How the Sober Brain Breaks Down Alcohol Associations (But They’ll Build Back Up if You Drink Again- A Replay)

0:00We believe that alcohol is required for vacations, unwinding, dealing with stress, celebrating, socializing, and basically everything else. We have built up powerful associations in our brains to reinforce these beliefs through dopamine and repetition. After you get sober, facing life without alcohol can feel impossible. Everything reminds you of it. You start to notice how prevalent it is on TV and in movies, and you think of all the things that you have coming up, and you can't imagine how you will do those things without alcohol. In this episode, I'm explaining how the brain builds associations, how that gets worse while we stay in the back and forth, and how we break down these associations after getting sober.

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2:21No one is addicted to alcohol when they first start drinking. This change happens over time as the brain gets used to functioning with alcohol present and as we reinforce that alcohol is the solution. Neuroplasticity allows the brain to adapt and change based on our current situation and reinforcement learning through dopamine allows the brain to build cues and a reliance on drinking. Eventually, alcohol feels essential for life. And if you feel that way, like you can't imagine life without drinking, then that is a problem drinker alert for you. When we quit drinking and really make that decision to be sober, this process happens in reverse.

3:10And no, please don't get any ideas here. Not all alcohol-induced brain changes and reinforcement learning is reversible. You will never be able to moderate. Never, ever. Controlling the obsession most of the time is not moderation. That is still being stuck in alcohol prison. Just because no one is addicted to alcohol when they first start drinking doesn't mean that this happened to you by random chance. Most people will never get addicted to alcohol despite it being an addictive substance. Something led you to think that alcohol is the solution and that's what you have to work on in sobriety.

3:51And I know it's easy to trick ourselves by thinking that we use alcohol to have fun, socialize, and relax, but people don't start listening to the Sober Powered podcast unless they're getting some negatives from their drinking. If it wasn't problematic for you, you would just go live your life. So for me, even at five years sober, if a client or a member describes the image of alcohol that they're romanticizing in great detail, my mouth will water a little bit. So depending on how far you progressed down the spectrum of addiction, we can have a physiological response to thinking about alcohol, and that is completely normal.

4:32A take-it-or-leave-it drinker isn't going to salivate or have their heart beat a little bit faster when they think about alcohol. This response doesn't mean that I'm doomed to relapse. It just means that my problem is still there in my head, but it's mostly dormant. I continue to live my life around it without issue, but if I start drinking again, I'll wake it back up. We are conditioned to believe that alcohol is required for certain things. Relaxing after work, celebrating, warm weather, dinner, the weekend, weddings, vacations. These beliefs cause cravings when the memories are triggered. And we didn't form all of these associations because we're losers or idiots.

5:16We formed them for two reasons. because it was fed to us while we were growing up, both from the media and what we observed in real life. I know that I learned that alcohol was a tool for stress relief in grad school. And the other reason is because our ability to form associations is meant to help us survive. If a food makes you sick, your brain remembers that and helps you avoid it. But with addiction, this survival mechanism gets completely hijacked. And that's because alcohol releases way more dopamine than any natural reward. So your brain categorizes it as critically important. To help you get more of it, your brain will actually start identifying earlier and earlier cues.

6:04So maybe sitting on the couch was your trigger. Like after you put the kids to bed, if you're a parent, if you're not a parent, maybe it's after you get home from work and everything is done and taken care of. then that's your trigger for, you know, quote, me time to basically blast your brain and numb out and escape your life for a couple hours. If this is repeated enough times, then whatever leads up to that, so that could be driving home, finishing work, 3 p.m., putting the kids to bed, whatever, becomes a cue. So your brain will start releasing dopamine before the drink, trying to pull you towards it.

6:46Your brain creates a network of alcohol cues and the more cues you build, the more alcohol stays on your mind and the harder it feels to live without it. A lot of this pull comes from anticipating the good feelings that you will get from drinking and you've probably experienced this yourself. Once you make the decision to drink or once you order a drink or whatever, you start to feel really good. And that's from dopamine and anticipation. That's often the best part or the second best part of the drinking experience. And we can't just decide to unlearn all of this, but with time and consistency, we can weaken the grip that alcohol has on our brain.

