This is a lightly edited transcript of a talk I gave recently to the Nutrition and Lifestyle Medicine Conference (NLMC26). It outlines what I think is going wrong with the way public health and clinical medicine is approaching the prevention of alcohol harms, and what a perspective informed by lived experience and psychological research suggests we should do differently. I think it will resonate with anyone - patient or professional - who has struggled to talk honestly and openly about the impact of alcohol.

I am a clinical and health psychologist and behavioural scientist by training. I’ve spent the last thirty years designing, delivering and researching behaviour change interventions, often in primary care, but also working as a secondary care clinician in diabetes care.

Throughout my career I’ve worked with people to try and help them understand and change their relationship with alcohol — from thinking about how to optimise prevention programmes, through to working with people who are in danger of losing their lives because their kidneys, pancreas and liver are failing.

My talk today is based on what I’ve learnt over the last thirty years. I will talk from three perspectives. Firstly, from the perspective of an applied behavioural scientist. Secondly, as a clinician. And thirdly, as someone who has firsthand experience of taking control of my relationship with alcohol and as someone who no longer drinks.

Let’s acknowledge the discomfort

I want to start by acknowledging that this is a sensitive area. Everybody in this room will have been affected by alcohol in some way — maybe their own drinking, maybe the drinking of other people. Because one in five people are drinking in ways that are harming their health.[1] And because this is so common, we don’t necessarily identify it as a problem.

And this is why the statement that there is no safe amount of alcohol by the WHO and UK Chief Medical Officer was such a controversial, brave, but necessary intervention.[2]

But it’s not only the use of alcohol that’s hiding in plain sight. It’s also the harms. Alcohol has a profound impact on the body, the mind, our relationships, our family, our community, and society as a whole. And we have developed a form of cultural blindness — possibly motivated by the fact that we don’t want to look too closely at what’s happening — which means we’re not appreciating the extent to which many of the problems we are currently facing are caused by alcohol.

Meet Bob

So let’s make this real by talking about what I think is a fairly typical clinical encounter. Let’s meet Bob.

Bob is 46. He’s in the GP surgery on a Monday morning to discuss his gastric reflux, his mood, and his blood pressure. He’s sitting there regretting his life choices, because he had family and friends round yesterday at a garden barbecue, and drank way too much. It was a fun time, but at four o’clock this morning he woke up regretting his life choices, and feeling very sorry for himself.

Bob is handed an alcohol screening questionnaire — the AUDIT — to fill out while he’s waiting. The AUDIT measures three aspects of a person’s drinking behaviour.

The amount. Bob knows exactly what the limits are, and rounds down from what he actually drinks to just above the risky line, so as to be realistic.

The degree of dependence — items such as do you need a drink in the morning? No problem there. The last thing Bob needs this morning is another drink.

The impact of his drinking — items such as have you ever been injured? Bob answers no. Nothing bad happens when he drinks. People think he’s fun. And there’s no real evidence that it’s a problem.

He has his consultation. They discuss the results. The doctor advises that he should probably drink less, and Bob acknowledges this. From the doctors point of view, that’s a box ticked. As for Bob, he leaves with a bunch of prescriptions — for depression, statins, and reflux — a commitment to not being in this situation again, and to cut down. And a slight sense of relief that he’s dodged the bullet of an uncomfortable conversation.

Bob is not a caricature. There are many thousands of people having conversations like this in every clinic, every day, in UK GP surgeries and during health checks. And it’s my contention that this is a great tragedy, and a huge missed opportunity to address a really significant, modifiable risk factor for Bob’s mental and physical health — which, if left undealt with, is likely to move from ordinary, everyday, normalised heavy drinking into a life-limiting addiction in every sense of that phrase.

What actually happens across the population

So let’s put some empirical flesh on Bob’s bones, and look at what’s happening across the population.

Alcohol screening is often delivered as part of a health check, increasingly done electronically, with no conversation. But opportunistic screening does happen albeit not very often — an opportunistic intervention happens in about 17% of consultations.[3] When it does, it lasts less than a minute, and very rarely are people given advice to cut down. And importantly, high-risk drinkers are not screened any more often than lower-risk drinkers.

When they happen, these conversations have an impact of reducing intake by about 20 grams of alcohol per week, which is about one pint of beer.[4] It is statistically significant but clinically meaningless impact.

When we look at the patients experience of these encounters, there is strong evidence that they under-report. Some of that under-reporting is unintentional — and interestingly, the more people drink, the less accurate their estimates are. Underestimates can be as large as 40%.[5] There’s also evidence of intentional under-reporting, because patients feel that if they report the actual amount they drink, health professionals will label them as having a drinking problem.

They also report that the conversations are difficult.

Such conversations, particularly for heavy drinkers, are described as awkward and judgemental, with nearly a fifth of risky drinkers going on to drink more after such a conversation, rather than less.[6] And on the basis of these results, if alcohol brief interventions were a pill, we’d have abandoned them long ago on the basis of safety.

Nobody is enjoying this

When we look at healthcare professionals’ experience, they don’t feel very confident about working with people with alcohol problems, and up to 40% can feel that such work is hopeless and discouraging.[7]

And there is a real sense of clinical nihilism about talking about alcohol, particularly with those who drink heavily. Health professionals feel that current practice is meaningless, that people need more support than is available to give them. And because that support is not available, health professionals are likely to avoid it.[8]

So my interpretation is that we’re not having the conversation. When we do, it isn’t experienced as helpful. And for many drinkers, it makes things worse.

We have created a system in which fear about harming relationships with patients, combined with clinical nihilism, lead health professionals to avoid conversations about alcohol. This means clinicians never develop the skills necessary to talk helpfully about heavy drinking. And because we don’t talk about it, people carry on drinking and become more difficult to help. This worsening of drinking over time feeds into further clinical nihilism. It’s a mess, and sadly one of our own making.

Given what we know about what alcohol does to individuals, families and communities, I think this is a shameful, systemic dereliction of duty.

Why are we getting this wrong?

So why are we getting this so spectacularly wrong?

Well, there are three failures in this system. One is at the level of the goal. The second is an under-appreciation of the emotional burden of alcohol conversations. And the third is that our approach is not informed by the very good behavioural science that we have.

The wrong goal

Let’s start with the goal. Most of our advice is based on population-level evidence and a public health strategy, which means that if we can get everybody in the population to drink less, there will be a positive population health effect. And that’s not an unreasonable assumption — until we consider that what drives drinking is not the same across the spectrum of consumption, from low to high risk.

And the missing insight is that alcohol is an addictive substance, and chemical dependence changes the nature of the task. And we now have very strong evidence that, paradoxically, the more people drink, the less likely they are to identify their drinking as problematic.

This is important, because only 18% of people who drink at risky levels agree that they would benefit from any sort of help, or from cutting back.[9] But what we do know is that once people understand that their relationship with alcohol is problematic, there’s a very strong likelihood that they will go on to seek help, to do something about it.[10]

Recognising a drinking problem

And it turns out that recognising that one has a drinking problem is an incredibly complex psychological task. It involves titrating three different ideas.

The person has to recognise that the amount they drink places them at risk. They have to recognise and accept that their drinking has escaped their control, which is dependence. And they have to accept that the problems they’re experiencing are caused by, or made worse by, their drinking.

What’s fascinating is that there can be failures in acceptance or recognition at any one of these ideas. We know people who drink too much underestimate their intake. We know people’s understanding of dependence is highly informed by media representations of extreme cases of alcohol dependence. And we know there is a very low levels of alcohol literacy in the population about what alcohol does to mind, body, soul and relationships.

And this matters, because problem identification precedes behaviour change. But the other thing we’re missing is that, as well as being incredibly complex, problem identification is a multi-year and non-linear process. It takes between two and five serious attempts at quitting before a person with an alcohol problem is finally successful at stopping drinking.[11]

A cruel double bind

Problem identification is further complicated by the toxic relationship we have with alcohol in our culture. We encourage people to use a dependence-forming substance to enhance their wellbeing. And then we demonise those who become dependent on it.

This way of thinking has its origins in the medical model of problematic drinking, which says that people who drink normally are fundamentally different from those who go on to develop a drinking problem. This idea was retired by behavioural and social science many years ago. We replaced it with a dimensional model, which says that anybody who consumes alcohol will be on a continuum of dependence, in much the same way that anybody who smokes is on a continuum of nicotine dependence.

On this view, the only difference between the person with the severe alcohol problem and the person who’s drinking at lower risk is that they are at different points on the ladder to severe dependency. There’s now convincing neurological evidence that simply consuming alcohol increases your risk of the next drink. Drinking is essentially a progressive phenomenon. Each drink makes the next drink more possible.

The spectre of alcoholism

When we invest in the idea that there are normal drinkers and abnormal drinkers, we engage in a process that sociologists call ‘othering’. We locate the problem of alcohol outside of ourselves and people like us, and within the psychology of an out-group – people not like us. This creates the conditions for invoking stigma towards people whose drinking escapes their control.

And levels of stigma against people who drink too much have increased in the last twenty years, whereas for all other forms of psychological difficulty it has actually fallen.[12] The reason this matters is that problem identification, psychologically speaking, involves a transition of one’s self-concept into what we call a discredited identity. This creates the compost in which the seeds of shame start to germinate.[13]

And the reason this matters is that shame gets in the way of identifying a problem. Once shame is activated, many people drink to cope with it. And the more people drink, the less able they are to control their drinking, which itself becomes a source of shame. And the more someone drinks, the more problems they develop — creating an unfortunate shame spiral, that people cope with by withdrawing, defending, or drinking.

Why I wrote my book

This process is incredibly subtle, and evolves over time. I’ve spent many years talking to people about the role of alcohol in their lives It’s always fascinated me that it could be completely obvious from the outside that a person’s life was absolutely falling apart because of their drinking, and yet from the inside they’re still asking themselves the question, do I drink too much?

This was one of the reason I wrote my book, Do I Drink Too Much? I wanted to create a resource to help people navigate this process of unravelling their relationship with drinking.[14]

Alcohol as brain malware

The answer to why this happens — which I think is really underappreciated — is that alcohol fundamentally changes the way people process information about themselves, their relationships and their drinking. It operates in the same way that viruses work in computer programmes, or social media algorithms: it distorts the way people think, in order to keep them from appreciating there’s a problem.

The nature of these distortions is incredibly nuanced and complicated. But, in summary, there are three main cognitive distortions that prevent people from spotting the evolution of a problem. I call these the Three Distortions of an Impending Alcopocalypse.

The first is confirmation bias, which draws attention to all the good things about drinking — which of course is reinforced by the culture in which we live, which says alcohol is great. The second is negativity bias, which draws people’s attention to everything that’s bad about stopping: boredom, losing friends, not being able to cope with distress. And finally, self-deception, which deliberately draws your attention to evidence that there’s no problem — the fact that you didn’t drink last Tuesday, you only had two glasses on Wednesday, and of course all of the other people that drink way more than you.

These work together to prevent people from understanding that they are essentially like a frog sitting in a pan of water that is being heated up, completely unaware that they are in the process of being boiled alive.

The dependence thermometer

But there are plenty of warning signs of an evolving problem. In Do I Drink Too Much? I talk about the concept of a Dependence Thermometer, which is a tool I created to help people take the temperature of how dependent they are on alcohol.

At the top of the thermometer is where most people think the signs of alcohol dependence are: needing a drink in the morning, signs of physical withdrawal, continuing to drink despite huge consequences. This is the point where most people think they need to get to before they should take action to reduce their intake.

But people don’t just crash land at the top of the thermometer. Before they get here there are signs of high dependence, such as repeated failure to take a break, persistent sleep disturbance, anxiety, alcohol being the primary go-to strategy when things are tough, and having no off button.

And people don’t just arrive here either. Before they become highly dependent, there are signs of increasing dependence: feeling that you can’t do social situations without alcohol, fear of running out of alcohol, prioritising events where alcohol is going to be available, increasing physical tolerance, or just a general discomfort at the idea of not being able to drink.

So there’s plenty of evidence, if we know how and, of course, choose to look, showing how alcohol is limiting people’s lives long before their behaviour ever shows up as problematic on a screening tool.

Six things we can do differently

So given that this is what’s happening, these are the things we can do differently.

One: aim for problem recognition, not reduction

Everybody needs to drink less, but for heavier drinkers we need to be focused on problem identification. And that involves helping people critically evaluate the way they drink, without inducing shame.

Two: adopt shame-sensitive practice

Shame-sensitive practice is a way of enquiring that avoids or minimises shame and its consequences.

There are several aspects to this. We can adopt a dimensional model, making it clear to our patients that we are not interested in judging anybody’s drinking. And we can normalise a whole range of things: the fact that one in five of us are drinking too much; the fact that alcohol is the cause of many common problems that make people miserable; the fact that loads of people are concerned about their drinking but just don’t feel able to say this out loud in a very pro-alcohol society. And we can also normalise that it’s difficult to talk about difficulties with alcohol. It’s just really not a comfortable topic in the current climate.

Shame is important, but it mustn’t stop health professionals from having the conversation. Openly acknowledging that its difficult to talk about alcohol can start to dissolve the shame that keeps people stuck, and creates an environment where there’s permission to talk openly — hopefully on both sides.

Three: treat drinking as a cause, not a symptom

We’re very comfortable talking about the consequences of excessive drinking, but we shy away from talking about drinking as a cause of mental and physical health problems.

I think health professionals think they need permission to talk about alcohol. My view is that you already have it. We are caught in a trap of thinking about heavy drinking as a symptom of distress and disease when it is more often its cause. By flipping this way of thinking on its head, we are more likely to gain accept the invitation to talk more openly and honestly about how alcohol is limiting and damaging people’s lives. Patients want us to talk about alcohol; we need to develop the courage and skills to do it effectively.

Four: be confident about the value of abstinence

The next thing we should do is be really confident about the benefits of abstinence. We have some amazing, well-controlled trials that show the clinical benefits of even just a month off — never mind six months or a year. A great example of this is the work of Mehta et al at the Royal Free.[15]

If any drug had half the positive mental and physical impact of a month off alcohol, we would have no hesitation about prescribing it. Abstinence is basically the statin or Ozempic of lifestyle medicine. It’s a superdrug — and we are not advocating for it nearly enough.

