The High-Functioning Alcoholic

Mothers Can be High-Functioning Alcoholics Too!

Sarah Allen Benton, L.M.H.C. — Tue, 20 Oct 2009 14:25:01 +0000

On Tuesday, October 27th I was interviewed on THE OPRAH WINFREY SHOW on an episode dedicated to Mothers, drunk driving and high-functioning alcoholics. Please visit Oprah.com for resources that I wrote as well as my book excerpt at: http://www.oprah.com/dated/oprahshow/oprahshow-20091022-diane-sch...

The most shocking aspect about the mother drunk driving tragedies recently in the news, such as the Diane Schuler Taconic Parkway crash and deaths of 8, is the public's surprise that mothers can have alcohol problems. Specifically, one NY Times parenting blog about this issue was titled "How could a Mother Drive Drunk?" http://parenting.blogs.nytimes.com/2009/08/05/two-quick-updates-o... Considering that type of judgment, my question is how can fathers, teachers, executives, politicians, physicians and honors students drive drunk? I do not personally have enough facts about the case to know whether or not Diane Schuler was an alcoholic, however that news story has prompted an important dialogue about mothers and alcoholism. A recent article in the Chicago Tribune titled "Mom. Businesswoman. Alcoholic" by Colleen Mastony addressed this topic. "Heather", now sober, who was interviewed for the story "asked the Tribune to withhold her last name because of the stigma associated with alcoholism" http://www.chicagotribune.com/health/chi-heatheroct11,0,4327578. While it is understandable that Heather would remain anonymous, it is symbolic of the core issue- the shame and stigma that mothers feel in admitting that they are alcoholic.

It is as though the image of the "mother" and that of the "alcoholic" seem contradictory. However, alcoholism does not discriminate and there are mothers who are able to fulfill their roles as mothers (in the literal sense), and even as professionals-therefore being high functioning. Those around them may not believe that these individuals could be alcoholic, because their outside life may appear "perfect". However, just as mothers are afflicted with cancer, diabetes, depression, etc. they also may also suffer from alcoholism. As long as moral judgments are cast upon these individuals, they will continue to drink in private, drink and drive and put their life or the lives of their children in danger physically and emotionally.

Research by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicates that there are over 2.5 million female alcoholics and that one-third of women report regular drinking consumption. In addition, research has indicated that there has been a 28.8% increase in in the number of women arrested for DUI's in the past decade and a surprising 7.5% decrease in the number of males arrested for DUIs-so why is the public so surprised that mothers can be alcoholic? Many experience shame around their drinking, feelings of being "failures" as mothers and unfortunately even embarrassment about being sober. The stigma of being an alcoholic is a barrier for many women getting help in the first place, but also prevents others from admitting that they are in recovery. What will it take for these individuals to feel a sense of pride in getting help for their alcoholism? Something needs to change- we are all human and are all dealt a certain hands in this lifetime. For those of us who are alcoholic, it is important to feel that we can live in our truth without judgment and to be able to reach out for help. Otherwise, mothers and women everywhere will continue to live a double life, refuse to take responsibility for their alcoholism and hide behind a façade of perfection in the hope that others will not discover the truth about them.

It is through the courage of sober alcoholic mothers such as Rachael Brownell, author of "Mommy Doesn't Drink Here Anymore," (available on Amazon.com) who came forward in her memoir about alcoholism and recovery that lessening of the stigma may begin. Brownell's book about her first year of sobriety while being a mother as well as her blog www.redsy.com have recently caught the eye of the media and she is becoming a beacon of hope for alcoholic mothers everywhere www.rachaelbrownell.com. Stefanie Wilder Taylor is another mother author who wrote "Sippy Cups are Not for Chardonnay" and while her book may not acknowledge her drinking problem, she is candid in her blog "Baby on Bored" about the fact that she has now been sober for over 5 months http://babyonbored.blogspot.com/.

May mother authors/bloggers such as Brownell and Taylor continue to prompt an important dialogue among communities of mothers about this issue so that others feel comfortable in coming forward to get help without feeling shame nor being judged.

For alcoholism resources and for more information on high-functioning alcoholics please visit www.highfunctioningalcoholic.com

Whitney Houston’s Interview on "Oprah" Revealed Common Misconceptions About What it Means to Be Sober

Sarah Allen Benton, L.M.H.C. — Tue, 22 Sep 2009 13:25:09 +0000

The Oprah Winfrey Show aired a 2-part interview with Whitney Houston on Monday, September 14th and Tuesday, September 15th. This revealing interview covered topics that the public has been waiting to hear about-from her relationship with Bobby Brown, to her daughter, to her career hiatus, to drugs. The striking part of this interview personally was the discussion about the chaos in her life, tumultuous marriage and Bobby Brown's alcoholism and drug addiction. At times it felt as though Houston's drugs addiction was the "white elephant" in the room only to be acknowledged as an issue when Oprah asked the following questions.

Oprah: Tell me how bad did it get, the drugs?

Whitney: When you don't speak and you live in the same home and you're sitting right next to that person and you're not saying a word for a week? You're just sitting there? And you're just watching TV? That's bad.

Oprah: You're just watching TV and doing coke? Or are you smoking?

Whitney: We were lacing our marijuana with base. We weren't on crack. We weren't on no crack stuff. We weren't buying $20 jumbos. We were paying money. We were buying kilos and ounces and ounces. We would have our stash.

Oprah: But you were freebasing cocaine.

Whitney: Basically. ... We weren't doing pipe smoking. We didn't get that far.