7:33Anticipation can come from external cues, like being offered a drink or being on vacation, or it can come from emotional cues like stress or celebration. In a 2010 study on flight attendants who smoked, cravings didn't spike based on how long they had gone without nicotine. They spiked when a smoke break was near. So it wasn't deprivation, it was opportunity that triggered the craving. But with alcohol, this is actually more intense. A 2011 study found that social drinkers only focused on alcohol when they knew they would get a drink, but heavy drinkers or problem drinkers fixated on alcohol no matter what, even when they knew it wasn't available.

8:24In this study, participants were told that they would have a 0, 50, or 100 % chance of drinking, and even when there was a 0 % chance the problem drinkers still fixated on alcohol. And that's the power of a conditioned brain. But sober time and support can change that. There are some studies on people receiving treatment versus people not receiving treatment. And these studies found that their brain activity was different when they were exposed to cues. People who were not in treatment had a greater expectancy of a reward because they could just use drugs after the test. But people who were in treatment did not have as much brain activation from the cue.

9:13And that's down to accountability and all of the support and ways of changing their thinking that they're getting in treatment. But when you're truly connected to your support system, you care about not letting them down. It's not just about checking in or being there when you need something. That's the wrong way to do support. It's about showing up, giving support, and belonging to a group. I was actually talking about this with a client the other day, and one frustrating part of the drinking experience and what we can't get out of is we are so willing to let ourselves down and disappoint ourselves that there isn't much of a barrier to drink.

10:01And that's sad and that can change once we get sober, but I was the same way. I thought drinking and checking out at the end of the night was self-care and me time, but really it was just the only time I could turn off my brain and escape my life. And even though I really wanted to be sober, I continued to sabotage myself because I didn't feel accountable to myself. And this cycle with associations can get worse. The more times that you quit and then go back to drinking, the more your brain will strengthen the association between alcohol and relief. And it's not relief from just your life. It's relief from withdrawal and the suffering caused by your drinking.

10:51Now this is a rat study, but it's still interesting. It was a 2022 study, and they looked at rats that drank during withdrawal and saw that those rats had stronger cravings for alcohol than rats that were just heavy drinkers. The rats who drank during withdrawal were more persistent, more motivated, and they kept seeking alcohol even when they would get shocked for it. And we do the same. We justify our drinking, make excuses, and power through any obstacle because drinking during withdrawal creates deeper, stronger cravings. Multiple cycles of withdrawal will actually reduce the brain's ability to change or neuroplasticity and then keep us stuck in the loop even more.

11:39Basically, the more that you go back and forth, the more your brain adapts to prioritize drinking and ignores anything that tells you not to drink. The connections that say this is not helping us get weaker and the ones that are screaming we need alcohol get stronger. And if we bring opportunity back into this, a problem drinker can tolerate an incredible amount of stress, pressure, and suffering if they know that there is a drink waiting for them at the end of it. We can even tolerate doing a challenge like dry January if we know there is a drink waiting for us on February 1st and cravings will actually be less and then we'll convince ourselves, oh it wasn't that hard, I must not have a problem.

12:28But this information isn't reason to give up or feel hopeless or feel like you pushed your brain too far and you're just doomed. It's a reason to stop the cycle today instead of continuing to delay it. So with support, consistency, and time, you can rewire your brain and build a new life for yourself where alcohol doesn't feel like it's required. My alcohol associations are pretty weak at this point. I still romanticize it occasionally, and I did genuinely enjoy the taste, so sometimes I feel sad that I can't try something, but I don't believe that alcohol will help with stress, anxiety, connection, fun, or that it'll make me have a better time.

