The stigma of (not drinking) alcohol

How often do you drink alcohol? Daily, weekly, a few times a month, a few times a year, not at all? When you drink, how much do you consume? Is there a pattern to your drinking (ie, have a beer or glass of wine to "relax" after work, go for a night on the town with friends, partying till all hours of the early morning, special occasions,etc.)? How many years have you been drinking? Can you remember what your life was like before you first drank alcohol? Can you imagine what your life would be like without it? Do you feel (or act) differently when you drink than when you're sober? These are but a few questions I asked myself recently.

In recent months, I have become increasingly aware of how frequently alcohol and drug addiction is mentioned in the media. Of course, I realize that the media is built upon the idea of sensationalism (the nice word for "drama" if you will), as well as exploitation...but given how working with addicts has been a large part of my professional career the last five years, it is very real and very accurate. In fact, I would go so far as to say it's even more rampant than what we even see in the media...but I digress.

Coupled with the aforementioned questions that have run through my head, I also had a growing awareness that alcohol is everywhere. If people aren't drinking, they surely will be soon. They talk about looking forward to drinking. They joke about needing a drink. They talk about how much they drank last night or last week, and with whom. They plan happy hours. They bar hop. They talk about their favorite alcoholic beverage. They mention alcohol as a reward for having to endure something crappy or stressful that's going on. They use it as a social lubricant, to feel that somehow they are more confident, fun, and interesting than they are sober. They are consumed by it and god forbid the response you get when you challenge this mindset by stepping outside the norm. Stigma for drinking? Think again. Stigma for NOT drinking: Katie's social experiment.

It has been 30 days so far that I have abstained from alcohol. Go ahead, ask "Why?!?!" with a very frantic, disturbed look on your face. This is the typical reaction. It's funny (ironic, not haha); I've had clients who struggle with addiction and/or are in recovery who have told me negative experiences they have had in regard to not feeling supported in their recovery as far as others not respecting their sobriety or even sabotaging their sobriety by offering them alcohol,or ridiculing their sober efforts, etc. A part of me wondered if they were full of it, like they were just making up some excuse as to why they relapsed....but now I'm seeing a different perspective. There's something about alcohol (because it's such a mainstream socialization behavior?) that really provokes a reaction in people. I'm not even bringing the topic of religion into the picture, because that carries its own separate factors that aren't relevant to what I'm discussing here. What I'm talking about is a sociological epidemic. There seems to be a stigma against NOT choosing to imbibe.

You tell someone you're on a diet, so you're not eating cookies or carbs. End of story. People generally understand and respect your efforts to exercise willpower, work on being healthier, etc. That's usually the end of it; there's no Spanish Inquisition around your decision and most people wouldn't judge you as being weird/abnormal for not devouring an Oreo's cookie with them. You tell someone you aren't drinking for awhile (note: I didn't even say completely, just for an unspecified length of time) and there's that strange look, followed by jokes like "What, are you in recovery?" or "Well, what do you do for fun then?" (followed by laughter). And of course there's the peer pressure with justifications attached. "What about if you just have (such and such a drink)? It only has such and such amount of calories..."

A little about me for anyone in cyberworld that might be reading this that doesn't know me personally:
1. I'm not in recovery/an alcoholic (but I'm beginning to empathize with how my clients must feel...that there is some truth to what they have shared with me about relapse issues in social environments)
2. I'm pretty damn fun sober (if I do confidently say so myself!) and don't "need" alcohol to enjoy my own company or the company of others.
3. I'm not doing this for religious or puritanical reasons (here I told myself I was going to stay away from bringing religion into the mix of this blog!), so no...I haven't given up alcohol for Lent or anything like that.
4. I don't need the mask of alcohol to have social relationships. Frankly, as I grow older I'm growing tired of that world/culture. I want meaningfulness with people and when alcohol is involved, many times I question how "real" my interaction is with someone. Is it deep or is it superficial? Is it all an illusion? I'm pretty sure you know what I mean. The conversations you had or the chemistry you felt while drinking with someone. Was it real or just "beer goggles", I or they were too drunk to know/care/remember? Would I have had these same interactions sober? Would they with me?