Oprah: Did the drugs give you any sense of relief?

Whitney: At times. Don't forget, there were some times we'd laugh our tails off. We had a ball. Sometimes you do have a good time. But when it gets to the point where you're sitting in your home and you're just trying to cover what you don't want people to know. It's painful. And then you want more just so that you don't let anybody see you cry. Or anybody to see we're not happy. ...

(Source: http://www.oprah.com/article/seriesandspecials/previousshows/pkgscreeningroom/20090831-tows-whitney-houston/15)

Given that she began using drugs in 1996, the statements above about her drug use, admitting that she attended rehab at least two times and was intervened on by her own mother-the following part of the interview was somewhat shocking.

Oprah: Does that mean your drug free?

Whitney: Yes maam- I mean, y' know- don't think that doesn't mean I don't have desires for it. There are times it take a minute to cleanse- get off, get off me- I have to pray it away.

Oprah: Absolutely.

Whitney: I have to pray it away. I have a drink now and then, don't get me wrong. If you see me at a bar, don't think...

Oprah: Don't think she's gone back.

Whitney: Please don't do that to me.

Oprah: Because drinking wasn't your issue.

Whitney: No, that wasn't an issue for me- but no week, no coke, no.

Oprah: Do you think you ever will again be tempted?

Whitney: Oprah, I can only take today, one day at a time, one day at a time. Right now no.

Oprah: Right now no.

Whitney: No.

Houston reported attending several rehab facilities in the past few years, where she would have learned that she would need to abstain from both drugs AND alcohol in order to be sober and to maintain long term recovery. The message that Houston gave viewers in this interview is that if you are a drug addict, then you do not need to abstain from other mood altering drugs such as alcohol (with the exception of medications that are taken AS PRESCRIBED by a medical professional). She appears to justify drinking "now and then" because alcohol "wasn't an issue" for her. However, it is known within the addiction treatment and recovery world that in order to be truly sober, a drug addict would also need to abstain from alcohol-even if they did not consider themselves an alcoholic. The same applies for sober alcoholics who report that they do not have a problem with marijuana-it should be understood that sobriety will involve abstaining from marijuana as well.

You may ask, what is the rationale for this sobriety criteria?
1. Addicts and alcoholics often return to their drug of choice when they are not fully sober: For example, a cocaine addict reports not having a problem with alcohol, drinks "occasionally" and abstains from cocaine. Drinking alcohol lowers inhibitions, and this greatly increases and almost guarantees a higher chance of turning back to using his or her drug of choice- in this case cocaine. The same applies for the alcoholic who quits drinking but smokes marijuana because they report that they do not have a problem with it. While high on marijuana, judgment is impaired and inhibitions are reduced, therefore leading him or her closer to or to the point of relapse.

2. Alcoholics and drug addicts may become addicted to a substance that they were not originally addicted to: If a Vicodin (pain medication) addict abstains from that drug and reports "not" having an alcohol problem but occasionally drinks alcohol, he or she may develop an alcohol problem. Addicts or alcoholics turn to outside substances to fix internal problems and also have addictive tendencies physiologically and psychologically. Therefore, to use alcohol or drugs that they claim "not" to have a problem with, opens the door to developing a new addiction.

3. True recovery from addiction involves learning to live life without drugs and alcohol: Alcoholics and drug addicts wreak havoc in their lives and those of their loved ones. Therefore, why would they take a chance that they may relapse or start a new addiction? Only an addict would even want to take that chance. Recovery is the process of an alcoholic or drug addict finding physical, psychological and spiritual balance in their lives without the use of mind altering substances (with the exception of medications that are taken AS PRESCRIBED by a medical professional) and by living their lives consciously. Alcohol and drugs are an escape that prevent the alcoholic or addict from learning to appropriately cope with life stressors and to tolerate pain and discomfort without trying to escape.

So the following questions remain: Why would Whitney Houston, after all of the pain, embarrassment, damage and danger that her addiction has caused her and her loved ones, consider going to "bars" in the future and choose to drink alcohol? What message is she sending to all of the sober or active alcoholics and drug addicts who saw that show? These are questions that she should honestly ask herself. In addition, assuming that she has some form of ongoing treatment team and/or recovery program should be addressing with her. Maybe because Houston was able to remain somewhat "functioning" despite her drug addiction due to her financial status, she did not hit a bottom low enough to take her recovery seriously.

A majority of The Oprah Winfrey show interview with Whitney Houston is available in transcript form at: http://www.oprah.com/article/oprahshow/20090831-tows-whitney-houston

For information about high-functioning alcoholics and alcoholism treatment resources, please visit www.highfunctioningalcoholic.com

Sept. is Recovery Month!!! Some Reflections on Recovery...

Sarah Allen Benton, L.M.H.C. — Mon, 14 Sep 2009 15:44:42 +0000

Recovery Month is observed annually during the month of September. This month is dedicated to increasing awareness about the benefits of substance abuse treatment, and passes on the message that recovery from substance abuse including alcoholism is possible. Recovery month is meant to encourage people to take action in the expanding effective treatment for those in need.

