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The Conversation: What Does An Addict Look Like?

“I don’t think you are really an alcoholic,” someone close to me remarked quite unexpectedly as we shuffled past a neighborhood bar, making our way through the cool dark to a restaurant by the sea. It wasn’t a conversation I welcomed chewing into at that time. I was hungry and I didn’t have the patience to get into how the term “alcoholic” is both dated and inaccurate, or what “alcoholic” even means anymore.

“Why do you say that?” I asked. My throat tightened.

“Because you’re not that weak,” he replied. The weight of those five words sunk to the pit of my gut and anchored there as carelessness and ignorance. This, from someone so intelligent, someone who knew me so well. “Well, that’s your opinion,” I said, having nothing more to offer on the matter and sensing that any further explanation would just be wood chips for the fire. I have since realized that those many cutting statements delivered to people in recovery are not only sprung from 
naiveté, but also from a desire for control. It is “Human Nature 3.0”- we like things to be predictable and we want to have the upper hand (more on this in a future “Conversation”).

"Because you're not that weak." 

Stereotypes imprison the addicted and block our collective consciousness from seeing that this crisis is perhaps the largest societal challenge we face today. After all, the vast majority of us are addicts in action; our poisons are the differentiator. Food. Sex. Gambling. Money. Shopping. Booze. Drugs. Pills. Work. “Perfection.” Love. Prestige. Exercise. Religion. Facebook. Beauty. Power. And yet, when people conceptualize the image of an “addict” in their minds, their own reflection is rarely conjured.

"Getting sober just exploded my life. Now I have a much clearer sense of myself and what I can and can't do. I am more successful than I have ever been. I feel positive where I never did before, and I think that's all a direct result of getting sober." - Jamie Lee Curtis

"Getting sober just exploded my life. Now I have a much clearer sense of myself and what I can and can't do. I am more successful than I have ever been. I feel positive where I never did before, and I think that's all a direct result of getting sober." - Jamie Lee Curtis

Imagined instead are: 

  • A drink upon waking
  • Homelessness and squalor 
  • Trembling hands, “the shakes”
  • Messy hair, body odor, bad teeth
  • Joblessness & living on the dole
  • School dropouts, lack of education
  • Marital and financial trouble
  • Piercings & tattoos
  • Drink or use every day 
  • Foolishness, weak-willed  

Maybe so many people have chosen to frame addicts this way because it’s easier, because the reality is far too close and unearths unacceptably discomforting levels of fear. Consider that over 7% of the US population and just under 4% of Singapore’s population fit the criteria for having an alcohol use disorder, according to population-based surveys (estimates should be considered extremely conservative, given self-reporting methods and the shame associated with admission). Millions of these people are educated, hold down jobs, and have family and friends to answer to. In fact, around 20 percent of individuals with an alcohol use disorder are considered “high functioning”- in other words, highly intelligent achievers who are able to maintain the façade of an accomplished and even enviable life despite their dependence on alcohol. Gabrielle Glaser, author of “Her Best Kept Secret: Why Women Drink,” writes that the more educated and well off a woman is, the more likely she is to consume booze, and that white women are more likely to drink than women of other ethnicities. And, according to a new survey by Protecting.co.uk, a third of workers in the UK have admitted to using drugs at work while nearly every respondent said they had gone to work drunk at least once.

                                                                                    "What made me stop [drinking]? I realized it was not going to end well." - Kristin Davis 

                                                                                    "What made me stop [drinking]? I realized it was not going to end well." - Kristin Davis 

In an age where nearly everything seems to revolve around cocktails- from bonding with friends to making important business decisions and even having sex (yes, many people admit that drinking is often a prerequisite requirement to doing the deed), what does addiction actually mean and how can someone tell whether or not they’ve crossed the line? Perhaps it is first crucial to accept that no one definition of addiction exists, as it is viewed from diverse perspectives.

Many scholars and doctors define addiction as a “brain disease,” which in my view is a simplistic and even dangerous way to categorize a many-tentacled beast that sucks its existence from complex social, cultural, biological, psychological and spiritual forces. Other addiction experts say that addiction is a chronic neurobiological disease characterized by impaired control, compulsion, continued use or behavior despite harm, and craving. This perspective to some extent minimizes the outcomes while focusing on the actions. Is an addict still an addict if she is no longer engaged in her addiction? SMART Recovery describes “addiction as an impulse disorder, favoring momentary satisfaction over the long term view,” while other programs consider addiction a “spiritual bankruptcy.” The origin of the word “addiction” perhaps gives us a clearer meaning; it is derived from a Latin term that means “bound to,” or “enslaved by.” This notion, “an enslavement,” resonates most with me; when you have an alcohol use disorder- or any kind of addiction- you must tie yourself to some external actor in order to feel ok; that desired sense of belonging or normalcy exists at the other end of the craving. Addicts without their fix- be it cocktails, cakes or cocaine- find it impossible to inhabit themselves.