If alcohol represents the primary cultural mechanism in which we express our identity and carry ourselves in social situations, what does this really reflect about ourselves as a society? And as separate individuals that comprise that collective whole?

I'm not sure how long I will continue my non-drinking stint, but it has been an eye-opening experience. Responses from people have been more challenging to face than the actual substance itself. It's just that powerful. An addicted nation?

Exploring Trauma

Back in January, I attended a phenomenal workshop led by John Briere (a brilliant, renowned professor and researcher in the field of PTSD/trauma therapy work). I highly recommend him to clinicians in the counseling field who are interested in learning very relevant and postmodern information on the difficult arena of trauma work, one of the hardest and most complex clinical issues to treat besides addiction (in my opinion). His presentation was by far the best workshop I've attended in my quest for practical and yet interesting, helpful continuing education seminars.

I was first introduced to trauma work when I first started working at my current job (back in July 2008), as many of my clients are survivors of physical, emotional, sexual, and psychological abuse. To make matters more complicated, most of my clients suffered through multiple traumas. Imagine what it would be like to endure one specific, isolated traumatic event. Compound that by years of chronic abuse at the words or actions of various people in your life (usually beginning from the toddler or early school age years and continuing throughout adulthood), and you acquire what has become known as Complex PTSD. It is more challenging to treat and heal because it is so ingrained in the formation of one's personality/identity. In fact, Briere believes that there is no such thing as Borderline Personality Disorder, only unresolved trauma (ie, personality disorders are strongly correlated to childhood abuse and neglect).

According to Briere, trauma has two parts: 1. any kind of painful experience that 2. overwhelms your capacity to handle it. This can be either non-interpersonal (such as experiencing a natural disaster, like an earthquake) or interpersonal (which tends to affect people more strongly because someone is intentionally trying to hurt us). One of the most fascinating things Briere mentions is implicit memories vs. explicit memories.

Implicit memories are those that are formed on a sensory, pre-verbal level (ie, birth to age 2-3) in the brain. When someone has an implicit memory, they are more likely to be triggered by something visual like a photograph or a flashback/nightmare...yet not have the words to describe how or what trauma is being triggered within them in that moment (because they could not put the experience into words if they were younger than age 2-3 when it happened). This is why it can be difficult for a therapist working with a pre-verbal trauma client to talk about/describe the trauma(s). How can they put into words something that occurred before there WERE words? See the Catch-22 of treatment and recovery? Explicit memories are formed on the verbal level (age 3 to adulthood), so naturally it is "easier" to treat trauma from an explicit memory standpoint.

In addition, Briere talks about the avoidance triad: substance abuse, dissociation, and tension-reduction. As it turns out, there is a meaningfulness to avoidance behaviors with the trauma survivor. I don't know about other clinicians, but it has been my experience that avoidance behaviors seem like mere forms of escapism from pain.....which they are to a degree, but it's more complex than that. Briere goes a step further to suggest that engaging in such behaviors is the only way the trauma survivor knows how to "soothe" or "take care" of oneself, however misguided and unhealthy it may seem to others. This is what he calls "tension reducation behaviors" or "TRBs." They are intentional, external activities the trauma survivor engages in (ie, gambling, excessive exercise, self-mutilation, binging/purging, compulsive sexual activities, and drinking/doing drugs) for the purpose of reducing painful, internal states. While the trauma survivor may feel that these behaviors "help"quell the emotional pain, it only serves to perpetuate a cycle of shame and often, degradation.

While pain may be inevitable, Briere makes a distinction that suffering is optional. What does this mean? Pain may be a given, but what you do with it is optional. The pain paradox theorizes that cultivating a focused awareness can lead to relief/resolution, whereas avoidance contributes to constant suffering and emotional intrusion. This is where mindfulness as a clinical intervention with the trauma survivor comes into play. When someone has been through horrific, painful experiences, the last thing you want to do is pour salt into the proverbial wound and make them hurt even more by delving into it....but this is exactly what MUST be done...just with a gentle, mindful and timely (ie, not too fast/too soon) approach via the 'therapeutic window.'

