doctorgettingsober

I’m going on a bear hunt…

The good news about quitting drinking is you get in touch with your feelings; and the bad news is you get in touch with your feelings as many a reformed addict will tell you. When you’ve used alcohol for years to keep those pesky emotions firmly locked away in the psychological equivalent of an escape room it shouldn’t be a surprise that removing the lock of alcohol creates some problems. Feelings that don’t belong to the here and now but feel like they do, can cause havoc with your current life, relationships and perceptions of same. Trying to disentangle the real meaning and the real source is not easy. The initial joy of quitting is replaced by self-doubt, questioning and intense reactions to anything and everything. My husband only has to take longer than a millisecond to respond to me and I feel abandoned, unheard and unloved. The more I berate him for it, the further he withdraws confirming my deep-seated belief that I am not loveable. This morning we managed to get through one of these exchanges and finish up with a hug. That’s usually what I need but I’m not very good at communicating it, preferring to see his failure to mind read and second guess me as further evidence of his and my own failings. It’s easier to show my anger than my vulnerability and pain. So what can I do differently? How do I learn to respond within an emotionally appropriate range, without attaching all this baggage?

Understanding where the baggage originates is important. I sometimes liken therapy to opening up cupboards in our mind, crammed full of stuff that spills out and has to be slowly sorted; carefully looking through it; throwing away what you don’t need, and eventually neatly putting away what you want to keep, with the door now closing easily. However, finding new ways to manage my emotions, past and present in the here and now is the key task that will help me off the hamster wheel of addiction; allowing feelings, not suppressing, not projecting on to others and not turning them into self-loathing.

In the moment I need to be able to clock that the emotions don’t belong to now and not respond as if they do; and find a way of telling myself that in a split second. Breathe and count to 6. Keep that mouth shut. Neuroscience and attachment theory teach us that these implicit reactions come from our early experiences, and danger in any form has the biggest influence on what we pay attention to and what we don’t. That makes sense as staying alive is the unconscious priority for all of us. The trouble is these automatic responses are from the unthinking part of our brain, the subcortical regions, primed to sense any hint of danger and to activate our fight/flight. After an unregulated outburst, guilt and shame ensue or an attempt to justify: ‘He doesn’t love you anymore, things have changed, I’m right to be upset etc’. Both perpetuate the cycle – increasing your self or other hatred and filling up the negative emotion tank ready to burst all over again. Without the lock of alcohol, it’s a pretty regular occurrence! I have to learn to accept my negative feelings and remember that they will pass. I have to unlearn my old ways, or figure out which ones I can keep.

This process is complicated by having to suppress them in order to function. I can’t allow my feelings when I’m at work, or rather it doesn’t go well when I do! I have to help others deal with their emotions; contain their anxiety, offer hope and ways forward. I have to be reflective, open and measured. All of this helps me to an extent; being in my more functional mode does lift my spirits and I love what I do; but it is part of the disconnect from the murkier parts of myself. When the murky stuff is bubbling up to the surface then it’s harder to be that functional person. Both parts of me are real and compliment each other. Without my demons I wouldn’t be as good at my job; I wouldn’t have as much empathy and understanding. Without my job I wouldn’t have the self-esteem to say I’m good at my job! Integrating these parts, not judging or valuing one above the other and not blocking either out is the task I’m facing now. To paraphrase the wonderful children’s book We’re Going on a Bear Hunt – I can’t go under it, I can’t go over it, I can’t go round it – I have to go through it.

Yoga and meditation really do help calm my mind and body. When I’m really low I struggle to do them, a perverse self-denial. I rarely denied myself a drink! Sometimes it’s hard to be kind to yourself and allow yourself things that help. Self-destruction is an easier path to choose than self- care. I allowed myself some comfort this morning and I’m writing this now. Small steps. I’ll post this now then go do some yoga!

‘Physician Heal Thyself’

I’ve long realised that I’m as messed up as a lot of my patients. I’m not one of those psychiatrists who has an ‘us and them’ mentality – more one that recognises fellow humans’ struggles as things I struggle with too at times; and I’m often in awe at how resilient people can be in the face of so much adversity. I see my job as trying to help them feel better about themselves; to recognise their strengths as well as trying to lessen their suffering. When I feel better about myself, I’m generally a lot nicer to be around and much more able to sort stuff out. I figure that’s true for most of us. What it has taken me a long time to recognise is that I have a substance misuse problem. Strange that I couldn’t see it; doing the job I do? I come from a family full of alcoholics; I was getting books out the library about alcoholism when I was 13 and I originally wanted to specialise in addiction. I saw the switch to Child Psychiatry as moving on from rescuing my mother to rescuing myself, but maybe it was more about avoiding my own demons? I like to think I’m quite an open reflective person, but where drugs and alcohol are concerned, I’ve had one hell of a blind spot!

I think it’s particularly difficult for those of us in the caring professions to acknowledge our own struggles; and we’re more likely than others to have addictions. There’s not a lot of research out there but compared to about 10% of the general population, 10 – 12% of doctors have addiction problems, and 20% of nurses. I think the nurses are probably being more honest than the doctors. Much has been made of increased access as a factor, but alcohol is the most frequently misused drug, the one that’s most available for everyone. It’s also on the increase, with underfunding, impossible expectations and a name and blame culture identified as causes by a support service for doctors (www.independent.co.uk 24.06.17).

