Category Archives: alcohol

Believe that there is more to you

It is a sad and common theme.

A person is struggling: with an addiction, or obsessions and compulsions, or moral injury, or the impact of trauma, and has come to a place where the sense of self has been entirely subsumed by the problem and its pain.

The definition of self becomes “the addiction,” or “the monster who did (whatever has led to moral injury)” or “the mental disorder diagnosis.”

And, of course, as a therapist, I believe it is critical to address mental health troubles with the best of the science we have, with the particular approaches suited, as discerned ongoing, with the specific needs of that client.

But I also believe that a parallel need is extant and urgent: the need for this person, who is suffering, to come back to an awareness of self as a deeply beloved child of God. Not generically loved, like we may say that we “love” some food or activity or type of animal – but particular, personal, and intense.  Women who, like me, have been blessed to give birth will recall that wild wave of emotion that engulfs us when we meet that little person face-to-face after the peculiar intimacy of pregnancy. It makes us irrationally jealous of everyone and anyone; what mother doesn’t remember resenting the nurses and physicians who separated us from the baby long enough to do the general assessments and necessary care? Well, that is a reflection God’s love for each person.

If a person who is suffering is willing to enter into, and do, the hard work of therapy, which will include lifestyle changes and “homework,” and also becomes open to reconsidering his or her existence as a deeply loved person, someone who is more than the addiction, or bad choices, or terrifying memories, or intrusive thoughts and painful compulsions, then true and deep healing can happen.  This is what I would wish for every person struggling with emotional wounds.

Loneliness can kill you…Part 1

According to new research from the journal Nature, Human Behavior published on January 3, 2025, loneliness and social isolation lead to molecular changes that, in my simple terms, seem to set the body up for serious problems – increased risk for dementia, depression, cardiovascular disease, diabetes, stroke, and early death.  The researchers’ recommendations include routinely asking about loneliness and isolation, the way a health professional asks about sleep habits, alcohol use, and drug use.

If you are lonely on an ongoing basis, this is for you.

Loneliness can strike through no fault of one’s own.

Losing your spouse, for example, or a best friend, will almost inevitably lead to a long stretch of deep loneliness during the initial year or so of grief, and can continue beyond, as the bereaved person struggles to outsource some of that emotional, intellectual and spiritual intimacy to other relationships. In a healthy marriage, you share all sorts of confidences with a spouse that you simply might not share with anyone else – fears, dreams for the future, spiritual insights and struggles, and the warmth of shared memories that are no one else’s but the two of yours.  Somehow, some of that must be extended to others, and depth built over time. It an absolutely monumental task to parcel out these small slices of the immeasurable depth of a healthy marriage.

Moving, alone, to a new city, for a new job, can be exciting, but the reality can include aching loneliness when everyone at the new job goes home to their lives and you go to your apartment and try to figure out how to build a life. Developing the big, and small, connections that make a place feel like home can be daunting, and for most people, it takes longer than they had ever anticipated.

Loneliness hits other people, too. Those who are living primarily second-hand, separated by screens and trying to substitute electronic connections for human ones, are often intensely lonely. Some people interact with others in person, but the conversations are shallow, guarded and therefore nearly empty of connection and meaning. This type of loneliness can be even more painful, because it seems inexplicable; how can a person live with family or a partner and yet feel deeply lonely?

So, what to do? Unfortunately, the impetus is mostly on the lonely people to do something differently.

Here are some suggestions I would give to a client in such a situation.

  1. Go to church or synagogue. If you are grieving, try to go back to your own – but if that’s painful, go somewhere else, at least for now. If you are new to the area, just find a place that seems like a possibility. Then go to the hospitality time afterwards. Introduce yourself, and invite people to tell you about the faith community. Do not stand around with your cup of coffee and wait for people to notice you. Set a goal: perhaps that you will introduce yourself to three people, get their names, and ask a little about this community. See what happens. Try to focus on the other person; make the conversation a chance to get to know them and about their community – not about you. If it goes fairly well, go back the next week, greet those three people (and anyone else you met) by name if you can, re-introduce yourself without taking them forgetting your name personally, and see if you can meet a couple of other people. Within a month, you will have some acquaintance with a dozen or more people and have a solid idea if this community offers activities for education, worship and service for you to join.
  2. Even if you usually like to do things solo join at least one activity – one exercise class, one art class, one talk at the local bookstore, etc. – on a regular basis. Get to be a regular. Greet other people.
  3. Volunteer in your community. Do this with others. Doing good solo is beautiful, but if you’re not getting out of your head and focused on others in an interactive way, you are missing part of the point.
  4. Be friendly but don’t try to bully people into being your friends. For example, if you are new to the area, don’t wear out your welcome with the neighbors who came over to introduce themselves on moving day.
  5. Please do not use alcohol or other substances, or resort to hanging out having drinks as a way to cut loneliness.
  6. Be patient and keep trying! Think of these steps as experiments. Track what happens over time; be willing to change to a different experiment if the first one isn’t working after a month or so.

