Ask An Expert: Karen (Psychologist)

Monday 23 Jan, 2017, 3:00pm by Mrs D 14 comments

These ‘Ask An Expert’ posts are interviews I’m carrying out with trained individuals who come into contact with people struggling with booze. The idea is to humanise and demystify the clinical/medical field for us all, to draw information from these kind and knowledgable people, and hopefully in some instances empower us to reach out more for the great help that is available in the community.

Today’s expert is Karen Nimmo, a Clinical Psychologist working in Wellington.

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Mrs D: How do you come into contact with people who have a problem with alcohol?

Karen: I see clients (many of them athletes) for many different issues. Alcohol is just one of them.

Mrs D: Is alcohol misuse often the main problem they face? Or are there often other underlying issues they are battling?

Karen: Alcohol can be the main problem for the athletes I see. Not very often though. Alcohol is almost never the first reason that other clients would book an appointment – it usually takes some time, and some questioning, for them to raise it. People come to a psychologist for all sorts of reasons – depression, anxiety, trauma, body image issues and – perhaps the most common of all – relationship issues, not just with their partner but with families, colleagues, friends and often adolescent children. A lot of the clients I see are high functioning people with families etc who have found that their alcohol use is just a little beyond healthy – and getting worse.

Mrs D: Do you think alcohol ‘gets in the way’ of a person being able to address underlying underlying issues?

Karen: Sometimes. Actually, definitely. Often people are in denial about their use – or the extent of their use. Psychological treatment can be a waste of time if the person continues to drink heavily throughout it.

Mrs D: What sort of impact can heavy alcohol use have on a person’s emotional wellbeing?

Karen: A massive impact. There are clear and evidenced associations between alcohol and depression, mood disorders and anxiety. Conflict is often fuelled or heightened by alcohol. And alcohol makes people do impulsive things, things that they later regret. The consequences of heavy alcohol use on a person’s life are significant. Psychologists will look at the fallout as part of assessment/treatment- on relationships, families, work, safety (e.g. driving, impulsive acts), ability to manage own emotions and live satisfactorily. Sometimes the real damage is seen a generation on. I couldn’t count the number of clients I have seen who have mentioned drinking as a problem for one or other of their parents, their home environment, their own emotional stability.

Mrs D: Often we think the alcohol is helping us deal with stress and negative emotions (I know I did), do you think alcohol helps a person deal with those things?

Karen: Alcohol may help in the moment by easing anxiety, helping you feel more chilled out or socially less inhibited – or by smothering negative thoughts and emotions. That’s really just a smokescreen for all that follows. Anxiety and mood swings (including anger) is often significantly increased in the aftermath of drinking heavily or even consistently. Stuffing your emotions away can have serious implications on your relationships with partners, friends, families and your children.

Mrs D: What sort of approach do you take with an individual?

Karen: The approach depends on how much people are ready to admit to and own their issue with alcohol. So I’d start with a motivational interview to assess where the person is at and what they are hoping to achieve. A motivational interview is simply a style of questioning that allows the psychologist to assess how ready a person is to make change, and also to see what personal characteristics or strengths they have that can be used to help them. Also, to identify any barriers or vulnerabilities that may hold them back.

Mrs D: How can you help someone gain the strength and determination needed to remove alcohol from their lives? How can they help themselves?

Karen: Depends on the person. You model the treatment to the individual – not the other way around. It’s very similar to treating weight loss – you can’t help someone unless they are ready to change. When they are at that stage, it is about building self understanding – so people are aware of their history, reactions, vulnerabilities, triggers. And also their strengths, the things they can call on to help them build a new way of life. There are lots of strategies that you can put in place to assist with their goals. You also have to think about relapse and ways to deal with this. One of the key elements of treatment is helping people build a new identity as a person “who does not drink”. This is vital because without it, people return to what they know – often as soon as they are put under emotional pressure.

Mrs D: What’s the best part of your job?

Karen: Helping people to understand themselves, contributing to someone having a better and more meaningful life. It’s gold.

You can find Karen’s website here.

14 comments

  1. Being that person who doesn’t drink has such negative connotations for me (boring, dull etc) yet I know I had got to a point of not being fun when I’d had too much (every family gathering especially). 18 days in I feel like there’s a big mountain to climb, even though physically and mentally I feel great

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  2. The piece that jumps off the page for me is “building a new identity” . Having a clear vision of the type of person you want to be definitely helps but it takes a while for this to develop.

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  3. Thanks for all the answers Karen – really helpful reading them all. I would really like to run groups – have to get my registration done, but this site has changed me from thinking I could never work with addictions, to having a way deeper understanding, first of myself, & secondly of others and the myriad of reasons we get ‘trapped’.

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  4. Thank you for this insight. Are you able to advise some tips for building a new identity as someone “who does not drink”. After reading this I understand the concept of how you could return to drinking as it is something you know but would like some advice to make this new identity. I am finding at 153 days that people are starting to say – when are you going to drink again or will you ever drink again. Its something I don’t want to do but the question plants a seed in the brain!

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    1. Hi Robbz
      Great comments, thanks. Building an identity that doesn’t involve drinking is an absolutely critical part of the process. The focus needs to be on who you are and what you do (instead of what you don’t do – drink). In a nutshell, the most important thing is to have a really good understanding of what you are good at and what you enjoy doing. And also to be aware of how you react in certain situations. This can be harder than it sounds so a little bit of professional help can be valuable. Karen

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  5. Thank you for being here!

    In your experience, what are some key changes that you see successful sober people make? Either mental changes or day to day habit changes?

    Thank you.

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    1. Hi Goldfinch
      I’d say a having a really good/structured plan around when you feel vulnerable – and knowing who your “people” are when you need support (e.g. your family, your key friends, your “community” And also having a good understanding of who you are as a person: what you enjoy, what you are good at, who you like being with (or not), what fires you up (and what doesn’t). Self-understanding is everything! Karen

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  6. Wonder why it is so many people don’t realise alcohol is a big reason they’re struggling emotionally or having trouble with relationships… why are we so blind to the negative effects of alcohol?

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    1. Hi,
      You are right! Life can be pretty difficult though and sometimes alcohol is just part of the big mess that people get themselves into. Probably the saddest fallout of heavy alcohol use/abuse is on relationships though – and that’s often the thing that drives people to get help – the knowledge that their drinking may destroy lives other than their own.
      Karen

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  7. This is very clear and sounds as if people who get to see you are fortunate indeed. Do you set up groups at all? Find those with similar motivation and compatibility likely, so they can support each other?

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    1. Hi Morgan
      Groups are a great idea – especially because AA doesn’t suit everyone often because of its religious/spiritual foundation. I think there’s a real need (massive!) for support groups that cater to modern drinking issues and the people who are struggling with them because alcohol abuse looks quite different than it did 20 – or even 10 years ago and the needs of people are different. I don’t currently run a group – I probably should!
      Best, Karen

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    1. Hi there,
      I know a few but it is most important to get a “match” with who you are and how you operate. Best plan would be to go on the NZ College of Clinical Psychologists (NZCCP) website, look under your region and find someone who specialises not so much in alcohol but in CBT (Cognitive Behavioural Therapy) or ACT (Acceptance and Commitment Therapy) – or a combination of both. Then look up their website and call them and discuss your needs. You’ll soon know if they sound like someone you could work with! Karen

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