Can a pill cure alcoholism? Film looks at how prescription drugs can fight addiction

Between one and 10 per cent of Canadians receive evidence-based treatment.

Mike Pond,Vancouver psychotherapist and an alcoholic, and his partner, Maureen Palmer, set out to make a film exploring the latest science on addiction treatment.



Research shows that addiction is approximately 60 per cent inherited and 40 per cent environment.

Their documentary Wasted by Bountiful Films, airs Jan. 21 on The Nature of Things on CBC-TV




People with a substance abuse problem are three times more likely to have a mental illness.

In this segment The Current spoke to:

  • Mike Pond,  psychotherapist in private practice.
  • Maureen Palmer, filmmaker and journalist.
  • Dr. Evan Wood, professor of medicine and Canada research chair at UBC.  He’s also an addiction physician and medical director for Addiction Services for Vancouver Coastal Health.

If you, or a loved one, have struggled with alcoholism and getting treatment, or if you have experience with the medications for alcoholism, let us know how effective they were for you.  

Send us an email. Reach out on Facebook or on Twitter@TheCurrentCBC.

This segment was produced by The Current’s Liz Hoath.


Realistic Thinking – Self Help Strategies

From AnxietyBC

We can all be bogged down by negative thinking from time to time, such as calling ourselves mean names (e.g., “idiot”, “loser”), thinking no one likes us, expecting something, terrible will happen, or believing that we can’t overcome something no matter how hard we try. This is normal. No one thinks positively all of the time, particularly when feeling anxious.

When we are anxious, we tend to see the world as a threatening and dangerous place. This reaction makes sense, because imagining the worst can help you to prepare for real danger, enabling you to protect yourself. For example, if you are home alone and you hear a strange scratching sound at the window, you might think it’s a burglar. If you believe that it’s a burglar, you will become very anxious and prepare yourself to either run out of the house, fight off an attack, or run to the phone and call for help. Although this anxious response is helpful if there actually is a burglar at the window, it is not so helpful if your thought was wrong: for example, it might be a tree branch scratching the window. In this case, your thoughts were wrong because there was no real danger.

The problem with thinking and acting as if there is danger when there is no real danger is that you feel unnecessarily anxious. Therefore, one effective strategy to manage your
anxiety is to replace anxious, negative thinking with realistic thinking.


Realistic Thinking

Effectively managing negative emotions involves identifying negative thinking and replacing it with realistic and balanced thinking. Because our thoughts have a big impact on the way we feel, changing our unhelpful thoughts to realistic or helpful ones is a key to feeling better. “Realistic thinking” means looking at yourself, others, and the world in a balanced and fair way, without being overly negative or positive. For example:


Steps to Realistic Thinking 

  1. Know what you’re thinking or telling yourself. Most of us are not used to paying attention to the way we think, even though we are constantly affected by our thoughts. Paying attention to your thoughts (or self-talk) can help you keep track of the kind of thoughts you typically have.
  2. Once you’re more aware of your thoughts, try to identify the thoughts that make you feel bad, and determine if they’re problematic thoughts that need to be challenged. For example, if you feel sad thinking about your grandmother who’s been battling cancer, this thought doesn’t need to be challenged because it’s absolutely normal to feel sad when thinking about a loved one suffering. But, if you feel sad after a friend cancels your lunch plans and you begin to think there’s obviously something seriously wrong with you and no one likes you, this is problematic because this thought is extreme and not based on reality.
  3. Pay attention to the shift in your emotion, no matter how small. When you notice yourself getting more upset or distressed, ask yourself, “What am I telling myself right now?” or “What is making me feel upset?”
  4. When you’re accustomed to identifying thoughts that lead to negative emotions, start to examine these thoughts to see if they’re unrealistic and unhelpful. One of the first things to do is to see if you’ve fallen into Thinking Traps (e.g., catastrophizing or overestimating danger), which are overly negative ways of seeing things. You can also ask yourself a range of questions to challenge your negative thoughts (see Challenge Negative Thinking), such as “What is the evidence that this thought is true?” and “Am I confusing a possibility with a probability? It may be possible, but is it likely?”
  5. Finally, after challenging a negative thought and evaluating it more objectively, try to come up with an alternative thought that is more balanced and realistic. Doing this can help lower your distress. In addition to coming up with realistic statements, try to come up with some quick and easy-to-remember coping statements (e.g., “This has happened before and I know how to handle it”) and positive self-statements (e.g., “It takes courage to face the things that scare me”).

