Breakingthecycles.com - Changing the Conversations

by Lisa Frederiksen

I gave a presentation of the above title to the Lane County Domestic Violence Council, and the feedback from those attending prompts me to write this post.

There have been many studies on the relationship between alcohol abuse and domestic violence. Statistics put the presence of alcohol in a domestic violence situation at approximately two-thirds. This is not to say there’s necessarily a cause and effect (i.e., a person’s alcohol abuse causes them to become violent towards their domestic partners), but the fact that alcohol abuse is present makes it imperative we assess and treat the alcohol abuser/alcoholic for their alcohol abuse, as well the family members who have lived in the alcohol abusing home. Why?

If you’ve been following my posts, you better understand that the impact of alcohol on the family system is huge because it skews the way an alcoholic or an alcohol abuser “thinks,” and equally important, it skews the “thinking” of the other family members, as well (whom I label “codependents” for simplicity’s sake). This is because the addiction aspect of the disease of alcoholism hijacks the pleasure/reward neural connections of the alcoholic’s brain, and the heightened sense of urgency to be on guard for or attempting to control or minimize damages of the alcohol abuser’s or alcoholic’s drinking behaviors hijacks the fight-or-flight neural connections in the codependent’s brain. Both the pleasure/reward and fight-or-flight systems are centered in the brain’s Limbic System — the non-thinking part of the brain. This is a problem because the cerebral cortex is where reasoned thinking occurs. This means that both the alcoholics and the codependents are not “thinking.” Rather they are both reacting because so much of their day-to-day behaviors are the result of neural connections firing in the Limbic System, not the cerebral cortex portions of their brains.

It is these skewed thinking processes that not only worsen the myriad of issues that comprise the fall-out of domestic violence, BUT they must also be considered as part of the overall intervention effort. For without this parallel and equal treatment, the positive effects of interventions with the domestic violence will likely not be successful long term given the following:

• the abused may continue to rationalize the domestic violence as something caused by the drinking, believing the abuser wouldn’t do what he/she does if it weren’t for the alcohol
• shelters may not admit women with alcohol abuse or addiction problems — especially if they have children — as they’re not equipped to treat that problem as well
• the abused may fear calling for help because if she’s sent to an alcohol treatment center, she cannot protect her children from the abuser or she may fear a social services agency may award her children to him because they may believe the abuser’s version of the situation or she’s afraid to accuse him of violence for fear he’ll accuse her of drinking too much
• the abuser may continue to use their drinking as an excuse,  e.g., they wouldn’t have done it, if they hadn’t been drinking or “You know I love you, I won’t let it happen, again. I promise. Please don’t leave me, I know what I have to do.”
• parental alcohol abuse or alcoholism is an important factor in a child’s decision to use or abuse alcohol
• parental alcohol abuse or alcoholism and the behaviors it spawns in the other family members is a significant contributing factor in a child’s perceptions of what constitutes “normal” behaviors and relationships

Understanding the new brain research, learning the facts about alcohol abuse not commonly known (e.g., behaviors most commonly associated with alcoholism are present during the alcohol abuse stage; in other words - you don’t have to be an alcoholic to abuse alcohol; all alcoholics go through alcohol abuse but not all alcohol abusers become alcoholics) and recognizing and appreciating what happens to the family members (because of living with an alcohol abuser/alcoholic) is critical to helping families who are victims of domestic violence when alcohol abuse is also present.

by Lisa Frederiksen

Much of the focus on alcoholism and alcohol abuse - with regards to treatment, education, prevention, public policy - is on the alcoholic or alcohol abuser. I’d like to draw our attention to those who are deeply effected by a loved one’s drinking (which I’m labeling “codependents” for simplicity’s sake) and the impact of that effect on the lives they touch (teachers, friends, fellow students, co-workers, extended family…).

