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07-18-2006, 03:54 AM
Chapter 2: What is Addiction?
Taken From The Book "When Someone You Love Is Addicted To Alcohol Or Drugs"
In the last chapter, we began to look at your deeper attitudes and the way they determine how you react to the alcoholic or the addict in your life. One important step in changing attitudes is finding out the facts. This chapter is devoted to helping your really understand alcoholism and addiction. Alcoholism is used as the model, but, if the person you are concerned about is addicted to illegal drugs or pills, don't skip this chapter or only read Chapter 3. Everything described here in relation to alcoholism applies equally to these other addictions. There is a huge amount of research on alcoholism, far more and going back far longer than for any of the other major addictions. The research on other major addictions confirms what has been discovered through research on alcoholism. So, although I mention alcoholism more frequently, my clinical experience is that the basic addictive process is remarkably similar across alcohol, prescription drugs, illicit drugs and addictive gambling.
'I don't understand it…'
Alcoholism is not only a destructive condition, it is also puzzling and confusing. It's not surprising that people have lots of different, often conflicting views about it. Here are some commonly expressed views:
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'He's always been a bit moody, hard to get close to. I thought the drink gave him relief and let him loosen up, so I ignored the nastiness that came out.'
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'I thought it was something wrong with me – you know, that I couldn't' give him the support or the love he needed and that's why he looked for comfort in the booze.'
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'Her Dad died when she was ten and she went to live with different relatives. She seemed so vulnerable – it made me fall in love with her. She's always been so insecure and moody. Drink let her escape.'
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'He tried to give up a couple of times. I hate to say it about my son, but he's not a stayer. No bloody willpower.'
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'I reckon that wife of his would drive anyone to drink.'
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'It's all the drink around nowadays. Started in her teens and it became a habit. Wouldn't have happened in my day.'
Your beliefs affect your behaviour
The people quoted above have a range of different beliefs and attitudes about the behaviour of alcoholics in their lives. The man who feels his son has no willpower is angry with him. The husband of the woman whose father died at an early age sees the problems stemming from an insecure childhood. He believes it's important that he's sympathetic and supportive. Looking through the quotes above, imagining the people, you'll begin to see that your view of alcoholism will have a major influence on how you react to the alcoholic and how you behave. For instance, the person who regarded the drinking as the fault of the alcoholic's wife, would tend to see the alcoholic as the victim, whose problem would disappear if only his wife did. The person who feels it wouldn't have happened in his day, probably lumps alcoholism together with anything else he regards as a modern–day evil. Obviously, all these different views can't be right. For this reason, it's extremely important to have an accurate, factual understanding of the condition.
Probably, living with alcoholism, all sorts of different views and explanations have occurred to you about why the person drinks. You may be loath to even call it alcoholism. Maybe you have one dominant view, but often people have no clear idea, just a mixture of different feelings and beliefs.
If you believe alcoholics are simply weak–willed people, you are likely to feel that your alcoholic should make an effort and pull his socks up. Perhaps you're convinced she could stop if you really tried. Maybe, if you see it as a weakness, you see yourself as having to provide the willpower and support to stop the drinking.
One of the most common beliefs is that alcoholism is caused by a deep–seated or childhood problem. If you believe this, you will try to be sympathetic and understanding of the person's 'need' for relief. But it could change your attitude to know that most people with unresolved problems do not become alcoholic. Many alcoholics do have unresolved problems, as well as alcoholism. Some alcoholics had these before the onset of alcoholism. Some developed problems during their drinking. But most alcoholics who go into therapy to resolve these sorts of problems continue their pattern of compulsive drinking. And it's important to remember that a large proportion of alcoholics have no particular problems, other than those which are part of alcoholism.
Having wrong or inaccurate beliefs about alcoholism will not only be damaging to you, but will usually also make an easier for the alcoholic person to continue on a downward path. In one way or another, alcoholics will justify their position, or make you into the wowser who's stopping them drinking. The truth – knowing what to do and how to behave, will help you enormously. Knowing the facts about alcoholism will put you in a position which will increase the chances of the alcoholic recovering.
