This blog is written for alcoholics and those who love and live with them, by alcoholics in recovery.
For those who know what it is like to live with alcoholism but would also like to know why alcoholism affects the alcoholic and those around him in the way it does.
We write this blog to help us and you understand how the alcoholic brain works and why they sometimes do the things they do, why they act the way they do?
Why is it sometimes that everything is going great and suddenly the alcoholic in your life overreacts and acts in an emotionally immature way, which can often cause hurt to others around them?
Why do they suddenly cut off their emotions so profoundly it leaves your emotions in limbo, confused and upset?
In this blog we seek to explain, in terms of the processes of the brain, why they do the things the way they do, act the way they do.
We hope to explain this disease state and behavioral disorder, which alcoholics themselves call a “emotional disease’, a “cancer of the emotions’ , a “parasite that feeds on the emotions” or quite simply “a fear based illness”.
It appears that alcoholics in recovery are aware to a large extent of what they suffer from. But why do they do what they do sometimes if they know what is going on? Are there times when they cannot help themselves?
Equally at other times, why do they not seem to be able to help themselves from disengaging in certain responses and behaviours?
Why do alcoholics, even in recovery, sometimes engage in endless engage in self defeating resentments, taking “other peoples’ inventory” or criticizing others.
Why do they project into future scenarios and then get emotionally paralyzed by doing so?
Why can they run through the list of cognitive distortions on a daily basis, why do they get self absorbed and engage in “me, me, me” behaviour!?
This is not to condemn but to understand. Knowledge we believe is power. It aids understanding and compassion of another person’s suffering.
We as recovering alcoholics still, after several years of recovery, engage in such behaviours. We do not wish to hurt anyone, especially not our loved ones, but sometimes do. Unwittingly.
We sometimes get wrapped up in ourselves and act in a selfish, immature and inconsiderate manner.
Some days are tough too in recovery. It is about being real, authenticate.
We lived in fantasy for too many years. Recovery is, at times unfortunately, about growing up too. This can be difficult. What normal people can do without thinking we can often find more difficult and distressing.
We need help with this at times distressing condition. That is what it is. Distressing, based on a emotion and stress dysregulation, even in recovery, hence we have to manage it. On a daily basis. It does not return to normal. To balance. To equilibrium. We have to take certain actions to restore emotional equilibrium.
Hence it can be hard work, hence we sometimes we come up short and emotionally overreact.
We have a distress based condition which has to be managed.
We also have to give ourselves a break, don’t distress ourselves further with perfectionist ideas of “should” – just do your best! That is usually good enough for most people. Why not us?
We are not saints, progress not perfection!
Or as progress not perfectionist!
In time various therapies, such as those which help regulate our emotions (and hence or thoughts and reactions) in time, through practice and the neuro plasticity (neural reshaping of the brain via behaviour) change how they act, feel and live in this life. How we think about ourselves and others. How we plan our futures.
In short, recovery changes the brains of alcoholics for the better.
As we are personally well aware, self knowledge does not bring recovery – only action does.
But this action can be based solidly on a better understanding of what goes on in the brain of an alcoholic for example, why should I mediate?
What beneficial, adaptive change will that bring, how will that “help my recovery”?
What is the point of doing the steps, how exactly do they effect change in one’s alcoholic brain? How can a bunch of steps help change how we regulate our emotions?
Is there a good healthy neurobiological reason for going to mutual aid group meetings like AA ?
Most alcoholics feel they never fitted in, did not belong, felt they had a hole in the soul? Why is this? Is this also about something to do with the brain chemistry of an alcoholic?
Some of us were hyper “sensitive”, engaged in risky behaviours, had conduct problems, were depressed and lonely, and others had impulsive behaviours all of which we believe are illustrative of an emotional dysregulation which makes certain individuals vulnerable to becoming alcoholic.
Science tells us there are many such vulnerabilities in children of alcoholics. The alcohol regulated, medicated these errant emotions which caused such distress, even at an early age.
It is these emotional processing deficits and emotional dysregulation (i.e. poor control of emotions, especially when distressed!) which lie at the heart of this psychopathology or if you like this psychiatric disorder called alcoholism.
It is a distress-based condition, day in day out, and we formally believe that various therapeutic regimes like the 12 steps or DBT, etc all treat this inherent distress state in some way.
