Time To Cancel Christmas?

Christmas CancelledAs Christmas draws ever closer, surprisingly people still continue to be surprised by my “Bah Humbug” ambivalence towards all the seasonal activities.

It may be the ‘season to be jolly’ but I don’t need anything (or anyone) to tell me when to be happy. It may be that time of ‘goodwill to all men’ but… shouldn’t we actually be like that throughout the year, every year?

Regular visitors will note that I tend to write a similar themed post to this every year. It’s not that I’m a miserable git, far from it. Neither do I take some great pleasure from raining on everyone’s festive parade, each to their own enjoyment. My seasonal angst is mostly directed towards all the high levels of hypocrisy displayed at this time of year. Falseness that is mostly presented in an attempt to enhance one’s own self-worth in the humanity stakes.

The traditionally understood Christmas values actually disappeared decades ago. It’s now little more than a period of self-indulgence, an opportunity to show off and/or score points against family and friends. Overt commercialism and grotesque levels of excess (and waste) are, unfortunately abundant.

Like many, I suppose I lost that feeling of ‘Christmas magic’ as I departed childhood. That said and as I’ve grown older, this time of year has almost always been a massive reality check for me. I don’t see any change to that any time soon.

Countries are still waging war against each other, we have global warming and there is still famine. We still have poor people and too many people are homeless, even in the so-called Western Civilised World. Sadly people still die from preventable illnesses, let alone the untreatable terminal ones, or they simply succumb to old age. People still beat hell out of their partners and/or children. People still get drunk, drive their cars have accidents and seriously injure or kill people. Just like any other time of the year, the ‘Grim Reaper’ doesn’t stop work just because someone told him it was time to be happy and party.

Irrespective of all the realities that life can throw at us; how many of us, hand on heart, can say that we’ve actually been good people all year? Who can say they’ve been a source of constant value and example to their families, never mind their neighbours and our society?

If you’ve never contributed, in any way shape or form, to all the ills of the world and the many problems facing our society, and you can answer an honest “yes” to the two questions above then have a very Merry Happy Christmas.

Failing that… Christmas is Cancelled and Bah Humbug!

Addiction: Time to bin the POD…

I like to use my Sunday morning to peruse the media outpourings of the week and gather some thoughts over a coffee. This week was no different and got me to thinking… when did we get so obsessed with perfection?

The spark of ignition for my thoughts, observations and questions actually came from an article in The Independent on the latest ‘new’ eating ‘disorder’ (Orthorexia Nervosa).

Although discussed in a similar vein to anorexia or bulimia by the National Centre for Eating Disorders UK, this “disease disguised as a virtue” (as some describe it), is not yet fully recognised as an eating disorder per se. But should adopting a diet focussed on natural foods actual really be considered as a ‘bad’ thing? The simple answer is YES, especially if, the person making that particular lifestyle choice, is becoming ill because of it.

Issues around so-called ‘eating disorders’ actually fit well with my particular area of professional interest i.e. Recovery from addiction. The actual part of this particular article which grates on me is: like much else in our lives today, we now seem to posses an inherent need to label anything and everything. A process that appears even more prevalent when we can’t/won’t endeavour to understand the many and varied underlying behaviours and issues behind the personal issue at hand. Label it, box it, throw a few pills in… job done now move on!

OK, so perhaps I’m taking a somewhat simplistic and/or flippant viewpoint? Irrespective of that fact, and in no way wishing to deride the undoubted professionalism of many working in this field, helping those who are suffering, things often boil down to the matter of time availability and/or hard cash considerations.

It’s a sad factor of our society today but almost everything has a time and monetary value (and constraint) attached to it today. We must also remember the prevalent personal, social and business drive or desire for the ‘quick fix’ to every problem, perceived or actual. And all this before you even start to consider the health care impacts (and profit needs) of the massive and powerful pharmaceutical industry. Undoubtedly a major factor also at play here however; it’s also an issue for a different time.

