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Anxiety can be debilitating sometimes, especially when you’re dealing with an onslaught of anxiety symptoms. In this blog, we have compiled a list of 10 ways that you can reduce anxiety on the spot, the perfect in the moment social anxiety disorder treatment. 1. Ask yourself the vital questions Applying Cognitive Behavioural Therapy (CBT) techniques that you learn as part of anxiety disorder treatment is a great way to reduce anxiety on the spot. Remember to do a reality check and ask yourself whether your worrying is justifiable and reasonable. Re-evaluating the situation can help soothe your nerves. 2. Breathe slowly and deeply Deep breathing exercises are a good idea to soothe anxiety - inhaling and exhaling slowly and deeply can help calm your mind and reduce anxiety levels. 3. Distract yourself Focusing on your anxious thoughts can have an extremely negative impact on your wellbeing, which is why you should focus on something else instead to avoid obsessing over your worries. You should ideally find something that offers relief and redirects your nervous energy. 4. Exercise When you start getting anxious thoughts, they can be difficult to stop until you do something else. For example, a burst of exercise can help you refocus and increase concentration. 5. Listen to music Similar to exercise, listening to music offers another great way to reduce anxiety and worries. Music can have a number of benefits regarding anxiety, alleviating stress and helping to calm your nervous system. So, grab your headphones or earphones and start your playlist. 6. Avoid alcohol, cigarettes, and caffeine It can be tempting to turn to familiar habits (which only temporarily reduces stress), such as drinking alcohol, smoking cigarettes, and drinking caffeinated beverages. However, these can actually increase your levels of anxiety and stress, so it might be wise to avoid these when struggling with nervous thoughts. 7. Chant a soothing mantra Creating a hopeful and safe mantra, and repeating this whenever you feel a rush of anxiety can help reduce your anxiety. Mantras can shift your mind away from debilitating thoughts that can repeat over and over in your head. 8. Meditate When you don’t have your anxiety medication on you, or perhaps you simply don’t know what to do in the event that you have constant anxious thoughts, one of the best things that you can do on the spot is to simply stop and meditate. Meditation is an effective way to calm your thoughts and increase your mindfulness, evaluating your emotions and feelings. 9. Laugh Laughter is a great remedy for stress and anxiety. Not only can it exercise and relax your muscles, but it also increases oxygen levels. Watch a comedy show or film on TV. 10. Reach out to trust family and friends Not everyone wants to indulge their anxious thoughts to other people, but reaching out to others can actually help with your anxiety. They can offer new perspectives that can help reduce your anxious thoughts and offer comfort. At The OAD Clinic, we offer anxiety disorder treatment for those struggling with anxiety symptoms, for UK residents and individuals from select countries. If you’re looking to come to the UK for generalised anxiety disorder treatment, then get in touch.

One of the books I read very early in my studies is The New Man (1961) by Thomas Merton. In this book, Merton writes about spiritual transformation. Leaving aside any religious considerations, we can consider something similar in the lives of those recovering from alcoholism. We can think of this as casting off the old and putting on the new. This transformation is both an event and a process. We can often identify a turning point in the lives of those recovering from addiction, at least with hindsight. This might not be a “flash of blinding light”. It could be something simple – an act of kindness or something said in a fellowship meeting. On the other hand, it might be the personal experience of “rock bottom” in suffering. The Greek term for this turning point is metanoia, which denotes a repentant transformation of the mind. When an alcoholic in long-term recovery shares his or her experience with others, a contrast is usually made between the former life of heavy drinking and the new life of sobriety. The purpose is to pass on the wisdom of experience to the sufferer. The story will include warnings and encouragement, highlighting what worked in setting the alcoholic on the path to recovery, and what marks the new life. The former life is usually described as one of chaos. This will include struggles with work or in personal relationships. The descent into addiction might also sometimes have been marked by more dramatic events. These might have included family breakups, homelessness, referrals to hospital, or perhaps sentence to prison. The alcoholic will often look back and describe this period of their life as one of “madness”. I can relate to some of this, though less dramatic. I was already drinking in my early teens. I then had to cope with the aftermath of my brother’s death when I was only fifteen. Subsequently, between the ages of twenty one and thirty two, I got married, had two children, changed jobs seven times and moved house four times. During this period, my drinking escalated out of control until I finally collapsed with panic attacks and was referred to an alcohol treatment unit. Was the drinking a way of coping with stress in my personal life or were both a manifestation of deeper problems? Was I chasing after perfection to resolve a deeper source of unhappiness in my life? I’ve previously discussed some of this in The Divided Mind and will no doubt return to these topics. The new life, by contrast, is described as one of order. The sober person develops new interests and relationships. Free of substance abuse, more attention is paid to the world around us and we find more purpose and enjoyment in what we are doing. Greater emotional intelligence is developed. Fundamentally, there is a greater ability to cope with whatever life throws at us and we want actively to share with others how we have got well. The transformation is not immediate, however, and sometimes, in my opinion, this is not properly understood by those newly entering recovery. Instead, although we can often identify the turning point, the journey is ongoing. In my own case, when I was referred to a treatment unit, I spent months in intensive therapy and remained sober for five years. But I didn’t really understand what was needed to continue on this recovery journey. I relapsed, plunged back into chaos, descended again into panic attacks and got a second referral to treatment. I knew the theory about what was needed to get well. It had been instilled in me, not just through therapy but also through study. This time I started to put it into practise. I started engaging with fellow sufferers for the first time. I was nervous about doing this in face-to- face meetings. I didn’t feel that I had much in common with the others. These feelings are common enough in those reluctant to engage. So I joined online chatrooms where I felt genuinely anonymous– I read what others were talking about, added a few comments of my own, and so on. Eventually, I started to participate properly in group meetings. Finally, I arrived at wanting properly to give something back by working as a mentor alongside those providing formal treatment for addiction to alcohol and other substances. What marks this journey as we cast off the old and put on the new? We are taught how to understand ourselves better and interpret how past experiences have contributed to the person we have become. We learn what it means to say that we are body, mind and spirit, and how we need to keep well in each of these categories. We are taught “the art of living well” and how to cope better. Rather than reach for the bottle, we reach acceptance and build resilience. Again, I can relate to this. For example, the past four years have thrown up a lot of challenges. I found the period of lockdowns during the pandemic to be extremely challenging, as did many other people. I have personally encountered a significant number of people whose drinking cascaded out of control during this period. In addition, I suffered other health issues and family problems. There were times when I sat with my head in my hands. But I coped – ultimately – and the thought of drinking never seriously entered my head. There was one occasion actually, during lockdown, when I walked down a quiet road in the centre of London after another set of scans feeling rather emotional. I briefly thought to myself – “I could really sink some vodka now”. It was like a small voice in my head but it quickly disappeared. Looking back, perhaps it was a warning that the temptation will always be there in certain circumstances. The reason I was able to cope is twofold. First, I have a long period of sobriety under my belt. Second, I know the techniques to cope. I was reminded of this recently when watching a discussion about mental health by ex-Special Forces. Somebody said – “when the going gets tough, it’s not so much that you rise to the occasion but that you fall back to your training. That’s why the training needs to be to the highest level”. Let’s try to sum some of this up. There is fundamentally a difference between the old and the new. Recovery is transformative but it’s ongoing. We are not perfect. Life is not perfect. We don’t become mini-Sages or Buddha-like. But the new life of sobriety is one of freedom and we (hopefully) arrive at what the ancients called ataraxia – calmness or serenity.

