Google “alcoholic pictures” and you will find that an alcoholic tends to be an unhappy adult white male who sits in the dark with his head in his hands. He is alone and depressed with only a bottle for company.
An alcoholic, defined clinically, is someone physically dependent on (addicted to) alcohol and unable to control how much they drink; alcoholic also has cravings and increased tolerance, and goes through withdrawal symptoms when alcohol leaves their system. Comparatively, a problem drinker, or an alcohol abuser, is someone psychologically dependent on alcohol but without the physical dependence (although a hang over is a collection of moderate withdrawal symptoms). For the problem drinker, the issue isn’t alcohol (because they can go without) but the reasons why they drink and what happens after they drink. National Institute of Health and National Institute of Alcohol and Alcohol Abuse classified U.S. alcoholics into five subtypes. These results are from a 2007 national survey, and it is estimated 14 million Americans qualify as alcoholics. Young Adult subtype: largest group in the U.S. with 31.5 percent of alcoholics. Low rate of mental illness, drug abuse and history alcoholism in their families. Least likely to seek out help. Young Antisocial subtype: In their mind-twenties, 21 percent of U.S. alcoholics. Early onset of alcohol use and problems related to alcohol abuse. More than half from families with alcoholics. About half are diagnosed with Antisocial Personality Disorder. Many suffer from the trinity of mental illness (depression, bipolar disorder and anxiety problems). More than 75 percent smoke cigarettes and marijuana, and many have problems with cocaine and opiates. More than a third seek help. Functional subtype: 19.5 percent of alcoholics. They are mostly middle-aged, well-educated, with stable jobs and families. Third have alcoholism in their family histories, a quarter had major depression at some point in their lives, and nearly half were smokers of tobacco. Intermediate Familial subtype: 19 percent of American alcoholics, they are middle-aged and half withs familial history of alcoholism. Most smoked, half of them had clinical depression, and 20% have had bipolar disorder. Nearly 20% had problems with cocaine and marijuana. In this group only a quarter get treated. Chronic subtype: 9 percent of U.S. alcoholics. Middle-aged; began drinking heavily at an early age. High rates of Antisocial Personality Disorder and criminality. Highest rate of mental illness (depression, bipolar disorder, anxiety disorder). High rates of smoking, marijuana, cocaine, and opioid dependence. 2/3 of the group get help (many of them to mandated to treatment making them the most prevalent type found in treatment. Information, which I summarized here, comes from: http://www.news-medical.net/news/2007/06/29/27074.aspx?page=2 http://www.alcoholic.org/research/alcoholism-statistics-and-information/ Are you an alcoholic? Find out here. In my practice I work to help problem drinkers with their emotional health, in addition to learning how to become a more mindful, moderate drinker.
I’ve tried to define risky or heavy drinking in a prior post. Naturally, a post on why one may want to consider cutting back or drink moderately follows. First, I’d like to distinguish alcoholism from alcohol abuse, i.e. risky/heavy drinking, by making the distinction between physical dependence on alcohol from psychological dependence. I am primarily concerned with psychological dependence and its relationship to emotional health. The following are the most common reasons/beliefs why people say they drink: 1. Alcohol makes me feel less shy and more social 2. Drinking alcohol makes socializing more fun 3. I am more interesting and fun to be with when I am drinking 4. I am more myself when I am drinking 5. Alcohol relaxes me 6. Alcohol unwinds me from stresses of life 7. Drinking makes me forget my troubles 8. I am more creative when I am drinking These reasons, for the most part, are valid and supported by the fact that alcohol has been around just as long as we have. There is no denying that ethyl alcohol, the active chemical compound in alcohol, does relax the brain and body, initially. One possible explanation for how drinking becomes problematic maybe because of habits. Once we hold an idea of ourselves to be true – I am more social and friendly after a couple of beers or alcohol helps me to relax – the repetition of the behavior, or the habit, reinforces the belief which first initiated the behavior. We begin to believe that drinking alcohol is the ONLY way we can be relaxed, be more social and have fun in a social setting. In a sense, we become trapped by the beliefs we have about ourselves. We become the person who we believe we are. But we can’t be sure this is true, even though it may have been true in high school or college when we first started drinking. But, we can discover new parts of ourselves by doing the same things differently or trying new things. By questioning established beliefs or behaviors and trying new ideas, we learn new aspects of our personalities, expanding our idea of who we are. As our self-image or self-concept expands, so does our self-esteem, which makes incorporating new ways of thinking and behaving easier. Practical application of this theory to problem drinking would be to see how it feels to go out and not drink or limit how much you drink so that you don’t go beyond the threshold where alcohol influences your ability to make decisions. I recommend to my clients who have identified heavy drinking as a problem to abstain from alcohol for 30 days. During these 30 days, they are encouraged to think deeply about their relationship to alcohol and decide how they might go about changing it. They may decide to stop drinking all together or try to moderate their drinking. This period of self reflection is not an easy one. Many people will give up, because it would mean dealing with their anxiety and depression. It is demanding work, and change does not take place over night. To be continued...
As you may already know the awards season has begun. Usually I am just an avid watcher and not a reviewer, but this year a couple of movies caught my attention, and I thought they related to what I am trying to do here. Here is my two cents on Flight.
Denzel Washington has been nominated for an Oscar for best actor for Flight directed by Robert Zemeckis. Washington's character, Whip Whitaker, is a commercial jet pilot and a functioning alcoholic. Did I get your attention yet? Just the premise alone is compelling! Predictably, things fall apart (literally, in the sky) for our anti-hero – there wouldn’t be a movie otherwise – and the reality of his addiction unfolds in a nightmarish scenario. For this reason, you won’t be seeing Flight as an in-flight entertainment option. The fatal crash/accident is part one of Whip’s hitting bottom, and the second part… Let’s just say there is a Hollywood ending, and he is redeemed.
What is interesting is the portrayal of addiction with its near limitless potential for denial. Even after a broken marriage, loss of his son’s love and respect because of his drinking, and the resulting social isolation (his only friend it seems is his drug dealer), Whip is so blinded by alcoholism’s cycle of shame, guilt and physical dependence, he can’t and won’t see what it has done to him. Unresolved shame and guilt lead to continued use because chemically altering the brain is the easiest way to avoid the painful act of self-reflection. The medicine that numbs uncomfortable thoughts and feelings also happens to be the source of discontent. As it is said there is no free lunch, one way or another there is a price to pay for delaying what is inevitable. To feel at ease with life requires that we take a long, hard look at who we are and come to terms with it, or make changes so that we can live with ourselves. For many who are caught in alcohol and drugs’ dark embrace, until something dramatic happens where they are forced to, they can’t listen or look at themselves.
What is the lesson from Flight? Listen to yourself and watch for how you feel. Are you unhappy? Are you sad? Are you lonely? Are you tormented by feelings of shame and guilt because of your out-of-control drinking and/or drug use? If you feel that you are partying a bit too much, do something about it, talk to friends or family members, or a professional, before it takes off on its own dangerous course.