Many of the behaviours which drive our compulsive and impetuous actions are often simply the result of personal choice; whether or not that choice was arrived at intentionally / unintentionally or even unconsciously, is mostly immaterial. It’s when those ‘choices’ become so obsessive that they’re damaging to our health that is of concern. It’s also the time when we immediately rush to ‘label’ it and define it as a ‘disease’ to ‘suffer’ from. But the label is often little more than a convenient excuse; one that we can easily hide behind and one that camouflages many of the true reasons for our actions/inactions.

It is my belief that; many of our addictive and compulsive behaviours find their roots in our almost relentless drive for personal perfection. Ingrained beliefs which are misconceptions resulting from decades of social programming. Materialistic thoughts and desires gleaned from learned behaviour and/or overt commercialism and overt/covert marketing. It’s all about those stupid ideas of only being perceived to be ‘successful’ once you reach the top of your career ladder. You’re no good unless you’re the best in your game. Until you achieve massive wealth or gain ‘celebrity’ status, you probably haven’t actually achieved anything, at least not something that is worthwhile and wanted by everyone.

But why do we succumb to all this constant pressure? Whey are we jealous about the achievements of others? Indeed, do all your peers actually want the same things? Are you any less of a person because they do and you don’t want the same things? The simple answer is no!

As individuals we allow ourselves to be driven by many of these common misconceptions… mostly due to greed and/or the desire for materialistic wealth. But was it ever really so wrong to be comfortable and happy being John/Jane Average? Why does there have to be the extremes of polarity in success and failure? Acceptance of your position on the mediocrity shelf isn’t actually such a bad thing… it’s a peaceful place to live, one that is usually full of peace and contentment. Getting to this place requires both a modicum of self-belief and some mental strength. The latter is sadly where many of us seem to fail. Too often we either don’t (or believe we don’t) possess sufficient mental strength to buck a social perceptions and/or trend(s).

The sad part of all this is; whilst we are constantly striving to achieve and realise all those things we are programmed to believe we need, we often succumb to the use substances during our personal quest for greatness. We use substances to; (1) help us celebrate or heighten our elation, (2) disguise or numb our failures (actual or perceived), (3) provide a crutch for our inadequacies (actual or perceived) or (4) simply just as a hiding place when stuff gets too hard.

The virtual space where we can retreat from reality and take respite from all the ‘voices’ of confusion in our thoughts and emotions. Our mental battleground of self-worth in a self-righteous and self-promotional world. That world where a large proportion of us are likely to be suffering from Perfection Obsessive Disorder (POD)… see how easy it is to invent a new label?

Mental strength is the commodity which provides us with the ability to not follow all the accepted social norms. We become more able to combat peer pressures, to choose which socially accepted paths we want to explore. It gives us far greater control over our thoughts, behaviours, emotions and expectations.

In her book (13 Things Mentally Strong People Don’t Do), Amy Morin[1] a renowned psychotherapist writes that “an individual’s level of ‘mental strength’ is reflected in how good they are at controlling their thoughts, behaviours, and emotions.”

“Mental strength isn’t often reflected in what you do. It’s usually seen in what you don’t do” (Amy Morin)

Many of those who praise the work of Morin, actually follow her teachings (or therapy) for overtly commercial reasons. They hang on her every word with a desire that total adherence will provide them with business success and achievement of wealth. Ironic? Yes, but the real irony here is; much of what Morin has espoused is also relevant to those wishing to escape the straight jackets of our materialistic world.

