By Terri-Lynn MacKay
In our culture, drinking is associated with all things fun. Alcohol is associated with making dinner, going out for dinner, sporting events, patios, vacations, concerts, barbequing etc. You name it, alcohol is often involved. You can even get alcohol in movie theaters and hair salons; activities that used to have no association with drinking.
What most people don’t know is that consuming alcohol over the years actually dampens our ability to experience pleasure from everyday activities. When we engage in pleasurable activities such as eating, sex, and novelty seeking (exploring) our brains naturally release chemicals that make these activities pleasurable. When you drink alcohol, it floods the brain with these same chemicals in a way that is excessive and unnatural; that is why drinking alcohol feels so good.
But, the brain is a very adaptive organ, and what happens over time is that the brain starts to become less responsive to the natural chemicals that are produced in response to pleasure. This effect is why people who drink alcohol start to feel that everything else is boring. Very simply, when you drink alcohol, you are damaging the pleasure receptors in the brain and making everyday “normal” activities start to seem boring in comparison.
Treatment for alcohol use often includes helping people start to disentangle the associations they have with drinking. Medications can be helpful in undoing these associations. For example, naltrexone is a medication that blocks the reinforcing effects of alcohol. In essence, it works by providing an umbrella over the pleasure receptors in your brain so they will not be further damaged. Medications are used in conjunction with therapy to help people learn to re-experience pleasure.
Therapy may focus on exploring new activities or helping people cope with participating in activities that were previously associated with drinking. Many people develop unhelpful thinking patterns (termed “cognitive distortions”) about the positive impact of alcohol. For example, they may believe that they are more fun to be around, better lovers, or more skilled at activities.
Your therapist may recommend that you engage in behavioural experiments to see if your positive beliefs about alcohol are accurate. A common behavioural experiment is to have people act “as if” they have been consuming alcohol without actually doing so. Research shows that when people think they are drinking alcohol (but are actually given a placebo) they act like they have been drinking. Simply pretending you have consumed alcohol can mimic the pleasant feelings (e.g., feeling less shy) associated with drinking.
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Dr. Terri-Lynn MacKay is a licensed Clinical Psychologist who has specialized in the treatment and research of mental health and addictive disorders since 2003. She leads a team of licensed professionals who practice client-centered, compassionate, evidence-based care. She is an Adjunct Professor at the University of British Columbia and the University of Manitoba. She is an active contributor to her community through volunteer activities such as Big Sisters of BC Lower Mainland.
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