What is alcoholism?
Alcoholism can be broadly defined in the following way: alcoholism is when a person continues to drink in spite of the consequences which are contrary to that person's own values, standards, interests and common sense. This simple definition makes sense to most people and it is important to keep it in mind. But to really understand alcoholism, you need to look at it in more depth. In the next few pages, you'll be given the key facts about alcoholism. Then, we will explore at even greater depth how this affects the alcoholic, the sort of person he or she becomes and some of the results of this.
Alcoholism creates abnormal behaviour
When trying to understand the addictive behaviour of a loved one, most people tend to think: 'Why does from he or she do it?' This preoccupation with the question 'What makes them do it?' is an important one. But to gain understanding of what has happened to your loved one, there is an even more important question: 'Why don't they stop?' An addicted person behaves in a way that no normal person would even though when sober or straight he or she can seem as normal as everyone else.
However the addicted person continues to choose to do something – that is, drink, take drugs, gamble – which he knows, through past experience, will result in consequences that are unpleasant and destructive. Normal people, on the contrary, did not continue to do things which cause distress to themselves and to others. If something is unnecessary and seriously harmful to oneself and others, no normal person would continue to do it. This is what is meant by 'out of control'. People who are unable to live their lives more or less in accord with their own values, standards and common sense, and no longer in control themselves. This point applies to all the major addictions – alcohol, prescription drugs, heroin, cocaine, marijuana and gambling.
But an alcoholic person does not have a pre–existing psychiatric abnormality that makes him drink. Nor was his personality abnormal before the alcoholic pattern of drinking began.
So it is not in these ways that the alcoholic fits into the definition of abnormal. The specific way in which an alcoholic is abnormal is that he does not regulate or adjust his behaviour in the way a normal person does. A normal person, finding he's having trouble with his drinking, moderates it. If he can't moderate it, he gives it away completely. Doing this is simple, basic sense.
Alcoholic people can't adjust their behaviour in this way. Although obviously unable to handle alcohol, they keep on drinking it. They may try switching drinks or setting times when they won't drink, but such remedies are short–lived and ineffective. Through alcoholism, they lose their ability to regulate or manage themselves in the way that most people do.
Alcoholism chemically changes personality
Most people know that too much alcohol causes serious physical damage – to the liver, the circulatory system, the digestive system and the brain. But even more devastating is the way alcoholism affects the personality. It reaches deep into the person and distorts fundamental processes. And then it takes over the person's conscious intellect and the thinking processes so that they are unable to think rationally about their problem. Even more frightening is that alcoholics are unaware that alcohol has this effect on them. You will find it useful to remember this. Your loved one's personality isn't changed just when he (or she) is drinking, it is changed even when he is sober. It is when he is sober that he picks up the first drink. If his personality was functioning normally, he would not do this.
How a chemical takes a person over
Alcoholism is different from other diseases in that it takes over the whole person, making profound changes, not only physically, but more importantly, emotionally and mentally. This is caused by the alcoholic taking in alcohol, which is, after all a chemical that changes the functioning of the brain.
Most modern medicinal drugs relieve pain or affect the workings of the body. They have various affects, but they do not take people over. When normal people drink alcohol it relaxes them and makes them less inhibited, but it doesn't totally take them over.
The difference with alcoholics is that alcohol provides something which is deeply satisfying to them at a level that others find hard to understand. The alcoholic uses alcohol to become intoxicated. This intoxication is so deeply rewarding to the alcoholic that alcohol becomes of paramount importance.
The intoxication effect
The alcoholic's brain is set up in such a way that he or she has a special and dangerous psychological response to alcohol. It doesn't just have the effect of making alcoholics looser, more relaxed, fuzzier and friendlier, as it does with most people. Here are some examples of alcoholics talking about the way alcohol made them feel:
Harry, forty: 'I can handle any problem that comes along when I drink. It's like I can channel my thoughts where I want to, feeling what ever I want to do. Other things, other people, just can't get in.'
