Lynne S. Gots, Ph.D.
Licensed Psychologist
Myths about Alcohol Abuse
By Lynne Gots, posted on February 22nd, 2012.
Alcoholism has been front and center in the news lately. As have countless stars before her, Whitney Houston succumbed to a lethal combination of prescription sedatives and alcohol before drowning in a hotel bathtub. George Hugeley V, the UVA lacrosse player convicted today for the murder of his ex-girlfriend Yeardley Love, kicked down the door of her room in an alcohol-fueled rage and is alleged to have smashed her head against the wall, leaving her to suffocate in her own blood-soaked pillow. Stories like these mislead us into thinking that alcoholism is always accompanied by drama and dissipation. Not necessarily.
Myth # 1: It’s easy to spot an alcoholic.
Contrary to popular belief, many alcoholics manage to keep their drinking under wraps and lead quite functional lives—until they don’t. You don’t have to be a drunk to be an alcoholic. Some alcoholics never appear intoxicated.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholism is characterized by the following criteria:
Craving –A strong need, or urge, to drink.
Loss of control –Not being able to stop drinking once drinking has begun.
Physical dependence –Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking.
Tolerance –The need to drink greater amounts of alcohol to get “high.”
Alcoholics often fool themselves into thinking they’re not alcoholic because they can “hold their liquor.” In fact, a high tolerance for alcohol is one characteristic of alcoholism.
I once treated a patient who came home from work every day, ate dinner with his family, and then drank a case of beer after everyone went to bed. He looked forward to his routine and didn’t see a problem with it because he wasn’t out at the bars and never missed work.
Was he an alcoholic? You bet. He craved his nighttime beer, had to finish his entire stash in one sitting, felt shaky and anxious if he couldn’t drink, and rarely appeared drunk.
Myth #2: If you’re drinking to “self-medicate,” you’re not an alcoholic.
I’ve heard this rationalization countless times. Sorry. It doesn’t matter whether you’re drinking because you love the taste and feel of booze or just to steady your nerves. If you’re dependent on alcohol to get through the day or cope with another problem, you’re an alcoholic.
Here’s an interesting factoid: About 20% of patients in treatment for Social Anxiety Disorder are also alcoholic.
Myth #3: You don’t have a drinking problem if you don’t drink every day.
Alcoholism is only one type of alcohol-related disorder. Problem drinkers may not be physically dependent on alcohol—that is, they don’t go through withdrawal when they stop drinking—but drinking may still interfere significantly with their lives. And, problem drinking can lead to alcoholism.
These questions from the NIAAA can help you determine if you have a drinking problem:
Have you ever felt you should cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
One “yes” answer suggests a possible alcohol problem. More than one “yes” answer means it is highly likely that a problem exists.
It can be especially hard to recognize that you have an alcohol problem if heavy drinking is the norm among your colleagues or friends. Many a college student has told me about prodigious excesses, while firmly denying a problem exists. Even though binge drinking is widespread on college campuses, its ubiquitous presence doesn’t necessarily inoculate students from becoming alcoholic. It just makes alcoholism harder to detect unless, as with George Hugeley V, the alcoholic is prone to violent rages. His friends, themselves hard drinking college athletes, were alarmed enough by Hugeley’s behavior to consider staging an intervention. But they didn’t, and then it was too late.
Self-deception goes hand in hand with alcohol abuse. If you find yourself invoking any of the three myths I’ve talked about to convince yourself or others you don’t have a drinking problem, you might want to reread the questions from the NIAAA. Most important, answer them honestly.
Posted in Mental Health and the Media |
Empty Calories: Psychotherapists Talk about Cupcakes
By Lynne Gots, posted on February 9th, 2012.
I’d been planning to continue my discussion of psychology in the media in a post about alcohol and drug abuse, but that topic will have to wait. I can’t resist seizing a timely opportunity to comment on an article in this week’s Food section of the Washington Post.
