Do alcoholics LIKE alcohol?

About 20 years ago, speaking to a group of addiction counselors assembled at a national conference on addiction, I asked this question.alcohol, alcoholic, alcoholism, recovery

I was met with incredulous stares and virtually everyone in the room raised their hands affirming their belief that alcoholics like alcohol.  What other answer could there possibly be?

They were somewhat surprised when I told them how wrong they were… but now I’d gained their attention.

Alcoholics do not like alcohol.  They love the stuff.

Normal drinkers like alcohol.  They enjoy the effect, the taste, the bouquet, and the ritual and conviviality associated with consumption.  They drink, enjoy, and move on into the rest of their evening, their week, their lives — not thinking about drinking until the next socially or situationally-appropriate occasion arises.

Alcoholics have a pathological love of the effect of their drink and, over time, matters such as taste, aroma, ritual and social context become less and less significant.

In fact, over time, the alcohol occupies the center point of the alcoholic’s life, obliterating relationships, jobs, interests, and ultimately, the health of the alcoholic.  Booze becomes the organizing element, the reason for being, in the ever-degrading alcoholic life.

For those of us who treat alcoholism and who believe that recovery from it is possible, it’s critical that we understand the grief that occurs when we ask someone to abandon the only source of relief that they know and, in some strange and twisted way, the most trusted “friend” they have.

We do understand that, and try to assist our clients in establishing recovery with the knowledge, delicacy, and understanding that the job requires.

- Mark B. Dunay, LICSW, LADC 1

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OnOctober 1, 2013, posted in: 12 Steps, AA, addiction, alcoholic, alcoholism, recovery by

The Red Flag

The Red-Flag Conundrum: To Deal or Not to Dealthe red flag conundrum in relationships

Week after week, year after year, clients show up to discuss marriages that are breaking down or, whether they realize it or not, have already irreversibly broken down.  They are sad, frustrated, angry, disappointed, often blaming themselves or their spouses for a process that began well before they began to address the issues, and one that now has a life of its own and may be beyond fixing.

In telling their individual stories and explaining why and how things got to this bleak, unfortunate place, there is often a particular kind of regret expressed around the theme “I should have known, I should have listened to my heart, I should have paid attention.”  Further discussion uncovers a common element in marital breakdown:  Red Flags.

These Red Flags are signals and signs which were evident and even consciously acknowledged by one or both partners during the pre-marital dating, courtship, cohabitation phase.  Sometimes the issues appear to be petty – ”He’s sloppy and messy.“  Sometimes they’re more obvious and troublesome – “She talks very disrespectfully about men.”  In any event, and for a number of very human reasons, the issues are not addressed, usually in the interest of avoiding confrontation. Often, the avoidance is tempered with a belief/hope that “Our love and commitment to one another are so strong that we’ll work around, figure out, overcome this small piece of who he/she is, what he/she does, what he/she doesn’t do.  Love will conquer all… and we will do whatever is necessary to remain in the ‘good 50%’ the still-married half of all couples getting married today.”  Would that it was this simple!

So the Red Flag Conundrum, the puzzle, is all about what happens when the nagging little doubts and reservations, the annoyances which occur early and often in a relationship that’s mostly quite good, are avoided and not addressed.

Usually, when we’re bothered by character traits, e.g. laziness, stinginess, sarcasm, self-absorption, we can be fairly certain that we’re in for trouble.  Character traits are character traits.  They’re part of who he/she is, how they’re wired.  We can’t love our partner enough to expect spontaneous or lasting change.  Not gonna happen!  If we address these characteristics early in the game our partner might feel attacked and may assume the no-win default position of “well that’s who I am” which is early-relationship code language for “Get the hell off my back!”  (Later on, the diplomatic veneer has worn off and only the “get off my back” message is conveyed.)

Red Flags also appear in relation to specific behaviors, e.g. personal hygiene, alcohol consumption, punctuality etc.  While no less important, these are generally easier to ameliorate because they can be identified, targeted and addressed with an infusion of attention, effort and perseverance.  New behaviors can be learned and old ones abandoned.  This is good news.

