Abstract

Alcohol use disorder (AUD) has been characterized as a chronic, relapsing disorder in which use continues despite escalating consequences. The prevalence of AUD is roughly 14 million cases in the US alone. Extensive research is focused on the establishment of remission from AUD and factors contributing to the maintenance of early remission. However, little research is available on what supports the maintenance of longer-term sustained remission from AUD. Self-concept (SC) is the subjective experience of a persistent being that one is. In healthy people, a stable SC is adaptive, but people with AUD, in sustained remission, SC stability is associated with continued use and relapse. Self-concepts of those with AUD are often organized around powerful core memories of early alcohol use, which confabulate drinking with experiences of belonging, interpersonal connection, and the quieting of self-doubts that had previously limited goal-directed behaviors. Self-concept-associated narratives in AUD, therefore, promote alcohol as beneficial by core memories and diminish or actively suppress factual episodic details about harmful drinking experiences. The self-concept must, therefore, change to accommodate the correlation of alcohol with its damaging effects for the remission of AUD to be established. Studies have correlated SC change in AUD in sustained remission with greater well-being and life satisfaction. However, It is unclear why SC stability supports long-term remission or quality of life. I conducted an auto-ethnography to increase knowledge regarding factors that support sustained remission in AUD over long periods. Self-concept in the study was operationalized as the labeling, describing, and characterizing lifetime periods during active AUD and at 32 years of continuous remission of symptoms. Wellbeing was assessed at the time of the study using four relevant measures, The Buss and Perry Aggression Scale, The Rosenberg Self Esteem Scale, The Tracy Pride Scale, and the Brief Symptom Inventory.

Two narratives were prompted: a) the last drink I felt bad about and b) the last time I wanted to drink but did not. The narratives were analyzed for self-concept change using the AI-based Linguistic Inquiry and Word Count software. Corroborating empirical data supported the research. Narrative a) support included being dismissed from the University of California at Santa Cruz in 1991 for poor academic performance and subsequent involuntary commitment to a psychiatric hospital for the period of one week for suicidal risk. Narrative b) support included Graduation with honors from UCSC, earning an MS in psychology, being a second-year student in a PsyD program in good standing, and current well-being assessment measures. The study hypothesized that SC would change over lifetime periods and that well-being would be high. The data supported the hypothesis.