We are all aware of the stigma sometimes attached to those suffering from alcohol and drug addiction. But somebody said to me the other day – “what about the stigma of being dry?” This struck me as an interesting reversal of the usual way of looking at things. It represents a potential barrier to those in recovery treatment. What does stigma mean? The dictionary definition is a “mark of disgrace”. This sounds a bit hard-hitting. It almost conjures up the image of being forced to walk around wearing a badge saying “unclean”. Why is stigma attached to alcoholics and those suffering from drug addiction? There are various reasons, including some or all of the following: · Weakness – addicts are viewed by many as fundamentally weak-willed, unable to get a grip on themselves in response to circumstances, though this fails to acknowledge background factors that may have contributed to addiction · Lack of self-control – related to the first point, this exhibits itself in an inability to exercise self-control both in private and in public · Poor behaviour – this results in poor behaviour in social or work situations · Harm to self – persistent abuse of alcohol and drugs is a form of self-harm and is therefore seen by many as irrational and a sign of personal failing · Harm to others – addiction causes harm to others around the addict, including family · Burden to the health system – as a result of requiring treatment, whether voluntary or not, the treatment of addiction is an expensive use of economic resources We could tackle each of these in turn with some observations and counter arguments. Indeed, some of these topics have been addressed in previous blogs. But it’s not the primary focus of this piece. With these obviously negative elements in mind, the approach taken by some medical professionals is to discourage terminology such as “alcoholic” or “addict”. Instead, the term “substance use disorder” is employed. This is partly to recognise that there is a spectrum of misuse. But it is also to avoid stigmatising people. The argument here is that stigma might prevent people from coming forward for treatment. Did stigma stop me from coming forward? Not really, because treatment was in some sense “forced” on me when I was taken into hospital and confessed to the underlying cause of my collapse. I was given a “brown envelope” with all of the details to hand on to my GP and the outcome was referral to an alcohol treatment unit. I hadn’t volunteered myself for treatment, as it were, and I’m not actually sure whether there was some subconscious awareness of stigma that had prevented me from seeking medical help before. I had told some people who were close to me that I had a “drinking problem”. Admittedly, however, I didn’t announce myself in business meetings as “Hi, I’m Andy, I’m an alcoholic, here to tell you my outlook for the Dollar”. It’s interesting to me, however, that I rarely, if ever, hear people confessing at fellowship meetings that they suffer from “substance use disorder”. Instead, they will openly self-declare as alcoholics or addicts. That is because they have reached acceptance – not always – and have come to believe that taking ownership of their problem is an important first step toward recovery. Self-description using well-known terminology is an act of confession and self-acknowledgement. True, I’m saying these things from a standpoint of more than twenty years of sobriety but, nonetheless, experience has taught me that failure to self-identify as an alcoholic can also be a barrier to getting well, despite what some medical practitioners might say. What about the stigma of being dry? Am I marked out as a “person of disgrace” because I don’t drink? Here are some of the perceived (and sometimes actual) reasons why stigma can be attached to sobriety: · Social outcast- the non-drinker is sometimes seen as being a loner and not very sociable · "Party pooper" – he takes himself too seriously and doesn’t let his hair down · Unfriendly – he or she is not very approachable · Not part of the crowd – the non-drinker is not a good team-player and is not supportive of efforts at “team bonding” · Uninteresting – the non-drinker is perceived as boring and somebody who won’t join in with banter. In reality, some of the “old timers” I’ve met over the years have very interesting things to say about their journey Some of these supposed “marks of disgrace” might of course relate to other underlying issues that contributed to the use of alcohol and drugs in the first place. That’s why it’s important to form a comprehensive assessment and design of a recovery treatment programme. The supposed stigma of not drinking is, I suspect, part of what lies behind the desire of so many of my mentees to return to “controlled drinking” when I first talk to them. For those who instead choose abstinence as a goal, it’s why I spend a lot of time talking with them about preparing strategies for when they encounter alcohol. Here are some of them: · Prepare in advance for what you will choose to drink · Choose an alcohol-free beer, perhaps – personally I don’t recommend this for those newly in recovery and I avoided this for many years – the range and quality of what is now available has improved dramatically over the years · Say you don’t drink for fitness and health reasons – some people are genuinely intolerant of alcohol · Be honest – I told people that I couldn’t control my drinking and it used to lead to some interesting reactions · Ultimately, move on from those who are uncomfortable with you not drinking – are they your true friends? Why should you participate in their desire to get drunk? Forget about the supposed stigma of sobriety. I’m loud and proud of my sobriety. I actually laughed out loud when I was told that I might be exhibiting a “mark of disgrace”. What a load of nonsense! I’ve been sober for more than twenty years – wide awake, (reasonably) fit and (reasonably) healthy, and certainly better able to cope with the problems life keeps throwing at me. Don’t hide your sobriety! Use your sobriety to help others!

