Am I an alcoholic (Part 2 of 2)

Am I an alcoholic? This blog is the second of a 2-part series in which I discuss this question that I am asked roughly once a month in my counselling practice in Bishops Stortford – (though sometimes it is asked as: “how can I know if I’m an alcoholic?”). It is not a question however I can answer simply by looking at somebody – it’s not like alcoholics set off sirens or begin flashing once they’ve tripped over that elusive line between heavy drinker and alcoholic. So, how can one tell then?

This week’s blog will describe and discuss a simple test anybody who is concerned about their drinking can perform in a effort to determine if, or how much of a problem they may have with alcohol. In my Bishops Stortford counselling practice, I always make it clear to anybody who asks me “Am I an alcoholic?” that I am unable to answer that question for them, but they can easily answer it for themselves. In doing this, we devise an experiment that can be conducted at home, in between sessions. We then discuss the results of this experiment together in the counselling room to evaluate the outcome.

The experiment

Step one: I ask each individual client to describe for me what, in their own opinion is an appropriate amount of alcohol intake (for them) each week.

I cannot stress enough that there is absolutely no input from me in this description, nor do I have anything whatsoever to say about their opinion as to what is an appropriate level of drinking for them. We are not trying to compare their thinking or opinions with any sort of national guidelines, what their partner might feel is right, or any other benchmark from any other source.  This is not an exercise in determining whether any individual’s ideas about drink match somebody else’s. The purpose is to establish what this specific individual feels is an appropriate level of drinking for them.

In doing this, I would first write out the days of the week on a sheet of paper. Next, we would go through each day and identify what would, in that person’s personal opinion, be an alcohol intake they would personally see as “appropriate” and that they would be content with if that was their level of drinking.  If therefore, on a Monday that person believed that a single glass of wine is appropriate, this is what I would write down. On the other hand, if they believe instead that 15 pints of lager is appropriate for a Monday evening, then 15 pints of lager is what I would write down. As I stated above, there is absolutely no judgement or comparison from external guidelines whatsoever during this exercise. We are only working to identify a level of drinking that this specific individual would feel OK about.

Step two: Having established this individual’s opinions as to an appropriate level of drinking during an average week, next we have to test whether that person is actually able to stick to those levels.

I am very aware that at first glance, this test may not seem a particularly difficult one for people to pass. It might seem that for those individuals who have stated 15 pints of lager each work night is appropriate, I am doing little other than enabling them to drink to unsafe levels. It might be seen that in asking people to place any limit they wish on their own drinking, that I am encouraging them to drink to inappropriate levels.

The reality however is usually very different. My experience is that when people provide me with their own guidelines as to what constitutes a level of “appropriate” drinking for them, they provide me with an amount that is less than what they are drinking now – regardless of that level. If an individual has come to counselling concerned they may have a drinking problem and are currently drinking 6 glasses of wine each evening, then in their description as to what is appropriate they will naturally lower that level to 3 or 4 glasses. If it is 15 pints of lager, they’ll state 10 pints as the safe amount. The test here is not: Can this person drink within levels set down by NICE guidelines?, but: Can this person stop drinking when they reach a level they personally have deemed “appropriate” without undue difficulty?

You see, ultimately the key to answering the question: Am I an alcoholic? comes down to the answers to a series of other questions. Questions like:

• “When drinking, do I regularly drink more than I intend?” (the stated self imposed boundaries laid out in step one).
• “Once I start drinking, do I consistently break through my own, self-determined boundary?”
• “Have I found that I need self imposed boundaries to keep myself from over drinking?”
• “Do I need such boundaries in any other areas?” For example: “Do I need to set a safe limit on my intake of  Brussels sprouts, or do I only need to monitor my intake of alcohol?” 
• “Even if I do manage to keep myself to my own, self determined boundaries, do I struggle to do so?”

To those who love and care for people with alcohol problems, these questions are immediately answerable. The problem is that almost nobody is prepared to listen to those answers coming from another. These must be asked, and answered for ourselves. It is only in answering these questions for ourselves can we determine whether we may be alcoholic.

If you are concerned about your drinking, there is a tremendous amount of information on the website for Alcoholics Anonymous. If you live in the Bishops Stortford area and you would like to speak with somebody about this topic in a confidential manner, please feel free to call 01279 836647 for a no obligation discussion of your needs, and to possibly arrange a private meeting.