In addition, this month serves to educate the public and inform the public that substance abuse is a national health crisis, that addiction is a treatable disease, and that recovery is possible. It is also emphasized that treatment should not only be for the affected individual, but for their family, friends, workplace, and society as a whole. Providing the public with accurate information reduces the stigma associated with addiction and treatment. For more information on Recovery Month and for recovery resources please visit: http://www.recoverymonth.gov/ There are "Voices of Recovery" featured on the Recovery Month Website that anyone in recovery may post on at: http://www.recoverymonth.gov/Voices-for-Recovery/Stories.aspx

It is the objective of my blog to continue the goals of Recovery Month throughout the year and to create a forum for a healthy dialogue and safe space for alcoholics and their loved ones to strive towards getting treatment. The following are the reflections of high-functioning alcoholics (HFAs) about their recovery experience, who were interviewed for my book Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights. These quotes demonstrate the true healing that is possible for any alcoholic and that results from effective treatment in mutual-help groups, individual therapy and medication treatment when necessary. Some of these alcoholics initially attended a detox or rehab program, while others did not. If you are considering treatment for yourself or a loved one, it is crucial that you obtain an assessment from an addiction professional or local hospital to determine what level of care that you may need. There is NOT just one way to get sober...

"I met myself in recovery." ~HFA, 2 years sober

"I learned how to live according to values and spiritual principles...I began to build a sense of self-esteem based on right living. I began to take responsibility for myself...I learned about acceptance-not spending my life battling reality-and that has brought a lot of peace." ~HFA, 10 years sober

"Externally, my life is improved. I have resurrected old friendships and started new ones. I am confident and helpful in my professional role as a physician. I am not afraid to look people in the eye, because I make a habit of apologizing and setting right my new mistakes before they turn into feuds. People are no longer afraid of me! I am, more often than not, approachable, reasonable and predictable." ~HFA, 3 years sober

"Life in recovery compared with that in early sobriety is not comparable. My quality of life is different. The only things that are the same are that I live in the same physical vessel and that I am still an alcoholic." ~HFA, 8 years sober

"I now believe, deep inside in a way that I never forget, that escaping my feelings with alcohol is no longer an option, ever...On the whole, I am happy and productive much more often than I am hopeless, bitter or resentful-and that is a radical change from my previous mode of living." ~HFA, 3 years sober

"I don't feel so afraid of feelings. I can see them for what they are, I know they won't kill me, I know they don't have to mean everything and I can let them pass." ~HFA, 10 years sober

"Throughout my life struggles, I had some part of my soul connected to my future path. I prayed and waited for the time to come when I could look back on my pain and help others to cope. That time has finally come and I have arrived here... I can finally look back on what was once me. I felt shame about the alcoholic part of my life and now I feel pride in sharing it with others. I felt fear about people knowing I am an alcoholic, but I now feel strength and liberation. I can honestly say that I have something to offer others-sobriety, wisdom and serenity." ~March 14, 2006, Sarah Allen Benton

PLEASE POST YOUR "RECOVERY THOUGHTS" IN THE COMMENTS SECTION OF THIS BLOG TO HELP INSPIRE ALCOHOLICS AND THEIR LOVED ONES TO GET HELP.

For alcoholism treatment resources and more information about high-functioning alcoholics please visit: www.highfunctioningalcoholic.com

The Various Ways High-Functioning Alcoholics Hit Bottom

Sarah Allen Benton, L.M.H.C. — Mon, 17 Aug 2009 15:13:24 +0000

"Only an alcoholic thinks that they need to hit a lower bottom in order to be alcoholic." ~sober alcoholic

Each alcoholic has a unique bottom, and some alcoholics report having several bottoms along the way that they have ignored. Generally, high-functioning alcoholics (HFAs) experience bottoms that are emotional and internal-including feelings of shame, remorse, loneliness and/or hopelessness. Some don't have a home or family to lose, which limits the type of bottom they may have. In contrast, lower functioning alcoholics often have bottoms that involve losing their jobs, family, friends and housing in addition to going through emotional suffering. These alcoholics go on for years denying that their lives are on a downward spiral, despite these losses. Some HFAs are lacking the "gift of desperation" that may motivate lower bottom alcoholics to get help. For others, high functioning only lasts until the disease progresses and the person cannot function anymore.

The following are exerpts from my book Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights. Different types of bottoms are described along with the experiences of several HFAs who were interviewed.

For many HFAs, their failed efforts to control their drinking are the concrete proof they need for them to discover the depth of their addiction. Certain drinking experiences may then allow this reality to "sink in" and lead them to admit that they need help. One 31-year-old HFA considers that her final bottom was her relapse after months of sobriety that was "my first deliberate attempt at controlling drinking...I consciously attempted to drink a single shot of whisky, honestly thinking that I would be able to leave it alone because I found that particular type of alcohol distasteful. This first shot led to me drinking nearly the whole bottle in a very short time. I felt as if I was at the mercy of something compelling me to drink when I didn't want to."

Many HFAs report that their bottoms are primarily emotional. They may look well on the surface, but are struggling internally as a result of their drinking. One 24-year-old HFA recalls that she was stuck in a cycle of drinking to avoid anxiety and low self-esteem-her view of the world became completely negative. She feels that her true bottom was "The complete inability to connect with other human beings, feeling totally desperate and alone, wanting to stop drinking but not being able to and hating myself."

For some HFAs who are accustomed to success and are perfectionists by nature, their bottom may be subtle, but enough to prompt change. One student began to notice his straight "A's" slip to "B's" and this was an indication of the beginning of his bottom. Therefore, because he had such high standards for himself academically, it was clear when his drinking began to impact his performance and he sought help.