It is this distress state that activates this “fear-based illness”, that makes one hyper aware of cues, alcohol, it is this distress that provokes memories of drinking, alcohol use schemata, that trains one attention on people places and things from the past.
Without this distress our illness barely gets activated!
For example, does your loved alcoholic, “over do things “on a regular basis, do they engage in short term thinking, or “quick fix ” thinking. Do they resist your attempts at sensible long term, goal directed, thought through thinking?
Does your alcoholic work himself to a frazzle, do they easily become exhausted by overdoing it, whatever it is?
Do they have a series of new addictions? Are they perfectionist doing too much, or nothing anything at all? Perfectionism is distress based.
Does your alcoholic fear the future, do they have an intolerance of uncertainty, do they live in the future, do they endless ruminate about things, do they react rather than act?
Do the most simple decisions provoke a “fight or flight” response?
Do they frequently come up with “I know how to do this, I have a great idea!” Only for it to be the opposite of a great idea! Decision making difficulties lie at the heat of alcoholism and all addictive behaviours
Do they give people “rent free room in their heads” because of resentments – replying the same old tape in their minds, over and over and over again? All distress based.
Fear based is distress based.
A recent study showed that alcoholics have a part of the brain that helps process emotions but it doesn’t work properly so is overactive all the time; it is exhausting being on red alert, all the time , living on a state of emergency.
Hence step 11 in the 12 steps.
The problems with this hyperactive brain region, called the ventral medial prefrontal cortex, is that it cuts out , hypo-activates, when more stress is applied and another compulsive area of the brain, the basal ganglia, takes over.
This part is automatic, habitualized, automatic,compulsive!
It results in more more more, and is driven by distress not goal directed consideration. It simple does, does, does, without consideration of future consequence.
How did your loved alcoholic get to be this way?
What happened to your own alcoholic brain?
We believe there is a vulnerability to these aforementioned emotional difficulties as certain brain areas which regulate emotion do appear to not work properly.
This means the brain areas regulating emotion are often are smaller, impaired and do not function optimally or are not connected properly.
Do you have an alcoholic in your life who does not accurately know how he is feeling properly? Does not know what emotion he/she is experiencing?
Cannot label an emotion properly which makes the processing of it difficult?
Can’t rely on a neural feedback to tell himself when he is tired, angry, hungry and that he/she should HALT?
This is the insular cortex not working properly. Does your alcoholic see error everywhere (and worse still give a running commentary on it!?), sometimes complaining about that not being right, or that being wrong?
” Why can’t they do things properly, be more perfect!! ”
That is partly to do with impairment of the anterior cingulate cortex which is impaired in monitoring error.
This fear based stuff is the result of a hyperactive amgydala, the “anxious amgydala”, which also acts as a switch between memory systems, from explicit to implicit memory, and recruits the compulsive “go,go, go” area of the dorsal striatum from the always “on the go”, hyperactive, ventral medial cortex.
The amgydala is at the heart of alcoholism and addiction. It not only switches memory but also reward/motivation/ and emotional response so that distress provokes a habitualized “fight or flight response” in the dorsal striatum.
It is said that alcoholics are emotional thinkers, engage in emotional reasoning, and these regions often also prompt an emotionally based “doing” which means emotional distress acts as a stimulus response.
The brain responds to the stimulus of distress in other words. As addiction and alcoholism progress the way addicts and alcoholics react becomes limited in line with addiction severity.
The further the alcoholic gets in alcoholism the more he will react out of distress, the more automatic his behaviours become, the more short term his decision making will be, the more he has to fight automatic urges and automatic drink-related thoughts, the more he has to contend with “fight or flight” thinking and feeling.
Alcoholics have a different (or low) heart rate variability meaning the have a heart rate more suited to being ready for the next (imagined) emergency).
The effects of alcohol are thus more profound on this group, and this HRV is also seen in children of alcoholics so represents a profound vulnerability to later alcoholism as alcohol profoundly alters HRV and allows us to relax.
Add to that depleted levels of dopamine, which is important in the addiction cycle.
Dopamine is involved in pathological wanting and in compulsive behaviours.
It is not about pleasure, it is about learning and memory, reward and motivation. It sends us out to get the substances which used to give us pleasure, and long after they had ceased to do so.
It hunts indiscriminately, in survival, for stuff that threatens our survival, just because it has done for so long.
