WHEN PEOPLE ARE STRESSED OR ANXIOUS

And who isn’t, these days? But a pandemic isn’t the only trigger for defense mechanisms.  For example, the death of a loved one, loss of a job, life-threatening illness, relocation, demotion . . . the possibilities are endless. So, for you reading pleasure and maybe your writing of believable characters, here’s a quick overview of ways people cope with thoughts, feelings, or acts that are too psychologically painful to tolerate.

Hulk throws the ultimate temper tantrums.

Acting Out 
Performing an extreme behavior when a person cannot otherwise express thoughts or feelings. A child’s temper tantrum would be one example. Hurting oneself is one form of acting out—cutting or burning oneself, literally banging one’s head against a wall.

Aim Inhibition
Rather than admit to failure, a person accepts a more modest goal. Think of someone who had hopes for a career in the NFL who becomes a high school coach.

If he can’t be the Flash, at least he can be Whizzer!

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Altruism
Rather than admit having no control over a situation, a person copes by helping others, perhaps compulsively. This is a person who needs to be needed and may promote helplessness in those close to him/her.

The Angel had such a strong compulsion to help everyone that Dr. Charles Xavier of the X-Men diagnosed him with “heropathy” (not an actual disease).

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Avoidance
Refusing to deal with the situation. In the current pandemic, choosing not to watch the news, read the newspapers, or respond to online postings.

Deadpool has been using running and laughing to avoid his horrible life situations since he was a child.

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Compartmentalization
Keeping different parts of one’s life in separate compartments, often with different moral guidelines. For example, someone who lies, cheats, steals, or hurts others to make a living but is unfailingly kind, helpful, and loyal to family and loved ones. Another example would be someone who enjoys extramarital sex but would never have “an affair” because that involves emotional intimacy and thus would be “cheating.”

Matt Murdock is a blind defense lawyer by day and the superhuman illegal vigilante Daredevil by night.

Compensation
Overachievement in one area because of failure in another. For example, throwing oneself into professional achievement because of failure of a marriage or intimate relationships. Or the opposite: not making it professionally and then becoming a helicopter parent.

Hartley Rathaway was born deaf and became obsessed with sound manipulation, eventually becoming the Pied Piper.

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The Amazons on Themyscira spent centuries denying the existence of any world outside their island paradise.

Denial
Basically, this is saying it isn’t so.  “There is no pandemic. It’s all a hoax—or an exaggeration.”  “It isn’t that dangerous.” Addicts often deny that they have a problem.

Displacement
Taking out frustrations, feelings, or impulses on people or objects that are less threatening. It usually applies to displaced aggression. The classic example is the boss criticizes the employee, the employee yells at his/her spouse, the spouse scolds the child, and the child kicks the dog. Of course, the person might just abuse the child or pet. Or one might smash a fist into the wall or break something.

Reed Richards “Mr. Fantastic” frequently expressed his frustrations with the world by beating his wife and children. This panel occurred immediately after such an outbreak.

Dissociation
Mentally separating oneself from one’s body or environment in order to keep an overwhelming experience at a distance. An example would be someone unhappy with his/her job has trouble concentrating at work, frequently “daydream” or finding his/her mind wandering.

Trance used her astral projection ability to escape the demonic Limbo pocket dimension and get help.

Fantasy
Retreating to a safe place in one’s mind. If one can’t find relief in fantasizing about being turned into a movie star or whatever, you can get much the same effect by binge reading or tv watching or gaming.

Michael Jon Carter hated his life in the 25th century, so he traveled back in time with stolen gadgets to live out a fantasy life as the superhero Booster Gold in the 20th century.

Humor
Seeing the funny or ironic side of any situation. This is actually a pretty adaptive way to handle stress and anxiety. For example, wearing a face mask with giant mustache attached or creating silly photo shoots of pets in quarantine.

Spiderman is a master of using bad jokes to torture his enemies.

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Dr. Manhattan is so brilliant that he loses all touch with humanity.

Intellectualization
Focusing on the problem/problematic thoughts in a cold, factual way. For example, putting the current pandemic into the context of  pandemics through the ages, how devastating they were, how they were transmitted, how they were dealt with, etc.

Passive Aggression
This is often the refuge for someone who can’t express anger or aggression directly (by scolding, hitting, etc.). For example, a teenager who is assigned a chore, such as mopping the kitchen floor, who begins by asking a gazillion questions about where to find and how to use the necessary equipment, then doesn’t sweep before starting, then mopping around the table rather than under it, and finally leaving soap scum behind.

