Case Example Alcohol
Bringing Control to two decades of Chronic Alcohol Abuse
How life was.....
Now, I can see that for the majority of my drinking days, which span two decades, I have drunk unhealthily and from a place of mental unrest. Over this time, my relationship with alcohol has been turbulent and varied. I have progressed from drinking pints of lager socially but daily and with people I didn’t even like but who drank too, to binge drinking neat vodka alone at home, then moving on to mainly drinking wine but also dabbling in the former two types of alcohol. I have been abstinent for periods, at times up to several months, but this has been as a result of outside interventions such as my parents and hospital stays. Never until now have I managed to abstain for any period of time of my own accord. Even after being treated in intensive care due to my drinking, though I vowed to stay sober, I could not control my drinking. I could not be sober.
When I came to Edward I was in a dire position. It had been known amongst family and friends for a about a decade that I had a drinking problem. Due to drinking, I’d shown myself up at and enough family gatherings and friend’s celebration for this to be clearly obvious to them. In the latter years of my drinking, I too could see I had a problem but couldn’t admit how severe it had become.
In recent years, out of desperation, family have pushed me to get help. I’d tried SMART, engaged with AA and local alcohol services but none of them made an impact, and instead ironically resulted in an increase in the severity of my drinking habit. My mental health team tried to work on my alcohol consumption too but their pleas and advice fell on deaf ears. I was off on my own disastrous path. So, by the time I met Edward I was deeply entrenched in a cyclical pattern of binge drinking. I say binge drinking because my parents, realising what I was doing to myself would intervene and prevent me from drinking further. If they hadn’t, I imagine I’d have been a daily drinker until the point where I physically couldn’t take another slip or had choked on my own vomit and died.
My parents would retrieve me from flat, where I live alone, take me to their house where I would sleep it off, sober me up and they would take care of me. The problem was after a couple of days the mental cravings for alcohol would be raging and I’d make my excuses at the soonest opportunity after feeling half human again, to leave and go back to my flat to start the drinking cycle all over again.
These cycles would start in frenzy when I’d become so overwhelmed by my emotions and pained by my thoughts. I’d be shaking in anticipation of the hit I’d get from the alcohol, trying to hold it together whilst I purchased it in the shop, longing for the initial release the alcohol would bring. On the first day, I would always buy two bottles of cheap (usually fowl) white wine, always a minimum of 12.5% ABV. At the soonest moment, I would neck most, if not all, the first bottle with my nose pinched and eyes shut, glugging just to get it down, to feel its effect on me. All dignity would be out the window by this stage and I’d drink it hidden in bushes around the corner from the shop, the pub toilets opposite Tesco’s or a public WC. I did not care as long as I felt a hit and fast.
I was desperate to feel the tingling in my stomach and the tension ease from my knotted muscles. For a time, words would flow easily, I’d be buoyant and feel at ease. This first part of the binge was the only part I can say there was even a glimmer of pleasure in. I quickly then would take myself back to my flat. As the effect of the first bottle lessened, usually within the hour, it would be time to start the second and drink it in exactly the same manner. I had to. I had to maintain the numbness and peace from my thoughts that the first bottle had brought-, the slightly woozy, removed from reality feeling I desired. I had to drink to oblivion. Then there would be nothing- blackout.
I’d wake the next morning early, disorientated, sometimes half clothed, always still drunk. I’d be panicked and anxious, not able to remember what I’d done, if I’d phoned or posted on social media. If there were dregs left in the bottom of the bottle, I’d drain those before quickly washing and in an (uncharacteristically) unconsidered way, dress, motivated only by the thought of getting out to get more wine. I’d drag myself to my local Co-op (my local booze supplier) where I’d but another two bottles of white wine. Again, I’d neck the first and follow up with the second but now it was purely just a matter of just getting it down my neck. And so, the pattern continued for the following days. Time and days would pass and I was unconscious for most of it.