As you can see, the remedies for loneliness all include getting out of your head and into the world. Focusing on others, in small ways (such as greeting them and showing interest) to big ones (such as volunteering), is a critical part of overcoming loneliness. This can be really hard, because loneliness tends to make people even more withdrawn, more insular – it is a self-perpetuating problem unless you boldly step out, even with small but courageous steps, into focus on others.

More about connecting with others in Loneliness can Kill You, Part 2, coming soon.

Stress…And a Lesson From Cognitive Behavioral Therapy for Insomnia

Cognitive Behavioral Therapy for Insomnia (CBTi) helps people with insomnia via examining and, where appropriate, helping them change their behaviors and thoughts surrounding the issue of sleep.  One important factor we explore are called “Sleep Safety Behaviors.” These are habits which people believe are helpful for sleep.  Some sleep safety behaviors are in fact very helpful, such as avoiding screens for a couple of hours before bedtime, using soft, warm light sources in the evening, and avoiding upsetting discussions before bedtime. Other sleep safety behaviors are counter-productive, but if a person is convinced that they are helpful the anxiety around giving them up ends up disrupting the process of falling or staying asleep. The objective is to have positive habits around sleep, not unhelpful sleep safety behaviors. It is not as easy or obvious as it might sound.

For example, many people use alcohol as a type of sleep safety behavior. They believe it helps them relax and unwind, and seem to either not know, or disregard, that it actually is a sleep disruptor. Alcohol-fueled sleep usually involves waking up in the middle of the night as the effects of alcohol wear off. It also disrupts the quality of sleep. However, the person convinced that they “need” a drink to sleep may become so anxious about going without the drink that they have difficulty falling asleep, which they attribute (wrongly) to the absence of alcohol.

In the same way, don’t most people have some sort of “stress safety behaviors” to cope with stressful situations or extended times of stress? Some are helpful and constructive, and others are terribly unhelpful and even destructive.  Some are fairly neutral until taken to excess; an ounce or so of chocolate as a snack is one thing; a pound is another. Odds are, you know someone who clings to a stress safety behavior even though it is clear as day that it is unhelpful and even harmful. You may have encountered the futility of trying to convince the person that the extra drinks, the avoidance, the angry outbursts to vent over and over, merely get in the way.

Imagine a person for whom life has delivered a set of one-two punches – illness, a hurricane or two, unexpected car repairs. There are all sorts of paperwork and bills to tackle, and after a long day of work it is all too much. He takes an evening off to binge watch a favorite series, and then, the next day, everything is one more day behind, one more day piled up, and even more overwhelming – too much to be tackled, again, after a long and wearying day. Surely there is a half a season or so of something that will distract from the looming piles of paper.

Perhaps the person doesn’t binge-watch. Perhaps she enjoys a glass of wine, or two, or three, or, heck, why leave only one glass in the bottle? She adds poor sleep and the three days it takes for the full effect of alcohol to leave the brain to the problems still piling up on the table. Perhaps he gets caught up in a vortex of videos about things he cannot afford – certainly not at this moment – and adds envy and resentment to the problems at hand.

Odds are, too, you know people who have some good “stress safety behaviors.” Those habits reinforce resilience. You might notice some people seem to surf through the ups and downs of stressful times without falling apart or adding to the trouble at hand. If you are that someone, that’s wonderful; stick with it. If you know some people like that, but are not one yourself, perhaps you might give some positive stress safety behaviors a try.

If I were making an official list of Stress Safety Behaviors (which I am not at the moment), I’d probably include these:

Sleep: getting regular and adequate sleep – not feast or famine approaches to the weekly rotation, where you pretend you can “get by” on four hours during the workweek and really make it all up to your brain with a long sleep on Saturday.

Move regularly and adequately. Exercise, appropriate to your overall health and physician’s guidance, is essential. The machine needs regular movement to function properly.

Limit exposure to negative influences. Don’t feed your envy, your insecurities, or your bad habits.

Minimize exposure to media and people that encourage you to compare yourself to other people.  Do you think it’s a coincidence that so many magazines and websites feature articles about improving oneself – and a surfeit of advertisements for products that will, in theory, improve those things?

