It was a good question. Anne* suffered extensively with fear, anxiety, and OCD. She wanted any relief she could find.
“Can I drink a little alcohol during exposures?”
Little Therapist Justin
As an early specialist in OCD, I said to Anne my favorite thing to say when I don’t know: “I don’t know.” So I looked it up and talked to colleagues and my mentor. I still don’t yet know of any research paper specifically on the topic. And the client, genuinely curious and desperately seeking for answers, referenced back to my common supportive statement: “We won’t get over all our distress in one day- we must take it hierarchically.”
So isn’t alcohol a hierarchical way to get through exposures?
What I learned was a basic building block to all exposure and essentially all work in overcoming our fears:
Anything that falsely keeps us attributing our well-being to avoidance of fear will eventually lead to its reinforcement. Our goal in therapy is MAXIMUM FEAR DISCONFIRMATION.
If we conquered fear through alcohol, wouldn’t people who drink to get through social situations or flying on a plane eventually feel better about it?
Sure, facing fears and distress and disgust- or whatever it is we are facing through exposure- must be step by step. And yes, clients will often drink to cope (up to 25% of sufferers of OCD alone will abuse substances at some point). Besides the fact that alcohol as a coping tool opens up a whole ‘nother can-of-worms, it interrupts our ability to learn and serves as just another avoidance. That’s why you won’t feel better after you “faced” a fear drinking alcohol (Karaoke?). You must go head-to-head. Step-by-step, for sure. If you struggle with alcohol use, substances, sex, gambling, or any other addictive problem, there is help and hope for that, too!
But as long as you’re asking, Alcohol interferes with getting over your fears.