Photo by Molnár Bálint on Unsplash
“When I look back on all these worries, I remember the story of the old man who said on his deathbed that he had had a lot of trouble in his life, most of which had never happened.”
– Winston Churchill
Worry is a defence against reality. More specifically, it's a defence against feelings that arise when we are faced with the unknown and uncertainty that life presents us with. It’s also a form of rumination and commonly a process of wondering what if this, or what if that, happens. For some people worry can be endless and establishes a pattern of pessimistic thinking called catastrophising - basically, thinking the worst. Like Churchill's old man and many others who suffer this tendency, it risks persisting until you find yourself on your deathbed reflecting on all the happiness you have forfeited by worrying.
All the time you are worrying you are not present. That means you are not able to mindfully enjoy or apply yourself to things you are doing and do your best job of them. This might include talking with friends, working, studying or exercising. Furthermore, worry will likely maintain a range of physiological symptoms of anxiety that might include tension, headaches, digestive or stomach problems and cognitive disruption that are your body’s original response to the threatening feelings that uncertainty triggers in you.
In order to help my clients break the habit of worrying, I take a two-pronged approach, as I do with those struggling with other compulsions or addictions. This involves both exploring the feelings that you are avoiding, and discussing and implementing the practical strategies necessary to achieve and maintain abstinence. One of these strategies is Mindfulness, a practice that promotes calmness and improves overall well-being. It does so by helping you become better able to stay with the certainty of the present and, in turn, it strengthens your ability to interrupt the process of tormenting yourself with the uncertainty of the future.
If you are a worrier, your mind is often busy fighting to make the uncertain, certain. This is a battle you and your fantasising mind will lose because, as we all know but sometimes struggle to admit, reality always wins. So, evaluating the likelihood of which of your fantasies is most likely to come true is rarely helpful and I would risk colluding with you in this unhelpful thought process and in avoiding the feelings that reality’s uncertainty brings up for you.
In order to face uncertainty I have to help you change our focus from what you don't know in the future to what you do know in the present, and be able to accept both. As one of my clients put back to me recently, ‘...so, I must leave the unknown alone’. The practice of Mindfulness will help you with this.
Mindfulness is free, and straight-forward. You don't have to be middle class or a hippy to practise it and benefit from it. I say this because, when I mention it in my practice, I sometimes hear such prejudices about it. A state of mindfulness can be achieved through meditation or through everyday activities. Mindful meditation involves sitting comfortably or lying down, usually with your eyes closed or half closed, and focusing on your breathing. If you do this, because you are thinking human being, your mind will wander. When it does you gently guide it back to your breathing.
As long as you are focussed on your breathing - your anchor - there is no other time or place you can be other than in the present, and there is no time or place left for worrying. You can do a mediation with or without a guiding voice, but if you are starting out, a guiding voice can be helpful. To find one, you can search mindful meditations on YouTube, or download a mindfulness app. If you are trying it without a guide, set a timer for 5 minutes to start, and work up to longer meditations when you feel ready.
You can also mindfully carry out everyday activities by using the sensory experience of what you are doing as your anchor. You might do this while you are swimming, or making something, or playing a video game. When you are reading, you could consider the words on your page, your anchor. If your mind wanders, as it often does when we read long texts, you can bring yourself gently - without irritation or self-judgement - back to the words. You may be surprised that if you try you can even immerse yourself in the most mundane of tasks like washing up or brushing your teeth. Perhaps you could try it next time you are doing one of these things and notice that you are not worrying while you do it. (Remember that having TV, radio or music on in the background will divide your attention, so turn any of these things off to fully immerse yourself in what you are doing).
Now, there are times when we have good reason to think about uncertainty and the unknown. To think and/or write in order to prepare the best we can for something happening in the future. This might be an event such as a performance or a speech or a wedding; or it might be that we have to consider a series of outcomes such as we might if we were going for an interview; or we might need to consider a dilemma.
This type of ‘worrying’ is best done mindfully with a pen and paper or using the notes app on your phone, and within a time-frame after which you stop doing it, so you can focus on other things. If you worry a lot in bed when you are trying to sleep, mindful worry time earlier in the evening might help you fall asleep more successfully.
