Paul Henry

Following a Ph.D. into the neuromechanisms of addictive behaviours (across gambling disorder, alcoholism and addiction), Paul Henry (pseudonym) is a researcher, recovering alcoholic, and blogger.

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Paul Henry

Paul Henry

Following a Ph.D. into the neuromechanisms of addictive behaviours (across gambling disorder, alcoholism and addiction), Paul Henry (pseudonym) is a researcher, recovering alcoholic, and blogger.

Posted by on in Alcoholism

 

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This was originally written as a feature article for Keys to Recovery Newspaper in 2018.

This article addresses how 12 step recovery treats the emotional disorder which underpins the “spiritual malady” that drives alcoholism.

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Posted by on in Alcoholism

 

In our previous blog we wondered if some commentators, who have co-occurring disorders may be puzzled at how having a “spiritual malady” could be related in any way to have a co-occurring condition?

This is a pretty valid question?

In fact this may be at the heart of the issue in many cases  of feeling the need to take medication  for so-called co-occurring conditions?

Seeing alcoholism as partly the product of a spiritual malady, instead of the affective disorder I believe it to be, may influence certain AAs to seek additional help for supposed additional conditions when the manifestation of these conditions may actually be part of the emotional disorder of alcoholism?

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Posted by on in Drug Addiction

 

A recent blog in the After the Party Magazine  has raised some very pertinent questions about the issue of co-morbidity in alcoholics and addicts seeking recovery via 12 step groups and suggests the extent of this co-morbidity is much higher than may have been anticipated.

This blog raises important issues but ultimately may leave more questions than it answers?

The blog starts “You hear it in 12-step meetings all the time—people who were once on psych meds discovered they didn’t need them after getting sober and doing the steps. Now they’re evangelizing at every meeting in town about how their problem was really just spiritual. Maybe they were never mentally ill to begin with or maybe the steps really did banish their mental illness right out of their brains. But for me, and plenty of others I know, this isn’t the case.”

The author then continues ” If anyone has any questions about psychiatric meds AA has an official stance that’s in a pamphlet called The AA Member—Medications and Other Drugs. ”

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Posted by on in Drug Addiction

In a recent blog from the Recovery Research Institute http://www.recoveryanswers.org/blog/12-step-mutual-help-and-medication-assisted-treatment/

by  Brandon G. Bergman, Ph.D. 

It was suggested that a survey of almost 300 long-term AA members (average time in recovery 13 years), more than half felt medication to resist alcohol cravings/urges was or might be a good idea, and 17% did not think it was a good idea, but were “OK with it”.

Obviously if these AA members have a respect for the Traditions of AA they would have been responding to the survey as individuals in recovery? As Tradition 10 of Alcoholics Anonymous states:-

“Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.”

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Posted by on in Alcoholism

 

 

Here I am being interviewed at length by Chris Aguirre on his excellent Since Right Now podcast about my theories of addiction, and other research, my experience of addiction and recovery and how academic and so-called anecdotal or “experiential”  evidence have been combined to shape my world view regarding what I believe is at the heart, the pathomechansim, of addictive behaviour and also what recovers in  recovery and why?

https://soundcloud.com/klen-and-sobr/episode-1516-paul-henry-the-alcoholics-guide-to-alcoholism

 

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Posted by on in Alcoholism

 

There has much discussion of the effectiveness of AA in recent weeks and months.

In order to address this complicated area of studying the effectiveness of a group which does not lend itself easily to being studied we will refer to cite and choose excerpts from an excellent study on AA from a number of years ago (1).

This is one of the most definitive studies of how and why AA works.

"Research on the effectiveness of Alcoholics Anonymous (AA) is controversial and is subject to widely divergent interpretationsThe goal of this paper is to provide a focused review of the literature on AA effectiveness that will allow readers to judge the evidence for AA effectiveness themselves.

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Posted by on in Alcoholism

 

In a recent blog a few days ago I challenged some of Gabrielle Glaser's "evidence" in her article   “The Irrationality of Alcoholics Anonymous “, which purported to demonstrate the so-called effectiveness of "controlling drinking".

Glaser cited the following in her article

“ To many, though, the idea of non-abstinent recovery is anathema. No one knows that better than Mark and Linda Sobell, who are both psychologists. In the 1970s, the couple conducted a study with a group of 20 patients in Southern California who had been diagnosed with alcohol dependence.

Over the course of 17 sessions, they taught the patients how to identify their triggers, how to refuse drinks, and other strategies to help them drink safely. In a follow-up study two years later, the patients had fewer days of heavy drinking, and more days of no drinking, than did a group of 20 alcohol-dependent patients who were told to abstain from drinking entirely."

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Posted by on in Alcoholism

 

In my previous blog blog we asked the question whether  neurobiological or “conditioning” or reinforcement models of craving predict relapse in abstinent alcoholics and addicts?

For us this is the most essential question. How do we explain relapse in those individuals motivated to remain abstinent, especially when they have followed some form of treatment, including 12 step groups?

We have seen that most relapse seems to be prompted by psychological stressors such as interpersonal relationships and the failure to cope with these.

This is very different to conditioning or reinforcement models that simply posit that people relapse because of the lure of alcohol or drug related stimuli, “cues”, or cues in the presence of stress or negative emotions, which we believe does have some affect.

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Posted by on in Alcoholism

What is craving?

Craving can persist years into abstinence (1).

Precise definitions of craving have remained elusive (2-5). Two general categories are based on conditioning and cognitive mechanisms (6) but are not mutually exclusive.

A Neuroadaptive Model of Craving – Scientists believe that a gradual and, perhaps, permanent adaptation of brain function (i.e., neuroadaptation) to the presence of alcohol is a central feature in the development of alcohol dependence (7,8).

Conditioning Models – The “conditioning” models posit that cues elicit the same physiological and psychological response as drug consumption itself  with these ‘respondent’ conditioning theories predicting that responses to drug-related cues either reflect aversive abstinence symptoms or mimic drug effects  have dominated explanatory models in cue reactivity studies (9).

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Posted by on in Alcoholism

Involuntary retrieval of drug related thoughts is a hallmark of addicted populations.

Intensity of obsessive thoughts about alcohol predict relapse rate (1), with addicts motivated to use drugs to “silence” obsessive thoughts (2).  The idea that abstinence automatically decreases alcohol-related thoughts is challenged by research (3) and supported by clinical observation that among abstinent alcohol abusers, alcohol-related thoughts and intrusions are the rule rather than exception (4).

Modell and colleagues (1992) highlighted symptomatic similarities between addiction and obsessive compulsive disorder with subjective craving for drugs or alcohol characterized as having obsessive elements. (eg, the compulsive drive to consume alcohol, recurrent and persistent thoughts about alcohol, and the struggle to control these drives and thoughts) similar to the thought patterns and behaviours of patients with obsessive-compulsive illness (5).

Modell et al. also point to the potential similarities in underlying neural pathways implicated in the two disorders, suggesting that they may share a similar aetiology. The Obsessive Compulsive Drinking Scale (OCDS) implies that as the severity of this illness progresses, so does the intensity of the obsessive thoughts about alcohol and the compulsive behaviours to use alcohol.

Kranzler et al. (1999) showed relapsers who scored higher in ‘obsessions’ craving measured by the OCDS predicted relapse in the 12 months after treatment completion (6).

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