Being an HFA and hitting a low bottom are not mutually exclusive. In fact, some HFAs hit low bottoms and continue to relapse afterward. A 26-year-old HFA believed that a bottom had to be an experience "so bad and painful that you would know you couldn't drink again." She proved to herself that a low bottom does not guarantee sobriety. After 3 days of binging on alcohol, this graduate student attempted suicide. She woke up 3 days later to the cries of her parents as she lay in the intensive care unit of a hospital with tubes in her nose, arms and throat. However, "like a true alcoholic... I drank within 3 days of leaving the hospital and went to rehab for the following 22 days."

Other HFAs report that their bottom was neither something that they noticed at the time nor what would have motivated them to get help. These individuals were forced to address their alcoholism by their loved ones or by the law. One 58-year-old man confirmed that the only reason he agreed to a 30-day stay at an alcohol rehabilitation center was because of pressure from his wife. He had no intention of permanently staying in recovery. Looking back, he can see that he had previously hit bottoms that he had ignored and his wife had forced him to confront what would become his last bottom. In addition, HFAs can engage in high-risk behaviors such as drinking and driving that can result in jail, injury and/or the loss of a life.

HFAs often define themselves based on their careers, thus, the threat of losing their job can be enough to bring them to their bottom. A 53-year-old HFA describes that the last time he drank he became violent and started to hit lights and furniture in his house with a tennis racket. When his distraught wife approached him, he pushed her and then both his son and wife called the police. He was terrified that he would be kicked out of the military-which was his entire identity. He spent the night in jail and the next day was brought for a psychological assessment. For the first time he was able to admit that he was an alcoholic and was willing to do anything to save his family and career.

Some HFAs, through a moment of grace and spirituality, are inspired to reach out for help. A 63-year-old shares that her bottom was "slow in coming...it was like I was swimming in the dirty ocean floor of alcohol's wasteland for several months." She was facing devastating financial problems in her life that were not directly related to her alcoholism. "It was the typical way a high-functioning alcoholic suffers-the slow deterioration of personal values and quality of life structures-until the light bulb goes off." Her lifelong spiritual practices "kicked in" when she was reading a spiritual book that led her to conclude "my drinking was a lie and my pride was keeping it in place and I could no longer live this way."

The motivation that an alcoholic may have to get help once they hit bottom is often limited because their denial may return and they are back drinking alcoholically. Therefore, no matter how an HFA arrives at his or her bottom, it is imperative for the individual to take action at that time to reach out for help.

There are a variety of ways to obtain help for alcoholism and for more information please visit www.highfunctioningalcoholic.com and click on the "Resources" page.

The Most Tragic A&E “Intervention” Show Ironically Features a High-Functioning Alcoholic

Sarah Allen Benton, L.M.H.C. — Wed, 22 Jul 2009 16:39:14 +0000

"The story of the high-functioning alcoholic is not one of obvious tragedy by that of silent suffering."

I have often said that a movie or a TV show featuring a high-functioning alcoholic (HFA) would not be viewed as "dramatic" enough by today's entertainment standards. An exception to this norm was the July 13th airing of the A&E show "Intervention" featuring Bret, an HFA, proved to be one of the most emotional and tragic episodes.

This American need for "drama" has unfortunately lead to a disproportionate amount of lower functioning alcoholics and drug addicts being featured in Hollywood productions-causing the public to believe that the "skid row" alcoholic is more prevalent than they actually are. In fact, research by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 2007concluded that 20% of all alcoholics are of the "functioning" subtype, 31.5% are in the "young adult" subtype with the potential to be functioning and that only 9% of all alcoholics are the "chronic severe" subtype or skid row alcoholic. But somehow lower functioning alcoholics have shaped the stereotype and receive more attention in the media, are the focus of more research and are the subject of more publications than the HFA. Why is this?

Although the show "Intervention" helps to increase awareness about addictions and intervention strategies, it ultimately fuels viewers' interest by featuring those addicts who have quickly experienced many losses (ie, job, daily functioning, relationships, housing)-those stories that will voyeuristically capture the attention of the audience. Last week's show featured Bret who has led a seemingly mundane middle class American lifestyle, was married to his high school sweetheart, has two children and had the house with the white picket fence. Bret states that he originally started to drink because he felt pressure to make more money and to "keep up with the Jones". Even his alcoholism was less than interesting and was described by his friend stating, "He wakes up on an average day and it's ground Hog Day for Bret everyday." Scenes of Bret show him as a maintenance drinker physically dependent upon alcohol, who averages, in his estimation, 11 drinks a day and he never appears visibly drunk. Through the years, his life begins to unravel as a result of his drinking-his wife divorces him and he loses his job. Over time, Bret was unable to maintain his level of functioning and was hitting a low bottom (HFAs can hit a low bottom and can experience a decrease in functioning as their alcoholism progresses). The intervention is the peak of the show and the most heartfelt intervention letters are those from his two children-specifically, his daughter expressing that he put her life in danger when he drank alcohol behind the wheel while driving her home from sports practice.

What may have started out as the least "exciting" episode, turns out to be the most tragic. Given all of the extreme addicts featured on "Intervention", ironically the HFA is [to my knowledge] one of two deaths to occur before the episodes actually aired. The first death was Lawrence Ryan, who died of Cirrhosis of the liver on February 22, 2008 before the March 19, 2008 show airing.

