Trauma, Stress and Alcoholism

By Bob C.

My early days in recovery were spent trying to fit in as best I could. Because the first men I met at the meetings were totally into the Big Book of AA, I in turn was totally into it. That includes my wonderful, faulted, evangelical first sponsor, Rob. From the start, though, you could say I had some problems with the material. Being not only inquisitive but at times downright obnoxious in my questioning, I likely irritated many of the people who diligently tried to bring me into contact with god – that entity who would finally enable me to get and stay sober.

I was taken through the Big Book, line by line, which for many is an effective way to have a spiritual experience and remain permanently sober. It didn’t exactly work that way for me though I believe I reaped good benefits from the process. I didn’t find god, or else god was ignoring me; I’m not sure. I kept coming back though, and this has been really important for my success in AA.

I had a lot of questions. I even questioned the introduction before chapter one in AA’s first publication, titled “The Doctor’s Opinion”. In it, Dr. Silkworth guesses that an allergy of the body might be at work in the loss of control I experienced every time I picked up liquor. I never jived with allergy. It didn’t seem accurate, although I could see its usefulness as a temporary explanation for something unexplainable. Dr. Silkworth also says, “One feels that something more than human power is needed to produce the essential psychic change (p. xxix).” And right there I had a problem on my hands, because for the next eight years, I searched for the power beyond human that was supposed to arrest my drinking. Unfortunately, the only thing that ended up getting arrested in that time span was me.

Out of all the old AA ideas that some members cling to, it may be “The Doctor’s Opinion” that dates our fellowship the most. Though it’s true that Silkworth and AA helped put alcoholism on the map as an illness, it’s been 80 years since that chapter was written. 80 years later, what we know about alcoholism has evolved. As we all know, science produces a huge amount of information about addiction today. Some people estimate that a new scientific study is published on the subject of addiction every four minutes worldwide. Some of that information must be of use to us in AA.

For me, it seems the longer I stayed sober – which eventually did happen – the more I questioned. One of my biggest questions has always been, what is alcoholism? And also, what is recovery from alcoholism? I knew that getting on my knees and asking god to take my drinking problem away got replaced out of sheer necessity by more practical ideas: Showing up to the fellowship of AA and showing up to life, to name just a couple. I put down interventionist deities in desperation, started to really connect to the people around me and I began to stop drinking. All the third step prayers in the world didn’t produce the same therapeutic value – for me – of taking responsibility for my health, and surrounding myself with others who were doing the same. Along the way, I also learned that I could tell my story – as frightening a prospect as that seemed when I first got sober.

This idea of connecting with others to relieve alcoholism has become one of the most obvious answers to me in my own recovery. It is, though, also one of the clearest answers that has come out of the research on alcoholism from the last 20 years. We people, it is said, are wired to connect and when we don’t we tend to get sick. Nothing new, right? We agnostics consistently label our relationships to others and to the world around us as critical features of our recovery stories.

In the biomedical model, alcoholism is a brain disease. Though I feel too much emphasis is put on this biomedical feature of our illness, it is interesting to know that some of the very parts of our brain that become addicted are the parts that are so-called wired to connect to other people. Addictive chemicals “hijack” the reward pathways in our brains, but these pathways are also responsible for making us want to connect to others – socially and sexually. The very same regions of the brain! It does not seem like a stretch to imagine that deliberately connecting to others would have the effect of reversing our state of addiction to alcohol.

These ideas are played out in all kinds of addictions research today: The addicted mind is a disconnected mind and the recovering mind is a mind that is relearning to connect. Research often says that this state of disconnection – which many suffering alcoholics new to recovery take as normal – occurs before addiction to alcohol takes root. Of course we people don’t experience “brain disconnected.” What we experience is pain, a sense of social awkwardness, a belief in living life by myself, for myself. This sort of thinking is often the result of people being poorly treated over and over, which sets the brain up for compulsive, pain relieving behavior such as ingesting alcohol.

