Do you have a drinking problem? Use this quick test to find out.

Published February 8, 2010 Alcohol and Substance Abuse Leave a Comment
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This post is being republished due to recent conversations I’ve had both in and outside of my office.

Do you drink alcohol?  If so, do you manage it easily and safely, or do you have a drinking problem? Social drinking (no more than 2 drinks a day for men and 1 drink a day for women) is widely practiced and accepted, and according to some researchers even may reduce the risk of coronary disease.  A “drink” should be considered as 12 ounces of beer, 5 ounces of wine or 1.5 ounces (one shot) of liquor. Many people however have a problem with alcohol that threatens their health, relationships and employment, and may endanger or distress other people.  Counting drinks on a daily basis may not give you a clear understanding of the impact of alcohol in your life or on others around you, so along with counting drinks a broader view is necessary.  Some signs of problems drinking include: Becoming moody or argumentative after drinking; Drinking more for the same effect; Drinking alone; Drinking to cope with issues such as loneliness, or discontent with ones partner or job; Drinking to ward  off depression or anxiety; Mishandling daily affairs or relationships; Forgetting events that occur while drinking; Discovering that former friends are staying away from you because of your drinking.

The Alcohol Use Disorders Indentification Test (AUDIT) was developed by the World Health Organiztion of provide a simple screening tool.  It can be used by anyone to help decide if you or someone you know might need a more thorough assessment for problem drinking.

To take the AUDIT  just answer each question with the honest number of 1, 2, 3 or 4 (**questions #9 and #10 can be scored only with a zero, a two or a four).  Remember, not being honest with yourself as you answer the questions may be a sign that you have a drinking problem you are afraid to face.

1.  How often do you have a drink containing alcohol? 0 (never)/1 (monthly or less)/2 (two to three times per month)/3 (two to three times per week)/ 4 (four or more times per week) 

2. How many drinks do you have on a typical day when you are drinking? 0 (none)/ 1 (one or two)/ 2 (three or four)/ 3 (five or six)/ 4 (seven to nine) ** Score 5 points if your response is ten or more drinks on a typical day.

3.How often do you have more than three drinks (women) or more than five drinks (men) on one occasion.  0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

4. How often during the last year have you found that you were unable to stop drinking once you had started? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

5. How often during the last year have you failed to do what was expected from you [not going to work or school, ignoring relationship, medical or legal expectations] because of drinking? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

7. How often during the last year have you had a feeling of guilt or remorse [for your behavior or for drinking itself) after drinking? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

8. How often during the last year have you been unable to remember what happened the night before because you had been drinking? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

9. Have you or someone else been injured [intentional or not, self-inflicted or from another] as a result of your drinking [and/or while drinking]?  0 (never)/ (no score of “1″ -skip to score two)/2 (yes, but not in the last year)/ (no score of “3″- skip to score 4)/ 4 (yes, during the last year)

10. Has a relative, doctor or other health worker been concerned about your drinking or suggested you cut down? 0 (never)/ (no score of “1″ -skip to score two)/2 (yes, but not in the last year)/ (no score of “3″- skip to score 4)/ 4 (yes, during the last year)

Add up the numbers for the ten questions to get your score.  A score of 8 or more indicates possible problem drinking and the need for a more thorough assessment.  If your score indicates the need for an assessment, you should consult a qualified health provider to discuss your drinking and the possible treatments that are available to you.   If your total score is less than eight but more than four, it would be advisable to consider how you are using alcohol, and ask someone close to you if they believe you are a problem drinker.  If your score is less than four, you are probably using alcohol responsibly, and can simply be mindful of any changes in your use or in the results of your drinking.

Happy Birthday, except…

Published February 4, 2010 Relationships Leave a Comment
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Birthdays Wishes came from nearly everyone…

except her.

My client said he was a little too sad to really celebrate the day, but said he’d managed to smile and chat with everyone during the impromptu party that some friends had organized.   He didn’t want to “talk” about it though.  He only wanted to tell me that he’d missed seeing her smoky eyes and mischievous smile when he looked at the group singing to him.  In the past she’d made his birthday feel so special.

And then he talked about it.   And the pain, disappointment and emotional turmoil was suddenly there, bouncing around with seemingly no place to go, like a flight of colorful balloons.