There are also two other reasons for abstinence. The first is that difficulty cutting back is diagnostic of a high level of dependence, and lots of people struggle to cut back. Secondly, you cannot see the shape of a drinking problem whilst you’re still drinking. It’s only after a couple of months off that people really start to understand the damage that alcohol has been doing to their lives.

Five: educate about the early warning signs

We need to get better at educating people about the early warning signs that I discussed earlier.

Some questions to use in clinical consultations include: is alcohol taking up more of your life than it used to? Does cutting down involve a lot of mental space or effort? Do you feel in control of your drinking, or is drinking starting to control you? And importantly: how might your drinking be holding you back?

Six: open the door to an extended conversation

Problem identification is a multi-year, non-linear process, and we need to recognise that it can take years of concern before someone is ready to identify themselves as having a problem.

So our goal should be to open the door to an extended conversation, not simply rely on a hastily administered questionnaire that captures a single moment in time.

And because of that, we need to consider how we support problem recognition. We need to provide ongoing access to education, to counteract the alcohol algorithm; to help people experiment with their behaviour and drinking and develop curiosity, for example, encouraging people to engage with time-limited abstinence programmes with opportunities for reflection. And finally, we really need to be making more of the huge resource that is people with lived experience, those who have been on this journey, and who have far more wisdom about this issue than most health professionals.

A final thought

I want to end with a final thought.

Our system encourages people to wait until they hit rock bottom before making a serious attempt to tackle their drinking. By that point it is often too late. And the problem with rock bottom is that too many people don’t survive contact with the ground. It would be better to help people find a reason to give up before it is no longer possible.

Alcohol, even at low levels, is probably the single most common barrier stopping people from achieving self-actualisation — which is the innate goal that we all have, to become the very best version of ourselves. We are so focussed on telling people why they should stop drinking that we have forgotten to ask them why they might want to. Perhaps its time to retire the medical model and see what a public health approach based on positive transformation and growth could achieve. [16]

People who give up drinking have a lot in common with the characteristics of self-actualised people. So I want to end with what giving up drinking looks like in a life.

You see things as they are, not how you want them to be. You learn to accept yourself and others, warts and all, have better quality relationships and more capacity for kindness and compassion. You learn to think for yourself, and develop a low tolerance for bullshit. You develop a capacity for gratitude and joy, which are great to have in themselves, but also promote resilience. You become altruistic. And you are more likely to achieve your goals and reach your potential.

This is the real gift of abstinence. And in this era of lifestyle medicine, shouldn’t we be looking towards this kind of transformational change for our patients?

Do I Drink Too Much? Stop everyday drinking from becoming a life-limiting addiction is available from Amazon.

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References

1. NHS England. (2026). Health Survey for England, 2024: Adults’ health-related behaviours. NHS England Digital. https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2024/adults-health-related-behaviours.

2. World Health Organization Regional Office for Europe. (2023, January 4). No level of alcohol consumption is safe for our health [News release]; and Anderson, B. O., Berdzuli, N., Ilbawi, A., Kestel, D., Kluge, H. P., Krech, R., Mikkelsen, B., Neufeld, M., Poznyak, V., Rekve, D., Slama, S., Tello, J., & Ferreira-Borges, C. (2023). Health and cancer risks associated with low levels of alcohol consumption. The Lancet Public Health, 8(1), e6–e7. https://doi.org/10.1016/S2468-2667(22)00317-6.

3. Lid, T. G., Karlsson, N., Thomas, K., Skagerström, J., O’Donnell, A., Abidi, L., & Nilsen, P. (2021). Addressing patients’ alcohol consumption — A population-based survey of patient experiences. International Journal of Public Health, 66, Article 1604298. https://doi.org/10.3389/ijph.2021.1604298

4. Kaner, E. F. S., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B. (2018). Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database of Systematic Reviews, (2), Article CD004148. https://doi.org/10.1002/14651858.CD004148.pub4.

5. Boniface, S., & Shelton, N. (2013). How is alcohol consumption affected if we account for under-reporting? A hypothetical scenario. European Journal of Public Health, 23(6), 1076–1081. https://doi.org/10.1093/eurpub/ckt016

6. Lid et al. (2021), as above.

7. Chan, P. S., Fang, Y., Wong, M. C. S., Huang, J., Wang, Z., & Yeoh, E. K. (2021). Using Consolidated Framework for Implementation Research to investigate facilitators and barriers of implementing alcohol screening and brief intervention among primary care health professionals: A systematic review. Implementation Science, 16(1), Article 99. https://doi.org/10.1186/s13012-021-01170-8; and Cazalis, A., Lambert, L., & Auriacombe, M. (2023). Stigmatization of people with addiction by health professionals: Current knowledge. A scoping review. Drug and Alcohol Dependence Reports, 9, Article 100196. https://doi.org/10.1016/j.dadr.2023.100196

8. Madden, M., Stewart, D., & McCambridge, J. (2024). Barriers and leverage points for seeing alcohol differently in integrated care systems in England: A senior stakeholder interview study. BMJ Public Health, 2(1), Article e000829. https://doi.org/10.1136/bmjph-2023-000829.

9. Smith, J. J., Spanakis, P., Gribble, R., Stevelink, S. A. M., Rona, R. J., Fear, N. T., & Goodwin, L. (2022). Prevalence of at-risk drinking recognition: A systematic review and meta-analysis. Drug and Alcohol Dependence, 235, Article 109449. https://doi.org/10.1016/j.drugalcdep.2022.109449

10. Glass, J. E., Grant, J. D., Yoon, H. Y., & Bucholz, K. K. (2015). Alcohol problem recognition and help seeking in adolescents and young adults at varying genetic and environmental risk. Drug and Alcohol Dependence, 153, 250–257. https://doi.org/10.1016/j.drugalcdep.2015.05.006. A single problem-recognition item mediated 97.6% of the relationship between symptom severity and help-seeking. See also Morris, J., Richards, D. K., & Albery, I. P. (2025). Problem recognition as a discrete concept for change processes in problematic alcohol use. Current Addiction Reports, 12(1), Article 23.

11. Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, B. B. (2019). How many recovery attempts does it take to successfully resolve an alcohol or drug problem? Estimates and correlates from a national study of recovering U.S. adults. Alcoholism: Clinical and Experimental Research, 43(7), 1533–1544. https://doi.org/10.1111/acer.14067

12. Kilian, C., Manthey, J., Carr, S., Hanschmidt, F., Rehm, J., Speerforck, S., & Schomerus, G. (2021). Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcoholism: Clinical and Experimental Research, 45(5), 899–911. https://doi.org/10.1111/acer.14598; and Pescosolido, B. A., Halpern-Manners, A., Luo, L., & Perry, B. (2021). Trends in public stigma of mental illness in the US, 1996–2018. JAMA Network Open, 4(12), Article e2140202. https://doi.org/10.1001/jamanetworkopen.2021.40202

13. Morris, J., & Schomerus, G. (2023). Why stigma matters in addressing alcohol harm. Drug and Alcohol Review, 42(5), 1264–1268. https://doi.org/10.1111/dar.13660

14. Chadwick, P. (2025). Do I drink too much? Stop Everyday Drinking From Becoming A Life Limiting Addiction. Strelitzia Press.

15. Mehta, G., Macdonald, S., Cronberg, A., Rosselli, M., Khera-Butler, T., Sumpter, C., Al-Khatib, S., Jain, A., Maurice, J., Charalambous, C., Gander, A., Ju, C., Hakan, T., Sherwood, R., Nair, D., Jalan, R., & Moore, K. P. (2018). Short-term abstinence from alcohol and changes in cardiovascular risk factors, liver function tests and cancer-related growth factors: A prospective observational study. BMJ Open, 8(5), Article e020673. https://doi.org/10.1136/bmjopen-2017-020673

16. Maslow, A. H. (1970). Motivation and personality (2nd ed.). Harper & Row. (Original work published 1954)

Summer is here, and many people are looking forward to a break in the sun. But holidays can be a source of anxiety for those in the early stages of giving up alcohol. The thought of a holiday without that cold beer or wine is unthinkable when you are drinking, and this is the undoing of many a sobriety attempt. There are many layers to the holiday drinking trap; the association of alcohol with the need for reward, relief and relaxation, the stress of being away from routines, boredom, and social pressure. That first holiday without drinking can be challenging, but its the kind of challenge you need to go through to reap the reward you are looking for. As with many things, the trick is lean into the experience and explore it for what it is, and what it means. For many, holiday are a time to escape, and alcohol is the tool they use to achieve this quickly. If you are serious about giving up drinking, you can’t afford to indulge in the fantasy of escape. That path leads right back to the ‘fuck it’ button. That first holiday without drinking is something to be explored, not endured. Holidays can either accellerate or destroy your sobriety. By leaning in to the space created by an booze free holiday, you will discover important things about yourself, your life and your relationship with alcohol. You will also enjoy it more, I promise.

What follows is my diary during my first proper ‘sun and sand’ holiday without drinking. I should probably follow this up with a Summer Holiday Survival Plan!

Day 58

I have arrived in my happy place. Club La Santa, Lanzarote. We have spent many happy holidays with kids, friends and family here. Just the two of us this time, but this is also great. I don’t associate this place with drinking particularly, so it feels safe in that respect. I’ve already done more exercise by lunchtime than I managed the whole of last week! I have got a bit of work to do today before I can start to switch off - the minor costs of being a freelancer.

Feeling very lucky and very happy. Almost too lucky and too happy - just waiting for the hammer to fall!

Day 59

A.M.

I had TEN hours sleep last night! And I could have easily slept two more. All set up for another day of exercise. There’s a 5k running track around the laguna opposite the apartment - the keen beans run it every morning. I like to monitor their progress from the apartment with my coffee. It’s nice they have found something they love doing! I love coffee!

P.M.

Day one of the holiday down. Feels good to be challenging my body again. Very tired. No Beef Hula Hoops but Spanish Crisps are an adequate substitute, along with Alcohol Free (Sin) beer. I doubt I am going to make it past 9pm tonight without falling asleep!

Day 60

60 freakin’ days! In one sense the numbers are completely arbitrary, but recently there’s been a shift in their meaning. They’ve moved from something I want to achieve to something I want to cherish. The gains in self-respect, mental health and sleep are things I value and don’t want to give up. If I drank now, I would be giving up more than just numbers, I would be giving up on a fledgling new me.

Yesterday, I told my partner I wanted to get to a year. This is the first time I have said this out loud to anyone. They were supportive. I don’t know why I’m not ready to talk openly about my desire to no longer drink. It still feels too big. Perhaps I know my psychology - as soon as I state for certain that I want something, the process of sabotage will kick in. So, I am aiming for a year by not stating that I am aiming for a year! Warped, I know.

Day 61

All good here. Did a run. Knee held out. Will swim later.

Meet Sobie - he’s my new Cactus Holiday Accountability Pal. I stop and have a good chat with him each day on the way to the pool.

Meet Sobie: Your new Holiday Catcus Accountability Pal

Day 62

A.M.

Broken sleep. Anxiety about nothing. But not too bothered - can always catch up on the sun lounger later. Squash, swim, and now a nap!

P.M.

Run, swim, and cross training this afternoon. I did have thoughts about drinking today - I think the trigger was boredom. I find it difficult to switch off and alcohol is the easiest way to get that chilled out feeling. I was also triggered by seeing a guy about my age relaxing after a long bike ride with a glass of wine AND an ice-cold beer. B@stard! I allowed myself a moment of self-pity – centred mainly around thoughts that (a) it was unfair that I couldn’t have the same, and (b) a mild anger that I had allowed my drinking to get so out of control that I had to go to the extremes of giving up completely. But these thoughts were fleeting. I’m writing this a couple of hours later. I have some chocolate, a wonderful view and am about to start a new novel! These are experiences worth having, and ones that would not have been available to me if I had started to drink at 3pm.

Day 63

A.M.

I’m in a weird place. I am happy, but also full of anxiety and can’t relax. I’m having an existential crisis about the point of life. Not in a depressed way, just a kids-have-left-home, career-choice-point, how-do-I-want-to-spend-my-life way. You know, normal holiday-without-drinking stuff!!!

Anyhow, I dare say that will sort itself out in due course. The answer usually presents itself if I sit still long enough to hear it.

I’m reading ‘The Biology of Desire: Why Addiction is Not a Disease’ by Marc Lewis. It’s a really great book on the neurobiology of addiction. This passage really made sense to me:

“People choose to stop when they have suffered more than enough. And when circumstances lend a hand. And when the possibility of self-control becomes as attractive - more attractive- than any other possibility, including temporary relief.

In fact, real choice is not a one-shot deal. It is not a moment in time or a fork in the road. Rather, self-control thrives, as does addiction, when new mental habits are fashioned, and rehearsed, and strengthened by ongoing self-reinforcement. Choice may indeed be the antidote to compulsion, but it is an evolving skill… fuelled by the desire for strength and freedom.”

I really like the idea of choice being a skill. If choosing not to drink is a skill, it can be learned. If it can be learned, then it is possible. There is no fatal flaw to be fixed. No need to prostrate myself in front of a higher power that don’t believe in. It’s just learning a complex skill. There’s lots of evidence I can do that.

P.M.

A good day today - spent most of it reading in between naps on the sun lounger. And some sketching on the shoreline.

A very strange thing happened in the resort bar today, I actually groaned out loud as I passed a woman chugging down a giant goblet of red! I had the urge to snatch it out of her hand and throw it down my throat. It came from nowhere - no itchy feeling beforehand. No Booze Bitch whispering in my ear. Just a pure stimulus-response thing. Luckily, I don’t think anyone heard me - they were probably too pissed to notice! I bent down and rubbed my knee so people would think it was a twinge from a sports injury.

Day 64

Woke up feeling calm and a bit normal. I’ve not felt settled on this holiday, even though I am enjoying it very much.

