denial

Why Can’t Recovering Addicts Use In Moderation?

A client asks: If we can change our thinking in order to abstain from using alcohol and other drugs, then why can’t we change our thinking to be able to use in moderation?

Why can't addicts use in moderation?  Think about it: why couldn’t we simply use “in moderation” without all the hassle of detox, treatment, and a program of recovery? If we couldn’t do it then, why should we be able to do it now? Those are the real questions!

The key is “change our thinking.” We don’t think our way out of addiction. We make a decision to get clean and sober, and to follow the suggestions of our program of choice, in order to facilitate abstinence. The thinking and process of our programs of recovery relieve some of the emotional pressures we created with our addiction and equip us to live sober lives, but they do not “cure” the addiction.

Abstinence and the subsequent repairs that our bodies are able to effect in our brains allow our addiction(s) to enter remission. Our brains slowly deactivate the extra receptor sites that clamored for more drugs and caused our compulsion to use, and at the same time the production of chemicals normally found in the brain has to ramp back up from being suppressed by the presence of the drugs. Not until this process is complete — and it can take months — do we reach the point of feeling relatively normal, although we begin to feel better long before the job is done.

Feeling better is part of the problem, too. Because the repairs to our brains depend on abstinence, as long as there are any of a wide variety of abusable drugs in our systems, the repairs can’t take place. And because they also take time, and that means that the desire to use won’t go away entirely for quite awhile; it will come and go. We can easily decide that we’ve been clean for a while so we ought to be able to “handle it.” But if we give in and use, even a little, the repairs to our brain will slow down, prolonging the physical recovery process. It is also quite likely that the combination of reuniting with our old obsession, combined with the indisputable fact that people on drugs do stupid things, will cause us to decide more would be better. Continued use will reverse the recovery process and kick us back into full-blown addiction.

Recovery is not a matter of willpower. If it were, we would have simply ignored the compulsion and stopped. The compulsion comes from a part of the brain that isn’t affected by conscious thought. We can’t think our way into sobriety; we need abstinence too. Here at Sunrise Detox, we see a lot of folks who think that they can use in moderation.  Again, and again, and again….

Denial on the street: “But officer, I slowed way down!”

There's an old cop joke about the guy who rolled through a stop sign, then complained to the officer who stopped him, “Hey, I slowed way down, what's the difference?” Supposedly the officer says to the guy, “OK, fine. I’m going to take this flashlight and hit you on the head. When you want me to slow down, say ‘Slow down!’, and when you want me to stop, say ‘Stop!’”

I answer a couple of dozen emails and blog comments a week, dealing with various aspects of addiction and recovery. Every now and then it becomes clear that someone wants me to cosign a desire to experiment with using again. Most often it’s folks who want to know if I think it would be OK for them to have a glass of wine at dinner occasionally, or folks who have stopped using some drugs but want to go on using another (usually marijuana). So I think it’s time to write a few words about this particular form of denial.

Of course it’s denial! Here’s someone who has had enough problems in their life from using alcohol or other drugs that they have quit, or are trying to. In most cases it is safe to assume it hasn't been the easiest thing that they’ve ever done. Presumably they went through that for a reason. Yet they come to a website that is obviously about encouraging recovery, and inquire if I think it’s OK for them to mess around with their recovery.

Sure, it’s OK, because there’s no recovery involved. If we aren't convinced that we need to remain clean and concentrate on learning to live in such a way that our desire to use is minimized and hopefully eliminated, then we aren't in recovery — whether or not we’re clean. It’s that simple. No such thing as partial pregnancy, and no such thing as being partially in recovery. It’s quite possible that we don’t need to be in recovery. But, if that’s the case, why did we come to the site?

If you think you have a problem, do whatever you can to solve it. Don’t mess around. If you don’t think you have a problem, then live it up. Eventually things will become clear, one way or another.

But don't tell this old cop that you want to slow down.

Things Clients Say In Detox — Denial On The Hoof

We thought we would list some of the things that we hear clients say.  You can substitute any drug for any other drug in any statement or comment.  Denial ain’t just a river in Africa, remember?

