Inattentional Blindness: What else are we missing?

All human beings experience anger at least occasionally. It’s a natural emotion helping us recognise that we or someone or something we care about has been violated or treated badly. When we feel threatened or our goals are thwarted, anger is a coping mechanism that enables us to act decisively, especially in situations where there is little time to reason things out. It can motivate problem-solving, goal-achievement, and the removing of threats. It serves a protective function and is not always a problem (Lowth, 2018; Stosny, 2020; Zega, 2009).

But anger is a complex emotion, and all too often manifests maladaptively in clients’ lives, when they perceive excessive need for protection, protect the “wrong” things, or use anger to thwart their longer-term best interests. The result is problem anger.

Perhaps because it is so multi-faceted, misperceptions about anger abound, and the question arises: how shall we regard anger? How do we advise the client to think about it? Folk wisdom often would say that the best thing to do is just let it all out, but is it? Clients complain that they cannot control it, that the tendency to be easily angered is inherited, but again, is there evidence for that? Here are common myths people tend to hold about anger, and factual statements following them that you can use to clarify for the client why learning to deal with problem anger is time well spent.

Myth 1: “Anger is inherited.”

This is the client that may try to claim that their father was short-tempered and they have inherited that trait from him, so there is nothing they can do. Such a stance implies an attitude that the expression of anger is a fixed, unalterable set of behaviours. Research shows, however, that expression of anger is learned, so if we have – say, through exposure to aggressive influential others, such as parents – learned to be violent in our expressions, we can also learn healthier, more appropriate, pro-social ways of dealing with it.

Myth 2: “Anger and aggression are the same thing.”

Fact: Nope. Anger is a felt emotional state. Aggression is a behaviour, sometimes carried out in response to anger, but not the same as it. A person can be angry, yet use healthy methods of expression without resorting to violence, threats, or other aggression. Anger does not always lead to aggression. In fact, some experts claim that most daily anger is not followed by aggression. When it does result in aggression the “I3 Model” (pronounced “I cubed”) is deemed responsible. This suggests that aggression emerges as a function of three interacting factors, which all begin with “I”:

Instigation, an event which instils an urge to aggress as a result of, say, being addressed rudely or learning that one’s partner has had an affair (or a relatively “minor” event, such as being cut off in traffic);

Impellance, meaning a force that increases the urge to act in response to an instigating stimulus. These could be strong hormonal releases or a belief system which says that the instigating event should not be tolerated, or even a sociocultural norm which demands that instigating stimuli be responded to immediately and harshly (such as punching back someone who has hit you);

Inhibition, referring to forces that typically work to counter aggression, such as cultural norms, awareness of negative consequences, or perspective-taking or empathy (Kassinove & Tafrate, 2019).

Myth 3: “Other people make me angry.”

Fact: How often in common parlance do we say things like, “He made me so angry!” or “You make me so mad I could kill you!”? Even though we may occasionally speak about people causing emotions other than anger, it is far more frequent to hear such statements in regard to anger. We can choose whether or not we let someone else’s behaviour make us happy, sad, or something else, but we often think and talk about it as if anger is caused directly by others. With the undiscerning listener, an angry person thus gets to use anger as an excuse for unacceptable behaviour. Ultimately, it is not the other person’s behaviour that causes our anger, and in fact, it’s not even their intention, though that may influence our behaviour. Being precise, we must acknowledge that it is our interpretation of their intention, expressed in their behaviour/language, which is causative.

Myth 4: “I shouldn’t hold anger in; it’s better to let it out” (either by venting or catharsis).

Fact: If by “holding it in” someone means that they suppress anger, it’s true; ignoring it won’t make it go away and squashing it down is not a healthy choice. Neither, however, is venting. Blowing up in an aggressive tirade only fuels the fire, reinforcing the problem anger. Ditto the use of pillow-punching or other means of catharsis; this may come as a surprise to therapists trained a few years ago, when catharsis was an anger management technique in good standing. Now researchers have found that, even though we feel better in the moment after hitting something, our brain notices, subtly changing its wiring. Then the next time we are angry it softly whispers, “Hit something; you’ll feel better”. The time after that, the wiring is stronger in the brain towards a hitting catharsis, and the angry-brain-voice speaks a little louder. Continuing in this vein means that eventually, we could decide to hit something more alive than a pillow. Rather than either angry venting or catharsis is the use of skills to manage the angry impulse.