Some agonising mornings, I’d wake before the Co-op had started serving alcohol and I’d pace the streets waiting until 8 am hit and I could purchase my release. Sometimes I’d wake to find it was still daytime. Disappointed I was conscious, I’d be compelled to drink more and I would walk to the shop yet again, buy a 3rd and 4th bottle of wine and drink until I passed out again. Most days I’d have no idea how much I’d drank or how many times I’d visited the shop to buy more alcohol. My worst nightmare was waking in the early hours of the morning with no wine left, when it was impossible to buy more and I’d spend hours tossing and turning, scared and anxious, writhing until daylight came and alcohol serving hours resumed and I could get my fix.
During this time, I would contact no one. I’d avoid all calls and texts from worried family who knew exactly what I was doing to myself. I’d avoid meetings I had planned. I’d either just not turn up to work or summon the guts to call in sick. As I drank more, I stopped functioning as a human being and existed as a wine guzzling machine. I lost reality. I didn’t know what I’d done, if I’d embarrassed myself, where I might have been. My personal hygiene worsened, the state of my flat deteriorated. I felt weak and ashamed of myself. So, I had another drink.
Each day I drank, I was becoming more and more ill. I increasingly felt the physical side effects of drinking excessively (the shaking from with drawls, the sickness, the headaches, the fatigue, the palpitations, the sweating) but still I keep forcing the wine down now to make those side effects temporarily disappear as well as to achieve numbed oblivion. I was constantly just ‘topping up’ my blood alcohol levels sol I would fall unconscious again. I lived in that exact moment, desperate to feel mental release - not considering anyone else or any consequences of drinking.
Then usually by binge day 5, my parents would come and haul me away, rescue me from myself.
Usually, I’d been privately praying for a day or two that they’d would come and save me, release me from the horrendous pattern of habitual, compulsory drinking I found myself in, unable to escape. And I truly felt unable to stop drinking on my own. I had to drink again because I’d drunk. Even though theoretically and logically I knew this was not the answer, emotionally what else was I to do. Drinking was my crux: regardless that I knew it worsened my mental health; even though I knew that eventually I’d have to experience the horrific withdrawal symptoms which would have me fearing my heart was going to stop and unable to pick up a cup for shaking; despite all the life limiting well documented morbidities associated with excessive drinking… what else, I’d ask myself, was I to do …but drink??
Beginning the change....
It was October 2019 and I was in a state of utter chaos. My drinking had escalated to a cyclical pattern of five-day binges, only interrupted when my parents ‘rescued’ me from myself. I’d been hospitalised numerous times for detoxing, even on one occasion ending up in ICU. I had been suspended from my job for drinking in the work place. I’d let down friends, missed appointments, days and weeks has disappeared. Money was an issue. My self-confidence and esteem were in tatters and worsening the more I drank. I felt alone, hopeless, drowning in shame, desperate and so lost that my only reprieve from the mental anguish was yet another drink…. and so, the cycle would continue.
I knew I needed help and it wasn’t that I hadn’t sought it out previously. I have other mental health difficulties in addition to my problematic drinking and at the time I met Edward, I’d been in therapy for over 18 years, as well as tried different approaches to addiction and recovery. But, none of these agencies were specific enough to me nor focused on real outcomes and real understanding. They offered paltry distraction techniques and a lot of talk but no action, and crucially I couldn’t ‘get honest’.
I chose Ed from numerous other therapists because on paper he appeared to have the most extensive experience particularly of dual diagnoses. Also, he favours a practical approach. On meeting him, this was apparent but more importantly I felt an immediate trust and warmth. I felt safe enough to be totally honest so we got off to a good start. During that first meeting, Ed came across as solid - none of my horrendous behaviours and shameful drunken acts shocked him nor did I feel judged by him. I felt accepted for who I was at that moment. Although I was ambivalent about signing up and working with him (I was scared that I might actually have had to look at my drinking and change the way I was living my life), I decided to go ahead and began an eight week course of therapy specifically for addiction recovery.
During this course I found Ed to be very focused and interested in my problems. He clearly has a strong desire to help and enable people to make positive life changes. He is articulate and a skilled practitioner. Sessions at times were intense but there’s a light-heartedness to them too. We would begin with a discussion about the previous week’s events, my thoughts and troubles, and an explanation of what might have been going on for me mentally and emotionally.