Emma Frost generally straddles the line between passive-aggressive and aggressive-aggressive, depending on her allies.

Projection
Ascribing one’s unacceptable qualities, thoughts, or feelings to others. Think Donald Trump accusing reporters of being rude.

Harley Quinn projected her brainwashing and Stockholm Syndrome onto Flash and tried to “cure” him.

Rationalization
Basically, this is making excuses. You did it, you aren’t denying that you did it, but you give rational or logical reasons for it. What makes this a defense mechanism is that the stated/acknowledged reason isn’t the real motivation. For example, you pawned your mother’s wedding and engagement rings and claim you needed the money when you really wanted to hurt her—or you hated your dead father and don’t want the reminder around.

Gin Genie can create seismic shock waves in direct relation to the amount of alcohol in her system. To be a powerful superhero, she also has to be an abusive alcoholic.

Kamala Khan wants to fit in and avoid trouble but goes out of her way to stand up and confront super villains and terrorists when she shifts into Ms. Marvel.

Reaction Formation
Replacing an unacceptable feeling, impulse, or behavior with the opposite. For example, subconsciously wishing a sibling would fail and so going out of one’s way to be helpful and promote success — the perfect fan.

Regression
A person reverts to a pattern of behavior that worked when one was younger. Think thumb-sucking, crying, sulking, or temper tantrums.

Zatanna feels such guilt over using her powers to erase the memories of her enemies and friends that her powers revert to a level she had when younger.

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Repression
I like to think of this as motivated forgetting. Things that are too painful are kept out of consciousness awareness, but may have a powerful effect on behavior. For example, a victim of early childhood sexual abuse who doesn’t remember the event(s) but has difficulty becoming intimate.

Jessica Jones has years of repressed memories thanks to brainwashing and mind control.

Suppression
Much like repression, but one consciously decides not to think about or remember something. This is fairly tough to pull off!  Every time it comes to consciousness, one distracts oneself with something else. One example: having an obsessive thought running through one’s head is a way to block other scarier or more stressful thoughts from surfacing.

The Red Room training forced Natasha Romanoff to remove all empathy and mercy and become the Black Widow. She had to retrain herself to join the Avengers.

Sublimation
Act out unacceptable impulses by transforming them into a more acceptable form. For example, aggressive impulses channeled into martial arts. Someone who likes looking at naked bodies takes up figure drawing.

Batman has turned the anger and grief from watching his parents’ murder into a drive to fight crime.

Undoing
Closely related to Reaction Formation but usually on a more conscious level; trying to make up for unacceptable thoughts, feelings, or behaviors — sort of like an unstated apology. For example, a child who is jealous of a younger sibling and wishes s/he were dead might make a point of giving that sibling toys, one’s cookie, etc.

Tomorrow Woman is an android created to destroy the Justice League. She achieves artificial consciousness and sacrifices herself to destroy her creators instead.

BOTTOM LINES FOR WRITERS: Everyone uses defense mechanisms. It’s how we cope. Choose defense mechanisms for your characters that are in line with his/her character in general. So, for example, a scientist is unlikely to use denial and more likely to use intellectualization.

Although using defense mechanisms is natural, normal, and helpful on an episodic or “acute” basis, long-term or “chronic” use can lead to emotional problems because the underlying threat or anxiety is never actually addressed.

The most emotionally stable superhero out there seems to be Zephyr aka Faith Herbert, from Valiant Entertainment. We should all be as awesome as Zephyr!

ALCOHOL: OTC MEDICATION?

Stress and alcohol go together like peanut butter and jelly—a burger and fries, mac and cheese, bread and butter, mashed potatoes and gravy, milk and cookies, or any other iconic duo you can think of. Yes, they can be separated but—oh, so often—you don’t have one without the other.

I started thinking about this when the Richmond Times-Dispatch ran a front page story (above the fold!) about liquor sales in Virginia. You will recall that ABC Stores have remained open as “essential” services. And according to numbers from the Virginia Alcoholic Beverage Control Authority, sales now hover around $22 million a week. 

In March, as the social distancing began, the ABC stores had more than $30 million per week.  Sales in April 2020 were up about 15% over a year ago. The article goes on to identify the top selling brands for the state and for the Richmond Planning District (City of Richmond, Henrico, Goochland, Hanover, Chesterfield, and Powhatan counties). I was less interested in the rankings than in the sheer volume!

Alcohol consumption is up all over the country. To look at one other location, in Tulsa, OK, one liquor store reported that looking at sales March 15 to April 15, liquor sales were up 56% and beer 48%. Compared to a similar date in April of 2019, one-day sales in April 2020 were up by 100%. 

