research that distress automatically gives rise to intrusive thoughts about alcohol. (1) This reflects emotional dysregulation as these intrusive thoughts are correlated to emotional dysregulation (2).

These thoughts to the recovering/abstinent individual can be seen as egodystonic which is a psychological term referring to behaviors, values, feelings that are not in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s self image.

Other conditions, such as OCD, have these egodystonic thoughts creating the distress that drives a compulsive need to act on them, rather than letting them pass.

In other words, these thoughts are seen as distressing and threatening and compel one to act to reduce this escalating sense of distress. A similar process can happen to those in early recovery.

Thoughts about drinking or using when you now wish to remain in recovery are egodystonic, they are contrary to the view of oneself as a person in recovery. The main problem occurs when we think we can control these thoughts are that these thoughts mean we want to drink or are going to relapse!

Early recovery is a period marked by heightened emotional dysregulation and the proliferation of intrusive thoughts about alcohol .

In fact, research demonstrates that alcohol-related thoughts can resemble obsessive-compulsive thinking (3,4).

In fact, one way to measure “craving” in alcoholics is by scale called the Obsessive Compulsive Drinking Scale (5) , thus highlighting certain similarities between alcoholism and OCD.

This finding is also supported by clinical observation and leads to the expectation that among abstinent alcohol abusers, alcohol-related thoughts and intrusions are the rule rather than the exception (6)

Relatively little is known about how alcohol abusers appraise their alcohol-related thoughts. Are they aware that alcohol-related thoughts occur naturally and are highly likely during abstinence?

Or do they interpret these thoughts in a negative way, for example, as unexpected, shameful, and bothersome? Misinterpretations of naturally occurring thoughts or emotional reaction to them may be detrimental for abstinence (7).

A number of papers and studies have shown that individuals’ appraisal of their intrusive thoughts as detrimental and potentially out of their control may lead them to dysfunctional and counterproductive efforts to control their thinking.

Alcohol-related thoughts cause an individual to experience strong emotional reactions; however, alcohol abusers will increase their efforts to control their thinking only when they have negative beliefs about these thoughts.

For instance, spontaneous positive memories about alcohol (‘‘It was so nice to hang out at parties and to drink with my buddies’’) may be appraised—and misinterpreted—as ‘‘the first steps toward a relapse’’.

Such an appraisal of one’s thoughts about alcohol as problematic may instigate thought suppression and other efforts to control the thoughts.

These efforts must be assumed to be counterproductive and will increase rather than prevent negative feelings and thoughts, and they may even demoralize alcohol abusers who are trying to remain abstinent

On the other hand if positive alcohol-related thoughts are not appraised as problematic but as a normal part of abstinence, the awareness of these thoughts might even lead to the selection of more adaptive coping responses, which could help to reduce the risk of relapse, such as talking to someone about them or just simply letting these thoughts go.

In one study (8), participants who reported on their thoughts about alcohol in the previous 24 hours, 92% reported experiencing at least some thoughts about drinking that ‘‘just pop in and vanish’’ without an attempt to eliminate them. This suggests that if both suppression and elaboration can be avoided, many intrusive thoughts will be relatively transient.

An “accept and move on’’ strategy provides an opportunity for the intrusion to remain a fleeting thought.

In other words, just let go.

This means the thoughts go, and the distress which activates them, too.

This is recovery a lo of the time. Getting embroiled in thinking and then letting go, repeat…

That is why helping others is important -it takes us out of our crazy heads

References

1. Zack, M., Toneatto, T., & MacLeod, C. M. (1999). Implicit activation of alcohol concepts by negative affective cues distinguishes between problem drinkers with high and low psychiatric distress. Journal of Abnormal Psychology, 108(3), 518.

2. Ingjaldsson, J. T., Laberg, J. C., & Thayer, J. F. (2003). Reduced heart rate variability in chronic alcohol abuse: relationship with negative mood, chronic thought suppression, and compulsive drinking. Biological Psychiatry, 54(12), 1427-1436.

3. Caetano, R. (1985). Alcohol dependence and the need to drink: A compulsion? Psychological Medicine, 15(3), 463–469

4. Modell, J. G., Glaser, F. B., Mountz, J. M., Schmaltz, S., & Cyr, L. (1992). Obsessive and compulsive characteristics of alcohol abuse and dependence: Quantiﬁcation by a newly developed questionnaire. Alcoholism: Clinical and Experimental Research, 16(2), 266–271.