In Bret's case, he had been warned by loved ones about his health for years and began to cough up blood while during the episode, but continued to drink despite his symptoms. Sadly, Bret passes away from esophageal cancer related to his alcoholism when he was 104 days sober. It is crucial for stories like Bret's to be told and to be seen, for they illustrate the point that being an HFA is just as dangerous and deadly as being lower functioning. In fact, it can be more dangerous in that HFAs and their loved ones maybe in more denial and delay getting them necessary treatment. It is imperative to take an HFAs alcoholism seriously and if necessary, for loved one to come together to stage an intervention-hopefully before it is too late.

"Remembering Bret" http://www.aetv.com/intervention/video/index.jsp?bcpid=1452232410... and preview for episode 93 "Bret" at full episode no longer available

For more information and resources about high-functioning alcoholics, please visit www.highfunctioningalcoholic.com

Summertime: Wedding Season, Vacations- Meaningful Times or Excuse to Drink?

Sarah Allen Benton, L.M.H.C. — Thu, 02 Jul 2009 13:23:29 +0000

"It's the summer, why not have a good time and get drunk?"

"I'm on vacation, who cares how much I drink?"

"It's a wedding, let's celebrate, where's the alcohol?"

These are just a few of the excuses that many high-functioning alcoholics (HFAs) and even social drinkers may use when it comes to drinking heavily during the summertime, at 4th of July parties, weddings, cook-outs, sporting events, outside concerts and beach parties. In our culture "celebrations" are often intertwined with drinking alcohol. For normal drinkers this may not pose a problem, however for HFAs this may be a time when their drinking either stands out or they simply blend in with the crowd. Many HFAs report that any occasion can be an excuse to drink and that it is easy to blame their belligerence on the event. Because social drinkers may drink more than usual during these summertime festivities, HFAs may feel that they can "let go" and drink the way that they really want to drink without holding back. For those HFAs that typically may have tried to hide their drinking or drank privately at home before or after an event, this may be an opportunity to feel that they will fit in with these heavy drinking scenes. However, many HFAs still end up humiliating themselves drunk and may vow once again that they will never drink that much again. Those in denial of the HFAs problem may also blame the event or the "open bar" at the wedding as the reason the HFA drank too much. In fact, some feel that a wedding is not considered a quality wedding unless there is an open bar. The irony is that the more alcohol is served, the less that the guests focus on the event and the more "forgettable" the occasion becomes.

The question remains, why do so many people believe that alcohol enhances these types of events? The implication is that a special event such as a wedding is not enough in its own right- that alcohol will "make it better". In a sense, the presence of excessive drinking can take away from the meaning of the event and lead those in attendance to become more focused on when they can get their next drink instead of the reason that they are there. We live in a culture where "more" is better and what we have is never enough- alcohol fits into that philosophy perfectly. One social drinker I recently spoke with has observed that some guests at weddings she has attended are hoping that the ceremony will finish quickly so that they can get to the reception and start drinking. She went on to explain that alcohol seems to be present at most social occasions, in the summertime in particular, and that people often use it to break the ice socially or to enhance the concert, vacation, beach party, sporting event, etc.

In addition, we live in a technological age where computers and text messaging have become the norm in terms of communication. Therefore, it is concerning that when given the opportunity for face-to-face interactions, many avoid the discomfort of talking socially to someone whom they don't know by having a few drinks. Social events can be opportunities to connect with others, meet people, and to enjoy the moment, but when excesive drinking is placed in the equation those possibilities may be lost. The truth is that one way to gain confidence socially is to avoid drinking, sit with the discomfort and practice talking to a stranger. My point is not that people should never drink, but I am suggesting that individuals become mindful of the role that alcohol plays for them in their life and on these occassions. It is easy for some to fall into heavy drinking patterns and a reliance on alcohol in social settings, particularly during this time of year.

For those trying to cut back on their drinking or for sober alcoholics, the summertime and the many celebrations that accompany it can be triggers. Many sober HFAs will report that the warm weather, the outdoor bars, family gatherings, vacations, the beach, sporting events, etc. can bring back memories of "the good ole' days". However, the memory of HFAs is much like Teflon, all of the negative experiences seem to slide away and they are left with a romanticized version of their drinking days and a craving to drink again. As I discuss in my book "Understanding the High-Functioning Alcoholic", it is really important for sober HFAs to stay connected to their recovery program, attend therapy, ask for help and receive treatment for co-existing conditions (anxiety, depression, etc.). It is possible to re-program their association with these triggering occasions by replacing their drunken memories with new sober experiences. They will begin to gain confidence in their social skills and to realize that their sober life is abundant with enjoyment and meaning- but now they can actually be in the moment and fully remember it.

More information on the topic of high-functioning alcoholics is available in my new book release "Understanding the High-Functioning Alcoholic: Professional View and Personal Insights" by Praeger Publisers (www.highfunctioningalcoholic.com)

Why some phase out of college binge drinking and others are alcoholic

Sarah Allen Benton, L.M.H.C. — Tue, 16 Jun 2009 14:58:11 +0000

"College drinking . . . to me it was all about getting drunk. I can actually recall being afraid that I wouldn't be 'drunk enough' for a concert, or for a football game. I would drink almost frantically and of course in haste. Sometimes, this provided a great buzz . . . other times it would hit me like a ton of bricks and I would end up throwing up on my boyfriend's comforter. You never knew."
~Lauren, college graduate

"Thursday, Friday, and Saturday nights I would black out, not know how I got home, and I would leave my credit card out."
~Andrea, college graduate

"College partying consisted of drinking at parties/bars and continuing the binge drinking until I would run home by myself or throw up and go home."
~Tiffany, college graduate

Lauren and Tiffany were binge drinkers in college, but as young professionals they were able to normalize their drinking and are not alcoholic. In contrast, Andrea was unable to phase out of college binge drinking and is a high-functioning alcoholics now in recovery. These quotes demonstrate the confusion of determining whether heavy college drinkers are alcoholics or problem drinkers who will phase out of these drinking habits. Recovering high-functioning alcoholics often have insight into their past drinking and can see signs of their drinking problems from the start of their drinking in high school or college. However, during the time of college binge drinking and even as young professionals, these individuals may have a difficult time knowing or admitting that they are alcoholic.