It can also be particularly helpful to write down your realistic thoughts or helpful coping statements on an index card or piece of paper. Then, keep this coping card with you to help remind you of these statements when you are feeling too distressed to think clearly.


Check out the worksheet




A Different Path to Fighting Addiction

JULY 3, 2014

Carrie Wilkens works with substance abusers and families at the Center for Motivation and Change in Manhattan. Credit Kirsten Luce for The New York Times

When their son had to take a medical leave from college, Jack and Wendy knew they — and he — needed help with his binge drinking. Their son’s psychiatrist, along with a few friends, suggested Alcoholics Anonymous. He had a disease, and in order to stay alive, he’d have to attend A.A. meetings and abstain from alcohol for the rest of his life, they said.

But the couple, a Manhattan reporter and editor who asked to be identified only by their first names to protect their son’s privacy, resisted that approach. Instead, they turned to a group of psychologists who specialize in treating substance use and other compulsive behaviors at the Center for Motivation and Change.

The center, known as the C.M.C., operates out of two floors of a 19th-century building on 30th Street and Fifth Avenue. It is part of a growing wing of addiction treatment that rejects the A.A. model of strict abstinence as the sole form of recovery for alcohol and drug users.

Instead, it uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people to take.

And unlike programs like Al-Anon, A.A.’s offshoot for family members, the C.M.C.’s approach does not advocate interventions or disengaging from someone who is drinking or using drugs. “The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Carrie Wilkens, a psychologist who helped found the C.M.C. 10 years ago. “Science tells us those formulas don’t work very well.”

When parents issue edicts, demanding an immediate end to all substance use, it often lodges the family in a harmful cycle, said Nicole Kosanke, a psychologist at the C.M.C. Tough love might look like an appropriate response, she said, but it often backfires by further damaging the frayed connections to the people to whom the child is closest.

The center’s approach includes motivational interviewing, a goal-oriented form of counseling; cognitive behavioral therapy, a short-term form of psychotherapy; and harm reduction, which seeks to limit the negative consequences of substance abuse. The psychologists also support the use ofanti-craving medications like naltrexone, which block the brain’s ability to release endorphins and the high of using the substance.

A 2002 study conducted by researchers at the University of New Mexico and published in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy and naltrexone, which are often used together, are far more effective in stopping or reducing drug and alcohol use than the faith-and-abstinence-based model of A.A. and other “TSF” — for 12-step facilitation — programs. Results of an updated study have not yet been released.

Researchers elsewhere have come up with similar findings. In 2006, the Cochrane Library, a health care research group, reviewed four decades of global alcohol treatment studies and concluded, “No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems.” Despite that research, A.A.’s 12-step model is by far the dominant approach to addiction in America.

Jack and Wendy’s son, who is in his early 20s, began drinking to alleviate crippling anxiety and ease persistent depression. His drinking, while worrisome, was not an entrenched pattern, his parents believed. Some of Jack’s friends suggested that if their son did not attend A.A. of his own volition, the only thing Jack and Wendy could do was attend Al-Anon.

“The implication was that there was no other solution,” Jack said. “There was a great deal of sadness on their part, empathetic sadness, which in some ways was frightening in itself.”

“A lot of people credit A.A. with saving their lives,” he added. “It’s understandable that they can’t dissociate themselves from a program that worked for them. But it’s an all-or-nothing commitment for life. That really freaked me out.”

In A.A.’s literature, “alcoholism” is defined as “a progressive illness that can never be cured.” Members describe themselves as being “in recovery,” which translates to lifelong abstinence and adherence to the 12 steps mapped out in the Big Book, published four years after the organization was founded in 1935. First among them is the obligation for members to admit their “powerlessness” over alcohol. It also relies heavily on faith; God is mentioned in five of the 12 steps.