This is how it sometimes goes in therapy.  It’s a time and place where you can say something – everything – you didn’t want to say.  And see something about yourself that you didn’t want to see.  And… more often than not, at sometime during the process, you feel a new sense of quiet satisfaction in your self-discovery.  A feeling that indeed you’ve reached and stepped beyond a milestone into a new understanding and a new kind of promise.   That there is much before you to be embraced, enjoyed and even celebrated. Then the “Happy Birthday” song - and all that goes with it – begins to take on new meaning. 

During the time he was in therapy he never again heard from her, but he did celebrate his next birthday with lighter spirit and a soft, musical memory of her.   He even danced.

7 TIPS for Self-Care.

Published February 1, 2010 Wellness and Nutrition 1 Comment
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TRY THESE SEVEN TIPS TO IMPROVE YOUR OVERALL HEALTH AND WELLNESS.

Each day for 1 week, carefully consider one of these “tips” and ask yourself how you can better bring it into you daily life.

1. Maintain nutritional eating habits- monitor and regulate your use of sugar and caffeine.  Be especially careful of your alcohol intake, and if you smoke, stop!

2. Restful sleep- develop effective pre sleep habits and practice moments of relaxation during the day.

3. Get some exercise- especially cardio enhancing exercise.  Go for a vigorous walk regularly, or get out your bicycle.

4. Plan activities for relaxation and fun. Be intentional, rather than passive, about playing.  Children don’t just play because they have energy.  They also have energy because they play.

5. Grow a support system – try to connect with friends who are emotionally encouraging and intellectually stimulating.  Ask “doomsayers” to leave you out of that part of their repertoire.

6. Learn to say “NO” – limit your activities to a level that can be accomplished.  Try not to over extend yourself to the breaking point and thereby expose yourself to exhaustion and continuous disappointment.  Reach beyond your capacity when you have the physical and emotional reserves to endure the journey.

7. Consider new perspectives and ideas about the world around you and your place in it- being able to change your mind and your attitude is important to your resiliency.  When we change the way we look at things, the things we look at change.  

 

HAVE A GREAT WEEK!

Drunk? And starving yourself too?

Published January 28, 2010 Musings 4 Comments
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A new medical and behavioral condition has been identified by The Eating Disorder Center of Denver.  They call it

DRUNKOREXIA          Seriously.

Drunkorexia, is mostly experienced by  young women and is characterized by their uncontrollable habit of starving themselves all day to save the calories that they will then take in through the alcohol they drink later.  Food is typically shunned all day and drinking starts in the afternoon and continues into the night.   If these young women do eat (usually only nominal amounts), then they also will purge either through intentional vomiting or more often through the involuntary vomiting associated with severe intoxication.   They continuously lose weight while they habitually drink until intoxicated.

Many of these women are also suffering from the influence and emotional intimidation both of general society as well as their husbands or partners.  They tragically try to conform to the distorted “photoshopped” images of waif-like girls that dominate female images in our social media, often because a male partner taunts them with jibes about being overweight.

And while men report drinking similar amounts of alcohol to women, the frequency of “binge” drinking is higher among women.  The National Association of Anorexia Nervosa and Associated Disorders reports that 72% of women who are addicted to alcohol also have an eating disorder!

If you can take a clear look at your life, and at your drinking behavior, and if you can see that you too are continuously starving yourself — losing weight to “look good” for someone – while you drink your life away in loneliness and despair, then it’s time for you to make an appointment with a qualified therapist.  Begin today to re-claim both your natural beauty and your independence from alcohol.  

Re-claim your life.  Top to Bottom.  

For more information on this critical issue, and on the Eating Disorders Center of Denver, visit this link:  http://tiny.cc/EgMMR.

 

Mood Problems? Food Matters!

Published January 25, 2010 Wellness and Nutrition Leave a Comment
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Everyone eats.  Many people struggle with how much (too much?  to little?), when, and what they eat.

At the same time the prevalence of mood disturbances seems to be evident in the waiting rooms of many psychotherapists. 

What might be the connection between these two personal challenges?  We know that when someone is experiencing stress, at the very time when physical and psychological reserves may be at their lowest, she or he is more likely to engage in one or more of the following:

  • Overeating

  • Skipping meals

  • Eating mostly fast food

  • Excessive drinking of alcohol and caffeine

The following suggestions may seem obvious, yet if you take a serious inventory you might find that you are depriving yourself of the balanced nutrition you need to maintain a more regulated mood, and a more comfortable relationship to food.

