Drowning in drink

Some expatriate drinkers find the realities they encounter in China are too hard to face. For many of them, the country becomes the place where they bottom-out. Others, who are grappling with alcoholism when they arrive, find a whole new world of challenges to their disease here.

"Alcoholism is a huge problem among expatriate clients," says Hong Kong-based psychotherapist Dr Cathy Tsang-Feign, who has specialized in expatriate mental health for 20 years. The author of Keeping Your Life, Family and Career Intact While Living Abroad explains that, "Partially, it's the general lifestyle of expats."

According to the Federation of American Women's Clubs Overseas' (FAWCO's) Substance Abuse Committee's Report To The 2006 FAWCO Conference, expatriation factors including, "lifestyle changes, multiple moves, work demands, traveling partners creating 'single' moms coping alone, factors such as loneliness, self-worth, alienation, homesickness, stress, peer pressure, can all lead to coping mechanisms of self medication through overindulgence in alcohol".

Co-chairperson of the FAWCO Substance Abuse Committee Connie Moser, who has been researching alcoholism among expatriates, says that among survey respondents, "stress, loneliness, boredom and the need to wind down to relax were factors cited for the self-medication with alcohol for adults. This can lead to drinking daily, which may easily increase until it becomes a habit, which in some people with a predisposition to addiction could become alcoholism."

Tsang-Feign points out that this tendency to self-medicate is exacerbated by the fact that, "When they live abroad, their basic support systems - their social support networks - have been removed. And drinking is so acceptable among the expat community, and especially in Asia, and Hong Kong, and (mainland) China. Many people say, 'that's the only way I can hang out'."

A 24-year-old American woman, who insisted on being referred to only as Lucy, told China Daily that when she came to work in Beijing, she hoped to get away from the drinking culture she encountered on campus during college.

"When I first came to China, my plan was to seriously cut back on drinking," she says. While Lucy does not consider herself to be an alcoholic, she says she began drinking more in Beijing than she did in the United States.

"I was eager to trade in all my alcoholic friends back home for the more alcoholically conservative atmosphere I expected to find in China," she says.

"Instead, when I got to Beijing, I discovered the bars never close. There is no last call. No open-container tickets in the street. No drunk-in-public tickets. No public-urination tickets.

"Booze is available on Sundays and after 2 am; it's available 24/7, and it's cheap This place is a budding alcoholic's paradise."

At last Sunday's meeting of the Beijing chapter of Alcoholics Anonymous, the speaker of the week - a young, recovering American alcoholic - explained how his budding alcoholism blossomed when he came to China.

"There's this pressure, this stress that comes from living in an environment that is different from your native environment," he told a group of 15 that came for the 11:30 am open-door meeting at AA's clubhouse in Yuan Jia Gouji Gongyu.

Jack (not his real name) says he was looking for something that would "fill a hole" inside him, and he found that in the capital's nightclubs.

"Whereas in a nightclub in LA, they wouldn't let me in, here, they treated me like a star," he says.

He enjoyed renting booths and entertaining friends, but as time went on, he began drinking more and more. When binges at nightclubs became too "messy", he started drinking at home, which he continued doing for about two years.

Eventually, a visiting friend whom he'd slapped across the face during an alcohol-fuelled spat in a Beijing nightclub took him to an AA meeting. He continued to drink after his first meeting but gave it up soon after.

Jack considers himself lucky to have gotten help.

Many alcoholics fail to admit they have a problem in the first place.

As one American member of the Beijing AA Fellowship, a Texan, who agreed to be interviewed under the condition that he would be referred to as Tim, says, "It's the only disease that tells you that you don't have a disease."

Tsang-Feign says that most of the clients she treats for alcohol problems at first come for other reasons, because they didn't recognize, or refused to admit to, their alcoholism.

And those who recognize their disease are often unlikely to seek help for fear of stigma.

"Expats, just like anyone else, also fear for their job-security if the company finds out," Moser says. "There are people who manage to function well enough at their work, then drink all evening to escape, which becomes a vicious circle."

And there's often a scarcity of resources available to those who decide to seek help abroad.

"Expats on assignment have less access to treatment facilities in some countries, or to English-language AA groups abroad," Moser says.

There are currently 11 listed AA chapters across China, located in Beijing, Shanghai, Shijiazhuang, Hebei Province, Qingdao, Shandong Province, Chengdu, Sichuan Province, Kunming, Yunnan Province, Taipei, Taiwan Province, Hong Kong and the provinces of Zhejiang, Anhui, Fujian and Jiangxi.

Some fellowships, such as Beijing's, have both English-only and bilingual meetings, in which Chinese and foreigners work towards facing sober life together.

Tim says that for him, attending these meetings made him realize the universalism of the disease.

"The value of going to Chinese meetings is that I'm helping another alcoholic. Just by being in that chair, I'm being of service."

Tim explains that AA isn't intended to make people stop drinking; that's something they have to do themselves. Instead, it teaches them how to deal with life while sober and provides a support network, which usually includes people who come back from the brink of devastation to lead mostly happy, normal lives.

Tim drank heavily for 25 years until he lost his house, job and wife. With the help of AA, he's now been sober for nine years.

"We've dealt with a lot of foreigners who've come over here to drink themselves to death," Tim says.

Others, he says, believe they can escape from their drinking problems by getting a fresh start in China.

"We call that a geographic," Tim says. "They think, 'if I go to Beijing, I've got this great job; I won't drink there'."

But usually, nothing's different, and they soon again pick up the bottle, he says.

Thomas (not his real name), an American designer who is among the four regular members of Shenzhen's AA program, says the fellowship changed his life.

He spent four years "wallowing" in his alcoholism in Shanghai, before moving to Canada, where he began AA.

He returned to China to start a new life a year after beginning the program.

The man, who is now married to a Chinese woman for nine years, says the program changed his life.

"As you grow in it, it becomes an addiction," he says, "and not in a bad way."

(China Daily 07/27/2007 page19)