Jenny, thirty–seven: 'The booze gave me courage. I felt like Superwoman. I could go out and do anything.'
Mark, twenty–eight: 'When I am sober, I think about being a good athlete, the when I drink, it comes alive and I really am the best. I am doing it.'
Peter, twenty–two: 'It coloured me in. I took the first drink and for the first time ever, I belonged to the human race. All those silly little things didn't worry me anymore.'
Judy, twenty–eight: 'It started the party for me and I thought it would never end. When it did, I couldn't believe it. I thought it must still be there and I kept looking in the bottle for it. I was living in my little room, too scared to go out for anything but my cheque and my grog.'
Powerful drug experiences
From the outside, the alcoholic is just a drunk. He isn't solving his problems, being a great athlete or being Superman. He is staggering round, probably at least a bit out of control. But inside, something very different is going on. Inside, everything that seems wrong, everything that seems at odds with the world, just dissolves and melts away. Nothing can hurt him, nothing can get him. He is what he wants to be and nothing matters.
For the alcoholic, fantasies and imaginings come alive and real in intoxication. Even knowing they aren't real doesn't matter one bit, because they seem as good as real. Intoxicated, alcoholics are separated from reality; above it, parallel to it, insulated from it – but never in it. Deep within them is a sense that they are whole, at one. It's and exhilarating feeling of being set free at last.
To the alcoholic, the intoxication effect is powerful and meaningful, and easy to repeat. Each instance cements the idea into the alcoholic's subconscious mind that he can rise above reality and be his true self. 'This is how I deserve to be... this is the real me,' is an idea planted at a very deep level. It becomes more than an idea or a belief; it becomes the deepest sense of self, part of the alcoholic's sense of identity. At this deep level, the person and the alcohol have become one.
This is the world of the alcoholic, very real to him or her, but totally artificial, a chemically created delusion. Alcoholics take it to be real when it's not real at all. The experience is so powerful that they can't see the reality – that they are just drunks, people who are increasingly obsessed with drinking. Sober, the alcoholic is just waiting to enter that world again.
It's important to understand that alcoholics have no understanding of this process. They can't observe it and decide whether or not to go along with it. They have been infiltrated by it and undermined from within.
Nobody sets out to become alcoholic
Alcoholism results in the alcoholic losing virtually everything. Over time, the alcoholic will lose his or her friends, family, self–respect, emotional stability, health, jobs, money, home and, quite often, his or her life. All this, just for the sake of getting drunk! No one chooses to become the sort of person who will lose everything of value in life just for the sake of being drunk. To make such a devastating choice as this, you would have to be hooked on alcohol already.
Alcoholism is caused by an outside agent
Research in clinical experience has shown that prior to the onset of the alcoholism, most alcoholic people had normal personalities. Of course, this is not to say that some of them didn't have psychological problems. But having problems does not make someone abnormal. A chemical, alcohol sets going destructive internal processes which result in people being unable to adjust their behaviour in the normal way.
Alcoholism is progressive
At the start of their drinking careers, many alcoholics are indistinguishable from ordinary drinkers. Others are obviously in the grip of alcohol from the very beginning. However, whatever the pattern of this early drinking, the alcoholism begins to affect the person to a greater and greater degree, both in terms of personality and in terms of the consequences.
Alcoholism kills
The mortality rate among alcoholics is between two and four times as great as for other people of the same age. Alcohol poisoning, liver damage, accidents, suicide and gastric disease are just some of the ways alcoholism kills. It can cause serious brain damage that results in severe, irreversible, short–term memory loss. This condition, known as Korsakoff's Syndrome, usually results in institutionalisation.
Alcoholism is a disease
Alcoholism is condition which is destructive, which a person does not choose to have, cannot choose to be rid of and which is set going by an external agent. It is progressive and frequently terminal. Clearly, such a condition is a disease. Some people object to the word 'disease' – it can just as well be called an illness, sickness, psychiatric disorder or condition. But whatever term is used the underlying point remains: the addicted person is in the grip of a destructive process beyond his or her conscious control and understanding. Conservatively, it is estimated that alcoholism affects about 2% of the Australian population over 18, heroin addiction about 0.4% and gambling about 1%. Strong genetic factors are involved in becoming alcoholic.
