#MeToo: How the Pain and Shame of Sexual Abuse Can Lead to Substance Use
Countless young women who have experienced sexual abuse cope by using drugs and alcohol. It’s important to address trauma and substance use simultaneously.
When someone – including a teenager – gets treatment for alcohol and substance abuse, it is standard practice to identify some of the reasons why they started using and the benefits they feel they get from these substances. This helps them reduce shame and best identify their triggers and areas to focus on. Among the research, most reasons for using alcohol fall into a few broad categories such as mood or personality enhancement, social reasons, and coping reasons. Reviewing personal motivations for using alcohol is often an “ah-ha” experience for the person seeking help but it needs to be handled with care as there is the potential in such a discussion to make alcohol use seem more appealing.
Nowhere is this concern greater than when attempting to prevent alcohol use in teens as many parents have a justified fear that such a discussion will promote alcohol use in kids who may not have otherwise been aware of the potential short-term “benefits” of alcohol. This fear has often caused parents and caregivers to avoid the topic, focus only on the consequences of drinking or minimize the reasons why people drink – especially with younger children. While reinforcing the consequences of underage drinking is always recommended, understanding teen’s motivations can also be useful to parents as a point for both prevention and early intervention of teenage drinking. Below are a few tips on using teen motivations to intervene and connect with your children.
A useful strategy is to ask teens about what they “expect” to get from drinking. Along with perceived risk, your teen’s alcohol use can be predicted by the expectation that one will feel a certain way when they drink. These expectations are reinforced by the media and by your teen’s peers. Expectations are essentially motivating (I want to relax and I will drink because I expect that it will help me relax). The first step is to identify what your teens think about drinking’s benefits or what drinking may give them. If you can identify the reasons they think people drink (or they drink), it is a point of intervention.
Tailor Your Strategy: Based on the motivations or expectations your teen mentions reports there are several options to continue the conversation.
1. Identify myths about the effects of alcohol: Teens may think that alcohol will help them achieve a particular outcome when in fact the opposite is true in the research. For example, if a teen says he drinks to relax, you can counter that alcohol only has temporary relaxing qualities (and only in moderation) and drinking actually reduces sleep quality which then causes stress. When teens understand that alcohol in fact may not actually give them what they want – they might think twice about drinking for a specific reason.
2. Once you have identified your child’s reason for drinking, encourage him or her to find other activities that will achieve the same outcome without alcohol. This is called “counter conditioning.” So using the above example you can identify other ways that are significantly more effective than alcohol in helping them relax (e.g. exercise, music, yoga). This is important because you will be teaching your teen a valuable coping skill that might prevent them from developing problems later on in life.
3. Lastly, point out that much of the “effect” they get from alcohol is simply based on what they expect they will get when they drink. This is especially effective for the “I want to have fun” motivation. My favorite way to talk about this is to discuss the numerous experiments done on placebo alcohol – yes – that’s right, studies where there was fake beer or tonic water alone and people thought it was actual alcohol. Individuals in these studies reported everything from being more social/sexual to being more confident to even having memory loss. In other words – you get what you expect. So simply being primed and thinking positively will give you what you need without the alcohol. These results are not unique to alcohol either – the placebo effect whether it be through fake surgery or a pill is extremely powerful. Studies even show that people who receive placebos have actual changes in their brain chemistry based simply on the expectation that they are getting what they need to achieve their goals. More importantly, some studies also reveal that people taking a placebo attribute their changes to themselves and not an external substance.
What I have found when I discuss alcohol motivations with teens is that they appreciate hearing a more rounded view of drinking. Teens are smart – they understand that people drink for a reason and if we ignore the reasons for drinking we are going to lose credibility with our teens. Discussions about expectancies and motivation typically also bring up much broader discussions of internal vs. external control. When I was working with college students who were referred to me for binge or excessive drinking – I would ask them to “pretend” they were drunk the next time they went to a party. It was a powerful experience for them to just hold a tonic water and pretend that it was a real drink. It helped them recognize the internal power they have over their actions and to feel more confident and secure. When teens begin to realize that they are in control of their actions they can begin to master the world around them to achieve their goals without a pill or drink.