Myth 5: “Anger, aggression, and intimidation help me to earn respect and get what I want.”

Fact: People may be afraid of a bully, but they don’t respect those who cannot control themselves or deal with opposing viewpoints. Communicating respectfully is a far superior way to get (most) people to listen and accommodate one’s needs. While the momentary power that comes with successful intimidation may feel heady in the moment, it does not help build the healthy relationships that most people coming to counselling yearn to have.

Myth 6: Anger affects only a certain category of people.

Fact: Anger is a universal emotion that affects everyone. It does not discriminate against people of any particular age, nationality, race, ethnicity, socioeconomic status, education, or religion. It is tempting for some people in the educated middle classes to believe that anger is more prevalent among the poor, or those who are less educated or lacking in social skills. Reality does not bear this out, although the expressions of anger do vary among different social groups. Remember, anger is just an emotion, one which does not make people “good” or “bad” for having it.

Myth 7: “I can’t help myself. Anger isn’t something you can control.”

We don’t always get to control the situations of our lives, and some of them may trigger our anger. In fact, it’s also agreed by experts that we don’t (in the short-term) control whether we have angry feelings or not; they just come – although there are longer-term ways to work with clients that see them less easily provoked, and therefore less prone to have the experience of anger. What we do have the short-term choice to control is how we express that anger. Continuing in sessions with you (the therapist) for the purpose of learning how to better handle anger means having more choices of response, even in highly provocative situations.

Myth 8: “When I’m angry I will say what I really mean.”

Fact: This is rarely true. Uncontrolled angry expressions are more about gaining control of or hurting others, not saying what a person’s deepest truth is. 

Myth 9: “By not saying what I’m thinking in the moment, I’m being dishonest and will be even angrier later.”

Fact: There is a strong pull to “speak our mind” when angry. But it is at this time that a person’s judgment is most severely flawed. To speak from anger is to allow the impulsive part of the brain to overrule the rational part. Better for relationships, career, and pretty much everything else to wait until that reasoning part can regain control.

Myth 10: “Men are angrier than women.”

Fact: The sexes experience the same amount of anger, says research; they just express it differently. Men often use aggressive tactics and expressions, whereas women (often constrained culturally) more frequently choose indirect means of expression, such as found in passive-aggressive tactics. This could mean getting back at someone by talking negatively about them or cutting them out of their lives (categories adapted from: Therapist Aid LLC, 2016; Segal & Smith, 2018; Morin, 2015; Morrow, n.d.; Better Relationships, 2021; Gallagher, 2001).

Thought for reflection

Anger has many facets to it, and we have introduced some information here that may seem either startling or counterintuitive. As you think back over the myths we just debunked, which aspect has surprised you the most? Do you have any sense of why that might be? One woman, for example, was very surprised to hear that “men are angrier than women” was only considered a myth; it turned out that in her family, women “never got angry” (we hypothesise that perhaps they were socialised to not show anger), and the men got angry all the time (perhaps more allowed in that woman’s family/culture). In what ways, if at all, might your views about anger have shaped how you behave? How you respond to others? 

And here’s the ultimate question if you share this material with a client: what are their responses to the above questions? How might hearing these myths help them seek more adaptive ways to deal with problem anger? 

The upcoming Mental Health Academy course, “Helping Clients Deal with Problem Anger” draws from numerous therapies and neuroscience to help clinicians and clients collaboratively create a program to address each client’s unique challenges with this universal human emotion.

References:

1. Better Relationships. (2021). Common myths about anger. Anglicare Southern Queensland. Retrieved on 13 April, 2021, from: Website.
2. Gallagher, E. (2001). Anger. eddiegallagher.com.au. Retrieved on 13 April, 2021, from: Website.
3. Kassinove, H., & Tafrate, R.C. (2019). The practitioner’s guide to anger management: Customizable interventions, treatments, and tools for clients with problem anger. Oakland, CA: New Harbinger Publications, Inc. 
4. Lowth, M. (2018). Anger management. Patient. Retrieved on 7 April, 2021, from: Website.
5. Morin, A. (2015). 7 myths about anger and why they’re wrong. Psychology Today. Retrieved on 13 April, 2021, from: Website.
6. Morrow, A. (n.d.). Anger myths. Stress and Anger Management Institute. Retrieved on 13 April, 2021, from: Website.
7. Segal, J., & Smith, M. (2018). Anger management: Tips and techniques for getting anger under control. Helpguide.org. Retrieved on 9 April, 2021, from: Website.    
8. Stosny, S. (2020). Beyond anger management. Psychology Today. Retrieved on 9 April, 2021, from: Website.
9. Therapist Aid, LLC. (2016). Anger warning signs. Therapist Aid LLC. Retrieved on 7 April, 2021, from: Website.
10. Zega, K. (2009). Holistic Psychotherapy (159). Retrieved on 7 April, 2021, from: Website.

