Live Sensibly (with alcohol): Glossary Page, Oldest First

SMART Recovery®

An abstinence-based program for moving beyond problem drinking:

From A SMART Recovery website - Helping Individuals Help Themselves:

Our Purpose:

To support individuals who have chosen to abstain, or are considering abstinence from any type of addictive behaviors (substances or activities), by teaching how to change self-defeating thinking, emotions, and actions; and to work towards long-term satisfactions and quality of life.

Our Approach:

• Teaches self-empowerment and self-reliance.
• Works on addictions/compulsions as complex maladaptive behaviors with possible physiological factors.
• Teaches tools and techniques for self-directed change.
• Encourages individuals to recover and live satisfying lives.
• Meetings are educational and include open discussions.
• Advocates the appropriate use of prescribed medications and psychological treatments.
• Evolves as scientific knowledge evolves.

-Glossary Intro

The words we use tell a lot about us.

Sensibility and Precision

In order to live sensibly, we need a sensible, precise vocabulary: Honest, direct, pragmatic.

Did you know that the word binge has evolved dramatically in recent years? That the thresholds used to define moderate and problematic drinking vary? That diagnostic criteria focus on alcohol abuse and dependence, and shy away from the term alcoholism?

Fresh words, fresh lives

Developing fresh ways of living requires that we also put new words to work, and tune up our usage of familiar ones.

We’ll keep track of those things here in the glossary. You’ll notice that each entry in the glossary is labeled with the date created and the most recent date updated. Definitions will be tuned up as we go, and I’ll cross-link them with our conversations to put them in context.

Abs

Short for abstinence. Can be used to describe a period of time planned to be alcohol-free: A 30 day abs.

Ambivalence

From the Merriam-Webster Online Dictionary:

noun

1. Simultaneous and contradictory attitudes or feelings (as attraction and repulsion) toward an object, person, or action
2. a : continual fluctuation (as between one thing and its opposite) b : uncertainty as to which approach to follow

For some, ambivalence is synonymous with being uncommitted, doubtful, unconscious of, or hiding from one’s problems — the second definition.

In facing issues related to drinking, many of us learn to value our ambivalence in the context of the first definition. We treat it as an earthy, grounded, conscious place to be, opening us up to looking honestly at the good, the bad, and the neutral aspects of alcohol in our lives.

During my first abs in 2000, I spent time examining my relationship with alcohol. I had been hesitant to admit that there are things I really enjoy about drinking, worried that such an admission might be proof of dependence on alcohol.

Embracing my ambivalence meant fully appreciating both the benefits and drawbacks of different kinds of drinking experiences, and that enjoying the benefits didn’t mean that I was denying the drawbacks.

30 days of abstinence

One of Moderation Management’s recommendations is that taking a 30-day break from drinking can provide a window in which to examine one’s relationship with alcohol.

That’s the way it’s worked for me. My first abs in 2000 opened my eyes to fresh concepts. It challenged me to try out simple tools and techniques (related to living, not just drinking or abstaining) that were new to me.

Doing 30 days of abs is not a magic bullet, though. It didn’t magically erase the challenges I face in living sensibly with alcohol. It provided the foundation, though.

Worth noting about doing a 30:

• We’re not all geared to jumping immediately into a 30
• It’s smart to plan ahead: What kinds of tools, activities, alternatives and contingencies are going to be used during a 30?
• Shorter or longer abs are great, too. (I’ve done a couple 30s, a 110, and a 99% abs — 361/365 days — year.)
• Doing a 30 has the potential to bring cool gifts along with the challenges.
• It’s OK to admit that we’re not yet ready to jump into a 30 even if it sounds like a good idea. We may be in an early stage of preparing to change. It’s important to examine whatever ambivalence we may be feeling, and work with it and through it.
• When we’re not yet ready to jump into a 30, we can prepare for it by charting, reducing harm, and increasing the frequency of DAFT days.

12-step

The twelve steps originally devised by the founders of Alcoholics Anonymous, variations of which are used widely by other addiction and compulsion support groups.

Within Live Sensibly, “12-step” refers to a general approach that includes the disease model, powerlessness to moderate the addictive behavior, the necessity of a spiritual response, and a need for life-long abstinence and support.

Al-Anon

A support group for the families and friends of alcoholics.