We’ve all found ourselves in circumstances, I suspect, when we’ve been told to “pull yourself together”. It might have been a wake-up call when we were overreacting, perhaps, to some situation or other. No doubt, in that particular regard, it may have served some useful purpose. But it’s certainly not going to be helpful if you are suffering in some way and it’s not going to encourage those who are trying to turn their lives around from addiction. Some criticise the notion of portraying alcoholism as a “disease”. This is surely correct in the following rather narrow sense. You can’t walk into a crowded stuffy room and pick-up alcoholism in the same way that you may catch Covid, for example. You don’t become an alcoholic through coming into physical contact with a fellow sufferer, though you may come to share their traits. I’m not a medical expert in any sense of the term. But it seems to me we do talk about disease in a more general sense, however. We develop cancers or disease of the heart, for example. Although our lifestyles, poor diet, or whatever, might contribute in some way to these cases, they sometimes just happen to us because of some genetic defect. Some go further and make the claim that the idea of “addiction” itself is false. They argue that this is a lazy descriptor or a cop-out for a certain form of behaviour. In support of this claim, they note that many people smoke, drink, and take drugs without becoming “addicted”. Indeed, opiates are used when we undergo surgery and most of us don’t typically suffer problems later. Not only that, many so-called “substance-abusers” do stop and remain clean and sober. This much is certainly true. The central claim here, however, is that what we commonly call addiction is just “weakness of will”. This, it seems to me, is overly simplistic. We might note the following: First, there may be a genetic predisposition for “substance use disorder”. I’m not a neuroscientist but I’ve read enough to know that brain chemistry may play a part in things like depression. Those who take mind-altering substances, including alcohol, may enjoy the relief they find, at least initially, before they find that more significant intake is required to have the same effect. Second, there may be a psychological disposition. Trauma is commonly at root of a tendency to self-medicate. Third, many sufferers from pain can only obtain relief from long-term medication. It is easy to understand how this can lead to over-reliance and significant withdrawal symptoms. The latter push people back to using drugs again. The point here is that although it might technically be correct to say that alcoholism is not a disease and that it is perfectly possible for the addict to stop, there may be reinforcing factors contributing to the behaviour, including the impact on neurotransmitters in the brain, that still deserve to be described as a sickness. This all suggests that we need a varied approach to tackling the problems of addiction – using a combination of medication, therapy and behavioural approaches, as required. This should include, based on my own experience and those I’ve known over the years, an approach to help the sufferer find new meaning and purpose in his or her life. With this in mind, we might say that addiction manifests itself as “dis-ease” or a “sickness of the spirit”. The Danish philosopher Kierkegaard says that “loss of self is despair”. He says that when we lose something, we instantly feel the loss. But when we suffer something infinitely more concerning, such as loss of self, we are never properly aware: “The greatest hazard of all, losing one’s self, can occur very quietly in the world, as if it were nothing at all. No other loss can occur so quietly; any other loss – an arm, a leg, five dollars, a wife, etc. – is sure to be noticed”, The Sickness Unto Death, 1849. What does he mean? In short, he is saying that we find ourselves so wrapped up in the world, struggling to survive, that we fail to pay enough attention to the basics. We care more about getting the job done and pleasing others than we do to our own well-being. We are fully aware when something bad happens, often quite trivial, but not sufficiently self-aware that we are suffering for other more deep-seated reasons. In these circumstances, we surely need to get to the bottom of the problem. Telling somebody that they are weak-willed and need to “pull yourself together” is hardly going to work. Instead, we need a comprehensive strategy to address all of the components and part of the strategy may involve helping the person to rebuild a sense of purpose, identity and self-worth. Another aspect of a related attack on the way of thinking about alcoholism and addiction follows from the discussion about our personal responsibility. Saying that alcoholism just happened to me, as if entirely outside of my control, is a denial of free will and responsibility. But accepting that you are responsible for your own fall does not mean that you can also recover on your own. Augustine says that we do have free will but we use it wrongly. We make wrong choices for whatever reason – self-pleasure, self-medication, the pleasing of others – and this becomes habit. Without our realising it, the habit becomes necessity or compulsion and we find ourselves stuck in a damaging pattern of behaviour. Put simply, once fallen we find that we can’t get back and we need help to get on the path to recovery. Fundamentally, I’m not really interested in whether we call it “substance use disorder” or “addiction”. I’m also not agitated about whether it’s a disease or not. Instead of getting worked up over the terms alcoholic or addict, why not focus on what really matters? Somebody is suffering, causing great harm to self and to others. Why not get to the bottom of it and see what we can do to help?

Those suffering from substance use disorder are often described as “chasing a high”. On the other hand, they are sometimes described as “seeking oblivion”. Arguably, these are two sides of the same coin – “self-annihilation”. This provides an important clue to an appropriate recovery treatment programme for those suffering from addiction. The word we often use for the experience of achieving a high, if we can accept the terminology, is euphoria. The literal sense of the word from its Greek origin is “bearing well”. We are said to feel euphoric (or exultant) when everything goes well. We sense a rush of well-being or intense pleasure. When we seek to experience euphoria through the use of alcohol and drugs, however, there is often a price to pay. We experience withdrawal when the effect wears off. We then find that it takes more to achieve the same feeling the next time around. We need something more than artificial to achieve a proper sense of well-being or happiness over the longer term. Ecstasy is closely related but different to the sense of euphoria. Some use the word ecstasy to describe the feeling of intense pleasure. The origin of the word in Greek, however, is ekstasia – “to stand outside of oneself”. Some alcohol and drug users talk about wanting to be taken out of themselves, as it were, or lifted out of their mundane existence. On the other hand, those suffering from substance use disorder are often said to be “seeking oblivion”. On the face of it, this sounds very different from chasing a feeling of intense excitement or pleasure. Indeed, we often use the word in a different context to imply destruction or reduction to nothingness. Instead, the dictionary defines oblivion as the state of losing memory or consciousness. It’s a bit like seeking to take oneself out of existence altogether, albeit momentarily. This is a state of non-feeling or perhaps a shutting out, as it were. In my own case, looking back, I’m fairly sure that I was drinking to reach oblivion. It was a way to shut out things that had happened to me in life and to cope. Actually, I didn’t always drink with that intended purpose in mind but it was often the way that things turned out through loss of control and blackout. The latter put me in dangerous situations a few times. That’s not to say that there wasn’t a sense of well-being in the initial stages of getting drunk but I wouldn’t describe it as euphoria or ecstasy. In any case, it’s hard to describe a drinking event as an experience of euphoria if it culminates in vomiting and unconsciousness. It hardly constitutes well-being when you get up the following day and go to work in a cold sweat with the shakes. I used to ask myself - "why do you keep poisoning your body?". But I continued to do it. If we think about what is going on here, it might be argued that there is a common thread in this understanding of euphoria, ecstasy and oblivion. The common factor, perhaps, is self-annihilation. The search for a sense of intense pleasure or well-being through artificial means is a denial or negating of one’s own ability to achieve this state under one’s own steam. It’s seeking a release from the constrained self. Alternatively, the desire for oblivion is motivated by just wanting to shut oneself down, albeit temporarily. There are clues here to recovery treatment. We all would like to experience a sense of well-being or happiness in life. But we need to focus on how to achieve that on a basis that will be sustained for the longer term. We need a proper foundation. Rather than seeking out an artificial release from our mundane lives, we need to find new meaning and purpose. We need to accept the conditions of existence and find what makes us truly happy. We can’t live in a dream or stumble around in a drunken haze. There is nothing wrong with dreaming, of course, but we have to live our lives in the real world. Shakespeare said through Prospero in The Tempest, "We are such stuff as dreams are made on". But this was in the context of actors playing out a role in life and we are surely more than simply actors going through the motions. In Greek mythology, Morpheus is the God of Dreams. This provides the link from the name to the dream-like effect of using the drug morphine. But we can achieve the sense of well-being through natural production of endorphins ("endogenous-morphine") in the brain. How do we do this? The proper use of the word ecstasy provides a clue. In philosophical terms, as already said, ekstasia is to stand outside of oneself. What this is telling us is that to be an authentic self, we need to come out, as it were, and stand properly in relation to others and the world around us. Lift your head and look around. We are not determined in isolated existence. Finally, the answer in recovery treatment is to turn away from oblivion. We don’t want to shut out reality. That is the way of those suffering addiction. They become isolated. Instead we need to encourage sufferers to turn outward. Rather than wipe the memory clean, we need to address the sources of despair. We need positive steps to negate the desire for oblivion. There is nothing wrong with feeling euphoric. We can achieve an intense sense of well-being and produce "feel good" chemicals in the brain through achieving something – winning a prize, running a race, being recognised by others, volunteering to help others less fortunate than ourselves and so on. Similarly, we can be lifted up from our day-to-day lives, by developing new interests and finding pleasure in small things. The end-result of recovery treatment is not oblivion but a free and happy individual, leading and enjoying life in communion with others!