To understand the actual experience of how a chronically painful or isolated state can precede alcoholism, trauma researcher Bruce Perry uses the analogy of a two men drinking a glass of water. One of the men takes a drink because he’s somewhat parched. The other, however, takes a glass of water after a harrowing ten-mile walk in the desert. The second man’s drink has relieved a much deeper thirst. For people who have experienced, for example, chronic childhood abuse or neglect, their first drink of alcohol at age 14 or 15 often has a far different effect than for someone who has not had such experiences.

I found myself feeling a little more at home when I heard stuff like this. I never really got that, “I was born with this disease.” It was too vague. I might have been a bit of strange kid, but I wasn’t close to the angry, fearful wreck I brought to the doors of my first AA meeting at age 25. I also knew that my first four beers, shared with my older brother John, relieved me of an enormous stress that had already begun to accumulate in me by age 13. On the weekends, I would basically run from my father’s place, where it was strict and where I could never be good enough. I’d head over to my mom’s in Toronto’s west end where my brother and I drank, hung around girls and pretended we were cool. It seems fairly straightforward to imagine or explain why I kept heading to mom’s and why I kept drinking.

There’s other really interesting research that talks about how chronic stress and pain can disconnect us, and how this disconnection creates havoc in us humans. Dr. Stephen Porges of the University of Illinois works on what’s called “ployvagal theory.” This research describes how our bodies are wired to connect, just as our brains are. Dr. Porges studies the areas of the body that are involved in speaking, hearing and feeling for others – the areas, in short, that are wired to connect on a biological level. He calls the nerves throughout the heart, neck, mouth and ears a “social nervous system,” which operates to automatically bring us into deep and loving relationships with other people.

The problem is that when a person is constantly exposed to stress or danger such as childhood abuse, or when people are exposed to sudden violence such as during war, this “social nervous system,” switches off. In its stead, people enter into fight or flight mode… a survival instinct takes over and replaces the social one. Once this happens, it can be very difficult to come back to a social frame of mind. Sufferers of PTSD know very well how hard it can be to begin to trust, love and connect again after being abused or exposed to horrible events. But people with less severe stress than PTSD suffer in similar ways, which make them vulnerable to compulsive pain relieving behavior like alcohol addiction.

I know that when I first came to AA, I was always on guard, distrustful and ready to flee at the first sight of danger. It took me years to overcome this kind of reaction. I still struggle with it. Years of joking around, staying sober, laughing, being invited out, being confided in by others… all this slowly produced the reversal of a survival instinct which dogged me in early recovery. Fortunately, a more connected person has emerged, one who is not as likely to run or fight.

Progress over perfection though, right? I went from fighting everything and everyone to fighting just some of the time. I still feel the survival mode coming on, when I’m stuck in really bad traffic or when I’m feeling alone and I haven’t hit a meeting in a week. But I have come a long way, and it has gotten easier. I believe Dr Porges would agree: As we begin to connect again, and as our social nervous system turns back on, it really has its own momentum. Recovery, as it were, has its own momentum.

If it seems a little strange that a disconnected body is partly to blame for alcoholism, it might seem even stranger that communities themselves can cause disconnection and addiction. Canadian psychologist Bruce Alexander studies addiction and its causes. His well- known Rat Park experiments provide scientific proof that rats do not become addicted when they are given the opportunity to live full, happy lives. Rats put into cages, however, become addicted very easily. When Bruce conducted rat experiments with addictive drugs like cocaine, he put some into cages, while others he put into a “Rat Park,” which had been designed based on what we know about white rats. Rats resist addiction-even to the most serious drugs- when they are free to play and socialize. The implication is that when rats – or humans – see the world as their cage, they will naturally manifest addictions – as well as a host of other psychiatric illnesses.

Dr. Alexander sees addiction as an adaptation to painful circumstances, rather than because of exposure to addictive drugs. To him, alcoholism is normal and expected, rather than abnormal or pathological. His work has demonstrated that when we people are deprived of rich culture and complex social connections, our mental health suffers. One of his best examples is his study of the addiction problems of aboriginal cultures, which disease theorists conveniently explain as a lack of biological resistance to alcohol. Dr. Alexander, however, has shown that North American aboriginal people did not develop problems with alcohol until well into the 17th century, at the time when their cultures began to be systematically undermined – 200 years after first contact with Europeans.