So, when does drinking become a problem; how do you know if you have an alcohol use disorder? Well, you can take a handy "Almost is Too Close to Always" quiz from Harvard, although I’m not sure its results are definitive, particularly since, again, the criteria varies. Or, you can go with a more traditional screening method like CAGE:
C
 Have you ever felt you should cut down on your drinking?
A Have people annoyed you by criticizing your drinking?
G Have you ever felt bad or guilty about your drinking?
E Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? 
According to a CAGE screening, two positive answers warrant further assessment. 

Be warned however, that most people severely underestimate how much they drink and count, on average, only one quarter to one half of the drinks they actually consume. I think, with many of these types of issues, we already hold the answers within. I knew years before I quit drinking that it was hollowing me out and stealing my spirit. But, if someone asked me about it, I wouldn't hesitate denying that knowledge.  

It is alcohol after all... cunning, baffling, powerful. 

So, if you suspect that your drinking may not be serving you well anymore, why not begin your exploration of that relationship by reflecting on these questions?

  • Is my alcohol use holding me back from my dreams?
  • Is my drinking negatively impacting my relationships or my health?
  • Do I actually enjoy drinking or has it just become something to do?
  • Am I drinking away boredom?
  • Would my life be better if I quit drinking? In what ways?

I quit booze when I realized that it was beginning to steal the life I was meant to lead- one with a sense of peace and confidence, a creative existence, a good marriage, a rewarding career, a spiritual belonging, the ability to accept myself as is. A few people might argue that I hit the bottom several times, while most others standing on the outside looking in could only see a woman who had it mostly together- top student, secure job at a great company, solid friends and marriage, and a rather exciting life in a "city so nice they named it twice." What I knew for sure was that I was deeply unhappy with who I’d become, and that if I chose sobriety, I’d at least have a chance to turn it around.

Best. Decision. Ever.

 Perhaps it will be the same for a few of you reading this today.

If you missed the first two installments of The Conversation, you can check them out here and here. Blogger EJ Austin-Jones also had some thought provoking things to write about this series, so check out her take here. I'd love to hear your thoughts, so please share them in the comments section. If you liked this post or think it might be interesting to someone else, please share! Stay tuned for next week's installment and if you have a question on addiction or would like me to cover a particular aspect, just send me a message. 

 

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The Conversation: A Weekly Blog Series on Women & Drinking

If you think alcohol abuse is primarily a men’s health issue and directly correlates with lower socioeconomic status, you might want to reconsider. Recent statistics are sobering, and the number of professional women with alcohol use disorders-- as well as the number of alcohol-related deaths and alcohol-related illnesses among white-collar women-- are rising swiftly. A 2014 poll by trade magazine, The Grocer, found that 16 percent of women admit to often finishing a whole bottle of wine themselves at home. According to Gallup, the more educated and economically well off a woman is, the more likely she is to drink; white women are particularly prone. According to author Gabrielle Glaser, in the US, the rate of women being hospitalized due to alcohol is five times that of men. In Singapore, excess alcohol consumption is rising swiftly; young women are the fastest growing group of binge drinkers.

While statistics are helpful in understanding a quickly evolving story about women, stress and excess, I’ve had a front row seat to its unfolding for nearly half my life. My own show began with alcohol-fueled hospitalizations and mandatory 12-Step meetings in my teens, a few years after discovering the magic powers of Kahlua and Goldschlager. This snowballed into something a bit more sophisticated when I had the opportunity to work at some of New York’s toniest nightclubs and bars for almost a decade, often finding myself in situations that even Carrie Bradshaw would be envious of. Champagne with Mary J. Blige in the back of her limo? Check. Shots with Diddy? Check. Partying with Kevin Spacey in the VIP lounge? Check. But, like all great parties, this one had to come to a close, and it faded out in the saddest possible way, like when the DJ accidentally cues Barry Manilow and everyone in the club forgets how to dance, dead stop. I ended up- hold your breath- in the daily grind, working the 9-to-5 professional gig in Manhattan while going to grad school, sporting button-downs and pleated trousers from Banana Republic and volunteering at non-profits in my spare time. It was a dignified, respectable life… Except that I kept drinking, and my depression persisted, and both my appetite and tolerance for booze and pills grew.