On a warm evening last month, about a dozen parents gathered to hear Dr. Kosanke describe the center’s program for families, which goes by the acronym Craft, for Community Reinforcement and Family Training. It rejects, she said, the use of three words: “addict,” “alcoholic” and “enabling,” a term often used to describe the acts of loved ones that help perpetuate unhealthy behaviors.

Instead of addict or alcoholic, she prefers the terms favored by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or the DSM-V, which says that patients suffer from “alcohol use disorder” or “substance abuse disorder,” terms that convey a spectrum of severity.

“Substance use takes on a lot of different shapes and sizes,” Dr. Kosanke said. “There are real downsides to labeling a child with a lifetime identity, when that truly may or may not turn out to be the case.”

And calling caring behavior enabling, she said, has a way of turning even acts of kindness into something negative. “Our field hasn’t done a good job of defining it in a narrow way that’s appropriate,” she said. “If you give your kid money knowing he will go buy pot, that’s enabling. If you take your kid to soccer practice, you’re encouraging healthy behavior. That’s not ‘enabling.’ ”

Part of the Craft approach has parents take care of themselves, too, said Lorraine McNeill-Popper, who volunteers for the parent hotline at thePartnership for Drug-Free Kids, a nonprofit group devoted to recovery for young people. “If you are sleep-deprived and stressed out, how can you think clearly?” she said.

Ms. McNeill-Popper has her own family history of drug abuse. Her twin brother died of an overdose, and she adopted his son, who later became a heavy marijuana user and ended up in rehab. “I tell parents, ‘It’s like when you’re on an airplane, and they tell you to put the oxygen mask over yourself first. That way you can help with the others.’ ”

The center’s approach is controversial in the recovery world. David Rotenberg, executive vice president of treatment at the nonprofit Caron Treatment Centers, a large drug and alcohol rehabilitation provider with branches in several states, cautioned against approaches that do not set abstinence as a goal.

“The majority of people who are chemically dependent would love to be able to drink and drug in a more moderate fashion,” Mr. Rotenberg said. “Most drug addicts and alcoholics would love to drink just a couple of drinks, and they try to do so, with poor results.”

The C.M.C. doctors say treatment for young people needs to be tailored for them, since teenagers and young adults are neurologically, psychologically, socially and legally different from adults, and have different treatment needs.

Dr. Wilkens founded the center with a fellow psychologist, Jeffrey Foote, in 2003. The two had worked together in larger hospital-based treatment centers where they struggled to introduce evidence-based treatments, she said. When it opened, the C.M.C. was one of the few centers in the nation that were not tethered to the 12-step model, she said.

“It was our strong belief that you can work with people at any stage of change, ranging from ‘I’m not even sure I have a substance problem’ all the way to ‘I just got out of rehab and want to go to A.A. meetings every day,’ ” Dr. Wilkens said. “We don’t have a judgment on how you address your substance use problem. Maybe A.A. is helpful to you and you find everything you need there. If it’s not, we genuinely believe there are many strategies for helping to resolve them.”

In fact, a majority of college binge drinkers do not go on to become alcohol dependent, said Stanton Peele, a Brooklyn psychologist who has studied substance use for decades and is a longtime critic of the A.A. model. While binge drinking and other drug use are risky, multiple studies show that most people “mature out” of such recklessness when they begin to have increased responsibilities.

A federally financed study of 43,000 randomly selected Americans, called the National Epidemiologic Survey on Alcohol and Related Conditions, orNesarc, found that 75 percent of those who are heavy drinkers eventually regain control without rehab or A.A., Dr. Peele said. The survey, which was conducted in the early 2000s and was designed to be representative of the larger United States population, was aimed at helping researchers understand high-risk drinking patterns, design better-targeted treatment programs and monitor recovery. It found that over half of those who recover managed to cut back instead of abstaining, Dr. Peele said.

“Isn’t it more encouraging to know that most people are going to outgrow these habits than to think they’re going to have a disease for the rest their lives?” Dr. Peele asked. “The data show that the odds are in your favor.”

