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Providing non-judgmental and non-criticizing support for family and friends of end-stage alcoholics through one-on-one coaching, support groups, blog posts, workshops and public speaking.

Tuesday, June 18, 2013

Just another word...

The other day a friend told me about a condition that explained a lot to me about why Riley is still in such denial about alcoholism creating his current physical limitations. The word is ANOSOGNOSIA. Of course, the first thing I did was look it up in Wikipedia.

“Anosognosia is viewed as a deficit of self-awareness, a condition in which a person who suffers certain disability seems unaware of the existence of his or her disability.”

“Anosognosia results from physiological damage on brain structures, typically to the parietal lobe or a diffuse lesion on the frontal-temporal-parietal area in the right hemisphere.”  This distinguishes the condition from denial, which is a psychological defense mechanism.
So, as I understand it, damage to the frontal lobe can cause a condition that prevents the patient from understanding or accepting their own disability. The damage can be the result of any number of things, such as a stroke, lesion, traumatic brain injury, and any other factor that causes injury to the brain. Using those criteria, then I suppose that would include brain damage from alcohol abuse.

What seems to be a simple state of denial that alcohol is a problem, could in fact be the result of Anosognosia. If this brain damage is present, it may be one of the reasons why alcoholics have such a high rate of relapse after going through a near fatal detox. They simply don’t know that their disability is alcohol. It could be the reason why Riley looks at me in confusion when I remind him that alcoholism is his disability and the only medication is to NOT drink again.
I don’t think that all denial is a result of brain damage. I know that denial is a part of the alcoholism cycle – for both the alcoholic and those who love an alcoholic. There must be some type of brain damage for the Anosognosia condition to be present.
In the beginning we family and friends deny the alcoholic condition because we just don’t want to believe it. We don’t want to see that our future may be bleak if the person we love is addicted to alcohol. We know enough to know it is not something we want for the alcoholic or for ourselves. It’s like turning our eyes away from the movie screen just as the axe is about to break open the head of one of the characters. We know it’s happening; we just don’t want to witness it. We know alcoholism is happening; we just don’t want to have a front row seat. Instead of closing our eyes, we deny that it is even on the screen.
Denying the real problem doesn’t serve us very well. The sooner we accept what is going on, the sooner we can find ways to keep ourselves from being the victim under the axe. Once we accept what the real problem is, we can take action to maintain our own sense of self even in the midst of alcoholic craziness.
As the person who is not addicted we cannot point a finger at brain damage and say that is why we do what we do. We do what we do out of desperation to save the alcoholic. Saving the alcoholic becomes the only thing in our lives that has a priority. The sad fact is that we are like Don Quixote jousting at windmills. We cannot save the alcoholic from alcoholism. We can call 911 when the alcoholic body starts shutting down, but we cannot save them from their own denial. The alcoholic’s alcoholism is the property of the alcoholic.
We can understand and accept. If Anosognosia is an issue we can learn about it and realize that it is hopeless to fight it. We can learn everything we can about alcoholism and the related health issues because knowledge is the key to survival. We can find ways to keep our own health from falling victim to stress related illnesses. We can stay engaged in our own lives with our own interests. We can maintain a circle of friends that support without judgment. We can find our own avenues of peace and calm.
It’s not easy to do all that stuff in the above paragraph. It may seem simple, but it is extremely difficult. The first step is to stop believing you can change the alcoholic. Stop denying that there is a problem with your own thought process. It’s not easy to look deep inside ourselves and try to find the person that existed before the insanity.  That person – maybe the art lover, stray animal feeder, avid baker, exercise nut, writer, computer whiz, organizer extraordinaire, coach or something else – is still inside you. That person will help you survive alcoholism and be happy if you can bring that person out into the open.
It doesn’t really matter to me if Riley has Anosognosia or not. It makes it easier for me to understand his point of view. But, it doesn’t really change anything. Riley is still an alcoholic who will quickly be an end-stage alcoholic if he finds a way to return to drinking. I provide him the means to have a healthy life without alcohol even if he finds it unpalatable. That’s all I can do for him. He is no longer accepted at rehab centers even if he had a desire to go. If it was a possibility, I would encourage him to go. I no longer spend hours trying to talk some logic into his damaged brain. Instead, I accept it for what it is – something I cannot change.
I have found my passion. Actually, I’ve reconnected with several of my passions over the past year. I like my life. I don’t deny that there are problems but I separate my fixable problems from the unfixable. I guess that’s the wisdom of knowing the difference.


Syd said...

Accepting I am powerless over people and alcoholism is a huge step. Having compassion for the alcoholic is good but what motivates them doesn't have to be my obsession or even my business.

Intervention services said...

Once if we addicted to alcohol,its hard task of quiting it,so we should take treatment to quit the alcohol. Family Intervention

Anonymous said...

Tell him Oliver bob and Steve say hello. Tell him we are still using his conference guide that he created.

Anonymous said...

I am an alcoholic, I guess, but ...
aren't ALL the physical health problems caused by long term heavy drinking reversible, with the exception of Wernicke-Korsakoff?

And I've heard so many life stories of people who drank much more than I ever have who die at an old age from a totally unrelated cause.

My great grandfather drank two fifths a week and died in his 90s, and he was a big man when men were much smaller. He was 6'4".

There's such variety in tolerance, how do you know you're killing yourself until you're actually killing yourself.