Since I have been well trained to think of alcoholism as purely an individual problem and disease, Rat Park has caused a huge shift in me. What I understand is that we don’t walk out of our latest AA meeting into a community that preserves connection and deep relationship as goals by which we should live. In fact, it is quite the opposite. We live in what social worker Brene Brown calls, “A culture of disconnection.” I can only feel for the newly sober drunk who exclaims to me, “Fine, I’m sober for the duration of this meeting, but what about the other 23 hours?” I nearly say a little prayer for him, because I know that our workplaces, larger communities and sometimes even our families produce and promote disconnection, rather than alleviating it.

Connecting to the men and women of AA has been largely responsible for my recovery. I suppose that means that I was not beyond human aid. If I have had deep and unexplainable experiences of love and surrender, it was when I was laughing with my friends until I cried, or when I held the teary glare of a stranger at a meeting, and allowed myself to feel their vulnerability and pain. The research I have read and continue to read about our illness does not seem to indicate that we are beyond human aid, or that we are hopeless. It seems, rather, to indicate the opposite.

__________

Bob C. 39, is a happy member in AA who just celebrated six years sober. He has a regular yoga practice, a cat and a beautiful wife named Lisa. He writes regularly on addiction, mental health and recovery, as well as poetry and short stories. His cat co-wrote most of his stuffy university papers while drinking feline energy drinks such as Red Tabby and Catnip-Star. He has also written an article for AA Agnostica called, The First 164 Pages. Bob spends an inordinate amount of time in his car and often resorts to listening to country music on the drive home. He is a social worker practicing in addictions and mental health, and is interested in research about how the human body plays a key role in healing from mental health disorders. He lives in downtown Toronto.

This Post Has 24 Comments

  1. Thomas B

    Wonderful article, Bob — thanks so much. My wife and I are traveling on our way to Toronto, and yesterday we sat in the small library room of the Gatehouse at the Sieberling estate where Bill first met with Dr. Bob because he needed to work with another alcoholic so that he would stay sober !~!~! From AA’s very beginning, it has been the human power of one drunk connecting with another drunk that has fostered the growth of AA and enabled us individually to stay sober. It still happens these 8-plus decades later. I stayed sober in New York City in the 1970s primarily because I got involved in the Young Peoples movement and co-chaired the first NYC Young Peoples Conference in the spring of 1978.

    I also totally agree with your conviction that trauma interferes with the ability of humans to connect with each other. In the mid-1980s a colleague — another survivor of Vietnam combat — and I did some of the first research and writing to establish the correlation between addiction and PTSD rampant among the combat veterans of Vietnam. That disastrous correlation continues today with the survivors of our many wars in the Mid-East.

    I’m currently reading a fascinating book by neurologist Marc Lewis, The Biology of Desire, which questions whether addiction is a disease. Rather, he posits that addiction is a habit often formed early in adolescence with people use substances to more easily navigate the daunting challenges of social and sexual connection during those awkward and cumbersome years when the body, mind and spirit are seemingly out of joint with each other, resulting in difficulties connecting with those with whom we are trying to relate.

    1. Bob C

      Thanks so much. I will check out Marc Lewis. I too, have a passion for vets. To me, their trauma experiences highlight the need to more widely acknowledge trauma, especially in certain cultures (like the military) where the “man rules” tend to prevent people from reaching out for help, or feeling ashamed to do so…<\p>

  2. Joe K. in Chicago

    Great article… thanks to you and all who contribute. This site and those that contribute help me more than I can express in words. While AA is the cornerstone in my recovery, I need stuff like this to fill the holes made when a my non-believer mindset struggles at the meetings.

  3. Lance B.

    As usually experienced, Sunday morning’s post has been pleasant and educational. You keep providing me with new and unexplored or only partially explored thoughts about our alcoholism.

