Case Study: The Addicted Engineer

How an engineer used REBT to overcome his alcohol addiction.

Posted Jun 09, 2018

Lee, a  dark-haired, quiet, slightly nervous 26-year-old with a warm smile came from a high-intensity, New York family. After two years at New York University he began experimenting with Ritalin. His strained relations with his family became worse, and their financial and emotional support was reduced to a thin trickle. Against his parents’ admonitions, he left home at age 20 to hitchhike across the U.S. with the vague notion he would “seek his fortune.”  He reached his destination in engineer’s heaven in Silicon Valley. 

Lee rented an apartment with two roommates and slipped into heavy drinking in place of his Ritalin habit. His advanced technical skills allowed him to get work as a software engineer with a large Silicon Valley company. Alcohol was his elixir in the evening when he returned to his apartment stressed from his job. He had always been shy around girls, and although he desired a relationship, Lee decided it involved too much stress and further used his excessive drinking as an excuse to avoid intimacy.

He came to me for help with his stress and drinking problems. Like most engineers he was looking for the kind of therapy that wouldn’t spend unproductive time exploring feelings, childhood angst, and family issues. He desired a solution-oriented approach with copious feedback from the therapist. When I explained at our first session that his excessive drinking was generated by his current thinking about his work stress, dysfunctional family situation, and lack of female companionship, not by these problems themselves, he agreed. Then I helped Lee list the disadvantages of his drinking. These included contention with his roommates, missing work, feelings of guilt, more stress, blackouts, and putting on extra pounds. I instructed him to read this list vividly multiple times daily. This meant dwelling on each negative for about 30-60 seconds and vividly imagining, feeling, and experiencing them to the greatest extent possible. As Lee practiced this, he noticed a change in his perspective: the negatives of his drinking, rather than the immediate pleasures, became more prominent in his mind. 

Next we set a goal. Lee thought it best to abstain for three months, then re-evaluate his two options: continue to abstain or experiment with moderation.

Finally I taught him the Three Minute Exercise (TME) featured in my book, Three Minute Therapy. Here’s one of Lee’s early TMEs:
A. (Activating event.) I had a difficult day at work. I’m tempted to unwind with a beer.

B. (Irrational Belief.) My life and work absolutely must be free of stress. I can’t stand these feelings. I must unwind with a beer. 

C. (Undesirable emotional or behavioral Consequences.) I had one beer, then another, then many more, until I fell asleep on the dining room table.  

D. (Disputing or questioning your irrational belief.) What’s the evidence my life absolutely must be stress-free? Where is it written I can’t stand feeling anxious? Why must I escape my uncomfortable feelings with a beer? 

E. (Effective new philosophy.) There’s no reason my life absolutely must be stress-free, although I greatly prefer to live a stress-free life. Since I’m a fallible human, born and raised to be anxious, of course, of course, I’ll feel stressed and anxious at times, perhaps much of the time. When I drink to avoid this immediate discomfort I only create more discomfort for myself in the long-term. 

Although it feels difficult initially, the more I practice resisting my urge to drink the easier it’s likely to become. I’m in control of my arms and hands and I can choose to drink or choose not to. I can decide to either squarely face my uncomfortable feelings, or escape by listening to music, reading, or other pleasures, rather than acting destructively. It’s up to me. 

Stress is quite uncomfortable, but it will hardly destroy me. I’ve survived it in the past and I will survive in the future. I dislike feeling wound up after work, but I definitely can stand what I don’t like. It’s not my urge to drink or my anxious feelings that are causing me to get drunk. Rather it’s my irrational thinking about it that’s the culprit. With practice, I can change my thinking and thereby change my emotions and behavior. I can still have a happy life with stress, although I’d be happier without it. 

F. (New Feeling or behavior resulting from E.) No beers, have dinner with a friend instead. 

Instructions:
1. Writing just one TME is usually not the solution. Rather practice writing 1, 2, or 3 daily with determined effort. Make each one meaningful and persuasive. 
2. Dispute the same irrational Belief, or a different one, at each writing. Experiment to determine what approach works best for you. 
3. Reinforcement is the royal road to learning. Learn through reinforcement and repetition to think in terms of preferences, rather than in absolutes. 
4. Your goal is to stop your compulsive drinking at its root: your core thinking and believing. 

References

Edelstein, Michael R. & Steele, David Ramsay (1997). Three Minute Therapy. Aurora, CO: Glenbridge Publishing Ltd.