The piece, part of a spread on the cupcake craze, starts with the headline, “Harmless or Hedonistic? An unfrosted look at how they feed our souls.” The reporter explores the long history of the diminutive confection and interviews bakery owners, economists, and food trend commentators about the explosion of cupcake emporia in the mid-2000s. All fine and kind of interesting to me because I like to keep up with food trends. But then the journalistic train starts to wobble wildly and finally careens completely off the rails when a number of mental health “experts” weigh in. The reporter quotes a psychiatrist; a “registered interventionist,” whatever that is, who’s a regular on The Dr. Oz Show; a psychoanalyst; and two “psychotherapists,” one of whom has also received the Dr. Oz seal of approval. Dr. Oz, by the way, is a cardiac surgeon, not a psychologist or psychiatrist.
Paraphrasing couldn’t begin to do justice to the psychological interpretations, so I will reprint them verbatim.
Everyone has come [to the bakery] for a hug. People are lining up not just because the cupcakes taste good. A lot of things taste good. They’re looking for that same feeling inside. They’re all hungry for hugs.
Cupcakes are indicative of where this country is with our desire to self-soothe through food. People tell themselves, ‘One won’t hurt me” because [cupcakes] are so small, dainty and delicious. Our desire for more and for self-soothing is out of control.
A good childhood experience is going to be relived over and over again as an adult. The experience [of buying cupcakes from a truck, like the ice-cream trucks of childhood] might evoke, consciously or unconsciously, a very positive experience of feeling connected to one’s parents and feeling special in one’s parents’ eyes.
And the best quote—and by best, I mean the most patently absurd piece of [looks like chocolate cupcake frosting] I’ve ever heard:
The popularity of cupcakes directly tracks the rise in cultural narcissism that has resulted from the Internet’s impact on our individual and cultural psyche. Through our over-reliance on the Internet, we’ve become a culture of emotionally disconnected individuals who live in socially isolated cyber-fantasy worlds. The fantasy worlds we create for ourselves on the Internet are an equivalent of the modern myth of Narcissus where we spend hours in an isolated aggrandizement of self. Through cupcakes, seemingly innocent little ‘treats,’ we can project fantasies of who and what we desire to be. Instead of connecting us to others, however, cupcakes keep us separate and add to our sense of isolation. . . cupcakes evidence the narcissism born of the Internet by feeding us in shallow and un-nutritious ways. Similar to the way we cruise the Internet looking for bite-size and delicious bits of information, cupcakes enable us to cruise the sugary world of self-indulgence.
Where to begin? After I finished reading the opinions of the therapists , I felt the powerful urge, which I am now indulging, to scream: I AM NOT ONE OF THEM!
Had the reporter interviewed me, I would have suggested that our current obsession with cupcakes–and I don’t mean “obsession” in the clinical sense–is a fad, plain and simple, like flagpole sitting in the twenties (boy, those Dr. Oz experts could have really had a field day with that one!). Food trends come and go. Remember bagels in the nineties before everyone worried about carbs and became gluten-sensitive? Did their popularity stem from a need to fill an empty hole in the middle of our soul? Or how about our rampant consumption of foamy coffee beverages? Maybe the omnipresence of Starbucks signifies our yearning for connection by means of a shared caffeinated experience.
Whatever.
I could sure go for a cupcake right now. I wonder what that means.
Tags: cupcake craze, psychobabble
Posted in Mental Health and the Media |
Three Common Myths about Obsessive-Compulsive Disorder
By Lynne Gots, posted on February 8th, 2012.
In TV shows and movies, Obsessive-Compulsive Disorder (OCD) is often played broadly for laughs. Emma Pillsbury, the prim guidance counselor in Glee, wears disposable plastic gloves to eat, polishes her fruit, and cleans her pencil sharpener for an hour because she “doesn’t like things messy.” The curmudgeonly writer played by Jack Nicholson in As Good As It Gets stockpiles bars of soap for his hand-washing rituals. Monk, Tony Shaloub’s detective on the TV show of the same name, struggles with a whole compendium of other anxiety disorders along with OCD. He gets panic attacks in closed spaces, lines up identical shirts and pants in his closet and avoids cracks in the sidewalk.