According to one store owner, buying habits are changing in that people are buying more at a time, shopping more during the day and less in the evenings and on weekends.

In order to facilitate buying alcohol, providers are offering digital ordering and delivery, curbside pick-up, hosting, hosting virtual tastings and/or cocktail hours. And some are branching out by stocking hand sanitizers and face masks. Virtual cocktail parties among friends and families are now common.

If your aim is absolutely perfect, your cocktail parties with neighbors don’t have to be virtual!

Estimates of the increase in U.S. alcohol consumption from now to the same time last year vary from 25% (WHO) to 55% (Healthcare Home [//healthcare.utah.edu]).

The uptick in alcohol consumption is not solely a U.S. phenomenon. The World Health Organization has issued statements urging countries world-wide to try to curb drinking during the current pandemic. They cite several health reasons to try to control excessive alcohol consumption. No matter how bad a situation is, excess drinking can always make it worse!

Magic Snowman Tea is guaranteed to be 100% alcohol free.
There are other substances one can turn to in times of stress. This is one of my favorites.

Also according to WHO, alcohol-related deaths number 3 million every year—before the pandemic.  And the WHO now has the added difficulty of trying to quash the misinformation that has circulated to the effect that drinking can make someone immune to the COVID-19 virus and/or cure one if infected. The presumed medicinal value of alcohol has a long history (see below), perhaps with roots in the dulling of physical pain.

Jackie Chan is a master of Drunken Fist Kung Fu ( 醉拳 )

The link between stress and alcohol consumption is so well established that it’s actually called “self-medication.” In fact, such self-medication can be pretty effective, at least initially, in relieving anxiety and depression. Alcohol is a “downer” (i.e., a system depressant) so if people are wound up, rapid heart beat, etc., alcohol can definitely make those symptoms of stress go down. But as mentioned above, alcohol also depresses inhibitions, increases risk-taking, decreases logical decision making, increases violence, and — after all that — is still likely to interfere with restful sleep.

Being home all day with bored and curious toddlers is a very stressful circumstance.

COVID-19 presents a set of circumstances that are problematic with regard to alcohol consumption.

  • High levels of anxiety associated with the unknown
  • Isolation from one’s usual support system
  • Loneliness
  • Economic distress/job loss
  • Food insecurity
  • Fear of infection/death
  • Mourning the loss of a loved one
  • Stress at having to work from home
  • Stress of having to work in an “essential” job interacting with the public

COVID-19 is dominating today’s headlines, but it is far from unique. Research indicates that alcohol use and abuse increase during and after “violent conflicts”—e.g., wars, periods of martial law, government coups. Other psychotropic substances are also used to deal with psychic strains and trauma, but alcohol is generally the most likely to be readily available, legal, and (at least within limits) socially acceptable.

Totally non-addictive!

During the 1918 Influenza Pandemic, bootleg whiskey was viewed as a respectable medicine. At the time, more than half the states in the U.S. had passed Prohibition laws and thus were “dry.” But for medicinal purposes, some officials decided to tap the vast stores of liquor that had been confiscated initially to aid the military, although the Army mostly remained silent about using it. In Richmond, Virginia—reportedly—two railroad cars of confiscated whiskey arrived for the benefit of Camp Lee. Over time, confiscated whiskey was distributed to civilian hospitals, too.

Medical isopropyl alcohol is now available at vending machines in Moscow.

The United States Pharmacopeia dropped whiskey, brandy, and wine from its listing of therapeutics in 1916. In 1917, the American Medical Association resolved that “the use of alcohol as a therapeutic agent should be discouraged.” Even so, more than half of physicians believed it was “a necessary therapeutic agent.” It continued to be available by prescription in dry states. To this day, strong alcohol is prescribed for medicinal purposes in some areas, even by doctors!

Besides the demand for alcohol, the Spanish Flu pandemic shared other characteristics with COVID-19:

  • Wearing masks
  • Social isolation
  • Use of disinfectants
  • Limiting group gatherings, including churches
  • Hospitals and funeral homes were overwhelmed
  • During Spanish Flu the treatment of choice was aspirin, up to 30 grams daily which is a toxic dose; currently, think ingesting bleach or disinfectants.
Bootlegger tunnels in Miami during Prohibition

Bottom line for writers: people use alcohol to self-medicate for stress. The current stressor is COVID-19 BUT consider all the other stressors out there, which might occur alone or in combination with COVID-19: death of a loved one, job loss, divorce, physical illness, mental illness, physical disability, too little money, going hungry, being homeless… Do you have a character who does—who could—self-medicate with alcohol?