Treat Sabbath time seriously. Set aside one day each week for renewal. Pray, rest, read, enjoy time with family and friends, play, create.

Journal. There are lots of ways to journal. There’s the quick “5 things you’re grateful for” at bedtime journal. There are prayer journals and journals that are brief paragraphs on the events of the day. Maybe it’s that annoying journal assignment your therapist gave you. The act of writing – more than just “thinking about it” – brings more of your brain into the process. This way, for example, you benefit more from noticing good moments during the day, recollecting them in the evening, writing them down, and seeing your words on the page.

Positive stress safety behaviors are simple, common sense…but they can appear to be just one more thing to keep you from getting things done. If you think, for example, that a short walk is just a waste of time, that you’d be better off using those fifteen minutes for the big mess at hand, well, that might be true if that were, in fact, what would happen. But if the thing that would actually happen was a big sigh or a venting of angry frustration and the welcome distraction of a text message from a friend – well, then, the short walk to breathe deeply, move quickly and focus yourself for action might be less of a time-waster than it seemed.

If you’ve taken a look at the task manager window on your computer, you know there are dozens of programs running even though you may be only engaged in one. Start clicking on random programs to turn them off and watch the warnings pop up that this will interfere with the proper functioning of the computer. It’s the same with these sleep and stress safety behaviors. The people who do these things do them consistently, even when things are smooth and rolling along just fine.  These habits operate like a background program, always running. They keep the system working properly but without a big fuss. Turn off, or pause, those background programs and the system stops working properly, or perhaps just shuts down entirely.

Even good programs need updates. Taking that weekly break gives you a chance to notice if you need to make changes to the routine. Ignoring necessary updates usually makes the whole system a bit glitchy.

7 Things to do When Life Is Crazy

Sometimes, life just goes horribly sidewise.  This week, like most weeks, I spent time with people who have lost their homes to natural disasters, lost their job, had loved ones die, and sometimes are grappling with multiple serious problems.  The world seems crazy, you can feel like you’re going mad, and it is oh-so-easy to slide into attempts to numb the pain that are ultimately harmful.

It’s easy to advise people on what NOT to do – don’t drink alcohol. Don’t use drugs. Don’t eat a lot of junk food. Don’t let yourself scroll through social media and/or your newsfeed for extended periods of times. It’s easier, though, to “do” than to “not do.”  Anyone who has tried to break a bad habit knows that; it’s easier to “eat an apple” than to “not smoke/drink/eat a bag of cheesy poofs the size of a pillow.”

So, here are seven things to do – and keep doing – when life is crazy

  1. Say grace. Say grace when you get to sit at a table and say grace – together – when you eating a granola bar in the shade after another few hours of trying to make sense of the debris that used to be your home.  Say grace when you are out on a hike, just about out of water, and have miles to go. G.K. Chesterton famously noted he said grace when he sat down to write, to draw, etc.  A moment of gratitude shifts the focus from the mud to the mountaintop.
  2. Put the social media/news scrolling down and, instead, watch something that will make you laugh, preferably either an episode of a sitcom or a funny movie. Why? These require sustained attention, will bring a focus on characters who have ups and downs, and have the potential to make you laugh. Laughter releases dopamine – that feel-good chemistry that helps you heal.  Make it better and share that humor break with someone else. Sharing laughter with the person you love helps that sense of connection that seems strained, or even lost, when life has gone crazy.
  3. Eat food that is good for you. Ongoing extreme stress causes havoc in your body, including your brain, and getting decent nutrition is essential to your well-being, now and later.  I did the price comparison:  a precooked chicken, a bag of salad, some fruit and a little something else healthy, for example, feeds two or four people far cheaper than most or all fast food. Your brain will thank you.
  4. Listen to music that is soothing: piano or guitar, instrumental jazz, classical, baroque:  as tempting as it may be to listen to “angry” music because you feel so angry about what’s become of your life, that will only reinforce your distress.  Let peace soak into you, however slowly it may come.
  5. Check in with other people every day. Reach out to someone to see how s/he is doing. It helps us get out of our own heads, our experiences, and feel less alone.
  6. Get outside, preferably in the morning, for natural light exposure. You don’t need to bake in the sun; just get out there. Take a walk if you can.  Early natural light helps the brain regulate the sleep/wake cycle, setting you up for a healthy rhythm of melatonin production over the course of the day.
  7. Ask God to show you where He is at work in the events of your life, because when life goes crazy, the fog can make God’s loving presence hard to detect. Ask for the grace to notice the helping hands, the kind words, the moments of clarity.

