Cravings, Decoded – Part 4 of 7
Part 1: What Causes Alcohol Cravings
Part 2: The Craving Escalation Cycle
Part 3: When Mental Cravings Feel Physical
Part 4: Double-Barrel Alcohol Cravings ← you’re here
Part 5: Hidden Triggers That Mimic Alcohol Cravings
Part 6: How to Weaken Alcohol Cravings Over Time
Part 7: Practical Tools for Managing Alcohol Cravings
There were times when drinking was on my mind and my body felt wrong at the same time.
I could feel anxious or restless, then start picturing the drink I believed would calm everything down. It felt like one craving.
But there can be two different things going on, and they can make each other much harder to deal with.
The physical side
Regular heavy drinking can lead our nervous system to expect alcohol. As the alcohol level drops, we could feel on edge, trembly, clammy, nauseated or unable to sleep. Another drink may ease some of that quickly.
That can look like a craving being satisfied, but it could actually be withdrawal being temporarily relieved. That is very different from an ordinary wish for a drink, and it needs a different response.
We need to recognise the physical side for what it is instead of treating it like an ordinary mental craving.
The mental side
The other pressure comes from what alcohol has become connected with in our mind.
A difficult day brings up relief. A social event brings up confidence. Friday brings up reward. The thought appears because we’ve followed that same pattern so many times before.
We can also create more pressure by picturing the first drink and arguing with ourselves about whether to have it. Those mental drinking loops can keep going even after the physical side has been dealt with.
How the two pressures join together
Physical discomfort can bring up the old promise that alcohol helps. Then thinking about the drink increases our attention, tension and anticipation, so alcohol starts looking even more necessary.
If we drink, the discomfort may ease and the argument stops for a while. Our brain can take that whole experience as proof that the drink worked, even though it may have been easing a problem alcohol helped create.
That’s how the two pressures can keep strengthening the same cycle.
Why mixing them up causes problems
If we treat physical discomfort like an ordinary mental craving, we might distract ourselves without understanding what our body is doing. If we treat every drinking thought like withdrawal, we might never look at the routine, memory or belief that brought the thought up.
And if we call everything “one huge urge,” it can feel impossible to work out what would actually help.
Ask two separate questions
First: what is happening in our body as alcohol wears off? Are there repeated symptoms? Do they improve after drinking? Have we been drinking heavily enough for dependence to be possible?
If the answer could be yes, we treat the physical side separately and follow the stopping plan that applies to us.
Second: what is our mind promising? Are we picturing relief, reward, confidence or escape? Did a time, place, emotion or memory bring the thought up?
Those questions help stop two different problems from getting rolled into one.
Deal with each side for what it is
The physical drinking and withdrawal cycle needs its own response. The mental side means looking honestly at what we expect alcohol to do and what normally happens afterwards.
Some days one side might be much stronger. Other times, both could turn up together.
We don’t have to call it one mysterious craving. We can work out what our body needs, what our mind is doing and which part needs attention right now.
What progress can look like
The physical side needs its own plan and time before we can really see what mental cravings are left.
Then we might notice that certain thoughts still turn up at five o’clock or before an event, even though our body is no longer withdrawing. That is useful information. We can now work on the belief and routine without confusing it with a medical problem.
As the two pressures separate, the whole thing can feel far less frightening and much easier to deal with.
— Brent