Shared with a friend tonight...

I’ve been trying to rev myself up to put fresh stuff out there (at my site), but life has been crazy work-wise (I’m getting incredibly positive recognition for what I’ve done lately, while being paid a fraction of the value of the results I’ve produced… but millions of folks know how that feels) and I feel badly about being AWOL.

You have inspired me, though…

I just want to encourage to to keep on keeping on… I promise that I will do the same. It’s not a perfect world, nor do I want it to be, but I wish you just one moment which feels perfect to you in the next week. You’ve already given me my moment, so wishing you the same is the least I can do.

Martin's Alcoholic Diary

Martin, a 30-something guy in the vicinity of Manchester, England, has been writing a diary of his journey with alcoholism since October, 2002.

He has mentioned his drinking history prior to getting inpatient treatment in June 2002, but not dwelt not on it. Dire circumstances precipitated the hospitalization, which led to 10 weeks of sobriety.

Early months: Alcoholism as a battle

True to his introductory words about living with alcoholism being a battle, the early journal entries recounted 4-10 drinking episodes in each month from November 2002 through March 2003. Sometimes he journaled while sipping the first glass of wine; other times he recounted having drunk 2 bottles (occasionally more) a day or two afterward. Some drinking incidents, like the single glass during Christmas lunch, were less substantial and others, like those in March, were heavier and occurred on consecutive days.

Throughout it all Martin seems grounded in the need to get good care. He talks about staying in touch with his GP to coordinate anti-depressant dosage and monitor side effects, and about having a good relationship with his company doctor. When drinking incidents seemed to accelerate in March 2003, he got back in touch with the treatment facility and returned for a 3-week inpatient stay ending in early April, and continued with its aftercare program.

A full spectrum: Good life amidst the challenges

By his own account, he has sustained a rich, productive life along the way. He and his partner have had a new home built, moving in a year ago. His young daughters are the light and joy of his life. His employer has adapted, if begrudgingly at times, to his health care needs. The relationship with his partner has seen ups and downs, yet some of its dark moments have turned out to be not as severe as they first seemed to him.

The stresses have been real, as well. The relationship with his ex-wife can be contentious, turning life upside-down on top of the trials that come with being a noncustodial parent. The drinking strains the relationship with his partner, whose career-related challenges have surged at times. Conflicts with members of the extended families, familiar to many gay couples, tend to spike around holidays and celebrations of milestones.

Turning point: Second round of treatment?

The second treatment episode, ending in early April 2003, seems to mark a turning point. Prior to it there were fairly regular cravings, little mention of aftercare at the treatment facility, regular attendance at AA meetings, and 4-10 days in each of the five preceding months during which he drank. For the year beginning in late March 2003, there was only one day on which drinking occurred (a single glass of wine), heavy involvement in aftercare at the facility, fewer mentions of cravings, and a tapering back of anti-depressant dosage for a while in the fall.

Things got a little more challenging in April of this year, with 3 drinking days, and drinking has come into the picture on 6 days total from May through August.

Overall trend: Up

There appears to be a positive trend over the past two years:

Martin still describes a significant gap between where he is and where he intends to be. Keeping 95% of his days alcohol-free is noticeably better his past, but the drinking days remain disruptive to his health, his relationships, and his peace of mind. The fact remains, though, that the 17 months since April 2003 have been 98% alcohol-free.

October 2003: One glass

Seven months after the start of the second inpatient treatment, Martin bought wine and drank a glass. Finding the experience to be very distressing, he consulted the folks at the facility and elected to get relapse-related care from them on an outpatient basis over the next 10 weeks or so. Also working closely with his GP, his antidepressant dosage was adjusted, and he followed his doctor’s orders to focus on self-care, away from work, for two weeks in December.

Many phases, multiple choices and solutions

The powerful thing about Martin’s story, to me, is the reminder that dealing with alcohol-related issues is a dynamic affair. From the outside, it may look like a lot of folks find recovery through an awakening that puts life on an entirely new plane, but even for those whose recovery journeys appear placid and peaceful the path has often been rocky.

His path has included working with treatment folks, peer support from AA, and leaning on sponsors for guidance. He’s worked with Acamprosate and tried out dietary options. Some aspects of the disease concept have appeared baffling at times, but he also has asked questions (about powerlessness, for example) and gotten answers that have been helpful.

The battle remains for him. Cravings spike, and frustrations sprout on good days and bad. Being a work in progress isn’t just an addiction thing, though, it’s a life thing. For so many issues, resolution comes from a process instead of a one-time result.

Martin’s journal shows a lot of tenacity — a steadiness about continuing to engage in the recovery journey amidst questions and challenges — as well as in choosing to do so publicly. Week in, week out, he has kept coming back to talk a little bit more about where things are at. Sometimes it draws feedback that may feel a bit intrusive, but he keeps listening.