From the Al-Anon/Alateen website:

Al-Anon’s Purpose

To help families and friends of alcoholics recover from the effects of living with the problem drinking of a relative or friend. Similarly, Alateen is our recovery program for young people. Alateen groups are sponsored by Al-Anon members.

Our program of recovery is adapted from Alcoholics Anonymous and is based upon the Twelve Steps, Twelve Traditions, and Twelve Concepts of Service.

MM: Moderation Management

A group for and by people who are concerned about their drinking.

From the MM page page titled What is MM:

What is Moderation Management?

Moderation Management (MM) is a behavioral change program and national support group network for people concerned about their drinking and who desire to make positive lifestyle changes. MM empowers individuals to accept personal responsibility for choosing and maintaining their own path, whether moderation or abstinence. MM promotes early self-recognition of risky drinking behavior, when moderate drinking is a more easily achievable goal.

What does MM offer?

A supportive mutual-help environment that encourages people who are concerned about their drinking to take action to cut back or quit drinking before drinking problems become severe.

A nine-step professionally reviewed program, which provides information about alcohol, moderate drinking guidelines and limits, drink monitoring exercises, goal setting techniques, and self-management strategies.

As a major part of the program, members also use the nine steps to find balance and moderation in many other areas of their lives, one small step at a time.

SOS: Secular Organizations for Sobriety

An abstinence-based program which is independent of spiritual approaches. From the SOS website:

What Is SOS?

SOS is an alternative recovery method for those alcoholics or drug addicts who are uncomfortable with the spiritual content of widely available 12-Step programs. SOS takes a reasonable, secular approach to recovery and maintains that sobriety is a separate issue from religion or spirituality. SOS credits the individual for achieving and maintaining his or her own sobriety, without reliance on any “Higher Power.” SOS respects recovery in any form regardless of the path by which it is achieved. It is not opposed to or in competition with any other recovery programs.

SOS supports healthy skepticism and encourages the use of the scientific method to understand alcoholism.

The SOS Groups

SOS is a non-profit network of autonomous, non-professional local groups dedicated solely to helping individuals achieve and maintain sobriety. There are groups meeting in many cities throughout the country.

All those who sincerely seek sobriety are welcome as members in any SOS Group. SOS is not a spin-off of any religious group. There is no hidden agenda, as SOS is concerned with sobriety, not religiosity. SOS seeks only to promote sobriety amongst those who suffer from alcoholism or other drug addictions. As a group, SOS has no opinion on outside matters and does not wish to become entangled in outside controversy.

Although sobriety is an individual responsibility, life does not have to be faced alone. The support of other alcoholics and addicts is a vital adjunct to recovery. In SOS, members share experiences, insights, information, strength, and encouragement in friendly, honest, anonymous, and supportive group meetings. To avoid unnecessary entanglements, each SOS group is self-supporting through contributions from its members and refuses outside support.

DAFT

Delightfully Alcohol-Free Today.

My personal word for describing abstinent days. They’re often about feeling free from needing to be a somber, responsible adult. To me, a DAFT day is generally more a gift than a burden.

Any number of “D” words may fit, as well: Deliciously, deliriously, delectably, daintily…

See the how the word came to be, in So Bored? and More DAFT than sober.

MM Meetings

Moderation Management’s face-to-face meetings.

Peer support and information-sharing gatherings for people who are concerned about their drinking.

Synopsis of typical meetings (see the full outline at Moderation.org):

• Opening Statement. Welcome… group consists of folks concerned about drinking… members don’t diagnose, treat, or judge each other… importance of individual choice.
• Ground Rules. Confidentiality… respect and tolerance… share experience and knowledge, avoid giving advice.
• Nine Steps. Meetings or online groups… abstain for 30 days… examine drinking’s effects… set personal life priorities… examine drinking behavior… learn MM guidelines and limits… set personal limits and take weekly steps… review progress & goals… continue as needed.
• Moderate Drinker Description. Enjoys a drink… relaxes without alcohol, too… avoids excessive drinking… doesn’t drink secretly or obsess about drinking.
• MM Limits. Obey drinking/driving laws… don’t endanger self/others… abstain 3-4 days/week… no more than 3/day, 9/week for women, 4/day, 14/week for men… avoid BAC in excess of .055%.
• Closing Statement.

Meetings are designed to include time for folks to talk about where they’re at, ask for feedback or ideas, and share their targets for the coming week.

Meetings are free and open to all; members are asked to contribute a small amount to offset costs of meeting space.