We often hear people, particularly children, exclaim, “I’m bored! I’m fed up! I’ve got nothing to do!” We’ve done it ourselves, no doubt. There are times when we feel stuck in a rut, can't get motivated and would rather forget about the world outside. Unfortunately, some people, including me at one time, reach for alcohol instead. We need the sense of something different to get us going, as it were. We need inspiration. Some claim to find it in the sense of freedom and excitement provided by alcohol and drugs. But this is an illusion. In reality, “substance use disorder” leads to a withdrawal from the world and a false or only fleeting sense of inspiration. One aspect of boredom is frustration and failure to get inspired by relentless repetition. Getting up, going to work, coming home, surfing through dozens of channels on TV without being able to find anything “new”. Indeed, we go through much of life on “auto-pilot”. We do things without even properly registering that we’re doing it because “it’s all the same”. The ancients talked about acedia. A better translation of the term is not just boredom but listlessness. The latter implies a lack of energy. There is nothing wrong with taking time out, of course, in a period of quiet meditation. But listlessness also comes with restlessness or “sitting on edge” waiting for something to happen. This is being unable to sit still but not really knowing what to do or how to change. Acedia means to be “without care” in the widest sense. It conveys indifference or something more than simply boredom or a lack of energy. It’s a failure to find meaning or to be unfeeling. It’s really a spiritual malaise, implying apathy In Greek philosophy, apatheia means emotional detachment. This can be a healthy attitude. We don’t want our emotions to be swinging all over the place. But the modern sense of apathy is lack of interest – “I couldn’t care less”. Some look to break the boredom or listlessness through using alcohol or drugs. I suppose it could be a way of letting go but not without the potential for negative consequences. There is a threshold of usage beyond which it’s hard to do anything very much and there are significant downsides over the longer term. In Confessions of an English Opium Eater (1821), Thomas de Quincey says he first used opium for relief from neuralgia but found it also increased his ability to think creatively. He describes enjoying opera under the influence of opium and walking the streets of London in a daze, taking in the sights and sounds. Interestingly, however, he titles the first half of his confessions “the pleasure of opium” and the second “the pain of opium”. The latter is marked by increased dependency and symptoms of withdrawal – two classic markers of addiction. He describes in great detail the nightmares he endured. These perhaps make sense against the background of his suffering in childhood, including the loss of two sisters at a young age. Did I feel creative when drunk? It sometimes brought an end to procrastination or in my case what we would call “writer’s cramp”. Fuelled by lunchtime drinking, I could write very quickly as the ideas in my head came tumbling out onto paper. But I’d end up often in blackout. I’d come back to the office the next day and not know why there were new entries in the diary, scribbling of forgotten phone conversations or signs of hasty attempts to wipe-up spilled coffee. The written masterpiece was not so great either! I was talking to a fellow alcoholic in recovery about this. We were talking about the very large numbers of creative people who reportedly have used drugs supposedly to stimulate their creativity. These include musicians, artists, actors, and so on. Perhaps the use of alcohol or drugs is also partly to help come back down from the stress of performing live in front of an audience. Some have survived but others have not. My understanding of the research literature is that there is no clearly established link between substance use disorder and creativity. It may be that some use alcohol and drugs to lose inhibition. But many have remained creative while in recovery from addiction, famously including Elton John, and Anthony Hopkins, for example. The latter recently recorded a seasonal greetings message in which he spoke of his 47 years of sobriety and encouraged those who are suffering to ask for help and believe in themselves. What is human creativity? It’s doing or making something new. But it’s not making something out of nothing, as it were. Instead, it’s about establishing a new relation between the subject – me and you – and objective reality – other persons and the world around us. We might think of creativity as providing a new overlay of meaning. Some might use creativity as an attempt to “unlock” a higher level of insight. Artistic expression is perhaps the purest form of creativity. This has long been recognised by psychologists and philosophers. The nineteenth century philosopher Friedrich Nietzsche sees art as how we give expression to the meaning we find in the mix of order and chaos we experience in the world around us. Art therapy is included among the suite of options in addiction treatment. I’ve encountered several people in my role as a peer mentor who are using creative skills to help their recovery - an actor, a film producer, a photographer. and somebody who creates “paintings” using modern digital technology. In a long conversation recently, a recovering alcoholic made reference to how he had recently discovered enjoyment of baking bread. I picked up on this immediately and gave him encouragement. How do we overcome boredom or listlessness? How do we stimulate creativity? We could make a start through greater attentiveness. This is an aspect of mindfulness – paying more attention to the present moment. Switch off the auto-pilot, stop going through the motions, and pay more attention to the world around us. We know there are things that will facilitate positive change. When the sun comes out, for example, my mood changes dramatically. If I then go outside for exercise, even if only for a walk, then I feel refreshed and better able to “snap out of it”, as it were. This stimulates a feeling of well-being and helps me to think more positively and creatively about my role in the world. What does the world look like to you? How can you think and behave creatively about your place in the world without alcohol and drugs? Give it some thought. Listen to the experience of others in recovery. Empower yourself with the confidence and support that you need to overcome your dependence on alcohol or drugs with The OAD Clinic’s bespoke detox programmes offer both drug and alcohol treatment, but can also provide you with the adequate support and treatment for anxiety, depression and trauama. Receive alcohol or drug addiction treatment that caters to your needs at The OAD Clinic. Enquire today.