Uncertainty stimulates painful emotions in some people. This may be because it triggers a memory of a previous experience or trauma that once left you with difficult feelings like anger, sadness or guilt. To defend against these feelings when they arise again, and against the physiological anxiety they trigger, your mind turns to worry in an attempt to create certainty.
In order to be happy or, at the very least, content, we have to be able to accept life’s uncertainty and, as my client so beautifully put it: ‘leave the unknown, alone’. If you are struggling with worry you might research and then begin to introduce mindfulness into your life as well as reflect on what uncertainty meant to you as a child or in the past. If you can't get to the bottom of it yourself, you may consider seeing a therapist to help you explore your issue more deeply.
Has your dry January started badly? Have you already had a drink? Are you feeling disappointed in yourself? Are you wondering whether to get back on the wagon or not? Did you want to do something about your drinking, but a dry January didn't seem possible? Well, here’s a much better proposal. And it can even have a more profound and long lasting effect. Plus, it may very well feel less overwhelming.
Using some straightforward strategies to moderate your drinking on a daily and weekly basis will change your relationship to alcohol and are more likely than abstaining for one month to work in the longer term.
That’s not to say moderating is easy. The TV and radio presenter, Adrian Chiles, famously tackled his over-drinking last summer in a popular BBC documentary. He then updated us on his progress in a Guardian article in December. Chiles points out that his choice to drinking moderately, instead of abstaining, was by no means the ‘cop-out’ that some might regard it as. On the contrary, moderation ‘requires constant thought; hundreds of decisions have to be made every week.’ He’s not wrong. Following a YouGov poll, Public Health England announced last September that ‘two thirds of regular drinkers say that cutting down on their drinking is harder than improving diet or exercise’.
It’s important to say upfront that moderating, like dry January, isn’t an option everyone. For many heavy or dependent drinkers, a medically assisted detox, followed by an extended period of abstinence, needs to be the priority. That’s a different article, but broadly speaking, if you’re drinking 3 or 4 drinks, or more, every day, cutting down or stopping suddenly could be dangerous. Consult your GP if you think this is you.
In my counselling practice, both private and for the NHS, I frequently help those who are struggling with alcohol problems and underlying emotional issues. Part of this work involves supporting those who wish to moderate their drinking.
Although I’ve never been alcohol dependent myself, I have had very long periods of daily drinking and over-drinking. In my 40s - I am now 51 - I started to moderate my drinking, and experience the physical and mental health benefits. The process also highlighted the things I didn’t miss about drinking so much: poor sleep, moodiness, anxiety, flatness, sweating, smelly farts and messy poos. Understanding the pitfalls and difficulties of working towards and maintaining moderation, now helps me in my work with those who want to do the same.
Some of my patients and clients are social and casual over-drinkers. They never drink in the morning, but they are drinking too much and too often, in the afternoon and evening. If they continue to drink at the same rate, it will impact negatively on their health - that’s if it isn’t doing so already.
The over-drinkers often tell me that they just want to drink like normal people, so in counselling we will talk about what these normal drinking habits look like. People generally do think about what they drink. Just as they think about what they eat, and how much they exercise and sleep. The normal drinking life, though, is a hard sell to some when they release the effort it takes. The key is to adopt the moderating strategies that work for you and, if you slip up or over indulge, reflect on the reasons why, learn from them, and get back on track. Here are fifteen tips and strategies:
19 tips for Moderate Drinking
1. Counting units
One of the tests of whether moderation is an option for you, is whether you can honestly and accurately count, not just your drinks, but the units of alcohol you consume. This is best done on a daily basis and reflected on at the end of the week, and month. This involves either using an smartphone app or calculating your unit consumption on paper using this equation:
Volume (ml) x ABV (Alc %) divided by 1000 = units of alcohol
Example: 568ml (pint) x 5% ABV (beer) = 2840, divided by 1000 = 2.84 units of alcohol
When I began moderating, I chose the smartphone app. I stopped using it after two years because my drinking had become consistent, predictable, and moderate. These days, I don’t need to record units but I still think about what I drink, in units. I even get pissed occasionally - on not much alcohol - and I always return to moderation. What I didn’t have to face to any great extent that some of my clients and patients do when counting units, is guilt and shame. These feelings stymie this process, and need exploring through counselling.