BAC: Blood Alcohol Content

Blood Alcohol Content (BAC) is the concentration of alcohol in a person’s blood.

Blood Alcohol Units

In the U.S., the most common gauge for measuring BAC is the concentration measured by volume as a percentage. A blood alcohol level of .08 percent (too impaired to drive in most states) means that 8 parts per 10,000 in the blood is alcohol. It may be abbreviated BAC% or %BAC.

Another common measure is percentage by weight, or grams of alcohol per 100 milliliters of blood, sometimes noted as g/100ml. Although blood alcohol test results are often described as a percentage by volume, most of the instruments used to determine it actually measure the weight.

The difference between percentage by weight and by volume is inconsequential for most of us, because they produce the same numbers. A BAC of 0.05% by volume is the same as 0.05 mg/ml.

BAC may also be given as mg%, which is similar to g/100ml. A level of 0.05% could be listed as 050 mg%.

Alcohol Metabolism Rates

HowStuffWorks.com briefly highlights how alcohol is metabolized:

Once absorbed by the bloodstream, the alcohol leaves the body in three ways:

• The kidney eliminates 5 percent of alcohol in the urine.
• The lungs exhale 5 percent of alcohol, which can be detected by breathalyzer devices.
• The liver chemically breaks down the remaining alcohol into acetic acid.

As a rule of thumb, an average person can eliminate 0.5 oz (15 ml) of alcohol per hour. So, it would take approximately one hour to eliminate the alcohol from a 12 oz (355 ml) can of beer.

BAC Charts

Moderation Management has a set of charts for approximating BAC based on our gender (male & female bodies metabolize alcohol differently), size, amount consumed, and elapsed time. The units used in the MM charts are “mg%”; a level of 080 there is the same as a BAC% of .08, the threshold at which most U.S. states prosecute for driving under the influence (DUI).

Comparing the one-hour-to-eliminate-one-drink rule to the MM charts, though, it appears the “average” person in question is 200-pound male or a 240-pound female, because if either of them has 3 drinks over 3 hours, their BAC will be under .01. A 120-pound woman is still going to be at .015 after consuming 3 drinks in a 6-hour period, and 160-pound man is likely to be at .012 after having 4 drinks in a 5-hour period.

Effects of alcohol based on BAC levels

The BRAD21.org website — Be Responsible About Drinking — was created by friends and family of Bradley McCue, who died of alcohol poisoning at 21. It includes a page which lays out the effects of alcohol, noting that “some users may become intoxicated at a much lower Blood Alcohol Concentration (BAC) level than is shown”.

WFS: Women For Sobriety

A non-profit organization dedicated to helping women overcome alcoholism and other addictions (per the WFS home page).

From the WFS site’s introduction page:

Why A Program For Women Only?

Until the founding of WFS, it was assumed that any program for recovery from alcoholism would work equally well for women as for men.

When it became obvious that recovery rates for male alcoholics were higher than for females, it was then declared that women were harder to treat and were less cooperative than male alcoholics.

WFS came forth with the belief that women alcoholics require a different kind of program in recovery than the kinds of programs used for male alcoholics.

The success of the WFS “New Life” Program has shown this to be true. Although the physiological recovery from alcoholism is the same for both sexes, the psychological (emotional) needs for women are very different in recovery from those of the male alcoholic.

Powerlessness

The first of the Twelve Steps of Alcoholics Anonymous is:

1. We admitted we were powerless over alcohol — that our lives had become unmanageable.

As described in A.A.’s message of hope page, powerlessness is equated with an inability to assert control over drinking:

Before … people came to A.A., most of them had tried to control their drinking on their own and, only after repeated unsuccessful efforts at such control, finally admitted that they were powerless over alcohol.

The Big Book of A.A., while introducing the 12 Steps in Chapter 5: How It Works, notes:

Remember that we deal with alcohol — cunning, baffling, powerful! Without help it is too much for us.

For Bill W. and the early members of A.A., recovery required them to name alcohol as powerful and themselves powerless, needing to give up their power to something outside themselves. Bill didn’t appear to qualify the powerlessness concept, either, following the “cunning, baffling, powerful” message with:

Half measures availed us nothing. We stood at the turning point. We asked His protection and care with complete abandon.

Over time, though, multiple interpretations of and responses to powerlessness have emerged.