Psychologically I am an alcoholic, and for 14 years. I don't deny that, but...it seems one may be such and live to a ripe old age.

Jackie said...

At anonymous of 14 yrs alcoholism - Yes you can live a long life but not without some medical intervention to bring you back to a healthier state of health. The problem is what kind of alcoholic you are. Most are the kind who involve loved ones into their lifestyle creating a terrible atmosphere to live in. And to make matters worse, the alcoholic may have a job that puts others in harms way. And don't even talk about driving because we know that is dangerous when drunk. I bet your Great Grandmother HATED your Great Granfather's drinking. Go ahead and drink but do it alone. Don't bring your family & loved ones down the path with you. I think most people could care less if the alcoholic drinks, gets severely ill, becomes helpless, just as long as they stay by themselves & cause no human harm. In other words - live alone, drink alone and fend for yourself so you harm no one and make them put up with your behavior. No one likes living with an alcoholic. You don't see that you might be a problem for your family or coworkers or humans around you. I think that you are a problem to all of those people to some degree. You seem to think it's no big deal if Alcoholism means living to an old ripe age but there are health & relationship problems. Look up what excessive drinking does to the brain, organs, nerves and thought patterns over time to your body. It's not pretty. I've never, never, never met a person who drinks enough to be considered an alcoholic not cause problems with their health, family, friends or their work in some way.

Anonymous said...


I don't know Jackie.

I don't discount your experience, but generalizing from one's particular experience is a human trait...one of mine too. And such generalizations are often wrong.

I find that alcohol is an effective antidepressant in moderation and in excess effective only when in the system, after which depression is much worse...but this is also true of prescription antidepressants.

I AM a loser and a failure who has never lived up to his supposed potential. I'm even a participant in the BGI GWAS of the "cognitively gifted".

But I only started drinking in earnest at age 25 (before which I hardly drank at all) because antidepressants didn't work and I have a "weight" pressing on me which is well described as CRUSHING.

If it weren't for drink, honestly, I think I would have killed myself a decade ago.

Of all mood enhancing drugs I think alcohol is the least expensive to both pocket book and body.

If I ever ended up like Kerouac I'd cease immediately.

As one ancient said, "Man is the only animal who knows he will die."

Anonymous said...

BTW, I'm not a social drinker. I'm not really social at all (and wasn't prior to drink either). I think I've only been in a bar twice in my life.

Anyway...the effect of alcohol on the personality seems to be idiosyncratic.

Some become violent or verbally abusive, others become quiet or fall asleep.

REALLY the ONLY legitimate criterion for alcoholism is:

Does one continue to drink when drink is shortening his life...but even then it may be the alcoholic is aware (not "in denial") of the harm he is doing himself...that is, for him, alcoholism is the most pleasant form of suicide.

Is the desire to kill oneself necessarily pathological? It usually is, almost always is, but only almost.

Anonymous said...

Blah. Blah. Blah.

Alcoholism, drug addiction, depression, etc. are to a very large extent purely IDEOLOGICAL terms in Marx's sense of ideology.

That is, when THE SOCIETY is the problem, the locus of pathology must still be found in the individual. Psychiatrists, AA, etc. make a business out of it.

Modern liberal capitalist societies exclude a large percentage of their populations and alienate an even larger percentage by design, that is, unavoidably.

Anonymous said...

Is it any wonder that alcohol consumption increases with SES and educational attainment.

Only MORONS don't drink.

Kiki said...

I can see vale in all the above comments. I grew up in a family of alcoholics, all at varying degrees and all relatively functional also at varying degrees not relative to the degrees of each one's alcoholism. Make sense?
Well, interesting that Anon thinks booze helps depression. That's twice I've heard that this month, the other a raging alcoholic who brags about being the only man with a certificate of sanity...from the nuthouse upon release. He's a hilarious dude. Think I'll write a post about him on my blog at KikiUnhinged.com

Jacque Gabrielle said...

Thanks for this new word..not that i know it's an actual condition..i shall have an easier time of "letting it go". Peace and Thank you.

Anonymous said...

Stop calling 911!

Isn't it strange that only the "caretakers" seem to look for explanations....I've gone through this for years..it does not change..only the month or year...It's a black hole and I'm being sucked in...just sucking the life right out of me.....

Anonymous said...

"I can see vale in all the above comments."

Is that the "vale of the shadow of death"?

Anonymous said...

If so...

Would you prefer the alcoholic blow his brains out? (Suppose he had the courtesy to do it in the bathtub with the curtain drawn or in the shower.)

The suicide lasts much longer on the sauce.

I've lasted almost 15 years.

I only started drinking in earnest when I wanted nothing more than to die.

Before then I didn't drink.

Anonymous said...

@anon.,you're intelligent and it can be a curse. My alcoholic used to tell me, us intelligent people are liars. My alcoholic was right. Let's examine your statement. You drink to avoid death which you crave. That is an oxymoron which can be further reduced to simply a lie. It is a lie because of the duality. Either you want to live or you want to die , and in life, sometimes you have to make a choice nd get off the fence. I believe you are still alive because some part of you rejects death,yet you drink because you crave death.you are living a lie,and sound like a whiny brat. Make a choice and be conscious. know that by choosing the bottle you are activly choosing death,albeit slowly.or choose to live.easy.

Grant said...

Another great read. Thank you!