From the Archives: Alcohol for Writers

"alcohol for writers" whisky poured into tumbler

 

In 2016, I wrote Alcohol for Writers: the famous authors infamous for drinking, facts writers should know about alcohol (even if they don’t imbibe), and what to know about your characters’ interactions with drink.

On the subject of alcohol, you can read about its consumption with tobacco in Smokers Drink and Drinkers Smoke. Perhaps not surprisingly, the people who drink the most, as a group, also consume the most tobacco.

Each of these posts explore the dangers of addiction, which I dive into in The Upside of Addiction for Writers. In addition to substance abuse, writers should also consider behavioral addiction, such as gambling, eating, or working. (And don’t forget Workaholics Day.)

Now it’s your turn: how do you treat alcohol in your writing? Let me know in the comments.

 

The Morning After the Night Before

beer and cigarettes
I have already written about smoking and drinking, but realized that there are several facts about alcohol—potentially helpful to writers—that I omitted heretofore. Other factors are so crucial to reality that I’ve repeated them here.

 

hungover

How much is too much?

 
When writing realistic drinking scenes, be aware of factors that affect the effects of alcohol. You probably know that eating—particularly fatty foods—slows the metabolism of alcohol and thus one gets high faster on an empty stomach. (I once read that ancient Romans drank straight olive oil to increase their tolerance before big feasts. Just saying.) You may also know that people who drink regularly and heavily have a higher tolerance. But regardless of anything else—as these two charts show—weight and gender are huge factors in alcohol effects.

 

Causes of gender differences: Besides weighing more in general, the male body tends to have more water to dilute alcohol. Also, women have significantly less of the enzyme that breaks down alcohol in the stomach.

 

Bottom line: Even when controlling for weight, women get drunk faster and stay drunk longer than men.

 

what is a standard drink
 

How long does alcohol stay in your system?

 
A normal, healthy liver can process approximately one drink per hour. To put it another way, one drink of alcohol stays in your blood approximately one hour. More than that, and it takes proportionately longer to get clear.
Alcohol stays in your urine about 80 hours.
 
Alcohol stays in your hair follicles approximately three months.
 
Alcohol can be detected on the breath as long as there is alcohol in the systemE.g., with a blood alcohol of .20, that would be approximately 13 hours.
 
Using the EtG test, one beer was detectable 16 hours later; six shots of vodka taken in 3 hours was detectable 54 hours later. Important note: this is the most sensitive test to detect whether a person has had alcohol. It does not detect drunkenness, which can have passed off during the intervening hours.
 
So, consider those factors when your are writing about alcohol testing, e.g. for a job application or entrance into a treatment program.

 

holding liquor

How long does it take to sober up?

 
Short answer: it depends on how much you’ve had to drink. (See above.) In many states, a blood alcohol concentration (BAC) of .10 means that 1% of your bloodstream is alcohol—and therefore drunk. Writers: Be sure to confirm the level for legally drunk in the locale of your story.
 
More technical answer: most alcohol metabolism depends on the liver, which takes one hour to metabolize 1.0 to 1.5 ounces of alcohol (depending on study cited). If one ounce of alcohol produces a blood alcohol concentration of .015 will have no alcohol in his/her system after 10 hours. The healthy, average liver metabolizes alcohol at a constant rate.

 

prescription drugs alcohol

Ramping up the problems

 
One sure way to do this is to write a character with other health problems that require medication. (See list above.)

 

Given the frequency of use for pain, over-the-counter NSAIDS (non-steroidal anti-inflamatory drugs) deserve special mention. According to my reading, Tylenol is the worst because it can cause severe liver damage from regular doses that are taken when drinking alcohol daily. Others are more likely to cause internal bleeding, ulcers, etc., which (in my opinion) would be likely to be detected sooner.

 

alcohol assessment

Conveying drinking problems without labeling them

 
You can find many self-tests online that would give you thoughts and/or worries for your character. Answers to the four questions on the CAGE assessment identifies 9 out of 10 alcoholics! Other resources include the MAST Alcohol Assessment Quiz, which comes in various lengths, and the 10-multiple-choice-question AUDIT Alcohol Assessment Quiz.

 

If the drinker is the POV character, these might be private concerns. If not, perhaps the character talks about these concerns with others.

 

Realistically, which characters are most likely to be problem drinkers?
 
risk factors drinking
Bottom line: I’ve tried to provide helpful info for realistic writing. Did I succeed?