Cartoons by:

KENDRA ALLENBY: Freelance   cartoonist and illustrator, teacher & speaker. Published in the New Yorker, Barrons, Fantasy & Science Fiction Magazine, Woman’s World, Alpinist etc.

” I like to draw the moments when the contradictions break the surface. I like to draw the things that are hard to put into words. When I can draw a thing, I can understand it. And I can share that understanding with someone else.” http://www.kendraallenby.com

ALL IMAGES published in New Yorker, 3/2020

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REVIEW ACoA posts : ♦ Ego States  ♦ ADULT  ♦  Inner CHILD  

CONTACT:
acoarecovery@yahoo.com
212-580-9631
646-460-7417

Dear Readers,

As some of you have noticed (followers), I’ve been sending out revised OLD posts now for some months – along with new info. The series on Alcoholism is the last NEW for a while.

I wrote in Feb. explaining what I’m currently working on – going over ALL old post to make corrections & modifications where needed. As of now I’m half way thru 2016.

I’m suspending all new material until I finish going thru 2010 – 2020 posts already published. There are many more topics in the wings, maybe for next year, such as “Attachment Types, What Children Need, Money Madness, more on the Enneagram & the MBTI….. ”

EXCEPTION : If I find something new I want to pass on, or is especially interesting & relevant, I will add it throughout the rest of this year.

I hope you enjoy the updates. While every post is being worked on, only the revised or split ones (when one is too long) get moved from draft to ‘publish’. Since that means only 1 or 2 posts in each series, it’s a reminder to review the whole set.

For non-followers, if you’re curious, you can go to year pages 2010-14 & pick up the refurbished posts. Many include new artwork as well.

In the meantime you’re welcome to listen to my podcasts – there are 20, covering all the basic ACoA issues. To access, go to:

• businesstalkradio1.com
• click on red button “Archives” at top right
• fill in my full name Donna M Torbico
• interviews are listed by date, but not by topic (unfortunately)
• Feel free to leave comments via email at acoarecovery@yahoo.com.

ALSO:
I continue to see individual clients for ACoA Therapy, by phone or Skype,
– intro session is FREE.
If you or someone you know would like to do some Recovery work, I’m available to take new clients. 

Thank you for you support & loyalty!

DMT

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PREVIOUS: Alcoholic TRAITS #3b

SITE: “Alcoholism & the Brain: An Overview” (extensive)

PHYSICAL characteristics – Alcoholism CAUSES:
• Compulsions : talking for hours & hours – to a captive audience (like one of their children), continually repeating oneself, stalking, unwanted phone calls, esp late at night…
• Loss of control – mental & physical – leading to accidents, fights, falling down, lowered inhibitions (perpetrating rape, incest, assaults, killing..)

• Many physical problems (see below)
• Patterns of drinking : daily, weekends, periodic, binge, steady…

• Personality changes : from chemical changes in the brain, serious blood-sugar level disturbance EXP : like someone with low blood-sugar when they’re out of fuel (food): headaches, nausea, very cranky, can’t think…
• Progression – in 3 stages, from mild to psychosis & then death
• Victimization : being vulnerable to crimes, sexual & domestic abuse

🚦☠️ Alcohol & Health
◘ Accidents : burns, fall, fights…. 
◘ Birth defects : binge drinking early in pregnancy is particularly risky for the developing baby
◘ Blackouts : blocked memory – a few minutes, several hours or more

◘ Brain : inflammation, dementia & other neurological deficiencies
◘ Cancer :  alcohol consumption is a risk factor for cancers of the mouth, throat, colon, breast & liver (even 1 drink per day is linked to a 20% increased risk)  

◘ Depression : worsens overall mental health & sparks a vicious cycle
◘ Diabetes : heavy & binge drinking raises the risk

◘ Digestion : alcohol alters the composition of needed bacteria in the GI tract, causing anemia, bleeding, gastritis, ulcers & other lesions, scarring
◘ Heart disease : heavy drinking appears to increase risk – high blood pressure & stoke…

◘ Infections : bacterial, respiratory & viral infections such as HIV, hepatitis (B & C), pneumonia & tuberculosis
◘ Immune System : affects the number of immune cells in a person’s system, alters their functioning, & can often kill existing cells

◘ Kidneys : affects rate of blood flow & disrupts hormones needed to filter out harmful substances from blood
◘ Liver diseases : alcohol poisoning, fatty liver, inflammation, cirrhosis

◘ Obesity : 2nd most calorie-rich nutrient after fat — packing about 7 calories per gram. Heavy drinking can cause increased weight gain
◘ Sex : F – unwanted pregnancies, infertility, menstrual problems, reduced lubrication, harder to have an orgasm….
M – physical insensitivity, erectile dysfunction, premature ejaculation, loss of sexual desire, ‘brewer’s droop’ into full-blown impotence
◘ Death : alcohol abuse is the 3rd most common cause of preventable death in the US, including drug ODs  (More….)

