Recovery Resilience

In the midst of a second wave of coronavirus, I’m an alcoholic struggling with the surge of emotions caused by isolation and nostalgia for a time free from fear. To clarify I mean external fear i.e. socially distancing, wearing masks, not going to public events, thinking twice about venturing out for anything not deemed absolutely necessary. I adhere to all these things to keep everybody safe but there’s a price. This cost correlates with how much effort I put into my recovery on a daily basis and thus it reminded me of the blind white-knuckling I did before I learned how to live one day at a time.

To me, white-knuckling and being ‘dry drunk’ are two sides of the one coin. One lavishes in ignorance and the other is a deterioration of recovery concepts eroded by, in this case, measures to control a pandemic. I’d like to reiterate that I am not against actions taken to reduce infection, I am reflecting upon how the disease of addiction can insidiously intercept logic and response.

I think I have experienced being dry-drunk during the events of this year. I understood that having conscious contact with a Higher Power, attending meetings and contributing to service to get out of my own way and working closely with a sponsor were all essential aspects of a healthy continuing daily recovery. On-line meetings seemed synthetic to me, plus the truth is I took physical meetings for granted in that world that seems liberated when I look back on it. I did have some joyous and divinely inspired AA moments where I knew I was being guided in certain direction despite my fear based fretting consuming the majority of my psyche. I was asked to do the main share at a meeting in another part of the country. I graciously accepted, recalling my sponsor saying that I need a very good reason to decline sharing my experience, strength and hope with other alcoholics, especially newcomers who need to hear the message of renewed hope, a daily reprieve, a solution, a method of recovery personal to everybody but accessible to all too.

Experiencing being dry-drunk is something I wouldn’t recommend as it brings you closer to relapse and tests your defence against the first drink. I have felt restless, irritable and discontent throughout the year and it intensified during national lock-downs. I stopped doing my daily readings and tapping the invaluable resource of prayer, meditation and mantra’s. I opted for petty arguments, resentment, indignation, unjustified anger and unbridled emotional surges of an unknown origin, somewhere I didn’t want to look because of fear of fear itself.

I do my best on a daily basis and that means forging recovery resilience by tempering the fragility caused by incessant fear. I haven’t drank today and that has to be enough sometimes. The number one offender is resentment, however the number one priority is sobriety. Sobriety is enveloped by recovery and recovery is what it means to you, what tools you have selected from the workshop. I picked the Serenity Prayer, Step One and One Day at a Time to fill my essential toolkit and I carry them with me wherever I go. If you’re reading this and relate to what I’m saying, trust in the process and ask for the willingness to be patient and it’ll happen. Keep coming back means don’t give up and it applies to all recovery journey’s. Keep coming back to the AA rooms or the SMART recovery group or the AVRT zoom group or the counselling sessions and your life will become something beyond your wildest dreams. Wealth is having a day to share smiles, contribute and become fulfilled – lighting the candle and feeding the spirit that was nearly extinguished by an unquenchable thirst and an unimaginable void of despair.

I have noticed that when I share my own experience with people I feel I’m being portrayed as selfish, self obsessed and ego-driven. I observe people being opinionated based upon media, societal trends, conspiracy theories, science and I don’t feel worthy enough to throw my ideas in because my recovery is a new trailblazing adventure into unknown territory where I feel uneasy approaching challenges. Whether these challenges are differences of opinion, other ways of achieving the same outcome, personalities, other people’s flaws, I doubt my ability to judge correctly. We all judge, it’s necessary to navigate our surroundings. I think the important thing to remember is to attempt to base judgments on core values of compassion, love and empathy rather than gossip, rumour and ignorance. I still struggle with using my own experience to express myself in conversation as it feels like it could be perceived as not hearing the person. I suppose I could try and just be in the moment with them and utilise patience until my experience is useful. I think I’ll use some quiet time to focus on this…and this is how I progress in my recovery one day at a time.