    One feature I miss in the aabeyondbelief format is one which aaagnostica added rather recently. It is that PRINT button on the bottom. I don’t know how that is done but it gave me a better result than my earlier method of copying and pasting into my notebook and printing the article from there. I used that method to get a printed copy of today’s article sans picture. Not bad, but could be better.

    1. John S

      Thanks Lance. We will add the print feature soon, if not today.

  4. Steve K

    Great article Bob! I really identify with the feeling of social disconnection leading to addiction and other types of destructive behaviour. I grew up in an alcoholic home as many do and felt both emotional neglect and rejection, particularly as a teenager.

    I started drinking as an escape from loneliness and feeling unloved and it enabled me to connect with my peers and in particular teenage girls! Alcohol, drugs, and women seemed to be the solution to my unhappiness and social anxiety, however, in the long run we all know that these artificial attempts at intimacy and social connection just compound our emotional problems and sense of disconnection.

  5. Robert M

    Excellent article Bob and thank you for writing it!

    Gabor Mate expresses about the Inuit and their alcoholism developing even later than the Native cultural crisis’, a state that really drives home loss of connection as the defining factor in addiction and other social ills compared to exposure to alcohol. I am currently reading Norman Doidge’s The Brain That Changes Itself. He starts with a case of wobbly syndrome a loss of the sense balance. A “sense!” So much for my naïve five senses mantra. Doidge explains how Bach-y-Rita used an accelerometer-hat which outputted electrical signals to a sensor placed on the tongue. This, in time, restored the sense of balance even though the normal sense system could not function.

    Brain pathways are fluid and change in time and experience; however old pathways had become entrenched, as a result, quicker than newly learned paths. This might explain the importance of meetings and quiet time in mediation to reinforce these new connections to a sober society. In early sobriety I loved the story of Bill W. tempted by the laughter and chatter at the Mayflower Hotel lobby where he reached out finding Dr. Bob. His white light experience had faded and he needed another drunk. Yes it is the time to update AA’s ideologies.

  6. John S

    I loved this article, it caused me to reflect on my own past and to think about how trauma effected me. The quote about the difference between how the man drinks water who is slightly parched compared to the man who just walked ten miles through the desert, really hit home with me.

    I wouldn’t say that my childhood was incredibly traumatic when compared to what other people have lived through, but I never knew what I would get from my parents. They could be loving one day, and hateful and violent the next. I never knew. I lived with fear on a frequent and regular basis. No wonder I liked that first drink of wine so much.

    As an active alcoholic, my drinking and my behavior brought on more stress and trauma. I don’t even know how many times I’ve been locked in a cell over night. It was a crazy life, and no wonder I kept reaching to the only thing that brought me any relief or at least a way to numb what I was feeling.

    It drove me further away from people too. I was alone with my problems until I found AA. That changed everything for me. People accepted me and loved me and helped me without asking for anything in return. I was becoming reconnected to other humans in a way that I have never before felt connected. That’s why I keep coming back.

    I also went to a group like Bob where we read from the Big Book, line by line, highlighting and underlining those sentences we felt were especially important. Unlike Bob, though when I questioned anything, I would quickly stop myself. It’s ironic that when by trying to keep an open mind to those things that I questioned, I was really closing my mind to new thoughts.

    This was just such a great article and had quite an impact on me.

    Thank you Bob for your contribution. Please keep writing. Your talent will help a lot of people like me.

    1. life-j

      Thanks to Bob for this article, it is really good, but especially thanks to you John for this gem:
      “It’s ironic that when by trying to keep an open mind to those things that I questioned, I was really closing my mind to new thoughts.”<\p>

    2. Bob C

      Thanks so much John.

  7. Chris G

    Thanks, Bob; I feel a very firm connection to what you say.

    I grew up in a “leave it to beaver”, bog-normal, loving household, and got into alcoholism much later than most. When I got into AA and met all the folks from dysfunctional homes and really bad situations, I had trouble relating. Then I also began reading the newer research as Bob presents. So what happened to me?