Research from the National Institute of Alcoholism and Alcohol Abuse (NIAAA) indicates that about 72% of people have a single period of heavy drinking in their life that lasts on average 3-4 years, and then they may mature out of it. This period peaks between the ages of 18-24 and most often occurs during college. There are 11 million underage drinkers nationally and over 7 million binge drinkers. Unfortunately, there is no clear way to determine which individuals will phase out of binge drinking and which will continue. There are a number of risk factors that increase the chance of an individual being alcoholic that include:

• The Surgeon General's 2007 "Call to Action" report indicates that genetics account for 50% of the risk of developing alcoholism, therefore, family history is one of the strongest determinations of who may be alcoholic. In addition, the drinking culture of the individual's family and the role that alcohol plays.

• The age that he or she began drinking is another key factor. Specifically, research by the NIAAA indicates that teens who begin drinking before the age of 15 have a 40% greater chance of becoming alcoholic with or without a family history of alcoholism.

• Certain work or graduate school environments tend to incorporate alcohol into their social events such as going out after work or class for drinks or drinking while networking (ie, law, business). These cultures may normalize heavy drinking and also breed a "work hard, play hard" mentality that enables alcoholic drinking patterns.

• The drinking patterns of the group of friends that he or she lives with or socializes with. Heavy drinkers tend to migrate towards spending time with others who drink like they do and this often allows them to justify and minimize their excessive drinking.

• The individual's predispositions toward mental illness (such as depression, bipolar disorder, anxiety) or a trauma history (PTSD) may lead he or she to self-medicate with alcohol.

• Impulse-control issues that include thrill-seeking behaviors and a need for immediate gratification.

• Certain drinking patterns are "red flags" for alcoholism including: blacking out (ie, memory loss when drinking),inability to have just 1-2 drinks, obsessing about alcohol, rotating their social life around alcohol, drinking daily or frequently, behaving in shameful ways while drunk, always needing to drink excessively before going to a party (ie, "pre-partying") and surrounding themselves with peers who drink heavily.

HFAs don't grow out of a heavy drinking phase, while those around them may. It sometimes takes until HFAs are in their mid-late twenties, thirties or older before it is clear that this drinking phase is not ending. But this does not mean that they will then stop drinking, because HFAs are able to maintain jobs, friendships, etc, and may not feel that there is reason enough to stop drinking. Over time, their alcoholism may begin to progress so that they experience negative consequences (ie, DUI, failed romantic relationships, high-risk sexual behavior, increased guilt and shame, health issues, weight gain, hurting others emotionally or physically). The best method for young professionals to find out if they can leave their college drinking days behind them is to try and control their drinking. If they never try to control it then they may fall deeper into denial and continue to engage in risky behaviors. Alcoholism does not need to keep progressing- now can be the time to become aware of heavy drinking patterns and to make a change.

The NIAAA "Rethinking Drinking" is an online program targeted towards young professionals and can help them to assess their drinking and even set goals to cut back on their drinking. (http://rethinkingdrinking.niaaa.nih.gov/).

Source: My new book release, "Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights". For more information or alcoholism resources, please visit www.highfunctioningalcoholic.com

Ways to Approach the High-Functioning Alcoholic in Your Life

Sarah Allen Benton, L.M.H.C. — Wed, 03 Jun 2009 14:02:13 +0000

Recently, I have received numerous emails and blog comments from the loved ones of high-functioning alcoholics (HFAs) who are unsure how to deal with the HFA in their life. Loved ones of HFAs are often confused about how to approach these individuals because there is often a lack of tangible losses to point to, but instead emotional consequences. HFAs typically do not realize the extent to which their drinking affects others. The fact that they are "functioning" and able to go to work, excel in academics, provide for their family and still drink alcoholically feeds their denial. They believe that their drinking only impacts themselves, that they deserve to drink because of their hard work or stress and that if life appears "put together" on the outside that they are entitled to keep drinking. This distorted thinking is part of the denial that HFAs experience and that enables them to continue drinking, despite the harm to others, risks, and negative consequences that they may experience (hangovers, drinking and driving, health risks).

Being an HFA affects every aspects of that individual's life - but they are often unable to see this truth until they get sober. In terms of family life and friends, there is also the problem of "secondary" denial that loved ones may have about an HFA by not believing that they are "real" alcoholics. This powerful sense of denial also prevents the loved ones of HFAs from intervening. HFAs may provide the main source of income for a family and therefore, the spouse or partner may not feel that they have the leverage to persuade the HFA to get help.

In terms of intimate relationships, many spouses or romantic partners have reported that they experience difficulty connecting emotionally with the HFA. Alcohol is the HFA's best friend and it is hard for anyone to compete with that relationship. In addition, these loves ones will report that while the HFA may provide for the family financially, that they are not able to be supportive emotionally for their romantic partner nor for their children. Alcoholism corrodes relationships and this can happen in a subtle manner over time, but can ultimately damage and destroy families.

So what should a loved one of an HFA do?