Powerlessness, Broadly Speaking

James J. Messina, Ph.D., & Constance M. Messina, Ph.D. offer a broad (2,000+ word) definition of powerlessness at their Coping.org site, excerpted here:

Powerlessness is:

• Being out of control, unable to regain control.
• Lack of control over how others will treat or act towards you.
• Lack of control over jobs, schools, weather, acts of God.
• Inability to change compulsive behaviors despite repeated attempts.
• Impulsive, addictive, compulsive behaviors beyond control.
• Lack of ability to cure AIDS, bring back a loved one who has died.

They point to consequences of not accepting powerlessness ranging from simple frustrations and self-pride to forgetting that one is a human being. Their suggestions for coping with powerlessness point several times to the corresponding need for a higher power.

Narrowing the Definition

Not all 12-step proponents interpret powerlessness as broadly as the Messinas. Freelance writer Anne Wayman self-published Powerfully Recovered, which affirms the 12 Steps while adapting them somewhat. For her, the first step is a powerful action to take. She describes the admission of powerlessness as:

…the total, unrestricted acceptance that, by ourselves, we cannot behave in a normal manner. It’s “hitting bottom” and it’s the place of humility that allows us to accept the help a 12 Step Program offers.

She continues:

Notice, however, that Step 1 says our powerlessness is only about our addiction. The 1st Step doesn’t say we are powerless over anything else but our addictive drug or behavior. Then the Step makes clear that our lives are a mess because of the addiction.

These distinctions are important because taking the 1st Step is indeed a powerful action. The admission and acceptance of our need for help is, in fact, probably the most powerful positive action we can take on our own behalf.

Admittedly, this is not the usual way Step 1 is talked about in most meetings today. The prevailing view is that as recovering addicts we are powerless forever, over everything. But this is a myth that has grown up in the Fellowship over time, and it’s truly sloppy thinking and far from what the founders intended.

I suspect the reasons behind the myth of Perpetual Powerlessness comes from fear of relapse (a fear we’re promised we don’t need to have IF we follow the Steps) and the recognition that many of us do need a good dose of humility.

Powerless to Drink Moderately

For some folks, the best application of powerlessness is to conclude that it is within their personal power to choose not to have the first drink, but that they are unable to drink moderately after. Somewhere along the line, whether after the first sip, or the first drink, or the third, the ability is lost to exert conscious control over stopping.

Asserting Personal Power and Responsibility

Albert Ellis, Ph.D. developed Rational Emotive Behavior Therapy (REBT), defined as:

an action-oriented therapeutic approach that stimulates emotional growth by teaching people to replace their self-defeating thoughts, feelings and actions with new and more effective ones. REBT teaches individuals to be responsible for their own emotions and gives them the power to change and overcome their unhealthy behaviors that interfere with their ability to function and enjoy life.

In 1992 he collaborated with Emmett Velten, Ph.D. in writing When AA Doesn’t Work for You: Rational Steps to Quitting Alcohol. On page 42, they question the disease model of alcoholism:

This attitude — it’s not my fault or my responsibility — often causes more misbehavior. It damages the fabric of our society because it helps people avoid answering for their poor behavior.

If you see yourself as having internal control, you assume responsibility for your behavior — good, bad or indifferent. If you see yourself as being externally controlled, you find — yes, actively find — something outside yourself to account for your behavior.

The cognitive-behavioral approach assembled by Ellis encourages folks to accept responsibility for behavior and for changing it, accept themselves as people who engage in self-defeating behaviors, and not to label themselves as losers or victims. That has been developed further by SMART Recovery®, which teaches self-empowerment and self-reliance.

Powerlessness as a Self-Fullfilling Prophecy

Echoing Ellis’ concerns, Jeffrey Schaler, Ph.D. made a presentation to the 1995 Conference for Treaty 6 First Nations of Alberta titled, Thinking About Drinking: The Power of Self-Fulfilling Prophecies:

Self-efficacy is people’s confidence in their ability to achieve a specific goal in a specific situation. For example, the more people believe in their ability to moderate their use of drugs, the more likely they will be able to moderate. The inverse is true too: The more people believe in their inability to moderate their use of drugs, the more likely they will not be able to moderate it.