ONE DRINK: Significant alcohol intake produces changes in the brain’s structure & chemistry, BUT some occur even with minimal use over a short time, to form tolerance & physical dependence

✴︎ 30 seconds after the first sip, alcohol rushes into the brain, slowing down its chemicals & pathways used to send messages. This alters mood, slows reflexes, throws the drinker off balance & they can’t think straight. Alcohol makes it hard to store experiences in long-term memory, so they won’t remember things later …. (More…. )

➡️ MRI scanner forms images using strong magnetic fields & radio waves

🌀 🌀 🌀

Behavioral Addiction is an intense desire to repeat some action that’s pleasurable, believed to improve well-being, or able to alleviating some personal distress – despite knowing its negative consequences

Researcher Jeffrey A. Gray (1981 & 87) proposed 2 brain-based systems which control a person’s interactions with their environment. Emotional situations are identified by the intensity of reaction, AND actions, based on what’s appealing or unpleasant.

⬇️ BIS & BAS brain activity have been connected to a broad range of psycho-pathologies, such as lifetime diagnoses of depression, anxiety, drug & alcohol abuse, ADHD & conduct disorder
❤️ FFFS = Fight, Flight, Freeze System (on chart↘️)

Systems controlling actions:
1. BIS – The Behavioral Inhibition System is responsible for curtailing, stopping, or avoiding ‘dangerous’ behaviors which can lead to disappointment or loss

People with strong BIS activity have a heightened sensitivity to new experiences that are non-rewarding, and to anything they experience as punishment, which they avoid to prevent feeling anxiety, frustration, terror & sadness.

🖤 OPPOSITE: People with low BIS (high BAS) activity have strong urges & desires, & are usually more impulsive & Extroverted

2. BAS – The Behavioral Activation System creates a high sensitivity to reward – actions that don’t produce punishment.
It’s the desire to approach, pursue & achieve goals, with emotions such as elation, happiness & hope, especially when a benefit is imminent.
Strong BAS activity produces impulsivity, which may lead to punishment – which is not a deterrent – so pleasurable behaviors will be repeated, such as the instant-gratification use of addictive substances.

💚 OPPOSITE: People with low BAS (high BIS) activity have weaker urges & desires, & tend to be more careful & Introverted   (MORE….. scroll down)

NEXT: PAUSE

PREVIOUS : Personality TRAITS (#3b)

🏴 REMINDER: NO ONE has ALL these characteristics!
Pick out several that fit your ‘favorite’ addict (or yourself ??), the ones that really stand out, that are over-blown, that keep getting in the way of a success, happy life.

PERSONALITY TRAITS  (cont.)
Underlying the addiction are what 12-Step programs call ‘character defects’, which contribute to the desire to escape .

2. Mental // 3. Emotional  // 4. Verbal

6. DEFENSES
• Blackmail. Threatening emotional withdrawal of acceptance, affection, approval, love, sex…. to force the other person to do something they don’t want to
• Bully. Demand others be or do what the addict wants, & won’t take no for an answer. Push, push push

• Chase. Keep running after someone who is not immediately /or/ no longer available, or not interested in them (short of stalking)
• Come-here-go-away. Crazy-making, drawing someone toward themself (love-bombing) & them pushing them away (insulting, ghosting….) when the other gets “too close”
• Defensive . Increased sensitive to criticism – about their drinking, choice of relationships, locations they spend time in, appearance….

«
VIOLENCE & ADDICTION
Active alcoholism is closely linked with various forms of crimes, aggressive behaviors & domestic violence across many nations.  More than an estimated 14 million people meet the criteria for an alcohol use disorder in the United States. (MORE… American AddictionCenters)

Because alcohol can impair judgment & reduce self-control, the likelihood of an active drinker being assaultive seems to stem from how they usually deal with their anger when not drinking. so previously suppressed rage can be acted out when sufficiently intoxicated.

Chronic use is also associated with psychiatric issues, such as disorders of : intermittent explosiveness, personality, mood …, which can aggravate violent tendencies. Aggression is the precursor & someone prone to being  aggressive is more likely to impulsively use physical force when ‘under the influence’.

Alcoholism in the workplace can significantly affect employee safety, causing workplace injuries, increased absenteeism, with lost productivity, & added healthcare costs. Chronic drunkenness plus aggressive behavior escalates the likelihood of workplace violence, and – environments that tolerate or overlook substance abuse continue to put staff at risk.