Morin’s 13 Things Mentally Strong People Don’t Do

  1. They Don’t Waste Time Feeling Sorry for Themselves: Mentally strong people don’t sit around feeling sorry about their circumstances or how others have treated them. Instead, they take responsibility for their role in life and understand that life isn’t always easy or fair.
  2. They Don’t Give Away Their Power: They don’t allow others to control them, and they don’t give someone else power over them. They don’t say things like, “My boss makes me feel bad,” because they understand that they are in control over their own emotions and they have a choice in how they respond.
  3. They Don’t Shy Away from Change: Mentally strong people don’t try to avoid change. Instead, they welcome positive change and are willing to be flexible. They understand that change is inevitable and believe in their abilities to adapt.
  4. They Don’t Waste Energy on Things They Can’t Control: You won’t hear a mentally strong person complaining over lost luggage or traffic jams. Instead, they focus on what they can control in their lives. They recognize that sometimes, the only thing they can control is their attitude.
  5. They Don’t Worry About Pleasing Everyone: Mentally strong people recognize that they don’t need to please everyone all the time. They’re not afraid to say no or speak up when necessary. They strive to be kind and fair, but can handle other people being upset if they didn’t make them happy.
  6. They Don’t Fear Taking Calculated Risks: They don’t take reckless or foolish risks, but don’t mind taking calculated risks. Mentally strong people spend time weighing the risks and benefits before making a big decision, and they’re fully informed of the potential downsides before they take action.
  7. They Don’t Dwell on the Past: Mentally strong people don’t waste time dwelling on the past and wishing things could be different. They acknowledge their past and can say what they’ve learned from it. However, they don’t constantly relive bad experiences or fantasize about the glory days. Instead, they live for the present and plan for the future.
  8. They Don’t Make the Same Mistakes Over and Over: Mentally strong people accept responsibility for their behaviour and learn from their past mistakes. As a result, they don’t keep repeating those mistakes over and over. Instead, they move on and make better decisions in the future.
  9. They Don’t Resent Other People’s Success: Mentally strong people can appreciate and celebrate other people’s success in life. They don’t grow jealous or feel cheated when others surpass them. Instead, they recognize that success comes with hard work, and they are willing to work hard for their own chance at success.
  10. They Don’t Give Up After the First Failure: Mentally strong people don’t view failure as a reason to give up. Instead, they use failure as an opportunity to grow and improve. They are willing to keep trying until they get it right.
  11. They Don’t Fear Alone Time: Mentally strong people can tolerate being alone and they don’t fear silence. They aren’t afraid to be alone with their thoughts and they can use downtime to be productive. They enjoy their own company and aren’t dependent on others for companionship and entertainment all the time but instead can be happy alone.
  12. They Don’t Feel the World Owes Them Anything: Mentally strong people don’t feel entitled to things in life. They weren’t born with a mentality that others would take care of them or that the world must give them something. Instead, they look for opportunities based on their own merits.
  13. They Don’t Expect Immediate Results: Whether they are working on improving their health or getting a new business off the ground, mentally strong people don’t expect immediate results. Instead, they apply their skills and time to the best of their ability and understand that real change takes time.

Perhaps its time for more of us try walking these ‘Thirteen Steps’ and hopefully, consign our POD to the trash can?

[1] As a licensed clinical social worker, college psychology instructor, and psychotherapist, Amy Morin has seen countless people choose to succeed despite facing enormous challenges. That resilience along with her own personal history dealing with tragedy inspired her to write “13 Things Mentally Strong People Don’t Do,” a web post that instantly went viral, and was picked up by the Forbes website where it has reached over 9.5 million people. Morin’s post focused on the concept of mental strength, how mentally strong people avoid negative behaviours—feeling sorry for themselves, resenting other people’s success, and dwelling on the past. Instead, they focus on the positive to help them overcome challenges and become their best.

The Alcohol Infused ‘Chicken & Egg’ of Post Traumatic Stress Disorder

PTSD Word MapI’ve been wondering for some time now: is there any connection (significant or otherwise), between the consumption of alcohol, particularly in large quantities, and the overall impact on the symptoms of Post Traumatic Stress Disorder[1] (PTSD)?

I suppose questioning the link, perceived, implied or implicit, should be something of a naturally expected quandary for me. My background of life and work experiences in and around the licensed trade, Emergency Services, Criminal Justice System enforcement, the Military and latterly Recovery and Mentoring in substance misuse, mean it would be strange for me not to examine the issues and questions in what is an increasing problem.