Powerlessness in Perspective

So, what can we make of the powerlessness concept? In an essay at the SMART Recovery® site, Joe Milon distinguishes between powerlessness as perceiving an external locus of control — finding strength and guidance outside oneself — and SMART’s perception of an internal locus of control — looking inside oneself for strength and self-control. He notes:

Either method works well depending on the type of person you are. If one thinks most of their problems are a result of other people, places or things, then that type of person is likely to do better with an external locus of control.

If one realizes that he or she would do best to take responsibility for their own feelings, that is, they know that they create their feelings, they are likely to do better with an internal locus of control.

It helps to realize that since people are different, one may do well with an internal locus of control, external locus of control of a a combination of both.

That sounds like reasonable middle ground to me. I prefer to avoid demonizing or empowering alcohol, and yet I don’t dispute that drinking itself can impair my power to make sound decisions. If I choose long-term abstinence at some point in the future because drinking moderately seems to be beyond my reach, I don’t foresee myself calling that powerlessness, but I won’t dismiss folks who frame their challenges differently as unreasonable.

We’ve got to find our own paths with this stuff, and I support anyone who is finding the conceptual framework that leads him or her to better health and balance.

Denial

“Refusal to admit the truth or reality

(as of a statement or charge)” (per Merriam-Webster).

A more clinical description from AlcoholMD.com:

Psychological defense mechanism … includ[ing] a range of psychological maneuvers that decrease awareness of the fact that alcohol use is the cause of a person’s problems… Denial becomes an integral part of the disease and is nearly always a major obstacle to recovery. Denial in alcoholism is a complex phenomenon determined by multiple psychological and physiologic mechanisms… Denial is the reluctance or failure to attribute problems to alcohol consumption; it is often a psychological defense against acknowledging the pain caused by the problem.

The NIAAA offers a Denial Rating Scale Decision Tree. It defines a scale of denial from Level 1 (an alcohol-dependent person saying that drinking is not a problem) to Level 8 (a person connecting with his self-image as an alcoholic, knowing how easy it would be to fall back to drinking without being threatened by it).

It’s certainly possible for us to gloss over tangible negative effects that drinking may have had on us or our loved ones. (I’ve dabbled in it at times.) It’s critical for us, as responsible, self-sufficient adults, to use all of the resources at our disposal to do personal reality checks and adjust our distorted perceptions whenever possible.

The challenge in identifying denial, though, is that the word has sometimes been used to describe:

• Any resistance to a recommended treatment approach.
• Academic disagreement about the necessity of adopting powerlessness and a higher power to achieve recovery.
• Resisting 12-step approaches, or refusing to identify one’s drinking problems as a disease, even mixed with willingness to pursue long-term abstinence.
• Believing that drinking problems don’t all progress to dependence and death (which they don’t).

There is no doubt that denial can be real — it’s possible for us to short-circuit our own logic, and even for long-term alcohol abuse to contribute to that — but slinging denial allegations can also be done sloppily. Once they’ve slung it, folks often feel vindicated by the inevitable resistance expressed by their target. “You’re questioning me? You just proved my point!”

Even when some form of denial is in play, the circumstances are often more complex than a simplistic lack of consciousness or smarts. If we’re not willing or ready to face the ways in which our actions are affecting others, we may still be cognizant that our behavior patterns aren’t smart. We may not be embracing the gut-level assessment by friends or family members, yet entirely willing to admit that things are breaking and/or broken in some fashion. And, the issues on which we disagree may be founded on rational, realistic perceptions.

Presuming that denial is always a player when we’re in a pattern of less-than-optimal choices can raise the spectre of shame. “Damn it, I made another choice that I promised I wouldn’t, so there still be a huge well of denial lurking within me. How could I be that stupid?” In truth, human behavior is often complex. It is not easily understood, and our actions are based on more than simply what we know or what we don’t, what we accept or refute. Taking on shame — thinking “since I did the not-so-smart thing again, I must not be smart enough to admit the reality of the situation” — does a disservice to the complexity of our honest, sincere, yet humanly flawed lives.

Denial isn’t even a universal component of alcohol abuse. On page 33 of his 1995 book, The Natural History of Alcohol Alcoholism, Revisited, George Vaillant notes that problem drinkers have reported their drinking accurately in non-threatening circumstances.

Other researchers have found that alcoholics describe their own excessive drinking practices more accurately than their relatives describe them (Guze et al. 1963; Haberman 1966). Sobell and Sobell (1975) have also documented that the symptomatic diagnosis of alcoholism can in fact be reliably made from the patient if certain rules are followed. Subjects should be without a clouded sensorium and relatively sober at the time of interview. They should be questioned by a sophisticated interviewer who asks the “right” questions, who is not in a position to threaten the alcoholic’s right to drink, who obtains reasonable rapport, and who has time to conduct an adequate interview.

