Kathy was scared and felt stuck. She had passed on her chance to go to college, had never really worked, and didn't see how she could possibly support herself and the children. As for talking to Jim, she was afraid to cross him. She cooked and cleaned and did what a “good wife” was supposed to do, but she became more and more depressed. Kathy gained weight and was ashamed of the way she looked, stopped visiting her friends, and rarely invited family to visit. Holidays became a nightmare for her because she had to be around people and never knew how drunk or how bizarre Jim would act. In her own words, “My life is a total disaster. I feel like dying. If it wasn't for the kids, I'd just run away.”
chapter 2
The Road Map
Holly and Dan
Holly came to our clinic after seven years of living, as she put it, “on the edge.” When they first married, Dan was what she called a “social drinker,” but as he moved up the ladder at work, he began drinking to unwind at the end of the day. “Advertising is a cut-throat business,” he always said, and he needed the drink to “de-stress” after work. In spite of repeated suggestions by Holly that he think about looking for other work that would be less stressful and more satisfying, Dan clung tightly to his job, his career aspirations, and the bottle he needed to tolerate it all. As Dan rose higher in the company, his drinking increased. Every day he would come home from work, change into sweats, eat dinner with Holly, and then mix the first of many scotch and waters for the evening. It was then, each evening, that they would argue endlessly. With no children (Holly was afraid to have a baby under these circumstances) and friends long-since turned off by Dan's intensity, there was nothing to do but continue to battle.
In this chapter you will work on three objectives. First, you will map out everything you know about your drinker's drinking patterns. (You will probably be amazed at how much you know.) Then you will use that information to get what we call a “baseline” on her drinking. In other words, we'll help you figure out just how much drinking is actually going on and under what circumstances. Finally, with that information in hand, you will make specific action plans for changing your behavior and, in so doing, changing your drinker's behavior.
Make a Drinking Map
Life with your drinker has given you a tremendous amount of experience and knowledge about his drinking patterns. Each time you think, “I knew he'd do that” or “There she goes again,” you prove it. You recognize the usual paths your loved one's behavior follows. In fact, there are probably times you feel downright psychic about what he will do next. This knowledge puts you in the unique position of being able to nudge your drinker's behavior in directions you want it to go. First, though, you need a road map. Use your experience to figure out what triggers drinking, what increases and decreases it, where you figure in the mix, and what the booby traps are. In other words, if you want to get to your destination, use a map!
A road map of drinking has three main parts. First, it describes drinking triggers. You can think of these as the highway signs that tell you an exit is coming up. Next, it describes the early signs of intoxication; you can liken this to the reduced speed signs posted on highway exits. Sometimes the intoxication signs are obvious, such as she's got a drink in one hand and is grinning like a moron. Other times you need to use your insight to know whether he's just in a bad mood or whether the highball he stopped for on the way home put him in a foul mood. In other words, you need to recognize the cues that tell you whether your drinker is still moving smoothly down the highway of sobriety or has already turned off at a drinking exit. Finally, the map shows the consequences of drinking. Once your loved one takes that drinking exit, a number of subsequent roads are available. Sometimes what you do in an effort to get your drinker to stop actually makes it more likely that she will drink. That's why it is so important not only to identify triggers and signs but also to map out what happens between the two of you when she drinks. Your map will help you figure out what leads to more drinking and what leads back to the sobriety highway and smooth driving.
Drinking Triggers
Drinking triggers are any events, moods, people, times, days, thoughts, places, or smells that lead your loved one to drink or that warn you that he is about to drink. At the point a trigger occurs, your drinker has not yet taken a drink but you can be pretty sure one is coming. These triggers are comparable to the highway signs that let you know your exit is coming up. Remember, just because a highway sign signals an upcoming exit, it does not always follow that you take that exit. Similarly, something can be a drinking trigger for your loved one even if it does not always lead to drinking. The definition of a drinking trigger for our purposes is that it often leads to drinking.
Although everyone is unique, some triggers are fairly common, so we have listed them for you in Activity 1. Read down the list and check off those that ring true for your drinker. This will help you see what sort of signs we are after. At the end of the list, add any we missed that apply to your loved one. Try to remember all the circumstances that have often triggered her to drink. Below we have shown you what triggers Holly sees in Dan's drinking road map. Holly first checked the items in Activity 1 that rang a bell with her. Then she reviewed them, thought through them, and summarized and individualized them to Dan's typical pattern. Study her activity and then do your own in your notebook.
What triggers have we missed that typically lead your loved one to drink? Add them to the list and then summarize everything to reflect your loved one's typical pattern. Holly has summarized Dan's pattern below.