I’m eight days in and this is the longest I’ve been on holiday without a drink. Went to a little taverna in the town next to the resort last night. We’ve been visiting this place for years. At the end of the meal, they produce a bottle of honey liqueur and pour you a glass without asking. It’s a lovely custom - but not for those doing battle with the Booze Bitch! I love the stuff - it’s really nice. Sometimes they make the mistake of leaving the bottle on the table, and Booze Me would have sneaked in at least two extra shots! This was a trigger point I anticipated. In fact, I had considered whether we should even go there as it might be a risk. But, although risky, it felt too restrictive. When the waiter approached with the bottle, I shooed it away before it got poured. He looked offended and I felt a bit bad, but the discomfort was short lived.

Apart from the odd micro-pang The Booze Bitch seems to have left her passport at home. It’s interesting to reflect on how different this was from the Paris trip. I felt her constantly whispering in my ear there.

It does get easier, but I am not allowing myself to get complacent!

Day 65

A.M.

The fuck-it button is right in front of me.

I just found out I didn’t get shortlisted for a job I was asked to apply for - a job I am already partly doing.

I’m miffed and mystified. Other good candidates did not get shortlisted either. Before I got the email, I was not sure I wanted the job anyway. In some ways not getting shortlisted is helpful because it closes off one avenue and simplifies my choices.

But still, I want to be wanted- don’t we all! I know it’s their loss. I know I could excel in the role if I had the opportunity and wanted it. However, at the heart of my relationship with booze is the fact that I am an all-or-nothing person, a perfectionist that does not tolerate failure very well. I’m either at the top or the bottom, people love me or hate me - there are few grey areas in my life. I hate that my professional network will know I applied and didn’t even get an interview! I feel ashamed of myself and foolish that I even thought to try! I can recognise these thoughts and feelings for what they are - dysfunctional and inaccurate (I hope), but they are still there, colouring the moment, eating away at the positive reframes!

I also wanted to add some intensity to my workouts today. If only to work off my frustration. But my knee is playing up and so I can’t do that. I tried but it was too painful. This is not turning out to be a good day.

Of course, these are the perfect setting conditions to hit the “fuck it” button. Slam that fist down and head to the bar. It would be so easy to nurture the hurt and get lost in a self-pitying narrative: I am Fat, Fifty, Follicularly Challenged and unFuckinployable! It is a well-practiced route to the booze fuelled pity party. If not getting shortlisted for a job that you are already doing is not a reason to drink, what is?

But I will not go there. I will find another way!

P.M.

Too much drama today, even for me.

Turns out I was invited for interview - it was a system error!

Frigging hell! I just can’t cope with the range of emotions I am going through today! Happy (“I am in my favourite place in the world”), to sad (“I am not wanted”) to relieved (“Didn’t want it anyway”), to confused (“Why don’t they want me”) to angry (“Stupid arseholes”), and now back to confused (“Do I actually want this now that I could have it?”).

Four seasons in one day!

And now I must stop myself from pressing the “fuck it button of success!” What better way to celebrate getting shortlisted than a pint or two?!

But I’m not going there. I will find another way!

Day 66

A quiet day after yesterdays drama. Exhausted, but happy I didn’t give into the Booze Bitch. Pilates, Yoga, Badminton, Swim and Step. Plus reading. Knee hanging on for dear life. Knackered. Reckon I will be asleep by 9.

Day 67

A.M.

Feeling a bit meh today. Tired of being in constant pain with my back (an old problem) and soreness and stiffness from exercise. I want to just go and smash out some high intensity exercise. However, I will be sensible and have limit myself to a swim, some core work and will prob go on a FW later (FW: F@ck Walk – a f@cking Walk for my f@cking stupid mental health).

P.M.

I went paddle boarding for the first time today. My entire body hurts. I went out on the water like I was on Hawaii-Five-O, only to realise that coming back in a headwind is bloody hard work and perhaps left to the experienced!

Nevertheless, paddleboarding is like sobriety. The moment you let your attention wander from the goal of staying upright, the water will take you! It’s the most perfect metaphor for how alcohol has taken me down the path it wants over the last twenty years.

Day 69

A.M.

Last two days of the holiday. I’ve just finished my fifth book of the holiday - this would have been unthinkable if drinking. I would have brought the books, but fallen asleep whilst reading the same page of the first book over and over again.

I’ve been thinking a lot about desire, no - not that kind of desire, but the experience of wanting something. I’ve been reading about this and it turns out that the “problem” of addiction is not so much the rewarding properties of the substance itself, but the fact that it sets alight those regions of the brain responsible for “wanting.” This is why we continue to drink when the actual act of drinking stops being pleasant or fun. The wanting has become dislocated from the reward, and the wanting takes over control of the brain.

I have also been reading “A Month In Siena” by Hisham Matar, which is an autobiographical account of a trip to Siena to view some paintings. Amongst all the musings on art, life and death was this rather lovely description of “desire”…

“Desire, its continuum, is reliant on yearning, on the unfulfilled wish, the frustrated appetite.

Desire…dies the moment it achieves its end. What keeps our passion for anything, anybody alive is the promise of attainment. In other words there is a contradiction between what desire wants - complete conquest - and what it needs to continue to survive: mystery, the unknowable.”

There, in the middle of this book about the Sienese School of Painting, was this beautiful passage talking directly to the experience of giving up alcohol. I’m taking this as a sign I am on the right path.

But, beyond the sign, what an amazing description of the inherent conflict at the heart of our relationship to alcohol.

Our personal mythologies about our drinking days, reinforced by society, fans the flames of our desire for alcohol. We are constantly told, and tell ourselves, what drinking will do for us. Let’s not pretend that alcohol once served a useful purpose at some point in our lives – the alleviation of anxiety, a social lubricant, a quick conduit to fun. But alcohol has now outlived that original purpose and has become the problem rather than the solution.

There are only two ways out of our desire for a thing we know is bad for us. We can continue drinking and submit ourselves to the “complete conquest” required by our desire for alcohol. Eventually this will result in self-destruction – the ultimate way out.

Or we can work to dismantle the desire from within. Educating ourselves to see through those personal and societal mythologies so that we can clearly see the realities of a drinking life; the misery from the false promises that we have been fed, and in turn have been feeding.

Todays image is a lovely decrepit old door I found in the town of Famara. I’m a bit obsessed with doors at the moment - portals to a new life and all that!!!!

PM. Swim, Run, Step Class today: Steptathlon! A moment of sublime happiness sitting on the apartment balcony, reading a beautiful book. Knackered. Content.

A beatiful old door in Famara, Lanzarote. A portal, perhaps.

Day 70

Finally in the 70’s - thought I was destined to be in the 60’s forever!

Had a proper drinking dream last night - my first. I woke up and cried - I was devastated. In that crazy place between sleep and waking, I thought it was real! This even though the dream involved drinking in a car that was lodged in the branches of a tree, alongside a talking owl! Perhaps there were magic mushrooms on last nights pizza!

The degree of devastation I felt was surprising – I didn’t think that sobriety meant that much to me.

It’s the last full day of the holiday. I got up after the dream, did some life admin, wrote for a couple of hours, then to a yoga class. I’m finally getting some flexibility back into my body and not grunting like a warthog with every downward dog!

Feeling very relaxed and not going to engage in anything too strenuous today. Just going to oscillate between snoozing and idly fantasising about how to spend more of my life doing less!

Right now there are no clouds on this horizon. I’m finally able to enjoy this moment, and there are no intrusive thoughts about past regrets or worries about the future. It won’t last, but that really doesn’t matter! This, right now, is more than enough.

Day 71

Holiday done. It’s been fantastic. I’m returning fitter than I arrived, with more mobility in this wretched body I have ruined by endless hours of overwork.

The picture is of the childrens playground at the resort. The last time I was here I got really pissed on the last night and went all Olga Korbut on the balance beam. I fell off and damaged my knee which meant I was out of action for a month. I was angry at myself and in a lot of pain. I found the video of the incident. It was pretty humiliating, but seemed so funny at the time.

Thankful that I am leaving in very different circumstances.

I have a hard partying friend staying with me for the next month, and a trip to a farmhouse with my Big Drinking Friends. Ironically, I am in charge of the food and drink, and have ordered crates of booze for everyone else.

Will take some earplugs and have also ordered loads of AF beer and sweets for myself!

My book Do I Drink Too Much? Stop Everyday Drinking From Becoming a Life-Limiting Addiction is out now on Amazon.

Day 51

I may not have gotten to the gym, or done a home workout, or even done my shitty little rehab exercises. I may still be insanely stressed about work, with perceived sleep quality that matches the worst of my drinking days. But I am up and out, drinking in this view which never gets old, and feeling smug as f@ck that I have no alcohol in my system. I got off the tube a couple of stops early on my way into work, and I am doing the most important thing I can do for my health and well-being; not drinking!

Day 52

Morning

Slept better last night. Woke up feeling like I’d been on a drinking session. Wondering if this is symptoms of morning caffeine withdrawal - I feel quite nauseous.

I have broken the back of my presentation - less worried now that I will commit career suicide on Monday. I got up early to work on it rather than go for a swim - I need to get myself together in relation to exercise. But will get off the tube early to add some extra steps in.

Day 53

Conference talk done. From the reaction of the audience, it went down well. I associate delivering a big presentation with a celebratory piss up at the conference drinks reception. I REALLY felt like I deserved a pint (or four) after the work I have put in - a symbol of my hard work and a way of coming down from the adrenaline high. It did feel sad not to join everyone in the conference bar after the talk – there was definite FOMO as I walked past everyone on my way out. However, I could not take the risk.

I had a plan. I identified a pub near to the venue that has Lucky Saint on draught. I walked there, ordered a pint and a pack of crisps (of course) and checked in with the group whilst slurping it down. I even stuck to my guns when the barman said that they needed to change the barrel and asked did I want a pint of alcoholic Peroni instead! It did seriously cross my mind to say yes, but I didn’t.

I kept the routine, but removed the alcohol. I don’t feel I am missing out.

And All Bar One in Villiers St stinks of old geeers pants!

Day 54

Morning

Made it through my first 25 day challenge. I joined after hitting a month AF, recognising that without a greater form of accountability I would drink again. I had started to have thoughts around whether things had been really that bad (they had) and whether I could have a secret little “just one” every now and again without telling the group (I mean, what the fucking hell?!).

The challenge has been humbling. Five very different people. All at different stages of our journey with different challenges to achieving our goal. Our reasons for no longer wanting to drink are also very different. But we are united in our commitment to improving our lives, and the importance of not drinking as the central pillar in that endeavour. After so long being alone in the dark, it’s been amazing to recognise my own struggles in the stories of others.

I saw a little display of guerilla gardening on my way to the tube. It made me happy. Wherever you are, whatever the situation, there is always beauty and hope to be found! You just need to learn how to look.

Evening

End of another busy day. The sun is out. London is bustling with life and energy – prime triggers for drinking. Got myself an ice-cold AF beer from the supermarket and some fresh coconut, and am hanging out in my favourite park on the way home. Much nice than a grotty bar. I feel content. No desire whatsoever to drink booze.

Day 55

Awful nights sleep due to worrying about work. However, it feels good to know that whilst I only had four or five hours sleep, the quality of that sleep was good, which means that I will be able to give my best today even if I may later need a nap.

Day 56

Right, so after losing myself down a work black hole due to my presentation I now have three hours to do all the work I neglected pack for a two week trip.

If I had been drinking, I would be hanging this morning, with hardly any sleep, and things would be just awful. As it stands, there’s lots to do but I will be able to prioritise and be effective.

This last 56 days has shown me that the problem in my relationship to work is not alcohol, not the toxic systems in which I work (and they are toxic!) but ME! However, it’s only by removing alcohol that I have been able to see this.

So, I’m heading to the Sun for two weeks of sport and relaxation. I have no excuse not to “do the work” on my mental health. I’m taking books, my writing materials and my art stuff, and I fully expect to be totally and utterly transformed by the end of April!

I’m not worried about not drinking, but I am not taking anything for granted. I have my group for support, and the work of checking in daily carries on even on holiday.

Not drinking is initially hard, but continuing to drink is harder.

My book Do I Drink Too Much? Stop Everyday Drinking From Becoming a Life-Limiting Addiction is out now on Amazon.

Less than one in ten people with a serious alcohol problem receive help for it.

This matters because those who get support are more likely to stop than those who don’t.

So, why don’t people seek help for their drinking problem?

The barriers are primarily psychological and include

• The fear of being judged by others: I don’t want others to think I am an alcoholic

• The shame of letting it get out of control it: I should be able to deal with this myself

• The minimisation of the problem: It’s not so bad that I need to get help.

Alcohol misuse has the biggest gap between recognising there is a problem and getting help for that problem of all psychiatric disorders.

This is because the psychology of asking for help is surprisingly complex.

To get help, you have to:

1. Recognise that there is a problem

2. Accept that you cannot deal with that problem yourself

3. Find and reach out for help

4. Learn how to accept the help that is offered

Each of these stages is its own challenge, and the process is far from linear. For example, it’s only by reaching out and connecting with others that you start to truly understand the shape of your problem.

At fifty days, I had accepted that there was a problem, that the problem was bigger than I realised, and found a tribe who understood and wanted to support me.

This was only the beginning.

The hardest step of all was learning to accept the help that was being offered.

Here are some lessons I was learning about asking for and accepting help.

ON COMMUNITY AND ASKING FOR HELP

1. Without accountability to someone other than yourself, you will drink again.

Alcohol completely changes the landscape of your brain to serve itself. Choosing to go it alone is setting out on a road trip with an outdated map.. You need an up-to-date map and a navigator who knows the territory – someone who has been there and done that. Preferably an entire team of them! Without such a team, you are destined to get lost.

Day 4

“I also know that without having a group to be accountable to, I would be in the pub with a pint right now, and not writing this.”

2. The moment it is hardest to ask for help is when this is the most important thing to do.

Distancing yourself from the people you know will be able to help is the first sign that you are going to drink again.

Day 45

“Part of me felt weak and stupid for reaching out. Even when the early messages of support came in I felt ashamed of myself for such a public declaration of weakness… I know enough about myself to recognise these thoughts and feelings for what they were — old, dysfunctional scripts being read aloud in glorious technicolour by the Booze B!tch.”