It could have been a lot easier to give it up when questions came up about his family reading it, or when things have not gone well. I admire him tremendously for sticking with it, for giving voice to a recovery path that seems to be headed in a positive direction.

This is a good guy, a fighter, a thoughtful dad, a real person. There is much for me to learn from him.

Julie R's Naltrexone Mini-Journal

Dean Esmay links to an article which reviews current and developing drug therapies.

One of the drugs, Naltrexone (Nal), has shown promise both for folks seeking to abstain permanently as well as those who are drinking moderately or working toward a moderate drinking goal. Julie R., a Moderation Management member, has journaled vividly about her recent experience with it and has graciously agreed to let me share a bit of it with you.

Her experience with it strikes me as similar to that of folks using antidepressants — some trial and error is necessary to find the best dosage, results can vary from day to day, and the drug supports, not replaces, insight and effort — and you’ll see that she describes trade-offs in using Naltrexone, as well.

Dr. Alexander DeLuca, M.D. is a great online source for papers on this topic, updated regularly as new stuff is published.

July 27 2004

I didn’t have a drink last night. It was my first abs night in months, I think. And it may be the beginning of an indefinite abs.

I preceded it the way so many abs periods start, with heavy drinking, which is actually not a very pleasant experience when you’re taking naltrexone. You keep reaching for that high, and reaching, and instead, all you get is stoned, stupid, dehydrated, and hungover. When I finally couldn’t hold anymore, I poured the rest out. When I woke up yesterday morning, I talked into a tape recorder for a while about how awful an experience it was and how much I wanted my freedom from what has become an unpleasant habit.

Thanks to naltrexone, alcohol has lost its value as a recreational drug. It took a while (I started taking it six weeks ago), and it is not an easy process, but it bloody well works if you take it as directed and have effective help for the issues underlying the drinking (sleeping, depression, neurotic fears).

I can’t remember what it feels to drink without nal. Those memories have been replaced by how it feels to drink with nal. Which ain’t all that great. I mean, it’s something — it gets you to sleep, it makes you forget, it relieves anxiety. But if you’re getting adequate support for the sleep and the anxiety and whatever, as I am, booze is a relatively poor self-medication, if you subtract the endorphin high, which nal does.

I suspect that the way it feels for me to drink on nal is the same as it feels for a non-drinker without any endorphin deficiencies or sensitivities to drink. You know, non-drinkers honestly just don’t like drinking as much as we do. If they did, they’d be drinking, by golly.

July 29 2004

I was watching a movie last night, and at some point three characters have reached the cocktail hour at the end of a long day and one of them says, “Harry, could you organize some drinks for us?” And I suddenly remembered what it feels like to drink without naltrexone. Of course I know it’s different, but I generally can’t remember what it was like to drink without naltrexone. Watching others do it on the screen reminded me — all the relaxing and forgetting of the first cocktail. “Let the healing begin!” as the guy in the New Yorker cartoon says as he order his first double martini, dry.

I wonder how long it will be before I have that feeling again. It is entirely my choice when I do or do not.

In the meantime, I’m more interested in figuring out what it is like to live without alcohol again.

I don’t much want a drink, because it would be a drink with naltrexone, which is not all that pleasant. I think I’d like to just stay the way I am for a while, give my liver a break, think things through with a clear head, do my job.

August 19 2004

I regret to report that my drinking is back up to my pre-naltrexone levels. My psychiatrist says, however, that I’ve got so much going on right now hormonally and neurochemically that it’s too soon to call the experiment a failure, and he has encouraged me to keep taking it and see what happens, so I will.

Update

Ooops, it was actually Joe Gandelman, who also writes at The Moderate Voice, who posted the link at Dean’s site. Dean weighed in with a comment shortly after.

Online Support: Not Just Vapor

Can internet-based contacts really make a difference once folks walk away from their keyboards? They did for me in 2000 when I connected with other folks from Moderation Management (MM). During my first period of abstinence, I reported my challenges and discoveries to my friends in the group. Knowing that I wasn’t going it alone, and wanting to report progress, often helped me to stay on track. When things didn’t turn out well, I could review what happened and get ideas for setting new priorities from the group; when things went well, I never celebrated alone.

This weekend, another MM member put that principle to work. He wrote to the group just before heading out for the weekend and again after his return, and was good enough to let me share his thoughts here.

He started out sounding hopeful and conscious of the weekend’s challenges, yet not exactly confident:

From: MNE
To: MM Email List
Sent: Friday, August 13, 2004 10:29 AM
Subject: [MM]Weekend challenge

---

Hi all who wants to read!
This weekend will be a challenge for me.