A third, and very significant area of concern, occurs when we see something that makes us uncomfortable in the relationship of the parents of our prospective spouse.  What’s most important here is the obvious connection between what we observe and internalize as kids, living in close proximity to role-modeling adults, and what we bring forward into adulthood.  “The Past is Prologue “is the key phrase here.  Thus, if your sweetheart’s parents are rude, disrespectful, mean-spirited, sarcastic, etc. pay close attention and maybe think about lacing up your running shoes, because you’re at significant risk to end up in a relationship that looks like what you observed in the behavior of the almost-in laws.  Not a good basis for optimism.

But, too often,  in the interest of keeping peace and moving inexorably forward to “Happily Ever After,“ we overlook, we excuse, we accommodate and alter our own beliefs, sacrificing our integrity… this is what’s known as Codependency… and we begin a long slow process of disappointment and disenchantment, leading to despair and often divorce.  Keeping our mouths shut may feel more comfortable, in the short run, but it will prove to be a very poor and regrettable decision over time.

Raising concerns about issues, conditions or behaviors with someone you’ve come to love and, hopefully, trust need not be a deal-breaker.  In fact, marriages are high-maintenance affairs.  Communication between committed, serious couples often is an evolutionary, learnable skill set.  While it might be uncomfortable… so is getting a tooth filled… it’s necessary for the health and growth of the relationship.

In golf, when a player considers a number of strategic options in selecting the next shot, the “Risk/Reward“ dilemma  comes into play… “If I take that particular risk, I might look like a hero but it’s so risky that I think a more conservative approach makes more sense.”  In relationship building, the same questions arise.

The Red Flag Conundrum, – i.e. do I address the issue or just leave it alone and hope that things will work themselves out – is almost universally common. How do I resolve the conflict and decide what to do?

Several considerations and elements should factor into the decision.

First, let’s start with the assumption that nobody has the right to “remake” anybody else.  If every behavior, every personality trait, every quirk is called into question, you can bet that resentment and unhappiness will not be far behind.  This will undermine the good will, support, love and hope upon which the young relationship is built.

On the other hand, some of these Red Flag issues must be addressed.  How to decide which ones?

Ask yourself “How important is this?”  “Can I live with this, or not?”  “Can this wait?”

“My partner hogs the car radio and only wants to listen to Country and I’m a Rock fan” may be a source of annoyance but it’s a small matter when compared to “My boyfriend has gambled away his paycheck twice in the last year and a half at the casino and can’t watch a football game on Sunday without having a bet on it.”  Big, important difference here, right?

Have the car radio discussion whenever the moment seems right… and do have it… but be absolutely certain to sit down (make excellent eye contact) and discuss gambling and the place that it will occupy in YOUR life.  No negotiation required here.  Losing your kids’ home to a bookie ten years down the road is an avoidable horror and it’s your responsibility to avoid it.  Don’t sweep this issue or others like it under the rug.  These are the marriage-killers and you have choices and options available to you that, for yourself, your partner and your yet-to-be-born children you are obligated to exercise.

The most important elements of this discussion are that Red Flags must be recognized and attended to.  They seldom, if ever, simply go away and, as time goes on, they usually become more deeply entrenched and more bothersome.  Some are more or less important and discretion may be applied in the timing and level of address.  Some, of course, e.g. the threat or commission of physical violence should be grounds to end relationships… battering is ALWAYS progressive and NEVER excusable.

Finally, understanding that relationships are complex systems that require constant monitoring, care and maintenance, give yourself permission to feel entitled to and positive about dealing with the data of daily life.  Address what needs to be addressed.

To Deal or Not to Deal is not a particularly valid question.

Deal!  You owe it to yourself and to the only life you’ll ever have.

- Mark B. Dunay, LICSW, LADC 1

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OnJune 1, 2013, posted in: counseling, psychotherapy, relationships by

AA works

Since its birth in 1935, Alcoholics Anonymous has helped millions of afflicted individuals achieve lasting and rewarding sobriety. Still, many more millions of their family members, friends and associates have achieved freedom and relief from the chaos and pain associated with the disease that touched their lives through their connection to the alcoholic. To say that AA has proven itself is an understatement.Alcoholics Anonymous

Alcoholics Anonymous is first and foremost a fellowship of like-minded individuals who, through open and honest sharing, help one another to stop drinking. The achievement and maintenance of abstinence from alcohol is the basis of a program of recovery. Sobriety is a prerequisite of recovery. There can be no recovery without it…ever.

