Cecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for us in many articles over the years. This week, she responds to a 58-year-old woman who knows she is drinking too much.
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Dear Dr. Ford,
I am a 58-year-old woman with two grown children who are successfully launched. I have been married for 28 years, and the marriage, while not exciting, is stable. Lately I have been worrying that I am drinking too much. I work in PR, and there is some entertaining involved in my business life. Also, my nightly glass of wine at home has become two or three, and I find that I am looking forward to it more and more.
How can I tell if I have a problem or not? Could I be an “alcoholic?” I don’t really want to have to stop, but it’s what doctors seem to tell you you have to do.
Holly
Dr. Ford Responds:
Dear Holly:
Many people worry about their drinking habits, wondering if they are abusing alcohol or not. The answer used to be, “If you are worried that you have a problem, you have a problem,” and the advice was, “Quit kidding yourself and quit.”
A more nuanced view has developed over the past few years. Many experts now believe that while some people cannot drink moderately, and total abstinence is the only answer, others find that it is possible to limit their drinking.
The first step is to evaluate the extent of your problem. There are several questionnaires online that can help you find an answer to your question. These sites also give treatment recommendations. Substance abuse is such a widespread problem these days that there are many different levels of options for those seeking help.
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In fact, alcohol use in women has risen significantly in recent years, leading to both more widespread acceptance and to abuse. Savvy merchants now market wines with names like Mommy’s Time Out. Gabrielle Glaser, in her book Her Best-Kept Secret, reports that many more women drink secretly at home. Canadian substance abuse specialist Bruce Alexander speculates that both the stress of modern life and the increased isolation of family members from each other are contributing factors.You don’t have to live far from your loved ones in order to feel isolated, however. Many people in long-term marriages find that, over the years, intimacy wanes to the point where the couple live like roommates or “ships passing in the night.” “Emptying the nest” can exacerbate the feelings of loneliness and isolation that a woman in this kind of relationship feels. Drinking can be the only reliable pleasure she has, at least at home, both disguising and soothing unhappiness.
Drinking is also part of your work life, however, which makes you feel that it is not only endorsed, but also perhaps expected of you. Thus you have a problem to battle on two fronts at once. Recovery experts often recommend the avoidance of “triggers,” which are situations, people, or stimuli that are associated with the negative habit or behavior, but it is unrealistic to expect you to be able to avoid such situations altogether if they are part of your job.
You may find that you can moderate your drinking without giving it up altogether. As I said, there are more options available now for people who may not want to—or be able to—embrace total abstinence. Sometimes people with a manageable problem will avoid seeking help because they feel that abstinence is their only option.
My colleague Dr. Andrew Tatarsky founded the “harm-reduction” program at the Center for Optimal Living, in New York City, when he was working at a treatment center that would not accept any clients unless they agreed to give up drinking from the start. He found that many people who desperately needed help were being turned away, and reasoned that it is unrealistic for therapists to expect patients to adopt the FINAL GOAL of the treatment process at the beginning, rather than the end.
However, experts insist (accurately) that people often lie to themselves (and others) because they want to continue drinking. I recommend that you make as honest an evaluation as you can, keeping in mind that you do not have to eliminate your behavior completely if you are ready to change. You may find that you can alter your routines, develop new habits, and improve some of the circumstances in your life enough that you can learn to drink moderately, or even minimally.
It is important, though, that you begin to take steps, no matter how small, to address your concern. The tragic death of actor Philip Seymour Hoffman this week has reminded us that anyone, no matter how talented, celebrated, or blessed, can fall victim to the monster of substance abuse. Don’t let fear of being defined by, or shamed by, labels hold you back. Any change, no matter how small, will lead to an improvement in your life.
Dr. Cecilia Ford
