I think one of the problems with this forum is that the people it works for stick around and the people it doesn't move on to work on something else. That was my situation, I did TSM for 6 months religiously, in 2010 or 2011 maybe but I found that it did very little to reduce the overall harm caused by drinking. In fact, I changed from a weekend binger to all week heavy drinker all in the name of extinguishing or whatever.
So what you have is the outliers who have been greatly improved by it sticking around and the rest have left...which gives you an obvious selection bias and inflated expectation. That was my case, I continuously read the success stories to reassure myself that the day would come when I could drink like a normal person. That day never came (in 6-7 months) and by that stage I had already failed my first semester exams and was bleeding PR due to my nightly TSM sessions. The TSM idea was very appealing to me, especially because I no longer had to worry about whether or not I was going to drink or feel guilty about it since it was all in the name of the cure. But I feel that the book was seriously misleading in its claims and was indeed too good to be true. I suspect it was written with a profit motive, which is not an uncommon story. People with alcohol problems are easily exploited because they are so desperate when they are hungover.
What worked for me in the end was a combination of self-will and acamprosate. People laugh at will power but it is in my opinion ultimately the only defence against drinking. Acamprosate has more modest claims than TSM but I have found it very useful.

AAA

I should say though that if you're intent on keeping drinking, Naltrexone isn't a bad way to go in reducing the ferociousness of your drinking. I definitely calmed down a bit when I was on Nal, but nowhere near what I had been led to expect. I'd suggest its a means of reducing harm in determined drinkers.

I have to agree with you. I have been taking NAL for over a year, and for me, although not cured, i feel that my drinking is at a "tolerable" level. I read the postings each day and although have not posted regularly for some time, enjoy following everyone's journey. The reason I don't post, I suppose is that I am sometimes discouraged when I see people, with shorter times, saying that they are "cured". I don't want to discourage anyone, but for some of us, there is only management.
Best Regards,
Movergal

This is a valuable conversation to be having.

There are some who describe their experience with Nal and TSM as having found a "magic pill." If you read this board with some care you'll find that many others fall somewhere else on the spectrum. And you'll also find those for whom TSM did not work. They said so and moved on to other approaches, including AA and other abstinence models.

Yes, many other people likely give up without explaining why. But we have no idea how carefully they followed the protocol, for how long, at what dosage etc.

You'll find many of us agreeing that the "Cure" book provides an incomplete picture of TSM.

But I'd also warn against universalizing from any one, individual TSM experience -- success or failure. Nor can we make ANY statistical claims about TSM -- positive or negative -- based on this discussion group. So when Spacious says "what you have is the outliers who have been greatly improved by it sticking around and the rest have left," this is a claim that simply cannot be drawn from this board because the stories here are just that -- anecdotes.

TSM's efficacy has not been well and widely studied, yet. I've seen evidence that there are a few well-established addiction researchers who are still studying the TSM approach. I, for one, would love to see a big, well-financed TSM study done. Because nal is a generic that may not happen, tho. The fact that studies are NOT being done is no proof, one way or another, that TSM is a legit choice among many approaches to alcohol addiction.

I'm glad that Spacious is describing his/her disappointing experience with TSM. We need to hear from those who do not succeed with the method, and those who describe their outcome as something between failure and total control/cure.

Whatever works, works. But willpower and abstinence-based approaches have their own success-rate problems (which are far better studied and documented).

There is ample evidence on this board -- and in this week's postings -- that willpower is recognized by most of the people here as an essential part of the TSM process.

I am hardly a TSM Pollyanna. This method may or may not work for me. So far, my experience is encouraging. Far from being a license to drink like before, TSM -- as practiced by me and many of the people on this board -- is a conscious and willful process of making our lives healthier and more balanced.

As a weekend binger, I don't think TSM was ever the right thing for you in the first place. I don't know that I would call anybody who drank to excess only on the weekends an alcoholic; many, many of us drink to excess everyday of our lives.

After reading the above post, I must ask what book did you read? It cannot be the same book I read. There are multiple statements in the above post that do not agree with how TSM is described in the book.

First, you stated you “changed from a weekend binger to all week heavy drinker all in the name of extinguishing or whatever.” The book describes the process as taking naltrexone one hour before drinking and then drink “normally.” Not drink like a fish to “extinguish” the habit faster. “Normally,” in the sense it was used in the book is as one is accustomed to. Second, “nightly TSM sessions?” What do you mean “TSM sessions?” From what you are saying, you wouldn’t have drank without TSM. That would mean your drinking deviated and wasn’t your normal pattern.