  1. Eat a number of smaller meals during the day and early evening, and in response to hunger rather than the clock.

  2. Refrain – especially at night – from eating foods made of simple sugars like corn syrup.  Soft drinks, cake, cookies, donuts and pies cause first a rapid increase then a precipitous fall in blood glucose, making it difficult for your body to self-regulate.

  3. Decrease or eliminate alcohol consumption.  Alcoholic drinks are high in calories but have almost no nutritional value, contribute depressed moods, sleep difficulties, increased anxiety, the problematic reduction of inhibitions and even bladder incontinence.

  4. Ensure that your diet is varied, and that you include more vegetables, fruits and grains than meat.

These simple suggestions will help to change your relationship to food and nutrition and start you on a path toward improved physical and psychological health.

For more specific suggestions consult a food and nutrition specialist such as a dietician.

Disposable Pleasures

Published January 21, 2010 Relationships Leave a Comment
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    Back “then” we called it: “Free Love!”

                                                                      Now they ask: “Hook up?”

 

 

 

The resurgence of sex devoid of emotional attachment has surprised and even shocked many grown up children of the 60s.   As they watch their own children and other younger people embrace a lifestyle that they thought had disappeared in the age of HIV/AIDS, some clients are having trouble reconciling their own youthful attitude with the current surge in recreational sexual behavior.

For some of my younger clients however, those who fall within the “hook-up” demographic, things at first glance are not so different from how they were five decades ago.   It’s all about just having some fun without “stressing” over who belongs to whom.    Interestingly, many of my female clients between the ages of 18 and 28 quickly and easily endorse their hook-up preference and history, and often lament the complications when some of the more “clingy” boys want to make them their girlfriend.  “Boring!” they say.

Yet, as we talk over the weeks of slow un-winding and gradual illumination, it often emerges that their perspective is more reactive than thoughtful.  The boys, they say, end up just using you anyway, so why not use them first?  If they could, they say, they would have a nice, sustained and mutually supportive relationship. 

We live in a complex world where constant multi-media communication tinted by emotional detachment is practiced by everyone, including our politicians and celebrities; where poly-amorous relationships are triumphantly splashed across the pages of popular social magazines; where 50% of marriages end in divorce, and where relationships of all kinds and descriptions are more and more acceptable to the general public.  Learning how to establish and maintain intimacy with another person must compete with the tweets, blogs, text messages, e/mail, voicemail, and other such trends that impart information without emotional attachment; and so far, while holding its own, “authentic intimacy” is definitely in a struggle for legitimacy.  “Boring”, they say.

I don’t believe there needs to be a litmus-test type template for what a relationship looks like, or for how one person creates and holds relationships in their life.  There’s room for all kinds of relationships, assuming mutual consent and reasonable contentment.  I DO believe the choice should be informed, thoughtful and a source of joy rather than being uninformed, thoughtless and a source of regret and remorse.

“Boring??”  Really?  

If you’re feeling bored – lost in a sea of hook ups in the arms of strangers, perhaps it’s time to consider making some changes.  Call and make an appointment with a qualified therapist today.   You can build a life of intentional commitment – and find more excitement than you imagine. 

 

You don’t see color?

Published January 18, 2010 Musings Leave a Comment
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Really???               

Then surely you are colorblind!

But that may not be the “good thing” you think it is.

When you declare that you don’t “see” color what you may be saying is that your own color – your race and culture – are at the center of the society and that you are willing to “not see” that others are different and that they may not enjoy all of the same invisible privilege you have – the privilege you also don’t see. 

Try instead to open your eyes and open your heart to see the wonderous diversity of your  family, friends, neighbors and co-workers.  Try to see that we all have strengths and frailties, and some of these are given to us by our birth status – being born of a certain gender, ethnicity, physical capability or nationality.  How different to be born and living in the slums of Haiti than to be born and living in a cosmopolitan city in the USA.

Learn to be comfortable with difference, and enrich your life with a full palette of color and culture, recognition, and understanding.  Work at it everyday in both small and large ways.  

As Bob Marley said, while he dedicated his life to inoculating people against hate through the use of love and music: “The people who are trying to make the world worse do not take a day off.  Why should I?”  

 

I was at the Lincoln Memorial on August 28, 1963. 

I saw and listened, and I remember every moment.

Keep the dream alive.  Happy Birthday Dr. King.

 

Getting to know you, part 2.

Published January 14, 2010 Relationships Leave a Comment
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How do you get to know about someone relatively quickly?  It’s not always easy to meet new friends or new romantic partners, and when you do you may be uncertain of what questions will give you a glimpse into the person’s values and beliefs.