I am traveling somewhere and will meet a lot of people and can’t really escape the situation. It will be expected to celebrate and having a great party. But at this very moment I DON’T WANT to drink at all. Not even moderate or even taste anything with alcohol in it. It’s a little hard to deal with because I am dealing with following:

1. If I say to everyone that I won’t drink or I’m cutting down, maybe they will think I am a drunk and I will get into the situation to explain why I don’t want to drink. Especially since I usually never really say no.
2. I just can’t see the point of drinking at this time. I have purchased a new membership at a gym, and after slipping 1½ weeks ago into one night of heavy drinking, only to go back into the gym after that and feel GREAT! At this point I feel absolutely healthy and great!
3. I have naturally started a completely new life after moving to a city about a month ago. After arriving here it’s been more natural to break or at least identify old patterns of not being healthy. I do have better sleeping and eating patterns and as a matter of fact, I do drink less! I even got myself a new girlfriend and she doesn’t drink especially much. But when we do share a bottle of wine, those moments of drinking at all I want to have with her. The rest of the time I don’t really want to drink “by habit”.

But I want to move to the next “health” - level. I want to continue going to the gym. I want to do a 30 day abs and just stay healthy with eating and sleeping patterns. I feel so damn much better.

Ok, I should go. First off to the gym. Then having a lunch, then getting away to see a lot of relatives and other people seeing how this weekend turns out to be.

Thanks for listening

MNE

But, listen to the difference a weekend makes:

From: MNE
Sent: Monday, August 16, 2004 2:11 AM
To: MM Email List
Subject: Re: [MM]Weekend challenge - YES, YES!!!

---

Hi all you who replied to my original posting!

It was great to come home to read mail on late Sunday night. I appreciate each one of the replies, and each one is something to keep in mind!

And the weekend…? Well;

Friday: Writing here to MM-list about the fear of the weekend. Then heading off for the gym. Then into the car getting off, driving for 5 hours. Did I drink on Friday night? Nooooo! Did I want to drink on Friday night? Nooooo. Did anyone mind me not drinking or even questioning it? Nooooo! Did I feel great? Yessssss! Did I have a great time? Yesssss!

Saturday: There was a ceremony in church during the day and in the evening the beer, wine and food was a fact. Did I drink? Well yes; 1½ beers during the entire evening! Which was exactly the amount of beer I enjoyed, then I said no to any more. Did anyone get bothered? Nooooo.

Sunday: No hang-over. Just feeling great! Then driving home, meeting up with my new girlfriend. Enjoying the evening together and ending up having great sex. Still very sober and no wishes to drink (didn’t really think of alcohol..)!

After all, the weekend challenge wasn’t that hard. It was very easy! But that is because of being able to lean on you people on this list while being off. When traveling off on Friday I just knew that there are others out there getting similar challenges - I am not alone. And for now this is the third major break of pattern within two weeks!

THANK YOU for being there!!!!!!!

MNE

Feeling reticent about talking through drinking problems is not unusual in any peer support group. The reluctance to open up is reinforced, for a lot of MM folks, by the suggestion that detailed planning or rule-setting is a problem, not a solution.

Obsessing publicly about diet, exercise, weight, physique, and an assortment of other health-related habits is widely accepted. The leading tabloids’ tracking of Oprah Winfrey’s weight is echoed by Oprah’s comments about how the discipline of daily workouts can be a struggle, not something that happens naturally. When it comes to drinking, though, folks in MM often have to reconcile with a curious cultural paradox — that putting forth the effort to create healthy habits might be considered suspect, or at the extremes, a “selfish, weak excuse to avoid the ugly face of alcoholism.”

Against that backdrop, online community-building often delivers the simplest, yet most profound result: Convinced that we are not going it alone, we empower ourselves to take small but decisive steps forward.

Sticking, not Stuck

On July 2^nd of 2000,

I started 30 days of abstinence. With the support of folks in MM, it turned out that having alcohol-free days was kind of freeing, not the burden I had anticipated.

Taking my abstinence past the 30-day mark began to appeal to me by the half-way point. I was figuring some stuff out about myself and adding new habits and skills. All of that would be helpful once I was drinking (but moderately this time) in the future, and I figured a longer period of abstinence would probably be good for me.

Rather than commit to another specific timeframe, I set this framework in place: I could choose to have my next beer (or whatever) at any time, but the decision had to be made a week ahead of time. No moral significance was attached to the timing — I could do it the next week or the next year — but the timeclock was available, and seven days after hitting it I would be free to crack open a cold one or pour myself a glass of wine.

Sticking with the 7-day countdown worked for me. It wasn’t a commitment I felt stuck with or burdened by, and the 30 days turned into 110.

