As I started thinking more about how an addiction recovery model can HELP treat obesity, I also started wondering how insights into addiction recovery can inform what kind of thing can HURT binge-eaters. Et-Voila! Dry drunkeness!
What is a dry drunk, you ask? Basically, it's "one that abstains from alcohol, but is still grappling with the emotional and psychological maladies that may have fueled their addiction to begin with, and continues to have a strangle hold on their psyche" (Carole Bennett, Psychology Today). They get sober, but can't work out why they were drinking in the first place so continue to struggle with the same demons. They fall off and on the wagon over and over. Some (very few) manage to maintain sobriety for life while never really "recovering". They "white knuckle" their sobriety, requiring complete dependence on willpower to stay away from the booze.
The similarities to a yo-yo dieter are shocking. Diets fail over and over again because we are only treating the behaviours, not the engine drivers. We rely on our willpower to carry us through. Eventually, and inevitably, willpower is not enough and we just give up until the next rock bottom when we give it another shot. Rinse and repeat.
Here are some symptoms of a dry drunk from the AA website and examples of how they manifest in an obese person on a health kick (embarassingly, but honestly, from personal experience):
1. Grandiosity - an exaggeration of one's own importance. This can be demonstrated either in terms of one's strengths or weaknesses.
"Yeah, I can't believe how much willpower I've had! I've been doing really well!"
"I'm having a terrible day. I keep going over my calories. There must be something wrong with me."
"I have this under control. I know what's right for me. I can do this all by myself. I don't need anyone else's help."
2. Judgmentalism (related to grandiosity) - Prone to make value judgments - strikingly inappropriate evaluations - usually in terms of "goodness" or "badness". i.e. "soapboxing"
3. Impulsivity - the result of intolerance or the lack of ability to delay gratification of personal desires. Behavior which is heedless of the ultimate consequence for self or others.
"I'm just going to go ______ (exercise, drink, smoke, to the movies, shopping, etc) RIGHT NOW."
4. Indecisiveness (related to impulsitivity) - while the latter takes no realistic account of the consequences of the actions, the former precludes effective action altogether. Indecisiveness stems from an unrealistic exaggeration of the negative possibilities of the action ; so one wavers between two or more possible courses of action, more times than not- nothing gets done.
"I think it would be really good for me to do something positive for myself...Yeah, that sounds great!...But, if I tell someone I'm going to do it does that mean I have to?...What if I don't do it well enough?...I'm probably just going to disappoint myself and them anyway...Eh, screw it."
Sound familiar? It's so easy to get caught in this trap. After all, we have a multi-billion dollar industry telling us that diet, exercise, and the willpower to stick to them are all it takes. When we think about alcoholism now, we find the idea of someone saying, "Just stop drinking and you'll be fine...what's wrong with you?!" completely inappropriate (although many still hold this false belief). The idea that sticking to a healthy diet and exercising is all that it takes is just as ineffectual. Society (and healthcare providers) just haven't caught up yet.