How We Learn to Self-Medicate

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It is said that in any AA or NA meeting 60% of its group members will have experienced some form of abuse (physical, emotional or sexual) as a child. Childhood abuse is a good indicator of later substance abuse and addiction. 

Recently I posted about ACE (Adverse Childhood Experiences) Study which showed that early adverse experiences, or traumas, predict adult physical and mental health problems that ultimately lead to early death. Adult substance abuse is one such consequence, in addition to smoking and obesity.

In this context, I've been thinking a lot of about validation. To validate simply means recognizing another person's experience of an emotion and their reaction.

If a friend is crying because his dog recently died, I would validate by saying something like "I see that you are really sad" or "You are really missing Buster." In my wanting to help, I might instinctively want to problem solve or advise him so he feels less hurt. I will get there, but first and foremost I acknowledge that his sadness is real and valid.

Imagine a little girl falls and scrapes her knee, and she cries. Her mother or caretaker hopefully will say something like "Oh, no, you fell. Come and let me look at it" or "Let me see. I think it's going to be okay." Both statements indirectly validate that an accident has happened and that the little girl's reaction is valid. But, another parent might simply order the child to stop crying, or say something like "I told you not to run" or "This is what happens when you misbehave by running." 

In a dysfunctional or abusive family, a child's feelings and reactions are invalidated, as the latter examples illustrate. It doesn't seem so bad when looking at just one example, but when it is long-established pattern, parental invalidation teaches the child that her feelings, especially negative ones, can't and shouldn't be felt or expressed. 

The same girl might grow to ignore, disregard, deny or avoid her feelings, especially uncomfortable ones like sadness, anger, shame, guilt, boredom, loneliness, even though they are part of every person's experience.

Enter alcohol and drugs, which in the short-term help her avoid unpleasant feelings. Repeat this way of coping and a dependence and addiction develops. And a cycle of self-medication begins: Immediate relief from unpleasant feelings followed by intensification of those feelings, and so on...

Surviving Mother's Day Without Mother

Depending on your history Mother's Day can be a mere annoyance or day you want to hide out under the covers. Maybe you lost your mother as a child or as an adult, or your relationship with your mother is beyond repair and you are mutually estranged, or you were adopted and you aren't quite sure how you to make sense of your relationship to your mother(s).

Below are some ideas to help you get through the day. Or they may help you alone in the process of mourning or reconciliation.

1. Acknowledge your feelings When you pause to reflect you may feel many feelings at once, which can be deeply uncomfortable especially if you've never processed your relationship to your mother. You may feel overwhelmed and confused or even conflicted. It's okay. Feelings rise to the surface and they dissipate. Cry if you need to.
   
2. Try not to feel resentful
   No doubt you will see families of various configurations on their way to wherever they are going to celebrate. You will encounter displays of love and affection. As difficult as it may be, try your best to feel happy for them. Recognize you are only seeing the surface and it's impossible to know the backstory.
   
3. Establish a ritual
   If possible arrange to get together with your siblings, other family members or friends who remember your mother. Or, if you are alone, think back and engage in something that remind you of your mother in a positive way. Did your mother like to eat or cook a particular meal? What was her favorite flower? Was there an activity you did with your mother? If it's not too painful, hold or look at mementos or photos that remind you of your mother.
   
4. Connect with your mother
   Write a letter or journal and tell her about how you feel. Tell her you miss her. Tell her something she might be proud of. Dig deep and try to connect and communicate your feelings and thoughts and feelings.
   
5. Get spiritual
   If you are religious attend a church service, light a candle, or say a prayer. Read a book or articles about the lasting connection between mothers and children. Death itself is not final. People may cease to exist in this material world but they continue to exist in memories of the living.
   
6. Nurture
   Obviously if you are a mother, this is a no-brainer, but for others without children, like Anna Jarvis, explore different options that will allow you to care for and nurture others. If you have a pet, be extra attentive and gentle. It could be simple as watering and tending your plants with extra care or maybe you will decide to volunteer to give a part of yourself to others in need.
   
7. Self care If you find yourself feeling sad, empty or lonely, or just plain confused, avoid activities that numb or tune you out from the world and yourself. Self-numbing behaviors can include drinking excessively, using drugs, compulsively surfing the internet or binge watching anything. At its base, self care is recognizing that you operate as a system. And systems require regular maintenance for it to operate optimally. Be sure to get enough sleep, feed yourself regularly, move your body, and connect with nature or whatever you do to feel grounded and solid. Ask yourself what how would your mother take care of you? And, if you were a mother how would you care for your child?
   
8. Distract
   If you lost your mother or broke off with your mother recently and your feelings are too raw, it may be tempting to ruminate or dwell on grief, anger, disappointment, regret, or some combination of difficult feelings. Try to plan ahead and schedule activities, and write them down. Putting them on paper will make it more likely that you will follow through with your plans. 