Take the time to go over the above points a few times, making sure that you can accept addiction - to alcohol or anything else - is a disease and that you understand the reasons why this is so. It is a very important step for you to see this
Realising alcoholism is a disease
You may wonder why it's so important to understand that alcoholism is a disease. Let's look at a completely different situation. Imagine a mother who's dealing with a whingey, difficult toddler. She tries to humour him, to change his behaviour, but after a few days, she's fed up. Then she discovers the child is coming out in a rash and has a high temperature. It's measles. Obviously, the mother begins to feel very differently. She now understands why the child was being so difficult. Even though she might find the child's behaviour annoying, she would no longer blame the child. And she' d find out what she should do to help the child's recovery.
Alcoholism is much more complex, but these two principles still apply - it's an illness, and the person cannot be blamed for getting it, and the thing to do is to find out the appropriate way to handle the situation.
It's very natural to feel some confusion because the alcoholic you are dealing with is a person who, in a totally irresponsible way, is doing exactly what he or she wants. And, what's worse, he or she does it again and again, despite the consequences. It gets even more horrible - alcoholics will lie to you, manipulate you, pretend, bully and bluster to get their way. You realise that their tearful remorse is meaningless as the whole cycle is repeated again and again. Confronted with this, in spite of all the facts, saying it is a disease might seem like a cop-out. Perhaps you think you should see alcoholism is a disease, because this book says it is. Or perhaps a psychologist or a social worker told you it is and you feel these people must know. Maybe you feel guilty because you're harbouring a few doubts.
But as you read on I hope that you will develop your own personal understanding of how alcoholism is a disease or psychiatric disorder. As you relate the ideas in this book to your experience of your addicted loved one, apparent contradictions will disappear. You will see that the addicted person is like this because of the way his personality has been taken over. He or she may have become a weak person, but that is the result of the problem, not its cause.
However, it's important to keep in mind that even though it's a disorder or disease, your loved one is not a helpless victim. He or she can't choose to just be free of it, but can choose to recognise the problem and seek help.
When self takes over
In chapter 1 it was explained how 'self' is the 'I' or 'me' of which we are aware in our thoughts, feelings and actions. It is through this self-image that we see ourselves, and it has a major influence on thoughts, feelings and behaviour. It is so much part of us, and it seems to be 'the real me' or 'the way I really am'. It provides a sense of identity, but, as was mentioned earlier, it is not an accurate representation of you as a person. For instance, someone who has a self-image of being not as good as everyone else, may, in fact, be an intelligent, capable and likeable person. But in some situations that they are more than capable of handling, these people feel inexplicably nervous and anxious. They may make apologetic remarks or give the impression they have to prove themselves. They will be unaware that this difficulty springs from self-image, because, to them, it is just the way they are.
Although 'self' is an extremely important part of your personality, it is certainly not the most important part of what you are as a person. Far more important are your basic values, your standards and your conscious understandings of yourself and your life. Using your intelligence and reason you can look to these to find out how to direct your life in a meaningful way. Self-image is implanted in the irrational part of the mind and is not a reliable basis from which to guide your life. Yet with many people, self can become too dominant and take over.
For instance, a woman feels she will be complete when she finds the right man. She has an inner image of herself as being inadequate and incomplete. For her, a relationship holds the promise of becoming complete. She pursues relationships desperately, not realising she's pursuing an image, an ideal that no reality could match.
A man may pursue sexual conquests in an obsessive fashion, not because he wants a meaningful relationship, but because each conquest validates his image of himself being wanted - on his own terms.