Dr. Wilkens is familiar with that pattern. She was a college binge drinker herself and also struggled with bulimia. Once she left her home state of Kansas for New York City, where she attended Hunter College, she felt culturally stimulated and intellectually challenged, she said, and the drinking and disordered eating disappeared.

“When you focus on building up the world around you, you find stimulation and rewards that are very different from using drugs and alcohol. You find other ways of soothing yourself, and things can get better,” she said.

That is precisely what L.S. learned five years ago. L.S., a Manhattan lawyer in his early 30s who asked to be identified only by his initials to protect his privacy, spent nearly a decade as an episodic binge drinker. He began drinking as a student at his large Midwestern university, where he played rugby and where many of his best friends belonged to fraternities. Alcohol, he said, flowed freely through both subcultures. L.S. said he thought his drinking — weeks of no drinking followed by serious binges of a few dozen drinks over several days — would end after college. Yet the behavior did not fade. The morning after his wedding, he awoke with a hangover that lasted a day and a half.

His father, who drinks socially, told him that people either were alcoholics or were not. But L.S. was unprepared to accept that label and began researching moderation on his own. He found a New York branch ofModeration Management, or M.M., a secular, peer-led support group that takes a cognitive behavioral approach.

In contrast to A.A., which stresses a drinker’s lack of power in the presence of alcohol, M.M. encourages personal responsibility for drinking. The group, founded in 1993, encourages members to start with an alcohol-free month, and then allows for the reintroduction of moderate amounts of alcohol. (Critics note that one of its founders, Audrey Kishline, was involved in a fatal accident while driving drunk. She left the group in January 2000 with the intention of joining A.A., and three months later, crashed head-on into another vehicle, killing the driver and his 12-year-old daughter.)

L.S. now attends hourlong meetings once a week at which he and about a dozen others discuss their goals for moderate drinking, as well as tips, challenges and progress on avoiding triggers. Since he began attending, L.S. limits himself to about five drinks a week, well below the 14 drinks M.M. advises as a safe limit for men.

L.S. is convinced that there is no single approach for all problem drinkers. “M.M. doesn’t profess to work for everybody. It has a scientifically based approach that works for some people,” he said.

The C.M.C. psychologists are blunt about the reasons many teenagers and young adults use drugs: When it comes to decreasing anxiety and relieving depression, substances tend to work for the short term. “Kids aren’t crazy for using them,” Dr. Wilkens said. “They have an effect that is reinforcing in some way. If you understand that, you can strategically work to support and reinforce other healthy, competing behaviors.”

That approach runs through the book she wrote with Dr. Foote and Dr. Kosanke, “Beyond Addiction: How Science and Kindness Can Help People Change.” It was published in February, just as the death of Philip Seymour Hoffman from a heroin overdose struck fear in the hearts of many parents whose children use drugs. It landed Dr. Wilkens on several talk shows and drew scores of calls to the center. (In addition to its New York office, the group has opened a residential treatment center in the Berkshires.)

Dr. Wilkens’s message struck a chord with Wendy. Her son had just left school, and the couple was exploring treatment options. Wired in the evenings with extreme anxiety, he drank excessively to get himself to sleep. Once in bed, he’d stay there till 5 p.m.

Before she read the book, Wendy said, she would stomp upstairs hourly to announce in an exasperated voice, “It’s 2 o’clock. You’ve got to get out of there.”

“I’d do that three or four more times and then be fuming,” she said. “I’d be fuming all day, at home doing my work and knowing he was upstairs sleeping off whatever he’d been drinking the night before.”

After learning the Craft approach, Wendy said, she stopped nagging, changing her negative, accusatory tone to a more pleasant one by asking open-ended questions.

Today, Wendy and Jack’s son is working with his psychiatrist and getting help for his depression and anxiety. He seems to be bingeing much less. When the family went out to dinner on a recent night, the parents each ordered a beer or a glass of wine and sipped slowly through dinner. “How will he learn moderation if he doesn’t see it modeled?” Wendy asked.