3. Not drinking requires you to be kind to yourself when all can feel is guilt, shame, anger and self-hatred.

The first stage in learning to be kinder and compassionate to yourself is learning to accept the kindness and compassion of others. The harder this is for you to accept, the more important it is you learn it.

Day 50

“Fertilising the ground with beef hula hoops, exotic donuts, insane amounts of sugar and the kindness of strangers.”

4. Addiction takes over your life by isolating you from others.

Alcohol is a predator that isolates the most vulnerable members of a group to make them easier to attack. The only way to survive is to stay close to the herd!

Day 50

“[I’m] thankful that I am no longer alone with the challenge. Thankful that I no longer feel powerless over alcohol, and that I have a choice about whether to drink. I’m a lucky guy!”

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My book Do I Drink Too Much? Stop Everyday Drinking From Becoming a Life-Limiting Addiction is out now on Amazon.

It’s a form of collective cultural madness that poisoning ourselves with a carcinogen is seen to be the highest expression of grown-upness. Much of this is a perverse and pervasive drink industry narrative: alcohol is required for peak experiences of release and enjoyment. But this narrative requires billions of pounds a year to sustain. Why? Because it goes against a deep, embodied and universal wisdom within us all - alcohol is not good for us. Our bodies tell us this every time we wake up with a mild or skull-cracking hangover or spend the morning dry heaving into the toilet bowl. This is why stopping drinking is often the first thing people do when they want to improve their health.

But what are the actual benefits of not drinking? Research into 30-day abstinence programmes like Dry January give us a useful snapshot. Those who complete Dry January typically report the following:

· 71% say that they enjoyed a better quality of sleep.

· 70% report better overall health.

· 67% report higher energy levels.

· 58% report losing weight.

· 54% say they noticed better skin health.

At the end of Dry January, 72% of participants say that they intend to drink less because of how good they feel, but the majority are drinking back at pre-programme levels within a month.

If not drinking feels this good, why do most people go back to it? The answer is complex — there are many layers to the alcohol trap. But what if the 30-day focus is part of the problem? What if 30 days is simply not long enough to deliver the kind of benefits that truly transform one’s relationship with alcohol? 30-day programmes are based on the idea that taking a break will spontaneously produce enough benefit that people will stop or return to drinking at lower levels. It a Reset Narrative. Unfortunately, the research does not support the Reset Narrative. There are benefits to Dry January, for sure. But these benefits last only as long as people don’t drink. There is little lasting physical, behavioural or psychological change. 30-day abstinence programmes have limited success in terms of changing long-term behaviour because they fail to appreciate that living a full, satisfying and rewarding life without alcohol is a skill. It involves a conscious, complex, non-linear process of learning and unlearning. And like any skill worth having, its acquisition can be frustrating, exhilarating, fun and boring. You can’t learn any skill worth having in 30 days. And definitely not the skills necessary to live a full and rewarding alcohol-free life.

No wonder so many people return to drinking after taking a break.

By personally and culturally investing in the 30 day reset narrative, we may be doing two things, First, we may be reinforcing our personal dependence on alcohol - as mentioned in part one of this post series, we periodically give up alcohol so that we can keep drinking. Second, we inadvertently increase the potency of the drinks industry narrative that alcohol is a necessary part of adult life. The reset narrative deflects attention away from the serious harms of alcohol. Perhaps the fact that the drinks industry ‘supports’ Dry January should alert us to the possibility that 30 day abstinence programmes may be part of the problem rather than the solution to the harms of alcohol.

At 50 days I was starting to understand the benefits of a longer stretch of abstinence. Life just kept getting better - something that I could never have known if I had returned to drinking at 30 days. When we limit ourselves to 30 days, we could be cheating ourselves of a greater prize.

The Reset Narrative and our cultural validation of the 30-day abstinence period stop us from appreciating the transformative benefits of a life without alcohol. Because the real goal of quitting alcohol is self-actualisation, not short-term relief from the misery of drinking too much. The drinks industry knows this, which is why it has largely got behind Dry January and its variants. Once the cat is out of the bag in terms of how alcohol limit people’s lives, the game is up for the drinks industry.

On what not drinking gives back

1. Sleep is the first gift and it is extraordinary.

Expect vivid, wild dreams and the ability to sleep through the night like when you were a kid. Mornings become something to look forward to rather than dreaded — even when you wake ridiculously early because your body is well-rested.

Days 3 and 4

“I had the most amazing sleep last night. I slept right through the night — which is something that rarely happens with or without booze… My dreams continue to be wild. Last night I accompanied the Obamas and their kids to Barack’s presidential inauguration ceremony!”

2. You get your senses back.

Food tastes better and your sense of smell improves. You’ll rediscover your childhood love of cheap sweets and the treat aisle at the supermarket will become your new home. The downside is that you realise people who drink stink — and continue to stink long after their last drink. The smell of wine on people’s breath is gross, particularly the vinegar breath of white wine drinkers. The early morning train carriage smells like a hotel room the morning after a stag do. You realise that your drinking may have been more obvious than you thought.

Days 15 (Paris)

“The smell of the expensive white wine was actually quite nauseating. It did make me wonder if that is what my kids smelt when I drank in front of them.”

3. You get time back — alarming quantities of it.

But time is only a gift if alcohol hasn’t atrophied your capacity to fill it. Boredom can become a burden, and that burden can lead you back to drinking. You need to rebuild your interest in non-drinking activities to prevent a return to alcohol.

Day 20

“F@ck me, how much more time do I have now that I don’t drink? In many ways it’s fantastic. So much more time to do things that are interesting. But the time you get back can also be a burden if alcohol has atrophied your ability to take pleasure in non-drinking activities.”

4. You get access to a sense of childlike wonder again.

You realise how much money you’ve been wasting chasing peak experiences to enliven a deadened nervous system. Your brain starts healing, and all you need is a shaft of sunlight and a couple of leaves to feel fully alive.

Day 13 (Paris)

“I realised that I know this feeling — it’s the wonder of childhood. There were no barriers between me and the experience… No part of my brain that wanted to be elsewhere.”

5. You can be fully present in life’s difficult moments.

Work panic at 4am is more bearable when your body isn’t wasting its resources expelling poison.

Day 39

“Last night my sleep was destroyed by a series of work-related panic attacks. This used to be a near nightly occurrence when drinking. Although unpleasant, these panic episodes are much more bearable when my body is not trying to expel poison from its system.”

Coming next in 50 Day Lessons: On asking and recieving help….

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My book Do I Drink Too Much? Stop Everyday Drinking From Becoming a Life-Limiting Addiction is out now on Amazon.

Research shows that the odds are against success for those who wish to quit drinking. Let’s look at some stats:

• Most people make 5 or 6 serious attempts to give up drinking before they finally succeed

• A return to drinking is most likely in the 3 days after an attempt to stop, and then 7 to 14 days after that.

• Only a third of people who attempt to stop drinking will succeed in doing so.

Depressing, but probably not surprising. Stopping drinking is hard. Really hard.

The active ingredients of success

The probability that anyone will stop drinking is depressingly low. Whilst there is no universal blueprint for stopping drinking, research has identified strategies that are reliably associated with success. Scientists call these Behaviour Change Techniques, and they are the ‘active ingredients’ in any intervention or quit attempt. They include:

• Substitute drinking with another behaviour. (Behaviour Substitution): Replacing the time and situations where drinking occurred with alternative activities such as reading, painting, exercise, cooking or eating. Anything that is incompatible with drinking.

• Trigger Management and Avoidance. Figure out what makes you want to drink and make a plan to avoid or handle those situations. This could involve avoiding triggers, or planning how to behave differently when you encounter one.

• Track your progress (Self-Monitoring): Recording progress, such as documenting alcohol-free days, which provides feedback on behaviour.

• Develop your social support systems (Social Support): Develop a network of supportive relationships with people who understand what you are trying to achieve and will provide accountability, practical, and emotional support. This can include friends, family, peers on a similar journey, or professional support such as therapists or recovery specialists. The fit and quality of the support matter more than the professional title.

• Change your environment (Environmental Restructure): Remove all alcohol from your home and avoid spending time in places where people expect you to drink or where alcohol is accessible.

• Develop your stress management skills (Stress Management): Stress and distress are major triggers for drinking. Developing your skills in managing stress in a positive, proactive way in critical to long-term success. This includes, but is not limited to: relaxation, breathwork, meditation, exercise, problem-focussed coping, and distress tolerance strategies.

Knowing isn’t doing

I was fortunate to know about these strategies thanks to my career as a clinical psychologist and behavioural scientist. These techniques were the backbone of my attempt to stop. However, knowledge of what works does not translate directly into action. I’d known about these strategies for thirty years before being able to use them to knock my drinking on the head. In fact, knowing what works but being unable to act on it can eat away at the hope that things could ever be different. Of all these strategies, the most important for me was finding a group of people on the same journey. Although there are no absolutes in the psychology of behaviour change. When giving up drinking, a choice to go it alone is almost always a choice to fail.

This is the second in my ‘lessons from 50 days of not drinking’ posts. These lessons are about how I learned not to drink when my mind, body, and soul was telling me to reach for the bottle. They put flesh on the bones of the strategies described above. Kind of a behaviour change textbook brought to life, my life, as it happened at the time. I hope they are helpful.

Lessons on how not to drink

Lesson 1

It is possible to predict the “fuck-it” moments where you are in danger of going back to drinking. Like predicting the weather, it’s not a precise science. But if you invest in mapping the terrain, you are less likely to be caught unprepared.

Day 6

“I have no desire to drink — but that can flip in an instant. I need to keep looking ahead to anticipate potential trigger points and put in strategies to deal with them.”

Lesson 2

By the time you feel a craving, you are already well into the danger zone. A craving is a sign that you are already at the point of meltdown. Eighty percent of the work that determines if you will give into a craving happens in the hours before it shows up. Keeping the goal of not drinking constantly at the forefront of your mind is critical.

Day 45

“It reminds me of advice about staying hydrated — by the time you recognise you are thirsty, you are dangerously dehydrated. I am going to keep on posting, writing, and checking in with myself before the crisis hits.”

Lesson 3

Giving yourself permission to drink can paradoxically reduce your desire for it. Telling yourself, “you can drink if you want to,” then making a commitment to re-evaluate whether you want to after implementing a distraction (coffee, cake, exercise, sudoku, conversation) can be way more effective than arguing with yourself.

Day 4

“I told myself that I could drink if I wanted to — no one could stop me, but I would commit first to having a coffee and something sweet to eat. Drinking my black Americano, I reflected that most ‘normal’ people don’t experience this kind of mental Battle Royale at the prospect of not drinking on a Friday night.”

Lesson 4

Allowing yourself to ‘white-knuckle it’ (putting yourself in the presence of things that are likely to trigger drinking and relying on brute willpower) may actually be an unconscious choice to drink. You cannot trust your brain to do what is best for your sobriety. Avoiding triggers is the most effective strategy in the early days.

Days 4, 6 and 11 (Paris)

“I took a different route to the train station, avoiding all the pubs where I have stopped off for a cheeky pint… I booked a film ticket for later that afternoon at a cinema nowhere near a pub… I paid to stay in a hotel rather than join the communal Airbnb. {these strategies} allow me to control my environment more and gives me a greater chance of success.”

Lesson 5

The “fuck-it” voice is creative, persuasive, and knows you better than you currently know yourself. It deserves respect as an adversary. Creating a character out of your “fuck it” voice will help separate the “you” that wants to stop drinking from the “you” that wants to carry on.

Day 37

““You’ve done nearly 40 days! Isn’t that enough?” “Why are you making your life more difficult than it needs to be.” “You’ve worked hard today, why not treat yourself to a nice cold beer?” The Booze Bitch brought her friends to the party tonight — a chorus of pissed-up lasses singing karaoke on a hen do.”

Lesson 6

You need a satisfying alternative to the act of drinking. Replacing drink with something — anything — sweet, fatty, salty, comforting, absorbing, reassuring. Stock up on whatever you need. And forget about your weight. That’s something to work on later.

Day 50

“Fertilising the ground with beef hula hoops, exotic donuts, insane amounts of sugar and the kindness of strangers.”

Lesson 7

Your early sobriety is a fragile seedling that needs protecting from harsh elements. The frost of survived temptation will eventually harden it into something that can stand on its own.

Day 50

“[I] hunkered down, reducing life to the bare minimum to protect this emerging seedling from the harsher elements… the frosts of resisted temptation only serving to harden this little seed as it grew into a plant.”

Up Next: Lessons on identity and behaviour change…

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References

Data on effective behaviour change strategies for a range of issues comes from the UK National Institute of Clinical Excellence, which has a rigorous process for identifying effective treatments.

NICE CG115 – Alcohol-use disorders: harmful drinking and dependence (Recommendations)

NICE PH49 – Behaviour change: individual approaches (Recommendations)

NICE PH24 – Alcohol-use disorders: prevention (Recommendations)

We have remarkably little good quality data on the the natural history on the natural history of problematic alcohol use in general populations, especially when compared to those who seek treatment. The data quoted are from general populations and will be different for the outcomes reported by treatment providers. David Kelly’s work (below) is the most rigorous epidemiological work on this issue.

Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, B. B. (2019). How Many Recovery Attempts Does it Take to Successfully Resolve an Alcohol or Drug Problem? Estimates and Correlates From a National Study of Recovering U.S. Adults. Alcoholism, clinical and experimental research, 43(7), 1533–1544. https://doi.org/10.1111/acer.14067

Project Three Sixty-Five is now at 50 days. It’s now over 1500 days since my last drink of alcohol - something unthinkable at 50. Milestones post provide an opportunity to reflect and extract lessons from one’s experiences (see my reflections on 1000 days without alcohol post). So, I thought I would look back on what I was learning at 50 days from the perspective of 1500 days.

It’s been fascinating. Two things stick out.

First, the richness of that early period - I was learning so much about my relationship with alcohol, with others and myself. Every day was a school day and it was exhausting.