In my post, “Codependents Have a Brain Thing Going On, Too,” I stated, “The repeated surges of adrenaline required to keep you safe in a dysfunctional home — always on high alert in order to uphold the family rules — cause your brain to eventually REACT without THINKING to hundreds of situations. What might trigger the alcoholic’s (or alcohol abuser’s) negative behavior one time, for example, doesn’t trigger it the next, and eventually, just about anything might trigger it. What worked to keep the children safe or calm or directed last year, no longer works this year. So a new approach is tried and then another and another. This constant high alert level of reactivity eventually becomes a chronic state of hyper-vigilance. This causes the codependent’s brain to become comfortable with a heightened level of adrenaline (and other related neurotransmitters and hormones) and angst. That comfort level then becomes “grooved,” if you will (because the same communications networks are used over and over again), and allows a codependent to experience the unacceptable as acceptable.”

In our relationship with the alcoholic or alcohol abuser, we hone our senses of sight and sound in order to “read” the alcoholic and the other family members so that we might protect ourselves for what may happen, next. For example, we listen to the sound of the key in the door or the tread of footsteps to assess how drunk our loved one may be. We seek their eyes to see if the lids are drooping or look for the licking of the lips that signifies they’ve stopped for a “few” on the way home. This helps us prepare for what we intend to do to “keep ourselves safe.” Or, our children may watch our body language. We may tense up and move quickly, maybe slam cupboard doors or respond in terse, clipped sentences to queries because we are mad or worried about the alcoholic/alcohol abuser’s behaviors. Our children “read” this as “stay out of the way” or “now is not the time to ask Mom if I can borrow the car.”

What happens, then, is we take this heightened sense of hearing and seeing into the work place, classroom or relationships with friends and extended family, and “read” their reactions, too. Except we’re reading them from a place of heightened anxiety and sensitivity; from a place of self-defense/preservation, and thus we’re likely reading things into a look or tone of voice that may or may not be there. This “reading” we do causes us to react in ways that causes problems that likely would not be there, except for our reaction. OR, we may allow unacceptable treatment by a boss or peer or relative or friend because we are so used to walking on eggshells to make sure the alcoholic / alcohol abuser doesn’t drink or one of the codependents doesn’t get more upset, that we have no real concept of what is or is not acceptable behavior.

More than half of all American adults report having a close relative who has a drinking problem and one in four children will experience familial alcohol abuse or alcoholism or both before the age of 18. In other words, a great deal of the population is affected by a loved one’s drinking. Clearly, we must start to not only educate society about the disease of alcoholism but the condition of codependency, as well.

by Lisa Frederiksen

The Salk Institute, established some 40 years ago by Dr. Jonas Salk, developer of the polio vaccine, announced findings by its researchers that “brings us closer to understanding how alcohol alters the way the brain cells work.” Reserachers anticipate that treatments for alcoholism, drug addiction and epilepsy will all benefit from these findings.

Quoting from the Institute’s press release:

“Ethanol, the alcohol in intoxicating beverages, is known to alter the communication between brain cells. ‘There’s been a lot of interest in the field to find out how alcohol acts in the brain,’ says Paul A. Slesinger, Ph.D., an associate professor in the Peptide Biology Laboratory at the Salk Institute, who led the study. ‘One of several views held that ethanol works by interacting directly with ion channel proteins, but there were no studies that visualized the site of association.’

“Slesinger and his team now show that alcohols directly interact with a specific nook contained within a channel protein. This ion channel plays a key role in several brain functions associated with drugs of abuse and seizures.”

by Lisa Frederiksen

Today is caping Operation Dry Water week-end. This is a coordinated effort to celebrate June 26-28 as “a national weekend of Boating Under the Influence (BUI) detection and enforcement aimed at reducing the number of alcohol-related accidents and fatalities and fostering a stronger and more visible deterrent to alcohol use on the water.” The National Association of State Boating Law Administrators (NASBLA), working with the states, the U.S. Coast Guard and other partner agencies, is coordinating Operation Dry Water. Here are their statistics:

• Boating Under the Influence (BUI) is dangerous and illegal. Over 20% of fatal boating accidents are a result of alcohol use.

• Alcohol can impair a boater’s judgment, balance, vision and reaction time. It can increase fatigue and susceptibility to the effects of cold-water immersion. Sun, wind, noise, vibration and motion –”stressors” common to the boating environment – intensify the effects of alcohol, drugs and some medications.