7. SOCIAL
• Arrogant. Condescending, sometimes or always ‘full of it’
• Demanding. “I want what I want – NOW!”
• Defiant. Don’t want to be told what to do, do opposite of what someone needs, wants or asks for – just to be ‘difficult / contrary’, but not from actual disagreement
• Isolated. Socially withdrawn, even when with others, not really connected. Can’t be reached, but complains that no-one understands
• Jealousy. Can become extremely jealous, paranoid, suspicious, even to the point of delusion
• Need for Power & control. Verbal & physical violence used to instill fear & maintain dominance
• People-pleaser. Overly agreeable, to keep the focus off themselves & get people to like them

• Sadistic (‘perpetrator’). Gets pleasure from hurting people, or secretly seeing them be hurt (physically, financially, socially….). Also harm animals & children
• Separation anxiety. Often use the mate as their primary emotional coping mechanism. If the victim tries to leave, the fear of abandonment triggers desperate behaviors
•  Sexual dysfunction. Alcohol is a depressant, making it difficult for a man to perform. It’s also a symptom of (male) Depression

• Socially awkward. Feel like they don’t know what to do or say
• Stalking. If separated or divorces, he’s unable to accept rejection. OR focuses all their fantasies on someone they’re seen but never had a relationship with
• Thrill junkie.  Deliberately goes for risky behavior, stuck in self-destructive mode
• Thwarts Authority. Rebels against ‘status quo’

8. SPIRITUAL
• Sickness of the soul – wandering in the ‘land of the living dead’. Not just a physical or mental condition, it’s considered deep inner  alienation from the drinker’s intuition & higher self,  from others, & from a higher meaning in life
• Restlessness . A chronic state of feeling irritable & discontent”, even when not drinking

• Search for the Transcendent. Alcohol craving may be a distorted, misdirected thirst for the vital stimulation of the Spirit, seeking ultimate peace through an external substance instead of inner alignment

•  Unearthly. The alcoholic may truly believe an ideal world is possible, & that it ‘should be’ – seeing everyone as a united family. However, they’re often feel disillusioned & disheartened when the world fails to live up to their Utopian ideals.

NEXT :  Alcoholism – PHYSICAL

PREVIOUS: Personality TRAITS (#3a)

SITE: “Personality and Alcoholism: Establishing the Link” ~ Stanton Peele (author of “Love & Addiction” highly recommended)

🏴 REMINDER: NO ONE has ALL these characteristics!
Notice a few that fit your ‘favorite’ addict so you know what you’re dealing with. IF yours – only work on your own healing

PERSONALITY TRAITS  (cont.)  ‘Character Defects’
2. Mental // 3. Emotional

4. VERBAL
• Argumentative : Always looking to start a verbal tussle, even when they actually agree with the other’s point of view – feel the need to fight against it
• Denial : Flatly rejecting that there is any problem at all, often insisting they can stop drinking whenever they want (but don’t)
• Combative. Always feel disrespected (bumped in the subway, not being greeted….) as an excuse to be angry, or to pick a fight

• Compulsive Liar : Lie as a habit, even when not necessary, or to cover their tracks – having lost conscious contact with The Truth.  EXP:  Directly falsify details about where they were, who they were with, or how much money was spent on alcohol
• Complaining. Highly critical of others & Self, often their own worst enemy. Whiny. Nothing is ever good enough or pleasant enough

• Double-messaging. Cause great confusion or paralysis in others by giving opposing info or expectations – as if both are true, (love you / hate you) OR demand that 2 incompatible rules both be obeyed
• Guilt-Tripping: Turning an argument back onto the concerned loved one by accusing them of being overly critical, paranoid, or controlling (“You’re always nagging me”)
• Minimizing: Downplaying the amount or frequency of alcohol consumed (“I only had a couple”)
• Vague or Circular “Reasoning” : Talking in confusing circles, never getting to the point, or changing subjects to derail a serious conversation about their behavior

5.  PSYCHOLOGICAL
• Boundary-less. Don’t know how / when / where to set limits, for themself & their behavior. Allow others to invade their rights, physical space & interfere with their relationships
• Chameleon. Easily change attitude & actions to match other people & their environment, blend right in, but not be their ‘real Self’
• Co-dependent. Using others to identify how they should think, feel & act. Deeply affected by other people’s emotions, reactions,  difficulties…. as well as any negative &/or toxic social influences not actually about their life (news, media info…)