There are problems with the book. The time frame for sure. The idea that one quits without willpower and discomfort is wrong, too. It took me about eight months to get my consumption where I was comfortable. I was discouraged multiple times, the hangovers really sucked and I became depressed for a while. Willpower? It took my imposing alcohol free days when I finally felt that I could. The process makes it possible to quit, it doesn’t FORCE one to quit.

In so far as there being a profit motive behind the book, naltrexone is a generic drug. Not counting alcohol, as I would have drank much more anyway, my total cost to control, was about $620. That’s for eight months of treatment. If I had gone to a “12 Step” rehab, a month’s “treatment” would have cost at least $15,000. Who’s in it for the money? There doesn’t seem to be much money in TSM. That might explain why it’s not being pushed hard.

I think a lot of people quit for whatever reason: unable to stand the hangovers or tolerate the naltrexone, dissatisfied with the results or unable to remember to take the pill. I also think those who strictly follow the protocol have a much higher rate of success than those who do not. If one wishes to replicate an experiment, the conditions of the experiment are reproduced as closely as possible.

When did you try TSM? 2010 or 2011? Did you log your consumption? If so, how did you measure the consumption? How did you ensure taking naltrexone an hour before you drank? Did you post here before? If not, why post now?

I take it from your litany of questions Heavy Fuel that you don't believe me or assume I didn't do it properly. Anyway, I know for a fact I'm not alone in my experience and suspect I may be in the majority. I did post before, but fell away to try other things and was eventually successful. The reason I post now, is that I wish someone had mentioned this when I was doing TSM, this forum is relentlessly encouraging of TSM and if harmless levels of alcohol consumption is what you're after then I don't think its the way to go. Its probably sensible if you'd prefer to have the pleasure of drinking every day like you tho.

Spacious:

This is a support forum for people trying TSM.

It is also a place where we encourage honesty about TSM, good or bad. I'm glad you are here, in your own thread, describing your experience. TSM does not work for everyone. You say it didn't work for you. I'm sorry it didn't but I'm glad for the info. You suspect that it works for a minority. You are welcome to that opinion and welcome to share it in your own thread.

I think rather few of us here are approaching TSM with the naive belief that it's an instant or certain solution. In my reading of the board that comes out pretty clearly here.

But, again, it is a support forum. So people are supportive and encouraging. Just as they are on message boards for other anti-addiction approaches which work for some and not others.

I'd suggest you be considerate enough to refrain from dispensing obviously unwelcome advice to folks seeking support in their own, individual threads.

I am not assuming anything: I am reading your posts with a critical eye. I have added nothing to what you wrote, nor taken away. You may very well be in the majority, however, your story is anecdotal, meaning I could be the majority. The difference is I don't twist what Eskapa says in his book, even though I have been openly critical of the book.

Anyone who reads this forum should be well aware of the possible outcomes, as Tiller said. It's here. There are some people who finally achieve control after two years. Most others would have fallen away by that time.

You have not posted your consumption. Tracking consumption is an integral part of TSM. I can tell you how much I drank and on what days. If there is anything significant about those days, I have noted that too. So, in short, I know the exact date I started. I don't have to guess. I don't have "TSM sessions." Nor did I change to achieve "extinguishing or whatver."

When you say a litany of questions, I hardly call asking basic questions a "litany." And you have answered none of them. You keep mentioning daily drinking and cannot get to harmless levels, why not look at my signature? How about Ketchikian1's, Nawayout's or Nipit's? We have all achieved control. And there is a lot of information about us on this board.

Your username was activated on April 28th, 2012 at 7:44 AM. If you had another username, why not reactivate it? More than one person has come back and said something else worked better for them. That's not an issue. Trolling is an issue.

Funny story actually, I tried to revive my old username but I damaged my Laptop sometime last January and haven't been able to get back on since, I don't have the password and I changed my email.

I did track my consumption when for a while, then I gave up because it didn't seem to make a difference, and then I tracked it again when I thought things were going better and I was encouraged. But I stopped again because I developed a serious health complication because of drinking. Not to say that it was TSM's fault that I drank so much, but the point was that it didn't do a damn thing to prevent it.

Don't accuse me of trolling either just because what I say is critical of the method. You sound like my old sponser "take the cotton wool out of your ears and put it in your mouth" etc . I mean, I'd love if it worked.... all that drinking with impunity.