I don't even know why I'm here.  I'm not an addict.

You're here for some reason.  You didn't just walk in to see what it was like.  Some major problem in your life got you through the doors.  You may as well hang out for a while and see if we can help you with the problem — whatever it is.

Marijuana isn’t addictive, because there’s no withdrawal.

It is true that years ago there was no noticeable withdrawal from marijuana use, but in those days cannabis had only about 1/10th the active ingredients that today’s hybridized varieties have.  Even then, chronic users often had trouble quitting.

Today, there is acute withdrawal that involves irritability, sleeping difficulties, mood swings, loss of appetite and other issues.  We also know that there is a post-acute withdrawal syndrome (PAWS) that  includes depression and cognitive disorders, and that can last for many months.

I'll stop drinking, but I'm still going to smoke a blunt now and then.

Recovery requires abstaining from all mood-altering drugs.  We cannot pick and choose.  All drugs work on our reward system.  Addiction occurs when the reward system loses the ability to make us feel good without the extra stimulation of drugs.  If we continue to stimulate the reward system so that it cannot return to normal, then we will continue to have cravings.

I only drink wine or beer.

All ethyl alcohol (ethanol) affects the human body the same way, and one six-ounce glass of wine, one 12 ounce beer, and one shot of 80 proof liquor all contain roughly the same amount of alcohol.

I only drink on weekends.

It is not important when we drink.  What matters is how much, and why.  If we are waking up with a hangover, which is really alcohol withdrawal, we are drinking enough to cause changes in our brains, even if we only do it two or three days out of the week.  And are we really remaining totally abstinent the rest of the week, or are we having a couple to “relax” each evening?  If that is the case, why do we need alcohol to relax?

I only use (pick a drug) occasionally, so I won’t become addicted.

There are millions of addicts who have found out the hard way that, despite their denial, the occasions tend to get closer and closer together until they have merged, so that we need the drug to be comfortable.  When we are more comfortable under the influence of drugs than we are without them, we are well on the way to addiction.

Alcohol doesn’t bother me; I can drink all my buddies under the table.

Increasing tolerance for alcohol or any other drug is the first sign of addiction.  If we can drink, snort, swallow or shoot more than we used to be able to handle, we’re in trouble.

“I can take it or leave it.”  (I just choose to take it.)

Put it down and don’t touch it for two weeks.  Let us know how that works for you.  Try it again.  Learn anything about denial?

I only have a couple of drinks at home, just to relax.

There is nothing wrong with that, unless we cannot relax without the drinks.  In that case we need to do some hard thinking.  We also we need to look at what we consider a “couple of drinks.”  A standard drink is one shot of 80-proof liquor, one six-ounce glass of wine, or one 12-ounce beer.  “Topping off” is cheating.  So is filling an iced-tea glass with ice and booze and calling it “a drink.”

My whole family drinks like me.

Alcoholism has a strong hereditary component, as do some other addictions.  Need we go on?

The bottom line is this: If drugs, including alcohol, are causing problems in our lives, whether they be hangovers, missing work, “discussions” with our spouses or partners, DUI’s, or any other issues, then they are a problem.  There are no two ways about it.  Either they cause problems or they don’t.  Then the big question becomes why we are continuing to do something that continues to cause us problems.

Now that is a good question — a very good question.

Denial Ain’t Just A River In Africa

When we get into recovery, regardless of the path we take, it won't be long until someone tells that us we are in denial about something. In fact, the chances are good that we heard that a number of times before we even thought about recovery. But what is denial?

Actually, denial is an important part of coping with day to day living. If we accepted as fact everything unpleasant that someone said about us, we wouldn’t be able to function very well, if at all. If we weren’t able to put aside the tragic reality of a death in the family and tend to business, we’d never be able to get through it. Denial helps us overlook the rough spots in life so that the immediate impact is lessened, and we can deal with the issues gradually. However, it becomes a problem when we use it to help us ignore important issues.