• Defensive. Very guarded & protective of internal world, constant justifying or excusing their thoughts & feelings
• Dependent. Needy, staying in childish mode. Expecting others to do for them what they can, but won’t do for themself
• Disconnected. Unaware of what they’re feeling emotionally, to the point of dissociation
• Distracted. In constant escape-mode. Use Alcohol/drugs, sex, social-media, over-sleeping…. to numb past & current painful life experiences

• Fear of Failure & Success. Stay stuck (work, home….). Feel like they ‘can’t win for loosing’, by obeying Toxic Family Rules & their Toxic Role
• Impatient. Can’t wait for things to unfold naturally, insist on getting attention, belief that waiting always means NO
• Impulsive. Often acts before really thinking through consequences to self, others or the situation
• Irresponsible. Undependable, rarely /never follows thru, arbitrarily changes plans, regularly breaks promises
• Low Frustration tolerance. Easily upset & knocked off balance
• Narcissistic. Everything is about themself, only their point of view & needs are valid. Use other as a source of energy & ego boosting
• Passive. Unwilling to exert themself to change a bad situation, to have a genuine opinion, to stand up for themself .….
• Passive-aggressive. Can’t show anger directly, so puts on a smile, but withholds, refuses to participate….  or secretly, indirectly does harm to whoever they’re angry at
• Perfectionist. Believe there’s only one ‘Right Way’. If they can’t do something perfectly, it’s worthless, so why try – causing procrastination & paralysis

• Separate. Never feel part of or belong anywhere – even in ‘similar’
groups (meeting, church…. ‘Different, not like the rest’ (negatively special)
• Superiority complex. The attitude / belief (not emotion) that  they’re better than / know more / feel deeper / more worthy…. than most others, maybe except their “soul mate”
•  Self-Hating. Deep down inside, blame themself for everything that’s gone wrong or that hurts them.  Nothing is never ‘good enough’ about themself, especially having needs

•👿 Secretly Suicidal – Chronic alcohol &/or drug use is “slow death”. May include self-haring (cutting) or actively tried suicide (unsuccessful?). It can also be choosing vey abusive partners & dangerous locations who can do it for them.

NEXT: Alcoholism – Personality, (#3c)

PREVIOUS: Alcoholism #2b

IMAGE ⬆️ : Pain directly linked to Emotional States 

SITE: “Heal suffering w/ Self-acceptance“ (+ Negative beliefs)

POOR MENTL HEALTH plays an important role in all forms of substance abuse, which often overlap with psychiatric disorders, because addictive substances change the way the brain works, impacting a person’s mood, thoughts & actions. Psychological evaluation of a potential patient includes
Personal history issues :  age when they first started using alcohol, family history of substance use/abuse, & all traumatic experiences, Also – housing, financial & marital status, education & employment, physical & mental health (theirs & their family), & legal problems..

RESEARCH: The central nervous system (CNS) processes – which integrate emotional behavior – are altered in people at high risk for alcoholism, with 3 markers :
1) Proportion: a characteristic balance of positive to negative emotions
2) Cortisol: emotion-related changes in this stress hormone
3) The Startle Eyeblink: a measure of emotion-related change in CNS activation

CHARACTERISTICS that underpin active addictions
🏴 NOTE: NO ONE has ALL of these! Look for several that fit your ‘favorite’ addict so you’re to confused. If you identify with any, work on correcting & healing.

There isn’t a single personality type that universally identifies all addicts . Certain traits may be more common : a family history of alcoholism, high stress levels, impulsivity, low self-esteem, & sensation-seeking.

1. GENERAL
👤 Afraid of intimacy – operate behind armor that keeps the world out 
👤 Low frustration tolerance – more upset when unhappy for a long time, or when annoying things don’t work out quickly – reacting more impulsively than most
👤 Low self-worth – isolated & trouble expressing their deepest feelings
👤 More sensitive, meaning a “low rejection threshold”, feeling more apart or left out. But often tend to be especially creative & gifted.
EXP : Most American Nobel Prize winners in Literature suffered from alcoholism.