One of the observations I would make of the people I’ve met who are at the early stages of tackling alcoholism is that they expect a quick fix. Looking back, I suspect I was the same. You only discover what it truly takes after a lot of anguish, repeated cycles and a final acceptance of what is required. Too often people turn up expecting a quick fix. This is exhibited in many ways. Some will turn up to a fellowship meeting not really wanting to be there. It’s been suggested to them by somebody else. They get there and don’t like the venue. They don’t feel anything in common with anybody else. They don’t want to open up in front of others. They go away thinking that this will not be helpful to them. Admittedly, it takes some courage to go to a meeting in the first place. But the pattern is often to attend two or three times and then disappear. Instead, if you don’t feel at home in a particular format or with a particular group of people, then why not shop around and find something more suited to you? Alternatively, some will turn up at a clinic or medical practice following a referral. They expect a quick fix – a “magic pill” or whatever. They enter therapy but don’t fully engage. The biggest frustration to me as a mentor is the number of people who express an interest in talking but who disappear quickly thereafter. What is going on here? I don’t mean to sound disparaging. As already said, it takes some courage to take the first step. Hopefully, those starting out on the path to recovery truly want to get well. But often the thinking tends to be – I’ve done what others asked me to do, I’ve perhaps been sober for quite a while. Something happened to me but I’m now back on an even keel and no longer need it. I was much the same. It took several years of knowing inside that I had a serious drinking problem before I finally got my first referral. I didn’t volunteer myself, as it were. It was forced upon me, in a sense, by my ultimate collapse but it came as a great relief in many respects. That is because it was out in the open, perhaps not to everybody but at least to those who mattered most. Moreover, I was receiving treatment. I was given medication. From memory this was some form of beta-blocker to control the panic attacks. I was assessed by a psychiatrist. I was given very intensive psychotherapy and I welcomed it. I was asked whether I’d ever contemplated suicide. I hadn’t. I experienced mood swings, especially during the winter, but I wouldn’t say that I ever felt truly depressed. We explored my childhood in great detail. I was given “homework”. All of this I now recognise to be very standard and it triggered a life-long commitment to study. At the end of all of this – from memory it lasted several months – it was decided, presumably with my agreement, that I was “better”. No suggestion was made to me about ongoing support and it was me who expressed an interest in group meetings. I went along a couple of times but didn’t enjoy it. A lot of people were smoking – I came away reeking of smoke, similar to having been in a pub in the olden days - and I didn’t feel very much in common with them. I was on my own. I’m not sure whether or not I truly believed I was better. I had acknowledged a problem. I’d collapsed and received treatment. It was a close shave and I’d learned my lesson or so I thought. In any case, I was then preoccupied with controlling the panic attacks and it took me about three years. But here is the key point. I had not properly realised that this was still the early stage. There was no quick fix and this needed to be for the longer-term. Without repeating much of what I’ve written elsewhere, I then repeated the whole cycle all over again. Relapse was followed by repeated efforts at control, further relapse, blackouts and so on, until another collapse into panic attacks and referral for treatment. We could break this down into something like fifteen years of heavy drinking, five years of sobriety, followed by another five years of heavy drinking. This time I was starting to get it. I knew that a commitment to sobriety needed to be truly for the longer haul. I started to engage with fellowship meetings. At first I did this online but eventually in person and I kept going. Although I had been sober for a number of years, I still found it helpful to hear and share experience with others. Eventually, I also arrived at the point of helping others and found this to be very beneficial. The key point here is that recovery is not a quick fix. Don’t stay in denial. Recognise and acknowledge that you have a problem that will take a lot of work to get well. You can study what others have done. Find some books and movies that work for you. Share your story with others who have found themselves in the same situation. Let’s try to sum it up. Recovery is about travelling along a path toward a promised destination. It’s a long-term commitment to a changed lifestyle, changed attitudes, and changes in who you mix with and what you do. It’s about opening up new meaning and purpose for you in the world. We are all "work in progress". Like anything in life that’s worthwhile, it’s hard work, it takes effort, but the reward is freedom and it’s priceless!

When I tell people that I've been sober for more than 20 years, they usually offer congratulations with a comment such as “we admire your strength”. I acknowledge the compliment and reply that it was not strength but fear that saved me. I suppose this blog is a bit about "fight or flight" but it’s actually much more than that. Alcoholics in recovery often talk reflectively about how fear was partly driving their behaviour. What they mean by this is that drinking to excess was a way of masking or coping with some basic feeling of insecurity or discomfort in their lives. They usually speak about the following causes and manifestations of fear, in no particular order: First, fear of failure – this might be indicative of low self-esteem. Drinking to excess then becomes a way of summoning up what we sometimes call “Dutch courage” to cope with whatever situation confronts us in life – perhaps at work or in social situations. Second, more generally, fear of “something always going wrong” – we might fear losing a partner or losing a job, for example. There could be a tendency to “catastrophize”, indicative of an underlying insecurity. Drinking to excess provides something like a “comfort blanket”. Third, “fear of missing out” (FOMO) – this could again be a manifestation of low self-esteem. Some drink heavily to be part of the supposed “in-crowd” because they want to be seen as the same as others. They believe, falsely, that this is what is required to win the admiration of others. Fourth, fear of others – this could be the result of bullying in the workplace, for example, or perhaps some form of “domestic violence”. Alcohol is then used to relieve suffering. Fifth, perhaps fear of repeating some past experience – this might be trauma in early life or losing a loved one, for example. Again, abusing alcohol or drugs is a form of self-medication to block out the memory or prevent its repetition in the mind. Fear sometimes may appear quite trivial. We probably all recall experiences in our childhood involving “fear of the dark”, for example, or “fear of something under the bed”. These instances are relatively easy to deal with. We leave the bedside light on or have a good look around the room to be reassured that nobody else is there. The more serious cases listed above are, of course, far more complicated to deal with. Whenever I listen to the stories of others in fellowship meetings, I always respond with the observation that my own experience of fear means something different to me. In a sense, it was fear that saved me or, more accurately, it was fear that marked my own “rock bottom” or turning point on the path to recovery. In that sense, arguably, fear played a positive role for me. My perception of raw fear in action came through the panic attacks brought on by years of binge drinking. The onset of severe panic attacks marked my first referral to treatment. The treatment took the form of a psychiatric assessment, attendance as an outpatient at an alcohol treatment unit and several months of therapy. My memory of