In mid-November of 2000,

less than a month past the 110-day abs, I lost my best friend and partner to suicide. I didn’t drink much, generally staying within MM’s moderate limits for the first couple of weeks. By the second week of December, though, buffeted by cheery holiday decor and songs about the most joyous time of the year, the only achievable goal I could imagine was conscious harm reduction.

For the rest of December, I didn’t set hard limits on how much I drank. I looked forward to the first beer of the evening, but also planned a good meal to eat with it. No stigma was attached to specific numbers, but free of self-judgment, I set drinking slowly and enjoying it fully as the priority. In January, with the holidays done and the edgiest of my grief softening, I did a 21-day abs followed by more moderation.

On March 1^st of 2002,

I kicked off a year of abstinence.

I had just lost another great friend, this time to alcoholism. I sent him off with a helluva eulogy, celebrating the gifts he’d given as well as the challenges he had brought to all of us who had cherished him. I wanted to do more than a bang-up eulogy, though. I wanted his death to spark something deeper in me, and a year’s abs felt just right.

It turned out to be a tumultuous year, moving from Iowa to upstate New York, starting a new job, and facing down an assortment of changes and crises.

Again, sticking with the choice to abstain worked. Some facets of it felt organic and natural, like the symmetry between not spending money on beer and my often paper-thin budget, and there were other times when it felt somewhat artificial, but manageable, to be celebrating, relaxing, or stressing in alcohol-free mode.

In October,

half-way through the abstinent year, I was hanging out with new neighbors at their Halloween party. Not drinking was not working for me in that situation. I needed to either skip out of there to catch a movie (something removed from the noise that would continue for a few hours directly above my place) or have a couple beers with them. Either choice was valid and viable for me, I realized, offering its own benefits and drawbacks. I elected to stay, and I elected to drink on three other days over the next few weeks.

December 2002 brought a markedly different decision from December 2000. I was comfortable with my choice to drink on the four days, but wanted the 80-some days remaining in the year to be alcohol-free. The commitment wasn’t difficult to make. It was the home stretch, and a couple months of being DAFT didn’t sound long.

The year ended up being 99% abstinent — 361 out of 365 days. I was happy with it. The four days were the perfect reminder that my choices on all 365 days were genuine and conscious.

Sticking with (not stuck with) my choices

Some folks are good at making a sudden change in their behavior solely because it makes rational sense. “Since my doc gave me my cholesterol levels and told me to change my diet, I’m stuck with eating low-fat food. I’m not happy with it, but I’m living with it.”

Most of us, though, need more than intellectual awareness about the wisdom of a particular behavior change in order alter ingrained habits. We have mixed feelings about giving up something familiar, and that ambivalence, like grief, is a natural human state. Neither responds well to being shamed, mocked, or short-circuited, but both will generally give way to peace, health, and productivity when accorded the respect, time, and energy they deserve.

Working vigorously with my ambivalence helps me to mold an “I’m stuck with…” into an “I am sticking with…” statement. Here are the distinctions, for me, between the two:

The specific goal doesn’t control whether I’m in the stuck or sticking category. If it had turned out that moderate drinking wasn’t viable for me, I might have started out feeling stuck with abstinence. It would have been crucial, though, for me to figure out how I could best own and embrace my commitment to being alcohol-free.

It doesn’t matter that some solutions work beautifully for millions of other folks; in order to integrate a new skill or habit, I have to tailor it to my unique values, coping styles, and experience.

Demystifying My Drinking

I first connected with Moderation Management (MM) in early June of 2000. In July, eager to test out its 9 Steps, I kicked off a 30-day abs, and ended up extending it past 3 months.

One of the concepts I worked through while abstaining was my fear that I’d slip right back into bad habits after the abs period finished, or even see my drinking escalate beyond where it had been before. It’s a pretty common sentiment; an MM member who is 10 days into his first 30 expressed a similar fear, and I responded:

From: Steve Boese
Sent: Wednesday, August 11, 2004 9:14 PM
To: MM
Subject: RE: [MM]abstinence

---

> Maybe I am a natural worrier, but it
> seems like things are going too easy
> right now. Like it is just a matter
> of time before I cave in and have that
> bender that will put me over the edge
> and set me back again….

That was me, exactly, four years ago.

Over time I decided that I had been framing my drinking as something mystical, something that could rise up like a beast and erase all of my progress, and that such framing was neither helpful nor accurate. I started DE-mystifying it, and the more I demystified my drinking, the more effective I became at marshalling some control over it as a simple habit.

OK, so it was a habit with a compelling edge — the allure of alcohol is stronger for me than, say, Play-Doh or broccoli, after all — but demoting my old drinking patterns to simple habits also got me thinking about healthier patterns as tuned-up, very do-able habits.