Second, what I was learning had very little do with my initial reasons for giving up drinking. This talks to a wider truth in the science of behaviour change, which is that our reasons for initiating a change are often very different to our reasons for maintaining a change. This is because changing behaviour triggers an identity shift that makes the original behaviour less appealing. Put simply: when we stop drinking, we become a different person, and that person doesn’t want to drink anymore. Put even more simply; change changes you!

Unfortunately, this kind of transition does not happen spontaneously. It comes from paying as much attention to the journey of change as you do the outcome you are looking for. It’s not enough to stop drinking and hope for the best. Identity change comes from learning about what alcohol is doing to you and exploring the reasons behind your behaviour.

By reflecting on the experience of not drinking, my commitment to a life without alcohol grew organically. I changed because I wanted to change, not because I needed to. This is an important distinction in the psychology of behaviour change: wanting to change is a more powerful predictor of behaviour than needing to change.

Not transitioning from needing to wanting to give up alcohol is the reason most people go back to drinking. Very few people arrive at Day One genuinely wanting to stop drinking. They arrive with a desperate need for relief from the pain caused alcohol. It takes time and work for this to translate into the stronger motivation of no longer wanting to drink. The mind cannot be brute-forced into wanting to give up alcohol, this has to be incubated and nurtured into being over time.

Most people leave it too late to stop drinking, and the majority never escape its clutches. In psychological terms, they wait until they need to change rather than acting on the early warning signs of a developing problem. This is enabled by the dangerous but culturally sanctioned myth of ‘rock bottom’. At the point people need to change, alcohol has already atrophied the psychological muscles required to reclaim their life. It’s the behaviour change equivalent of waiting until the fuel gage is on empty before looking for a petrol station.

It’s not that it’s impossible to change from a place of rock bottom. However, many people do not survive contact with their rock bottom, and even if they do, it comes at a considerable cost to themselves and those who love them. It would be better for everyone if society retired the myth that people need to hit a rock bottom before they address their drinking. We need to encourage people to want to give up drinking at the first available sign they are on a path to severe dependence.

What follows in this and the next couple of posts are the lessons I learned in those first 50 days. These lessons are the beginning of my transition from needing to wanting to change. I never intended to give up drinking forever. I hoped that a significant period off the booze would reset my brain and make drinking fun again. But as I learned more about what alcohol was doing and experienced the benefits, of not drinking my intentions changed, and life is much richer and more enjoyable.

If you are interesting in making this transition yourself, the most important thing you can do is reflect on the journey you are taking. I did this through writing, but joining a group, talking with others, or keeping notes in whatever form will also do the job. Even just some quiet reflection every day will help the process along.

50 Day Lessons Part One: On the ‘Problem’ of Drinking Too Much

So, here’s the first tranche of lessons. These lessons focus on the ‘problem’ of drinking too much.

1. Periodic breaks don’t reset your relationship with alcohol — they reinforce your dependence on it. You stop so you don’t have to stop.

Day 31

“I’m realising that my previous attempts to limit my drinking have only increased my desire for it. What an insane and perverse paradox — I periodically stop drinking so that I can carry on! I stop so that I don’t have to stop!”

2. The difficulty of giving up drinking is itself the diagnosis. If it’s hard, that’s all the evidence needed to know you are already dangerously dependent on an addiction-forming substance.

Day 40

“If trying not to drink is exhausting, your relationship with alcohol is likely to be problematic. The fact that giving up alcohol is hard is the reason you have to do it. The difficulty is all the diagnosis you need to know that there is a problem.”

3. Drinking to manage anxiety is a honey trap. Alcohol entices you in by providing immediate relief, then systematically devalues all healthier methods of dealing with stress and worry.

Day 39

“I’m fully appreciating Laura McKowen’s phrase that drinking to cope with anxiety is like throwing gasoline on an open fire. Not drinking has not reduced my anxiety so far, but it has made it easier to cope with.”

4. We have been conditioned to think that Alcohol is an essential additive to experience, when the opposite is true. Alcohol dulls the senses and creates a barrier between you and your natural capacity for joy. So many people are missing out on life because part of their mind is fixated on getting to the ‘drinking bit’.

Day 13

“Some part of my brain was always wanting the museum visit to be over so I could get to the drinking bit. Yesterday felt different, like a shroud had been lifted. There were no barriers between me and the experience of being at the gallery or Cemetery.”

The desire to drink is like an iceberg. Most of what is waiting to sink your sobriety is beneath the surface of conscious awareness. It takes time to learn how to tune into what’s there.

Day 31

“I feel good for not having drunk for a month, but I can sense the heft of desire moving underneath this surface sense of wellness. There’s a monster stirring in the depths, rocking my makeshift raft of sobriety. My booze bitch is a Kraken!”

Coming next: lessons on the mechanics of not drinking, identity and change, culture and other peoples responses, and what not drinking gives back to you…

My book ‘ Do I Drink Too Much? Stop Everyday Drinking From Becoming a Life Limiting Addiction’ is out now on Amazon.

I returned to Broken Hill this evening, with my hula hoops and a strong black coffee. This is where I made the decision I could not go on as I was, that I needed help. I was all ready to go to the local AA group but reached out to an online group first.

I’m trying to connect with the me that sat on this bench 50 days ago. He was in a wretched place. He was six weeks out of a job that had become toxic for him, four weeks into failing miserably at Dry January. He was in the worst physical shape of his life, despite weeks of renewed efforts in the gym. He was missing personal training sessions because he didn’t want his trainer to spot that he was hungover. He was turning up to Writing and Art class hungover, unable to make the most of opportunities he had worked hard to create for himself. He was consumed by panic that life was slipping away from him, that the best of life was behind him, and that he should give up on the dreams he once had for himself.

But within all this wretchedness there was a sliver of hope things could be different. He placed that seed in the soil of an online support group and pressed that fucker down with everything he had left. He watered it with daily posts, reading everyone else’s posts as if they were sacred scripture, and let the beginnings of a new life germinate. He hunkered down, reducing life to the bare minimum to protect this emerging seedling from the harsher elements. And fertilising the ground with beef hula hoops, exotic donuts, insane amounts of sugar and the kindness of strangers.

And then he went to Paris! I suppose this was the do or die hardening-off strategy! Risky, but the seedling survived, the frosts of resisted temptation only serving to harden this little seed as it grew into a plant – a Chadwickus Soberistus to give it its Latin name!

50 days later, I am back on the bench on Broken Hill. I’m still feeling pretty broken - only this time it’s because of a relentlessly punishing, self-inflicted work schedule. I feel like sh!t and I’m angry at myself for not being able to manage my life and my self better. There are lessons to be learned, and I need to give myself time to learn them. I know this. But after 50 days of not drinking, the sediment of chaos caused by alcohol has settled, and I am better able to see the causes of my distress and dysfunction.

However, despite my current sadness, I am also thankful. Thankful that I am free of any guilt or shame about drinking, and that I am no longer alone with the challenge. Thankful that I no longer feel powerless over alcohol, and that I have a choice about whether to drink. I’m a lucky guy!

Photo by Deepak Rastogi on Unsplash

My book ‘ Do I Drink Too Much? Stop Everyday Drinking From Becoming a Life Limiting Addiction’ is out now on Amazon.

Day 46

Up at 4am with hot sweats and the shakes - as if I had been out on a session. Irritating, but also nice to remind myself that this was sometimes a daily occurrence and so good to feel no guilt or shame. Done a couple of hours work before heading into art course. Was a bit of an irritable douchebag on my work calls. Stinking headache! Will get some neurofen, water and fruit. I need some time off!

Day 47

Ill. Miserable. No hot toddies. No excuses. Just drugs of the entirely legal and non-psychotropic kind.

Day 48

All fine here. Feeling much better. Did a spin class. Lovely brunch with friends ending in an mildly unsettling debate. Now going to curl up on the couch and watch a film.

Tonight I ate fried frozen gyozas straight from the pan, and tinned mandarin segments straight from the can!!!

Day 49

The Japanese cherry blossoms are out in the park. Job application submitted - five hours of my time I will never get back. If I ever get my hands on the f@ckers who INSIST that you apply by CV and then replicate the same information on a crappily designed form then I will enact violance and dump them in a compost heap to rot!

How’s that for mindfulness!

Anyhow, in the middle of all that I had a lovely time meeting some of my oldest friends at RHS Wisley. I discussed my AF experience and they were generally dismissive of the value of being AF or sceptical of my ability to last. F@ck em though! It doesn’t actually bother me. We are entering the National Trust Years anyway - no more meeting in pubs. These days it’s all about the size of the scones!

Day 45 (counting, counting, counting!).

Feeling more centred after yesterdays F@ckWobble. Glad I am not resetting to Day 1.

I honestly can’t believe the support I received yesterday - it was awesome. I find it very difficult to ask for help – for lots of reasons, I have always seen it as a sign of weakness.

I was taken aback that people responded with such kindness and generosity.

It would have been so easy for me to not reach out yesterday.

Part of me did not want to reach out. I knew that you would tell me stuff I did not want to hear (don’t drink, use this strategy, remind yourself why you stopped - blah, blah, blah f@cking blah!!!!).

Part of me did not want to hear what I knew I would be told - that I “got this”, and that I had the power to choose not to drink.

Part of me felt weak and stupid for reaching out.

Even when the early messages of support came in I felt ashamed of myself for such a public declaration of weakness. This triggered thoughts that I did not deserve the help that was being offered; that I was attention seeking.

Luckily I know enough about myself to recognise these thoughts and feelings for what they were - old, dysfunctional scripts being read aloud in glorious technicolour by the Booze B!tch.

I’m glad I allowed myself to be helped, when my natural reaction would be to denigrate the support (“what do you know?!”), myself (“just pull yourself together”) or rationalise (“well one little drink is not really resetting - especially if people don’t know!”).

It’s made me reflect how important it is to reach out early. The longer you leave it the further down the road you are to taking a drink. I think this is why it is important that I write this daily post - it prompts me to check in with myself, to take my emotional temperature, and assess whether I have everything in place to protect my sobriety.

Life is so hectic, our brains so full, and we are so busy getting on and/or doing for others that we don’t even know what state we are in half the time. Our first sign that something is not right is when something happens “out of the blue.” But it’s never out of the blue. There’s always trigger(s)- and it’s often painfully obvious to others what is going on - if only we took time to stop and ask!

It reminds me of advice about staying hydrated - by the time you recognise you are thirsty you are dangerously dehydrated!

So, I am going to keep on posting, counting my stupid (but fantastic) days, writing, and eating every frigging sweet and fatty thing I can lay my greasy, sugar-dusted fingers on!

And I won’t leave home without anticipating where my triggers might be and a plan for managing them for the next few weeks.

Supporting professional and research literature

It’s been estimated that more than 90% of people who stop drinking go back to it in some form. Technically this is called ‘relapse’ and the risk is greatest in the first year after stopping drinking. For most people, relapse occurs when they experience some kind of trigger that generates a craving - an intense desire to drink. How people respond to cravings will determine the path of their alcohol-free journey.

I think this post nicely illustrates the complexity involved in responding to cravings, and the importance of social support, self-regulation, and self-awareness helping people manage triggers. It also shows the importance of connection as a core condition for dealing with unhelpful scripts of vulnerability, shame and self-belief that create acts of self-sabotage. Asking for and receiving help can be incredibly challenging for many people and vulnerability, shame and stigma isolate people from the thing they most need and often want least. It is possible to give up drinking without the support of some kind of formal or informal support group, but the chances that it will happen are much reduced. Sometimes overcoming an addiction is not about the mechanics of controlling intake, it’s about learning how to allow oneself to feel vulnerable and safe in ones connections with others.

There is a wealth of research and evidence on the value and importance of these contributions to relapse and strategies to manage cravings, but here are some of the classics:

Kelly, J. F., Humphreys, K., & Ferri, M. (2020). Alcoholics Anonymous and 12‐step facilitation treatments for alcohol use disorder: A systematic review and meta‐analysis. Cochrane Database of Systematic Reviews.

- Shows that mutual-help groups and 12-step facilitation improve drinking outcomes largely via social support and increased engagement.

Moos, R. H. (2007). Theory-based processes that promote the remission of substance use disorders. Clinical Psychology Review, 27(5), 537–551.

- Identifies supportive social networks and help-seeking as central mechanisms in preventing and managing addiction.

Havassy, B. E., Hall, S. M., & Wasserman, D. A. (1991). Social support and relapse: Commonalities among alcoholics, opiate users, and cigarette smokers. Addictive Behaviors, 16(5), 235–246.

- Shows how stronger social support predicts lower relapse rates.

Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., & Fletcher, L. (2012). Slow and steady wins the race: A randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. Journal of Consulting and Clinical Psychology, 80(1), 43–53.

- Describes how targeting shame and self-stigma improves substance outcomes.

- Schippers, G. M., & Nauta, J. (2006). Cognitive therapy for addiction: Addressing maladaptive schemas. In W. O’Donohue & E. Levensky (Eds.), Handbook of Evidence-Based Treatment Manuals for Addiction .

- Reviews schema-focused CBT can be used to change dysfunctional “scripts” around worth, weakness, and deservingness that can get in the way of recieving help.

Witkiewitz, K., & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. American Psychologist, 59(4), 224–235.

- Describes how identifying triggers and intervening early in the “relapse process” reduces relapse.

Marlatt, G. A., & Donovan, D. M. (Eds.). (2005). Relapse Prevention: Maintenance strategies in the treatment of addictive behaviors (2nd ed.).

- The classic text on the theory and practice of monitoring early warning signs for drinking and how to manage these.

Todd, M., Armeli, S., & Tennen, H. (2009). Ecological momentary assessment of the triggers and contexts of drinking in young adults. Journal of Studies on Alcohol and Drugs, 70(1), 22–31.

- Shows that drinking is preceded by identifiable situational and emotional triggers.

Shiffman, S. (2009). Ecological momentary assessment (EMA) in studies of substance use. Psychological Assessment, 21(4), 486–497.

- Shows how frequently checking in on how you are managing emotionally improves understanding and management of cravings. This can be the foundation of sharing with others, eliciting effective social support when it is needed.