Ellie hopes her daughter, too, will be able to change her drinking patterns. Ellie is a New York editor, who asked that her last name be withheld to protect her family’s privacy. Her daughter, 23, has struggled with binge drinking since she was 16. While her daughter graduated from college and holds a responsible job, she still binges on weekends. “It’s so much a part of the culture, it’s everywhere,” Ellie said. “She says she’d have no social life if she stopped drinking.”

Ellie, who grew up in a home in which many relatives attended A.A., at first tried Al-Anon. “They talk about ‘disengaging,’ ” she said. “But it’s your child, and I’m not one of those people who can put her out on the street.”

While their daughter has resisted treatment so far, Ellie and her husband have begun seeing a therapist at the C.M.C. to better navigate their relationship.

“My child is much more than a label or a diagnosis,” she said. “She’s not a problem to be solved, but a child to be loved and guided toward a better life.”

Less known in Canada than U.S., sobriety coaches help addicts stay abstinent

TORONTO – Toronto Mayor Rob Ford has engaged a “sobriety coach” after completing a two-month stint at an Ontario addiction treatment centre. But just what is a sobriety coach or companion and what do they do to help clients keep off alcohol or drugs as part of their long-term recovery?

While the existence of such sobriety buddies may be unfamiliar to many Canadians, the job of providing support to newly abstinent alcoholics or drug addicts has been fairly common south of the border for a number of years.

Celebrities like Lindsay Lohan, Matthew Perry and Owen Wilson have reportedly hired sober coaches, as they’re more typically called in the U.S., to help keep them from taking a tumble off the wagon.

“Somebody needs a sobriety coach when he or she has made multiple attempts to maintain abstinence, multiple attempts at residential addiction treatment … and multiple attempts at success — always followed by failure,” said Doug Caine, founder of U.S.-based Sober Champion.

The company, begun in 2006, has a stable of trained employees in such cities as New York, Chicago and London, who can be hired as coaches or companions to help keep recovering addicts on the straight and narrow, especially during the early and vulnerable period of sobriety. Last month, Caine expanded the business to Toronto.

“Ordinarily in the States — and this may not carry into Canada — when I talk about a sober companion, I’m talking about somebody who’s present in your life 24 hours a day,” Caine said from the Los Angeles area. “That’s real full-time work. And that person may be in your life for a week or month at a time.

“A sober coach typically is a person who will spend a certain number of hours per day or per evening with you, and the truth is the roles can be interchangeable,” he explained, noting that a client could, for example, ask the service provider to accompany them on an out-of-town business trip for a couple of days.

The service can last 30 or 45 days or longer, depending on the client’s needs and pocketbook.

Sober coaches charge from CDN$75 to $150 per hour, so the service could cost as little as $300 to $400 a day for two to three hours, he said. With a 24-7 companion, who may be staying at the client’s home, the cost can easily hit more than $1,000 per day.

Sober Champion employees — all recovered addicts who must have specialized training — work not just with the client but also with the person’s family, close friends and even co-workers.

“We perform many interventions all day long,” said Caine, formerly a professional musician who was hooked on heroin and cocaine until he finally got clean in 1999 and revamped his life.

“The goal is to model behaviour and to keep the eye on the prize — and the prize is to keep him off drugs (or alcohol) today,” said Caine, who is well-versed in Ford’s very public battle with substance abuse, which has garnered international attention.

Those interventions can take many forms — from discouraging contact with people the client used to drink with on adjacent bar stools to shutting down a person’s supply of alcohol or illicit drugs.

Caine recalls going to a New York client’s three favourite alcohol suppliers and persuading them not to sell to the woman, a “degenerate alcoholic,” because they were feeding her illness and would be hastening her inevitable death from drink.

“I’ll go so far as stealing somebody’s shoes and keys and wallet,” he said, adding that a service agreement signed by a client could also require them to surrender their passport, driver’s licence, credit cards and any cash.

But Caine admitted that there are times when there’s nothing a coach can do to stop a client from breaking down and plunging back into their habit.

“We can’t tackle the person.”

There are no rules about how far a sober coach or companion can go to protect their client — nor are their services or training regulated either in Canada or the U.S.