Many people have a strong feeling of something lacking built into their core self-image. They can become obsessively involved in religious cults, or in any activity which, the image, gives them a sense of being whole. The irony of it is that very often, as people, they are not lacking in any particular way at all. They only feel they are. With the alcoholic, the self becomes distorted, giving a very deep sense that the world of intoxication is the real one. It is very obvious to other people that this is distorted. But alcohol gives the alcoholic an experience of some impossible, total sense of completeness in the self when he or she is drinking. The person he or she is when sober seems, to the alcoholic, a pale version of the open ' real' person he or she can be drunk. In other words, the drink creates its own need by creating a paradise of the self.
Try and capture the sense of this. Just pause a moment, relax and start to get in touch with some of your more inward, secret, even partly forgotten dreams, feelings and desires. Bring up those feelings about what you could have been, what you deserve to be, what you would love to be or to have now, if only your very deepest wishes could be fulfilled.
Imagine there's a magic pill you can take and you start to be the way you've always wanted to be. Nothing, absolutely nothing, outside can touch you. Your secret longings, some you didn't even know your had, become a reality. Tension, uneasiness, divided feelings within you are replaced by a deep feeling of wholeness and oneness that no one can take away. This is deep within you, far more than a surface feeling. Just imagine the seductive power of such a pill.
Magnify that imagined affect, make it real, and that's what the magic bullet of alcohol does for the alcoholic. Normal drinkers don't get this profound effect. Certainly alcohol relaxes them, reduces their divisions, exaggerates their feelings about themselves and others. But it does not produce that experience of self being disassociated from reality that causes alcoholics to continue chasing the effect, while life falls apart around them.
Genetic factors
As stated earlier, alcoholism occurs primarily for genetic reasons. This has been shown in research studies. And commonsense makes it clear that only if someone has the sort of brain in which alcohol produces the effect of self being disassociated reality, can addiction develop. Whether you have a brain like this is a matter of genetics, not choice. Of course other factors are involved, but they will not result in addiction without this genetic factor.
Different patterns
Like most other diseases, alcoholism has many different patterns. It is not simply how much people drink, what they drink or even the effect on their behaviour. Alcoholics vary enormously - may have different personalities, different intelligence levels, different social backgrounds. Some have perfectly normal backgrounds, others have disrupted childhoods.
Some alcoholics are violent and dangerous, others are withdrawn and isolated. There are others who never seem outrageously drunk or out-of-control. They simply keep topped up to a level which maintains the way they want to feel.
Some alcoholics may be able to maintain a reasonably normal lifestyle for years and years. They keep going to work, often in responsible, or even demanding jobs. In their home life, they are able to maintain the everyday social niceties, although, because of the process going on within them, they are incapable of a deep or committed relationship. Their spouses or children are aware that something is wrong, but because the alcoholic is never forced to make a choice between alcohol and his or her family, the family remains blind to the fact that he or she would undoubtedly choose alcohol. In fact, in drinking, in living in their own world, alcoholics are choosing alcohol rather than their families, because they are rarely in a condition to relate to them normally.
Many people believe the person they love can't be in alcoholic because he or she isn't living in the park, sucking on a metho bottle. But it's important to realise that the stereotype of the alcoholic is false. Only a very small percentage of alcoholics are on Skid Row.
There are bender drinkers and chronic drinkers. Some people drink alcoholically from the start. Others move into alcoholism over a period of years. Some alcoholics had a drinking pattern which means they are not actually physically hooked on alcohol, although this is unusual. But what they all have in common are the disease processes alcohol has set going in them. Once these processes are set going in a person, that person is increasingly under their control. Let's outlook at these processes.
The pathological self
Above, it was explained how alcohol takes over the core self. The effect of this on the person is profound. The alcoholics sees his or her 'real' self in intoxication. This inner world of self becomes the alcoholic's underlying reality - where he or she is untouchable. The sober self and actual reality are irritations to be put up with until the next drinking session. Although the alcoholic doesn't realise that, reality has become a whim that can be pushed aside.
Many alcoholics go through a phase where they can function quite well in some areas of living in spite of alcoholic drinking. But as you can see by now, they do so from the position of profound self-delusion - the delusion of what they see as their real self and the delusion that reality is optional.