Geographic Alcoholic

The first time I heard of ‘doing a geographical’ was at AA meetings. I kept coming back to meetings, as suggested, and this enabled me to become familiar with phrases applicable to alcoholism. I understand it as blaming the location for the current behaviour and changing the location in an attempt to leave the behaviour behind.

The disease alcoholism inevitably follows the alcoholic to wherever they go. The external environment may have contributed to the introduction of alcohol and availability prior to the onset of symptoms such as obsessing, craving and dependence, but changing the environment is insignificant in addressing the problem once it’s present.

I had a traumatic experience in my early twenties when a family member passed away suddenly from cardiac arrest. The paramedics attended, then left, and police eventually arrived several hours later. A sudden death requires police attendance. I decided shortly afterwards to leave home for the first time. I moved to Dublin, Ireland in an attempt to start fresh.

Whilst living in Ireland I felt liberated. I developed good working relationships with colleagues in good jobs and I had a steady relationship. On the surface everything was positive and exciting. This didn’t last. I would finish work and between getting off the bus and getting to the front door I would buy some cans and maybe a frozen pizza, but the alcohol took priority because I wanted to change how I felt rather than sustain my basic needs.

I was introduced to other drugs, however I was only ever interested in alcohol. I thought I knew how to handle it. I regard it now as nicely packaged poison but before embracing recovery the allure of alcohol was all consuming. My drinking gradually became unmanageable. I moved from the apartment I was living in to a shared house near to the airport. My relationship ended, I gave up on work so I could carry on drinking. Urinating into empty wine bottles so I didn’t have to leave the room seemed reasonable to me at the time. I didn’t want to face anybody, the thought of going out to buy more alcohol filled me with dread. I felt bewildered, lost and fearful of everything.

My geographical had been a self fulfilling prophecy before I’d even left home. Alcoholism is like being on a train. You’re in the safe surroundings of the carriage, clickity clopp clickity clopp clickity clopp until you notice there’s no next stop, only carnage, devastation and an abrupt end. The insanity of repeating the same thing and expecting a different result but ending in death can be avoided, there’s hope, we do recover.

There’s loads of pitfalls to alcoholism and wiping the slate clean to fuck it up again was how I treated life, disposable. Life becomes meaningful when we stop running and not only face life, but accept it with a conviction to be wise enough to change what we can.

Further Reading: On The Move – Working the AA program showed this alcoholic how to get from geographics to gratitude. p486-493 Alcoholics Anonymous

A.U.D Vs Alcoholism

I’m interested in how Alcoholism is defined within professional circles and how this interpretation filters down into society to the individual. Is it a mental disorder, a spiritual malady, a disease, a choice, a combination, and how is it diagnosed and treated? Following is what I learned and it isn’t necessarily what I was expecting. Please leave some feedback, I’d really like to start a discussion regarding your experiences as individuals trying to embrace meaningful long term recovery.

The Diagnostic & Statistical Manual of Mental Disorders (DSM) IV was published in 1994 by the Americam Psychiatric Association (APA); it took 14 years of contentious revision for the DSM V to be published in 2013. Alcohol Abuse and Alcohol Dependence diagnoses from the DSM IV were combined to introduce Alcohol Use Disorder (AUD) with sub-categories of mild, moderate & severe. ‘Legal problems’ was removed as criteria for meeting a positive DSM IV diagnosis of Alcohol Abuse/Dependence. ‘Cravings’ was added to the considered DSM V criteria when diagnosing cases of AUD.

Obviously these changes have had an impact on how people are perceived by their peers, health care professionals, private businesses i.e. insurance companies, landlord’s and the State i.e. welfare/universal credit eligibility. The DSM IV defined Alcohol Abuse as meeting one + out of four possible criteria, and Alcohol Dependence as meeting three + of seven criteria within a year. The DSM V similarly has eleven criteria, however only two have to be met within a twelve month period to diagnose AUD within three severity levels.