5. Anton, R. F., Moak, D. H., & Latham, P. (1995). The Obsessive Compulsive Drinking Scale: A self-rated
instrument for the quantiﬁcation of thoughts about alcohol and drinking behavior. Alcoholism:
Clinical and Experimental Research, 19, 92–99.

6. Hoyer, J., Hacker, J., & Lindenmeyer, J. (2007). Metacognition in alcohol abusers: How are alcohol-related intrusions appraised?. Cognitive Therapy and Research, 31(6), 817-831.

7. Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the
treatment of addictive behaviors. New York: Guilford Press

8. Kavanagh, D. J., Andrade, J., & May, J. (2005). Imaginary relish and exquisite torture: the elaborated intrusion theory of desire. Psychological review, 112(2), 446.

The Fanatic in the Attic

Posted on June 8, 2015 by alcoholicsguide

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!

Don’t fight your thoughts!

Posted on June 10, 2014 by alcoholicsguide

The idea that abstinence will automatically also decrease alcohol-related intrusive thoughts has been dismissed by research and vast anecdotal evidence.

Practically all therapies for alcoholism e.g AA, SMART and so on suggest that urges create automatic thoughts about drinking. This has been demonstrated in research that distress automatically gives rise to intrusive thoughts about alcohol. (1) This reflects emotional dysregulation as these intrusive thoughts are correlated to emotional dysregulation (2).

These thoughts to the recovering/abstinent individual can be seen as egodystonic which is a psychological term referring to behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s self image. Other conditions, such as OCD, have these egodystonic thoughts creating the distress that drives a compulsive need to act on them, rather than letting them pass. In other words, these thoughts are seen as distressing and threatening and compel one to act to reduce this escalating sense of distress. A similar process can happen to those in early recovery. Thoughts about drinking or using when you now wish to remain in recovery are egodystonic, they are contrary to the view of oneself as a person in recovery. The main problem occurs when we think we can control these thoughts are that these thoughts mean we want to drink or are going to relapse!

Early recovery is a period marked by heightened emotional dysregulation and the proliferation of intrusive thoughts about alcohol .

In fact, empirical research demonstrates that alcohol-related thoughts can resemble obsessive-compulsive thinking (3,4).

In fact, one way to measure “craving” in alcoholics is by scale called the Obsessive Compulsive Drinking Scale (5) , thus highlighting certain similarities in pathomechanisms between alcohol and OCD.

Relatively little is known about how alcohol abusers appraise their alcohol-related thoughts. Are they aware that alcohol-related thoughts occur naturally and are highly likely during abstinence? Or do they interpret these thoughts in a negative way, for example, as unexpected, shameful, and bothersome? Answers to these questions obviously inform with implications for relapse prevention, because misinterpretations of naturally occurring thoughts may be detrimental for abstinence (7).

A number of conceptual papers and empirical studies have shown that individuals’ appraisal of their intrusive thoughts as detrimental and potentially out of their control may lead them to dysfunctional and counterproductive efforts to control their thinking. Alcohol-related thoughts cause an individual to experience strong emotional reactions; however, alcohol abusers will increase their efforts to control their thinking only when they have negative beliefs about these thoughts. For instance, spontaneous positive memories about alcohol (‘‘It was so nice to hang out at parties and to drink with my buddies’’) may be appraised—and misinterpreted—as ‘‘the first steps toward a relapse’’.

Such an appraisal of one’s thoughts about alcohol as problematic may instigate thought suppression and other efforts to control the thoughts. Because these efforts must be assumed to be counterproductive (Fehm & Hoyer, 2004), they will increase rather than prevent negative feelings and thoughts, and they may even demoralize alcohol abusers who are trying to remain abstinent

If positive alcohol-related thoughts are not appraised as problematic but as a normal part of abstinence, the awareness of these thoughts might even lead to the selection of more adaptive coping responses, which could help to reduce the risk of relapse.

In the context of mental health, metacognition can be loosely defined as the process that “reinforces one’s subjective sense of being a self and allows for becoming aware that some of one’s thoughts and feelings are symptoms of an illness.”

The assumption that metacognition mediates reactions to alcohol-related cues may help to explain why “craving” does not inevitably lead to relapse.

In one reported study (8), participants who reported on their thoughts about alcohol in the previous 24 hours, 92% reported experiencing at least some thoughts about drinking that ‘‘just pop in and vanish’’ without an attempt to eliminate them. This suggests that if both suppression and elaboration can be avoided, many intrusive thoughts will be relatively transient.