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

Procrastination

Delaying something can have various consequences. A deadline in work is meaningless a week later however putting off a trip, visiting a person, a place could cause regret and sadness later on. Live in the moment with an attitude of gratitude is difficult for me to practice when fear encroaches, develops and consumes. The fear arrives in the guise of perfectionism. Seductive negative talk manipulates the mind into inaction.

I started this blog post three days ago, progress halted by thoughts of online shopping, trash TV and fast food, yeah, procrastination. It’s not laziness, it’s routed in fear of adequacy. What can I contribute to the discussion of alcoholism, addiction and recovery that hasn’t already been addressed by AA and learned professionals? The answer comes when I allow humility to whisper after my ego has finished with the intrusive disparaging thoughts of ridicule.

Pondering procrastination I considered what it was like to drink zero percentage beer all those years ago. I was white-knuckling and trying desperately to regain my physical, mental health without resorting to what I knew best i.e. drinking into oblivion. Emotionally I felt guilty for surviving major surgery and wanting to drink. I knew the illness had suppressed my alcoholism and I sincerely wanted to gain employment and get my life back together again. I got some bottles of alcohol free lager to watch whilst watching the Formula One. The condensation on the glass surface of the bottle felt familiar. The clink of the bottle pinging another bottle as I took it from the refrigerator was a reminder that I had more bottles to come back to. Grasping the bottle opener and pivoting the crinkled cap off, gas smoking briefly as the fizz allows the hoppy smell to escape. The first taste is fresh, crisp at the back of my throat as I exhale the vapour through my nose, the taste biting as the liquid gulped down disperses into my body …not bad this stuff, not bad, as I look at the lable. The whole experience was a sensory explosion that was to inevitably encourage a deluge of alcoholic drinks some weeks later.

I think what I’m trying to say is that procrastination is a defensive move against intrusive thoughts and negative emotions that manifest as self fulfilling prophecies. Then the intrusive thoughts have a foundation on which to build bigger and more elaborate deceptions because hey, remember the last time you tried the non-alcoholic beer? It was fine right? A few real beer’s would be fine, right? Similarly, I find that in recovery I succumb to anxiety and depression fueled by procrastination routed in fear. Waking suddenly in the early hours with thoughts of an unfinished task or overthinking conversations is exhausting. I have to recite the Serenity Prayer many times in an attempt to make contact with my Higher Power so that I can find some peace and sanity. The wisdom to know the difference between the things I can change and the things I can’t comforts me in that dark lonely place we find ourselves in at times.

Procrastination is a byproduct of the avoidance I would achieve through active alcoholism. ‘Life on Life’s terms’ is fucking difficult to practice despite the term rolling off the tongue of most recovered alcoholics. I say ‘recovered’ because today I haven’t drank which means I am recovered from the hopeless state of body and mind I was once in. Recovery means acceptance of what life brings to us on a daily basis. I can ask for the willingness to believe I can make the best of any given day and the situations, places, people in that moment. I can choose to forgive myself and others. I can choose to practice restraint of tongue & pen i.e. I’ll keep the sarcastic remark to myself instead of being passively aggressive or I wont send that text in anger with exclamation marks, capital letters and rolling eye emoji’s.

On occasion I’ll make the wrong choice and procrastination will envelop my perspective with a mist of poor judgement and doubt. The lighthouse keeper is my sponsor and he tends to the light throughout the storm of life because he knows there’s half empty vessel’s like me thrashing around in the ocean hoping not to hit the jagged rocks. I have to type SOS in Morse Code if I want help. I have to steer myself towards calmer waters and enjoy the awe inspiring sunrise through humility, gratitude and grace.