In a previous post ["Getting To Know You; Getting To Know All About You" - posted on 8/28/09] I offered some questions that were suggested by clients and by colleague Jamie Showkeir at Henning and Showkeir Associates (www.henning-showkier.com).

Recently two more questions were posed by clients during sessions that focused on the issue on on-line dating, and how to find out about prospective dates.  Here then are two additional suggestions.  If you are interested in the full list of questions, please see the noted  post for the original list.

Q:  If you had to lose most of your physical senses, which two would you keep and why?

Q:  If you had to be a particular book, which book would you choose?  This question of course was inspired by the story Fahrenheit 451.

If you have any illuminating questions to contribute, please reply to this post with your suggestions.

T-ACE: Test your drinking behavior

Published January 11, 2010 Alcohol and Substance Abuse Leave a Comment
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Happy New Year???

Have you resolved to reduce your drinking?

Many people have a holiday season filled with a little (or a lot) too much alcohol.  Perhaps there was a round of parties, each more “wet” than the next.  Or maybe it was a quiet holiday season, with time at home – maybe with just a few family or friends – and plenty of time to sip your way through the week.

But it’s happened before, and each time you ask yourself if it’s time to seriously cut back.

Here’s a quick and easy screening test to see if you may have a problem with alcohol.

The T-ACE Test is composed of only 4 questions, but has proved useful in diagnosing alcohol problems in both men and women.

T - Does it TAKE more than 3 drinks to make you feel high?

A - Have you ever been ANNOYED by people’s criticism of your drinking?

C - Are you trying to CUT DOWN on drinking?

E - Have you ever used alcohol as an EYE OPENER in the morning?

A “yes” answer to any two of these four questions is an indication of possible alcohol abuse or alcohol dependence.

** Remember:  as with all screening tests, a more in-depth evaluation is needed if there is an indication you may have a problem.  If you answered even one question with a “yes” it may be time for you to consider talking to a professional therapist about what’s going on in your life and to get support in deciding whether you need more focused help with reducing or eliminating your alcohol use.

Make your Happy New Year a decision, not a question.                                


Did he love me…

Published January 7, 2010 Relationships Leave a Comment
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… and what did it all mean?”

This is the question that began each of our first 3 sessions.  She seemed endlessly sad and hopelessly confused.  She told me that he seemed to want to be with her, and that she  always had so much fun when they were together.  He listened to her talk for  hours, sometimes joining with his own reminisces and other times just holding her closely while she “chattered” about this and that – basking in the acceptance she felt in his arm and the desire she saw in his eyes.  Still… sometimes he didn’t act in the ways she wanted, and did not call her for days.   “What did it all mean?” she wanted to know.

As the sessions progressed, we discovered more about her long-held interpretations of loving behavior, and how her’s might have been different from his.  We talked about how some people feel loved only when they receive the kind of affection that they themselves would offer to someone – the love we give being the kind of love we know best.  We talked about what he might be feeling when she acted angrily or she pouted for reasons he could not understand.  And we finally found that she needed more attention and affirmation than she had realized, and perhaps more than he was capable of giving… or even perhaps more than was possible  for anyone to give consistently.

My client was not unlike some other people, in that she loved deeply and desired passionately, but lacked true understanding of and empathy for her lover.  She essentially wanted someone who lived and loved just like her, and was continually disappointed when her partners had not been able – or willing - to “become her.”  She began to see that she had been too quick to take offense, too often assumed the worst, and reacted with flashes of volatile and punishing anger that she herself would not have tolerated.   And then finally she understood why:  she was afraid.  Afraid not only that he didn’t really love her, but that perhaps she was not worthy of loving.  She began to reveal some of the things she’d said and done to make him feel the fear and pain she sometimes felt.  Most of her insults were mild.  A few were definitely very vindictive and probably incredibly hurtful to her lover.  It seemed that she hadn’t really ever considered how very hurtful she’d been.

Before too long, she decided that she and her lover had been right for each other, but had not been able to “capture” their love.  There had been complications and entanglements to deal with, and she admitted that they hadn’t dealt with these very effectively. 

She was still a little sad as we finished therapy, but now for reasons she felt were the better ones, and with a more realistic perspective about her future. 

If you’re wondering “What did it all mean?” about something in your life, perhaps it’s time to explore the issue with a qualified therapist.  Call today, and begin asking questions likely to bring you an understanding of how to shape a more rewarding future.

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