Health News and Information

The alcoholic’s entering treatment, especially residential treatment, may impose very real immediate problems for the family. The spouse may be concerned about even more unpaid bills, problems of child care, fears of yet more broken promises, and so on. In the face of these immediate concerns, long-range benefits may offer little consolation. Attention must be paid to helping the family deal with the nitty-gritty details of everyday living. Just as the alcoholic is requiring a lot of structure and guidance, so is the family.
Another issue for the family will be to develop realistic expectations for treatment. On one hand, they may think everything will be rosy, that their troubles are over. On the other, they may be exceedingly pessimistic. Probably they will initially bounce back and forth between these two extremes.
The family at some point will also have a need to have the alcoholic “really hear” what it has been like for them at the emotional level. If there has been an intervention, it stressed objective factual recounting of events and being sympathetic to the alcoholic. Although a presentation to the alcoholic of the family’s emotional reality may not be apropos at the time of the intervention, it must take place at some point. If the alcoholic and family are to be reintegrated into a functioning unit, it is going to require that both “sides” gain some appreciation of what the alcoholism felt like for the other. How this occurs will vary. Within some family weekend programs there may be a session specifically devoted to “feelings,” led by skilled family therapists. These sessions can be very highly charged, “tell-it-like-it-is” cathartic sessions. To do this successfully requires a lot of skill on the therapist’s/counselor’s part, as well as a structure that provides a lot of support for the family members. For the alcoholic, the pain and remorse and shame can be devastating. For the family this, in turn, can invoke guilt and remorse, as well. These responses must be dealt with; a session cannot be stopped with the participants left in those emotional states. More commonly this material will be dealt with over time, in “smaller doses.” It may occur within family sessions and frequently also within the context of working in the AA program. Again, the important issue is that you recognize this as a family task that must be dealt with in some way at some time. Otherwise, the family has a closet full of “secrets” or “skeletons” that will haunt them, come between them, and interfere with their regaining a healthy new balance.
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There are two different kinds of sleep, and they alternate with each other throughout the night. During REM sleep dreams are experienced, and during NREM sleep there are few or no dreams at all. When we fall asleep we go through NREM sleep, then REM sleep; these two combine to form one sleep cycle and we have a few sleep cycles throughout the night In this chapter we are going to study NREM sleep in detail.

In NREM or non-REM sleep there is an absence of rapid eye movement as recorded by the electro-oculogram or EOG. The brain waves are also calmer, in contrast to those of REM sleep. During REM sleep, the brain waves are not much different from those of the awake state. However, during NREM sleep the brain waves are slow and big and are divided into four stages according to their frequency.

During NREM sleep the mind is in complete rest, and is passive, peaceful, and calm. In REM sleep, in contrast, the mind is active and explosive, and the whole brain is working to capacity. Some experts report a 40 per cent increase in the blood flow to the brain during REM sleep.

During NREM sleep, the breathing is slow and regular. The blood pressure is lower than when we are awake, and the heart rate is also slower as if we are in complete rest On the other hand, during REM sleep the breathing is very heavy, and irregular. The blood pressure can be sky-high and the heart rate can be as fast as if we had just finished a 100 m race. It has been observed that if a heart attack or stroke takes place during sleep at night, it occurs during the REM stage. However, the peak incidence of heart attacks is between 7 a.m. and 11 a.m. in the morning and not during sleep. So you can sleep easy.

What about the muscular system during sleep? During NREM sleep, the muscles are active and the muscular system is fully engaged with the brain. There are spontaneous movements in the body during NREM sleep. We turn over many times during the night. This movement is important. People who cannot move because of illness such as quadriplegia suffer from bedsores. They need to be turned by nursing staff continuously throughout the 24 hours. The reason is that if the body is not moving during sleep, the skin which is under pressure from the weight of the body will be blanched and the blood supply to that part of the skin will be insufficient. That area of skin will break down and slough off to form a bedsore. So it is important that the body turns automatically during sleep. Also, this turning and moving of the limbs prevents the stiff neck and joint pain that most people experience the morning after they have been drunk the night before.

During REM sleep the muscular system is disengaged, as if a jamming mechanism is preventing the body from moving. This prevents the physical acting out of dreams. REM sleep is also called ‘paradoxical sleep’; the brain is so active and yet, paradoxically, the body is completely paralyzed.

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This is generally best for asthmatics and for middle-aged subjects. At first it is wise to use an armchair so that your arms can rest comfortably on the sides of the chair. It is best to sit up in the chair rather straight without the body slumped, which could tend to make the position too comfortable. The head can rest on the back of the chair. The legs are bent at the knees, and women find it wise to remove their high-heeled shoes.

When a fair degree of relaxation can be attained in an armchair, try a straight-backed

dining-room chair. The head is now unsupported, and the forearms rest comfortably on the thighs.

The Squatting Posture-In this position we sit on a cushion cross-legged on the floor. Our arms can hang loosely at our sides or rest in our groins. The whole of our head, neck, and back is unsupported.

Try to keep the back and the neck fairly straight so that the muscular effort to maintain the position is reduced to a minimum. The cross-legged position usually makes enough tension on the joints to induce mild discomfort. As a result of these factors, relaxation attained in this posture is usually very effective. The position is very satisfactory for youthful subjects, and those who suffer from asthma, as it makes for easier breathing than lying down.

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