The problem with dopamine supplies is that our excessive levels of stress reduce our amount of dopamine, that we are always on the hunt for more dopamine. Anywhere, we use our dopamine to point us and shunt us to our next obsessive compulsive behaviour, even in recovery.
Our depleted dopamine can hence never get enough.
Add to this that stressful states increase our brain in “dopamine seeking” in an attempt at transient homeostasis and you have a brain that is always trying to get a buzz out of something, especially when in distress states.
Then there is other deficits to the serotonin system, to the natural opioids system, to oxytocin (involved in attachment to loved others – often sadly lacking in alcoholics and addicts), all of which take a beating and are reduced by the excessive stress systems cause by addiction.
But all are increased via love and looking out for our fellow man, our families, loved ones and other’s in recovery.
We can manipulate our brain chemistries, this is what happens in recovery in fact!
Chronic stress also impairs the prefrontal cortex the cognitive, conscious “top down” controller of the brain’s emotions and urges, instincts and so on.
It doesn’t help that it doesn’t work too well in alcoholics. The brain of an alcoholic is a “spillover” brain, it is a brain that spills over into various types of disinhibtion, impulsivity and compulsivity .
It often acts before considering, speaks before thinking. decides this is a great idea without consulting, reacts without sufficient reason or cause. It needs help, this alcoholic brain. From another brain, from someone other than himself.
Recovering alcoholics need an external prefrontal cortex to help with the top down cognitive control of the subcortical emotional and motivational states.
The problem with emotions are they, in the alcoholic brain, have become entwined with reward. We feel a certain way, negative for example, and fix this negative feeling, with something rewarding and it seems this has been the case with certain alcoholics since childhood.
Dealing with emotions by the granting of treats. Feeling better by consuming. Finding different feelings in a bottle, or a pill, or a syringe or snorting them up one’s nose.
Fixing our feelings by external means.
Alcoholics need a spiritual awakening, this sudden change in how we feel, think about and act in the world because the old feeling about the world will lead to the same old behaviours.
Plus alcohol and drugs were crude, approximate spiritual awakenings, they dramatically and very instantaneously help change our feelings, thoughts, perceptions about the world around us.
This is the purpose of a spiritual awakening too, a sudden (or gradual) change of consciousness.
We believe the best and most sudden way to achieve this is to let go of the thing that causes all the suffering in the first place, the self.
It appears we can live without the “self” . It also appears helping others brings a bigger buzz than even helping ourselves.
Helping others reduces our distress.
This brain also needs someone outside of self, outside the self regulation network in the brain which is so impaired and cannot be relied on because at times it is maladaptive.
It sometimes can’t be counted on the make the right decision because it favours short term over the long term, can be based on “fight or flight “thinking and not rational, hence this decision making is distorted by fear. If we have been thinking in this maladaptive way all our lives, it is no wonder we ended up where we have.
We used alcohol to deal with our errant and quite frightening emotions. I positively ran away from my own emotions. I used to say to my wife, the main reason for my drinking is “to get away from my self”.
Now we have to find a solution to living with oneself, these sometimes tortorous alien state of emotional sobriety.
I remember being asked by a counsellor to sit with my emotions for half on a hour.
I felt I was being possessed by some poltergeist, the feelings associated with emotional regulation were so alien to me, so frightening. I didn’t know what they were even. I had to have by wife label them for me and help me process them.
I believe steps 4 and 5 of 12 step programs help one emotional regulation hundreds and hundreds of unresolved, unprocessed emotions from the past otherwise they will continue to be in there, haunting us like “neural ghosts” from the past, adding emotional distress to our conscious daily experience and encourage relapse.
This is the case for many newly recovering alcoholics. Being haunted by a million thoughts produced my rampant emotional dysreguation.
Resentments swirling around the mind and driving the newcomer back to relapse. What the newcomer finds is that the drink stops working, and the emotional difficulties remain, in fact much worsened by years and years of sticking a neuro toxin down our throats and in into our brains .
Havoc is then further reaped on an already not fully functioning brain. In AA they often they say that they are stuck at the emotional age of when they started drinking which is usually around the early teens when the cognitive part of the brain that controls emotions is still developing.
But we can act much more immaturely than that, we can act like the terrible twos or children on occasion.
Our emotional brains never really grew up. This emotional dysregulation apparent as teens then shaped all our future decisions and eventually our alcoholism.
That is what they mean in AA, when they say all your best thinking got you here. So there you have it . Sound familiar? Recognize anyone here?