As you plan your summer boating adventures, it’s important to know that operating a recreational vessel with a Blood Alcohol Content of .08% or higher is against most state and federal laws. The vessel’s voyage will be terminated, the boat may be impounded and the operator may be arrested. Penalties may include fines, jail, impoundment of boats and loss of boating and/or driving privileges.

So be safe and protect the safety of others on the water - don’t BUI.

Alcohol’s Effect on Brain is Rapid, Detrimental
Researchers at Heidelberg University in Germany have found that it takes only six minutes for a change in brain cells to occur after drinking the equivalent of about three glasses of beer or two glasses of wine, Science Daily reported June 15… read more

Fathers’ Alcohol Affects Children’s Alcohol, Drug Habits, Alcohol Treatment and Rehab
Alcohol dependence or abuse among fathers living with adolescents (youths aged 12 to 17) may increase the risk of alcohol or illicit substance use among their children according to a new national study… read more

Houston Plagued By Drunk Driving Deaths
… urban sprawl combined with a lack of public transportation, and tough enforcement of drunk-driving laws have affected the prevalence and reporting, respectively, of drunk driving in Houston… read more

Bipolar Teens at Greater Risk for Substance Abuse
Adolescents diagnosed with bipolar disorder should be carefully screened for drug and alcohol abuse and cigarette smoking, because they are at significantly higher risk for developing substance abuse problems, according to research… read more

Researcher Decries Parental Permissiveness on Drinking
A Penn State researcher says that parents who let teens drink alcohol may be setting their kids up for binge drinking in college… read more

by Lisa Frederiksen

For years I couldn’t relate to this phrase. It seemed so overused, and frankly one that got my blood boiling because it sounded so overly simplistic. Yet, it’s now one of my favorite mantra phrases.

On heavy stress days, I’m practically chanting, “Let it go…”. And, I’ve just come through a couple of weeks of heavy, heavy stress days as my planned move and purchase of my dream home unraveled and eventually fell through - poof!

But the years of recovery work I’ve done and my understanding of the codependent’s brain (see this post for more on this) has changed everything. Between the two I was able to keep pulling myself back to the fact that I had absolute control of what I thought, and therefore, how I responded - what I did. This is not to be confused with how I felt, how I reacted. And, let me tell you, my feelings were ALL OVER the place - anger, sadness, frustration, rage, despair, hope, resignation, emptiness, loneliness, “why me?”, “what happened?” “haven’t I gone through enough?” “Now what?” And, my reactions? They followed the wild ride of my feelings, ranging from tears to dazed walking the neighborhood streets to yelling at the walls to grinding my teeth (and, oh yea…headaches, too).

But thanks to the “new me,” I’m able to weather these kinds of setbacks, knowing that I have absolute control over what I think, therefore how I respond (again, not to be confused with how I feel and how I react). Responses (as opposed to reactions) occur when I can jar my thinking out of the Limibc System in my brain and move it down different neural pathways — the ones in my Cerebral Cortex, the thinking part of my brain.

So I use this phrase, “Let it go…” (and others, such as “THINK,” “HALT” and “BREATHE”) to remind myself, I am in control - when and if I’m ready. To help me figure out what to do next, I talk about the problem with friends and family, go swimming, sleep, research, write about it, work — some of these activities are directed at finding a solution and some are just to take my mind off the problem.  In other words, after I feel my feelings and the range of reactions they inspire, I can think things through and then “calmly” respond. Followed, of course, by “Let it go…” to remind myself to move on - enjoy the moments - because who knows what might happen, next.

Before I sign off… I have to be clear - “Letting go…” does not mean I’ve necessarily found an easy or immediate solution or that all is well. I am devastated about loosing this house and the dream I had. Letting go… is more like a clearing of my mind for that moment or period of time. It’s a reminder that I can’t solve it all at once, but I’ll do what I can, when I can, however I can. For now, I’m going to meet my daughters and spend the day at the beach!

by Lisa Frederiksen

Just as there is a series of chemical reactions taking place in the brain of an alcoholic or abusive drinker, so too is there a compulsive-like process occurring in the codependent’s brain. Instead of that process involving dopamine and the pleasure/reward communications networks (as in the alcoholic’s brain’s Limbic System), the codependent’s brain taps into adrenaline (among other hormones and neurotransmitters) and the fight-or-flight communications networks (which also originate in the brain’s Limbic System).