Denial is of interest to addicts (and therapists) when it gets in the way of our recognition of behavioral problems. We alcoholics and other addicts use denial to smooth the path of our addictions, help us ignore the cold, hard facts, and continue doing what our instincts tell us we have to do. It becomes automatic. In order to recover we need to be able to recognize denial, become able to see the effect it is having on our recovery, and adjust our thinking. As the old 12-step saying goes,

Lying to others is rude, but lying to ourselves is often fatal.

There are many forms of denial, and all sorts of names to describe them. We’ve listed some of the common ones, with examples of how we use them to protect our addictive behavior. There are dozens of other examples and names, but denial generally falls into the following categories.

Normalizing: “Everyone has a few drinks on a weekend” (their birthday, to celebrate, during the game, etc.) “A couple of beers never hurt anyone.” (See minimizing)

Minimizing: “I only had a couple! (Of 6-packs). “I only drink socially.” (Five nights a week) “I might have had a couple more than I should have.” (I couldn’t stand up.)

Rationalizing: “I don’t have a problem, I’ve quit for months at a time. I just don’t feel like stopping right now.” “I have to socialize with people, it’s part of my job!” “It’s a prescription drug; my doctor knows what he’s doing.”  “I deserve it!”

Comparing: “Joe’s been married three times, in jail twice, lost his license and has to go to those meetings. That’s what happens when you drink too much. I’m doing fine.”

Uniqueness: “You don’t understand.” “If I go to treatment now, the business will fall apart and fifty people will lose their jobs.” “My family has an exceptional capacity for alcohol. I never get drunk.”

Deflecting is making jokes, changing the subject, angry outbursts that intimidate the opponent, threats, “important” phone calls, blowups when confronted and similar ways to take the focus off the issue.

Omitting: Leaving out information, or telling just enough of the story to satisfy the other person while leaving out the part that will get you in more trouble. “The doc said my health is great!” (Except if I don’t stop drinking I’ll be dead in five years.) Simply ignoring the other person’s remarks falls under this category as well.

Blaming: “If you had to put up with (my wife, boss, kids).” “I was doing just fine until I found George doing lines in the bathroom.” “The doctor keeps giving me prescriptions!”

Intellectualizing: This is coming up with all sorts of explanations that “obviously” anyone who thinks about the matter has to agree with, in an attempt to make questioners feel off base and uninformed. “The latest studies show that a couple of drinks a day are good for you.” It’s also a good way to fool ourselves.

Poor Me: “I’ve tried and I just can’t quit. I can’t do it no matter how hard I try.” “I give up, I’m just going to die drunk.” “My life’s in the toilet, I might as well….”

Manipulating is using power, lies, money, sex, or guilt to defuse the issue. “Remember who you’re talking to here!” “Don’t talk that way to your mother!” “Would I ever say something like that to you?” “Mommy doesn’t need to know about this. Here’s some money. Go shopping”

Compartmentalizing is doing things that you keep separate from other parts of your life. If you find yourself thinking something like “If he only knew,” or “If anyone ever found out,” then you’re compartmentalizing.

If we're honest with ourselves, it probably won't take us long to recognize some of our old — and perhaps not so old — tricks.  And maybe, just maybe, we ought to pay attention to the next person who accuses us of denial.

 

Change is less scary if we take our recovery one day at a time.

I received this comment about change on an article that I wrote about getting through post-acute withdrawal from alcohol and other drugs:

I am 3 days clean, and after reading this. I feel totally hopeless and want to go blow my brains out. Exercising, eating healthy, none of that is me and will never happen. I give the fuck up.

Here was my response:

Hi L…..,
Recovery is about changing many things, but it doesn’t have to happen all at once. That’s why we say, “One day at a time.” When you decide to really change your life, things will get better.
In the meantime, good luck and best wishes.
Bill

So many of us felt that way when we looked too far ahead during those first few days and weeks!  They say around the rooms that “recovery is simple; all you have to change is everything.” The prospect of making changes in our lives can seem so daunting that folks who aren't yet committed to recovery often find it a great excuse to go back out and drink or use other drugs. Change is scary, but it doesn't need to be terrifying.