Stanton Peele and Archie Brodsky, in a 1991 article in Reason Magazine, talk about the emphasis on denial in Alcoholics Anonymous:

This proselytizing tendency, originating in the religious roots of the movement, was legitimized by the association with medicine. If alcoholism is a disease, then it must be treated — like pneumonia. Unlike people with pneumonia, however, many people identified as alcoholics don’t see themselves as sick and don’t want to be treated. According to the treatment industry, a person with a drinking or drug problem who does not recognize its nature as a disease is practicing “denial.”

In fact, denial of a drinking problem — or of the disease diagnosis and A.A. remedy — has come to be a defining characteristic of the disease. But indiscriminate use of the denial label obscures important distinctions among drinkers. While people sometimes do fail to recognize and acknowledge the severity of their problems, a drinking problem does not automatically prove a person is a lifelong alcoholic. Indeed most people “mature out” of excessive, irresponsible drinking.

The disease approach uses the concept of denial not only to force people into treatment, but to justify emotional abuse within treatment.

Peele and Brodsky don’t point to denial as something that never happens or doesn’t need to be considered, but to the dangers of indiscriminate use of denial.

Emphasizing the potential, and looking intently, for signs of denial has been found to be counterproductive by some researchers. Instead, they have found it more helpful to consider the natural role of ambivalence as folks progress through the stages of change, and look for ways to increase personal motivation.

Harm Reduction

In my mind, Harm Reduction is taking steps to reduce the actual or potential harm caused by drinking. In my life, that has included drinking slower, lighter, later, and eating well before or during drinking when purely harm-free drinking has not been viable. Read more about that on this page.

As it’s worked for me, harm reduction hasn’t been an optimal long-term solution (I’d rather eliminate harm than reduce it) but it’s a great step when better answers are out of reach.

The UK Harm Reduction Alliance cites this definition from The Reduction of Drug-Related Harm, published in 1992:

Harm reduction is a term that defines policies, programmes, services and actions that work to reduce the:

• health;
• social; and
• economic

harms to:

• individuals;
• communities; and
• society

that are associated with the use of drugs.

The Canadian Centre on Substance Abuse (CCSA) identified these core principles (excerpted here) in 1996:

The main characteristics or principles of harm reduction are as follows:

• Pragmatism: Harm reduction accepts that some use of mind-altering substances is a common feature of human experience…
• Humanistic Values: The … user’s decision to [drink] is accepted as fact… No moralistic judgment is made either to condemn or to support [drinking]…
• Focus on Harms: The fact or extent of a person’s [drinking] per se is of secondary importance to the risk of harms consequent to use…
• Balancing Costs and Benefits: Some pragmatic process of … assessing the relative importance of [alcohol]-related problems, their associated harms, and costs/benefits of intervention…
• Priority of Immediate Goals: …Achieving the most immediate and realistic goals is usually viewed as first steps toward risk-free use, or, if appropriate, abstinence.

Charting

A simple but essential tool for changing a habit: Tracking the progress.

Spirituality

AA’s approach to spirituality.

From page 121 of Bill W: A Biography of Alcoholics Anonymous Cofounder Bill Wilson:

As AA sees it, alcoholism is neither a curse nor a punishment. Nor is it a sin or the product of a weak, debased, or immoral character. Alcoholism is a malady that, in its essence, is a soul sickness, one that causes a kind of spiritual eclipse. Relief can come suddenly, as in Bill W’s case, or through a gradual process, which is the path AA’s Twelve Steps attempt to define. Healing is characterized by a reconnection with one’s spiritual, and benevolent, nature, coupled with an awareness of the universe as a spiritual place, to which we are all profoundly and positively connected.

An alternate approach from an Episcopal priest.

The perspectives of some spiritually-oriented folks who work with problem drinkers are relatively nuanced. Father Leo Booth contributed an essay to Spirituality and Chemical Dependency titled “A New Understanding of Spirituality”. On pages 10-12, he said:

There is a lot of confusion about the difference between the powerlessness of addiction and the corresponding need to let go of control which permits recovery, and spiritual empowerment which puts people in charge of the changes in their lives… The myths about spirituality and dysfunctional religious messages have given people the idea that powerlessness equals helplessness…

…Nearly everything in our religious and inspirational teachings tells us we are little children who must be guided, fixed, rescued — that if we do something good, God did it for us — we’re only capable of making mistakes.