Compulsions—repetitive behaviors performed to reduce the intense anxiety brought on by a feared object or mental image (i.e., obsession)—can seem senseless and even comical to an onlooker. In fact, OCD sufferers themselves often recognize the absurdity of their own rituals even though they’re powerless to stop them. But characterizations of the illness in the popular media, exaggerated for entertainment effect, contribute to several common misconceptions about it and intensify the shame people in the grips of OCD already feel.
Here are three common myths about OCD.
Myth #1: “I don’t have OCD. I’m a slob.”
OCD can take many forms. While some people with OCD, the stereotypical neat freaks, spend hours arranging and straightening, many others don’t care at all about maintaining order. They may fixate, instead, on cleaning and washing to keep contamination at bay; counting and repeating to ward off harm from bad thoughts; or checking locks, stoves, and faucets to prevent break-ins, fires, and floods. The variations in people’s fears and the rituals they engage in to ease them are endless, although obsessions do seem to cluster in several typical categories: aggression, contamination, sex, religion, symmetry and exactness, and body-focused concerns about health or appearance.
Myth #2: “I don’t have OCD. I don’t do any rituals.”
Compulsions can be subtle, even invisible. Patients often tell me they’ve been diagnosed with “pure O” OCD, but the concept of obsessional OCD without accompanying rituals hasn’t held up under scientific scrutiny. More likely, if you think you’re engaging in pure, mental obsessions, you’re probably carrying out rituals in your head. Common mental compulsions include reviewing facts, scanning your body or environment for information to make you feel safer, and reassuring yourself in a variety of other ways. You also might be doing some things you don’t consider rituals, such as researching facts on the Internet, asking other people for reassurance to calm you down, or avoiding your OCD triggers altogether.
So how do you know if you’re performing a compulsion? It’s complicated and sometimes hard to sort out. Short answer: a compulsion is anything you feel driven to do to relieve the intense anxiety brought on by an obsession.
Myth #3: “OCD is caused by childhood trauma. You have to uncover its roots to treat it.”
Popular culture, literature, and even many therapists rooted in the psychoanalytic tradition really go to town on this one. And it makes me angry because so many people with OCD have endured bad treatment as a result.
While stress or acute trauma can certainly activate or intensify OCD—or any other psychological condition, for that matter—the root “cause” is brain chemistry and misfiring neural circuits. Or possibly a strep infection, as in the case of sudden onset OCD in childhood (PANDAs). It can be tempting to blame your aversion to germs on your mother’s fastidious attention to your toilet training or figure out why you might want to harm old ladies when an image of running over one in your car pops into your head. But such intellectual exercises are red herrings. They distract you from the real business of dealing with OCD: confronting your fears through systematically exposing yourself to them and eliminating rituals.
E/RP (Exposure/Response Prevention) treatment really helps, as hundreds of research studies have shown. It usually reduces anxiety over the long run, which is the outcome most people desperately seek. But an even more important consequence of exposure exercises, in my opinion and that of most other OCD specialists, is learning to tolerate the core fear underlying all obsessions and compulsions: the fear of uncertainty.
Movies and TV shows depict people with OCD as weird, ill tempered, endearingly quirky, or even crazy. In real life, they usually don’t stand out at all. OCD is more often a hidden illness with rituals carried out in secret. Most of the patients I see lead productive, successful lives and suffer in silence. No one would suspect the depths of their inner turmoil. Even friends or family members in whom they’ve confided can’t really understand how painful OCD is, often trivializing it, albeit unintentionally, with comments like: “I’m so OCD about that” and “Do you polish your grapes like Emma on Glee?” But you can’t really blame them for their ignorance about OCD, when the media keep getting it so wrong.
That’s why I’m trying to set the record straight.
Tags: Obsessive-Compulsive Disorder
Posted in Mental Health and the Media, Obsessive Compulsive Disorder |