this period of my life is that it was horrific. The initial collapse involved fear of dying. This was followed by fear of anything that might provide a “trigger” of a panic attack. Fear of leaving the house and going back to work, fear of being in tall buildings, fear of walking across a bridge, fear of flying were just some of the experiences. I couldn’t join the others climbing to the top of the Harbour Bridge in Sydney on a business trip to Australia (I took a ferry to Manly on my own, instead). I declined an office excursion to the London Eye (the “Millennium Wheel”) one summer’s evening. I couldn’t live any longer like that. It was my rock bottom. I knew that drinking to excess brought on the panic attacks and I had to get well. Having undergone intensive therapy, I came to believe that something more was required to sustain recovery. Something like Cognitive Behavioural Therapy (CBT) will help to address some of the causes of fear discussed above. You can be taught to challenge your so-called “core beliefs” about yourself and the world. It’s not true that you are always a failure or that everything always goes wrong. It’s not true that you are unloved. In a way, therapy is about “fight or flight” – confront the triggers of fear in a rational manner, deal with them and learn to cope rather than fleeing into a form of self-destructive behaviour. In this way, apprehension can be used positively to instil courage and enhance performance. This is all well and good but what about “existential fear”? Who will help you with that? Here, we are talking about something much deeper. Philosophers and theologians talk about the sense of anxiety, or dread, when we consider the meaning of life. When we contemplate our existence, we are always heading towards death. But we also fear life. This fear leads us to hang on to something. We falsely think this will help. We cling to things but attach false significance to them. For some, this culminates in “substance use disorder”. We have the freedom of possibility. At one level, we can seemingly do whatever we want. On the other hand, however, we are caught by the concrete circumstances in which we find ourselves – where we were born, how we were brought up and educated, what responsibilities we have for others, and so on. The anxiety arises because of the tension that exists between the “what might be” and the “what is” in our day to day lives. We avoid confronting our deepest desires and exhibit unwillingness or fear to make the leap into unknown freedom. Some avoid this existential conflict by retreating into what is perceived to be “safety” but never resolve the underlying problem. What are the lessons, particularly for those suffering from addiction? First we need to address the fears most commonly experienced in our lives, such as those listed above. Recognise and confess the source of distress. Share with others. Engage in therapy, and perhaps use medication if needed. Second, more fundamentally, we need to re-orient our attitude to life. We need to find a sense of ulterior meaning and purpose beyond our mundane lives. Decide what makes you happy. Do it with others. Then we can face life with hope, fortitude and resilience, recognising that the proper response to life is how to respond to challenges and not to regard them as sources of fear. Don’t flee. Choose the path of recovery in addiction treatment and find freedom through sobriety!

Alcohol treatment practitioners have different views on abstinence. Some take the approach that it’s possible to have a goal of “controlled drinking”. Others take the view that recovery from addiction is only possible through abstinence. I can only speak from personal experience and I possibly wouldn’t be here today if it were not for a commitment to abstinence. The overriding objective is for the sufferer to get well. Abstinence may form part of an overall strategy in treatment but we have to recognise that we can’t all get there. It’s important to keep users alive and functioning. It’s important to help somebody stay in a family unit, if there is one, and to keep a job, if there is one. Meanwhile, recovery treatment lays the groundwork for sobriety. In this regard, we can say that abstinence is a goal or an ideal but we may have to embrace a wider perspective. There will be relapses, perhaps, and the road to recovery is tough. Somebody said to me – “I want to be in a position where I’m in control of my drinking, and drink is not in control of me”. Well, yes, I guess that’s where we would all like to be. Being able to have a glass of wine with dinner or sit down after exercise with a cold can of beer as reward is quite appealing, although I can genuinely say that it’s lost appeal to me over time. As an alcoholic in recovery, there are occasions when I’d like to be able to do those things but I’ve learned the hard way that I can’t. Each session would usually just end up with vodka until I couldn’t drink any more. An uncle of mine said to me recently – “are you still not drinking? What, not even just a glass of wine with Sunday lunch?” Now, of course, this line of questioning strikes me as extremely odd and I shrug it off. Only abstinence works for me and for the recovering alcoholics I’ve met over the years. As I’ve said before, why would I want to put recovery to the test? I’ve attempted it many times over many years and failed. Perhaps the experience of some others is different. If we say that abstinence is an ideal, then does it make us hypocrites if we can’t live up to it? Should we always practise what we preach? When you truly believe in something, you don’t have to throw it away just because you keep slipping back. It doesn’t make you a bad person because you can’t always stick to it. I was thinking about this topic in a different context. I’d like to think that I know as much about therapy as anybody else. Does that mean I no longer suffer? Of course not! I let my emotions run away with me from time to time. I lose my temper. I behave irrationally and make wrong choices without thinking things through carefully. Guess what? I’m only human after all. But I know the techniques that will help me to cope and they are used from time to time. I said to somebody in the office – “I’ve learned all of the theory and I’m trying to help sufferers from addiction to cope with life. Am I failing to practise what I preach? Do my own struggles point a finger at me and accuse me of being a hypocrite?” I sometimes worry quite a bit about this one in my role as a mentor. That is because people are looking to me, hopefully, as an example and for advice. The reality, in my view, is that we all need an Ideal to guide us through life. We should think about an Ideal as a Promise, which reaches back and affects how we live our lives in the here and now. But we remain human. We are creatures living under the real world constraints of space and time. We are subject to the “devices and desires of our own hearts”, so to speak, and we all struggle to live up to ideals. It’s doubtful that any of us practise truly what we preach. We’d like to think that we always do the right things, that we are kind to our neighbours and that we set an example to others. But we still commit selfish acts, pass judgment on others and walk on the other side when we encounter sufferers on the streets. None of us are perfect. In Stoic philosophy, which I’ve referred to many times in these blogs, only a so-called Sage reaches this state of perfection. We still need goals in life. We need a sense of purpose and standards to live by, even if we find them very hard to keep. We need hope to sustain us through the setbacks. Abstinence is just like this. Some can attain it and others can’t. It might turn out that some don’t even need it. It’s a hope to live by. We’re all aiming at the same thing in recovery treatment, which is to help the sufferer get well. We try to practise what we preach but we don’t always succeed. We should try to do the best we can. Don’t beat yourself up for the lapses. Don’t dwell on the mistakes. Try to learn from slip ups. What can we say, positively speaking? Focus on the successes. Give yourself a pat on the back. Look back on how far you've come. You remain on the journey. The destination lies ahead.