So what, in simple terms, is PTSD? The UK mental Health charity MIND (www.mind.org.uk) offers the following explanation[2]: If you are involved in or witness a traumatic event, it is common to experience upsetting, distressing or confusing feelings afterwards. The feelings of distress may not emerge straight away – you may just feel emotionally numb at first. After a while you may develop emotional and physical reactions, such as feeling easily upset or not being able to sleep. This is understandable, and many people find that these symptoms disappear in a relatively short period of time. But if your problems last for longer than a month, or are very extreme, you may be given a diagnosis of PTSD.

With the nature of the work our military and emergency services personnel carry out, they are clearly more likely than most to experience incidents leading to possible PTSD. Historically, there has also been a heavy social drinking culture attached to all these professions. Whether this culture is born out of a perceived need to relax from their stressful day or simply, driven by macho peer pressure is mostly immaterial.

Over half of men (55%) surveyed by the NHS in 2012 had drunk more than four units (the lower risk guidelines) in the last week. Nearly a third (31%) drunk twice the maximum lower risk guidelines at least once. The definition of ‘binge drinking’ (for men) is consuming eight or more units in a single session. Subsequently, 5% of men in the UK are “at risk” drinkers i.e. someone who drinks more than 50 units per week[3]. I’m sticking with the statistics for men as there are currently higher percentages of men within the professions covered here.

In 2013 more than one in five adults (21%) said that they do not drink alcohol at all. This figure has also been showing a slight increase year on year[4]. Young adults (16-24yrs) were primarily responsible for this change, with the proportion of young adults who reported that they do not drink alcohol at all increasing between 2005 and 2013[5].

What was previously and often dismissed by indulging participants as ‘heavy drinking’ (50+ units per week), was indeed prevalent however statistics suggest this may well finally be changing? We can but hope that this statistic is also proves to be indicative of a similar trend within our military and emergency services.

PTSD is the mental illnesses most associated with military service but there are also a range of other more common mental illnesses which might affect Service and ex-Service personnel. These include depression, feelings of anxiety, panic attacks and substance misuse and interestingly, most commonly alcohol misuse[6].

Combat Stress (www.combatstress.org.uk), the leading Mental Health charity for veterans in the UK, has experienced an increase in the number of referrals for PTSD over recent years[7]. To that end the following questions become ever more relevant.

  • Could the symptoms of PTSD be wholly or partly dependent upon the quantities of alcohol consumed by a sufferer, prior to or post diagnosis?
  • Could alcohol actually exacerbate the symptoms being experienced during occurrences of PTSD?
  • Which factor appeared first; alcohol issues or PTSD?
  • Should the management[8] and treatment of the two things be addressed as separate issues or in a more holistic manner?
  • If alcohol isn’t a direct causation factor leading towards the severity of PTSD symptoms, perhaps there could be some indirect correlation between the two?

I have no doubt that alcohol consumption, particularly in excessive quantities, is likely to present major impacts upon an individuals cognitive and emotional perceptions. It can also have negative impacts upon behaviour however; could those impacts be more pronounced in respect of (1) the susceptibility to or likelihood of someone suffering from PTSD and/or (2), after being clinically diagnosed with PTSD? Could the use of alcohol also present negative impacts on the prognosis for any expedient recovery?

Previous research has shown that alcohol (and drug) abuse commonly co-occur with PTSD[9]. In addition, there is a growing body of evidence that appears to show; recovery from PTSD (and/or other anxiety disorders) may be hindered, or the condition worsened, by medication or substance overuse, abuse, or dependence; resolving these problems can bring about a marked improvement in an individual’s mental health status and anxiety levels[10].

PTSD is a clearly a mental illness however; alcohol abuse can also present or be resultant of mental health issues. According to the NHS, the specific symptoms of PTSD[11] can vary widely between individuals, but generally fall into the categories described below.

  • Re-experiencing: the most typical symptom of PTSD. This is when a person involuntarily and vividly re-lives the traumatic event in the form of:
    • Flashbacks
    • Nightmares
    • repetitive and distressing images or sensations
    • physical sensations – such as pain, sweating, nausea or trembling

Some people have constant negative thoughts about their experience, repeatedly asking themselves questions that prevent them from coming to terms with the event.