This may sound like an obscenely unique example, but the average addiction recovery meeting proves otherwise, quite usually an even mixture of women and men from all walks of life, many of who have seen quite colorful days and who have their own stories- or drunkalogues- to tell. In my nearly six years of sobriety, what I’ve also been able to spot outside of the protective recovery bubble are increasing numbers of women living just as I had been- a bottle of “fine” wine after a stressful day at work (and everyday is stressful…), regular martini lunches with friends, Facebook and Instagram posts of yet another night out, another exclamation about Happy Hour and need and how amazing it feels. Don’t get me a wrong, there’s nothing the matter with a woman enjoying a drink from time to time… until it becomes day in and day out, until the booze begins scooping up her dreams, until her life undulates in those telltale waves and she finds the whole of her being tipping over, sinking, engulfed.

So, here begins a conversation about women and drinking, one that will probably be quite unique, controversial and, at times, heated. Each week on the blog, I’ll be covering one aspect in this massively complicated puzzle, and I’ll propose ideas, sources and questions to help move us along to something that’s so desperately lacking: Answers. Solutions. Alternatives.

One thing to note- I am not a medical doctor, and I’m not an expert on the subject of alcohol use disorders by the traditional, academic version of the word (not yet at least. Those who know me well know that I have an addiction to school…). I’m not a counselor, a psychologist or an epidemiologist either. I’m simply someone who has been up, down and all around this issue and who has decided to dedicate part of my career to helping other women who are presently enmeshed. I don’t propose to have or to offer all the answers, and I do think that what works for one person may not work for another. Let’s make this a respectful and solutions-oriented conversation. If you disagree with me on a point or would like clarity on a topic, say so. If you’d like to share your perspective or story, please do! If you think I’ve overlooked something or have made an error, politely call me out on it- I’m here to learn and if I want to make a real impact in this area, I have a hell of a lot more to do in that respect!

I’ll be sharing “The Conversation” blog posts both on the site and via the newsletter, so if you’re not signed up yet, please do so! So, first things first, if you have a particular aspect of drinking that you’d like me to write about, leave a comment or contact me. If you’d like to contribute a blog post as an expert or as someone who has been on this journey, the same applies.

Thank you for reading, and I look so forward to having a fruitful conversation with you!






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Three-Martini Playdates? Time for a Chat.

Define "moderate"...

Define "moderate"...

A few weeks ago I went to a women’s meetup group here in Singapore, something I try to do at least once a month. There were about twenty of us that evening, and as I took my usual survey of the room, I noticed that I looked to be the only one without a glass of wine, bottle of beer, or fruity cocktail in front of me. There is nothing unusual about this, and I’m thankful that my days of fixating on the difference between “me- teetotaler” and “them- party animals” have come to a close. “She’s a health nut- it’s her job,” one woman said to another, in effect apologizing for me, as I poured my Pellegrino into a tumbler and propped up a sliver of lime on its edge. “Quite a good turnout tonight,” another woman commented, “but I’m sure everyone only comes for the drinks!”

I quit drinking booze four years and two months ago- finally, and after many attempts- and I have not touched the stuff since. My reasons for quitting were blandly simple- I’d become a sad lush, and alcohol no longer served me. Drinking all the guys under the table ceased being cute once my college bartending days came to a close, and my extended “happy hour” after the daily corporate grind had drained my energy, dignity, drive and wallet. Don’t let me fool you. Bidding the booze farewell was no easy feat. I had to ask for help (lots of it), sever relationships, change the majority of my habits, and rearrange the constructs of my life.

Friends sometimes ask me if I feel awkward at the usual shindigs and soirees where the order of the evening is social lubrication to the point of oblivion. Actually, I find it fascinating. I’m mesmerized by how absolutely dependent people are on intoxication in order to communicate with each other, no matter what the conversation or circumstances. It astounds me that alcohol has become the glue in business and politics, and it makes me wonder if it’s one of the contributing factors for all of the poor decision-making going on around the globe. I’m amused when a fellow adult tries to shove a drink in my hand and pleads, “c’mon, just have one.” Seriously, are we in high school again? In some ways, being the only sober one in the room is like getting front row seats to the best movie in town- but you have to wear those paper 3-D glasses that make you really dizzy and the guy sitting next to you is gnawing on fried chicken like its his last meal on earth. 