Ford’s sobriety coach is alleged to have kicked a protester while the mayor was holding a news conference Tuesday. Little is known about the man, and Ford’s spokesman Amin Massoudi did not respond Thursday to a request for information about him, including whether he is on duty with the mayor around the clock or how long he will stay on the job.

Dennis Long, executive director of Breakaway Addictions Services, says the Toronto treatment organization does not use sobriety coaches.

“It’s a new term to me,” said Long. Although recovering alcohol and drug addicts typically have a sponsor to call on for support and advice through groups like Alcoholics Anonymous, “having someone with you 24-7 is not usual,” he added.

“My assumption would be that they act somewhat like a sponsor in the AA sense. It’s somebody who is responsible for helping the individual. Somebody would accompany them, be there for advice, for guidance to sort of warn them when situations are getting out of hand.”

Long said that if the chemistry works between the two people, the concept of a sober coach or companion could be a good idea.

“But recovery’s not a short-term process … It’s not just stopping using. Recovery is a multi-faceted process which requires change in virtually every aspect of an individual’s life.

“And in the case of somebody like Mayor Ford, who is in a very, very high-stress, very visible position, it’s going to be a big job for the sobriety coach to try to support him in that.”

When relying on any service provider, and especially people who may not have had professional training and whose vocation is unregulated, “you can get good ones and you can get bad ones,” he offered.

“If it works, it can work really well. If it doesn’t work, it can go south in a really big hurry.”

Follow @SherylUbelacker on Twitter

Faire du sport pour la santé mentale

La Frontiere

Par Karina Osiecka

ROUYN-NORANDA – Un nouveau concept est né à Rouyn-Noranda. Une journée de marche et de course est organisée au Mont Kanasuta le 27 septembre. Le but est d’aider à surmonter la maladie mentale.

En effet, la journée Monter pour surmonter sera principalement au profit de la fondation Martin-Bradley venant en aide aux organisations qui soutiennent les personnes touchées par une maladie mentale. Une partie de la somme amassée sera remise au Club Dauphins Rouyn-Noranda. « 100 % de l’argent recueilli sera entièrement remis à ces deux causes », a souligné Sandra Bisson, une organisatrice.

« L’activité physique est beaucoup reliée à la santé mentale. Plus que les gens font de l’activité physique plus ils ont les chances d’éviter une dépression. C’est une cause qui touche pratiquement tout le monde. Chacun connaît quelqu’un qui a déjà souffert d’une maladie mentale », a ajouté Rémi Thibault, un organisateur.

Ghislain Beaulieu, président de la Fondation Martin-Bradley, est très heureux que la maladie mentale soit au cœur de l’événement. « Je félicite les organisateurs pour cette idée originale. Le fait que les organisations pensent à aider dans ce domaine prouve que la cause progresse beaucoup. Ça me réjouit. Ça veut dire que les actions de la Fondation portent fruit », a-t-il fait valoir.

Une activité accessible à tous

Monter pour surmonter est tout d’abord une activité physique rassembleur et accessible à tous. Pour cette raison, les organisateurs ont créé quatre volets participatifs: corporatif, familial, individuel et cross fitness. Toutes les arrivées vont se faire en haut de la montagne.

Le coût du volet corporatif est de 1000$. C’est un parcours de cinq kilomètres pour les membres d’une même entreprise. Le volet familial est destiné aux familles de quatre personnes et coûte 250$ pour l’inscription. « On demande l’âge minimum de huit ans pour que la montée reste agréable autant pour les parents que pour les jeunes. La course va se faire sur une distance de 3,5 km », a précisé Mme Bisson.

Le parcours individuel est une course solo de cinq ou 10 km. Le coût d’inscription est de 25$. « C’est une course à pied sans obstacle. Le sentier sera sécuritaire », a assuré Stéphane Richard de chez Momentum. « C’est un défi pour les participants. Les chances d’aller courir au Mont Kanasuta sont rares. Ce n’est pas permis d’habitude. C’est donc une opportunité », a-t-il poursuivi.

Le volet cross fitness est ouvert aux groupes mixtes de quatre personnes et se donne sur deux jours. Une partie va avoir lieu vendredi soir chez Momentum. Samedi matin, les participants vont se rencontrer pour un entraînement qui va finir par la course au Mont Kanasuta dans l’après-midi. « Ce n’est pas ouvert à tous. L’activité demande une bonne condition physique. On vise 20 équipes », a indiqué M. Richard.

