How do you know if you have a problem?

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(03/08/13)

A good friend of mine brought something to my attention. If you say things like, “I need to start watching how much I drink” or “I’m going to start moderating how often or how much I drink” then you probably already have a problem. Because if you didn’t have a problem you wouldn’t have to consciously think about moderation. And if you’re one of those people who gets a bottle of medication and follows the instructions exactly without wondering or thinking about it, then you don’t have problem potential with stuff. But if you get a bottle of pain pills or sleep medications and you look at it and think, “Huh, I wonder how many I can take? I wonder how many of these I need to catch a buzz? I wonder what happens if I drink a 12-pack with these?” Then you have problem potential.

I don’t believe that you need to fill out a questionnaire from a therapist or an online survey to determine if you have an alcohol or substance problem. The answer is usually pretty clear. If you’re taking an online survey, you probably already have a problem or you wouldn’t have sought out and taken the survey. What you were most likely trying to do is massage your mind and tweak your answers so you can look at it and say, “See, I don’t have a problem. I just need to moderate a little bit. At least I’m not as bad as (insert name).” Isn’t it interesting that while taking these surveys or talking with a therapist we will often compare our own behavior to someone else that we know.

I’m not implying that you’re a liar, but who wouldn’t talk with a therapist or fill out a survey about themselves and give answers that reflect you in the best possible light? If the answers through the online questionnaire reveal something you don’t like, you go back and change a couple of the answers. We naturally look for and often create an image of the results that we want to see. Again, this doesn’t mean you’re a pathological liar or a full blown nut case. You just want to see yourself reflected in the best possible light.

I’m going to give you a few examples of some surveys because I think this is fun stuff:

Take a clinical Psychopathy test sometime. I would be so bold to guess that if you were to take the PCL-R (Psychopathy Checklist-Revised), and providing that you answered the questions honestly, you would “qualify” as a psychopath based on certain behaviors and emotions that you at one time or another exhibited in the past. (I would be considered a psychopath—at least by my former wife and most of my former girlfriends.)

What are some of the “signs” of being a psychopath or sociopath?

  • Egocentricity
  • Callousness
  • Manipulative
  • Impulsive
  • Thrill-seeking
  • Sexually promiscuous
  • Unfaithful
  • Irresponsible
  • Deceptive
  • Secretive
  • Grandiose
  • Lack of concern for the suffering of others

(This could all sound like a fun weekend or a bad date depending on your point of view.)

Who hasn’t, at one time or another, while drunk or not, exhibited some of these traits? Fortunately, 99% of us do not continue with all of these behaviors simultaneously raging at full speed. Unless you hear voices in your head (other than your own), you’re not a clinical psychopath. But based on your “interview answers,” you could be viewed as one.

Now let’s ask some questions about whether a person is an alcoholic.

The traditional “alcoholic” questionnaire will query you about blackouts, memory loss, sexual promiscuity, missing responsibilities, volatility of relationships, frequency and amount of drinking, isolating, etc. The majority of adults could answer “Yes” to most of these questions. You say, “Aw, no way!” Well, have you ever forgotten to pay a bill or paid only the minimum amount? Have you ever argued with a friend or family member? Ever seen someone or been around someone that got you sexually aroused? Ever forget someone’s name or misremember facts?  It happens all the time to people who don’t even drink.

Now to the questions of frequency and amount you drink:

What if grandma drinks a glass of port wine every night at dinner and another glass before bed? She says it helps her sleep and has been doing this routine for 20 years. Is SHE an alcoholic? She drinks 7 days a week! On paper she sounds like an alcoholic. But would you do an intervention and send grandma off to a 12-step program? Unless grandmas going out to bars wearing a leather miniskirt and tearin’ it up as a geriatric Superfreak, you’d probably leave her be.

Here’s a more relevant example. What if you drink every day, alone, at home and never argue with anyone, always pay your bills on time, get to work on time and perform your job well. The only criteria that you match as, “An alcoholic” is that you drink every day. But what if you don’t do that every day? What if you are so controlled and under a routine that you only do it on Monday, Wednesday and Saturday night? You pay your bills, you’re responsible and you don’t go out and get into fights. However, on Monday, Wednesday and Saturday night you sit on your couch and drink until you fall asleep in front of the TV. Do you need an intervention or to go into a program? Are you an alcoholic?

I feel that it comes down to whether YOU are happy with your behavior. Do you really need clinical confirmation or exoneration to determine whether excessive drinking is causing problems or not? Who gives a shit whether you hold the official title of alcoholic or not?

When you go to outside sources or services about substance abuse, you often aren’t searching for confirmation that you ARE an alcoholic or an addict. You’re trying to massage your own mind to tell yourself that you AREN’T an alcoholic and may even use your “test results” as a way to defend yourself when others observe, suggest or outright accuse you of being an alcoholic or addict. Chances are good that if you perform a questionnaire about your drinking habits you won’t say, “Wow! Am I glad I took that test. I had no fucking idea that I drink too much. This must be my lucky day.”

All jokes and kidding aside, there is value in taking online questionnaires or talking with a therapist. Not necessarily because of the results it may show you, but because YOU are showing concern; somewhere inside of you something is bothering you about this. Being curious and recognizing that you have a substance overuse problem can be your first stage of getting your life under control.

Here’s my point. You don’t need to take all kinds of online quizzes or see a therapist to decide if YOU have an alcohol overuse problem. That decision is YOURS and the evidence is probably right in front of you. Look around your house or your car. If your garbage or recycle bin is filled with empty beer cans, booze and wine bottles the evidence is right there. (As a side exercise, take all those bottles and cans out and add them up. See how much money you spent on the creation of piss. Not a fun exercise is it, when you see the truth in numbers.) Yes, you might want to get outside confirmation from some other source, but what would that “confirmation” change? Your doctor, therapist, minister, boss, spouse or friend could all tell you, “Yes John, you have a drinking problem,” and you can still massage your own mind by saying, “Well I still have my job. I haven’t lost my home. And I’m certainly not as bad as (insert name).”

Instead of filling out a survey, talking with a therapist or attending a meeting out of curiosity, just try living completely alcohol free for 30 days. See how you feel, behave and react to life during those 30 days. (I also suggest that you stash $10 away every day during that period.) At the end of 30 days you will have a better idea if you have a drinking problem (and YOU will also be $300 richer). And if you’re already sober, maybe stop calling yourself an alcoholic. How can you be an alcoholic if you don’t drink? I’m just sayin’…

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