Norman, P., Webb, T. L., & Millings, A. (2019). Using implementation intentions to reduce alcohol consumption in heavy drinkers: A meta-analysis of randomised controlled trials. British Journal of Health Psychology, 24(2), 292–310.

- Shows how making plans to anticipate and manage cravings significantly reduce alcohol consumption.

Share Control Issues

Day 42

AM. Had a solid 9 hours sleep last night. Busy week ahead. Still in lots of pain with my back, so will prioritise stretching and Pilates this morning. Got in a couple of hours writing this morning as it’s my turn to present my work in writing group next Monday. Last time time I presented it sent me into a bit of a vortex, so keen not to make same mistake again.

PM. Quite overwhelmed by things at the moment. So today I simplified what I could, prioritised what was absolutely necessary and what would bring happiness. Met up with a couple of friends with whom I have shared many crazy drinking adventures. None of us drank and the laughter still flowed. No alcohol required.

Day 43

AM. Up early. Back Pain. Did yoga and rehab to help, and then rearranged my office so I can use my standing desk. Now on my back taking a break! I should get help for it. Not sure why I am not! This is a pattern! Gonna try and break it!

PM. (Written outside a Greggs in Central London). Ok, so I’m having a really bad craving. Really bad. It’s come totally out of the blue.

I’m just coming back from doing a talk at a conference and the f@cking Booze B!tch is telling me I should just go for a drink. My partner is away and so I could drink and no one would know.

Apart from me, of course!

I’ve checked my HALTs:

Hungry. No - just had a Greggs! And a pint of Ribena followed by a Beef Hula Hoops chaser!

Angry: I don’t think so. But I am frustrated with a few things, so maybe that’s it. I think I have a lot of pent up energy from not being able to exercise.

Lonely: No - looking forward to some time to myself.

Tired: Possibly. Have got a lot on mentally.

I’m gonna get home - that is a safe environment. I then have to give another talk online, so that should distract me. And then all I need to do is hold out till the challenge - there’s no way I could drink after that. I’ve got emergency Beef Hula Hoops and an Alcohol Free Beer if I need it.

F@cksake! This morning I actually had the thought “oh this is easy now!”

That will teach me to be complacent!

I’m also posting to the group for accountability.

Learn more about the HALT approach to managing cravings from this post…

HALT…

Monologue for an Onion

Monologue for an Onion
I don't mean to make you cry.
I mean nothing, but this has not kept you
From peeling away my body, layer by layer,

The tears clouding your eyes as the table fills
With husks, cut flesh, all the debris of pursuit.
Poor deluded human: you seek my heart.

Hunt all you want. Beneath each skin of mine
Lies another skin: I am pure onion—pure union
Of outside and in, surface and secret core.

Look at you, chopping and weeping. Idiot.
Is this the way you go through life, your mind
A stopless knife, driven by your fantasy of truth,

Of lasting union—slashing away skin after skin
From things, ruin and tears your only signs
Of progress? Enough is enough.

You must not grieve that the world is glimpsed
Through veils. How else can it be seen?
How will you rip away the veil of the eye, the veil

That you are, you who want to grasp the heart
Of things, hungry to know where meaning
Lies. Taste what you hold in your hands: onion-juice,

Yellow peels, my stinging shreds. You are the one
In pieces. Whatever you meant to love, in meaning to
You changed yourself: you are not who you are,

Your soul cut moment to moment by a blade
Of fresh desire, the ground sown with abandoned skins.
And at your inmost circle, what? A core that is

Not one. Poor fool, you are divided at the heart,
Lost in its maze of chambers, blood, and love,
A heart that will one day beat you to death.

From Notes from the Divided Country by Suji Kwock Kim. Copyright © 2003 by Suji Kwock Kim. Reproduced with permission of Louisiana State University Press. All rights reserved. Embedded with permission from the American Academy of Poets

I have a morning ritual: wake, sit, meditate, read the next poem from whatever anthology I’m reading (no browsing, just going with whatever is there), then pour myself into morning pages. Like most rituals, it’s sacred but imperfectly executed. Today’s poem was Suji Kwok Kim’s “Monologue for an Onion.” It landed like a slap.

It’s been a difficult few months. My mental health is on the fritz. Mainly anxiety due to overwork, travelling between the UK and US, and a move to New York. It’s approaching three months of early morning waking, endless rumination, and a body that feels like a rubber band ball: taut and primed for threat. All made worse by my gnawing need to label, explain, control, and fix everything around me. And frustration. I’m a psychologist. I fix other people, so why not myself?

I arrived at this morning’s ritual having woken at 3, followed by three hours of doing the opposite of what I know I should – get up, drink a herbal tea, read until my eyes droop, and return to bed. But no, I stay put, fire up the Kindle, read some shit about warring wizards, wage and lose an internal war against those who have unknowingly wronged me, then onto an episode of Star Trek. Because nothing shouts sleep hygiene more than a Klingon blood feud! Sleep eventually claims me at 5:30, and the alarm goes off at 6. I get up; sleeping in never makes a sleepless night better. Besides, I have my ritual.

This ritual is a form of meditation. I read whatever is presented, and most days, the poem provides something I need. Poetry focuses and calms my scattered mind. My morning mind is a sponge, receptive to lessons. I was not expecting today’s lesson to be delivered so brutally, and by an onion.

The Onion mocks my anxiety:

“Look at you, chopping and weeping. Idiot.

Is this the way you go through life, your mind

A stopless knife…

…slashing away skin after skin

From things, ruin and tears your only signs

Of progress? Enough is enough.”

I saw myself as the onion sees me, and it was not a good look! I saw how it views every bit of emotional labour I do to appease others and keep myself safe - every ruminative thought, every carefully crafted thought, text and email. Its disdain a glass of cold water thrown in my face.

I sat for a moment, stunned.

Then laughter. I’ve just been owned by a fictional onion. How ridiculous, meaningless, and futile all this worry is. I feel released.

The “stopless knife” of the poem stops!

The Onion is a metaphor for the way psychology understands the nature of distress. Much modern psychological practice is based on depth psychology, which suggests the origins of distress are to be found by peeling away layers of meaning to reveal a core defect that can be corrected. There’s much to be said for this type of meaning-making. All forms of distress are ultimately made better by understanding. However, we need to choose these meanings carefully. Excavation has value—understanding and integrating past hurts can reduce suffering—but it can also trap people in an endless archival project: peel, find another layer, peel again. This can feel like progress. But it can also lead people to believe distress must be eliminated before life can be lived.

Depth psychology is a Western idea, but there is an alternative. Approaches informed by Eastern philosophies of mind, and backed by Western science, suggest that whilst we are built to search for and make meaning about our internal lives, we are also doomed to be very poor historians of its causes. In the same way a loaf of bread can never remember what it was like to be flour, water and yeast, we can never accurately comprehend the crazy mix of genetics, learning history and social relationships that create ourselves. It’s a curious irony that evolution bequeathed us the wonderful gift of a mind that can make meaning whilst restricting access to the data that it needs to understand ourselves. It’s the stuff of Greek tragedy: the man gifted with incredible empathy that can understand anyone but himself! Philosophers call this the ‘epistemological gap’ and psychologists have found the mind rushes to fill this gap with stories. Psychological theories of distress are themselves a type of story. Sometimes theories can help, and sometimes they can perpetuate the distress they are designed to alleviate.

Most distress-causing events are inert happenings on which we heap layers of meaning, like toppings on a plate of cheap nachos. Guacamole of Hurt, yes please! Jalapenos of Shame – double helpings! And don’t forget that creamy Sour Cream Sadness! We keep heaping on the meaning, hoping to make our distress digestible. Unfortunately, this often results in a gloopy mess of distressing mental slop. It serves to make the problem worse, not better. And yet we keep eating, despite the discomfort.

Eastern approaches to living with distress suggest the task is like learning to live with the weather. Mental events, good or bad, are like the transient passing of different conditions, and our job is simply working with whatever is presented on any given day. We can explain the weather using meteorological science, but understanding why it’s raining doesn’t help with staying dry. That is best achieved by putting up your umbrella. We can drive ourselves mad trying to uncover the sources of our pain, when it might be better to accept its presence. According to this view, sometimes the best balm for distress is acceptance without explanation.

I’m often encouraged to get therapy to help with my anxiety. As if I haven’t tried! I’ve been slicing away at the onion of my anxiety for over 30 years. Medication, slice. Relaxation, slice. Transcendental meditation, behavioural therapy, psychoanalytic therapy, antidepressants, cognitive therapy, mindfulness, acceptance and commitment therapy. Slice, slice, slice, slice! Aged 52, I am knee-deep in discarded onion skins.

“Beneath each skin of mine

Lies another skin: I am pure onion – pure union

Of outside and in, surface and secret core.”

And still anxious. I’ve given up on my hunt for the core. There’s peace to be found in accepting that you might never know the truth of what drives your pain. This Onion’s cruelty is in fact a gift. An invitation to stop this endless search for truth or self-improvement and get on with the business of living. It tells us to stop treating distress as a mystery to be solved and see it as an experience to be lived.

What has all this got to do with addiction? Well, like many before me, I gave up drinking to fix myself. Turns out I can’t be fixed, or at least in the way depth psychology promises. The mind is not a machine with an ideal state of functioning. Most minds, in fact, I would say ALL minds are simply Heath Robinson machines – a basic shell with a hodge-podge of patches and hastily assembled fixes to help us survive. Deliciously messy, delightfully different, and wonderfully unique. This is something to be celebrated and embraced, not homogenised and straight-jacketed into submission by the technologies of therapy.

We stop drinking to fix ourselves only to find that there is no fix for life. This does not mean that we should go back to drinking. It means that we just must accept, take responsibility for, and work with the way our minds are. Today I am wild with anxiety. My mind is a clusterfuck of jumbled thoughts and competing priorities tossed around in a tornado. But I am not going to make this worse by drinking, or by getting angry or frustrated with myself. I am what I am, and this is what it is. I can’t change my brain’s tendency towards anxiety, but I can secure my foundations and not add energy to the impending storm. I can accept The Onion’s invitation to stop beating myself up, and to stop searching for an unknowable truth behind my pain. Distress doesn’t always need an origin story. I am what I am, and learning to live with myself is a daily practice. Today I am supported in that practice by my good friend and therapist, The Onion. And for that, I am grateful.

Photo by K8 on Unsplash

Monologue for an Onion, read by the poet Suji Kwok Kim

Scientific and professional literature underpinning this article

Readers interested in the scientific underpinnings of this article can look at the sources below. The ideas are broadly consistent with Acceptance and Committment Therapy. However, the theories of functional contextualism, radical behaviourism and relational frame theory are best explored by reading the origional empirical papers rather than more popular descriptions of the approach, which tend to water down the more radical aspects of the approach.

Nisbett, R. E., & Wilson, T. D. (1977). Telling more than we can know: Verbal reports on mental processes. Psychological Review, 84(3), 231–259.

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25.

Hayes, S. C. (2004). Acceptance and commitment therapy,
relational frame theory, and the third wave of behavioral therapies. Behavior
Therapy, 35(4), 639–665.

“Are you an alcoholic?”

When I was drinking more than I wanted to, and for several years after stopping, this was the question I dreaded most. I burned with shame at the question and quenched the flames by drinking more.

Addiction isolates people, and language enables this. The words for drinking too much are loaded with stigma and shame. The heat of the A-words - alcoholism, alcoholic, addict, addiction - flock to the behaviour of excessive drinking like inflammation around a wound.

The stigma of excessive drinking has its origins in the disease model of addiction: those who lose control of their drinking have a disease of the brain, like diabetics have a disease of the body. This is thought to explains why only a subset of people who drink heavily develop a serious and life-limiting condition. It separates the ‘us’ who can handle their drink from the ‘them’ who are alcoholics.

Scientific research and lived experience cast doubt on the validity of the disease model, suggesting that problematic drinking is better explained as a continuum. It suggests excessive drinking is a progressive phenomenon. There is no ‘us’ and ‘them,’ only a single continuum of dependence on which we all exist. The science behind the continuum model is simple. The brain adapts to a psychoactive substance by becoming increasingly tolerant, which is why the more you drink, the more it takes to get drunk. The more alcohol you consume; the greater the negative impact on your physical and mental health; the more your relationships and work suffer, and the more you will rely on alcohol to cope with the problems caused by drinking. Drinking becomes like a Chinese finger puzzle – drinking to cope tightens alcohol’s grip on the brain. This end-state is how most people think of the A-words. But this state is not a different category of being; it’s just the natural consequence of playing with the fire of a mind-altering substance.

The disease model suggests people cross an invisible threshold from normal drinking into problematic drinking. From ‘liking a drink’ to ‘alcoholism.’ It relies on lists of signs, symptoms, and criteria that are supposed to define when ‘too much’ becomes pathological. I’m not sure this line exists. The development of problematic drinking is a biological and psychological journey. Everyone who lost their health, a job, a loved one, or their life because of drink took the same journey: benign social drinking became a severe and life-limiting addiction.

Our reliance on the A-words to describe growing alcohol dependence is a problem. It perpetuates stigma and activates shame. This prevents people from thinking critically about their drinking. The language of the disease model creates an ironic and dangerous double bind. Society encourages us to play with fire, then blames those who get burned. The disease model and its A-words enable this double standard. If language creates a division between those who drink problematically and those who drink normally, stigma will stop people from acting before it’s too late.

To prevent people from progressing into serious addiction, we need a non-stigmatising lexicon to describe the experience of becoming dependent on alcohol. We reach for words like ‘alcoholic’ because we don’t have alternatives. This is a problem because words create reality. Language conjures up and breathes life into things that don’t exist but take on the semblance of things that do. Think about Dragons. Dragons don’t exist in the real world, and yet the concept of dragons drives a multi-billion-pound industry. In trying to explain problematic drinking, psychiatrists tried to describe a pattern of behaviour and gave it a name: Alcoholism. They created a Dragon. They took the bones of neurobehavioural chemical dependence and wrapped it in the flesh of guilt, secrecy and shame.