Adapted from AIPC (2022), Institute Inbrief, Issue 363.

Oftentimes, a brand new year is used like a clean slate. We can do this any time throughout the year, however, I understand that there is an added element of our “collective consciousness” in the universal atmosphere motivating us with some renewed energy and will. At this time of year, humans perceive that everyone else is also feeling hopeful, invigorated, and full of promise. But the road to realisation of goals is littered with the carcasses of broken dreams, unfulfilled promises, and intentions that dissipated in the stress and mundane of everyday life – our goals did not receive the “oxygen” required to be sustainable.

What is our “Will”?

Have you ever fallen short of accomplishing you New Year’s Resolution? Sometimes, even before the end of New Year’s Day? People many think, “I don’t have the will power to sustain it”, however, if we look at this from the perspective of Psychosynthesis, a transpersonal psychology, we will understand why our understanding of “will power” if often incorrect. If you did anything today, you have will inside you. You have drive, motive, and energy.

While our will may not have all the “power” that we would like it to have, our will is always present with us, somewhere. Psychosynthesis counsellors, especially trained to be observant about will, acknowledge that one of their sacred duties with clients is to track their will, but all mental health professionals can tune more into the willing function of self, for the ultimate good of the client. What do we need to know to do that?

First, will isn’t just desire energy. It is not synonymous with control, it is not about “strong-arming” someone, and it isn’t merely about repressing undesirable material.

Personal and transpersonal will

At a personal level, “will” can be understood as an essential impulse toward our own wholeness. It is that drive within us which coordinates the often-conflicting parts of our personalities into self-expression. As the function closest to the self, it regulates and directs other functions, such as imagination, intuition, impulses, sensations, thoughts, and feelings. It is will which guides us toward personal integration. As we align our lives with a broader vision for what we may be, we go beyond personal will, receiving guidance from transpersonal will: the will of Self (as opposed to “self”).

Along that journey, however, people can fail to execute our will in a way which allows our goals to be realised. This post looks at the aspects of will, which, if they are not employed or are employed badly, can stunt the client’s intentions, keeping their goals from ever realising.

Aspects of will: Strength, Skill, and Virtue

Strength

When people make statements as mentioned above, decrying their lack of “will power” or “internal energy”, they are probably referring to the most well-known aspect of will: that is, “strong will”. It is believed that when we are born, we are unaware that we are separate from our birth giver. The beginning of individuation (the process of forming a stable personality) is the beginning of recognising that “will” exists. We are not only separate from Mum; we actually want something other than what Mum seems to be giving us. We come to see that we have arms and legs and a mouth, so we use these tools to explore the world the way we want to. We learn that crying will have certain needs met. It is the aspect of “strong will” that ensures that our willed act — say, crying for food — contains enough intensity or “drive” to carry out its purpose (getting us fed).

In other words, have you ever seen a really hungry baby stop crying after a very short time if it is not fed? Generally, not. It is possible that our new diet or exercise regime has failed because we didn’t elicit the intensity or “drive” to the intention to exercise or stick to our new diet. We may need to explore what situations in life are keeping us from applying greater intensity to the question. Maybe our desire to change is not worth the requisite “will” or “energy”. The road of least resistance is very common as we age and accumulate more life responsibilities.

This is not true for everyone. Some people will vehemently proclaim that do want to change. It is not lack of wanting, or lack of “will”. What is missing may be the second aspect of “will”, equally important to the first: that of skilful will.

Skill

Several sayings are relevant here:

1. Environment is stronger than will power.
2. When imagination and will power go up against one another, imagination wins every time.

These axioms allude to the often-unrecognised reality that we cannot generally achieve our goals through strong will, alone. Consider the alcoholic who desperately wants to stop drinking but they continue relapsing. If we put our will into competition with other psychological forces — such as impulse or feeling — it becomes overwhelmed; we end up stressed without accomplishing our goal. What we are missing in this case is likely to be the capacity to develop strategy, approaching the goal skilfully, and practically. Oftentimes, we want to achieve our goal without attaining the skills necessary to achieve it.