Ed would give me thought points and suggestions for the week to come. I found this process very engaging, thought provoking and uplifting as week on week I felt I was making progress. I came to look forward to our sessions, to what I would discover about myself.
I feel from the start Ed gave me hope and believed in me (…so I am not a hopeless case after all!), Previously, I had found this lacking in other avenues of help. This hope and belief have evidently had a positive impact on my self-esteem and confidence- which is the crux of the matter.
Quite how Ed does this, I do not know- but it works!
In part, it comes from his practical common sense and ‘real life’ approach which he carefully tailored to me and my specific issues. He doesn’t have a one size fits all approach. Rather than solely submerging ourselves in my past (as most therapists have done) we looked more at the present, at what was driving my drinking now, and he guided me through, encouraging me and supporting me.
By making my habitual thoughts and the resultant drinking behaviours understandable, I began to be able to separate my thoughts from my urges to drink. I gradually gained mastery of my mind, my emotions and actions.
I no longer feel a slave to the bottle.
It’s a work in progress but I have now been sober since the day I met Ed, over 7 months ago. I am not an alcoholic nor ever was. I have forgiven myself for my drunken wrongs. Ed has given me a safe arena in which to lay down all my cards, work through my trauma and pain and discover I can live a better life.
It is not my old life- it is an enhanced life with far greater awareness, empathy and resilience. I feel empowered now. Ed has given me the confidence and tools to be able to trust myself to solve my own problems. He has effectively made himself redundant. I am lighter nowadays with much more joy in life. And that’s thanks to Ed. Give it a go. You’ll be surprised how strong you are and what you can achieve with the right help.
Chronic alcohol dependency, like most ‘addictions’ are treated as diseases, and the general prognosis is poor. Abstinence is wished for and methods are simply – abstain and cling on.
Little insight is given to the ‘why’s and the what’s’ of what is occurring for the individual. In fact, I have heard clients and people whom I know refer to being discouraged from therapy, for the reasoning that only an alcoholic can be understood by another alcoholic. Well yes, perhaps in the hell of it personally, but not necessarily in the architecture of what gives it strength. However, I would rather be on the operating table of a surgeon rather than the block of butcher. Both equally skilled with the knife, yet their starting position so different. The former considers the subject worth saving and improving, whilst the latter knows them already to be dead and beyond help. It is an an analogy which mootly sums up the attitude of a multi billion pound industry wherein no one appears to know what they are doing and the success rate languishes at approximately 5%.
Similarly therapists, key workers etc., often lack the specialist skills to get into the process and undo the mechanisms that 'are' the addiction. A learned set of behaviours. Where the prefrontal cortex, the thinking part of the brain is no longer utilised and therefore actions are 'reactive' and ingrained. They now operate from the striatum and function outside of conscious planning and control.
What is missing is the sensitivity to the need for the healing of the confusion that has caused the dependency to never abate. The layers of erroneous thinking, complex emotional entanglement and lack of life structure and mechanisms that enable someone to lead a stable life. This needs to be done in a manner as working with a clean slate, and remaking a of a clean slate, mentally, emotionally and behaviourally. These elements are done in parallel. The focus is on the person, with an eye on the behavior. They are worked and integrated together with powerful integrative directives that can be tried and proven to work or not. Stimulation of the cognitive functions reinvigorates the prefrontal cortex and change begins to occur.
A person is rebuilt from the inside out. And they come to understand themselves differently, by evidence of their own practice, the content of their minds, their feelings and behaviour. What can come out of this can be and is truly astonishing. I am for ever awed and humbled by what can be achieved.
Fifteen years of quietly listening to people telling me what did not work for them, applying what does work and having the skill to piece this together in a cogent process has its merits. This incredible achievement in the case below I hope exemplifies the life a person can earn themselves by their brave efforts and desire for a better life.
The work done by neuroscientist Marc Lewis and his book 'The Biology of Desire', explain what is it that is going on in addiction. Well worth a look - video here. My methods parallel his theory and were learnt in practice and study.