CASE STUDY 2 : ALCOHOL/DUAL DIAGNOSIS
Two decades of alcohol dependency to maintained abstinence utilising the eight week intensive program.
Chronic alcohol dependency, like most ‘addictions’ are treated as diseases, and the general prognosis is poor. Abstinence is wished for and methods are simply – abstain and cling on.
Little insight is given to the ‘why’s and the what’s’ of what is occurring for the individual. In fact, I have heard clients and people whom I know refer to being discouraged from therapy, for the reasoning that only an alcoholic can be understood by another alcoholic. Well yes, perhaps in the hell of it personally, but not necessarily in the architecture of what gives it strength. However, I would rather be on the operating table of a surgeon rather than the block of butcher. Both equally skilled with the knife, yet their starting position so different. The former considers the subject worth saving and improving, whilst the latter knows them already to be dead and beyond help. It is an an analogy which mootly sums up the attitude of a multi billion pound industry wherein no one appears to know what they are doing and the success rate languishes at approximately 5%.
Similarly therapists, key workers etc., often lack the specialist skills to get into the process and undo the mechanisms that 'are' the addiction. A learned set of behaviours. Where the prefrontal cortex, the thinking part of the brain is no longer utilised and therefore actions are 'reactive' and ingrained. They now operate from the striatum and function outside of conscious planning and control.
What is missing is the sensitivity to the need for the healing of the confusion that has caused the dependency to never abate. The layers of erroneous thinking, complex emotional entanglement and lack of life structure and mechanisms that enable someone to lead a stable life. This needs to be done in a manner as working with a clean slate, and remaking a of a clean slate, mentally, emotionally and behaviourally. These elements are done in parallel. The focus is on the person, with an eye on the behavior. They are worked and integrated together with powerful integrative directives that can be tried and proven to work or not. Stimulation of the cognitive functions reinvigorates the prefrontal cortex and change begins to occur.
A person is rebuilt from the inside out. And they come to understand themselves differently, by evidence of their own practice, the content of their minds, their feelings and behaviour. What can come out of this can be and is truly astonishing. I am for ever awed and humbled by what can be achieved.
Fifteen years of quietly listening to people telling me what did not work for them, applying what does work and having the skill to piece this together in a cogent process has its merits. This incredible achievement in the case below I hope exemplifies the life a person can earn themselves by their brave efforts and desire for a better life.
The work done by neuroscientist Marc Lewis and his book 'The Biology of Desire', explain what is it that is going on in addiction. Well worth a look - video here. My methods parallel his theory and were learnt in practice and study.
It was October 2019 and I was in a state of utter chaos. My drinking had escalated to a cyclical pattern of five day binges, only interrupted when my parents ‘rescued’ me from myself. I’d been hospitalised numerous times for detoxing, even on one occasion ending up in ICU. I had been suspended from my job for drinking in the work place. I’d let down friends, missed appointments, days and weeks has disappeared. Money was an issue. My self-confidence and esteem was in tatters and worsening the more I drank. I felt alone, hopeless, drowning in shame, desperate and so lost that my only reprieve from the mental anguish was yet another drink…. and so the cycle would continue.
I knew I needed help and it wasn’t that I hadn’t sought it out previously. I have other mental health difficulties in addition to my problematic drinking and at the time I met Edward, I’d been in therapy for over 18 years. These therapies had done little to curb my drinking. I’d tried with AA for over a year and that ironically made my drinking worse. For me, the tenets of the AA Fellowship told me I was weak, “powerless over alcohol” when I felt I needed to be strong and self-empowered. Moreover, AA labelled me an alcoholic for life, a term I am not comfortable applying to myself as it further erodes my self-esteem and confidence. At that time, I thought “I may as well live up to the label I am being brandished with” and so acted like an alcoholic. I had tried SMART as well as my local alcohol service but nothing worked. None of these agencies were specific enough to me nor focused on real outcomes and real understanding. They offered paltry distraction techniques and a lot of talk but no action, and crucially I couldn’t ‘get honest’.
I chose Ed from numerous other therapists because on paper he appeared to have the most extensive experience particularly of dual diagnosis. Also, he favours a practical approach. On meeting him, this was apparent but more importantly I felt an immediate trust and warmth. I felt safe enough to be totally honest so we got off to a good start. During that first meeting, Ed came across as solid - none of my horrendous behaviours and shameful drunken acts shocked him nor did I feel judged by him. I felt accepted for who I was at that moment. Although I was ambivalent about signing up and working with him, I was scared that I might actually have to look at my drinking and change the way I was living my life. I decided to go ahead and began an 8 week course of therapy.
During this course I found Ed to be very focused and interested in my problems. He clearly has a strong desire to help and enable people to make positive life changes. He is articulate and a skilled practitioner. Sessions at times were intense but there’s a light-heartedness to them too. We would begin with a discussion about the previous week’s events, my thoughts and troubles, and an explanation of what might have been going on for me mentally and emotionally. Ed would give me thought points and suggestions for the week to come. I found this process very engaging, thought provoking and uplifting as week on week I felt I was making progress. I came to look forward to our sessions, to what I would discover about myself.
I feel from the start Ed gave me hope and believed in me (…so I am not a hopeless case after all!), Previously, I had found this lacking in other avenues of help. This hope and belief has evidently had a positive impact on my self-esteem and confidence which is the crux of the matter.
Quite how Ed does this, I do not know, but it works! In part, it comes from his practical common sense and ‘real life’ approach which he carefully tailored to me and my specific issues. He doesn’t have a one size fits all approach. Rather than solely submerging ourselves in my past (as most therapists have done) we looked more at the present, at what was driving my drinking now, and he guided me through, encouraging me and supporting me. By making my habitual thoughts and the resultant drinking behaviours understandable, I began to be able to separate my thoughts from my urges to drink. I gradually gained mastery of my mind, my emotions and actions.
I no longer feel a slave to the bottle.
It’s a work in progress but I have now been sober since the day I met Ed, over 7 months ago. I am not an alcoholic nor ever was. I have forgiven myself for my drunken wrongs. Ed has given me a safe arena in which to lay down all my cards, work through my trauma and pain and discover I can live a better life. It is not my old life, it is an enhanced life with far greater awareness, empathy and resilience. I feel empowered now. Ed has given me the confidence and tools to be able to trust myself to solve my own problems. He has effectively made himself redundant. I am lighter nowadays with much more joy in life. And that’s thanks to Ed. Give it a go. You’ll be surprised how strong you are and what you can achieve with the right help.