All of us have some deluded attitudes and perspective that come from distortions in the self. And many non-alcoholic people see themselves and the world in a way which seriously distorts reality. The chemically created, pathological self of the alcoholic is an extreme example of how this delusion operates.
Every time the person drinks, this delusion is reinforced. The inner world of self takes a more and more dominant place in the person's awareness. In the normal personality, there's a balance between the self and the other things that go to make up a whole person. In the alcoholic, this balance is destroyed. The self takes over to a pathological extent.
The domination of the pathological self is the central problem of the alcoholic and because it tackles this, the Alcoholic Anonymous program is successful in helping alcoholics to achieve sobriety. The basic text of AA, the 'Big Book', Alcoholic Anonymous, makes reference to the need for the alcoholic to be relieved 'of the bondage of self' and the conviction that 'self, manifested in various ways, was what had defeated as.' The AA program offers the alcoholic a way to escape from the pathological self created by alcohol and to be able to use, once again, all faculties as a person.
Values, standards and commonsense are part of the sober self and reality. The alcoholic can feel the degradation, shame, physical pain and embarrassment when he or she drinks. But this remorse and concern is short-circuited by the knowledge that he or she can get away into the 'real' self whenever he or she wants to.
At times alcoholics will recognise drink is a problem, but they are partly shielded from this thought because, to them, reality is optional. Doing something about the drinking problem is going along with reality - something they don't have to do.
Take the case of Joe, a building subcontractor are of 45. He is alcoholic who drank for 15 years and has been sober for five: 'I grew up in a house where we had pretty firms standards. You got into debt, you paid your bills. You said you'd do something, you did it. When I got married, I stuck to those standards, until I began to drink heavily. Then, those sort of things gradually became irrelevant to me. My wife used to hassle me for the rent money and I'd say, "Why should we pay those bastards?" I'd undertake to do jobs and take the down payment. It'd never get done and I'd get very angry with people who hassled me. I'd tell them outrageous lies and feel quite justified. All these people making a fuss - it used to annoy me. I couldn't see what it had to do with me. Now, I think about the way I behaved and I'm horrified. I know it's the booze that did it to me, but at the time, there was no way I could see it. I did an about-face on all the things I believed in and I really felt the world was very unreasonable. You become a different person. The scary thing is that so few of us ever get back, because, when you're in the middle of that, you just can't see it.'
So, back to our question: 'Why don't they stop?' We now have an answer. Their genetically-determined brain response to alcoholic or drugs has made a permanent change in their personality. Through its action on the brain, the chemicals has made them unable to respond to obvious reality. This arises from changes in the deep part of their personality, which then result in changes to their conscious perspectives and thinking. Rather than helping them see how to come to grips with their problem, their conscious thinking processes now prevent them recognising that there is a problem. This inability to respond to obvious reality is a true psychiatric abnormality residing at all levels of the personality. The powerful psychoactive chemical (alcohol or other drug) has created a damaging abnormality that was not there before.
However, addicted people are still very much people, so still have all the ability to see and acknowledge that there is something wrong with them, and do something about it. But the addictive process means they will resist doing this, which is why your approach may tip the scales towards recovery.
Understanding how the alcoholic is pathologically out of touch with reality makes it clear that the alcoholic needs to come to a point where reality will cut through the delusion. This will be looked at in greater depth in a later chapter, but you can see now that it is no use appealing to or fighting with his or her real self. Unfortunately, this is what many people do, living in hope that the old self will, one day, show through this mess. The old self is in the mess somewhere, it's been permanently distorted and arranged. In recovery, the qualities that are in the alcoholic's nature as a person will be there, not as part of the old pathological self, but as part of the new sense of self that develops in recovery.
Obsession
The alcoholic is not aware of the deep, pathological changes going on within him, but he can be aware of any increasing preoccupation with alcohol, a preoccupation that develops into an obsession. No matter what's happening, the urge to drink lurks somewhere in the alcoholic's mind. Many alcoholics go through a phase where they don't resist this urge, but when they do, it is futile. In fact, the stronger the resistance, the stronger the urge, until the person finally gives in.