I’m sorry if life has gone crazy. It is scary, and lonely, and disorienting when disaster strikes. If you find that you are sinking, reach out for help:  call your local helpline (in Pinellas County, FL the number is 1-888-431-1998, for the new Care About Me program that helps match those in crisis with an appropriate mental health provider).  Call a friend, a family member, or, if you are feeling unsafe and considering suicide or plan to harm yourself or others, go seek immediate help via 911 or go to an emergency service location.  When life has gone crazy, it is natural to feel frightened, confused and even helpless, but remember that none of us were designed to “handle it all.” We are, in fact, designed so that our strengths are distributed so that each has something to offer but none has every gift and ability.  Please reach out for help if you feel you are sinking.

An Alcohol Dilemma

Alcohol can be a touchy subject. Addictions, generally, are frequently considered to be only something other addicts, including those in recovery, can help with.  Someone like me, who never drank regularly and now, since surgery a few years ago that included a bad anesthesia reaction, can’t drink any alcohol except, oddly, 3 or 4 ounces of Guinness on a couple of holidays each year, is automatically considered ineligible to be helpful. Despite my ineligible status, in a previous post, I included the life lesson that, for many, alcohol is not a friend.

This assertion flies in the face of much research, perhaps most famously Blue Zones data, which includes moderate alcohol use as a generally positive factor for long life. On the other hand, avoiding alcohol is well-supported by substantial research in the medical field.  Shake or stir in my non-drinker status and, well, it seems like I am a fun-killing fuddy-duddy looking for an excuse to ruin my clients’ good time.

What are the benefits of alcohol? Much research has focused in particular on resveratrol and relaxation.  There ways to get antioxidants and relaxation that don’t carry the risks of cancer, liver and brain damage, and some of the regrettable behaviors that alcohol can carry along. This might be a worthwhile topic of discussion with your healthcare provider. Eating grapes, prayer and meditation, physical activity and laughing might hit all the right keys on this.

If you are misusing alcohol – relying on it to “unwind” after the day, to “help you sleep” (it doesn’t, actually), or to get through social situations (there are ways to deal with social anxiety that don’t interfere with functioning) – please seek help. Other signs your relationship with alcohol is unhealthy? Using more than the recommended amount – 1 serving max per day for females, 2 for males. Feeling anxious if you run out, or worrying you will run out. If you worried more about stocking up with booze than water, batteries and nonperishable food for the past two hurricanes, that’s a bad sign, too. Any binge drinking is a danger sign. Binge drinking raises your blood alcohol to .08 in two hours or less, usually four or five single drinks. Any changes in your functioning at home, work, or socially are likewise danger signs. Pretending that these signs don’t apply to you is itself a sign.

Where to go for help?  Go to an AA meeting. Call a therapist. Call 866-210-1303, or 211, or another helpline. See your physician. Tell someone you trust you’re ready to make a change. Just take that first bold step towards help. There are good people eager to help you change the course of your life for the better, preferably before it becomes unmanageable.  

Random Life Lessons

Here, on a beautiful autumn day, are a few life lessons I’ve picked up on the way…perhaps one will be useful to you.

Walking in the morning, before sunrise, can lead to being stopped by law enforcement, who, upon getting a look at me from the front (wrinkles and rosary beads) say things like, “Oh. I thought you were a kid out breaking into cars.”  Wearing a reflective vest and a skort, instead of baggy gym shorts, has solved that problem. Either that or I have succeeded in looking old from behind. The lessons: be reflective and dress appropriately to the task at hand.

Don’t save special stuff for special occasions.  Eventually someone else will just throw your treasure away or it will end up, sad and dusty, on a thrift store shelf. Use it up, whether it’s that fancy cocoa mix someone gave you at Christmas or your grandmother’s crystal. Drink sweet tea out of a fancy goblet.

Not from personal experience (see a prior post about this issue) If you change your hairstyle and/or color on a regular basis, you might not be the best candidate for a tattoo. The same goes if you try to destroy or at least hide any photos of you from five or more years ago because you can’t believe you left the house looking like that.

