B.A.C.P. Registered Counsellor in Tonbridge, Kent

Alcohol & Substance Use Counselling

I have spent many years working with people that have difficulties with their use of substances/alcohol and behaviours and one thing I would like to point out is that we are all unique, therefore we choose to look at our struggles in different ways, we choose to face them in different ways and we have very different beliefs. I believe that it is the right of everybody to not be labelled and to choose our own words to describe our difficulties. I have met people who find calling themselves an alcoholic or addict helpful to them, I too have spoken to people that felt these words were detrimental to them seeking help.

Every ones use of alcohol, substances and behaviours is different and unique to them. Some people have a difficulty in their life with drinking or using unmanageably for a while and then never have a problem again, others discover that for them complete abstinence and changing their behaviours is the only way. I believe through counselling, groups or whichever path people choose they can find their own individual way to their solutions and their own truth.

My model is an integration of Person Centred Counselling and Brief Solution Focused Therapy. I use a person centred model incorporating a Brief Solution Focused model, Harm Minimisation and Relapse Prevention Techniques.

Person- centred therapy is a non-directive approach enabling the client to identify the changes they would like to make in life. It appears to work well when working with those struggling with alcohol/substance use and behaviours.

The brief solution focused model is focused on the future and solutions.

The aim of Harm minimisation is to address alcohol and drug issues by reducing the harmful effects on individuals.

Relapse prevention is designed to support clients experiencing difficulties after ceasing drug and alcohol use by providing coping strategies to enable them to avoid relapsing back into their old behaviours of using drugs and/or alcohol.

People can use different behaviours or substances as an escape and to self- medicate such as: Alcohol, Heroin, Cannabis, Cocaine, Mephedrone, Ecstasy, Ketamine, Glue, gasses and aerosols, GHB, Tranquillisers, ‘legal highs,’ Gambling, Sex, Cybersex and pornography.

I also have found the 12 step model to be of great help to people suffering with their use of alcohol, substances and behaviours. The Twelve Steps were originated by Alcoholics Anonymous and many members of 12-step recovery programs have found that these steps were not merely a way to stop drinking, but they also became a guide toward a new way of life. The 12 step programme can be a very helpful tool to those suffering with alcoholism and addiction and can turn lives around. The programme is also used by those who have difficulty with other substances and behaviours such as narcotics, gambling and sex.

Alcohol

People can have difficulty controlling their use of alcohol and this can have harmful consequences both emotionally and physically. These behaviours often arise from a need to escape emotions, situations, memories even life in general. Facing anything without having a drink can seem unbearable. But the process of drinking itself brings about its own difficulties and this can result in a self- defeating process affecting the one using alcohol and all those around them. Behaviours resulting from drinking can leave you feeling so ashamed and fearful that you may feel the need to take another drink to forget what has happened. Then you do something else that you want to forget – so you have another drink - a vicious cycle is set up.

Do you drink every evening or all day every day and night? Have a massive binge on alcohol about once a month stay drunk for a few weeks then just stop? Are you confused by your behaviour? Do you have blackouts where you can’t remember where you have been? Do you behave in ways that you can’t believe and feel full of shame? Is your drinking affecting your family life? Are you losing people, jobs, money? Are you in debt, feel desperate and no longer enjoy life? Perhaps you are just unhappy with your weekend drinking or the bottle of wine you drink every night?

The question to ask yourself is – is my drinking affecting my life? Think about it.

I offer you a safe, non-judgemental, caring space to really hear what is going on for you, what is happening in your life. I don’t want to label you or tell you what to do, that is your decision. Here you can talk through your problems without judgement and establish what your needs are. Counselling provides a warm and welcoming atmosphere.

Alcohol is Europe’s most widely available and frequently abused drug. In excess, alcohol is known to cause a large range of physical, mental and social problems due to its harmful and behaviour-altering properties, including liver disease, cognitive impairment, risk of accident and heightened crime.

The recommended limit for men is 3-4 units of alcohol a day and for women the recommended limit is 2-3 units a day. If you do drink more heavily than this on any day it is advised that you allow 48 alcohol-free hours afterwards to let your body recover. One unit of alcohol is 10 ml (1 cl) by volume, or 8 g by weight, of pure alcohol. For example:

  • One unit of alcohol is about equal to:
    • half a pint of ordinary strength beer, lager or cider (3-4% alcohol by volume)
    • a small pub measure (25 ml) of spirits (40% alcohol by volume)
    • a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume).
  • There are one and a half units of alcohol in:
    • a small glass (125 ml) of ordinary strength wine (12% alcohol by volume)
    • a standard pub measure (35 ml) of spirits (40% alcohol by volume).

Your liver processes alcohol and can only cope with so much at a time. Drinking above the recommended safe limit is hazardous. About 1 in 3 men and 1 in 7 women drink more than the safe limit. There are roughly four levels of alcohol drinking - social, heavy, problem and dependent. As a rule, each level increases the risk to your health and safety. Some people use the word alcoholism to describe dependent drinking.