Any conversation with an HFA about his or her drinking should occur when the alcoholic is NOT under the influence of alcohol and can often be most effective when the HFA is hungover and possibly feeling guilt or remorse. It is important to express to an HFA how his or her drinking is negatively affecting you (emotionally, spiritually, physically) and how you perceive it is harming others as well (friends, children). In order to prevent an HFA from getting overly defensive, you can place the emphasis on your feelings and concerns - instead of stating how you think he or she should be living or acting. You can also dispel some of the myths and stereotypes about alcoholics that I have written about in other blog posts on this site and in my book "Understanding the High-Functioning Alcoholic." You can help to slowly chip away at his or her denial, but it is also important to come from a place of compassion and not from a position of judgment. Just because you open up about this issue does not mean the HFA in your life will immediately get help. However, what you are doing is planting a seed that may increase the chances that this individual will get help in the future. If the HFA is open to your concerns and is willing to seek help, he or she should also receive an assessment by a therapist or physician about what level of care may be appropriate. You can also suggest finding a recovery program support group such as A.A. (www.aa.org), SMART Recovery® (http://www.smartrecovery.org/ ) or Women for Sobriety (www.womenforsobriety.org) that have meetings online and in person throughout the country and internationally. You can even offer to attend an "open" meeting of one of these support groups with your loved one to ease their fears.

Sometimes an HFA many become defensive and express that they are unwilling to seek help for their drinking. He or she may not believe that they are alcoholic and believe require more concrete evidence of being alcoholic in order to even consider getting sober (you can refer to my last blog "Social Drinkers, Problem Drinkers and High-Functioning Alcoholics: Differences and Warning Signs" for help in determining what type of drinker the individual is). You may also suggest that they visit the "Rethinking Drinking" online assessment by the NIAAA and if necessary, try to set low risk drinking limits for themselves through this online program (http://rethinkingdrinking.niaaa.nih.gov/). If the HFA is not able to adhere to low risk drinking limits (ie, no more than 3 drinks in a sitting, no more than 2 times a week), his or her lack of control over drinking may become clear and he or she may become more open to seeking help.

There may come a point where the HFA in your life is unwilling to seek help and is continuing to drink alcoholically despite your efforts to offer help. Therefore, you may need to set clear limits and, for example, state that you will not spend time with them when they are drinking or take a break from your relationship with them (romantic or friendship) until they get help. If you make it clear that your loved ones drinking is leading you to put distance in our relationship, it may have impact as well as protect you from the emotional toll of having an active alcoholic in your life.

Loved ones and friends of HFAs can also seek support for themselves in order to learn how best to navigate their relationship with the alcoholic in their life, to detach emotionally and to heal. Al-Anon (www.al-anon.alateen.org/) is a free, anonymous national support for the friends and loved ones of alcoholics and ACOA (www.adultchildren.org) is a free, anonymous national support specifically for adult children of alcoholic parent(s). The book "Co-Dependent No More" by Melody Beattie is a resource for the loved ones of alcoholics that is highly recommended by many therapists. In addition, attending individual therapy or even family therapy with the HFA can be effective. It is best to find a therapist who specializes in treating addictions, and you can often do this search through your insurance company, by asking your physician or by asking a therapist whom you may know for a suggestion. Finally, as a last resort, there are professional "interventionists" that are available to assist family and friends of an alcoholic in confronting that individual, presenting ultimatums, and providing resources with the hope that the alcoholic will ultimately agree to seek help.

For more information on the topic of high-functioning alcoholics, resources or information on my new book "Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights" please visit my Website www.highfunctioningalcoholic.com.

Social Drinkers, Problem Drinkers and High-Functioning Alcoholics

Sarah Allen Benton, L.M.H.C. — Tue, 28 Apr 2009 13:15:02 +0000

When the term "high-functioning alcoholic" is mentioned, various types of drinkers often begin to question their own drinking and worry if they fall into this category. Part of this confusion is that many individuals are unclear about the differences in charactersitics of social drinkers, problem drinkers and alcoholics. There is also a lack of awareness of what the true warning signs of alcoholism are.

Social drinkers are those individuals who drink in low-risk patterns. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), "low-risk" drinking for females consists of no more than 7 drinks per week and no more than 3 drinks per sitting. For males, it consists of no more than 14 drinks per week and no more than 4 drinks per day.

Problem drinkers display clear differences between their drinking habits and those of alcoholics. In fact, according to the NIAAA, 72% of people have a single period of heavy drinking that lasts 3-4 years and peaks at ages 18-24 (typically occurs during the college years) that they phase out of. When problem drinkers are given sufficient reason to cut back on their drinking (ie, have a negative drinking consequence, debilitating hangover, becomes a parent), they are able to self-correct and return to drinking in a low-risk manner. In contrast, alcoholics may be given countless reasons to cut back on their drinking but they are unable to permanently cut back on their drinking. Alcoholics may have occasions where they drank in a low-risk manner, but they inevitably return to their alcoholic drinking patterns. High-functioning alcoholics (HFAs) in particular tend to minimize their drinking by falsely labeling it as a "problem" or as "heavy" drinking because they often do not believe that they fit the stereotype of the typical alcoholic. However, what defines an alcoholic is a person's relationship to alcohol and not how they appear to the outside world in terms of their personal, professional or academic life.