13:19I know that I can handle everything myself and handle it better than if I had alcohol. I've seen people with many years of sobriety say on social media that I'm not going to drink over it. And that's an odd statement to me. And no criticism of them, that's just not how my mind works. In my opinion, one of the biggest milestones in doing the work is realizing that alcohol has nothing to offer you. Drinking doesn't cross my mind as an option anymore. I automatically think of other things that I can do. And now I'm sure that I'm not totally immune to cravings or urges just because I've done a lot of my work, but I have so many more effective tools and skills that I can use instead.

14:07And it took a while for a thought of drinking alcohol to not pop into my head when I had an issue or something I would typically drink over, but that is how you can see progress for yourself. So let's talk about now that we understand how we build these associations and why they are so difficult, let's talk about how the brain breaks them down after we get sober. You know those pieces in your closet that you reach for constantly because they look good, feel good, and work with almost everything? That's exactly what Quinn's does so well. If it's itchy, fits weird, or doesn't feel like me, it will sit in my closet for all eternity.

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15:35Get free shipping on your order and 365-day returns. Now available in Canada and the UK too. And when Quinn's asked where you heard about them, let them know it was sober-powered. It's a great way to support the show. That's Quinn's Q-U-I-N-C-E. Once we get sober, we begin the process of breaking down the associations that we have with alcohol so that it's not required for fun, stress relief, socializing, connecting with others, vacation, etc. This happens when these cues are presented to us and then we don't drink. And at the same time, we're not just not drinking, we're choosing better things to do or better ways to think and those are forming new associations in the brain.

16:26I associate warm weather with being able to go on walks and get some sunlight. where before I only associated warm weather with sitting on the porch getting drunk on rosé. If warm weather means wine to me, then of course I am going to be thinking about it when I'm sober and the weather warms up for the first time. The associations that you have with alcohol right now are not permanent as long as you keep staying sober. The worst part about this is when people do some dabbling, like they'll take breaks, they'll go back to drinking, they'll suffer, they'll take more breaks, and so on. That just keeps it alive.

17:08And despite all of this, despite the fact that we do break these associations down over time, cue exposure therapy in a clinical setting is actually not very effective. And once someone leaves treatment, the cue can be reinstated. And this is because changing the association doesn't completely get rid of the original association with alcohol. And this is why we can never drink again. There are a few ways that a conditioned response can be reactivated in sobriety. One is just the passage of time. And if you listen to episode 270 about incubation of craving, then you probably understand that. Over time, we can do our work or we can avoid our work.

17:55And if we avoid it and we keep our lives somewhat the same, then our reasons for drinking are there and they gain power over time. And the whisper of just one drink gets more convincing. Another way that a conditioned response can be reactivated in sobriety is called rapid reacquisition. And this is a process where the cue outcome association builds back up much faster than it was initially formed. So for example, the cue of drinking after work and the outcome of being able to relax. And that's why when we take breaks and then we think we're cured, maybe we're cured briefly, but then we descend back into how we were drinking pretty quickly, where it took years or sometimes decades to get to that level of drinking when we first started trying alcohol.

18:51When I took my 90-day break, I was convinced that I would be cured from it. And I was cured, I guess, for a couple months. I drank two glasses of wine on Saturday nights, stopped on my own, and didn't want to drink the other days of the week. It was a miracle because before that I had been drinking seven days a week with no control. I was able to control it by isolating, meaning I didn't socialize at all, and because 90 days had allowed some brain healing. But when I had my first opportunity to make an excuse and drink the way I wanted to, which was on a vacation, I was immediately back to where I had been drinking before.

19:34There was no slow progression. I picked up right where I left off. Over time, if we don't do the work, then our reasons for drinking will continue to show up and just beat us down. It can make drinking feel more attractive than continuing to stay sober. And once that happens, we start rationalizing it by saying it'll be different this time, or we've learned so much, or maybe I went overboard with this whole sober thing. And then we drink and we realize that it's actually not different. And then we have to start the process of fighting to get back out again. I've observed clients and members go through this fight over the years, and it can take anywhere from a few weeks to a few years to get back to the other side.

