There is some evidence that abstinence is an easier goal for most older, married persons and that moderation is easier for most younger, single people. But, what may be easier is just one factor and not by itself grounds for a decision. There is no authority, other than a physician pointing to specific disease conditions such as diabetes and liver problems, who can tell someone else whether they must abstain altogether rather than moderate. Someone who belongs to a church which uses wine in Communion services won’t want to, and doesn’t need to be, absolutely abstinent. Other than the exigencies of health and religion, the most critical factor in choosing a goal is what a person believes he can do and what he wants to do.
Beginning moderate drinking after long term abstinence has many pitfalls and is not recommended. The only serious problem with abstinence as a goal is its difficulty for most people. If someone is already successful, why tamper with success? An advantage of the goal of moderation is that the option is always open to abstain if it is later decided to be easier, which for some people it is. Perhaps the best way to begin moderation, however, is by abstaining for two weeks*1 or so. The benefits are two fold.
First, tolerance decreases and a relatively small amount of alcohol will give an appreciably greater effect. Second, by paying careful attention to oneself, to the feelings and thoughts that arise while abstaining, the role of the excessive drinking comes more clearly into focus.
For example, a person who feels extremely lonely when he abstains will be able to focus his attention on finding better ways of interacting with others. If he feels helpless or powerless, he can look for ways to regain the perception of control in his life.
It is important that a person who has been drinking to great excess see a physician. Medical advice can be helpful and perhaps even life saving but any suggestion by one’s doctor that “people rarely recover on their own,” that one should go to AA or than one should meet someone “in recovery” can be ignored. It is also important to take note of the doctor’s body language and, if it is discouraging of one’s decision to quit or moderate without “help,” to consciously discount the source.*2
Although strong emotion may be experienced, abstaining or moderating is not necessarily difficult. While it may seem overwhelming for some who decides to “never drink again,” it is relatively easy to ignore “forever” and merely postpone or delay a decision to drink; to just do something else.
For example, someone in the habit of drinking after work, instead of worrying about the difficulty of, or struggle in, abstaining forever, will find it far easier to just go to a movie, watch TV, meet friends for dinner, go on a date or read a book.
Central to maintaining moderation or abstinence is having or developing a “can do” belief and motivation. Motivation can perhaps be best thought of in terms of what you “would rather” do. Humans are rarely clear cut in their motivation. For example, someone who is planning a vacation may want to go to two mutually exclusive places. Perhaps he wants to go to Europe and to South America but only has two weeks off work and a limited budget. He wants to go to both. What he actually does in based on what he “would rather” do.
The same is true when choosing whether or how much to drink on any given occasion. Mixed emotion often plays a part. Wanting a drink is not a sign of looming failure. Comfortable success in abstention or moderation doesn’t necessarily depend on feeling horror or revulsion at the thought of drinking but on the development of “would rathers.” For example, someone who has decided to abstain may have an urge to go out on Saturday night for a few drinks at his old hangout. This is no “big deal” and need not lead to “relapse” or failure. All he needs is to find one thing he would rather do. Then he not only doesn’t drink, he doesn’t feel cheated.
Important for the abstainer, when “craving” (wanting) a drink, is to have alternative ways to better meet the same ends. Someone who has been abstinent for several months may find himself looking forward to the day he can “control” his drinking. Of course, people can and do control their drinking when they want to but they are less likely to want to as long as they remain blind to the reasons they drink and can’t see better ways of filling their needs. The most important point is to not waste time pining for what is not available but to recognize and take full advantage of present opportunities. By finding better ways to accomplish what one did in the past by drinking, the desire to drink progressively diminishes.
Taking accurate notice of the costs and benefits of excessive drinking helps develop motivation. For example, a man who is angry with his wife may gain a sense of control in his life by storming out and getting drunk. He is “in control.” She isn’t. While a sense of control of one’s life is essential to well being, by recognizing and carefully weighing all alternatives, better choices can be found which give the perception of control without doing harm and perhaps are even constructive. He may decide he would rather honestly discuss the underlying problem with his wife, work out a compromise, go for relationship counseling or get a divorce. By being aware of, and carefully considering, all possible alternatives, one can fine something one would rather do than drink.
The person who drinks as a substitute for real intimacy can work on intimacy problems and, though he may want to drink, he may find that he’d not only rather share real intimacy, but that he is more than competent and capable of doing so.
Developing motivation and a sense of competence and capability are mutually supportive. The more one wants to quit or moderate, the easier it is to do so. Realizing that one would rather not drink powerfully counteracts lessons of learned helplessness concerning drinking. The more obtainable the goal of stopping or moderating seems, the less grief expected in reaching the goal, the more desirable a course of action it becomes.
Essential to developing a sense of competence is to think in terms of how one will succeed instead of how one will fail. “Slips” or “relapses,” should they occur, can be thought of as failure but they can’t occur without success. They can also be great learning opportunities. One can ask oneself, “Why did I?”, “What did I expect to be the advantage?”, “Was there a ‘pay off’?”, “What are the disadvantages?” and, most importantly, “What better choices are there and how will I make them the next time?”