2. MENTAL
• Cognitive distorted. Have many unrealistic or completely erroneous beliefs. Includes ‘all-or-nothing’, ‘black-or-white’ thinking…..
• Cynical. Bitter, an overall very negative assessment of people & life
• Comparing: Defending habits by pointing to someone else who allegedly drinks more or behaves worse

• External Blaming: Attributing drinking behavior to stress, a partner, a bad day at work, or external pressures rather than personal choice.
• Justification : Constantly creating conditions or “rewards” that logically require a drink (“I earned this after the week I had”).
• Unforgiving. Unable / unwilling to release of all the bad things done to them, & the pain it caused. Can’t seem to cope with people, place, things – as they are

 3. EMOTIONAL
• Angry. Volatile E-motions, explosive temper, often acts out in violent ways
• Anxious. A general feeling of anxiety, without knowing where it comes from or what’s causing it
• Ashamed. Intensely ashamed of themself, their family, their circumstance, their inability to ‘fix’ a loved one…..
• Depressed. This can be physical /hereditary and/OR from decades of abandonment & abuse. Either way its’s long-term & debilitating
• Desperate. Feel like their would is falling apart. Don’t know what to do

•  Fearful / Terrified. Worry a lot. Anxious, agitated…. always expect only the worst
• Guilty. Continual, overwhelming self-blame for real or imagine harm they did to someone, either by a damaging action, or by neglecting to do something
• Hyper-sensitive. Take everything personally that happens to them or even around them, as if they’re the center of everyone else’s world
• Insensitive. Can’t sympathize with another’s hardship, or to empathize with someone’s emotional distress

• Hopeless. Completely convinced there’s NO possibility for their life to get better (“learned helplessness”), they have no options, no one to help
• Joyless. Nothing is fun, relaxing, stress-less.
• Lonely. Feel alone, can’t ask for help because ‘no one cares’

• Paranoid. Assume everyone secretly (or blatantly) intends to hurt them. Can’t trust anyone. NO one’s safe
• Resentful – of oh-so many people… Carry a long list of grudges towards anyone who’s disappointed or hurt them in life

• Sad. Deep sorrow because of too many losses, often hidden from oneself, or unexpressed.
• Un-comforted. Nothing is soothing, pleasant, stress-free
• Uncomfortable in their skin. Don’t know ‘who I am”, or ‘how’ to sit, stand, walk… Restless, irritable, discontent. Life is a painful, unpleasant journey
• Unlovable – Unable to love themself or to receive love from others.

NEXT: Personality = Verbal, Psychological 

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PREVIOUS: Alcoholism – STAGES (#2a)

STAGES (cont.)
1. Denial // 2. Dependence

3. PROGRESSION  – Physical / Emotional deterioration
• An obsession with drinking. During the dependence stage, the alcoholic still planned their day around the drink. Now they simply take it with them wherever they go

• Alcohol is needed to function. The morning drink is a daily ritual, drinking is throughout the day, & keeping a steady supply available, like a flask in the purse or bottle in the desk drawer

• Loss of other interests. Social activity continues a decrease because of erratic behavior. as drinking isolates them from friends & family. Hobbies & intellectual interests once enjoyed are long gone, & drinking is the only companion, the thing that keeps them going

• Depression, anxiety, insomnia. Alcohol is a depressant, so the physical effects will worsen in an already emotionally unhappy person. They can’t get to sleep without a drink, & often end up paranoid – become overly fearful but can’t explain why

• Family relations continue to deteriorate. If it wasn’t noticed before, slowly the addict become increasingly irritable, arguing with the spouse, attacking their children, alternating between being sullen & snappish. Stop attending family functions, preferring to drink, or showing up drunk – sloppy, obnoxious, sexually inappropriate or belligerent

• Friendships change or end. There’s a decrease in social activity because of erratic behavior,  a sudden change in friends, trouble talking to strangers….. old friends will be run off when they confront addict with their drinking

• Financial, legal problems. Racking up debts, domestic abuse, calls to cops, harassment or stalking of spouse or lover – possibly resulting in a Restraining Order, divorce & child custody fights, court appearances for DUIs, & sometimes vehicular homicide……

• Serious health problems. Personal hygiene begins to slide, & eating properly is a thing of the past.  The addict will get sick much more often (respiratory infections, malnutrition…..), & the doctor will warn about damage to liver & pancreas

4. CULMINATION
• Loss of control is obvious. The addict no longer takes care of themself, (no medical care, poor hygiene, careless appearance….), & normal responsibilities have long been neglected. Without a co-dependent rescuer, they’re behind on bills, can’t borrow any more money from family & friends, & have built up credit card debt to support their drinking. May even become homeless

• Family & friends are gone. The addict may have been to rehab – several times, but still found it impossible to quit, having become a slave to the bottle

• Physical symptoms are excruciating. Without medical attention, this stage of alcoholism is incredibly dangerous.  Unable to hold food down, the tremors begin mere hours after any ‘last’ drink, & hallucinations or seizures might have even set in

• Full-blown addiction cause heavy withdrawal symptoms & an increased risk of developing life-threatening conditions. Symptoms can be so painful that the person needs to drink simply to alleviate them. Life expectancy in this stage can be as short as six months.