20:21And you never know how long it's going to take you until you're in it. It has nothing to do with weakness or willpower. I had to fight for four months after my drinking went back to normal to get back out. And that was a time of intense suffering in my life. When we activate a memory, like a cue memory or an alcohol memory, it can enter a temporary unstable state where new information can be added to it before it's reconsolidated into long-term memory. So that can either strengthen the initial memory or modify it. So it seems like if we briefly recall a memory, it's more likely to be strengthened.

21:07But if we recall it over and over without the reward, it's more likely to undergo extinction where it loses its power. That doesn't mean that you should expose yourself to triggering situations or sit around and think about how much you'd love to drink. So I'm not saying that. Please don't do that. It means as you experience life, alcohol memories are weakened as you do your work. We can't avoid things forever. And if you need support with this, we are discussing being comfortable around alcohol in one of my community meetings in mid-April if you would like to join that discussion. I think a really important part of this process is thinking about it.

21:53And if you listen to my episode about doing the work, episode 202, that was basically the message. We need to think about it. We need to show it to other people, see what they think about it, turn it over and look at it from the other side and then think about it that way. People don't make progress when they won't confront what's going on. It's about being present in your life and actively making choices, not passively going through the motions and then being shocked that that leads you back to drinking. And I also believe that commitment is required for this process to work. There are a lot of studies that find that cue exposure therapy is not the most effective thing for us.

22:41So that would mean just exposing yourself to a cue and then not drinking or trying to form a new association for that cue. And I believe that that's because we have to want to be done and we have to be willing to face life without an escape hatch. It's not just about unpairing the association with alcohol because those associations are so powerful. It's about wanting a better life for yourself and being open-minded. And now this is my opinion, but based on everything I've been saying, my interpretation of this is if I have the association that alcohol and warm weather go together, that association doesn't disappear or go away.

23:31It just weakens. That's still in my brain because it has been so deeply reinforced for years and years and years. I can build new associations alongside it and strengthen those associations. So now when the weather gets warm, I get excited because I know my depression is going to get a lot better because I can get some sunlight. I can go on walks. I can get fresh air. That's what I associate warm weather with now. but the alcohol one is still there with me. It's just weak. But if I decide I'm cured, it'll be different. I can moderate now. I will just go back and strengthen the alcohol association again.

24:15And before I know it, I'm right back in the trap. So how do we start unlearning our associations with alcohol? For most people, when they do something and they get a bad outcome, they learn to avoid the thing in a process called aversion. This links drinking alcohol with being tired, having a headache, feeling sick, or whatever else they experience. That doesn't work in addiction and it's why you shouldn't label your drinking a bad habit because it minimizes it and it makes it more likely that you label yourself a loser because you can't break the habit. When the brain is convinced that alcohol is the most important thing.

24:56It's easier to blame ourselves for our suffering than it is to blame alcohol. I really believed that I was just an anxious, depressed, suicidal person, and that alcohol gave me a couple hours of relief from me. Another rat study, but also very interesting, a 2015 study found that when rats were ready to work for cocaine, but the cocaine was delayed, it became aversive. So what that means is you would think they wouldn't want it anymore, but actually it created a very uncomfortable state of mind that the animals wanted to avoid. So they took even more cocaine when they could, and that's called a punisher.

25:40And we develop associations with them just like cues and predictors. The thing is, when we reinforce a predictor or a punisher, it creates a permanent response. Like I said, the associations are permanent where sequences of environmental stimuli lead us to alcohol. So if we talk about the rats and the cocaine, they had cues that predicted a delayed reward. So that means that someone who's addicted to cocaine would work very hard to avoid those delays. So then those cues would cause high amounts of stress, and then when they did get cocaine, they would take extra to cope with the stress. Aversive stimuli are things that cause discomfort, pain, or distress, so basically things that we want to avoid.