History of Mother's Day Ironically the woman responsible for making Mother's Day a national holiday never married nor had children of her own. To honor the memory of her own mother Anna Jarvis made it her project to make Mother's Day a national holiday. Her dedication finaly paid off in 1914 when president Woodrow Wilson declared second Sunday of May as Mother's Day. Not long after, however, Jarvis became disillusioned by its co-optation by commercial interests (florists, card companies, department stores) and she unsuccessfully tried to take Mother's Day off the national calendar.

Child Adverse Experices (ACE) and Adult Health

Federal law defines child abuse as the following:

• "Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation"; or
  
• "An act or failure to act which presents an imminent risk of serious harm."

Number of reported cases of child abuse is about 3 million annually. Every ten seconds another case of child abuse is reported to child protective services. 

I can't help wonder the actual number of children affected by child abuse and neglect. In my private practice and my work at a community mental health clinic, vast majority of clients experienced some form of abuse and neglect as children, but most of these cases did not get reported.

So, why do my clients come to therapy? Main complaints are: depression, anxiety, problems with drug and alcohol, addiction to food or sex, relational problems, sleep issues, low self confidence, general dissatisfaction in life. 

The relationship between childhood trauma and its effect on adult physical and mental health has been measured and documented in a study with over 17,000 people: ACE Study (Adverse Child Experiences). You can measure your score here. 

I will definitely revisit this subject in future posts.

Dangers of Binge Drinking

Have you drunk more than 8 drinks in a single occasion this month? If you answer is yes you are not alone. On average 38 million American adults binge 8 or more drinks at a rate of 4 times a month.

I've written about binge drinking and its dangers before. One of the biggest misconception about binge drinking is that it's a problem primarily for young people — minors, college students and young professionals. What may surprise you is that the group of people who are at most risk from dangers of binge drinking (defined as drinking 5 or more drinks in one occasion) are middle aged adults.

According to the latest report from the CDC, 6 people on average die from alcohol poisoning each day. Surprisingly, 75% of them are adults between 35 to 64 years old. And majority of them (75%) are men.

Clients I see will NOT die from alcohol poisoning. The problem as I see it is that frequent binge drinking or heavy drinking normalizes drinking until it becomes habitual. It becomes the norm. Without so much awareness habitual drinking becomes the way to deal with unwanted feelings and positive feelings. Prolonged alcohol abuse weakens all the systems in the body and contribute to unnecessary health conditions, lower our quality of life and contribute to early death.

It's difficult to believe but alcohol-related deaths outnumber all drug overdose deaths each year.

In our culture we celebrate, socialize and cope with stress with alcohol. Inherently this isn't a bad thing. As long as we have inhabited this planet, we have invented concoctions to help us escape reality.

What is "bad" is when alcohol use or overuse becomes the "go to" to deal with stress, anxiety, loneliness and boredom.

If you find yourself drinking habitually ask yourself these questions.

• Am I drinking too much? (Everyone has that inner voice of reason, which is often more ignorable under the influence)
• Do my friends or social circle drink too much and act up in ways that raise red flags (DUI's fights, arrests, questionable sexual behavior?
• Do I wake up middle of the night and find myself unable to fall back asleep?
• Am I hungover in the morning and have a hard time getting going?
• Am I missing school or work because of my drinking?
• Have others (friends, family, partner, husband or wife) nagged me about my drinking?

Binge Drinking

Dictionary definition of binge:
a : a drunken revel
b : an unrestrained and often excessive indulgence
c : an act of excessive or compulsive consumption (as of food)
Binge drinking is defined as drinking five or more drinks in one sitting or session. If you want to get technical it's five for males and four for women. Women, due to size and biology just can't handle as much alcohol. Excessive or heavy drinking cutoff is more than 15 drinks per week for men and 8 for women. Just to get really nerdy, a drink is equivalent to a 12 ounce bottle or can of beer (this means a pint is a drink and a half), a shot of liquor and 5 ounces of wine (five units in a bottle).

Why is binging on alcohol so bad for you?
• You will feel bad the next day. Hello hangover!

• Increased likelihood of injury from falls, trips, bumping into things
• Under the influence (drunk) you are more likely to be disinhibited: doing things you normally wouldn't, like having unprotected sex, deciding to drive home, spending money excessively, etc.

• Alcohol poisoning which can permanently damage your brain, liver and other organs
• Getting into fights with friends, strangers, or your significant other
• Getting arrested, going to jail, etc.

• It may become habitual, which means you are at risk of becoming alcohol dependent and early death

According to the CDC, one in six adults binge drink about 8 drinks 4 times a month!