In 1969, Elizabeth Kübler-Ross described the five stages of grief. In my experience, these also characterise aspects of confronting “substance use disorder”. Keeping these in mind also helps us to build recovery treatment for those suffering from addiction. Grief, of course, is triggered by many different situations – bereavement, a broken relationship, terminal illness or loss of a job, for example. We experience many of these at various stages in our lives. How we cope partly defines the person we become. I suffered grief with my family when my brother died. I’ve mentioned this several times in my blogs. In fact, I’m coming to realise that it’s played a bigger part in my drinking than I’ve previously acknowledged (see The Divided Mind). It seems to me completely legitimate to apply a model of the outworking of grief to addiction. Here we are considering not the specific event or trigger of grief, though trauma plays a major part in the addiction literature. Instead, we are talking about a process. That is because in turning around we acknowledge that there are common stages of experience and behaviour. The first stage is Denial. This is very common for addicts. We try to carry on as though nothing has happened. I’m not sure this is a coping mechanism, as such. Rather, it’s the fact that we refuse to acknowledge that the repeated cycles are indicative of loss of control. More generally, we also refuse to acknowledge the damage to ourselves and to others. Why do alcoholics and others with addictive disorders stay in denial? I think it’s partly because we see it as failure in ourselves. We don’t want to admit to what we believe others will see as weakness. We don’t want others to think that we can’t cope without the help of others. In my experience of reaching out or being available as a mentor, it’s by far the major stumbling block in persuading others to engage with me. The second stage is Anger. Nobody likes to be told they’ve got it wrong. Nobody likes to be told that they’ve got a problem which needs to be addressed. This, of course, goes hand-in-hand with denial. It’s why we need to be extremely careful when approaching alcoholics with an offer of help. If you’re not careful then you’ll be told to go away in not very polite language – to mind your own business, basically. It needs to be done with care. Anger is also the manifestation of a frustration within the addict confronted by his or her circumstances. Why does this happen to me and not somebody else? What have I done to deserve this? Why does everybody else seem to think the problem lies with me? Why does everybody seem to believe it’s my fault? We don’t, of course. But we’d like to help you get to the bottom of it and see what we can do together to help you turnaround. The third stage of this model is Bargaining. I’m not entirely sure how this applies to grief. With regard to addiction, I see it as part of the repeated cycles of attempts to get the usage disorder under control. This is an attempt to convince both yourself and others that you can cope. Examples of bargaining include – I will only drink at the weekend, I won’t drink spirits, just let me drink occasionally and I’ll keep it under control is basically the plea. I tried all of these many times! The fourth stage is Depression. You can’t do it on your own. This is a collapse inward. This for me is the stage at which there is a realisation of the seriousness of the situation. The denial, the anger and the failed bargaining have seen some people drop away leaving you alone with the underlying problem unaddressed. You are still locked into destructive behaviour. It hurts but you are running out of options. Understandably, the mood blackens, only worsening the self-destructiveness. The fifth stage, finally, is Acceptance. Having experienced a sense of shock and loss in life, this is the stage at which the emotional response to the situation is calmed down. It really happened, there is no going back, it’s time to face the facts and move forwards. I’ve seen this at the turning point of many alcoholics. It’s the time at which resentments go. Basically, we are laid bare, broken in humility, and ready to respond. I was ready to do whatever it took to get well again. Here I would add confession. We have talked about this before (see Confession and Memory – Write It Down). It’s the time to talk. We are done with the denial and the raging. Finally, we accept our situation and we are ready to talk about it openly and freely. This helps us to get so far but is incomplete. Acceptance and confession are the important first steps in any recovery programme. But we need more. As said in previous blogs, acceptance and confession are cleansing. This marks a turning point. The task at this stage is to use that opportunity to build upon the foundation stone. Hence we need to go beyond the five stages of grief in building recovery treatment. This is the stage for reconciliation. This means reconciliation within the divided self and with others. There can be no reconciliation without forgiveness. We need the forgiveness of others and we need to forgive ourselves. Acceptance, confession and reconciliation are restorative or, dare we say, redemptive. We change the way we lead our lives through seeing the world and others through a different lens. Recognising the parallels with the stages of grief is important in addiction treatment. We are on a journey but, importantly, this is only the first part of recovery – onwards and upwards!

All of us, presumably, would like to be at peace. Most alcoholics and drug users are restless. They can’t sit still. They’re not comfortable in their own skin, for whatever reason. Put simply, they are not at peace. What can we understand and do about this? One motivation for drinking to get drunk is that life somehow lacks meaning. What we have is not enough. We need a feeling of exultation or euphoria. The opposite end of the spectrum is the desire to block something out. In either case, reliance on alcohol to address life’s problems is not the answer. Ultimately, the result for many is loss of control, blackouts and dependency. This fractures relationships, and causes lasting damage. I used to drink to get drunk. The initial motivation was happiness but the ultimate desire was oblivion. If somebody were to ask me, is there any one thing that you have been looking for in life, I would answer immediately, Peace. I’ve always said that. I felt it when young when I started drinking to get drunk. I felt it through my descent into alcoholism and I’ve often felt it since. Why did I feel like that? I suppose part of it was personal circumstances. Another part of it was that I put myself under a lot of pressure and still do from time to time. I’d returned to work after my first collapse. I’d entered therapy and was not drinking but I had to cope with the panic attacks. I’m not sure whether I attempted to return too soon but I persuaded myself that I didn’t want to develop something like agoraphobia. At any rate, my senior manager entered the room. I couldn’t speak. He sat down and said, “Take your time”. I replied, “I know that I have to change”. And he said, “No, you need to accept”. There were some things I needed to change, of course, but his point was a more fundamental one. He explained that I was achieving success in my career because I set high standards for myself and was always trying to improve. But it came at a cost. Instead, what I needed to do was to accept the person I am and the circumstances around me. There was no point in drinking to block things out or somehow cope with the stress. This brings to mind the Dutch philosopher Baruch Spinoza’s concept of acquiescentia in se ipso – or “acquiescence in oneself”. When we talk about acquiescence, we usually have in mind a sort of reluctant giving in. Instead, what Spinoza was saying, oversimplifying, is that we are at rest in self-contentment when we accept ourselves as we truly are in relation to others and to the world around us. That is because we let go of illusions and attachments. Is Peace out there to be discovered? It’s a bit like the old question – can the Truth be learned? These questions are asking, at least in part, whether there is something about our fundamental existence as human beings that we are missing or needing to learn. Much of the debate in philosophy (and theology) is whether we can ever discover this for ourselves. One of the key insights of Buddhism is that suffering results from forming wrong impressions of others and the world around us. This gives rise to false attachments, which result in wrong behaviours including our emotional responses. Attachment leads to craving, which results in suffering. Spiritual practise, including meditation or contemplation, aims to calm the mind and restore right ways of thinking and behaving. There is something appealing about sitting on top of a mountain in quiet contemplation