If you want to lose weight, for example, could think that you simply need to eat fewer calories and the extra kilo’s will start dropping off. Calories in Vs Calories out. But your role as strategist can be very helpful if you establish, for example, whether you’re often in situations where controlling food intake is difficult: say, when going out to eat or eating at private parties, or it’s the holiday like Christmas. Are you eating balanced meals, with sufficient protein (for example) to sustain yourself? Are you getting enough sleep to avoid overproduction of the hunger-inducing hormone ghrelin? How much do you know about body composition, the endocrine system, metabolism, nutrition, and exercise physiology?

There are myriad ways to be skilful around weight loss plans, and you may need to consider adopting some of them for success. For example, do you have effective interpersonal skills to communicate your needs to the people in your life that exercise and healthy eating is valuable to you, and you need their support? Or do you have the skills to join a peer group that exercises regularly. Perhaps you could improve your financial skills to budget for a Personal Trainer.

If we must merely “strong-arm” ourselves to achieve every end, we end up exhausted and discouraged, with few accomplishments. “Skilful will” allows us to use will not as a direct power or force, but as a function which stimulates, regulates, and directs other functions of ourselves so that they lead to the goal. For example, learning mindful eating skills may cultivate a relationship with bodily sensations which allows you to observe the sensation of true hunger pains as opposed to times when you eat because of boredom or wanting to feel good (temporarily). You can also learn skills to meet alleviate boredom or feeling emotionally nourished in other ways.

Even with employing strong and skilful will, however, your may not achieve your goal(s). That’s okay. Please do not judge yourself. It’s what Buddhism called the second arrow. That is, you already didn’t meet your goal (the first arrow) and then you judge yourself for it (the second arrow). You are human, not superhuman.

A third aspect, equally important with the first two, may also need to be employed. It is “Virtuous Will”.

Virtue

Is your goal something you can achieve all by yourself through prudent use of strong and skilful will? No one is an island; we all live in communities and interact with family, friends, co-workers, gym instructors, enemies, and others on a regular basis. Those willed acts that succeed in accomplishing the will-er’s goal do so because they have considered the need to choose goals that are consistent with the welfare of others and the common good of humanity. They also must be consistent with “virtuous will” to the “self”.

The bottom line here is that many people need to do serious work around having virtuous will for themselves. For example, if you “hate” yourself for weighing more than what you would like, the motivation for change is unlikely to succeed because it is born in self-hatred. It is more effective to improve your self-esteem and sense of worth as a person, independent of your goal, so that any weight loss and subsequent weight maintenance can be in the context of “something I do to value myself; I like myself as I am and want to enhance the health of that self”.

Accessing transpersonal will

According to Roberto Assagioli, the founder of Psychosynthesis, using our will doesn’t stop with developing strong, skilful, and virtuous will: the three aspects of personal will. Assagioli claims that we can manifest all three of those and still be unhappy if we do not see how our personal goals align with something greater than ourselves. Having that solid sense of meaning and purpose to achieve something beyond the benefit of our little “self” helps us to reach beyond the limitations of ordinary consciousness to more expanded, intense states of awareness.

To yearn for that and not have it is what Viktor Frankl called “the abyss experience”: the opposite of Maslow’s peak experience (Boeree, 2006). Yet it is often in the abyss and despair of meaninglessness that we feel the pull of the superconscious, activating our transpersonal will and giving us access to another level of being. And then life becomes more interesting, as we try to balance the needs of material life (our immanence) and those of our higher levels of being (our transcendence), experienced as intentions arising from our transpersonal will.

Even the hypothetical person’s goal of weight loss (seemingly a very personal goal) may be able to access transpersonal will. Let’s say you lose the weight, arriving at your goal weight. You may enjoy a slender new body for a while, but ultimately that may not be enough to sustain lasting contentment, peace, and satisfaction. Looking “good” may not be the sole purpose of the original intention. If you can transform your goal, however, to a goal more inclusive of potential good for humanity as a whole — you may find that your personal will is aligned with transpersonal will. Just look at all the people on Youtube trying to help others, or the reward and continued sobriety members of Alcoholics Anonymous are given by “helping others”. Transpersonal will goes beyond the self and comes back to support our intention. Perhaps you want to write about healthy-body image as a method to transcend your Will to others.