As an allied health professional and abstainer, there’s only one version of the truth I can offer you: Alcohol will blunt your discipline and control, and if you have lofty goals for fitness and life, booze has little business being in that plan. Let’s face it- you are not going to get to the gym regularly if you’re hungover, and even if you do happen to crawl your way there, your workout is going to suck. Alcohol makes people moody and dismissive. It becomes so much easier to say, “I don’t feel like it right now, I’ll do it tomorrow” when you have a few drinks in your belly. Here’s my theory: millions of women today KNOW that they drink far too much, but because it’s become so socially acceptable in our culture, they’re easily able to overlook the very real damage it causes and instead chalk it up to “normal.”

I am not alone in this idea. Alcohol researcher Sharon Wilsnack believes that we are now witnessing a global epidemic in women’s drinking. Wilsnack found that females "born between 1978 and 1983 are the weekend warriors, drinking to black out,” whereas “women in their 40s and 50s have a very high risk in terms of heavy drinking and weekly drinking.” While alcohol abuse impacts all social classes, women who have a college degree are twice as likely to have a drinking problem, and those with high-status jobs in male-dominated environments have increased risk of alcohol-use disorders over their blue-collar counterparts. Take an honest look around and you’ll notice that women are drinking more than they ever have before.

We’ve all seen studies on the benefits of alcohol. These stories tend to clog up our Facebook feeds every few months and are usually posted by individuals who drink a bit more than the average bear. Headlines assert that “moderate wine drinking is good for your health,” and “people who drink live longer than those who don’t,”or so the story goes. Sometimes I wonder if the scientists and journalists are in cahoots with each other as a means to justify their own drinking problems. All joking aside, defining “moderate” drinking has become extremely subjective, and the way I see it, too many people who believe that their consumption is within the healthy zone are only kidding themselves.

The fact is, even moderate consumption of alcoholic beverages can impede your progress by undermining your focus and drive. For most people, it’s often easier to kick back with coworkers over a few drinks than it is to hit the gym or sketch out a business plan or train for that half marathon. After a beverage or two, time and motivation have been tossed out the window. Drinking also impairs judgment, thereby drastically increasing your chances of ordering that pepperoni pizza instead of sticking with your nutrition plan. We all know that after a few beers or glasses of wine, we’re far more likely to make poor choices, which can spiral into regret the next day. This is often where a pattern starts to form- you don’t want to feel badly about failing to meet your goals and commitments, so you drink again to numb the associated feelings of guilt and shame. When we drink to drown our problems, we’ve crossed the border into dangerous territory.

Alcohol also wreaks havoc on the body in several ways.  Alcohol contains 7 calories per gram and has no nutritional value; add in mixers and you may be drinking more than half of your daily recommended caloric intake in booze. Alcohol signals the body to produce the stress hormone, cortisol, a primary cause of abdominal fat and one of the greatest impediments to weight loss. If you’re working on building muscle, all that hard work you’re putting in at the gym can be undermined by regular drinking since alcohol interferes with the body’s ability to produce adenosine triphosphate (ATP) and inhibits the absorption of muscle and endurance-building nutrients like Vitamin B12 and zinc. Many studies also show that alcohol consumption increases your risk of cancer, kidney problems, infertility and dementia, while contributing to increased blood pressure and mental illness.

I’m not here to tell you to quit drinking forever, and I do believe that you can succeed at what you put your mind to even if a few drinks a week are part of the equation. Instead, what I’m trying to say is that we, as women, are avoiding an honest and overdue discussion about how much we drink and what it’s doing to our lives. We’re hiding behind what has become an institutionalized hazard- the wide social acceptance and even encouragement of being a drunk. Yep, let’s call a spade a spade. At the end of the day, there’s nothing amusing about drinking Chardonnay from your child’s sippy cup, or getting plastered at a meeting on women’s leadership, or holding a three-martini playdate. Sex in the City isn’t all it’s cracked up to be (trust me, I lived it), you’re not really wittier three sheets to the wind, and Joan Crawford was a horrible lady. You, my dear, are worth far more than any of these played out stereotypes. Perrier, anyone? We have a lot to chat about. 

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