Another way I framed things: I reminded myself that every day of abstinence (as well as moderation and harm reduction) changed me. Once I added those experiences to my life, nothing could erase them, nothing could take me back to where I was in June, 2000. Even if I went back to nonproductive drinking patterns exactly like before, the new experiences told me unequivocally that I would never be content again living in the old ways.

So, I’d encourage you to trust that these 10 days have changed you. They are not a magic bullet, of course, but you are not going to erase these experiences from your consciousness. You are proving yourself able and powerful, self-reliant and wise. You will — all of us will — take what we learn from the good days and make better days, better lives, with them.

—Steve

That’s different from concepts that many A.A. members find helpful, that alcohol is “cunning, baffling, and powerful” and the path to better health includes accepting powerlessness, eh? We each need to figure out what works best for ourselves.

David: Life at the Extremes

David describes himself as “addicted to almost everything”, prefacing that by noting:

Addiction. What is it? Im sick of the word. Its never really been defined for me anyway.

He seems to have some powerful ambivalence going, as he continues later:

Heres the thing, my addictions make me feel weak and vulnerable; like a failure, someone unable to control his own impulses and desires. Yet I know, deep down that these impulses and desires are the seat of my power. The only true power I have. At one point or other in my life I have given up everything I was addicted to; booze, sex, drugs, computer games, sugar, exercising, gambling. They just keep coming back. So Im currently in a mode of indulging those addictions that I am unwilling to give up but keeping them contained. Hows it going, you ask? Not well. But Im not willing to castrate myself from myself and make some ridiculous, hygienic choice to purify my soul and rid myself of my desires, which in turn almost always turn into my addictions. Theres got to be a way; a way to dance with the Devil; a way to give the Devil his due and still walk in the light for most of the time. I suppose there is and I suppose its different for every single one of us, finding that balance.

The dynamics he describes are familiar to me, some of them from the first half of 2000 and earlier when I was in my 6-8 beers-per-night phase:

• Feeling weak and vulnerable at times, wanting better control.
• Feeling empowered and finding value in not living life as a purity campaign.
• Refusing self-shame and -castigation.
• Being determined to pursue better balance.

Dr. Lance Dodes, MD talks about folks for whom the decision to indulge in an addictive act can actually be empowering. To me, it’s not limited solely to addictive behaviors. Choosing to do something, breaking free of feeling stuck and having no options, can be helpful even when the specific choice is less than optimal.

In 2000, drinking too much on a generally daily basis, and making little or no progress when I tried to scale it back, was tiring and frustrating. I sometimes wondered if a power larger than me was assuming control, but found it counter-intuitive and counter-productive to indulge those sorts of thoughts for long.

In fact, the first couple beers of the evening did good things for me. They relaxed me, lightening my mood. My thinking grew more expansive, and the brainwaves that had been racing at breakneck speed all day seemed to slow down. I would re-ground myself with the reminder that life was about more than just producing, it was about appreciating many simple gifts. (Separate but relevant point: My current life includes just as much good stuff, but with a fraction of the beer.)

I hear echoes of those kinds of thoughts in David. Something deep, something meaningful is touched with the behaviors he describes as addictions, even as he identifies it as “dancing with the Devil.”

Prolific blogger Dean Esmay, who made a very public switch from active alcoholic to non-drinker in February and has since written a bit on AA alternatives, responded by describing his experience:

I can’t tell you the shame I have in realizing that’s where I was. Where I could even see the physical toll it was taking on my body and my soul, and still said, “fuck it, fuck everything, I just want more, I need to numb out the other shit that’s bugging me and I need more of this pleasure. It makes the bad go away and makes everything else feel good.”

That’s when you’re to the point of addiction my friend. When you consciously or unconsciously are making that destructive choice.

And the point of salvation? Where you have that moment of clarity when you realize that’s what you’re doing, and decide you must put a stop to it.

And the point of damnation? When you have that moment of clarity and realize that’s what you’re doing—and say “fuck it” and keep doing it anyway.

That is the choice between salvation and damnation, I truly believe.

The black and white, salvation-or-damnation, clarity is central to a lot of folks’ experience with substance use that became abuse and finally dependence. Behavior that escalated to extremes drew them into an extreme response, and framing the issue in blacks and whites helps to keep the focus on a worthwhile target.

But that’s not the only valid or viable response for everybody.

David wants to find balance apart from living a pure, hygienic life. One of the challenges I think he’s up against, as I described in my introduction to this site, is that so much of the public conversation about abuse and dependence focuses on the extremes, seldom appreciating middle ground.

Plenty of folks understand 12-step-based abstinence, as well as the idea that some folks abstain or moderate relatively effortlessly. But how many can talk about taking pragmatic steps to reduce harm, which most of us have done in some fashion? How many of us have avoided talking about intentionally moderating our drinking because some experts consider setting rules for controlling our drinking to be a sign of having lost control?

