What are your thoughts on a nightly glass of wine?
I am asking, because sentences I hear often include:
"My doctor says a glass of wine a day is fine."
"I read that red wine is good for the heart."
"My husband doesn't think my drinking is a problem."
Here are my thoughts on the issue:
Whether a nightly glass of wine is a problem depends:
Most of all, it depends on the actual amount consumed. Quite casually, a glass of wine at home turns into two, or three, or a whole bottle, and before we know it, we have lost track of how many glasses we really drank - and who measures them in millilitres, anyway?
If this happens occasionally, there is likely nothing to worry about, but if we frequently drink more than a glass or have less than two alcohol free days per week on the regular, we might start feeling ashamed and choose to ignore both the true quantities and underlying reasons for our drinking.
The problem with the nightly glass begins when it turns into two. Or three. Or four.
In order to determine whether a glass of wine at the end of the day is ok, becoming mindful of how much we really drink is key.
For those of us open to an experiment, a weekly log might help; even if in the morning all we remember to note is "lost count".
Pre-existing health conditions and gender specific factors play a role as well when we are trying to determine if a daily drink is fine.
As you likely know, alcohol affects women more negatively than men in many ways.
Age, genetics, and life circumstances often further complicate the situation and add vulnerability.
Research advises women who are pregnant or breastfeeding, taking medications or restricting their food intake to avoid alcohol entirely.
Keep in mind that alcohol dependency often looks much less dramatic than the media make us believe:
Not everyone who drinks problematically is homeless, economically disadvantaged and single.
Quite the contrary is the case: Many upper and middle class mothers struggle, but suffer in silence because of expectations regarding their role in society and fears around what might happen to their children if a problem were to be admitted.
What to listen for in conversations with your patients or clients:
As a rule, problematic drinking creates problematic situations.
Those who have experienced feelings of guilt or shame after drinking know what it's like: a fun evening somehow turned into a series of painful or embarrassing mishaps.
When drinking affects our clients' self-worth and impacts those around them negatively, our alarm bells should go off. Clients might like themselves less and less and become more quiet and withdrawn, because they understand that their behavior didn't help the situation, but they are unable to initiate change on their own.
Make sure to take their symptoms and concerns seriously, even when no direct negative health consequences are apparent or they "don't look like" they might have a problem. This goes for eating disorders, too, by the way - most often, they are invisible illnesses!
By the time attempts at cutting down regular drinking are unsuccessful, or when family members voice their concern, seeking professional help is recommended - if only for a second opinion.
Use your professional leverage to advise patients or clients that there is no shame in letting a counsellor know that it's all a bit much at the moment. In fact, the sooner problematic behavior can be addressed, the easier it will be to establish new nightly habits and rituals.
What to do when you suspect that someone you care for (or about) abuses alcohol
If you suspect that a client, patient, friend or family member abuses alcohol, gently inquire if she would like to talk about your observation.
Try to withhold judgment and attempt to find out what would help her in her current situation.
If you can truthfully alleviate fears around the possible apprehension of her children by child protection services, do so. (Many women are scared to discuss the true extent of their substance use due to legitimate concerns around losing custody of their kids.)
Normalize the use of substances to deal with stress.
Help her get in touch with a counsellor, if that would make her feel supported.
Keep in mind that change is difficult; not everybody who we feel needs help will agree with our assessment.
If they are not receptive to help, respect their autonomy and let them know that you are ready to support them whenever the time is right for them to move in a different direction.