"Hi, my name is Amanda...and I might be an alcoholic"
I swear nothing has made me happier than motherhood, but God forgive me, I find parenting after work between 5 and 9 P.M. a Sisyphean hell—picking Play-Doh out of the carpet; putting Polly Pocket clothes in one bin, shoes in another; coaxing my daughter into the tub; apologizing for the soap in her eyes and snagging knots in her hair; making dinner and lunch for the next day; folding laundry; strongly suggesting table manners; cleaning up dinner and more toys; and finally reading stories about lizards and princesses and talking cars. What can I say? It's a lot easier with a little buzz going.
Dr. Kosanke has me do a cost-benefit analysis about my alcohol consumption. I rate how drinking affects my relationships, job, health, and finances. I discover that, for me, the benefits of alcohol consumption slightly outweigh the costs. Wine worked. If it hadn't, as Dr. Kosanke pointed out, I would not have kept using it. The list showed me wine makes me a calmer, if hazier parent; and it's not very expensive since I like only cheap Chardonnay. On the downside, my sleep is totally disrupted, and my husband is worried because I've begun drinking every day. (Also, I am really bloated.)
"So, um, do you think the fact that it sort of works means I should keep drinking?" I ask.
"I think that you need to find other ways to get the benefits you get from alcohol," says Dr. Kosanke.
The Center for Motivation and Change is a freesia-scented, tastefully decorated place on New York's Fifth Avenue and 30th Street. It is staffed by bizarrely good-looking psychologists who offer a spa-like menu of services, such as a "mindfulness immersion day" (yoga, breathing, and meditation exercises), a two-week "readiness for change" evaluation (to see if you really want to give up your habit), and a "tracking program" (a way to assess how using drugs or alcohol is affecting your life). Inside its East-West/postmodern chicness, though, one of the center's philosophies is the extremely basic 33-year-old community reinforcement approach (CRA).
Taught by psychologist Robert J. Meyers, PhD, research associate professor of psychology at the University of New Mexico, CRA works on the principle that the most effective way to get people to reduce their substance abuse is to make sobriety more rewarding than addiction. "Some people drink because their personal relationships are terrible," says Dr. Meyers, who is the coauthor of Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening. "Others drink because their work is meaningless. Some are depressed. Some are anxious. Some are just bored. A few are burdened with a genetic predisposition for alcoholism. Many drink for an amalgam of all those reasons. But if you ask a person what they want out of life and help them start to achieve it, they're more likely to reduce their drinking than if you just tell them to stop drinking."
CRA has been lauded by the Journal of Studies on Alcohol as among the most cost-effective alcohol treatment programs and has been shown, in studies funded by the National Institutes of Health, more effective than traditional interventions. For instance, in one 2001 University of New Mexico study, alcoholics were randomly assigned to a CRA program or a 12-step treatment program. Over a six-month follow-up period, the CRA participants averaged 3 percent of drinking days, and those in traditional treatment averaged 19 percent of drinking days. In an earlier in-patient study, the CRA participants averaged only 5 percent of days unemployed, but the hospital's Alcohol Anonymous participants averaged 62 percent.