David is smart, in my book, to be consciously thinking about balance and noting that we’re not all going to find it the same way. At some point, even though it’s unpalatable now, he may find that abstinence is a better direction to go on some or all of the the indulgences that attract him.

In the short term, though, he probably stands a better chance of making progress by other means. When I find myself in a place similar to his, I find it helpful to stick to the simple stuff:

• Figure out what sorts of things are bothering me most
• Highlight those that are causing the most trouble
• Look for ways to scale the trouble or harm back by:
  • planning, and learning to enjoy, more frequent abstinent days
  • taking the non-abstinent days more slowly
  • taking action — doing things that matter more to me than drinking
  • recognizing, but not obssessing about, possible catastrophes and worst-case scenarios

Most of us know the stories about folks who have hit the extremes of addiction and abstinence, damnation and salvation. But how many of us also recognize the more boring, ordinary stories of folks who have matured out of their excessive behavior?

Sometimes the best thing we can do is to take genuine stock of ourselves and focus on making simple steps forward. Chances are good that our choices will trigger neither a lottery jackpot nor a lightning strike, but we can take a lot of small steps in better, neutral, or less harmful directions.

Why Would I Care about the NIAAA?

As a layperson, why in heck would the National Institute on Alcohol Abuse and Alcoholism (NIAAA) matter to me? Here are a few reasons:

• As a U.S. citizen and taxpayer, it spends almost a half billion bucks of my money every year.
• Like other parts of the National Institutes of Health (NIH), it is supposed to provide a scientific foundation for understanding health issues.
• The NIAAA is a key player in setting standards, definitions, and thresholds for things like moderate drinking, binge drinking, and treatment.
• Research, as funded and interpreted by the NIAAA, has a lot to do with the kinds of information, support, and treatment that are available to me.
• Like any organization, the quality of the results produced and/or funded by the NIAAA is going to be as good (or as limited) as the expectations set for it by the public (i.e., me and you).
• The NIH is not immune from conflicts of interest and other flaws.

So, if the NIAAA assigns a low priority to understanding the full spectrum of options (harm reduction, motivational enhancement, moderation) for folks who abuse alcohol like I have in the past, the chances that other folks will have those sorts of options available to them decreases.

If the NIAAA emphasizes research into relapse among folks who pursue all available treatment options any yet don’t reverse the severity of their binges, the chances of finding more effective options increases.

And, if the primary focus of the NIAAA is on discovering genetic markers which appear to contribute to drinking problems, there is likely to be less focus on how to help folks assert personal responsibility in the face of alcohol abuse.

In other health issues, it has often been the folks most directly affected who have driven research concerns. Parents of kids with autism have challenged the NIH to look closely at the possibility that common vaccines have contributed to their kids’ challenges. Breast cancer survivors, and family members of those who did not survive, have been the most effective advocates for increasing the dollars devoted to prevention and treatment research.

If I want to see alcohol-related care shift, I gotta be one of the folks standing up and challenging the research gurus to cover all of the bases, and holding the folks in charge accountable for spending public dollars.

More DAFT Than Sober

(Previous message here.)

From: Steve Boese
Sent: Tuesday, January 29, 2002 5:11 PM
To: ModerationManagement@yahoogroups.com
Subject: I’m DAFT!!!

Hello, All…

I came up with an acronym that fits me — DAFT. It stands for Delightfully Alcohol Free Today. Or, you could substitute all kinds fun D words — deliciously, deliriously, delectably, daintily — but the point is that it is a positive spin on being conscious and actively about this business of life.

The “T” — Today — is meaningful to me, too, because that’s the most important time span to address.

Of course, there are days when being alcohol-free doesn’t feel like anything more than a struggle or a burden. Some times, the only way to reframe something is to begin using the positive words before we’re feeling them.

Of course, there are days when being alcohol-free doesn’t feel like anything more than a struggle or a burden. Some times, the only way to reframe something is to begin using the positive words before we’re feeling them.

It’s also a good pun… I’m perfectly content admitting that I’m more than a little nuts on a regular basis. Describing myself as DAFT hits multiple buttons, reminds me not to take myself too seriously, tells me that I’m crazy enough to find the sanity I need when things get out of balance.

Whaddya think? How many others are DAFT today?

—Steve

So Bored?

From: Steve Boese
Sent: Friday, January 25, 2002 8:08 PM
To: ModerationManagement@yahoogroups.com
Subject: RE: [ModerationManagement] Question????

I just noticed the similarities between the words “sober” and “so bored”.

Hmmmm… then, looking up the definition of “sober”, M-W.com gave me:

• marked by sedate or gravely or earnestly thoughtful character or demeanor
• UNHURRIED, CALM
• marked by temperance, moderation, or seriousness
• subdued in tone or color
• showing no excessive or extreme qualities of fancy, emotion, or prejudice

And, y’know, those definitions are all entirely TOO serious, too sedate, too grown-up… I think you’ve got a point there.