Briere mentions the therapeutic relationship to be one of the key elements (the therapist as a caring, nurturing, and safe agent for facilitating change/healing within the trauma survivor client) and being able to teach mindfulness skills to the client.

The workshop delves into various clinical interventions/tools the clinician can utilize with the trauma client, which I won't explain in detail here. You'll have to attend the workshop yourself if you want that information.... :)

For more information, visit http://www.johnbriere.com/.

Is atmosphere really everything?

Like a little kid in a candy shop, I always have a sweet craving....for books. The three tiny bookshelves in my modest studio apartment are comprised of both books devoured and those still unread.... some dusty and ignored, others that have been manhandled by too many to keep count. Sometimes I think the nerdy part of me is in desperate need of a vacation reserved just for reading and writing, no distractions to pull me away.

I remember my years in Chicago as a time I was reading and writing voraciously like never before. Don't get me wrong, I've always been a reader....in utero, if possible! I grew up around book lovers (my mother and her father/my grandfather) who instilled within me a desire to learn and question the world around me as my curious eyes danced across the pages of numerous novels. Eventually, that love of reading also spilled into writing. I have heard that if you want to be a fantastic writer, it is suggested that you experiment writing in different places....coffee shops, restaurants, at the beach, in the woods, the airport (think of all the stories you could concoct!), the laundromat, on vacation, on the road, and the list goes on. I tend to think the same may be true of reading in different places as well. I'm also a firm believer that to be a helluva writer, you must be a helluva reader (this means read ALOT).

I wonder if atmosphere really IS everything.....if the cliche' "variety is the spice of life" carries more weight than I have previously considered. People who have followed my writing over the years (from the beginnings of my MySpace blogs to the blogs I write on here, and the pieces I have written for a creative writing class) have definitely noticed a transition in my writing, in regard to content, quality, and frequency of writing.

When I first started writing blogs back in 2005, I had just finished grad school and was entering the daunting foray of addiction counseling. Perhaps it was the adrenaline rush of doing something unknown, challenging and scary...I don't know. Whatever the case, I was also still working part-time at a bookstore, a unique alternate universe in and of itself. I was constantly people watching....customers, coworkers, and clients alike. I soaked up books like the world was coming to an end; I couldn't finish one to start another fast enough. Frequently having unreliable and disengaged clients at work, I took advantage of the free quiet time and typed out blogs within the quiet confines of my purplish-blue walled boxy office. Sometimes the events that transpired within the walls compelled me to write as well. Most of my writing was done back in that office on Elston Avenue.I wrote several times a week, at times more than once a day.

I have yet to find that same voracious writer part of me here in Seattle. Perhaps it is hiding out and waiting for me at a wireless coffee shop, or hidden in a crevice of my apartment. It's surely not in the comforting, yet distracting office I share with six other therapists. If there's one thing I need in order to write, it's privacy and sometimes absolute stillness (depending on the topic I'm writing about). Then there's the aforementioned inspiration. Timing is also essential. I cannot be rushed when I write. Time has to stand still; it has to become irrelevant if I am to let the words flow out of my mind and onto the page (or keyboard). I think this is why I wasn't good at churning out writing pieces for the creative writing class I took recently. I got too caught up in the pressure of deadlines that it suffocated my creative flow.

With that said, I have to say "Yes." Atmosphere is everything, yet what it is to me is different than what it is to you. Atmosphere may be sipping a caramel macchiato and listening to shuffling songs on your iPod while simultaneously reading a compilation on how writers think and what inspires them to write, thus inspiring the reader to want to abruptly leave Barnes and Noble in order to rush home and write before the inspiration fades (that would be me today).

Atmosphere could also be a special place that you inhabit when alone or in the company of fascinating, colorful others. Atmosphere could also include mental, emotional, physical, or spiritual elements.It may be found in a conversation with a friend. It may be tangible and it may be unpredictable.

Atmosphere: the ultimate muse?