26:32In the context of alcohol, aversive stimuli can either drive someone to drink as a way to escape or numb, or result from drinking and then reinforce the cycle. Error correction models say that learning occurs when there's a difference between what is expected and what we actually get, but that happens all the time with our drinking and then we continue to want to drink. Other studies have suggested that people with alcohol use disorder have slower associative learning and it gets even slower the more severe your problem is. So basically it takes us a long time to get the point that our drinking is the cause of our suffering.

27:16A 2022 study published in the Psychology of Addictive Behaviors found that people with alcohol use disorder struggle to learn to avoid negative consequences. So what this means to me is this is why we spend more time in the back and forth because we struggle to believe that alcohol is not going to fix our problems. In my opinion, getting sober requires some degree of hope for the future and acceptance that you can't change the way that you drink. And once you have those things, you can start to build new associations for your cues and let the alcohol associations decay over time. When I was first considering that I may have a problem and need to quit drinking, I went to therapy to ask if I was an alcoholic.

28:08And while we were discussing it, I said I had no idea what normal people did after work if they didn't drink all night. When I got sober, I was faced with not drinking after work five times a week. So I built up new associations quickly. Some things are easier for us to break down than others. I've worked with clients before who have broken down their coping associations before coming to work with me and they no longer drink to cope, but then something unknown keeps pulling them back to alcohol. So let me give you two examples of a predictor association and a punisher association that I've broken down for myself.

28:49So I gave you the example of after work, so I'll give you two that are more difficult. So vacation is a huge cue for many people, And while I would gladly drink for any reason, vacation was one of the most difficult associations for me to break. Vacation just signals a break from responsibility and a time to relax, which is deeply linked to alcohol for many of us. Vacation has many cues like being around alcohol constantly, being somewhere where constant alcohol use is normalized, no routine or schedule, anticipating pleasure and treating ourselves, feeling left out, whatever. If your brain has been conditioned to associate freedom, pleasure, relaxation with alcohol, then vacation will light up the whole network of associations, even if you have been sober for a bit.

29:39My husband and I were doing some vacation planning this week, and I love going on walking food tours. One of the tours that we looked at had a platter of cold beer and fancy glasses, and I felt sad that I wouldn't be able to participate in that. And I wasn't even a beer drinker, but I was a person who would drink whatever was offered to me and be happy about it. But anyway, I still have a small feeling of sadness about not being able to participate in drinking stuff on tours, but I'm able to accept it, let it go, and move on. Pretty quickly, actually. There are two things that helped me the most when I started breaking my vacation association.

30:21I didn't go on vacation to drinking places. We started with a long weekend in Cape Cod and then a cruise to Alaska. Neither of those places are known for drinking and partying. The other thing that helped was to observe the drinking things and how everyone else participated in them. That platter of beers that I felt sad about will likely make up about one minute of the tour. People will grab one, set it down, drink it slowly, or leave some behind. The end. Observing how these things really go versus my romanticized version of it in my head has been important. And here's another example. When I was 18 months sober, I had my first big urge to drink.

31:08Something bad happened that I didn't want to handle. And I had an urge to get drunk and check out of my life. I associated intense discomfort and emotional pain with drinking. It took me a long time to build other associations because I'm not exposed to intense discomfort and emotional pain that often. But by the time I was three years sober, that association was so weak that it didn't trigger urges to drink anymore. Having an urge to drink is normal, but every time you regulate it and do something else, you gain a little bit of power. These associations do not just go away as they break down.

31:50They become dormant. So what that means is if you start drinking again, you strengthen the associations again. If you want some support with this, then please check out the ways that I can help you in the show notes. But I really want to emphasize problem drinkers build associations with alcohol that are more powerful than anything else. Problem drinkers can't imagine living life without alcohol. Problem drinkers rationalize it, tell themselves just one drink, that they'll be one of those special occasion drinkers or whatever. All of those are red flags. and once you've reached that point you can control the obsession and you can stay fixated on alcohol and just thinking about it all the time for the rest of your life or you can accept that trust all of the people that have gone before you get some support and find freedom in sobriety moderation keeps the obsession alive the end i will talk to you next week

33:09We'll be right back.