Les inscriptions se font chez Momentum. La date limite est le 12 septembre.

The Disease to Please: Curing the People-Pleasing Syndrome


Recommended book: The Disease to Please: Curing the People-Pleasing Syndrome  by Harriet B. Braiker, Ph.D.


What’s wrong with being a “people pleaser?”


People pleasers are not just nice people who go overboard trying to make everyone happy. Those who suffer from the Disease to Please are people who say “Yes” when they really want to say “No” – but they can’t. They feel the uncontrollable need for the elusive approval of others like an addictive pull. Their debilitating fears of anger and confrontation force them to use “niceness” and “people-pleasing” as self-defense camouflage.

They may appear to the outside world as perennial “nice” people, but they are only concealing their true anger and resentment behind public “happy faces.” And they are hurting themselves and those they would otherwise seek to please.

Now, best-selling author and frequent Oprah guest Dr. Harriet B. Braiker offers help for people-pleasers. The Disease to Please presents clear, positive, practical and easily do-able steps toward recovery from a malady that sounds harmless, but can actually have serious and destructive consequences.


Like million of others, you may suffer from this incapacitating but surprisingly common problem. For many, the difficulty may start innocently enough with genuine and generous attempts to make others happy. But this seemingly harmless passion to always be “nice,” to put others first and to compulsively please them even at the expense of your own health and happiness rapidly spirals into a serious psychological syndrome with far-reaching physical and emotional consequences.

The Disease to Please explodes the dangerous myth that people-pleasing is just a simple problem of going overboard in seeking to please others. It reveals the underlying approval addition, toxic mindsets that rationalize and perpetuate the problem, and the fear and avoidance of anger, rejection and confrontation that fuel the emotional avoidance pattern.

Begin with a simple but revealing quiz to discover what type of people-pleaser you are and find out what drives your impulse to please others. Then learn how making even small changes to any single portion of the Disease to Please Triangle – involving your thoughts, feelings, and behavior – will cause a dramatic, positive and long-lasting change to the overall syndrome.

Next, you will be ready to embark on a 21-Day Action Plan for Curing the Disease to Please. This plan offers step-by-step, easy-to-follow solutions whose healing power you will experience for yourself one-day-at-a-time as it leads you through the small steps that will produce lasting rewards and recovery.

Inviting, warm, wise and inspiring, this truly therapeutic book will help you deal constructively with normal – though difficult – emotions and relationships, instead of trying to “please” your way out of them. As a recovered people-pleaser, you will finally see that a balanced way of living that takes others into consideration but puts the emphasis first on pleasing yourself and gaining your own approval is the clearest path to health and happiness. As Dr. Braiker points out, sometimes “it’s okay not to be nice!”

Read the book and join the ranks of recovered people-pleasers, and you will finally understand that there is far more to you than how much you do!

Alcohol kills millions a year, WHO says

A World Health Organization report finds that alcohol is killing or contributing to the deaths of 3.3 million people around the world every year. (World Health Organization)

A World Health Organization report finds that alcohol is killing or contributing to the deaths of 3.3 million people around the world every year. (World Health Organization) Staff

Published Monday, May 12, 2014 9:20AM EDT 

Last Updated Monday, May 12, 2014 2:26PM EDT

The World Health Organization is calling on governments around the world to take tougher action, in a new report that says alcohol is killing or contributing to the deaths of 3.3 million people a year.

“More needs to be done to protect populations from the negative health consequences of alcohol consumption,” Dr. Oleg Chestnov, WHO’s Assistant Director-General for Non-communicable Diseases and Mental Health said in a statement Monday, to coincide with the release of a new report.

In its “Global status report on alcohol and health 2014“, the WHO notes that alcohol can not only lead to violence and injuries, it also increases the risk of more than 200 diseases, including liver cirrhosis and several types of cancers.

The report found that 7.6 per cent of men’s deaths around the world are related to alcohol, as are 4 per cent of women’s deaths. The authors say they are also concerned about the steady increase in alcohol among women.