Dan's Drinking Pattern
Dan has a high-stress job, which for most people does not automatically lead to drinking, but for him is definitely a drinking trigger. He often feels inadequate at work and worries that one day he will be “found out” for the “fake” he feels he is. Thus, whenever project deadlines are coming due (as they do quickly and often in advertising), or Dan has to give a presentation where he feels he will be evaluated, his stress level goes through the roof.
Over the years of listening to Dan's reports about work and watching his evening drinking bouts, Holly has identified the following drinking triggers. Note that in Dan's case, they all revolve around stress over being evaluated.
Dan's Drinking Triggers
Project deadline due within three weeks
Dan has to give a presentation to a client with his boss present
Company functions (picnics, golf tournaments, parties, etc.) in which Dan will be socializing with people above him in the hierarchy
Comments by co-workers that lead Dan to believe that someone else might be given an assignment he wants
Anytime Dan comes home and says it was a “cut-throat” day
(We know that many drinkers don't need a specific “trigger” to start drinking. However, you can usually find a pattern that frequently precedes heaving drinking.)
Drinking Signs
Now that you have a rough picture of what sends your drinker in search of a drink, think about how you know he has already had one. Between the first swallow and being drunk, there are usually signs that tell you someone is moving from sober to drunk. Once alcohol hits the brain, the time for reasoning and negotiating is past. Liquor and other drugs almost immediately interfere with a person's ability to think clearly. At that point, you have only two objectives. The first and most important is to remain safe. If your loved one is showing any signs of violence, you need to implement your safety plan (see chapter 3). If safety is not an issue, your second objective becomes prime and that is to do nothing to encourage further drinking. The behavioral maps you develop will show you how to achieve this second goal.
What changes as your loved one begins to drink? Does he start pacing? Do her eyelids droop? Does he start looking for something to pick a fight over? Review the list in Activity 2 and add any signs we missed that signal a drinking episode has begun. If you have trouble with this exercise, try tracing backward from her last drunk and figuring out what happened or what she looked l
ike each step of the way.
Holly described Dan's drinking signs like this. Study her activity and then complete Activity 2 for your loved one in your notebook.
Think about other signs that your loved one is on the way to a drunk. List them and then summarize it all to reflect your loved one's typical pattern. Holly has summarized Dan's pattern below.
Dan's Drinking Signs
Dan goes through periods when he tries not to let me see him start drinking because he knows how upset I get. When he does that, he'll often stop for a drink on the way home or offer to run an errand after dinner and stop in at Joe's Pub while he's out. Even if I can't smell the liquor on his breath, I can tell when he's done this by the following signs:
His voice gets louder.
He clenches his jaw.
His tie is loosened. (He never loosens it until he gets home if he's sober; ruins his image he says.)
He forgets to take off his shoes when he comes in, and he always takes off his shoes if he's sober.
He keeps going to the fridge as if he's looking for something to eat but nothing appeals to him.
He complains that no one at work appreciates his talents.
Good job. You now have a pretty good picture of what situations are high-risk for drinking (that is, drinking triggers) and what signs your drinker sends as he takes that drinking exit. This completes the first and second parts of the map.
Drinking Consequences
The final part of the map outlines the consequences of drinking. The more specifically you can identify a step-by-step sequence that ends in drinking or in drinking-related problems, the easier it will be to figure out how to change that pattern.
What are the results of your loved one's drinking? Depressing as this exercise may be, without it your map will be incomplete and so will be your ability to change your situation.
Sit back for a moment and think about all the consequences caused by your loved one's drinking. Be sure to consider not only the immediate consequences such as arguments and hangovers, but also the long-term negative consequences such as financial debts, medical problems, missed opportunities, and lost friends. While you're at it, also think about any positive consequences you experience from her drinking. Odd as that sounds, it is possible that your loved one's drinking serves some useful role in your life. Perhaps it allows you to avoid an unsatisfying sexual relationship or keeps your drinker dependent on you. We're not saying there has to be a positive consequence—only that you need to honestly consider the possibility so that you don't get blindsided by it as you start making changes. Remember, knowledge is power.
Holly was able to identify consequences of Dan's drinking that she had not thought about before. Becoming aware of them helped her figure out what to change and how.
Use Activity 3 to start your own list of drinking consequences. Remember to think both long term and short term, as well as about costs to your drinker and to you. Here is Holly's work on the activity. Do your own activity in your notebook.
Think about other consequences of drinking that matter to you. List them and then summarize the whole set to reflect your situation. Holly has summarized her situation below.
Dan's Drinking Consequences
I always thought that Dan's drinking basically caused our arguments and not much more. Of course, I worried about what problems it would cause in the future but didn't really think it was doing much damage at this point. When I sat down and thought about it, though, I realized there were many more consequences than I realized.
