During a recent group therapy session, one of my clients mentioned that his drinking habit, which according to him, was well under limits and control, was misunderstood by his parents. He was living with his parents as a result of the pandemic. His wife and his son, he claims, understand his drinking as a recreational habit of his. He was at loggerheads with his dad who was a teetotaler. His problem was that he was an adult who knew his liquor but his dad still saw him as a teenager who was giving in to alcohol.
Alcohol is a “social evil” that incites extreme responses from many people. We have those that get excited at the escapism that it gives and we also have those that publicly deny any association with it while secretly craving for it. And there are also those that call for banning it which in itself is an extreme step. And further, restrictions imposed on the sale or consumption of alcohol lead the way to excessive consumption, black market sales, smuggling and other illegal activities.
For those that have constantly assessed where they stand with respect to their drinking or the occasional indulgence, alcohol consumption is an area of their life that is seemingly under control. However, there are times when our assessment of how much we are in control of our indulgences can be misleading. Like the client in the group therapy session, who came back after having a conversation with his father and said that his dad’s point of view made him realize that he had been wrong about his “control” of the habit.
What had started out as a light drinking habit, had, over the years, taken an ugly turn when he had passed out or started behaving erratically after going overboard, ignoring his wife’s requests to stop after 2 or 3 drinks. Moving in with his aged parents to be supportive during the pandemic had also paved the way for an “intervention” of sorts led by his father to get him to understand that alcohol had started becoming a “dependence” rather than just a habit. But the intervention was creating stress for him because he felt the way his father approached it was with a certain amount of disdain and with an accusatory tone. So, the intervention, being wrong in its approach, timing and source, failed and in fact, became one of the reasons for the client to drink more and escape the stress that it caused. There are many who are stuck in this situation where they realize that they have a problem that could lead to addiction and health problems, but cannot seem to find the right place or starting point to start addressing it.
A drinking problem, instead of being called addiction, is now widely referred to as Alcohol Use Disorder or AUD (by the World Health Organization as well as national level public health organizations) and various studies show that there are many factors that contribute to it. A mental health professional or a medical doctor trained in treating alcoholism and substance abuse can assess where a person with drinking problems stands on the AUD scale. Before we go deep into what makes a person with a drinking habit, an abuser or dependent on alcohol, we need to understand that there are various patterns to drinking. These also have a gradation in their effect on the person’s physical and mental health and very importantly, their relationships and social image. The following image explains the various stages of alcohol consumption.
Now, for a drinker, to accept that he has moved on from the social or light drinking level to any of the higher levels is a very tough thing to do. In many cases, it happens only after a severe health problem knocks on their doors. Or an intervention by a friend or family member makes them understand the extent to which this habit has taken control of their mind.
The immediate reaction is usually a sense of betrayal or “being cornered” that is felt by the individual who is confronted by something that he/she had thought to be under control. Now, if the interventionist is a family member/spouse/friend, there are a hundred ways in which the conversation can take a wrong turn depending on the nature of the relationship they share with the concerned person (as it was in the case of the client mentioned at the beginning of this article). There are also family or friends who think every problem with alcohol needs to be dealt with by approaching a rehabilitation center. This is a misconception because the majority of cases of alcohol abuse stems from an internal conflict or psychological issue that the person has been undergoing for a very long time and has tried to escape towards alcohol as a solution.
For example, an individual who used to be a light drinker might start drinking more and with greater frequency, because they are going through emotional stress/trauma that they cannot deal with by themselves and are too much in denial about because they categorize that stressful/traumatic scenario as one that is beyond them to handle or something they just have to live with. And so their increased reliance on alcohol seems like a solution rather than a problem.
For such individuals, and this includes, contrary to popular belief, both men and women, taking treatment from a rehabilitation center can feel too extreme and this is where therapy and counseling come in. The need of the hour for people who realise that their drinking is deep-rooted in their own insecurities, fears, failures or any other demotivating/depressing feeling, the best option is to find a therapist or counseling psychologist with whom they can open up and talk about their issues with their own psychological state. This will pave the way for them to be more accepting of how alcohol is compromising their rational thought and decision-making capabilities. This would be the first step in their journey towards reducing their alcohol intake to a level that is considered healthy or even quitting it altogether.
Psychological issues like childhood trauma, bad parenting, school/teen bullying, non-recognition at home or workplace, financial pressure, inability to meet expectations from loved ones or superiors at work, rejection by a loved one, feeling unhinged by being treated without respect are all possible triggers that push a person to seek solace in alcohol. In many cases, the morning after is characterized by a bit of remorse but pretending to not acknowledge it because it would also mean acknowledging the underlying psychological issue that started all of this. This can be a bruise to their ego and the “image” that they want to present to their family and social circle.
However, there will be times when they feel trapped because of their dependence on alcohol, and this is most felt when it damages their dynamics with those that love them and depend on them. The inability to be their best version due to their increased reliance on alcohol further pushes them to depression and can make them lose their identity. Many such people who have young kids at home try to shield this aspect from them leading to a gap in their parenting which has its own set of problems for the kids.
I have had many clients who shun the idea of taking help for their alcohol problem because they realize quite well that it is not just the alcohol that messes up their mind but the underlying conflict within themselves that serves as the starting point for this vicious circle of over indulgence, abuse, mental trauma and loss of self-identity. I strongly urge them to not label themselves as “addicts” and their problem as an addiction unless I know that they need medical intervention and treatment from a rehabilitation program. And I have seen that addressing that underlying problem goes a long way in helping them be the person they know they can be. To not fall into the category of “addict”, by acknowledging that their problems can be resolved with help from a professional who can be non-judgemental and accepting of their vulnerabilities and guide them in moving away from the mental and emotional triggers that make them turn towards alcohol. The main thing here is to be able to feel that trust and confidence with a therapist who will know how to help effectively.
If you find yourself in such a situation where you need help with your alcohol habit, or know someone who does, please encourage them to talk to a therapist (or two, until you find someone who can understand you and you are comfortable enough opening up to) and find the answers to their problems. Acknowledge that this problem can be addressed and feel positive that your drinking problem will not turn into a “dependence” or “addiction” if you start now and make that appointment with a professional. You will thank yourself for taking that step when you see the amends that you make after therapy which will heal broken relationships, help you get back that identity that was lost, and finally, enrich your life.