Next up in my queue (thank you all for your patience!) was a request to write about alcohol use.
Something that I tell my clients frequently is that coping skills are morally neutral. Some cope with meditation, some with a bag of Doritos, others with yoga, and still others with a glass of wine or a cigarette. Those are all means of coping, and they’re morally neutral. They just all have different potential consequences.
Without moderation even nutritional means of addressing mental health or stress can go a direction that has negative consequences. Exercise is another “healthy” coping skill that can go off the rails without care. The things we label “right” means of coping or “healthy” ways to cope can still head off the tracks and into the underbrush.
Bottom line: all coping skills are neutral; they just have different consequences. They all have similar goals regardless of how the coping tool accomplishes it – to reduce stress, relax, distract, sleep, calm, etc.
For some people, alcohol is a coping tool. We often hear people use the term “self-medicating” when using a glass of wine to relax or chill after a stressful day.
At a certain point that one glass can become more, as the body builds a tolerance of amounts of alcohol, and over time dependence can occur. When there’s a dependence on alcohol a person will continue to drink even if the consequences of doing so are negative (interfering with health, relationships, or work). Other people may drink enough that it causes negative consequences but aren’t physically dependent on the substance.
When dependence is present, the clinical term is “alcohol use disorder”.
As alcohol is used in this way, the pleasurable effects of it can increase, making it more enjoyable to continue doing it. When dependence occurs, a person may continue drinking to avoid withdrawal symptoms which can be physical and extremely unpleasant.
If you’ve ever felt that you should cut down on your drinking, felt upset or annoyed that people criticize your drinking, felt guilty about it, or had a drink first thing in the morning to steady your nerves, you may have an issue with alcohol, and should seek out some evaluation from your PCP/GP and/or a therapist trained to work with alcohol use disorder.
There are several takes on treatment when a person is ready to switch things up and stop using alcohol. What is right for you depends on your unique circumstances.
In most cases, within the work that I do, I tend to look at where the use started and why. I like to find out what exactly it’s helping with. Humans also love our rituals and routines, so I like to find ways to interrupt and replace the ritual of drinking. Some need inpatient rehabilitation – it just depends on where you’re at in the process.
Because I take the morally neutral stance that I do, I’m not a big fan of stone-cold, cold-turkey, all substances are “bad” takes. A client may have a significant issue with alcohol, but their (legally obtained) other substance isn’t a big issue that interferes with their life, so we leave it alone.
Bottom line: A good treatment approach is one that you feel is doable, fits with your personal ethics, and has some research support behind it.
The main goal is getting someone to a place where they feel ok with what they’re doing to make it through this wild ride we call life with all its ups and downs – and in a way that makes them feel good about themselves and what they’re doing.
Here's to feeling good!
Whitney
PS. A great tool for your use on this topic is "The Addiction Recovery Skills Workbook" available here.