The fight-or-flight reaction is one of the brain’s non-thinking (automatic) responses to cues or memories that spell danger. When activated, we tend to perceive whatever is going on as a possible threat to our survival and move into “attack” mode, completely bypassing the thinking part of our brain. (1)

If you mistakenly put your hand on a hot burner, for example, you don’t think, “Oh, my, it’s hot. I better remove my hand.” You simply yank it off. Many of the chronic verbal and physical exchanges that occur with someone who has an alcohol abuse problem or is an actively drinking alcoholic prompt similar fight-or-flight, non-thinking reactions in the codependent. When a drunk person comes raging towards you, calling you names, you react. You may try to get out of the way. You may start yelling. You may leave the house. But, in general, you don’t just stand there — thanks to adrenaline and the fight-or-flight communication networks in the Limbic System.

The repeated surges of adrenaline required to keep you safe in a dysfunctional home — always on high alert in order to uphold the family rules — cause your brain to eventually REACT without THINKING to hundreds of situations. What might trigger the alcoholic’s (or alcohol abuser’s) negative behavior one time, for example, doesn’t trigger it the next, and eventually, just about anything might trigger it. What worked to keep the children safe or calm or directed last year, no longer works this year. So a new approach is tried and then another and another. This constant high alert level of reactivity eventually becomes a chronic state of hyper-vigilance. This causes the codependent’s brain to become comfortable with a heightened level of adrenaline (and other related neurotransmitters and hormones) and angst. That comfort level then becomes “grooved,” if you will (because the same communications networks are used over and over again), and allows a codependent to experience the unacceptable as acceptable.

Part of living your life will be learning how to redirect your non-thinking reactions away from the fight-or-flight communications networks in the Limbic System and toward the rational, calm, thinking-and-response communications networks in the Cerebral Cortex. It is from the Cerebral Cortex that you’ll be able to change the codependent coping skills you’ve adopted in order to survive — change them to ones which will allow you to thrive!

Suggestions for how to make these changes and for help with identifying the copying skills you’ve likely adopted (so that you can better recognize the behaviors you’d like to change) are found in my book, If You Loved Me, You’d Stop!… This information can help you change your brain’s wiring — move it from the Limbic System to the Cerebral Cortex where you can respond instead of react — and thus improve the quality of your life — regardless of whether or not your loved one stops drinking or not.

__________________________
(1) Neimark, Neil F., M.D., “The Fight or Flight Response,” Mind/Body Education Center, http://www.thebodysoulconnection.com/EducationCenter/fight.html

by Lisa Frederiksen

The “Rapid Response to College Drinking Problems Initiative” is a grant program supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in response to survey findings showing a dramatic rise in alcohol related deaths amongst college students and the number of students binge drinking. Through the initiative, NIAAA scientists worked with 15 colleges facing alcohol-related crises, pairing them with five multidisciplinary teams of prevention and intervention experts, according to the NIH News release. Quoting from the release, “[t]he collaboration yielded a mix of programs that showed different benefits. Examples from their findings include the following:

• James F. Schaus, M.D., and colleagues at the University of Central Florida found that brief motivational interviews proved effective for high risk drinkers seen in a busy college health clinic. Compared to a control group, students who participated in two sessions reported consuming less alcohol six months later and had fewer drinking-related problems nine months later.

• Hortensia Amaro, Ph.D., and colleagues at Northeastern University in Boston developed a one-on-one counseling program for students with alcohol and drug policy violations. Six months later, students who received the intervention were drinking less than counterparts who had not been through the program.

• Joseph A. LaBrie and colleagues at Loyola Marymount University in Los Angeles evaluated the long-term effectiveness of a motivational-enhancement group intervention for first-year college women. Participants consumed significantly less alcohol across 10 weeks of follow-up, but not at six-month follow-up, suggesting the need for booster sessions during the first year of college.