Now I’m wondering, what words can we use to describe alcohol-free periods of time in more positive ways? Exuberant consciousness? Clear-headed flamboyance? Obnoxiously perceptive? Agggh, too wordy, none of those works for me.

Maybe we need to make up a new word to describe non-drinking… something silly and fun, I’m thinkin’, though nothing is coming to mind yet.

Oh well, in a couple of hours I’m embarking on a 1000-mile road trip from Iowa to DC, so I’ll have all kinds of time to ponder inanities like that…

—Steve

(Follow-ups here.)

Email messages

I like to write. Spilling, editing, and tuning up my words tends to clarify things for me and keep myself moving forward. So, it is no surprise that participating in email-based peer support groups worked well for me when I started with MM.

In telling my story in the journeys section here, I’ll sometimes pull from my archive of email messages sent to friends in MM. I won’t reveal personal details about anyone else, of course. Sometimes it’s intriguing to see where I’ve been and what my thought process was, sometimes embarrassing. Sometimes fresh lessons emerge. I’ll try to share some of all of that.

Keeps me honest, too, to put original stuff out there — I can’t filter it through my wacky memory.

Anonymous?

Nope, I’m not anonymous. My name really is Steve.

Alcoholics Anonymous finds it critical to guard its members’ anonymity:

Anonymity […] assures our members that their recovery will be private. Often, the active alcoholic will avoid any source of help which might reveal his or her identity.

And AA describes it as essential to the character of its organization:

Anonymity is the spiritual foundation of A.A. It disciplines the Fellowship to govern itself by principles rather than personalities. We are a society of peers. We strive to make known our program of recovery, not individuals who participate in the program.

Good stuff, certainly. Wouldn’t it be great if life was uniformly about principles more than personalities, and programs were known by their merits more than their leaders or participants?

I respect any person or organization that holds to its deeply-held values, and I can understand how valuing anonymity has served the members of AA.

For myself, though, I believe there can be costs attached to anonymity. It is more difficult, often impossible, for an anonymous person to be publicly accountable. Sealing one part of our lives behind a closed door can imply that shame is being allowed to roam freely.

Honesty can disarm. Illuminating the things I dislike or fear most about myself demystifies them, normalizes them, reveals them as something which need not be hidden away. In my life, leaving shame and anonymity behind has often made it possible to learn more about the world around me at the same time that folks I encounter in the public sphere learn from me.

Betty Ford comes to my mind as one whose journey with substance abuse and recovery has not been anonymous. It wasn’t her choice — in 1978, word of her hospitalization in the alcholism unit of Long Beach Naval Hospital in 1978 reached the press before she even arrived — but it was consistent with her history. She had proven herself to be a pioneer of sorts by talking publicly about breast cancer, and continued that tradition regarding her cosmetic surgery later in 1978.

In her 1987 book, Betty: A Glad Awakening, she talked about being asked to lend her name to the center she helped create:

Somewhere in the middle of the process [of hurdling all the barriers to creating a first-of-its-kind treatment center in California], Leonard [Firestone], Joe Cruse and John Sinn asked if they could call the new facility the Betty Ford Center. I said I was honored, but I didn’t think so. […] They convinced me that it would be beneficial to our cause if I allowed my name to be used. It was definitely not my desire.

I choose not to be anonymous even though it’s not my deepest desire.

I’m glad that it has worked well for others, and I have no problem respecting such choices by folks who contribute their thoughts and experiences here.

I think folks need to know that there are many ways to work toward having a healthy, balanced life in the wake of unhealthy drinking patterns. Folks who are struggling with drinking problems, especially, are likely to benefit from knowing that their peers have used many different paths to better their lives. Telling my story honestly and openly, being accessible and real, is one of the ways I choose to contribute to that process.

I’m Steve Boese. I’m a former problem drinker.

Intro to Journeys

Recently, a guy I know said something smart (paraphrasing liberally here):

The best way to reach a person isn’t by teaching, preaching, or arguing. We reach each other by telling our stories.

When I tell my own story, there’s nothing to argue about. Nobody can take my journey, my story, away from us.

That makes sense, don’t you think? It’s hard to preach without wagging a you-shouldn’t-do-that finger at one’s audience. Teaching implies a wiser one talking (down) to a less-wise one. Every argument has its counter-argument.

My rational side needs to see evidence in order to accept something as true, but my common sense side isn’t satisfied until I’ve seen real-life examples.

When I started my journey from not-so-smart drinking patterns to better ones, it made sense to me that people could do so by a variety of methods, but I knew no stories about folks who had.