While not everyone can make a meaningful, productive connection to AA it seems to be, by a wide margin, the most effective treatment option for the widest range of alcoholics. Fortunately, for those who do not find that AA is a good fit, other treatment approaches and treatment technologies are currently available and, hopefully, everyone who needs help can find it in places and utilizing resources outside the realm of Alcoholics Anonymous.* Suffice it to say, however, that for better than the past three-quarters of a century, AA has been the best approach and has done the most for alcoholics and their families.

Perhaps the most difficult and critical element of getting AA to work is simply getting to AA. Most individuals, either because of misconception, misinformation, embarrassment, or fear, find the notion of walking into a room of self-diagnosed alcoholics daunting at best and horrifying at worst. Couple those factors with the denial associated with alcoholism and the usually embedded illusion that “I can do this on my own “and the getting there becomes quite problematic. Few individuals wake up on a given morning and say, “Gee, I think it would be a great idea to go to AA today.” The process of getting there just doesn’t work that way.

How then does it work ?

Many years ago I assisted the brother of a colleague, (whose life was in shambles ), in getting sober. He was ready when he was ready. I had the knowledge and motivation to help and, because he was willing to follow a few simple directions, he made an immediate connection and commitment to AA and, precisely because “AA Works,” he achieved sobriety, remade a very fine and commendable life, and has been sober, productive and happy for the past 27 years.

Relatively early in his sobriety, my colleague, his sister, had attended a number of AA meetings with him and came to me with an interesting question. She said, “I go to these meetings and see roomfuls of seemingly happy, comfortable individuals who, on the surface have nothing in common, sitting next to each other, apparently, nicely connected to one another and enjoying each other’s company… guys in motorcycle jackets sitting next to older ladies, blue collar guys sitting next to others in tweeds and shiny shoes… I don’t get it. Is there any single element that you can think of that holds this thing together, that explains the connections ?”

Hmmm…interesting question and one that I’d never been asked.

“Pain,” I answered. People get to AA only when they’ve had enough pain. The denial no longer works. The excuses, the rationalization, the lying and self-deception have run their course. Finally, the dawn breaks and the alcoholic recognizes, (in a genuine, profound and often private way), that the pain, shame, self-hatred, fear, chaos, loneliness etc. which characterizes his life is a direct consequence of the use and abuse of alcohol. Period !

So, not particularly for any high-handed or noble reason, the alcoholic is interested simply in making the pain go away. If giving up alcohol is what’s required, then, so be it, he becomes willing to accept help. He surrenders to reality. And this surrender becomes the basis of recovery.

If only the acceptance of help was a simple proposition! No, it’s often complicated and difficult. A lot of common misgivings about AA come into play, e.g. “I don’t believe in God” (not a requirement), “I don’t want to talk in front of people” (not a requirement), “I’m embarrassed and I don’t want to expose my identity” (so use a phony first name… last names are never used, anyway… not a problem). The list goes on… and on.

There is one (and only one) requirement for AA membership and that is “a desire to stop drinking.” Not only that, but AA doesn’t require membership for attendees at many meetings and it’s perfectly legitimate for newcomers to check things out, over whatever period of time they choose, before deciding to affiliate, or not.

Once affiliated, the new member will be welcomed and energetically coached and supported in achieving sobriety and adopting a manner of living which recognizes that alcoholism is a disease that never takes a day off. Thus, the skills necessary to achieve and maintain, often hard-won, sobriety are employed on a daily basis. “One Day at a Time,” as the bumper stickers proclaim.

With the acquisition of sobriety, comes the “Program of Recovery.”

The Twelve Steps of Recovery are an interrelated and precise series of procedures which, taken one by one and taken as an entire system, are a simple-in-appearance but deep and life-altering roadmap for living a life… free of alcohol and the madness and misery associated with it.

Like many aspects of our lives, sacrifice and hard work are essentials to growth and betterment. Seldom has there been a better reason to sacrifice, focus and work hard. The remaking of a broken life… and “broken” is a relative term… is worth the effort and time.

In the most extreme sense, beyond remaking, Resurrection occurs.

AA Works.

*While we clearly endorse Alcoholics Anonymous as a primary and valuable treatment option we also recognize the worth of other available approaches and treatment models, including medically, i.e. chemically, supported treatment. We understand that “One Size Does NOT Fit All.”

- Mark B. Dunay, LICSW, LADC 1

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OnFebruary 1, 2013, posted in: 12 Steps, AA, addiction, alcoholism by