Some of the following alcoholism warning signs are tailored to HFAs but are applicable to all subtypes of alcoholics and include but are not limited to:

1. inability to control alcohol intake after starting to drink
2. obsessing about alcohol (ie, next time the person can drink, how they are going to get alcohol, who they're going to go out drinking with)
3. behaving in ways, while drunk, that are uncharacteristic of their sober personality
4. repeating unwanted drinking patterns
5. surrounding themselves socially with heavy drinkers
6. getting drunk before actually arriving at parties/bars (pre-partying)
7. increasing sense of denial that their heavy drinking is a problem because they are able to succeed professionally and personally
8. setting drinking limits (ie, only having 3 drinks, only drinking 3 days per week) and not being able to adhere to them
9. driving drunk and, by sheer luck, not getting arrested or involved in an accident
10. always having to finish an alcoholic beverage or even another person's unfinished beverage
11. using alcohol as a reward
12. drinking daily
13. living a double life by separating drinking life from professional or home life
14. binge drinking (more than 5 drinks in one sitting)
15. having chronic blackouts (memory lapse due to excessive drinking) and not remembering what they did for a portion of their drinking episode
16. feeling guilt and shame about their drunken behaviors
17. taking breaks from drinking and then increasing alcohol consumption when they resume drinking after a period of time
18. people have expressed concern about their negative drunken behaviors
19. engaging in risky sexual behavior when intoxicated
20. not being able to imagine their life without alcohol in it

If individuals display a number of these warning signs, it is important for them to address this issue. Finding someone in their lives that they can be honest with and admit they need help, can assist individuals in beginning this process. In addition, speaking with someone in the mental health or health care field, such as a therapist or social worker (preferably an addiction specialist) and/or medical doctor can help potential alcoholics receive a thorough assessment of their drinking patterns and provide suggestions for appropriate treatment. There is no harm in at least checking out an abstinence-based program such Alcoholics Anonymous, SMART Recovery® or Women for Sobriety meetings. Each of these recovery programs has members who are HFAs as well as lower functioning alcoholics. Meetings are held in person as well as online and are typically listed on their Websites. It is most important for alcoholics to realize that they are NOT alone and that there are millions of sober alcoholics who now have fulfilling lives without drinking.

(Source: Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights)

For online alcohol screening tools or alcoholism resources please visit www.highfunctioningalcoholic.com

Assessing your drinking habits online

Sarah Allen Benton, L.M.H.C. — Thu, 09 Apr 2009 09:54:34 +0000

April is Alcohol Awareness Month which is intended to educate people and communities about the consequences of alcohol-related problems. There are over 18 million individuals or 8.5% of Americans who suffer from alcohol-use disorders. In addition, there are millions of individuals who experience the devastating effects of the alcohol problem of someone in their life. In fact, 25% of U.S. children are exposed to alcohol-use disorders in their family.

April 9th is National Alcohol Screening Day and an important part of Alcohol Awareness month. This day is intended to help individuals who may not know how much is too much to drink or if the amount that they drink is putting them at risk for injury, illness and addiction. Screening for Mental Health, Inc. was the first organization to introduce the concept of large-scale mental health screenings in 1991. These programs now include both in-person (mainly held at colleges and universities) and online screening programs (intended for the general public and military).

According to the National Epidemiological Survey on Alcohol and Related Conditions, only 25% of alcoholics ever receive treatment. High-functioning alcoholics (HFAs) and potential HFAs are the type of drinkers that need to take alcohol screening tests but are not always the ones that do. These individuals could benefit from using Alcohol Screening Day as an opportunity to take a brief amount of time to honestly assess their drinking habits. So often, drinking is something that is done mindlessly and individuals are not paying attention to how much nor how often they are drinking. Therefore, this can be an opportunity for individuals to be mindful about their drinking habits and assess if they need to make cut back on their drinking or ask for help.

Online Alcohol Screening Resources

Mental Health Screening, Inc.
online alcohol screening tests for the general public, military and college students (colleges participating in Alcohol Screening Day are listed with links):
http://www.mentalhealthscreening.org/

National Institute on Alcohol Abuse and Alcoholism
"Rethinking Drinking" online assessment of drinking habits as well as a brief program to help individuals to set goals and cut back on their drinking:
http://rethinkingdrinking.niaaa.nih.gov/

Counseling Resource.com
4 question CAGE self-test screening:
http://counsellingresource.com/quizzes/alcohol-cage/index.html

Thinking About Your Drinking...

If an individual does not want to take an alcohol screening test, he or she may consider answering the following questions in order to be honest about the role alcohol plays in his or her life.

Examining Your "Relationship" with Alcohol:

o Why do you drink?
o How often do you drink? Can you go more than a week
   without drinking?
o Have you tried to control your drinking and if so, how
   much time do you spend thinking about drinking or about
   how not to drink too much?
o Can you imagine your life without alcohol?

Friendships:

o What activities do you and your friends like to do
together?
o Do you have friends who do not drink?
o Can you socialize or go to parties without drinking?

Interests:

o What is your favorite thing to do?
o Do you have interests, activities and hobbies that do
not involve drinking?
o Does drinking alcohol distract you from taking part in
these things?

Career/Academics:
o Does drinking interfere with your job, your grades
   and/or the effort you put in (even slightly)?
o Do you excel professionally/academically and use your
   success as an excuse to drink?
o Is alcohol your reward for working hard or doing your
   academics?

Family:
o What is the drinking culture of your family?
o Do you hide your drinking from your family?
o Do you have a family history of alcohol problems?

For more alcoholism and treatment resources as well as information about my new book release, Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights, please visit my Website: www.highfunctioningalcoholic.com