HOW TO CURE ALCOHOLISM Limantsev V.V. I started working as a narcologist in 1986. Soon it will be 30 years that I have been in this profession. And I want to share my opinion about this disease and its treatment, drawing attention to those aspects that receive little attention in narcology - psychological and analytical. What is alcoholism. There are different diseases. For example, a man broke his leg. He is taken to the trauma department. X-ray, bones were aligned, plaster was applied. Two months passed, the bones fused, the plaster was removed. All the people recovered. And if he never breaks anything again, he will no longer suffer from this disease. Or the person fell ill with another disease. Diabetes mellitus. He goes to the doctor’s clinic to see an endocrinologist and gets tested. A diagnosis of diabetes mellitus was made. Treatment was prescribed: a) diet, b) insulin injections. How long will such a patient take it? For the rest of my life. Why? Because this disease is incurable. What category of diseases does alcoholism belong to? To the second category. In diabetes mellitus, a breakdown occurs in the endocrine system. And for alcoholism in the enzyme room. Both damages cannot be restored. Therefore, “Once an alcoholic, always an alcoholic.” It is not possible to cure alcoholism, but it can be stopped in one way - complete and absolute sobriety. If an alcoholic does not drink alcohol, his disease does not manifest itself and does not progress. Everything seems simple. However, quitting drinking is not the most important thing, not the most difficult thing. The hardest part comes later - learning to live without alcohol. Alcoholism is not only a disease of the body, it also has other levels.1. Biological (body)2. Psychological (personal)3. Social (family, work, society)4. SpiritualAs the disease progresses, it develops from stage to stage (1,2,3) and covers all four levels. At the biological level, alcoholism is incurable. But on a psychological, social and spiritual level, you can fully recover. But on one condition - complete sobriety. What is alcohol? Alcohol is a psychoactive substance that can change a person’s state of mind. That is, it is a fat-soluble drug of medium strength (narcogenicity). And in our country it is allowed and available. Why do you take alcohol? To stress, be sad, and cry. No, to relax, relieve emotional tension, melancholy, depression, stress... Or to cheer up, have fun. Alcohol is a universal medicine. It will relieve a bad state of mind and stimulate a good one. Therefore, when he is taken away, you must learn to live without him. That is, to be sad and happy without him. Ask yourself a question. Why do you drink alcohol, what does it give you? But they begin to think that this has become a problem only when “Thunder strikes.” A car is wrecked, a man is killed, his wife leaves, he is fired from his job. And often it’s too late to return something. And if in this situation you don’t think about it and continue to drink. Then the disease will determine your life scenario (destiny). And all alcoholics who drink too much end their lives the same way. They become losers in all areas of life (personal degradation, family, work, etc.) And the ending of this illness and the life of an alcoholic has three options: 1. PrisonAccording to statistics, eight out of ten people commit criminal offenses while intoxicated.2. Psychiatric hospital. You can go there with delirium tremens. Stay there for the rest of your life 3. Cemetery. A drunk person is dangerous not only for others, but also, first of all, for himself. Ask yourself a question. For what and for whom are you ready to part with alcohol? Resistance and psychological defenses to recovery from alcoholism. To begin recovery fromalcoholism must be recognized: - That alcoholism is a disease and I am sick with it (on). - That this disease brings problems into my life on a biological, personal, social (family, work), and spiritual level. - That this disease on a biological level is incurable .-It is impossible to control consumption (quantity, stop in time), and to manage this process (behavior while intoxicated). And this will never be restored. - To begin recovery, you need to stop drinking alcohol (and not for a while, but forever). - That the recovery process is long and you need to spend a lot of both independent effort and receive outside help (especially at the initial stage). Each of such recognitions is “unpleasant” for the personality and consciousness. It is necessary to admit that alcoholism is a disease and I already have it. It is necessary to admit that drinking alcohol has brought many problems and losses into my life. There are problems not only with consumption, but the disease brings troubles to various areas of my life. My character and personality are changing. There are already problems at work and in family relationships. My interests and values ​​are changing. It is also very unpleasant to admit that this disease at the biological level (of the body and changes in the enzyme system) is incurable. But it can only be stopped in one way - to completely and forever give up alcohol. And it is impossible to fix everything (to be cured) in an instant. Long-term, many-year work on your personality and social status is necessary. Subject to complete abstinence from alcohol. Without recognizing all these