Alcohol causes death and disability relatively early in life, the report says. Approximately 25 per cent of deaths among those aged age group 20 to 39 can be attributed to alcohol.

The report found that on average, every person in the world over the age of 15 drinks 6.2 litres of pure alcohol per year. But since less than half the world’s population drinks at all — 38.3 per cent — those who do drink consume 17 litres of pure alcohol a year, on average.

“We found that worldwide about 16 per cent of drinkers engage in heavy episodic drinking – often referred to as ‘binge-drinking’ — which is the most harmful to health,” explains Dr Shekhar Saxena, director for Mental Health and Substance Abuse at WHO.

Globally, Europe has the highest consumption of alcohol per capita. South-East Asia and the Western Pacific are seeing increases in consumption, while in the Americas and Africa, consumption trends are stable.

The report notes that some of the 194 countries it reviewed already have several measures in place to try to protect people from the risks of alcohol. But many don’t have national awareness activities to remind citizens of the risks of drinking. And many more don’t have national policies aimed at reducing the harmful use of alcohol.

The report says all governments have a responsibility to implement and enforce public policies to reduce the harmful use of alcohol, including:

  • regulating the sale of alcohol, in particular to younger people
  •  enacting drink-driving policies
  • reducing demand through taxation and pricing
  • raising awareness of public health problems caused by harmful use of alcohol
  • providing affordable treatment for people with alcohol-use disorders

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Beverage tax ‘to fight alcohol abuse’

BY LINDA ENSOR, 06 MAY 2014, 08:48

A MAJOR review of the taxation of alcoholic beverages being undertaken by the Treasury as a contribution to the government’s fight against alcohol abuse is likely to result in higher taxes and prices.

The industry, faced with a deluge of regulatory proposals, is likely to resist the Treasury’s suggestions as it believes it is already overtaxed.

It is also having to fight off a proposed ban on liquor advertising, which Health Minister Aaron Motsoaledi is pushing for, as well as restricted trading hours.

Tougher law enforcement and stiffer penalties for drinking and driving have also been introduced.

The Treasury believes alcohol abuse in South Africa is “unacceptably high” and has to be reduced as “an urgent national priority for government”, not only because of its social consequences but also because it places too heavy a burden on the fiscus and on non-drinking taxpayers.

But it cautioned in a discussion document released on Monday that tax increases could not be so high that they drive heavy drinkers to illicit or more harmful alcohol.

In nominal terms, excise rates increased between 2002-03 and 2013-14 by 149% for beer, 233% for wine and 234% for spirits.

The inflation rate increased by a cumulative 62% over the same period. In 2012-13, the duties generated about R14bn for the fiscus.

Currently, the total tax (excise duties plus value-added tax — VAT) on beer, wine and spirits as a percentage of their weighted average retail selling prices is set at 23%, 35%, and 48% respectively.

The Treasury argued in its discussion paper that some of the social costs of alcohol abuse needed to be included in the price of the product. However, it was not sure whether the current system of excise duty was the correct mechanism for this.

It noted that the external costs that were associated with alcohol abuse were borne by the broader society due to the inability of liquor markets to adequately internalise — and price — for them.

In 2009-10 the national government allocated more than R10bn and provincial governments about R7bn to deal with the direct consequences of alcohol abuse, reduce the extent of such abuse and address its negative social impact.

After the revenue from excise duties on alcoholic beverages, VAT collected on alcohol sales and provincial liquor licences, net alcohol-related expenditure of about R890m had to be funded by the fiscus.

This did not take into account the expenditure incurred by municipalities, and the tangible and intangible costs of alcohol abuse for society, which have been estimated to be as high as R38bn and R243bn respectively in 2009.

“If excise taxation were to fully internalise the external costs of alcohol abuse, excise duties on alcoholic beverages would need to increase significantly,” the Treasury’s discussion document said. “However, higher excise rates may exacerbate social problems arising from excessive alcohol consumption as heavy drinkers turn to cheaper, or illicit, alcoholic beverages.”

The public has been given until June 30 to comment.