RECOVERY requirements:
✴︎ A sincere desire for help
✴︎ AA, Ongoing group, individual & family therapy
✴︎ Physical detox & medical treatment

✴︎ Assessing clinical treatment needs for co-occurring disorders :  anxiety  / ADHD  /  bipolar   / college mental health  /  cross addictions /  depression  /  food  /  PTSD   / obsessive-compulsive   /  personality disorders   / schizophrenia  / self-medication……

✴︎ Establishing new ideas, attitudes & life goals
✴︎ Rest, structured daily routine, proper nutrition & sleep habit

✴︎ New circle of stable, sober friends / sponsors & mentors
✴︎ Increase in self-care, confidence, self-esteem
✴︎ ODAT – HALT: ongoing work toward lasting sobriety. MAY eventually need to do deep FoO work to improve quality life.

RELAPSE
A hallmark of any chronic condition is the potential for relapse. The sufferer & doctors work together to identify the best treatments to manage the condition.

Addiction is no different. Relapse rates (40-60 %) are similar to asthma (50-70%) & adult-onset diabetes (30-50 %), reported by the National Institute on Drug Abuse.
The initial treatment may not be quite right, or the person tries to quit without help. Over time, control is lost & the person drinks again.
And an in-patient program of less than 90 days has limited effectiveness.

However, this is not an indication of failure. It’s possible to interrupt the cycle of Use —> Abstinence —> Relapse, by a determination to have a better life, & by getting the right treatments.

NEXT: Alcoholic TRAITS  #3a

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PREVIOUS: Alcoholism INTRO #1b

SITEs : “What is Alcoholism?”
  🧠 Alcohol-induced brain damage continues after alcohol use is stopped 🧠

📌 Addiction STAGES outline
a. EXPERIMENTAL : non-addicted
• Use a substance out of curiosity, peer pressure or rite of passage. No change in behavior or emotional reaction & is limited

b. SOCIAL :  pre-addicted
• The ‘use‘ is part-of & acceptable-in their social environment. They still consider the amount normal, & keep it only to those events

c. INSTRUMENTAL : early-addicted
• Substance starts being needed to cope with personal, work & social problems, as a substitute for facing & correcting them directly

d. COMPULSIVE : fully-addicted
• The substance is the person’s main preoccupation – how / where they can get more. Shame develops, so there’s a need to hide its use, & their life is negatively affected, spinning out of control.

📌 4  Addiction LEVELS
1. DENIAL  – Adaptive – early stage symptoms (hangover denial)
• Occasional drinks taken to relieve stress or other problems – used as a crutch to cope with or escape reality. Alcohol becomes a way to take the edge off after a long day, & blur sharp outlines of life

• Gradual increase in drinking frequency & tolerance – rely more & more on alcohol to get through difficult times, so it’s less enjoyable & more of a habit. Now drinking either stays moderate – or progresses to the next stage. Tolerance is an indication that the brain has changed in response to the drug

• Thoughts become more focused on the next drink : “If I can just make it through these last 2 hours of work, I can head straight to the bar for some relief”
• Rationalizing alcohol over-use / abuse – telling oneself  “I’m just having a rough few days, drinking isn’t that big a deal, or I’m not going out getting wasted every night, so I’m fine”

• The (now) addicted person is likely still unaware that alcohol is gradually becoming a controlling force in their life, & others have not yet seen that the person’s drinking habits are getting increasingly more dangerous

2. DEPENDENCE  – Loss of control
• Desire to drink is more intense – the body has become used to larger amounts with little or no effect. As it gains a tolerance, it expects the alcohol at a certain time, so drinking will start earlier in the day to compensate for the frustration that settles in during the afternoon. The drinker can still function, but becomes more & more focused on getting that next drink

• Loss of control over drinking habits – still easy to find excuses for needing one throughout the day in regular society, which makes it somewhat acceptable.
Consumption is more than the average person’s, but it can be explained away: “If you had the stresses I did, you’d drink too. / Everyone has a beer at lunch when we go out. There’s nothing wrong with it…. ”

• Alcohol-induced blackouts are common – the drinker can lose a lot of time (several hours, an entire day or longer….). They won’t remember where they went, what they did or who they were with, with obvious harmful physical, mental & financial consequences

• Withdrawal symptoms get more severe – when the effects of the alcohol wear off, 6 – 24 hrs after the last drink –  dry mouth, painful headache, morning shakes, nausea, sweats & trouble sleeping. Hangovers are a regular event, but still ‘seem’ manageable.

