alcohol addiction

Steps Six and Seven of Alcoholics Anonymous: Surrendering – Humbly Asking God to Remove All Defects of Character

The challenge of discovering oneself intimately, and letting go of the old, addicted persona, is increased with the lessons of steps six and seven.

Steps six and seven further confront the addiction as character defects are identified and slowly eliminated. For the remainder of this article addiction will be used for both alcoholism and addiction to other substances.

Invaluable these steps are, if the trapping of the denial system is to be accomplished. However, it must be strongly impressed that the denial system can never be eliminated. The best that can be hoped for is to chain it down and cage it. See an unleashed denial system as a wild beast stalking prey.

Logically, it follows that, if the chains and cage are not checked and periodically re-checked, the denial system can be set free only to continue hunting and ravaging.

Defects of Character

Alcoholics Anonymous lists about 20 character defects. This is not an absolute list, and the number is not the key issue. Rather, a defect of character is any human factor that allows the addiction/denial system to take hold and continue the rampage. In order to prevent lapses (slips) and subsequent relapses, each and every defect or negative dynamic of character must be identified and removed.

Some Defects of Character:

  • “Anger;
  • Resentment;
  • Lying;
  • Fear; and,
  • Self-justification..

Surrendering to Removal

Surrendering to the removal of all defects of character is not as easy as it sounds. This is a process.

It is important to set realistic goals, otherwise, the endeavor may become too overwhelming, thus setting up a scenario of relapse territory. “This is too hard, I give up! Lick my wounds with something to drink.”

Best course of action:

  • Identify the defects;
  • Be consciously mindful of them; and,
  • Work towards letting them go.

For each identified defect compose a short description of how this was revealed in the past and the preventative measures or escape routes available to fall back upon in the present. Do not expect immediate results and allow for mishaps. Set up a support network – sponsor(s), phone contact(s) and recovery group(s).

Readiness to Take the Risk

The core of step six, however, is readiness to let go and move to the next level. Yes, it is scary leaving the old and familiar behind and stepping out to an adventure!

For comparison sake, think of it this way, how many times were drinking and driving an issue? Wasn’t it scary operating a vehicle – a potentially lethal weapon, blitzed?

How many times was a night in jail a consequence? For most people these would be very fearful ventures.

Asking God to Remove the Defects

Breaking out of isolation, reaching out for help, placing ever increasing amounts of trust in a supreme being, a sponsor and/or a recovery group, or a counselor are key components to step seven. No longer is the addiction or the once actively addicted persona allowed to operate secretly. No longer are the denial system and cycle of addiction allowed free rein.

Whatever and whoever the Higher Power entity is, accountability and responsibility as well as forgiveness are additional earmarks of this step. Realistically, faith/trust in a supreme being makes this step a little easier, in that only a supreme being has the ability to completely remove defects.

If the Higher Power is the recovery group, AA sponsor or addiction therapist, the removal must come from the recovering person through mindfulness and practice.

It is important to understand, many recovering people rework the steps over and over again. It is a logical and healthy activity to pursue, because relapse is a component of addiction. Sincere, 12 step inventories are a catalyst for growth, thus, keeping a full-blown relapse at bay.

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Alcohol and Liver Disease: Ethanol Contributes to Fatty Liver, Hepatitis and Cirrhosis

Alcohol can cause liver injury that ranges from fatty infiltration and inflammation (hepatitis) to full-blown cirrhosis. The main factors that contribute to alcoholic liver disease are: quantity of alcohol consumed, duration of alcohol consumption, nutritional status, and genetic or metabolic disposition. You want to beat alcohol, before you start developing conditions like cirrhosis.

In the United States, annual alcohol consumption is estimated at ten liters of pure ethanol per person. Approximately 15 million people abuse or are dependent on alcohol, and men are nearly three times as likely as women to abuse alcohol. No matter how hard to work to maintain a healthy diet, if you are binge drinking, you are negating the effects of a health nutrition plan.

While only 10 to 20% of alcoholics eventually develop cirrhosis from drinking alcohol-more than 60 grams of alcohol daily (about five drinks) for two to four weeks induces fatty liver in otherwise healthy men. 80 gm/day can lead to alcoholic hepatitis, and 160 grams daily for a decade can lead to cirrhosis. (The Merck Manual, 18th Edition:211-214)

Factors that Increase Susceptibility to Alcoholic Liver Damage

  • Female gender: Women are more susceptible than men to alcohol-induced liver damage, even when adjusting for smaller body size. Women possess less alcohol dehydrogenase in their stomach linings, thus increasing the amount of alcohol from any given beverage that is absorbed directly into the bloodstream.
  • Familial tendency: Alcoholic liver disease often runs in families. This may represent a deficiency of cellular enzymes that metabolize alcohol.
  • Malnutrition: Alcohol is preferentially metabolized by the liver at the expense of other metabolic processes. A lack of specific nutrients, particularly proteins and B vitamins, slows the oxidation of alcohol, reduces the levels of antioxidant molecules in the liver, and leaves the liver susceptible to damage by other toxins.
  • Diets high in unsaturated fats: The liver prefers fatty acids as a fuel source. Fatty acids that aren’t used immediately are normally placed into triglyceride “packets” which are then routed to other organs and tissues. When alcohol is present, fatty acid metabolism and transport are delayed.
  • Iron deposition: Iron increases oxidative stress within liver cells. Certain diseases (e.g., hemochromatosis) increase the amount of iron stored in the liver. Indeed, chronic alcohol use itself leads to increased stores of liver iron.
  • Age: As people age, liver function (and the ability to metabolize alcohol) declines.
  • Chronic liver disease: The presence of other liver diseases, particularly hepatitis C, significantly increases one’s susceptibility to alcohol-related liver damage.

Stages of Alcoholic Liver Damage

  1. Fatty liver (steatosis): As noted above, alcohol interferes with the normal metabolism of fatty acids in the liver. Drinking for only a short period of time can induce significant accumulation of lipids. Fatty liver is potentially reversible.
  2. Alcoholic hepatitis: Continued exposure to alcohol leads to progressive damage to liver cells, accompanied by inflammation and various degrees of liver dysfunction. Alcoholic hepatitis may range from a mild, reversible illness (fatigue, fever, jaundice, abdominal pain) to a life-threatening condition (jaundice, liver failure, electrolyte abnormalities, bleeding).
  3. Cirrhosis: As liver damage progresses, extensive scarring replaces the normal architecture of the liver. Cirrhosis is irreversible (and increases the risk of liver cancer), but the liver possesses a remarkable ability to regenerate. With abstinence from alcohol, small islands of remaining cells may recover and continue to offer some level of liver function.

The key to preventing alcoholic liver disease is limiting alcohol consumption. “Sensible” drinking limits have generally been defined as:

  • For men, no more than two drinks daily
  • For women, no more than one drink daily
  • For individuals over 65 years old, no more than one drink daily

One-drink equivalents are:

  • One 12-ounce beer
  • 4-5 ounces of wine
  • 1 ounce of 100-proof distilled spirits

 

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