points, even the beginning of recovery is impossible. But admitting all these things can bring enormous heartache. And in this case, mechanisms against mental pain - psychological defenses - begin to work. Therefore, working with psychological defenses (denial of the disease) is an important stage in the beginning of recovery. Psychological defenses are an unconscious mechanism for protecting our consciousness from unpleasant and dangerous experiences. It consists of distorting information that can bring unpleasant experiences (thoughts and feelings). Types of defenses. Psychological defenses protect the consciousness and psyche of the patient in two ways: a) distorting the emotional component of the information entering consciousness, b) distorting the cognitive (mental) component entering consciousness information. Denial – defense blocks information from reaching consciousness. The patient is completely unable to admit the fact that he has an illness. "I'm not sick, I don't have any problems." “I’m not an alcoholic.” Repression – incoming and conscious information is withdrawn (repressed) and forgotten. Unpleasant behavior and actions while intoxicated are not recognized. “I couldn’t do this, you’re slandering me.” Projection – problems in the patient’s life are recognized, but at the same time attributed to other people, chance, circumstances, etc. “I'm not sick, I'm not an alcoholic. Here is the neighbor from apartment 13 who is an alcoholic - he goes on binges for a week at a time, his wife left him......". There are many psychological defenses that patients use. And they depend on the patient’s personality, intelligence, stage of the disease and other factors. (introjection, sublimation, rationalization, isolation, splitting....) From a psychoanalytic point of view, alcoholization itself is a psychological defense against intrapersonal or interpersonal conflict. This is a departure from reality, so as not to think and feel. Resistance. The usual, normal reaction of the human psyche to any changes that require effort is resistance, which manifests itself in actions and behavior. Resistance is closely related to psychological defenses. Psychological defenses are associated with emotions and thoughts. And resistance is related to behavior. In order for recovery to begin, resistance must be overcome. To do this, the patient must be critical of himself and the manifestations of his illness. And also make efforts to change. If resistance is not recognized and overcome. Then it can develop intoSabating recovery. And it can manifest itself in the form of a “Game of Recovery” with a demonstration of one’s efforts to recover and agreement with the recommendations. But not keeping promises and not doing anything. Resistance can manifest itself in the form of Pretentiousness (overconfidence in one’s abilities). Ignoring the recommendations of doctors and psychologists, disdain for the limitations of sobriety, self-pity, teaching others how to recover, hoping that one day they will learn to drink like everyone else. Managing and monitoring alcohol consumption. If resistance is not overcome, it can develop into Ignoring - avoiding conversations about recovery, confronting rehabilitation staff, doctors, psychologists, consultants. Open sabotage of recovery, aggressive attitude towards other recovering people. Unovercome resistance can result in Regression - complete disregard for restrictions and recommendations (not drinking alcohol), resumption of communication with people who drink. Avoiding people who may remind you of illness and recovery. Resumption of alcohol consumption. Honesty and openness to oneself and others, the ability to be critical of oneself and a willingness to change. Taking real action towards recovery is what is needed to overcome resistance. Therefore, understanding your psychological defenses and overcoming resistance is a prerequisite for beginning recovery. Treatment. When the question of treatment arises, everyone begins to look for the most effective treatment methods. And advertising offers a quick, cheap and permanent solution to this problem with 100% results. And only after the third filing or fifth coding it becomes clear that it is impossible to recover completely in this way. It turns out that quitting drinking is not the most difficult, not the most important thing. The most difficult and important thing comes later. If an alcoholic has not decided to give up alcohol, it is very difficult or simply impossible to help him. And you need to part with alcohol not for some time, but forever, since this disease is incurable at the biological level. After abstinence has been stopped and filing or coding has been done, the most difficult crisis period of “Unstable Equilibrium” begins. Which can last from 3-6 to 18 months (this is the integration period) And it passes in waves with periods of exacerbation (mood swings - anger, aggressiveness, melancholy, apathy, depression, dreams about drinking.....). With the appearance of a strong desire to drink alcohol. Therefore, a patient with alcoholism should be under the supervision of a doctor. And the main method of treatment is psychotherapy (this is the Adaptation period from 1.5 to 3 years). When there is recovery at the personal, social and spiritual level (individual and group psychotherapy, visiting Alcoholics Anonymous