• The drinker finally starts to realize there’s something abnormal about their drinking & others start to recognize it too. They still hiding it from others – spiking coffee or soda, stashing full bottles throughout the home & ones in the garbage away from home. Lying about where they were when out drinking…..

• Relationship problems & social isolation increases – late nights, drunken fights at home, falling down, car accidents….
May begin missing work or social obligations because of late-nite drinking or painful hangovers. Drink at inappropriate times, such as when caring for their children, when driving with family in car, & at work

✴︎ They may make several attempts to stop drinking, even attend support groups. However, many are not ready to face the rigors of Recovery, & resort to old habits.

NEXT: STAGES 3 & 4, + Recovery (#2b)

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PREVIOUS: Alcoholism INTRO #1a

SITE: Behavioral Addiction (many articles)

🖌️ Addiction vs. Alcoholism
🖌️ LEVELS of SEVERITY for AUD

1. HIGH Functioning Alcoholic (HFA)
Denial
• trouble seeing themself as alcoholic because they’re successful , & not on Skid Row
• uses alcohol as stress-relief & a reward
• has few tangible negative consequences from drinking, by sheer luck

Professional Life
• keeps consistent employment, well-respected for job performance
• has a good education
, with academic accomplishments
• makes artistic, social or political contributions

Personal
• externally seems to be managing life well
• maintains family &/or romantic relationships & friendships
• skilled at compartmentalizing (separate professional & drinking lives)
• usually has one or more co-dependent helpers covering for them (rescuers, enablers)

Drinking Habits 
• one alcoholic drink sets off craving, become obsessed about next drink
• obvious personality changes, compromises morals when intoxicated
• repeats unwanted drinking patterns & self-destructive behaviors

SITE: ” The Cure for High-Functioning Alcoholism”

2. AVERAGE functioning alcoholic can be someone who:
✴︎ drinks alcohol to replace eating food
✴︎ has angry or defensive reactions when someone suggests alcoholism
✴︎ can’t remember what happened while under the influence
✴︎ sets drinking limits, but can’t stick to them
✴︎ does “pre-drinking” before an evening out
✴︎ tries to hide drinking from others

✴︎ drinks in the morning, throughout the day or while alone
✴︎ jokes about the possibility of being an alcoholic (More….)

⬆️ SITE: “I’d drink to just about anything. Being a functional alcoholic is no fun at all”, writes Kristen Pyszczyk

ADDICTION CYCLE
a. Problems – external stressors & internal emotional pain causing anxiety 
b. Fantasize – about using something for relief of symptoms
c. Obsession – about how using a substance will make life better 
d. Actively using – engage in addictive activity
e. Frustration – dissatisfied that relief doesn’t last
f. Addiction  – lose control over substance use
g. Shame – feelings of remorse & guilt re. bad behaviors
h. Promises – to self (& others), resolves to stop using, but can’t

“DRY DRUNKS”
If an alcoholic stops drinking, they’re not sober, mental-health-wise. But then it’s early days. AA says: “It takes a drunk 5 years just to get their brain out of hock!” Then they can start growing up.
OR maybe – the person is a narcissist who resists self-reflection & so can’t mature emotionally,  which mainly shows up in personal relationships, even though their life may improve in many other ways.

• ANGRY
Dry addicts are as angry after stopping, as when they were still drinking. But instead of directing it at the effects of the substance, they often aim it at whoever forced a change, whenf it comes from : a spouse threatening to leave, a boss to fire them, or a judge to jail them….  Resentment can surfaces after a few weeks into the ‘honeymoon period’ of abstinence. Unchecked, it can lead to a resumption of drinking.  “The person I was – will drink again”.

• UNHAPPY
The ‘dry drunk’ may sink into depression when beginning to see their life with a little clarity. While drinking, they may have though everything was OK. But sobriety can bring an awareness of age, missed opportunities, health problems, & career & relationship failures.
IF Married  : New expectations & demands are rarely welcomed, such as promising to be monogamous, to babysit the children, to attend church or family gatherings, to do well at work….. Pretending to be happy about these changes is waring & can’t be kept up

• IMPULSIVE
Not ‘using’ doesn’t change the alcoholic’s basic impulsiveness, which usually involves doing things against their best interest. Even if the addict did want to stop drinking, it’s common for them to switch substances. Irresponsible behaviors can be promiscuity, gambling, over-eating, over-spending…..
AND unfortunately, poor judgement can be ‘encouraged’ by still hanging out with the old crowd of bad influences, OR the family’s attitude : “As long as they’re not drinking, we don’t care what they’re doing”

• IMMATURE
Newly dry alcoholics often miss many opportunities provided by psychological maturity – not being ready to handle a job, a healthy relationship, parenthood…
Unlike their ‘grown-up’ peers, they’re still acting like irresponsible teenagers.
They still demand immediate gratification, & when charm doesn’t get them what they want, they can become withdrawn, manipulative, passive-aggressive, complaining, attacking …..