The Will and the End of this Article

An effective and intentional use of will increases joy, openheartedness, and equanimity. Through use of not only strong will, but also skilful and good will — and perhaps even transpersonal will — your New Year’s resolutions will be far more likely to succeed, and you can experience willing as an act that leads to joy.

References

3. Assagioli, R. (1973/1984). The act of will: A guide to self-actualization and self-realization. Wellingborough: Turnstone Press.
4. Boeree, C. G. (2006). Viktor Frankl. Personality theories. Shippensburg University. Retrieved on 5 November, 2012, from: Website.
5. Mental Health Academy. (n.d.). Understanding Will. Mental Health Academy.

1. Alcohol (ethanol) enters the body through the oral cavity (i.e., the mouth). The inner surface of the oral cavity is mucosal tissue to keep the cavity lubricated and it is capable of absorbing alcohol into the bloodstream. This absorption is considered “insignificant”.

2. Alcohol flows down the oesophagus to the stomach where 10-20% of ethanol will be absorbed into the bloodstream. Alcohol enters the bloodstream via the mucosal tissue of the stomach wall, and travels straight to the liver. Alcohol can take 5-10 minutes to reach the brain because of the ethanol absorbed via the stomach. If you drink alcohol on an empty stomach, the pyloric sphincter [gateway between the stomach and the small intestine] is going to be more open, and the alcohol is going to immediately enter the small intestine after reaching the stomach. If food is also present in the stomach, the sphincter will open and close at a rate that allows food to enter the small intestine gradually, therefore if alcohol is also in the stomach, it will gradually enter the small intestine.

3. Alcohol flows through the pyloric sphincter into the small intestines where most alcohol absorption occurs. Human intestines are attached the to the posterior abdominal wall by a fold of membrane called the mesentery. Alcohol is absorbed into the mesentery via veins and then travels to the liver.

4. One function of the liver is that it detoxifies toxic elements into non-toxic elements before passing it to the heart and then the rest of the body. The liver sustains considerable “abuse” from a variety of toxic elements and chemicals, and therefore it needs to be capable of full regeneration. NOTE: Many diseases and exposures can harm it beyond the point of repair. These include cancer, hepatitis, certain medication overdoses, and fatty liver disease.

In the liver, ethanol is met with an enzyme called alcohol dehydrogenase and converts ethanol into acetaldehyde [ass-eh-tal-de-hide]. This chemical is more toxic than ethanol, so the liver uses another enzyme to convert acetaldehyde into acetate, which is non-toxic to the human body. NOTE: the amount of alcohol consumed + the timeframe it is consumed [and a variety of other factors] will influence the ability of the liver to effectively convert acetaldehyde all the way into acetate. The liver can’t handle the entire workload effectively therefore ethanol (before being metabolised) will go straight from the liver to the bloodstream and make its way directly to the heart.

NOTE: Genetics will play a role! Certain people do not produce the liver enzymes in enough quantity to properly breakdown ethanol.

5. Blood leaves the liver through the hepatic veins. The hepatic veins carry blood to the inferior vena cava—the largest vein in the body—to the right side of the heart. The heart will beat and send the incoming blood to the lungs to oxygenate and expel carbon dioxide as we breath out. This is how ethanol can be on your breath. Inside the lungs, at the very end of the bronchioles, are hollow air sacs called alveoli where there is a gas exchange. Ethanol evaporates through capillaries into the air sacs and exhaled out of the body. Breathalysers can detect the quantity of ethanol in a person’s system based on the quantity of ethanol in our breath.

6. Not all the ethanol will expel from the body via the breath. The rest will flow back to the heart, with newly oxygenated blood, and then get pumped all the way up to the brain and around the body. NOTE: Ethanol is water soluble. It will be distributed to every cell in the body except bone and fatty tissue [some will enter fat cells but not easily]. Ethanol will interact with every other cell i.e., every organ, gland, nerve, muscle etc.

7. Ethanol will affect and compromise protein synthesis inside muscle tissue. Therefore, if you have been training at the gym, running, swimming etc., your muscles will not effectively be able to repair.

8. Once ethanol has reached the brain, it will cross the blood-brain barrier and begin to affect chemical messengers [neurotransmitters] in the grey matter of the brain. It affects serotonin, dopamine, gamma-amino-butyric-acid (aka GABA), glutamate, endorphins etc. The person will experience pleasure, euphoria, lowered inhibitions [related to dopamine], lowered cognitive ability (e.g., decision making/problem solving, emotion regulation) and lowered coordination and reflexes.