First-person accounts of turning substance abuse around via abstinence and 12-stepping were plentiful among friends and neighbors, just as they are in the media. Personal references to past excesses were easy to come by, as well.

But to me there seemed to be a deafening silence about how people follow alternate paths to easing away from bad habits and transitioning to more reasonable ones.

(To be honest, I’m self-conscious talking about my own transition. I’d rather not talk about having slipped into unhealthy territory — and certainly won’t dwell on it.)

It’s important for us to share our stories, though. This is where the rubbery gobbledygook of science meets the road. Evidence and theory take on life and breath as we demonstrate what they mean in the fabric of our ordinary lives.

I’ll tell my story. Please feel free to share yours, too. Drop a little (or a lot) into the comments. Shoot me an email message. If you’d like to tell some of your story but hate to write, maybe we can talk by phone and I’ll summarize for the benefit of Live Sensibly readers.

Introducing Bose

My friends call me Bose,

short for my last name, Boese (rhymes with Rosie). I’m Steve, and I’m in my mid-40s.

I’m a freelance writer based in Washington DC. I spent my adult life in Iowa until 2002, working mostly in technical areas (computer analysis and programming) mixed with tech writing and training delivery. I dabble in a bit of music (piano plunking, songwriting), enjoy dialoguing on challenging personal and cultural issues, and love to travel as my budget allows.

In 2000, my drinking habits had moved into uncomfortable territory. Too many mornings found me waking with dry eyes, a pasty mouth, a fuzzy brain, and 6-8 (occasionally more) empty beer cans stacked in the kitchen. I’d resolve to cut back, or skip a few days, but converting that morning resolve into evening results was another story.

It wasn’t for lack of warning or trepidation on my part:

• My dad’s quarter-century of heavy daily drinking had cost him — and my relationship with him — dearly.
• My best friend, Brian, had struggled with the effects of 6-10 severe binges per year for a decade.
• I had attended a few Al-Anon meetings years earlier, and didn’t want my drinking to escalate any further.

And yet, attempts to change my drinking patterns hadn’t really gotten me anywhere, either. I didn’t feel powerless — I took full responsibility for my choices, even though they weren’t all working for me — nor was I in denial about this not being a healthy long-term pattern.

I had found the tools and techniques I needed previously to deal with everything from episodes of depression to building my own kitchen. It seemed to me that the tools and techniques for changing my drinking patterns ought to be out there, too, but I wasn’t finding them.

Discovering Moderation Management

In June of 2000, I learned for the first time about Moderation Management (MM). I met a lot of folks in MM’s online groups who were exploring pragmatic, self-directed options for making substantive changes in their habits.

One of the MM recommendations was that abstaining for 30 days could open the door to fresh insights. MMers had used that time to look at what triggered their desire to drink, as well as develop new skills in situations where they were accustomed to drinking.

Thirty days without a beer sounded OK, but long. I had done one- and two-week stints independently (usually intending them to be longer), but found abstaining to be a challenge.

After listening to folks in a couple of MM email groups (this one and this one), I decided to take a stab at it.

There were challenges along the way, but a couple weeks into that first abs I was finding it easier (a relief of sorts) to be leaving alcohol behind for a while. The 30 days stretched into more than 3 months.

A beginning, not a cure

I’ll talk more about my journey as we move forward, but for me that period of abs was an important beginning. It’s not that being abstinent for a while was a magic bullet that erased the challenges I faced. It’s not that it prevented me from doing not-so-smart things forever afterward. It was a start, and a very important one.

Prior to July 2000 when I started that abs, I had relatively few alcohol-free days and not too many light (1- or 2-drink) days.

Since then, well over half of my days have been alcohol-free and when I drink, the majority of my days and weeks have fallen within reasonable limits.

One of many options

Even more significant than finding MM was finding out out that it was just one of several great options.

Moderation Management promises that it won’t work for everybody, noting that some 30% of the folks who try it ultimately opt to pursue long-term abstinence.

Not knowing whether moderating would ultimately be a good fit for me, I found it reassuring in my early days knowing that I could shift to abstinence if I needed to later. I wasn’t ruling out a 12-step option, but for me the 12 steps run counter to my intuition and the sorts of problem-solving techniques that had worked for me.

Ultimately about living, not drinking or abstaining

The changes that I’ve made run deeper than merely drinking less. I have more energy and ability to do things that matter to me. I relax and celebrate in any number of ways that don’t require a drink.

The words “Live Sensibly” in the site’s logo are splashier than “with alcohol” for good reason. For folks reading this site with a text browser, I use parentheses: “Live Sensibly (with alcohol)”. It could just as easily say “without alcohol”.

My goal is to live, and live well, first. To the extent that alcohol fits in with a balanced and healthy life, great! And, to the extent it gets in the way of having a decent, sensible life, I’m determined to leave it behind.