For example, they may wonder why the event happened to them and if they could have done anything to stop it, which can lead to feelings of guilt or shame.

  • Avoidance and emotional numbing
    • Trying to avoid being reminded of the traumatic event is another key symptom of PTSD. This usually means avoiding certain people or places that remind you of the trauma, or avoiding talking to anyone about your experience
    • Many people with PTSD try to push memories of the event out of their mind, often distracting themselves with work or hobbies.
    • Some people attempt to deal with their feelings by trying not to feel anything at all. This is known as emotional numbing. This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.
  • Hyperarousal (feeling ‘on edge’)
    • Someone with PTSD may be very anxious and find it difficult to relax. They may be constantly aware of threats and easily startled. This state of mind is known as hyperarousal.
    • Hyperarousal often leads to:
      • Irritabilit
      • angry outbursts
      • sleeping problems (insomnia
      • difficulty concentrating
  • Other problems: Many people with PTSD also have a number of other problems, including mental health problems – such as depression, anxiety or phobias
    • self-harming or destructive behaviour – such as drug misuse or alcohol misuse
    • other physical symptoms – such as headaches, dizziness, chest pains and stomach aches
    • PTSD sometimes leads to work-related problems and the breakdown of relationships.

I haven’t done the scientific stuff here but In conclusion I would offer the following opinions. These are based upon a combination of observations, experience and professional knowledge.

  1. My ‘chicken & Egg’ analogy in the issues surrounding PTSD and alcohol abuse, although each have a correlation with the other, is mostly irrelevant.
  2. The symptoms of PTSD are exacerbated by the excessive consumption of alcohol.
  3. For any successful outcome when addressing PTSD and alcohol issues the patient must firstly recognise the issues at hand and secondly, take personal ownership of the desire to ‘recover’ from the problems he/she is experiencing.
  4. Where there is a history of excessive alcohol consumption in a PTSD patient, irrespective of which came first, one issue won’t be addressed successfully without dealing with the other.

I look forward to any observations or comments from those suffering from PTSD and/or Alcohol issues, from those who work in either field or, anyone else who has an interest in the issues discussed. Hopefully this article, along with any resulting comments, will go some way towards helping to address the issues being examined.

References:

[1] Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events. Someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt. They may also have problems sleeping, such as insomnia, and find concentrating difficult. http://www.nhs.uk/conditions/post-traumatic-stress-disorder/Pages/Introduction.aspx

[2] Mind UK: Post Traumatic Stress Disorder (PTSD). https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/about-ptsd

[3] Drink Aware: Alcohol & Men. https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/effects-on-the-body/alcohol-and-men

[4] Health & Social Care Information Centre (HSCIC): Statistics on Alcohol – England 2015. http://www.hscic.gov.uk/catalogue/PUB17712

[5] Health & Social Care Information Centre (HSCIC): Statistics on Alcohol – England 2015 http://www.hscic.gov.uk/catalogue/PUB17712

[6] Combat Stress UK. Myth Busters. http://www.combatstress.org.uk/veterans/myth-busters

[7] The Telegraph (August 2014) PTSD rises by a fifth in British Military. http://www.telegraph.co.uk/news/uknews/defence/11004038/PTSD-rises-by-a-fifth-in-British-military.html

[8] NICE Guidelines [CG26] – : Post Traumatic Stress Disorder: Management. http://www.nice.org.uk/guidance/cg26

[9] Maxmen, J. S.; Ward, N. G. (2002). Psychotropic drugs: fast facts (3rd ed.). New York: W. W. Norton. p. 348. ISBN 0-393-70301-0.

[10] Cohen SI (February 1995). “Alcohol and benzodiazepines generate anxiety, panic and phobias”J R Soc Med 88 (2): 73–77. PMC 1295099.PMID 7769598

[11] NHS. Post Traumatic Stress Disorder – Symptoms. http://www.nhs.uk/Conditions/Post-traumatic-stress-disorder/Pages/Symptoms.aspx

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