This creates a different kind of unmanageability — the kind which grows from a belief that we have no control over our lives — that we must constantly look to someone who can do it for us…

Real spiritual power comes from what I call a co-creatorship with God — a partnership which signifies equality and balance of power.

…Step Three (turning our will and lives over to the care of our Higher Power) isn’t about handing our will and our lives over to a Spiritual Power who is now going to call all the shots. It’s about making the decision to change… It involves developing a relationship with a support group of guides who can dialogue with us about what action to take to effect that change. This is an adult relationship with God.

Explicity religious approaches

Some spiritual approaches are geared specifically to religious practics:

• JACS (Jewish) Spirituality Pages.
• Alcoholics Victorious (Christian) Creed.

Non-spiritual options.

Others groups, like SOS and SMART Recovery® to name a couple, take a non-spiritual approach to recovery.

Bottom line: No simple definitions.

Spirituality, naturally, defies simple definition. It’s no surprise, amidst a wide spectrum of spiritual heritage and experiences, that some of us knit spirituality into every part of our lives, some of us do not, and all of us make valid, heartfelt choices.

Willpower

Willpower: From the Dictionaries

The definition of “willpower” wins a brevity award at M-W.com:

Energetic determination.

The Rosetta Edition of Webster’s Online Dictionary takes a slightly different tack:

Control of one’s behavior.

Synonyms: self-command (n), self-control (n), self-will (n).

The WordNet 2.0 dictionary database hosted by Princeton lists one sense for willpower:

self-control, self-possession, possession, willpower, self-command, self-will — (the trait of resolutely controlling your own behavior)

Twelve-Step Approaches: Willpower is Not Enough

Arnold Washton and Donna Boundy captured one of the memes I remember from the 1980s in the title of their 1989 book, Willpower’s Not Enough: Recovering from Addictions of Every Kind. In the introduction, they summarize:

Willpower isn’t enough because it springs from the very thinking that causes the addiction — the belief that there is a “quick-fix” to everything and that if we just exert enough control we can avoid all pain and discomfort… when we try to break an addiction we [also] … think, “There’s got to be an easy way.”

Using willpower alone to break an addiction is what’s called “first-order change.” It never works very well because the “solution” comes out of the same mindset as the problem. When an addict has already lost control over her use of a mood-changer, how can yet another attempt at controlling it be a lasting solution?

In “second-order change” the problem — and the solution — are reframed within a different set of concepts and beliefs. Second-order change for addiction means not trying harder to control the addiction, but throwing up your hands and admitting defeat — admitting that you are not in control.

This thinking can be traced back to Bill W’s framing of his recovery, as described on page 154 of Bill W: My First 40 Years:

It was not daylight-clear why the clergymen’s advice “You can do it, but only with God’s help” hadn’t worked. By contrast, Rowland, Ebby, and I had admitted that we of ourselves couldn’t do anything at all. Nearly all the cases cited by Professor James had made the same admission… The sociologists and psychologist who would restore self-confidence had been mistaken. God-confidence was the thing, not self-confidence.

Seeds of Willpower: Self-reliance

While that sense of giving up self-confidence ultimately worked for Bill and others within A.A., there are also folks like Father Leo Booth who take an approach that emphasizes making decisions to change and taking conscious action in the context of what Booth calls “an adult relationship with God.”

From a psychoanalytic perspective, psychiatrist Lance Dodes names “You Need To Surrender” as the fourth of ten Myths of Addiction. On page 95 of The Heart of Addiction, he expands on that myth:

The idea that you must surrender your will before you can give up your addiction arose from … Step Three [of the 12 Steps]. This step is based … on the belief that, “Our whole trouble had been the misuse of will power.” …

While some people can make use of this idea, it is clearly not for everyone. … [T]he appropriate solution is not to shamefully admit that you cannot manage your life, but to take over more management of your life — by understanding yourself and your addiction better so you can use that understanding to take power more directly in the place of the addiction. The last thing you want to do is give up taking control of your life.