Psychiatry created the dragon of alcoholism with good intentions. But it has been hopeless at slaying it. The term ‘alcoholic’ does not have any validity in modern science and clinical practice, yet it remains the dominant cultural concept for explaining problematic drinking. Millions of people feel that ‘I am an alcoholic’ is a meaningful way to describe their relationship with alcohol. However, for millions more it is a word that wreaks psychological havoc, leaving people cowering in fear, shame, and secrecy. And these responses are justified. Prejudice and discrimination against people with alcohol problems is real and appears to be increasing. There are significant emotional, social, and career risks to being open about a drinking problem. The fear of being labelled ‘an alcoholic’ kept me drinking long after the point I wanted to stop. If the only words for describing our experience of drinking too much are conduits for stigma, shame and discrimination, most people will choose silence. And if we can’t talk about our concerns, we cannot receive reassurance, help, and support.

Which brings us to the point of Control Issues, this post, and its companion post: Better Conversations (Part One). We need to talk more about problematic drinking, but we need to talk differently. Contrary to the rhetoric of Big Alcohol, the harms associated with drinking are at an all-time high. Whilst young people are drinking less, alcohol remains the primary preventable cause of death and injury in youth, and particularly young men. We are blindly walking into a public health tsunami of cancer, dementia, kidney and liver disease caused by high levels of alcohol consumption. In 2025, UK deaths directly attributable to alcohol reached their highest ever level. All this is preventable if we can get people to step off the path to serious addiction sooner. The disease model of addiction seeds the myth that only some types of people get into trouble with their drinking, leaving the rest of us to carry on without worry. If only this were true. Since sharing my experience, many others have shared their own alcohol-related concerns. Most are not people one would identify as having a drinking problem, and yet alcohol is clearly taking a toll on their lives. The disease model of problematic drinking is contributing to a dangerous conspiracy of silence. More people than we think are worried about how they drink. They just don’t know how or are too afraid to talk openly about it.

‘Are you an alcoholic?’

Not one person asked me if I was an alcoholic during the thirty years I drank heavily. After I stopped, it’s all people wanted to know, even if most have been too afraid to ask directly (see Better Conversations: Part One). It’s ironic that living well with a stigmatised condition often involves having to embrace the concepts that kept you in secrecy and shame. Many find liberation in reclaiming the labels that society uses to shame them. This is why “My name is Bob and I am an Alcoholic” holds such power for many who struggle with their drinking. But the journey to this type of acceptance is not easy. For every person who finds liberation in that phrase, there are many more who lose valuable years, and sometimes their lives, fighting against being defined in such a way. Given such harms, it might be time to retire the language of disease and invest in developing a more descriptive and scientifically accurate language that dismantles the stigma of problematic drinking.

The words used to describe our drinking have profound personal consequences. They also create ripples in the lives of others affected by alcohol and our culture. I used to agonise about how I would answer the question, ‘Are you an alcoholic?’ The dragon concept of alcoholism kept the question hot with shame. As a professional with lived experience of drinking too much, the words I use have the power to feed or help slay the dragon. It’s taken me a while to find a way of articulating why I stopped drinking that does not feed the beast. A way that was true to my experience and based in scientific reality – that integrated my personal and professional understanding of the issue. Here it is – a work in progress:

“I realised I was drinking more and more, and I didn’t like the impact it was having. My brain was increasingly dependent on a substance with dependence-forming properties, and it was limiting my life in ways that distressed me, even if friends and family were not that bothered.”

This is a good enough reason to stop drinking. In fact, it might be the best. If more people acted at this point, the individual, familial, and societal burden of serious addiction would be greatly reduced. Isn’t that what we all want?

For readers interested in the science underpinning this article…

Papers on the problems with the disease model and the stigmatisation of alcohol

• Heather, N., Best, D., Kawalek, A., Field, M., Lewis, M., Rotgers, F., … Heim, D. (2018). Challenging the brain disease model of addiction: European launch of the addiction theory network. Addiction Research & Theory, 26(4), 249–255.

• J. Morris, A.C. Moss, I.P. Albery, N. Heather. (2022). The “alcoholic other”: Harmful drinkers resist problem recognition to manage identity threat. Addictive Behaviors, 124,107093.

• Morris J, Schomerus G. Why stigma matters in addressing alcohol harm. Drug Alcohol Rev. 2023; 42(5): 1264–1268.

• Kilian, C., Manthey, J., Carr, S., Hanschmidt, F., Rehm, J., Speerforck, S. and Schomerus, G. (2021), Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcohol Clin Exp Res, 45: 899-911.

Articles on the record number of deaths associated with alcohol

• UK Deaths from alcohol at record high

• Guardian article on UK alcohol deaths

Yesterday was tough. I wrote “I just want to get wankered” in my journal.

My brain is too full. Full of too many emotions. Full of a punishing workload. Full of the impact of living with near constant pain. Full of the complexity of the decisions I need to make.

I just wanted to escape. To have fun. Fun of the old kind. Messy, fuck-it fun. I felt like I was standing in front of a mirror in which I could see different responses to this situation playing out. I could see the ‘fuck-it’ version - calling friends, heading to the pub and escaping into an afternoon of booze, fun and laughter – momentarily relieved of the burdens of duty, pain and anxiety. I could also see the no-drinking version, and it felt drab, colourless, depressing and dutiful. The pull of my old life was strong. Very strong.

So I wrote it all down - IN BIG LETTERS that matched my BIG EMOTIONS.

That evening, I went to a Tori Amos gig. I nearly didn’t go, fearing it would be too strong a trigger in my current state. But the tickets were a gift, and it felt wrong not to use them. And my booze hound was probably seeing this as an opportunity to press the ‘fuck it’ button. I was close, especially being surrounded by people with their bottled lagers, and tumblers of gin and tonic, which looked so good. But a sense of accountability to my group prevailed, and one bottle of AF beer was enough to silence the calling of the Booze Bitch.

I’m glad I didn’t cave, because I had an amazing time. I love Tori Amos’s music because it is fearless, unashamedly emotional, complex and challenging. I was able to escape into the moment and become absorbed completely by the music. She played songs from her new album, plus songs I knew well, but with new arrangements. I usually feel annoyed at new versions, craving familiarity over novelty. But yesterday I noticed I could appreciate the new arrangements without hankering for previous versions.

I feel relinquishing alcohol is like learning to embrace new versions of old songs. You can hanker after the past, or you can choose to embrace the new. You must use the lines and refrains from your drinking life and weave them into a new and rewarding soundscape. This takes effort and will not happen by chance. Until you do this, your alcohol-free soundtrack will remain a disconnected mess of musical phrases snatched from sobriety memes and abandoned quit lit. It will feel off key and discordant, leaving you vulnerable to reaching for the old familiar song, however damaging or boring that song may now be.

So, this morning I got up early, loaded up the coffee pot and wrote without censorship, letting the words fall out of me and allowing them to arrange themselves on the page. Writing my song.

I felt on fire. Liberated. Free. The mirror image from yesterday was reversed.

This booze free life is the ‘fuck-it’ life. This crazy, nuanced, complex, emotional and unmedicated life is what being wankered is all about. You don’t need drink to get wankered, just a willingness to meet life as it is, not how you wish it to be. It’s drinking that leads to a colourless, washed-out reflection of a half-lived life.

My brain is still too full. I will make plans to make it less so. But they won’t involve drinking.

Day 37

I’m writing this after spending the day in my old office. From my desk I could see directly into the pub garden where I have done much of my after-work drinking. The pull was strong. I found myself squinting through the window to see if anyone I knew was there. I had niggly voices singing the “f@ck it” song all the way from the top floor of the office to the tube. The Booze Bitch brought her friends to the party tonight – a chorus of pissed up lasses singing karaoke on a hen do.

“You’ve done nearly 40 days! Isn’t that enough?”

“Why are you making your life more difficult than it needs to be.”

“You’ve worked hard today, why not treat yourself to a nice cold beer?”

I think that without the accountability of the small group and a target of getting to another 30 days, I would be in the pub right now. Probably doing karaoke with my chorus of Booze Bitches. It would not have been pretty, but admittedly it might have been fun!

Until it wasn’t.

Day 39

Last night my sleep was destroyed by a series of work-related panic attacks. This used to be a near nightly occurrence when drinking. Eventually I gave up trying to sleep at about 4 am and got with my day. Although unpleasant, these panic episodes are much more bearable when my body is not trying to expel poison from its system. My anxiety levels are very high - but I am realising this is normal for me! I’m also fully appreciating Laura McKowens phrase that drinking to cope with anxiety is like throwing gasoline on an open fire. Not drinking has not reduced my anxiety so far, but it has made it easier to cope with. At least now I can get up and get sh!t done instead of rotting in bed with a hangover and wishing the world would just go away!

My son locked himself out of his flat today. God knows how, and all will be revealed in due course. It was nice to reflect that I could have driven him back to his flat if needed because I hadn’t had a drink. Went to the pub for dinner because I just did not want to cook. Had two small AF beers in a pint glass. It tasted so good - and it didn’t even cross my mind to want an alcoholic drink. I do wish pubs would serve a better range though - I do love the bitter taste of beer. I genuinely think it’s that I miss, not the ethanol.

Day 40

This is the longest I have ever gone without a drink. And a nice round number! I‘m lucky enough to have been given tickets to see Tori Amos in London tonight. It was a last minute gift and unexpected She has been a favourite of mine for a long time and it’s been an ambition to see her live.

It will be my first “gig” sober, and I am a bit nervous about it. I feel like I have not had enough mental space to prepare myself for going out to this kind of event without a drink. Although what’s there to be fearful about - it’s not exactly going be a mosh pit! Another milestone, I suppose.

I sometimes feel a little weary of all the effort it takes to not drink. The decision not to drink sometimes throws a shroud over experiences that should feel joyful. It adds complexity to things that would feel spontaneous and fun if I were drinking. I can see why most people return to drinking.

But, here is the thing. If trying not to drink is exhausting, your relationship with alcohol is likely to be problematic. The fact that giving up alcohol is hard is the reason you have to do it. The difficulty is all the diagnosis you need to know that there is a problem! It reminds me of one of those motivational phrases:

If you do what is easy, your life will be hard.

If you do what is hard, your life will be easy.

This could not be more true of the experience of drinking, and not drinking.

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Felt a bit ‘meh’ yesterday. Realised too late that I was probably in the prodromal phase of a shitty migraine. Went to bed early. Today, I feel washed out, but better.

I have been reviewing all my posts since I joined as part of my process of taking stock of lessons learned. I won’t bore you with details, but the first 8 days were notably different compared to the last 8 days. It’s clear that I was incredibly vulnerable and shaky early on. It felt like any tiny thing could knock me off my path. I was only ever one or two thoughts or bad decisions away from a drink. Now I feel much more stable and that it would take much more to knock me off the path. I felt every minute and hour of those first few days.

I hope this shift is evidence that one day I will just be able to put this to the back of my mind. Not drinking will become a thing I do, not THE thing I do. I am tired of thinking about drinking. And thinking about not drinking. But I accept that ‘not drinking’ must be at the front and centre of my mind for the foreseeable future.

I had my writing group this evening – we are nearing the end of the course. People are starting to make plans for end-of-course drinks. It is taken for granted that this will be in a pub and will involve alcohol. I am already starting to feel anxious about it. I’m starting to notice how excluding and exclusionary British drinking culture is. I felt a shift in the classroom from the moment that drinks were mentioned. We are an ethnically and religiously diverse group, and it’s likely that many don’t drink for a variety of reasons. The default assumption that our end of course celebration will involve alcohol has created an unarticulated division between those who do and don’t drink. The voices of the drinkers and loud and dominate the planning. The non-drinkers acquiesce, relinquishing any claim on how the event should be. I’m guessing some non-drinkers will go to any event and not be bothered, but I can now see others starting to withdraw from the group. I feel it too. I want to be part of the event. I want that opportunity to cut loose and get to know people a little better, to hear about their experience of the last ten weeks and share my own. To gossip and laugh and share perspectives on our shared journey. This can be achieved without drinking. However, I am fearful that doing so in a pub will overwhelm my will not to drink. Experience tells me I am likely to hit the fuck-it button in such situations, and it would be wise for me not to go. It feels like I must choose between being part of the group or being sober. And this feels like a shitty choice. I understand the world doesn’t revolve around supporting my tortured relationship with alcohol. However, it also occurs to me that I would not have to choose if our culture were not so alcocentric. There are many ways an end-of-course celebration could be organised in which alcohol does not play a central role. It does not even occur to us to even think about what that could be. And if it does occur to some of us, it would feel dangerous to say it out loud. It would likely be met with derision, incomprehension or horror. Drinking dominates so much of our social lives – no wonder it is so hard to stop.

Anyhow, I’ve started the process of managing the situation early. The moment that drinks were mentioned I told people that I am not drinking at the moment. I notice that I do not say that ‘I don’t drink,’ probably because I don’t yet believe this about myself. It feels like I am in a transitional phase – I’m trying not to drink, but I don’t want to be sober. I hate that word – at least for me. But more about that another time.

I’ve done a month off the sauce. I failed at Dry January, so attempted Dry February instead. This is the point I normally celebrate by having a drink. There is a lot of expectation riding on that first drink. Once the initial relief of near-continuous December hangovers is over, I usually spend the rest of January counting down the days until my next drink - fantasising about how amazing it will taste! It occurs to me that I spend most of Dry January heavily investing in the idea that alcohol is a precious commodity. I’m realising that my previous attempts to limit my drinking have only served to increase my desire for it. What an insane and perverse paradox – I periodically stop drinking so that I can carry on! I stop so that I don’t have to stop! Behind this paradox is the secret hope that not drinking for a month will reset my brain. By taking a break, I will restore my brain chemistry to a place where just one pint will be enough to get me to a loose, happy state! Goodbye problematic drinking! Farewell hangovers! In just 30 days I will have restored the damage done by 30 years of heavy drinking! Isn’t the brain a remarkable thing? Aren’t I so clever to have found a way to beat biology!