    As an introvert, I had always had trouble connecting. Then one year in my late 20’s, I got a job post to a new city, with (to me) horrific new responsibilities, and that move caused a separation from my wife, who had become my social window to the world. Suddenly I was on my own, scared, overwhelmed, and disconnected from everything familiar.

    Within a year, my drinking went from social to heavy to ridiculously heavy. Sometime the next year, I first had a panic attack when I ran out of booze one evening. That was the start of the familiar path down the drain.

    Sort of fits the social disconnection & stress theme, doesn’t it?

    AA supplies my social life now, almost entirely, and as long as I keep in close touch with others, the addiction is buried. Let me get lonely, especially lonely and stressed, and I can feel it poking a tendril out of the ground. Meetings, sponsoring a couple of folks, and general involvement work wonders. No mysticism needed.

    1. Eric T

      Wow, thanks for that Chris – very, very similar to my own experience! Good to be sober and connected today, whatever I’m feeling.

  8. John L.

    Bob, I agree that Dr. Silkworth’s ideas are “dated”. You quote him as saying “One feels that something more than human power is needed to produce the essential psychic change (p. xxix).” This is just plain wrong: for claiming that a supernatural power and “psychic change” are needed for sobriety.<\p>

    I endorse James R. Milam’s “biogenic approach” for alcoholism recovery, according to which alcoholism itself is the primary problem. Alcoholism is a physical addiction to ethyl alcohol; it is not merely a symptom of psychological problems or character defects. Milam’s book, Under The Influence, is in my opinion the best book ever written on alcoholism.

    According to Milam, alcoholism causes psychological problems — turns good people (Dr. Jekyll) into bad ones (Mr. Hyde). With total abstinence and time the good personality (Dr. Jekyll) re-emerges. This does take time — sometimes years — and may need the help (experience, strength and hope) of other people — but is happens mainly from the healing of the body and all of its organs, including the brain, liver, pancreas, etc.<\p>

    For sobriety, the main thing will always be the 24-Hour Plan: Stay away from the First Drink a day at a time. Time and abstinence are the great healers.

    1. Bob C

      I agree, too much focus is on underlying conditions, to the point that we forget how much damage just drinking all the time can do. And thanks for the reference to Milam, I will check that out. That’s one of the things I love about this site: Its an exchange of ideas.

  9. Christopher G

    Love the article, Bob. Thank you.
    Bill W., in my opinion, used the big book to bait and switch from a physical disease model to the so-called “spiritual” malady. I like to say he used the “shotgun” approach, scattering ideas and opinions in such a far and wide stretch of definition so as to appeal to most anyone with less regard to whom it might offend. In short he was trying to please everyone in order to gain influence and success. Well, at least he did what he thought was best and kept the discussion going albeit today some of it remains antiquated and restrictive and some is still worthy of reference .
    Thanks for the new data and references. They are fresh and thoughtful and worthy of pondering.

    1. Bob C

      Thanks Chris. Bill was a real persuader, like my first sponsor. I think it was even more misleading that his “spiritual hilltop” experience set a benchmark for everyone else’s future breakthroughs, whether or not they included the appendix on “educational varieties.”

  10. Chuck L

    Bob, thanks for a very interesting article. I am new to AA, a little over 3 months sober. I have struggled with the big book on a number of levels. I have also been feeling that I may not share the normal AA story. My drinking by comparison was less consuming than the stories I have read, but I felt I was working too hard to keep my drinking to the 2 drinks a day. I saw the issue differently depending if it was the middle of the night after drinking 4-5 glasses or 5pm and I had had 1 glass. <\p>

    So as I search for what was my drive to drink, I don’t have the stories like those I’ve read. I did not have a traumatic childhood. I keep coming back to loneliness. I spend too much time alone in the evenings. So I find your description of disconnectedness as a truth that resonates for me much more that what I read in the big book..<\p>

    Thank you.