If there is something you really want to do, and it’s realistic for you, then pick a reasonable time frame (say, one year) and reverse engineer backwards all the way to tomorrow. If you want to achieve “X” – your G.E.D., your master’s degree, a marathon, writing your first book – there will be something specific that you do and/or don’t do tomorrow that is different than yesterday. Then the next day, you will, again, do/not do something different because you have this goal. If it’s your G.E.D., and you want to pass by one year from now, then the first thing to do is look up where to go for information. Then call the place. Then go. Then decide what you will give up to make time to study. Then do that: give up some of that time to study. Learn how to study (a lot of people get to college without knowing how to study; no shaming). And study again and again. Enlist people who will encourage you because it will be hard and discouraging and there will be people who try to pull you off course.

Don’t spend time around people who discourage you when you are trying to become a better person. If you have thought things through, and realized you must change some habit or adopt a new plan for life, and wise people agree it is a good move, then be very skeptical about the motivation of people who try to interfere.

Unless you have doctor’s orders to the contrary, odds are that alcohol is not your friend. Remember when Pinot told you what a great dancer you were at your cousin’s wedding?  Or how some kind of brown liquor helped you straighten out that miscommunication with your in-laws? Yeah, not your friend. Besides, alcohol is eager to share bad things: disrupted sleep, increased risk of cancer (it’s a major factor in a number of types of cancer), dementia, prematurely aging skin and who knows what else. Disclaimer: I don’t drink and I’m not in recovery, which means this one comes from 1) observing life and 2) reading the medical research.

Be wary of people who think it is funny to scare animals. A guest who tries to frighten your cat because it’s “funny” when the cat’s fur stands on end needs to go away and not visit again. This is a red flag, no matter how “nice” you thought this person was. They exert power by terrifying others; is that nice? No. If a five-year-old could easily explain it, I shouldn’t have to say another word.

The above does not include the person who is willing to make an absolute ass of themselves trying to scare a squirrel, bunny, rat, lizard, etc., out from under their parked car so they can leave without killing it. 

Try, if you can, to be patient with people who act as if they didn’t need to let you know about something they wanted you to know about because they put it on social media. Give yourself permission to explain that you don’t spend time looking for something you ought to know on social media. Unless you do, in which case you have bigger problems, perhaps, than missing one person’s newscast.

And, in closing, bear in mind that one person’s life lesson is not necessarily yours…but then again, maybe it could be.

(Un)Social Drinking

4th in a series: I could tell you but you’re not going to like it: Social Drinking often isn’t.

Yet again, I am stepping into the fray to offer the kind of information that can be helpful but feel quite unwelcome. In this case, it’s the raw fact that, for many people, Social Drinking…isn’t.

Social drinking is one of the terms for the use of alcoholic beverages in disciplined moderation, with others: the glass of wine at dinner, the single drink at happy hour.  It means the person is not an alcoholic, and everything’s under control…but as the term is used, perhaps not.  The American Psychiatric Association has established a low bar to meet the criteria for mild Alcohol Use Disorder: these are two of the many criteria, and perhaps these two will resonate with some social drinkers:

“Alcohol is often taken in larger amounts or over a longer period than was intended” and

“Continued alcohol use despite persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of alcohol.”

In other words, if someone often drinks three glasses of wine when they meant to have just one, or plans to have “a drink” with a friend that turns into a three-hour hangout with multiple drinks, that is a marker of a potential problem. If someone uses alcohol, and then becomes argumentative with friends and/or family, or zones out in front of the television and, yet again, neglects chores or short-changes the dog’s evening walk, the so-called social drinking isn’t just social drinking. Stir in failing to get up on time for work due to a hangover, or having the alcohol cause headaches, belly aches, acid reflux or blood sugar issues, and there is a storm coming.

So, perhaps, unless your physician advises otherwise, you might do a bit of an experiment if you are a social drinker. The experiment is, no alcohol for a month; six weeks would be better. Fighting a habit takes time. Then see what happens.  If you discuss alcohol with your physician, please be honest: the health professionals’ unofficial guideline when people tell us about alcohol use is, double it, or perhaps even triple what the person tells you.

Evening alcohol use disrupts sleep; people may fall asleep more quickly but will often have sleep problems a few hours into the night.  Alcohol impacts the brain in a host of ways: it impairs balance and spatial judgment, slows physical reaction time, weakens impulse control, and interferes with cognitive functioning. It also interacts dangerously with a host of common medications, including but not limited to medications for pain, anxiety, depression, OCD, ADHD, allergies, and more; if you are on any medications, over the counter or prescription, check with your pharmacist about using alcohol with these medications.  Mixing alcohol and medication can be deadly. Perhaps during your alcohol-free weeks, you will find yourself more motivated to get up and get that morning walk or workout in; perhaps you will have fewer unproductive arguments with the people you love. At that point, it may seem that social drinking may not be social, after all.