I would like to explore a key concept of The Sinclair Method which often seems overlooked, and yet for myself has been a vital component aiding towards my recovery.
The Sinclair Method has three main facets as stated in Dr Roy Eskapa’s book The Cure For Alcoholism: An understanding of the Alcohol Deprivation Effect, and an understanding of Pharmacological Extinction. The third is Pharmacological Enhanced Learning (PEL). PEL can be used as an aid to replacing the bad behaviours of repeated alcoholic drinking with good, non-detrimental behaviours. Selective Extinction is the more common term for specifically focusing on extinguishing drinking behaviours whilst drinking with naltrexone or nalmefene, and then enhancing the more positive reinforcement rewards on days when you are not drinking/taking naltrexone or nalmefene.
So, how does one work towards the practicalities of incorporating PEL into everyday life? Below are some suggestions of how I made PEL work for me.
Well, the very first thing I did was to forget I had read it! I stored it away in the back of my brain for later.
I was drinking everyday and since PEL relies on experiencing good endorphin release on non-drinking, non-naltrexone days the idea of PEL seemed very distant to me. Without a doubt the first thing I wanted to do was to get used to drinking on the naltrexone, and try to work towards one non-drinking day a week. My priority was to take the first steps towards a happier life. It felt like I would be jumping the gun so early in treatment to spend time and energy focusing on a concept that I wasn’t even sure I was going to be able to achieve.
As you can see from my drink diary opposite, during my first 14 days on The Sinclair Method I only had 2 days when I managed not to drink – Monday the first week, and Friday the following week. This was quite an effort for me, but I was conscious of flushing my system of the naltrexone as per the suggestions in The Cure For Alcoholism by Dr Roy Eskapa. However, two drink-free days in 14 was a good start. I was very happy with this – it was after all what I initially set out to achieve. I believe it is more practical to set small, achievable goals and then progress further as each goal is reached. It is no good trying to touch the moon when your feet are firmly planted on Earth’s soil.
Though I did not go into a complete self-imposed hibernation for those first two weeks, I was careful not to partake in those things that I do enjoy, but on remaining faithful to the drink+nal=cure equation. As I see it, first things first…… I was willing to do whatever it takes to get TSM to work for me, no matter what I had to sacrifice at the time.
From the end of the second week, I felt more assured with both my mental and physical condition. I made the decision to try for more than one drink-nal-free day for the third week. Referring back to The Cure For Alcoholism (as I have done many times during the weeks), I read again about Pharmacological Enhanced Learning. What was it? How do I work it into my TSM program? More specifically, pages 120 to 122 cover maximising your results using selective extinction and I found this most useful.
“On naltrexone- and drinking-free days, the opiod system in your brain will be more sensitive to reinforcement from endorphin release because of a phenomenon know as receptor upregulation, which causes receptor supersensitivity.”
As result of this, now is the most perfect time to flush the receptors with endorphins from the activities you wish to encourage – to reinforce positive behaviours. That sounded intriguing to me. Up until then, I had felt a little dull in myself, most probably caused by the fact that I am normally an active person. I like to cycle, and walk, and making the conscious decision to not do these things hadn’t really sat well with me, even though I understood it was necessary in order that I did not begin to extinguish these good reinforcements. In effect, I was following TSM as well as I could by selectively extinguishing the negative reinforcement of my drinking. I did not enjoy the feeling of being ‘trapped’ and inactive, but understood that it was not going to be helpful to my recovery in the short term so I was sure I could forgo those things just for a little while.
During weeks 3 and 4, I experienced a total of five drink-free-nal free days. Slowly, I incorporated the things I enjoy back into my life. One day I went for a cycle ride, two days I went to the gym, went for a hike another day, and organised a meal out with my family.
These things were all feeling better than normal – was that because my senses were no longer dulled by alcohol? A little, perhaps, but that wasn’t the the main reason.
”You will find your interest and enjoyment will increase progressively for the healthy activities, helping to fill the vacuum as drinking decreases”.
Planning my days ahead really helped me focus on not only enjoying what I was doing, but also helped me to gain the positivity I needed to face another few days without the activities I enjoy. Success was breeding success! It was useful to document my good activities with my drink diary so I could see a pattern beginning to form. Eventually I was looking at my drink diary and reading of more positive, enjoyable behaviours than drinking days. This was such a positive boost for my ongoing recovery.
I began to look forward to the enjoyable activities and quickly regained my passion for looking after myself, something that I had disregarded for such a long while. I lost weight (a combination of healthy activities and lack of alcoholic calories), gained a taste for cooking again, started to really enjoy the gym and my cycling. Everything felt wonderful in fact! I realised I wanted more of these days!!
In the run up to the stressful holiday period, I was spending fewer days drinking which allowed for me to take a short walk in the cold air more days than not. Without a doubt, this relaxed me and helped me cope whilst others around me were struggling with the long list of things to be done before the holidays. It has been a valuable part of my recovery to date. It has been so very important to replace the time I spent drinking, or thinking of drinking, with much more enjoyable activities.
Should you not be a naturally active person, then you have the joy of beginning a new life with small steps. Once cleared by your doctor, if necessary, think of some new ways to gain pleasure in your life. You will find these useful in your battle to replace the habitual activity of drinking, or to help you cope with stress when drinking triggers appear. These activities can be anything that release endorphins ie. opiodergic behaviours. Eating a spicy meal, exercise, yoga or taking the dog for a walk are all suitable activities. Later in recovery, you may choose to take up a hobby that previously fell by the wayside when your drinking behaviours got a hold over you – do you have a burning desire to take up an acting class, or join a gym? With the upregulation of the receptors, now is the best time to try these things out. The reward is justification in itself and may even be a little overpowering, but it will also feel so wonderful.
In fact, you may not be aware that something as simple as using our senses produce endorphins. Now your brain is slowly becoming clear of the fog that is alcoholism, your sense of smell and taste may become heightened.
Personally, I cleaned out and refilled the bird feeders and bird bath in my garden. Then watched and listening as the little birds chatted happily as they fed and bathed. It helped to appreciate that the world is full of wonders that I had forgotten existed as I spent so many years trapped in the never-ending cycle that was addiction to me.
The point is that we all have interests, either new or old, that would be perfect to replace our old drinking habits. For most of us, drinking has taken over our lives to the point that we forgot how to feel any real pleasure. Now is the time to re-introduce yourself to your real self.
Have fun with that – explore and enjoy!
Despite what you may have read in the past, recovery from alcoholism doesn’t have to be miserable at all. The Sinclair Method encourages the positive, so the negative can slowly fall away.