Social Rejection And Alcoholism

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We all know that there’s a distinct connection between leading a miserable life and alcoholism. Sometimes, cause, consequence, and correlation become inextricably tangled within the vicious cycle of heavy drinking and personal misfortune. A recent study, however, has shone a light into the connection between alcoholism and social rejection. It’s an important finding, which has implications across the board – on a healthcare level, it could help us to both prevent and treat alcoholism in vulnerable people. On a societal level, it demonstrates the kind of changes we need to make in order to keep the (fast-growing) spectre of alcoholism at bay.

The study, published by the Research Society on Alcoholism, saw participants use their smartphones to record social interaction and personal alcohol usage for fourteen consecutive days. Researchers then analyzed the style of interactions recorded, and the alcohol usage on the days when they occurred. They found that there was an association between rejective social experiences and the amount of alcohol drunk, with those who had had interactions classified as ‘rejective’ tending to drink more than those who had not.

Researchers were keen to stress that the closeness of the relationship in question appeared to be a significant factor. Those who had experienced rejection from those they considered ‘close’ were significantly more likely to drink heavily on the days when said interactions occurred than those who had experienced rejection from people who were not as close to them. Rejection by mere acquaintances did not appear to impact upon the likelihood of drinking. Interestingly, this is in contrast to previous lab-based studies, which have found that rejection and/or ostracism by strangers has more negative consequences than rejection by those close to us.

Though the contrast between the lab studies and the smartphone study are interesting, and bear further investigation, the study nonetheless has interesting implications. It is well established that ‘outcasts’ are more likely to become problem drinkers than others – although the link between rejection and drinking has not yet been made explicit. Children in the care system, for example, are more likely to grow up to be problem drinkers and substance abusers than children who grow up in stable family environments. Many former care-home children have spoken about the perpetual sense of rejection which comes from being shunted from foster family to foster family, and never getting ‘close’ to any one carer. Many feel a deep sense of ostracism, hardwired into their psyche by these early experiences of ‘rejection’ by caregivers. If the new study is to be taken seriously, it perhaps implies that many of the children who may grow up to become alcoholics could be saved from such a fate if they are provided with a sense of stability, and consistency in their caregivers. Yet another reason to ensure permanent, stable homes for children which enter the care system.

This finding could also help us in the treatment of alcoholics. Currently, the best models we have for alcoholism treatment are group work, aversion therapy, cognitive behavioral therapy, medically managed withdrawal (and supervision thereafter), and therapies which involve family and loved ones. Of these, alcohol-busting groups (AA, for example), and therapies which involve family and loved ones have the highest rates of ‘success’ (although nothing is certain – therapy for any alcoholic depends a lot on the individual in question, their triggers, their personality, and their prior life experiences). If rejection is a factor causing alcohol, could acceptance help to battle it? Providing an alcoholic with a loving, supportive, forgiving social environment – in essence, giving them a ‘family’ to accepts them for who they are – is a big factor in what makes groups like Alcoholics Anonymous so effective. Could the element of inclusion and acceptance here be what’s making the model work, and could that be rolled out across the medical and therapeutic disciplines in general, when dealing with alcoholism?

Quite why social rejection links to alcoholism like this remains unclear, but we all have something of an idea, I’m sure. For a start, social rejection leads to loneliness and feelings of inadequacy. These lead to depression, which is a well-established trigger for dangerous drinking behaviors. And we’ve all used alcohol as a ‘social lubricant’. Those who have been conditioned by rejection to believe themselves socially sub-par may be more likely to drink heavily in order to lower their social inhibitions and make themselves (in their view) more ‘interesting’. Quite how this can be tackled on a societal level remains to be seen, but the findings do solidify something many of us have implicitly known for a long time. Now we simply have to work out how to do something about it.

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Kaitlyn Mirabella

Is a contributor to The Almost Doctor’s Channel.