  11. Jon S

    Hi Bob. That’s a wonderful piece. Well done. I got sober thanks to hard harded sponsorship, but rethought AA after around 13 1/2 years and now live recovery in a new way. The future of AA will be shaped by more open-minded people such as yourself. AA will evolve. It is inevitable. Keep sharing. I wish web sites like this had been around when I was first trying to get sober.<\p> Jon S

  12. Jon S

    Another great book, which explains the deep evolutionary sources of alcoholism, is “The Drunken Monkey: Why We Drink And Abuse Alcohol” by Dr Robert Dudley. Alcohol abuse is NOT a character defect, it’s a one time evolutionary advantage hard-wired into our genes. Over 120 million years only our mammalian ancestors who binged on fruit managed to survive the lean times, and alcohol is a chemical indicator of ripeness. The section on recovery is poor, but the rest of it is a real eye-opener. Singe best book I’ve read on what really causes alcoholism – and also obesity.<\p>

  13. joe c.

    About a month ago I interviewed Marc Lewis (Rebellion Dogs Publishing, Rebellious Radio) about THE BIOLOGY OF DESIRE: WHY ADDICTION IS NOT A DISEASE. Like his first book, MEMOIRS OF AN ADDICTED BRAIN, Lewis has a refreshing neuroscientific approach to both addiction and recovery. Thanks Bob; I really enjoyed your other article about the Big Book, too.

  14. Denis K

    Hello Bob, thank you for this essay as well as your previous offering, “The first 164 pages” , I connected with both pieces. Passed along your essay to a non-alcoholic friend who made the following comment which best reflects my own thinking. Here is what she replied. “Great piece, certainly resonates with me. We are all seeking connection, for some the search is darker than for others.Putting this (alcoholism) down to a disease and something removed from ourselves and our experience makes the pathway to change much more difficult and convoluted”. My friend also added, “Lucky people that have him as their social worker.”

    May I add, lucky us to have Bob a contributing essayist to AA Beyond Belief.

    Denis K

  15. Chris C

    So, where is the AA? No disease concept, no higher power (even the group?) and (forget alcoholism) addiction depends on a bad cildhood. Please take AA off this site and don’t hide dissolution behind the word evolution. We have enough religious zealots doing it already.

    Chris C. From Lenoir, NC

    1. Steve K

      The disease model belongs to the medical profession. AA’s view is an illness of the mind, body and soul. Bill W didn’t think alcoholism was technically a disease and preferred the term illness. (1) The big book suggests maladaption to life, as well as a physical factor. Alcohol abuse does bring about biochemical changes in the brain (“some sort of physical component” as suggested in the BB). The behavioural account acknowledges this.The “allergy” suggestion in the BB, was an early guess/theory at this physical component in alcoholism and as “laymen” didn’t claim certain knowledge or authority on the subject.

      The above essay very much acknowledges the healing power of the fellowship or AA group and genuine connection with others.

      1. See Ernest Kurtz’s paper, ‘Alcoholics Anonymous and the Disease Concept of Alcoholism.’

  16. Jane Doe

    I have to disagree with you, not on your diagnosis, but on your conclusion. The idea that support of other people is definitely appealing, but only if they promise not to drink again and/or if they do, they promise to try to not do it again.

    Unconditional love is the only true answer. If a person was going to commit suicide, would you give up after awhile and hand them a gun? As long as people judge other people, drinking too much will continue, as will a lot of other behaviors. I personally have no one other than my mother and she is the only one that has unconditional love. What if she went drinking with me and told me that I should stop at the 3rd or 4th and I knew she would be there to comfort me with whatever ails me. I would say a lover other than a mother, but mothers are more likely to have unconditional love than lovers.

    That is the reason I hate AA. I have only hurt myself, but have otherwise made other people sad. They may have been sad or angry about what I’ve done when I’ve been drunk, but I  never hurt them. I realize that’s not true for everyone, but that’s my experience. I don’t like or trust people because they can’t handle messiness or the un-handle-able. It’s too much to ask anyone to do and therefore no one can ask anyone else to be able to deal with the demons they struggle with.

    It’s only when society can live and let live that people who drink too much will not feel like outcasts and will finally be able to integrate socially. It’s a truly an ideal which probably won’t be reached in my time because people are too afraid, socially insecure or threatened. However, one can hope..

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