NEXT: Alcoholism #2a

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PREVIOUS: DOM / INF in Combination

IMAGEs:  ⬆️ “Overdose”, and “Hangover”  ↘️  ,  designed & created by DMT (2017)

SITE: Brad Pitt, @ functional alcoholism
SONG : CHANDELIER (words & meaning)

The distinction between physical dependence & psychological addiction is  important. National Institute on Drug Abuse explains that physical dependence is not itself addiction – which is psychological & emotional.

Once the body is regularly used to a certain amount of alcohol – & then has to go without it for even a short time – withdrawal sets in. This is so painful that the alcoholic will resume drinking to avoid experiencing the distressing symptoms. The cycle continues unrestrained until some type of intervention occurs (self, legal, family….)(More….)

ADDICTION : A chronic brain disorder affecting a person’s sense of pleasure, motivation & memory. While there are psychological, biological, social & environmental factors that can play into it, a large part of the risk for addiction is genetic.

Addiction is any obsessional thinking about & the compulsive need for – drugs, alcohol, food (sugar ), sexual activity (dopamine), fear (adrenalin), romantic ‘love‘ (dopamine), dangerous sports (adrenalin)….  despite the negative consequences that acting on them will cause.
It includes developing a tolerance, intense physical cravings, & withdrawal symptoms. These develop over time, starting with misuse, moving into abuse & resulting in addiction.

WHY: The more stressors we have to deal with, the more we search for solutions to alleviate suffering, to feel better. Using substances to manage uncomfortable emotions & life problems is not about which ones a person chooses, but rather it represents impaired coping mechanisms – instead of learning how to solve issues in healthy ways.

IMP: Not all drug dependence is addiction. EXP: an asthmatic will depend on a daily dose of medication to breathe properly. This is not addiction. In this case, the body was not working properly before the drug was introduced – which is the correct solution to the physical problem – & did not cause the original dysfunction.

ALCOHOLISM is a disease that usually develops over time. Whether or not initial alcohol use is likely to lead to addiction is often a matter of individual circumstances. Mayo Clinic describes a number of risk factors:
• A family history of substance abuse or other mental health disorder
• Childhood abuse &/or neglect / • A Chaotic living environment
• Peer group or family that is permissive about substance use
• Depression, social issues, loneliness…..

Medically, alcoholism is referred to as Alcohol Use Disorder – AUD – determined by 11 criteria in the DSM-V . In 2012, an estimated 7.2% of American adults 18 & older (about 17 mil.) had a diagnosable AUD.
Men are almost 2x more often chemical-substance abuser than women (11.2 mill vs. 5.7 mill). And teens are not immune. In that same year, an estimated 855 thousand young people (ages 12 to 17) also had this disorder.

The National Institute of Alcoholism & Alcohol Abuse (NIAAA)
🚦 TWO or more of the following symptom indicate AUD
a. Moderate (“Normal”): Per day – 1 drink for women, 2 for men
b. Binging: Any drinking that brings blood-alcohol level to 0.08 – over a 2 hr. period, women = 4 drinks, & men = 5
c. Heavy Use: Binge drinking episodes on 5 or more days in the past month

LEVELS of SEVERITY for AUD
Mild: 2 -3 symptoms // Moderate: 4-5  // Severe: 6 or more
🚥 Only TWO (or more) of these symptom are needed to indicate AUD:
• Drink a larger amount or for longer than – you originally intended
• Spend an excessive amount of time drinking (many hours)
• Want to cut down or quit drinking, but so far unable to

• Developed a tolerance to alcohol, or the need to drink larger amounts to get the desired effect
• Have a craving for alcohol when not drinking, or want a drink so badly you can’t think of anything else

• Often been physically sick as a result of time drinking – & it has interfered with the ability to take care of your home & family, causing problems at work or in school
• When not drinking, have withdrawal symptoms (trouble sleeping, body tremors, nausea, sweating, or seizures….)

• Continue to drink in spite of external negative consequences (trouble with family, friends, work, the Law)
• Continue to drink in spite of internal negative results (depression, anxiety, worsening health problems, blackouts….)

• Cut back on or have stopped participating in activities you once enjoyed because of your drinking
• Found yourself in dangerous situations many times – as a direct result of drinking, (driving, swimming, in dangerous areas, unsafe sex….)

NEXT:  Alcoholism STAGES #2a