This time feels different. I’m entering this stretch of abstinence with a different goal – to eliminate my desire for alcohol. Over the last couple of years I have been taking more and more ‘strategic breaks’ and yet my drinking has ramped up considerably. It’s as if the breaks have given me permission to drink more. And each time I go back to drinking, my tolerance has not subsided – I can drink as much as I ever did. I know this is a bad neurological sign.

Reaching a month is point of vulnerability. The call of the drink is strong and this is the time I would normally answer. For this reason, I am joining a ‘small group challenge’ – a 30 day period of increased support. The desire for alcohol cannot be eradicated in 31 days, even thought I would like for this to be the case. I feel good for not having drunk for a month, but I can sense the heft of desire moving beneath this surface sense of wellness. There’s a monster stirring in the depths, rocking my makeshift sobriety raft. My booze bitch is a Kracken!

As part of the small group challenge, we were tasked to write down our reasons for starting this journey – apparently these are known as the ‘whys?’ Here are mine:

1. I don’t want to die with a big fat “what if” hanging over me. What if there was a better life out there for me that I just didn’t have the courage to try? What if there was more to life than an endless cycle of drinking, hangovers, regret and worry? What if there was something better beyond the veil of drinking, but I was just too afraid to draw back the curtain and look? I don’t want to be a “what if” guy.

2. I don’t want to continue running on empty - living a depleted, washed-out version of life.

3. I can’t achieve the things I want to achieve or be the person I want to be if I continue to drink alcohol. I don’t know who the AF version of me is, or what is possible for them - but I know that alcohol is holding me back.

4. I don’t want to be scared and fearful anymore. I’ve been using alcohol to manage social anxiety and fear all my life. It’s been my shield since I was thirteen. I’ve propelled myself through life on an ethanol shaped rocket. It’s time to step off and meet life head on. What’s the worst that can happen?

So, there we have it. 31 days under my belt. 30 days of increased accountability to go. If I achieve this then I this will be longest I have gone without alcohol since I started drinking. This is a sobering thought in itself.

Perspectives from the research and professional literature

It’s fascinating to read this diary entry having not had a drink for well over three years. It creates a huge sense of relief that I achieved my objective of eliminating my desire for alcohol. But it also generates anxiety when I see how precarious my early sobriety was - how easily it would have been to slip back into drinking and to lose the chance to live the kind of life I now enjoy. At this point in my journey there was no serious intention to give up alcohol forever - I simply wanted to carry on with a period of abstinance long enough to reset my brain so that I could go back to drinking.

It also makes me reflect on some of the research into the short and medium term outcomes and benefits of Dry January participation. Despite the increasing awareness and participation in Dry January and Sober October, we have very little high quality research evidence on its impact. The best research currently available is the work of Professor Richard de Visser and colleagues at the University of Sussex who completed a series of small studies looking at the characteristics of those who try Dry January, their progress, its psychological impact and drinking behaviour trajectories during and beyond the month long campaign. The outcomes reported by these studies suggest that individuals who take part in Dry January are more likely to reduce their alcohol intake than those who do not formally take part, and that participation is associated with improvements in self-reported physical and psychological wellbeing. This data also suggest that a significant number of participants make lasting reductions to the amount they drink for up to six months following the end of the campaign, and that there is little evidence of a rebound effect in those that resume drinking (i.e. people don’t end up drinking more than they did).

These studies contribute to an encouraging picture of Dry January participation, but there are some important caveats. The data on six month impact on behaviour is based on only 37% of the origional sample - not atypical of this kind of research, but it warrants caution when extrapolating to understanding a population-level impact. The data also suggest that those that participate in Dry January attracts people who drink more heavily than those that don’t, and that those that fail to complete a month of abstinant are the heaviest drinkers with the greatest degree of psychological distress. For this reason, I would suggest that trying and failing at Dry January or Sober October is an important warning sign that your drinking is on its way to becoming a serious problem.

I’m also left thinking that our research efforts into Dry January are quite naieve and unsophisticated. I think the field (health psychology, public health) has taken a rather naieve, albeit understandable, view that a period of alcohol abstinence is an unproblematically positive thing. But I think the research of de Visser, and this diary entry, suggest that many people come to Dry January with complex motives. We have not really taken very seriously the idea that participation in short-term abstinance challenges could play a part in a wider cycle of increasing dependence. This does not mean that we should give up on these campaigns - I believe that they are a good thing. But perhaps the organisers could do more to help people reflect on their experience of taking part in the context of their historical drinking patterns.

This post is from my daily diary of my first year of not drinking.

Ding dong the Booze Bitch is dead! Actually, she’s probably on a temporary break, but that will do for right now. Last night I was craving a pint of beer really badly. I couldn’t tell whether it was the pint I wanted, or the beer. To test this out I went to a local bar, bought two cans of AF beer, asked for a pint glass, and poured the beer into the glass. It was the pint, and not the booze I wanted. Itch scratched and I was home watching TV by 10pm.

Today was a good day. Managed a walk and a session on my spin bike. Since there are no Beef Hula Hoops to be found anywhere I’ve temporarily designated Jelly Tots to be my Emotional Support Food.

This morning, I met with two friends I had not seen for a while. They commented on how happy I seemed and that there was a lightness about my demeaner. I explained that the change was due to not drinking for a month, and that I was planning to carry on for another month. I waxed quite lyrical about the benefits of no drinking. Perhaps I am becoming a Sober Bore - that’s quite a few people I have told now.

Well, if so, so be it. In the words of Rizzo from Grease “there are worst things I can do, than not drink a pint or two…”

Post Scripts: Insights from the Scientific and Professional Literature

The ‘Booze Bitch’ referred to in this post is my personification of the way alcohol was influencing my life. The creation of the Booze Bitch is an example of ‘Externalisation,’ a technique from family therapy, and later developed as part of Narrative Therapy.

Externalisation invites people to see a problem as an external entity rather than an intrinsic part of their identity. This is achieved by creating some kind of persona for the issue, giving it a name, and perhaps visualising how it might look and speak. This becomes the starting point for exploring the influence of the problem on a persons life, reducing feelings of guilt and shame, and freeing their resources to think more flexibly about the issue at hand.

The technique is most memorably described in the book Narrative Approaches to Therapeutic Ends by David Epston and Michael White, and the most famous example of externalisation is the brilliant ‘sneaky poo’ character used to help families work with the distressing issue of persistent soiling (e.g. smearing faeces).

Externalisation offers an interesting possibilities for the way people experience problematic drinking. Many problematic drinkers struggle with seeing themselves through the lens of the dominant medical model - the idea that all problematic drinking reflects a disease labelled as ‘alcoholism.’ Instead of having to adopt the stigmatised identity of being an ‘alcoholic,’ externalisation invites people to see problematic drinking as something outside of themselves. It seperates the behaviour from the person. You become someone who drinks problematically rather than a problem drinker. Seperating the behaviour from the person opens up the possibility of relinquishing the behaviour whilst preserving a positive sense of self. It creates a space to understand the seriousness of the issue without having to adopt an entirely new and potentially problematic identity such as ‘an alcoholic’ or ‘addict.’

Narrative therapy approaches invite us to think about the story we want to tell ourselves and others about our drinking. There are no right or wrong stories to tell about alcohol dependence, but all stories have implications for the way we see ourselves, how we behave and our relationships with others. Our personal stories draw from wider cultural narratives about problematic drinking. These are woefully impoverished, generally stigmatising and often shame promoting. This sets up a self-fulfilling prophecy where the shame associated with the extremes of addiction keeps those in the early stages of dependence from being able to explore their drinking with non-judgemental curiosity. Narrative approaches invite us to tell different stories about alcohol, stories that seed curiosity, experimentation and are linked to what it means to enjoy life, not merely survive it.

Photo by S O C I A L . C U T on Unsplash

References

White, M., & Epston, D. (1990). Narrative means to therapeutic ends. WW Norton.

Diamond, J. (2000). Narrative means to sober ends: treating addiction and its aftermath. Guilford Press.

Rizzo: There are Worst Things (I Could Do).

I’ve been struggling these last two days. I feel very flat and just plain meh. It’s difficult to pinpoint why. I reached my first goal of a month (note that I picked February - the shortest month!), and I am proud of myself for achieving that. I intended to sit down and write some reflections on what I have learned from the experience - but I just don’t seem to want to do this. Perhaps it’s because there are no Beef Hula Hoops in the shops – I haven’t been able to find any anywhere. Apparently, there is a National Crisp Crisis because of a disrupted supply chain for frying oil. This national crisis is in danger of becoming a personal tragedy. I’ve come to rely on my daily walk with coffee and a bag of Hula Hoops to process things. Without my trusty hoops, my sober powers are depleted.

My brain seems to be rebelling. I just want a pint. Although on closer inspection it feels like I want the pint more than the alcohol. I think “the pint” represents the ability to relax and let go. The after-work pint has been my number one method of coping for so long. I do know how relax with other methods - I’ve had more baths than Mr BathTime from Planet BubbleBath. But I’m still restless and over tired. I feel like a toddler that has not had its afternoon nap.

There’s a bit of Fading Affect Bias in here too. Was it really that bad (yes it was)? Was I as bad as some of the others on here (yes to some, no to others, but comparisons are not relevent!)? Who would know if I only had one (I would know, and that’s the only truth that really matters!)?

None of these thoughts are dominant, but they are present, like weeds in my path.

I think the T is dominant in my HALT (Hungry, Angry, Lonely, Tired). I have been pushing myself very hard.

I’m working full time hours, whilst doing a 2 day a week art course, and a day a week writing course. Plus a 3 hour a week meditation course! I’m trying to fit an eight and half day work week into seven days. It’s only when writing this right now that I realise how ridiculous this is! I’ve also doubled my hours in the gym - so my body is really, really sore from DOMS. Hopefully that will pass as I get fitter). It’s great that I have the energy to work so hard. But hard is still hard even if you are doing things that are good for you, and the mind/body will out.

Who knew it was possible to burn out from self improvement?!

Well, almost any of my friends if I had asked them. It was almost inevitable that I would take the wrecking ball approach to sobriety, as that is entirely consistent with personality. And possibly one the reasons for drinking so much in the first place!

So, this is why I needed a small group challenge! If I hadn’t signed up for increased accountability, I would have a pint in my hand right now. I’m glad I don’t. But at the same time I don’t think there’s enough scented bath salts in the world to soothe this bitch of an itch. I’m going to have to just sit with the discomfort, - it’s just an itch, nothing serious. But it better be f@cking gone tomorrow!

I’m going to buy a box of Beef Hula Hoops from Amazon. And to order a takeout. I shouldn’t be washing up with my T in ascendency! It will break me.

Post Scripts: Insights from Professional and Scientific Literature

Fading Affect Bias (FAB) is the psychological tendency for negative aspects of an experience to be forgotten more quickly than positive aspects. The concept of FAB is widely talked about within alcohol free communities. It is used to explain why people who repeatedly experience negative effects of their drinking (brutal hangovers, arguements, injury, fights) carry on drinking. The theory is that because the negative aspects of a drinking session fade from memory more quickly than the positive events, people expect that having the next drink will be positive.

FAB is believed to be a coping mechanism that helps keep a person’s overall mood positive. It is believed that holding onto memories that have a negative emotional association is burdensome for the mind and the body. Fading Affect Bias is hypothesised to have evolved as a mechanism to help maintain a positive mindset.

Despite the ubiquity with which FAB is talked about in the alcohol free community, there have been remarkably few research studies of the phenomenon applied directly to alcohol. In fact, I can only find one small empirical study of FAB applied to alcohol, and this is in a population of individuals without serious alcohol problems (Gibbons et al., 2013).

Many, many people find the concept of Fading Affect Bias helpful. And if it helps, then let’s celebrate it and use it! However, it’s an interesting example of a psychological concept that has achieved the status of ‘fact’ within the alcohol free community despite there being very little direct empirical evidence. Given its influence, I think this concept is probably due some rigorous scientific attention. Perhaps FAB is a good topic to explore in Control Issues!

References

Gibbons, J. A., Toscano, A., Kofron, S., Rothwell, C., Lee, S. A., Ritchie, T. D., & Walker, W. R. (2013). The fading affect bias across alcohol consumption frequency for alcohol-related and non-alcohol-related events. Consciousness and Cognition, 22(4), 1340-1351.

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Day 25

All good here. Did my first Pilates reformer class today - surprisingly effective! I have no core after two years hunched over my desk during the pandemic.

I can feel the siren call of the beers as my month milestone approaches. I’ve joined a challenge to get me to at least Day 50 and hopefully beyond. I’m finding the idea of “never ever again” too daunting even though that is that I want. So I am following advice and focussing on daily milestones and hoping everyone is right about the impact of having enough of those under the belt.

I met a friend for lunch today who has seen me suffer over the last year. I was able to tell her that I am really happy at the moment, and that not drinking is part of that. Another close friend has decided to do Dry Feb and March after me talking with her about my decision to stop.

Day 26

Grumpy. Went to parkrun for first time in two months - hobbled round with the Cardiac Crew at the back. Failing miserably at my writing task for Monday, so feel that I have wasted my valuable Saturday and have nothing to show for it. Apart from doing four loads of washing! I’ve got a “right cob on” as we would say back home. Gonna have to find something positive to do to shake the mood.

Day 27

Much less grumpy than yesterday. Was at my desk writing at 4:30 am - eventually sent of my writing homework for review at 9am. Then it was the gym and the Louise Bourgeois exhibition at the Hayward.

Today was saturated with alcohol, from the smell of red bull and tinnies being downed by the football fans, to the bars of the South Bank. A little voice in my head was whispering “you could just go and have one - no one will know, besides you’ve nearly done a month and you can start again on Tuesday with the challenge.”

There was no way I was going to act in the voice - mainly because I also was having such a great time without the drink. I genuinely believed that a drink would not enhance my experience and would actually make it worse. Just the Beer Goblin trying to sneak up on me!

Day 28

Post writing group treat was two donuts: Peanut Butter and Jelly, and Lemon Meringue. Feedback on my work was good (even though I had vowed never to write again yesterday!). 28 days ago I would have been two pints (at least) instead of two donuts down. Am pleased to have broken this association between drinking and treating myself.

Photo by Alexander Grey on Unsplash