Q. Do you think that alcohol is the kingpin of British socialising, and if so, why?
A. I think historically perhaps it has been. Culturally, a lot of social engagement has taken place at the pub. But this is starting to change, whether it's couples meeting for first date 'coffee' rather than automatically going to a pub. Or even a group of mates choosing to meet up for morning sober raves instead of going to a drink and drug heavy club. I definitely feel there's a shift in the way people are socialising.
Q. Alcohol can act as a social lubricant, but it also erases inhibitions, which can be embarrassing and risky in social settings, so can we talk about that?
A. Many of my clients express anxiety over the impact of their drinking, particularly in work situations where they don't remember what they said or even who they spoke to. While alcohol may feel initially like a conversation ‘lubricant’, unfortunately it can become an inappropriate ‘laxative’. For some, the price of relieving social anxiety can be regret the day after. Others find that alcohol triggers them to call their ex or stalk them via social media.
Q. Given alcohol is a disinhibitor, encouraging more impulsive decisions, it can be tricky to stop drinking once you've started, is that right? The alcohol itself removes the capability to say no to more?
A. For some, alcohol not only can beget the consumption of further alcohol but can act as a ‘gateway drug’ to cocaine and other addictive substances. I’ve worked with several clients who find that after one or two drinks, not only can they not stop themselves from drinking more, but calling a drug dealer is also a virtual inevitability. None of my clients who take cocaine take it sober.
Q. Why is sober socialising nerve-wracking at first?
A. If you've relied on alcohol as a disinhibitor, as a social crutch, then the removal of that crutch without having learnt to walk without it can feel really destabilising and potentially exposing too.
Alcohol distorts our mental clarity, something that's widely acknowledged even in those that have no desire to give up or temper their consumption. But what’s less widely appreciated, I feel, is the aftermath of alcohol consumption. A friend of mine coined two alcohol related acronyms, which I think nail it – PAD – which stands for Post Alcohol Depression and PAS – Post Alcohol Stress.
The irony is that many of my clients who suffer chronic anxiety also drink a lot. In the short-term alcohol can silence the anxious thoughts but inevitably they return with greater intensity when they’re withdrawing from alcohol. Most of my clients who self-medicate this way also feel intense shame about it – they often express a sense of frustration about why they do it to themselves KNOWING that the outcome will be that they feel twice as bad about themselves. So while the act itself feels self-destructive, their self-judgement on the drinking compounds the feeling even further. Many people use alcohol as a flimsy plaster to cover their wounds; but often those wounds need exposure to the air to heal.
Q. We realise that you're a psychotherapist rather than a neuroscientist, however, have you learnt anything interesting about the neuroscience of non-drinking?
A. A psychology lecturer of mine once used the analogy of ski-runs when explaining neural pathways, which I found really helpful. A strong neural pathway is like a well-worn ski track. For example, maybe I come home from work, go to the fridge and pour myself a glass of wine. The brain allows me to do this without much conscious thought because it’s regular, it’s routine.
Trying to build a new behaviour (say choosing to do some yoga when you get home or grabbing your trainers and going out for a walk to let off the work stress) is like going off-piste skiing. It requires more deliberate effort, more conscious navigation.
However, the more you navigate the new off-piste route, the easier it becomes to ski down, and at a certain point, it becomes your main route. This is thanks to the fact that the brain is a living organ, thus our neural pathways are flexible and we are capable of developing healthier habits over time.