The more ethanol ingested, the more dopamine is secreted and communicated between neurons (i.e., nerve cells). One of dopamine’s functions is to make you feel pleasure or ‘rewarded’ for doing things that are good for humans, hence, from an evolutionary perspective, we are likely to do them again to help us thrive in our environment and social world. Dopamine is secreted when we:

• eat healthy foods (but also recently developed processed foods that are high in sugar and salt)
• exercise
• achieve goals
• be productive (e.g., finish a task like cleaning, cooking, work-related tasks)
• master new skills (e.g., learning an instrument or a new talent), and
• have positive and stimulating social interactions

Ethanol influences so much dopamine secretion and communication that the brain becomes unable to make responsible decisions cognitively. The simultaneous experience of euphoria and lowered cognitive ability means we are more likely to be “happy” about making irresponsible decisions.

Increased dopamine is how drinking alcohol “blocks” unpleasant emotions like fear, stress, anxiety, and insecurity. When we don’t feel these unpleasant, yet necessary, emotions we will behave in ways that are dangerous, abnormal, potentially embarrassing, and generally problematic.

Another significant brain region affected by ethanol is the hypothalamus and the pituitary glad [together known as the hypothalamic-pituitary axis]. These structures control the entire hormonal system. The hypothalamus monitors the body, and it will send instructions to the pituitary gland based on information it receives from the hypothalamus. The hypothalamus is aware that ethanol is flooding the brain and it starts adjusting the secretion of hormones via the pituitary gland.

One of the instructions it gives the pituitary gland is to start modulating the adrenal glands to secrete cortisol (i.e., stress hormone) and epinephrine and norepinephrine (i.e., adrenaline).

Now, our cognitive capacity is diminished, inhibitions are lowered, and we will experience a rush of stress hormones and adrenaline coursing through the body. Cortisol and adrenaline will provide a boost of energy. It will increase the heart rate, blood pressure, body sweat, sugar levels in the bloodstream, and enhances the brain’s ability to use glucose. Glucose is a “fuel” source for brain functioning, including the generation of neurotransmitters. Behaviourally, we can see this in children when we say they are “hyperactive” because they’ve ingested too much sugar.

The pituitary gland will also slow the secretion of anti-diuretic hormone (aka. vasopressin). A diuretic is something that makes us urinate. If the anti-diuretic hormone (also called vasopressin) slows down, then we won’t be “holding on” to water as effectively, hence we begin to urinate more. People call this “breaking the seal”.

9. South of the body, blood is pumped into the kidneys via the renal artery which spreads through the renal cortex. The blood is then filtered into urine and expelled from the body. The lowered anti-diuretic hormone will dilate (become wider/bigger or more open) blood vessels in the kidneys which means more blood gets passed through and filtered, but it also means we lose a lot more body water which leads to dehydration. Vasopressin is essential in the control of osmotic balance, blood pressure regulations, and kidney function, therefore, when vasopressin is lowered, we are losing essential water and minerals/electrolytes. Electrolytes are involved in urination because the kidneys need them to make the process of filtering blood more efficient.

The loss of water and electrolytes will contribute to a hangover. Electrolytes play a role in cellular water absorption so if we are losing more water than we are bringing in, and we are losing the electrolytes that support the absorption of water, we become dehydrated very quickly.

10. The Hangover

Symptoms: nausea, fatigue, diarrhoea, vomiting, paranoia, anxiety, anorexia (i.e., loss of appetite), increased thirst, muscle weakness, irritability, sweating, increased blood pressure, and headache.

The exact cause of a “hangover” is not yet known however variables affecting the hangover are:

• individual differences such as sex, size, body fat, genetics etc
• lack of sleep
• general health
• drinking behaviour e.g., frequency, duration, quantity
• food intake before and during
• water intake before and after
• your body’s ability to metabolise alcohol i.e., excessive amounts of acetaldehyde due to fewer enzymes to metabolise alcohol in the liver before entering the bloodstream
• general behaviour while drinking e.g., poly-substance use, dancing, sexual activity, risk-taking behaviours etc.

Strategies for Controlled Drinking

• Setting personal drinking limits and sticking to it
• Alternating alcoholic drinks with soft drinks i.e., one alcoholic drink then a water, soft drink, or juice
• Have a meal before drinking
• Switching to low alcohol drinks
• Having regular alcohol-free days/weeks/months
• Identifying high risk situations for heavy drinking and creating a management plan

Engaging in alternative activities to drinking