groups). And only after 5-7 years (this is the Stabilization period of 5-7 years) complete stabilization occurs at all levels; according to statistics, after this period of sobriety they no longer return to drinking alcohol. Prevention of alcohol relapse. Quitting drinking is not the most important or difficult thing. The most important and difficult things begin later. After treatment (medication) has been carried out and the decision has been made to give up alcohol, the most difficult crisis period begins, the “Period of Unstable Equilibrium.” Which can last from 3-6 to 18 months. This period is characterized by the fact that it passes in waves with periods of exacerbation, mood disturbances and a strong desire (“craving”) to take alcohol. Typically, the mood during a period of unstable balance can change from irritation, anger and aggression to melancholy, apathy and depression. And we must understand that this is a painful reaction to quitting alcohol. And over time it will pass. The desire to drink (attraction) can be different: 1. Obsessive (obsessive) When the patient is sober, does not use for a month, a year, five years. This attraction is usually provoked by something or someone. It appears and disappears. And it can be controlled, it can becontrol, it can be docked (curved). 2. Compulsive (irresistible, like thirst or hunger) This attraction appears when the initial (starting) dose of alcohol (“the first glass”) is drunk. It is impossible to cope with such an attraction. Therefore, if the alcoholic is in remission (hasn’t drunk for a long time), there should not be a first glass. 3. Impulsive (I wanted to drink - I gave up everything and got drunk). Such an attraction appears in drunken, degenerating alcoholics. It can occur both in sobriety and after taking the initial dose. Therefore, you can only cope with the first attraction (obsessive). And how to do this will be discussed further. Therefore, everyone who has decided to give up alcohol should know that this period will happen. And he must know what to do and how to do it so that a breakdown does not occur. And then a relapse (return of the disease). Factors that can provoke the desire to drink alcohol can be external and internal. Although this division is conditional and they are interconnected. External factors: 1. Do not go to places where alcohol is consumed (holiday feasts, birthdays, etc.)2. Don't date people who drink. Or with whom you drank alcohol (friends, acquaintances, relatives, drinking buddies, etc.)3. Do not go to places where alcohol is sold (shops, supermarket departments, etc.) How to refuse an offer to drink. And explain why you don’t drink. Among those with whom we used to drink. Or with those who know that you drank. (that is, whose opinion is not so important to you if they find out that you are an alcoholic or have been treated for alcoholism). Recognize your illness. - I have undergone treatment for alcoholism (rehabilitation) and I can’t drink because... I can’t control my consumption. - I’ve already drunk mine. Among those who do not know that you have problems with alcohol. And you don’t want them to know that you are an alcoholic. (Around unfamiliar but significant people, when applying for a new job, etc.) It is not safe to admit your illness. - It’s better to refer to your health. Invent any disease (heart, kidneys, etc.) This is usually understood. They usually offer to drink no more than 3 times. In the future they do not offer or persuade. Internal factors. Those emotional states that lead or can lead to the desire to drink. Alcohol is a universal medicine that can relieve any bad emotional state. Or enhance the good. Therefore, you need to be especially attentive to bad moods and emotions (sadness, anxiety, resentment, depression, etc.). It will not be possible to avoid this, and the desire may appear. However, it can be controlled and managed. What can be done in this situation: 1. Distract yourself - that is, do something that is interesting and evokes positive emotions and a good mood.2. Don't be alone. Go communicate with those people who can listen to you, understand, help, support you. If you go to the Alcoholics Anonymous group, call a friend, mentor (have several telephone numbers from the AA group). Call on Skype.3. Postpone the decision to drink for an hour, until the evening, until tomorrow. Time passes, and so does the desire to drink.4. Eating a hearty meal makes you full, a full stomach removes the desire to drink.5. Call the “Trust” phone number - emergency psychological assistance.6. Go to your psychologist, psychotherapist.7. Take medications that relieve the desire to drink, prescribed by your narcologist. Dreams. The period of unstable balance is also characterized by drinking-themed dreams. Dreams can be very diagnostic. If you drank in a dream and this is accompanied by unpleasant feelings. And when you wake up, you are scared - did I really do this? This confirms that the process of adaptation to sobriety is going in the right direction. If the use in a dream was pleasant. And when you wake up, you do not feel disappointed. This is a harbinger of a breakdown. At the biological level, alcoholism is an incurable disease. It is impossible to cure. But this disease can be stopped in one way - complete and absolute sobriety. 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