Alcohol Use During the Pandemic
As the coronavirus crisis disrupts clients’ usual routines and attachments, how do we assess for problematic drinking, and support clients to find alternative sources of safety and security? To mark Alcohol Awareness Week, addiction specialist Stefan Walters shares some helpful questions for exploring clients’ relationships with alcohol during the pandemic.
Many of us will be familiar with the saying that ‘addiction is the opposite of connection’. Often, when a connection to secure attachment figures has been lacking or disrupted, this trauma can result in a dysfunctional relationship with alcohol, frequently becoming a reliance and habitual addiction over time. The alcohol itself becomes the object of attachment, and clients will often report that their drinking provides them with the brief sensation of safety and security and emotional regulation; despite the awful consequences. Over time this relationship can disintegrate from a secure attachment to a dysfunctional and chaotic one, as it develops into a physiological dependency, as well as a psychological one, and becomes a true addiction.
So how do we assess for this, especially during a pandemic, when so many of our clients’ usual attachments are going through a period of disruption? How do we help our clients to determine what qualifies as ‘problem drinking’ at a time when social drinking is not even possible, and alcohol might be seen as a source of much needed relief? And how can we help clients to develop new methods of accessing that feeling of safety and security, during such an unprecedented and traumatic time?
It may be useful to ask very specific questions to explore the emotional and logistical impact of the current pandemic on our clients’ lives:
- How do they feel it has impacted their social connections?
- If they are feeling more disconnected, how are they managing this?
- How do they feel about the increase in time spent at home?
- If they live alone, how are they combating loneliness?
- If they live with others, how is the sudden increase in proximity and time together impacting those relationships?
- Are they experiencing boredom or stress, and how do they manage those feelings?
- What does their daily routine look like at the moment?
- We can also ask directly about their alcohol use at this time:
- Is there alcohol in the home, and how do they feel about this, or decide how much might be appropriate to consume?
- What are the specific emotions or triggers that they might associate with alcohol at this time?
- What resources are available to them if they do start to feel that they are emotionally dysregulated, or that their alcohol use might be problematic?
These questions may be particularly important with clients who have experienced addictive tendencies in the past; whether to alcohol, or to other substances and habits. They may be vulnerable and at risk of developing new addictions, or of resorting to old coping strategies. We are all feeling more vulnerable, therapists included, at a time when so many of the things we used to rely on for emotional regulation – such as our old routines and familiar social networks – have been suddenly taken away from us.
In the past, our clients may have been able to seek support from multiple sources such as friends, family, meetings, sponsors, or fellowship. They will now need to find new resources, and it is so important that we explore these options and also help them to find and strengthen an internal sense of resource, through therapy.
Whatever our modality may be, the most important asset in therapy is the attunement we have with our clients, and our ability to hold space for them. As long as we continue to maintain this, and to build a secure base with our clients as they process their traumas, then we can be sure that they will begin to access that felt sense of internal safety and security that will help them to self-regulate. In doing so, we move them out of the chaotic or dysregulated states of the nervous system and back into a safe and secure state of regulation and flow.