Arguments (obvious)
My migraine headaches (more frequent and severe when he's drinking)
Occasional missed work—Dan with a hangover, me with a migraine
Dan gets out of helping with dinner clean-up and evening chores like paying bills and taking out the trash
It allows us to avoid discussing whether to have children (Dan really wants to, but I'm not sure I want to interrupt my career)
Our sex life is almost completely dead
Dan gets clumsy and breaks glasses
Let's look at Holly and Dan to put together what we have covered so far.
Holly identified Dan's drinking triggers as work-related situations that make him feel he will be evaluated and come up short. These are the “cut-throat” days to which Dan refers. Holly also identified signs that Dan has already had a drink and is heading for a drunk. When Dan arrives home with his tie loosened and his jaw clenched, she knows he has left work a little early and stopped at the local bar to have a drink. The set of his jaw also tells her he is not about to be talked out of another drink (there is no point in trying to have a rational conversation with someone who's brain is under the influence of a drug). The consequences for Dan and Holly are probably familiar to you: arguments, anger, resentment, loss of intimacy, angry words that sting long after the silence begins, broken glass as Dan gets clumsy, and missed days of work for both of them (Dan with hangovers and Holly with migraines and sadness).
Your most important task at this point is to make sure you can identify your loved one's drinking triggers, can tell when he has started drinking, and know what the consequences will most likely be. With that information on hand, you can begin to make changes. Just as Holly can tell when Dan comes home primed for liquor and arguments, you can tell when your loved one is heading down that road. Knowing this, you can choose not to go there. Instead of engaging in the same old dance of arguments and tears, take note of the triggers and signs and change the consequences that are within your control. You can remove yourself from the situation, change what you say, how you look, and what you do. You will see as we go along that there really is a lot you can change.
Get a Baseline
“Baseline” simply means the place from which you start. Getting a baseline on your drinker means estimating as best you can how much and how often she drinks. In other words, describe her current drinking patterns. There are two reasons to establish a baseline. One is to complete the map that describes everything you know about your loved one's drinking, and the other is to help you recognize progress as it happens.
How Much Does Your Loved One Drink?
The first step in getting a baseline is figuring out how often and how much your loved one drinks. Use Activity 4 to do this. Think carefully and try to answer every question. If you have trouble getting a clear picture of his drinking, use a calendar and think back day by day. Did she drink yesterday and, if so, how much? How about the day before and the day before that? Does your drinker tend to drink less/more during the week or weekend, or does the pattern change each week? If he has a fairly standard pattern of drinking, this exercise will be easier to do but, in either case, it is important.
Almost every drinker has “special drinking days” on which she tends to really indulge. Depending on your drinker, special drinking days might be holidays, paydays, Super Bowl Sunday (or any Sunday), Stanley Cup play-offs, birthdays, Friday nights, or any other day that serves as an excuse to pull out the stopper.
If you know your loved one drinks more than you can observe or if you think he drinks more than you know about, go with your instincts. Many problem drinkers sneak drinks, so you're probably right. At any rate, you can't monitor her activities twenty-four hours a day so use your best estimate.
As you answer the questions in Activity 4, use the following drink definition as a guideline. Each of the following counts as one drink:
12 ounces of beer
4 ounces of wine
1-1⁄4 ounces of 80-proof liquor
1 ounce of 100-proof liquor
Each of these quantities contains 1⁄2 ounce of ethanol, which is the chemical in alcohol that makes it a drug.
Activity 4. Estimate Drinking during a Typical Week
Note: If your drinker does not work a standard Monday through Friday week, adjust the activity accordingly.
How many drinks does he/she usually drink on a typical Monday, Tuesday, Wednesday, and Thursday? Multiply the usual
daily intake by 4.______
How many drinks does he/she usually drink on a typical Friday? ______
How many drinks does he/she usually drink on a typical Saturday?______
How many drinks does he/she usually drink on a typical Sunday?______
Add up your answers to questions 1, 2, 3, and 4.______
The total you entered on line 5 reflects the number of drinks during a typical week for your loved one. Compare this number to your estimate of his typical drinking a year ago, three years ago, or when you first met. Has this number increased over the years? Does the number of drinks go up or down on special days—holidays, vacations, other special times?
You can also estimate how many hours each day are spent drinking or in alcohol-related activities. Time spent going to liquor stores, in bars, being hungover, and stuck in jail or the hospital is part of the drinking pattern and costs. Also add to your baseline any other drugs your loved one may use. A detailed picture of where you are today is knowledge that will help you get to where you want to be tomorrow. Repeat this exercise periodically as you implement the Alternatives. Changes in these numbers will be one means of measuring the impact of your efforts on your drinker. Remember, though, even if your loved one does not move toward sobriety, the more important measure of success will be an improved quality of life for yourself and those who depend on you.
Get Your Loved One Sober Page 4