of the world – at least there is to me. But I’m uncomfortable with the idea of being an ascetic - somebody who practises self-denial in seclusion. Withdrawal is surely not the answer. Life is for living. Surely, instead, we need to re-engage with others and the world but with a different sense of meaning and purpose. When we come back to earth, in the life of the alcoholic and the drug user, much of this seems irrelevant or too far-fetched. There may be no mountains nearby – we may live in an inner city flat! We have to work to pay the bills, deal with the “cost of living crisis", and get through the suffering that results from the many trials of life. I still feel the need for Peace after more than twenty years of sobriety. Is that so surprising? Surely, you might say, you are supposed to be the one who is advocating a spiritual approach to recovery? If you are still searching for Peace, then where does it leave the rest of us who are still going through the painful cycles of relapse, rehab and recovery? Well, it’s not quite like that. I’m still a human being. I still experience fragility, anxiety, and the need to withdraw and take a deep breath. But I recognise the signs and the triggers, and I know how to respond. That does help to bring about peace, at least in some measure. The restlessness and the emotional swings come from within. It’s how we react to circumstances and people. So here are some practical strategies to cope: First, don’t catastrophize. Just stop and think about it for one moment. There are some bad things that can and will happen in all of our lives. But it’s not true that things “always go wrong”. Bring to mind similar circumstances from the past and recall how they often worked out better than feared. Second, switch off the news media. We now live in a world of 24-hours news coverage, which tries to find drama and crisis around every corner. Rarely do we hear about good news. Instead, we are often presented with people who claim to know better than we do, shouting each other down. Third, don’t engage with the toxic aspects of social media. To be sure, the latter has positive elements. But don’t pay any attention to supposed adults spitting vitriol and throwing abuse at each other. Don’t look at those who are constantly showing off and seeking approval. Let them take care of themselves. Have confidence and trust in your own ability. Fourth, don’t rise to the bait. Anger comes from within. Take ownership and a deep breath. Don’t be too quick to respond in a way that will only inflame the situation. Finally, and most importantly, be self-aware. Take a temperature check, as it were. I’m very aware of when I’m starting to experience emotional swings and, as an alcoholic in recovery, it makes me feel unhappy and vulnerable. I put the steps listed above into action; meditate, take stock and share with others. I (usually) return to “normal” after a while. Alcohol is not the source of peace and contentment!

When we hit problems in life, whatever they might be, we need first to acknowledge that we don’t have all of the answers. This is especially true when we are unwell, including those suffering from “substance use disorder”. Those who seek earnestly to recover need to practise humility. What does this mean in practical terms? For whatever reason – ego, a false sense of pride, or insecurity, perhaps – we sometimes don’t want to listen to others. This is often so if our problems involve others in our immediate circle, including family, friends and work colleagues because we don’t want to show weakness. We don’t want to be told what to do by others. We don’t want to show that we don’t know. We want others to believe that we have the situation under control. I see the problem many times in alcoholics when meeting somebody for the first time in recovery treatment. I’ve also witnessed this sometimes in fellowship meetings. The newcomers know better than you, or think that they do. They question why they are even there or what you can tell them. Often that’s because they are intelligent and something big in their own circle. What could you possibly tell them? We view humility or modesty as the opposite of pride. There is nothing wrong with a sense of pride in one’s achievements, of course. We can take satisfaction from having done something well – passing exams, raising a family, getting promoted at work, for example. The problem of pride arises when inner-satisfaction turns into self-aggrandisement, constantly trying to prove that we are better or bigger than somebody else. Such behaviour may, of course, be a mask to hide behind. It might manifest a troubled upbringing or lack of self-esteem. We live in a competitive world. We have to demonstrate that we are qualified to do something. We have to earn promotion or a new job impressing somebody. But problems arise when we are constantly comparing ourselves with others and worrying overly about what others think about us. This leads to resentments. We see the problem all too prevalent in the destructive use of social media. As Epictetus said, "when someone is properly grounded in life, they shouldn't have to look outside of themselves for approval" (Discourses, 1.21.1). With regard to alcoholism, how are you going to get better if you can’t acknowledge that you have a problem? How are you going to recover from addiction if you won’t listen to others and hear their story? Turning up for a quick fix, expecting to walk out of the door with the problem solved is not going to work. We might learn something if we start paying attention to what others tell us. We start to re-define ourselves. We start to get well and to reach out to others. We need humility to admit that we need help. I was broken and brought low when I was strapped into a wheelchair and taken by ambulance to hospital. I was prepared to do whatever it would take to get well because hospitalisation, albeit brief, was the culmination of years of “loss of control” drinking. But I have to admit that I was not ready to pay attention to the stories of others. That came only at a later stage of recovery. In a sense, we need to be brought low before we will truly reach a turning point, albeit this involves suffering for the user and for others around them. This is the process or personal journey to “rock bottom”, however individually defined. Harsh as it may sound, we need to see a broken and contrite heart as part of openness to recovery. This is what some call the “gift of desperation”. It describes how we reach the point of final resignation in which we are willing to do whatever it takes to get well. Humility is sometimes seen as a person lacking in self-confidence. This may indeed sometimes be the case. It is important, then, to encourage the sufferer to be open about their experience and to express a view. This requires courage. It takes courage to acknowledge a problem and embark on a recovery journey. Of course, if you go around telling the world that you are humble then then this is not practising humility! Humility doesn’t need to announce itself. It is partly for this reason that Aristotle did not believe that humility is one of the virtues, though this has been debated by philosophers. Can one be modest or practising humility if one believes oneself to possess virtuous qualities? Instead, Aristotle views humility as consistent with “temperance” – steering a middle way between extremes. We also don’t want humility to stand in the way of progress, of course. David Hume, the Enlightenment philosopher, argues that humility about one’s achievements can restrict growth in personal excellence and, hence, social progress. Perhaps what matters most here is not to do with beliefs or knowledge but more practical in terms of how we act in the world. What we are saying, returning to our main topic of addiction, is that in seeking to get better we need to be open to alternative points of view. We need to put to one side our own estimations of superior knowledge. By the way, the medical practitioners also need humility. They don’t have all of the answers. They are not experiencing our individual obsessions and addictions, much as they try to help us get well. Alcoholics and drug users don’t all fit into a tidy box. In a different context, I was taught a valuable lesson as a young lecturer. I was asked a question by a student that I couldn’t answer. As I tried to bluff my way out, I dug myself deeper and deeper into a hole with embarrassment. Now, if I’m asked a question about one of the areas of my supposed expertise, I have no problem saying – “I don’t know but I’ll try to find out and get back to you”. There is a well-known saying in fellowship meetings – “leave your ego at the door”. This is not meant to sound harsh or judgemental. Instead, it’s intended as wise advice. If you want to get better then listen to what others have to say and learn from those who have been through the same experience.