November 2009

Binge Drinking Counselling

Adam Szmerling's picture
Submitted by Adam Szmerlingon 7th Nov 2009

I worked with a 49 year old woman who wanted to stop binge drinking, let’s call her Lisa. Lisa said she wanted to discontinue her 10 year binge drinking habit because it was ruining her health, her relationship and career. On the surface she seemed to have it together; intelligence, sense of humour, sharp and witty. But she reported feeling panic/anxiety when she was not drinking, but while drinking she coudn't stop and would "embarrass herself incredibly".

She was focused on getting rid of her drinking but felt she had no control herself to do so. Initially we spent time exploring her drinking triggers, and building a trusting counseling relationship in which she felt she could tell me anything.

Lisa felt guilty and frustrated with herself that she did not know why she would binge drink. Like so many clients she would say things like “I don’t know why. I had a good childhood!” As therapists we know this kind of defence often blocks unfulfilled emotional needs from the past due to painful feelings.

So as I began to wonder what Lisa was really trying to “fill up” by drinking excessively, it became clear that she had not adequately dealt with the death of her father 20 years ago. He died while she was doing a postgraduate degree. A lecturer actually said to her “Look, for goodness sake it’s been three weeks since he died, just move on!” This lecturer whom Lisa had come to admire academically nonetheless delivered this remarkably unskillful hypnotic suggestion to Lisa (most likely a projection of his own unresolved grief or death anxiety) which she took on board, small wonder given she was vulnerable and in the initial shock stage of the grieving cycle.

So she blocked her normal emotions associated with grief, such as anger and mild depression. Most of Lisa’s psychotherapy with me involved processing her grief reactions and learning self-hypnotic skills in which she could fill herself up emotionally without relying so much on external sources.

Gradually, her drinking ceased completely and her previously avoided feelings of anger and depression were then able to be skillfully worked through. Her anxiety also reduced and she ceased having panic attacks.

Combining mindfulness counseling (non-judgemental acceptance of inner experience), hypnotherapy and psychotherapy helped Lisa to gain insight into the source of her drinking and stop at her own free will with minimal withdraway and no relapse to date. A lot of therapists have commented that people who regularly abuse alcohol and other drugs are not responsive to insight oriented work and thus are better suited to more surface based therapies which focus only on thoughts and behaviour. Lisa helped disprove this view. I believe almost anyone willing to work through the causes of their suffering can change with mindfulness based counselling.

Any identifying information has been changed to protect the confidentiality of the counselling case.

Making Irritable Bowel Syndrome (IBS) Go Away

Adam Szmerling's picture
Submitted by Adam Szmerlingon 7th Nov 2009
I saw a client for help with overcoming IBS, let’s call her Kathy. Kathy was in her early 40’s and had received a diagnosis of IBS some years previously. She had oscillating symptoms of diarrhoea and constipation numerous times per day. She was so angry that she had done every kind of medical test suggested by her GI specialist but they always found nothing.

She had been seeing a naturopath and nutritionist which helped with a small amount of symptom reduction. But she would still bloat and have daily constipation and diarrhoea. She was referred to counselling by someone who had achieved a positive outcome with me for a completely different issue. However this person was an avid believer in the mind body connection.

Like many people who begin psychotherapy, Kathy began with a fixation on “fixing the problem.” This sense of urgency, I reassured her, was understandable but subtly undermining of likely progress. Instead, I invited and helped Kathy to develop an open minded, non-judgemental curiosity towards her inner experience.

Shortly thereafter, Kathy became aware of more symptoms such as bloating and stomach pains. How could she be getting worse? She began to wonder. I reassured her it was perfectly normal for IBS sufferers to get worse before they get better initially when they unpack unresolved emotions, because the physical side of the syndrome may represent "undigested" feelings from the past.

As Kathy really began trusting me and thus process and digest her feelings, she became acutely aware of a sense of panic. She had a history of abuse but was of the view that she had “dealt with it” years ago in therapy. However what became clear is that she had “dealt” with her thoughts associated with the trauma but the feelings had not changed. By believing her past traumas were dealt with, she was actually repressing her traumatic feelings into her stomach. Kathy had sub-consciously stored her fear and anger in her stomach and was experiencing either constipation (strong holding onto familiar negative feelings) and diarrhoea (intense rejection of painful feelings).

Counselling and hypnotherapy involved mindfulness meditation techniques in which Kathy befriended her bodily experiences, emotions and thoughts. Psychotherapy to help Kathy work through her family of origin and associated anxiety which had not been processed at a somatic level previously, was applied. Kathy was able to become non- judgemental with her emotional life and gradually her symptoms resolved completely, as more and more trauma from the past was put into context.

Her self-confidence also improved dramatically as she learned self-hypnosis in our sessions. She began going out socialising, something she previously avoided through fear of having an IBS attack. Both Kathy and I were very pleased with her fast progress and the mature ways in which she was able to use counselling to help herself.