The International Classification of Diseases (ICD) was last published in 2019 (ICD 11). It’s used by the WHO and professionals globally. ICD11 isn’t used as widely by psychiatrists as the DSM V is more thorough and exact. For example, ICD11 looks at behavioural symptoms of AUD as apposed to leaning towards neurobiological processes as the DSM V does.

A hopeful development that remains elusive to date is the connection between societal tendencies and cognitive function in relation to AUD. Both the ICD11 and DSM V mention the social dimension, however modelling the processes has proven difficult to define. Could a breakthrough in this area of neuroscience pave the way for effective anti-addiction medication?

Existing medications include:

  • Disulfiram causes unpleasant symptoms such as nausea and skin flushing whenever you drink alcohol. Knowing that drinking will cause these unpleasant effects may help you stay away from alcohol.
  • Naltrexone blocks the receptors in your brain that make you feel good when you drink alcohol. It can also reduce your craving for alcohol. This can help you cut back on your drinking.
  • Acamprosate helps you avoid alcohol after you have quit drinking. It works on multiple brain systems to reduce your cravings, especially just after you have quit drinking.

I’ve always disliked the Medical Model’s definition of abnormality needing to be fixed, cured or prevented. The emotional and spiritual elements seem to be neglected for a preference to scientifically solve the physical, psychological and social dilemmas. Of course they’re all linked as the combined elements that make us human beings but my recovery required something that nourished each aspect of our human experience.

My personal experience of navigating through episodes of prolonged drinking, binges that developed into dependence, home detox and relapse have been documented by various medical institutions. The GP that advised I avoid AA meetings as I could potentially be exposed to people in various states of inebriation and I was doing so well being sober for three months. I sensed another drinking binge about to happen and visited my family doctor for some kind of support. On this occasion white knuckling tragically turned into another inevitable relapse.

I was an out-patient at the local hospital that used shock tactics such as explaining the consequences of when esophageal varices rupture and liver cirrhosis to warn attendees. I found it amusing that they condoned and actively encouraged ‘controlled drinking’ after a prolonged period of sobriety. At the time I instinctively knew that once I had began to drink there was no guarantee when I was going to stop; either when the money ran out, or when I was in a hospital bed, a cell or I had come full circle to drink myself sober and experience the moment of clarity where sobriety is the answer.

We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve. A.A. pg. xxviii

The above excerpt was included in the foreword of the Big Book of Alcoholics Anonymous, 1947. The DSM didn’t include ‘cravings’ in its definition of alcohol abuse / dependence until the the most recently revised edition 2013. Until we have a holistic approach to addiction recovery where people can learn what recovery means to them and what tools are available to them (detox, supported accommodation, AA, peer group support, CBT, SMART, AVRT etc), we will continue to suffer on a personal, societal, national, global and spiritual scale.

Since I last drank, 17th March 2017, I have pursued sobriety longevity and learned that recovery is achievable on a daily basis through abstinence supported by Fellowship. The Big Book states “We are not cured of alcoholism. What we really have is a daily reprieve contingent on the maintenance of our spiritual condition.” p85. My spiritual condition is revived, maintained and conditioned by unity, recovery and service against a physical, mental and spiritual disease.

The opposing methods of how to treat alcoholism tend to merge at the crossroad of social gathering. Whether it’s described as the ‘pathology of social cognition’ or quite simply ‘fellowship’, the key to stopping the advancement of the disease is through engagement, presence, belonging.

Brené Brown’s definition of spirituality emerged from data decoded in 2009. I was in awe of her discoveries as a statistician because numbers don’t lie or coerce in ways people can. ““Spirituality is recognizing and celebrating that we are all inextricably connected to each other by a power greater than all of us, and that our connection to that power and to one another is grounded in love and compassion. Practicing spirituality brings a sense of perspective, meaning, and purpose to our lives.”

References:

Alcoholics Anonymous

Brenebrown.com