If your body becomes used to consuming a lot of alcohol, you may start to develop withdrawal symptoms. So even if you want to stop drinking this becomes difficult because of the symptoms of withdrawal which include: feeling sick, being sick, dry heaves, trembling, sweating, craving for alcohol, and just feeling awful. Convulsions occur in a small number of cases.

As a result, you may drink alcohol more often and depend on it to prevent withdrawal symptoms. The severity of dependence can vary. The more you drink the higher your tolerance to alcohol which may mean you need more alcohol for there to be any effect. This can make things worse, as it can make you want to drink even more.

If you are alcohol-dependent you drink regularly. However, you might not feel drunk. You may ‘top-up’ – (drink smaller amounts regularly) to keep any withdrawal symptoms away. You become used to feeling this way and for you it becomes normal.You must never stop drinking alcohol without medical help, this can be dangerous even fatal, please see your doctor.

Delirium tremens (DTs)

This is a more severe withdrawal reaction after you stop using alcohol. Symptoms include: marked tremor (the shakes) and delirium (agitation, confusion, and seeing and hearing things that are not there). Some people have convulsions. Complications can develop such as dehydration and other serious physical problems. It is fatal in some cases. Call an ambulance.

People who have stopped drinking at some point in their lives sometimes drink again, this can be a one off or can lead back into heavy drinking. Many people have several attempts at stopping, there are various reasons and so much can be learnt from this and turned into positive knowledge for the future. I am often told people feel shame and I feel that may stop people seeking help again. This is an event in your journey in life and support is out there for you. There are many options you can take that can help support you, such as self-help groups, your doctor and drug and alcohol units. Please see the section for useful numbers on this site for more help.

Substance/Drug Use

I know that some people do not like the word addiction and it could also be referred to as misuse. I have also heard from people who for them the word addict helps them to face their difficulties. Again we are all unique, but whatever language we use if it is causing you problems in any way you may want some help. So for the purpose of this section I am going to use the word addiction.

Addictions can begin as a result of how people feel emotionally and physically when they use substances. These feelings can cause pleasure, relief, euphoria, escape, intense highs energy and oblivion – which can cause a powerful urge to carry out the activity again to recreate this feeling. This can develop into a repetitive cycle that becomes extremely hard to break away from.

Physical addiction is being dependent on a substance for an emotional high, even the thought of getting the substance can provoke a feeling of anticipation and can begin to calm someone. The effect of the substance can fulfil the need for a release from reality. It can provide a warmth and joy that ‘cannot be matched’. Although often the first use is the ‘best’ and the person uses again and again to recapture the original feeling, a most terrifying feeling being when the substance no longer ‘works.’

When reality returns after using, fear, hopelessness and despair can set in which leads to the desire to use the substance again to regain the feelings it brought with it. In these cases the body adapts to the substance so that it no longer has the same effect. This causes a tolerance so that when the substance is withdrawn – no longer taken- it increases cravings and the person using the substance becomes trapped in a spiral of escalating use.

Psychological dependency is more an outcome of someone using substances to cope with a psychological issue. This using of substances attempts to fulfil a need, to fill a void, a hole in their lives. Its aim is to block out bad experiences, memories and stresses. Maybe this explains the behaviour of changing from one drug to another for example drugs to alcohol, alcohol to behaviours, behaviours to drugs. The need is to do something to ease the emotional pain and distress. For many this can bring on further difficulties such as feelings of shame, guilt, despair and failure, causing rifts and problems with family members and friends.

The consequences of using substances can unfortunately be many. Some people find themselves with financial difficulties and mounting debts. Jobs may be lost due to their unpredictability. Relationships and family life suffers, homes are lost and due to the costs involved in obtaining substances being in trouble with the law is another possible consequence.

A list of indicators of dependence to substances

  • Unable to limit the use of a substance to the extent that signs of physical impairment show.
  • Intense cravings and compulsions to use the substance.
  • Escalating use of the substance - indicating tolerance.
  • Continued use of the substance despite increasingly negative consequences.
  • Irritability, anxiety, poor focus, the shakes and nausea if they attempt to withdraw from the drug or activity.
  • Repetitive lapsing/relapsing.
  • Personality and behavioural changes, such as taking risks (either to make sure they can obtain a substance or doing so while under the influence).
  • Neglecting responsibilities and important activities in everyday life, including work and family.
  • Becoming increasingly obsessed with focusing all their time and energy on ways of getting the substance.

I feel can be an escalating problem, what starts as a one off time of using something can spiral out of control and could end up with prison, homelessness and death. The first step in seeking help is usually to speak to someone about how you are feeling. The doctor can help you medically and it is important you get medical assistance, there are also treatment centres and charities especially set up to support you. There are also many self-help groups. Please see my section on further help for phone numbers and websites.

Counselling provides a new way for people to think, feel and act - and helps you to view difficult situations in a new light. I offer a supportive and caring environment for you to feel heard and understood. I am non-judgemental and committed to supporting you on your journey.