Whilst those things are undoubtedly making everything worse for professionals on the frontline, I think we’ve probably always been more vulnerable. Caring for others, dealing with pain and suffering day in day out will deplete anybody. We likely chose these jobs because we’re good at meeting others’ needs; not so good at meeting our own. Our identity and self-esteem become tied up with our job; one which society respects and rewards; but couples that with high expectations. Having problems of our own is shameful, we’re supposed to be sorting out everyone else’s. Shame corrodes our self-esteem, the ‘what if they knew the real me?’ thinking; pushing us further into addiction. Our substance of choice suppresses our emotions, including our shame. The traumas of the day are literally washed away, and our minds are anaesthetised to the pain of not being the superhuman perfect being that society and ourselves expect us to be. We can’t say anything because if we do, we will be referred to our regulatory body, and could lose everything. Most of us will be functioning addicts and really good at hiding it from everyone else. Once you admit it to yourself, the ongoing secrecy and isolation compounds the shame. ‘You should know better, you should be able to handle it, you’re a doctor for God’s sake – sort yourself out!’ – the kind of things my mind would tell me when I woke up dry mouthed with a headache in the small hours. There are multiple things that have led me down the path of addiction. My chosen profession is one of them.

The first time I stopped drinking was December 14^th, 2017. It was my eldest daughter’s birthday and I got upset in the restaurant as my food wasn’t good. I didn’t completely ruin the evening, but my younger daughter later commented ‘I don’t think it helps being pissed out your head most of the time mum either’. It was the reality check I needed. I’d been secretly obsessing about my drinking, occasionally openly saying ‘I must cut down’ with a tiny part of me hoping that someone would say ‘Yes you should – you really do drink too much’. As an outwardly functional person, a professional whom others ask for advice about all kinds of things; a fun happy drunk on the outside this was unlikely to happen. It was very easy to ignore my worries by literally drowning them in Sauvignon Blanc most nights. My daughter named the elephant in the room and I will be eternally grateful to her for that.

I stopped for 100 days, and then decided I could go back to moderate drinking. I went to a few AA meetings, but they weren’t for me. I’d done Xmas, New Year and my birthday sober. It hadn’t been much fun if I’m honest. I felt I’d failed at drinking and I felt deprived without it but after a 3 month break surely I could keep it to the odd one socially?

Fast forward another year and I was breaking every rule I set for myself around moderation and I was consumed with thinking about alcohol except for when I was drinking it! I’d learnt some things during my break so rather than let things get worse – (wondering what my own personal rock bottom might look like) – I stopped. The difference this time is I didn’t go it alone. I signed up for Kate Bee’s online Sober School and I’m now almost 11 weeks AF. The course really helped me change my thinking and I wholeheartedly recommend it for anyone considering embarking on this journey. It’s a lonely path on your own. Now the course is over I’ve moved from the pink cloud feeling I’ve read about to the wall of depression though. I don’t want to drink but I don’t want to do much else either. I think I’m grieving my old self whilst not knowing who the new me will be. I’ve drank a lot for over 30 years so it’s bound to be a bit strange. I’m not used to reaching out to others for support – it’s usually the other way around. Writing this blog is to help me keep on keeping on through this difficult bit on the way to what I hope will be a content sober life. I’ll be exploring how I got here; the ups and downs of recovery and anything else that comes up. If it reaches other health professionals battling their demons secretly and helps them feel less alone that will also help me.

Welcome to My New Sobriety Blog

Be yourself; Everyone else is already taken.

Oscar Wilde

I’m quite new to my relative sobriety, finding my way in a world where I’m used to being the helper not the helped. I’m thinking there might be other people out there like me, scared to come out because of their professions so if I reach you and you feel less alone then I’ve helped us both.

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Sunshine at last!

After what has felt like weeks of relentless rain, storms and gales here in the UK as I walked the dogs this morning the sun was shining warming my face through the mostly still bare trees; and I could believe that Spring is just around the corner. The crocuses and daffodils are coming through and nature begins her cycle again. In spite of the weather my spirits have been good. I’m on my way back to work and have agreed that from September I’m going to do half a day a week for them of training and supervision – no direct work. The rest of the week I shall work for myself. It feels a real win win and now I have a plan everything seems manageable again. On the home front it no longer feels a Herculean task to get out of bed or go do the weekly food shop and I’m sorting out things that have been left a long time. Drinking stopped me doing stuff and then depression. I’ve cleared my study so I can have my yoga and meditation space there and a nicer space to work which feels good. I’m meditating and/or doing yoga every day and I swear some days I feel high on it! I wondered on Monday if I was getting hypomanic but I’m just joyful. I’m able to focus on every day pleasures – the taste of food; watching the dogs play; drops of rain on a leaf; cuddling up to C. I’m also being sociable and enjoying company again. In short I feel more like myself and it’s great! My brain and body were slowed up and foggy and it’s taken coming out the other side to appreciate how bad I had been.

In the 11 months of being alcohol free the onion ring of reasons why I drank have slowly revealed themselves and peeled away, and I’m now wondering if at the heart of it I was self medicating for depression alongside staying manically busy to keep the stress hormones flowing. The impact of this was living life oscillating between high octane stress and arousal, that I then shut down with booze and ramped up again in the morning with coffee to combat the sluggishness from being hungover. Every now and then it would all get too much; I’d shut down for a few days then repeat. I’ve lived like this for years – decades even. No wonder it’s taking time to adjust to living life differently. Much less oscillation; a calmer steadier state. That used to signal boredom to me; a need for stimulation; possibly a warning to my unconscious low mood was coming if I didn’t do something about it quick! Don’t let the darkness catch you!

Without drink I’ve been depressed; done some processing and finally admitted I needed help. Now I like calm and steady. I like to notice the world around me; to savour moments instead of mentally attending to whatever’s coming next. I’m learning to live in the present and it’s making me happy. Not ecstatic, not buzzing, not excited – just happy.