Willpower: A Good Start

So, what can we do to make positive, coherent sense of the willpower concept? I like the answers offered by Prochaska, Norcross, and DiClemente in their 1994 book, Changing For Good. After studying thousands of folks who made significant changes in their own behavior, they laid out four myths which can “keep us from freeing ourselves from self-defeating behaviors.” Here is the second one, from page 61:

Myth: It just takes willpower [to create self-change].

When we ask successful changers, “How did you do it?” the universal answer is, “Willpower.” Our research seemed to confirm what everybody already knew. When we examine what “willpower” means to people, however, two different definitions are given. The first is technical: a belief in our abilities to change behavior, and the decision to act on that belief.

The second, sweeping definition is that willpower represents every single technique, every effort under the sun, one can use in order to change. If this is so, then it is inevitable that it takes willpower to change. This is a classic case of circular reasoning.

Self-changers do indeed use willpower in the first, true sense of the word, but it is only one of nine change processes, the one we call commitment. People who rely solely upon willpower set themselves up for failure. If you believe willpower is all it takes, then you try to change and fail, it seems reasonable to conclude that you don’t have enough willpower. This may lead you to give up. But failure to change when relying only on willpower just means that willpower alone is not enough.

Putting the Pieces Together

So, are you as dizzy as I am yet? Depending on the dictionary, you could say that willpower is about tenacity or about control. A strict reading of 12-step spirituality says willpower is suspect, and yet a priest who uses the same steps insists on taking responsibility and action. An analyst challenges us to manage life better, but of course long-recovering AA folks are doing the same on many fronts. What gives?

Did you notice that the 12-steppers and the self-changers ended up agreeing on something, though? They both say that willpower is not enough, each with their own reasons. And, the dictionary folks echo the self-changers in finding divergent ways to name it.

Seems to me the primary issue is that willpower is often a fuzzy target, not a foundation, easy to knock down like a straw man, but that its self-reliant, committed core is the theme that folks who are successful in any endeavor end up embracing in their own way.

Skillpower

How are skills developed?

• Practicing?
• Coaching?
• Training?
• Toning muscle?
• Tuning?
• Strength?
• Agility?
• Studying?

Perhaps, all of the above, or any number of combinations and permutations of the above?

Withdrawal Symptoms

From WebMD:

Withdrawal is an uncomfortable physical or psychological change that occurs when the body is deprived of alcohol or drugs that it is accustomed to getting. Symptoms of withdrawal are caused by decreased amounts of a substance in the blood or tissues of a person who has grown accustomed to prolonged heavy use and who then suddenly stops using or drastically reduces the amount of that substance.

Symptoms of alcohol withdrawal begin from 4 to 12 hours after you cut down or stop drinking or as long as several days after your last drink. The symptoms can last a few days and may include:

• Nausea or vomiting.
• Sweating.
• Shakiness.
• Anxiety.

In severe cases, delirium tremens, or DTs, can bring tremors, hallucinations, and seizures.

Bottom line: It’s a medical condition, can be life-threatening, and requires immediate medical treatment.

Harm Reduction Psychotherapy

From the Harm Reduction Therapy Center’s (HRTC) home page:

Harm Reduction Psychotherapy is based on the belief that substance abuse develops in each individual from a unique interaction of biological, psychological, and social factors.

Harm Reduction Psychotherapy is a non-judgmental approach to helping substance users reduce the negative impact of drugs and alcohol in their lives. It respects that people use drugs for reasons. It addresses the complex relationship that people develop with drugs and alcohol. Drug and alcohol issues are addressed simultaneously with social and occupational concerns and psychological and emotional issues.

The HRTC’s About page identifies the target audience for Harm Reduction Therapy:

Harm Reduction Therapy is suited for anyone who:

• is questioning whether their use of drugs and alcohol is a problem.
• has tried abstinence-based approaches and found them to be ineffective or undesirable.
• relapses frequently after attempts to be clean and sober.
• also suffers from emotional or psychiatric problems and wants help with these issues simultaneously.
• prefers an alternative way of thinking about their drug use.

Big Book of AA

The foundational book of AA, titled Alcoholics Anonymous.

The entire book is available online.

Alcoholics Victorious

A Christian recovery group.

From its home page:

Founded in 1948, Alcoholics Victorious support groups offer a safe environment where recovering people who recognize Jesus Christ as their “Higher Power” gather together and share their experience, strength and hope. Both the 12 Steps and the Alcoholics Victorious Creed are used at most AV meetings.