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Gary's Story: Part One - Discovering the Cure

NOTE: This is Gary's candid, personal account of his experience with The Sinclair Method.
This three-part series is used with permission.


“To cease smoking is the easiest thing I ever did. I ought to know because I’ve done it a thousand times.” —Mark Twain

...And isn’t that the sad truth?  To me the above joke - commonly attributed to Samuel Clemens (AKA Mark Twain), but employed on numerous occasions in different variations by W.C. Fields to refer to his drinking habit - epitomises the very definition of addiction. 

When it came to my own experience of alcoholism it was never the fact that I drank a lot and drank quite regularly that indicated that I had a problem... or whether I could even summon up the willpower to stop.... no, it was more the fact that I never seemed to have the willpower to stay stopped for any reasonable length of time that was the real problem.   

This was the vicious cycle that I seemed to be locked into for the better part of two decades.  Countless broken “Never again” promises and constant self-loathing.

How could I be so weak?  How could someone with such a bright, resourceful and determined personality as myself (in respect of everything else in my day-to-day life, that is) have such a battle on his hands in exercising self-control when it came to such a simple chemical substance as alcohol?

Truth be told, I was a mystery even to myself. 

Naturally, I tried to find answers.  As my addiction grew progressively worse there was the usual circuit of GPs, psychiatrists, addictions counsellors, Alcoholics Anonymous, CBT, Antabuse (*yeuch*... a horrible, horrible drug that’s prescribed as a cruel form of deterrent for alcoholics to abstain from drinking – see: http://en.wikipedia....wiki/Disulfiram), occasional hospital detoxes... and even, at one point, acupuncture... but it was all for naught. 

Nothing could get rid of this persistent hunger for alcohol.

Then a glimmer of hope around December 2012/January 2013.  In my desperation to fix myself I had turned to the internet, looking for something (Goddamnit, anything!) that might provide an answer.  A voracious reader since I was young, I went on a veritable feeding frenzy trying to absorb as much information as there was to glean on the subject of treatments for alcohol addiction.

And this is how I first heard about The Sinclair Method.  By stumbling across a couple of references to naltrexone on the world wide web and reading about its supposed near 80% success rate.  As you can imagine, this bold statistic practically jumped out of the screen and speared my eyeballs upon first reading it.

And my first reaction to this? ...That it was horse excrement, to put it bluntly.

But the fact of the matter is that around about this time I was becoming extremely ill.  My blood pressure was through the roof (we’re talking borderline hypertensive crisis which can lead to organ failure), the blackouts were getting increasingly worse and my mood swings were appallingly unpredictable by this point – I was a danger to myself and everyone around me... and so... to sum it up... I was an absolute physical and mental wreck.

So no... I simply didn’t have the luxury to cynically discount anything out of hand by this point.  I had to rigorously investigate every possible solution.  The fact of the matter is that I knew that my “expiry date”  had been moved forward because a GP had already told me that unless something changed I certainly wasn’t going see my fiftieth birthday and – as for what birthdays I’d see inbetween – well... that was a moot point.

Back to The Sinclair Method: despite my initial scepticism, I was shocked to learn that there was already quite a lot of research behind this treatment method... a mountain of research, actually... some 100+ clinical trials/studies, in fact.... and that it could all be in fact traced back to some groundbreaking theories first proposed by one gifted American psychologist studying alcohol addiction in Helsinki, Finland back in the late 60s. 

The psychologist’s name: Dr. John David Sinclair (or just “David” to his friends).
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(Dr. John David Sinclair, Ph.D., Emeritus researcher)

What Dr. Sinclair proposed with his theory of addiction and de-addiction through Pavlovian reinforcement and extinction (respectively) was so profound and, it has to be said, so elegant that I knew that I had to find out as much about it as I could... so I immediately resolved to buy Roy Eskapa’s book The Cure for Alcoholism – a seminal work which most consider the definitive instruction manual on TSM.

Through this book I learned more about the vital role that the brain’s own endogenous opoidergic system (AKA endorphin system) and the role that opiate blockers such as naltrexone and nalmefene play in pharmacological extinction and how this method of treatment is unique in respect of the fact that to ensure success a person has to take the medication and then drink “as they normally would” an hour later.

Yes, dear reader, you read that correctly; your eyes aren’t deceiving you: you have to drink whilst you’re on this medication to enable pharmacological extinction to take place.  This treatment simply does not work any other way.  The formula is Nal + Alcohol = Cure.

The reason for this is that in order for selective extinction of a learned behaviour such as alcoholism to take place, the specific behaviour that is desired to be extinguished (in this case the drinking of alcohol) needs to be present in order for reinforcement (i.e. “learning”) via the endogenous opidergic system to be blocked by the opiate blocker.

In Pavlovian terms, here’s what happens: the dog learns to salivate at the sound of the bell when food is accompanied with the ringing... to the point that the dog associates its very sound with food and salivates on cue... but in order to unlearn this behaviour – for the dog to “get wise” and ignore it - the bell has to be rung a number of times, but in the absence of food.

Its human alcoholic analogue is thus: for extinction to take place the bell still has to be “rung”... meaning that drinking needs to take place... but the endorphin receptors need to be blocked so that the reinforcement of the neural pathways that have grown into superhighways (to the point of making a person hopelessly addicted to alcohol) can no longer take place... and so that with repeated, targeted use of this method, pharmacological extinction takes place instead... the superhighways shrink and turn into narrow roads – and control over alcohol is gradually regained.

If no behaviour is targeted by being performed whilst our nervous system’s own natural “learning short cut” (the endorphin system) is blocked, then no extinction of this behaviour can even begin to take place.

Taking naltrexone or nalmefene without drinking is comparable to an especially dim-witted computer programmer (think Homer Simpson during a particularly vacuous moment) typing a piece of code saying “Uh duh... I think I want something deleted... uhmmm, I think...” and the computer shooting an error message right back at him saying “Delete what exactly??  You haven’t specified anything.  Your coding is incomplete: insufficient data.”.

So: what you instead have is incomplete and in fact worse than useless because it’s quite possibly detrimental (see HERE for an old article that I wrote that explains why naltrexone + abstinence is a bad idea for an alcoholic).

Anyway, I must apologise.  I’ve gotten a little ahead of myself here.  I need to rewind a bit and go back to one or two other things that were going on around the same time that I discovered The Sinclair Method... and at this point a certain Hollywood actress takes centre stage and is a crucial catalyst in my finally acquiring the treatment that I so desperately needed.

I’ll discuss that and more in Part Two
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