Drinking more or behaving worse when drinking upon deciding to quit or moderate can be good signs. The higher the price paid for drinking to excess, the more difficult it is to continue
It might seem odd to suggest that someone with a drinking problem should work to enhance the drinking experience. However, excessive drinking is heavily based on false expectations. The more clearly a problem drinker discriminates between when drinking is pleasurable and productive and when it is unpleasant and destructive, the more difficult it is to continue excessive drinking.
Two entirely different drinking styles point out the benefits of drinking for maximum pleasurable effect. Imagine a man who, on an empty stomach, slowly sips two drinks and feels pleasantly “high” for a couple of hours. During that time, he may enjoy stimulating conversation and music. If he is having a good time, he may stay a little longer. If he is not enjoying himself, he’ll leave sooner. After drinking, he eats and quickly becomes unintoxicated. The next morning he wakes up sharp and alert, ready to take advantage of the day.
In contrast with this “social drinker,” imagine a man who customarily drinks large quantities of alcohol. Due to his steady high consumption, he needs to drink a lot to feel a little effect. When he drinks on a full stomach, he needs to drink even more. In the morning he is groggy and hung over so he guzzles huge amounts of coffee. This creates a need to drink even more when he does drink to feel an effect. While he may have some pleasant experiences while drinking, he stays “high” long after the pleasure is gone and will continue drinking whether he is enjoying the experience or not. He also disrupts his ability to sleep well. He suffers hangovers and the long term health consequences of excessive drinking.
It is important for the moderator to carefully discriminate between a desire to drink for a pleasant experience and drinking to avoid undesired feelings and ignore problems. Before drinking, one can ask, “Do I feel good?” and “Do I have unpleasant feelings I want to drown out?” If the answer to the latter is yes, drinking is never in one’s best interest. If the goal is abstention, the question to ask when feeling good is, “Do I want to risk changing it?”
While drinking, it is important for the moderator to notice whether he is enjoying himself and whether the environment is pleasantly stimulating. When it is not, it helps to develop the habit of stopping drinking and doing something else. For some people, since so much of drinking behavior is merely the habit of sipping or gulping, it is helpful to have a glass of water or soft drink to sip on. It also helps to do “intoxication checks”; to frequently take careful notice of the physical and mental effects of drinking. It is rather pointless to drink for the “high” and not pay attention to one’s body, to ignore the effects. The more attuned one is to the effects, the less one needs to drink to feel them.
Paying close attention to emotional states and their effect on drinking helps. If an angry or sad thought comes to mind, what is its effect on drinking behavior? Do you reach for the glass? Do you take bigger gulps? Just noticing the behavior and the futility of it can help maintain moderation.
Closely related is taking notice of the environment. Drinking in an unpleasant environment is like to be an unpleasant experience. Drinking in a pleasant environment is likely to be pleasurable. Much of the enjoyment in drinking comes, not from the alcohol itself, but from the environment and one’s own mood and expectations.
Of course, if someone clearly would rather get very drunk or clearly would rather drink moderately, not much will make a difference.*3 However, people are often somewhere between the two and any little substitute habit, awareness or effort can have dramatic effects.
When drinking more and enjoying it less, it is important to ask oneself what one would really rather do; what would be more fulfilling. There is no real benefit to alcohol except as a mild social lubricant. It fills no real needs.
In studying drinkers whose goal was abstention, it was found that those who succeeded felt confident and capable and had “multiple ways of dealing with stress.” Those who “relapsed” drank over frustration, anger, social pressure and interpersonal conflict.242 In other words, those who returned to self destructive drinking did so in response to more or less everyday stress. Those who succeeded had multiple ways of responding in stressful situations.
The stresses leading to excessive drinking are chronic although perhaps intermittent. To a large degree, the responses to those stresses are subconscious and automatic. The dynamics of a particular situation may be entirely out of the conscious awareness of the problem drinker. He may be mystified by his drinking.
There is no single way to deal with stress nor is stress itself the problem. For example, imagine a man in a forest being chased by a pack of wolves. It certainly is a stressful situation. What does he do to deal with the stress? Does he meditate, exercise or take relaxation therapy? Or does he deal with the problem and climb a tree?
Parallel situations exist in everyday life. Someone who has an unsuitable job becomes “stressed out.” There are many things he can do to deal with the stress, to make the undesired feelings go away, including drinking or meditating. That takes care of the stress. It doesn’t, however, solve the problem. He still has unsuitable work.
Someone may feel “stressed out” over an intolerable relationship. The stress can be “dealt with.” It can be made to go away. He still, however, has a bad relationship.
The problem drinker who is having continued trouble moderating or abstaining needs a greater awareness of his problems, of his choices for solving them and of his power to make those choices. The tools for this greater awareness lie with the problem drinker’s much scorned and disparaged self.