2. How much is moderate?
Another important decision is how many units a week you are aiming to maintain. For many, the UK Chief Medical Officer’s recommended 14 units a week for both men and women, is too much to achieve - at least at first. For some, double this is doable, and a hell of a lot less than they are drinking. Whatever amount you decide upon, based on this decision and your daily monitoring, you need to do some anticipating of your week’s diary and social events, and you need to consider how you are going to manage unexpected social events that may pop up at a point that you’ve already consumed your week’s allowance of units, or on a non-alcohol day.
3. Dealing with peer pressure
One of the main problems with maintaining moderate drinking habits is peer pressure. Having a partner who is not moderating, or friends or colleagues that aren’t, can add the temptation to drink when you hadn't planned to, or to drink more than you intended. Sometimes the pressure is spoken, and sometimes it’s in the mind of the moderator; either way, it adds further challenges, especially for people pleasers and those who suffer with FOMO (fear of missing out), or struggle with self-discipline.
4. Explaining yourself and declining drinks
A difficulty for many is explaining the reason behind their moderate drinking, to others, including your friends. This is embarrassing for some people, as it draws unwanted attention and stupid comments. I know from my own experience of ordering half-pints and asking bartenders about alcohol content, that you have to manage idiotic remarks and funny looks about just this quite a lot of the time. There are also those who tell you to have another drink, to contend with. This is one of the hardest tests you will face. It will help to talk to a counsellor if saying no’ is difficult to do, or if you worry unduly about what other people think and say. In general, people - normal people, anyway - don’t really care what you do. It’s actually often a talking point.
5. Alcohol-free days
The other thing to consider to help exercise moderation, is alcohol-free days. These are a big challenge for some. I recommend that my moderating clients and patients take at least a few alcohol-free days in the week, starting with one and building up to 3 or 4, preferably consecutive days.
6. Alcohol-free drinks
Another strategy that is becoming more commonly adopted by moderators, is drinking more non-alcoholic drinks. The technology behind these drinks has greatly improved in the last few years, and this is evident in the taste and the range of beers, gins and wines now on the market. Unfortunately, most pubs and bars don’t serve a very good range. The best range can be found in your local supermarket.
7. An alcohol-free home
Making a decision to only drink socially, i.e., not at home, is also a helpful moderation strategy. This is made easier if you can stop bringing alcohol into your home. The stumbling block to this may be that walking past the alcohol aisle in the supermarket can be as much of a challenge as walking past the pub.
Looking at your relationship with alcohol, and your family's, currently and historically, is a useful process if you have never done it before. Looking at the reasons you drink is also helpful; thinking about why you are having each drink is a good place to start: is it a coping drink? What do you have to cope with? Does it really help you cope? Is it a drink for pleasure? If so, when does the pleasure end? Is it a drink someone else wants you to have? If so, why did you say ‘yes’ to it?
If you are someone who already exercises, increasing the amount or regularity of your exercise will likely make you feel like drinking less and undoing all your hard work, self-discipline and self-care.
10. Medically supported moderation
There are a few medical options available to those who can find a specialist doctor to support their aim to moderate their drinking. These include the opiate antagonists Nalmefene or Naltrexone that can be prescribed to reduce the euphoric sensations associated with drinking, and so help to reduce intake.
Other simple strategies to help you moderate your drinking:
11. Interspersing alcoholic drinks with soft ones, or water.
12. Drinking a glass of water or soda-water alongside your alcoholic drink.
13. Choosing drinks with lower alcohol content (to keep your units down).
14. Sipping your drinks instead of gulping them.
15. Drinking more slowly by taking longer between sips.
16. Skipping rounds. See if you can make your drink last two rounds.
17. Ordering a half pint of beer instead of a pint, or a small glass of wine (125mls) instead of a medium (175mls) or a large (250mls).
18. Buying smaller bottles of wine and beer for home use.
19. Buying a bar-person’s measure for spirits and wine to more accurately measure the drinks you pour yourself at home.
Toby Burton is a psychotherapist practising in North London.