As I wrote to the young woman, in recovery we say “One Day At A Time.” Thinking about all the details of any major project can be alarming, especially for us addicts. We’re accustomed to thinking no farther ahead than the next drink, or the next meet-up with the guy down on the corner. Ask us to consider big changes early on, and many of us are just not emotionally able to handle the prospect.

All I have to do is stay clean and sober today. If I can do that, I can make some plans. I can go to a meeting this evening. Between now and then I can get a little laundry done, buy some groceries, and call another recovering person. (Oh yeah, maybe I’d better take a shower, too.) After the meeting, maybe someone will want to go for coffee. Then I’ll come home, thankful for one more day, and crawl into bed. Tomorrow will be another day.

Obviously, we do have to make some long-term plans, and when the time is right we can do that. But worrying about the details of our future is a good way to (and a good excuse for) deciding we’d be better off doing what we used to do. At least we know how to do that. All too well.

The secret is to make little changes. It gets us used to change and gives us practice. As long as we stay clean and sober and work our program, one day at a time, the bigger changes will happen — often without our even noticing.

What about “non-alcoholic” beer in recovery?

Q. I quit drinking about 6 months ago. Things are most certainly getting better but I was wondering what effects if any have you seen in regards to non-alcoholic beer?

Beverages may be called non-alcoholic if they contain no more than 0.5% alcohol (one-half of one percent). That is roughly one 1/10th the percentage in a can of regular beer. That’s not much, but we don’t know how much it takes to keep the brain from recovering as it should, nor how much having low levels of blood alcohol for hours at a time (assuming that you drink more than one) has an effect. It seems to me that it is a danger that can be avoided, and thus undesirable.

Just as important, however, is the psychology. I’m telling myself that I can’t drink, but that I can keep on pretending that I can. I can hang with my troops and do the stuff we used to do, I’ll just drink O’Doul’s® or whatever. That shows reservations about our disease, regardless of what excuses we adopt, and indicates a definite ambivalence about remaining clean and sober.

I suspect that you may not be attending enough meetings, and that you didn't discuss this issue with your sponsor (if you have one).  If you aren't going to meetings, then I'd start. You can cheat on some things, but cheating on sobriety — whether physically or mentally — eventually lands you off the wagon and back in the muddy rut. It seems to me that knowingly drinking alcohol, even in small quantities, comes extremely close to just plain old drinking.

Some folks might disagree about this, but I know people who relapsed after thinking they could drink the stuff. I can’t say whether or not that was the cause, or just an expression of the “easier, softer way,” but I certainly wouldn’t take the chance myself, even after all this time.

Geographic Cures and Denial

Q. I've heard people at meetings refer to “geographicals,” or “geographical cures.” What's that about?

Hand-drawn map of North America, 1811 -- Library of Congress, Geography and Map Division

A geographical cure is an attempt to avoid the reality of our addiction by changing location.  They are a form of denial, a defense mechanism in which we are faced with a fact that is too uncomfortable to accept and so we convince ourselves that it is not true despite what may be overwhelming evidence.

Excuses are a major form of denial. We learn their usefulness as small children: “She hit me first!” We usually grow out of that phase, but for addicts the need to make excuses and convince ourselves and others that we're really okay is our way of protecting the addiction. We say things like, “If you were married to that bitch,” or “If you'd seen the things I've seen…,” all of which, we have convinced ourselves, justify our drinking, drugging or whatever we may prefer not to look at too closely. (If we did, we might have to do something about it.)

So, when things get rough, we sometimes convince ourselves that all we need is a fresh start in a new place, and we'll be able to get our lives back under control. However, unless our geographical cure has also involved detox, treatment and a program of recovery, we discover that it doesn't take long for the things that we thought we'd left behind to hop out of the trees and right onto our backs again.

We failed to consider one of life's major truths: No Matter Where You Go, There You Are!  We need to change our way of living, not where we live.

Hitting the road doesn't solve our problems, it just means that we have to face them in a strange place, among strangers.  If, however, we decide to get out of the old neighborhood and get some help, that's not necessarily such a bad idea.