• Two separate studies developed programs in which colleges worked closely with their surrounding communities, using measures such as increased police patrols in problem neighborhoods and raising student awareness of their responsibilities as community residents. The studies found reductions in heavy drinking and a decrease in the number of off-campus incidents involving students. One study was led by Mark D. Wood, Ph.D., of the University of Rhode Island, and the other by Robert F. Saltz, Ph.D., of the Pacific Institute for Research and Evaluation, working with two universities in Washington state.

• Another study found that colleges have made online alcohol-policy information more available and accessible to students, parents, and other interested parties. This shift may reflect a greater engagement of colleges and universities in the issue of drinking on campus in general, according to lead author Vivian B. Faden, Ph.D., acting director of NIAAA’s Office of Science Policy and Communications.”

Consider passing this information and NIAAA’s Statistical Snapshot of College Drinking along to your college student and(or) the student health administrators of your student’s college.

by Lisa Frederiksen

I’m writing this post with input from my daughters - ages 21 and 20 - neither of whom live at home, but both of whom went through those long summer days when the parents were gone, the beach was hot and there was nothing to do. We’ve put together the following suggestions to help parents cope with teens, summer and the temptations of alcohol:

1.   Talk to your teens about the latest research on brain development and the impact of alcohol during years 12 - 25. What?!?

• One of the things that helped my daughters was to better understand why not drinking during one’s teen years is important. This is not to say that they don’t, haven’t or won’t, but the information was extremely helpful. Don’t make it a lecture - more of a conversation -  click here for help.

2.  Empty the house of alcohol or monitor it carefully.

• Somehow this can feel as if you’re “telling” you teen you don’t trust them not to sneak or take your alcohol, but it’s best not to present the temptation. It gives them a solid out, “My parents don’t have any in the house,” or “My mom counts the beers in the frig.”

3.  Make connections with the parents of your teen’s friends.

• This is so much easier said than done as it feels like you’re intruding on your teen’s life, and, again - not trusting them. But, it’s the same idea - you remove the temptation. If you track on your teen’s whereabouts and confirm another parent is on board with oversight, you’re really helping your teen avoid the situation of trying to protect or go along with a friend or friends and what can happen when parents aren’t home.

4.  Monitor your own alcohol use.

• Check out this website, Rethinking Drinking, to review your own alcohol use and confirm that you are staying within moderate drinking limits. Most importantly, if you and your spouse take the kids out to dinner and share a bottle of wine and one of you drives home, the message is, “there is an amount you can drink and still drive safely.” Teens notice this and think the same can be true for them or one of their friends who “only had a couple” and offers them a ride home.

5.  Be up and awake when your teen’s curfew arrives.

• Set the alarm and get up fifteen minutes before your teen’s curfew. This way, they have the excuse that they can’t drink because “their mom is always up waiting for them.” They know that you’ll talk to them, hug them and kiss them goodnight and thus be able to tell instantly if they’ve been drinking, which they can share with their friends as a reason they can’t drink.

Most importantly, talk frequently and often about alcohol use / abuse / dependence. Use television programs, ads, articles, news headlines or sporting events as segues to talk about how people use alcohol, why they do, what might they do instead, how they act, whether a 32 ounce cup is “just a drink”…you get it. Click here for additional information and suggestions for talking with teens.

by Lisa Frederiksen

With Patrick Kennedy’s decision to check into an addiction treatment center “…to temporarily step away from [his] normal routine to ensure that [he is] being as vigilant as possible in [his] recovery,” according to Erick Tucker’s Associated Press report, there has been a great deal of headline news on his decision, which brings up the subject of relapse.

Relapse is not uncommon.  To learn more about relapse and ways to help the brain strengthen it’s “stop” system, check this out — a site produced by HBO in collaboration with NIAAA, NIDA and the Robert Wood Johnson Foundation.

Patrick Kennedy is to be commended for his courage to do what he needs to do to protect his recovery and for all of the work he’s done to raise public awareness about the disease of addiction and its related issues.