The alcoholic can't choose to rid his or her mind of the constant preoccupation with drink. It'll be there whether drinking or not: 'where's the next drink coming from?... I won't drink till after five o'clock... But will they really have enough booze at that party?... I'll stock up for the weekend... I'll suggest to drink at lunch... I won't drink when I get a new job'. The fighting, the struggle, the preoccupation are endless. When the alcoholic fights it, it gets worse and sooner or later, he or she is shown to be powerless against it. You can probably understand what this is like because you possibly have a similar preoccupation with the alcoholic's drinking and its effect on your life. 'How can I get him or her to stop?... What'll I do if he or she walks in with a flagon?' It starts to dominate your thoughts to the exclusion of other things and there are times, when try as you might, you can't stop thinking about it.
Denial and self-deception
Alcoholics usually lie or attempt to disguise their drinking. They may definitely dismiss criticisms or comments on alcohol consumption. They'll react angrily to helpful suggestions. The deep down the knowledge that there is something very wrong with the way they drink exists.
Although their sense of self is being taken over by alcohol, their intelligence, their values and commonsense are still in them somewhere. This means there is conflict at a deep level between the obsession with drink, their values and their commonsense. Automatically, self-deception and denial develop in them.
Self-deception is present as a natural tendency in all of us. It allows us to ignore, brush aside, twist or neutralise facts or ideas we don't want the like. It's a tendency which will cause a lot of problems in anyone if it gets out of hand. Alcoholics become absolute masters of it and at the same time, complete victims of it.
Personality deterioration
The disease processes of alcoholism lock into the negative aspects of personality and make them worse. In addition, constant drinking of large amounts of alcohol produces emotional and psychological disturbances. Fears, anxieties, brittle arrogance, resentment and aggression, low self-esteem, despair, social isolation and reactive depression are just a few of the things an alcoholic may suffer from.
Physical dependence
And alcoholic person doesn't continue to drink for physical reasons. But physical dependence causes the craving to go rampantly out-of-control and locks the alcoholic further into the disease. Physical dependence occurs when the body is so used to having alcohol that it has made a physiological adjustment to it. Then, if supply isn't kept up, the body starts to react and the person suffers from the discomfort of withdrawals. The solution, for the alcoholic, is to drink more.
Vicious cycle
These disease processes combine into a vicious cycle. The more successful denial is, the more the alcoholic drinks. The more he or she drinks, the greater the growth of the pathological self. This makes the desire to drink stronger and this leads to stronger denial and self deceit. As the disease progresses, what the person was or could have been is distorted, almost beyond recognition.
Is the alcoholic responsible for recovery?
You can see very clearly that alcoholism is a disease which a person is not responsible for having. The alcoholic is not aware of the processes going on within him or her. Knowing this lets you understand how an alcoholic can behave in a way that is so irresponsible. Alcoholics are not capable of stopping drinking or staying off alcohol without help. But they are capable at times, as the disease progresses, of recognising that they have a problem and need to seek help. In fact, people close to alcoholics need to behave in a way that brings them to a point that they must take responsibility for their actions.
There are times at which alcoholics and not so badly in the grip of the disease, when they are able to acknowledge that they should get help or that they are causing great suffering to those around them. On these occasions, alcoholics are being consciously and knowingly irresponsible in continuing to drink. They know they could choose to look for help. In the earlier phases of the disease, these occasions are rare. As the disease progresses, they become more common until the person may eventually seek help. The difficulty is, that as the disease progresses, the disease processes are working at a deeper level. The pathological denial of alcoholics is more developed. They are less in touch with reality. These processes are neutralising the concern that their own standards and values would otherwise generate in them, and which would lead them to seek help. That is why the approach of those around and can be a crucial factor.
At some level, every alcoholic has the knowledge that there is something wrong and he or she needs help. Some alcoholics are actually aware of this at a conscious level, but choose to continue drinking. They know recovery is possible, have been involved in recovery programs and understand that there are things they can do which will lead to recovery, but they choose to ignore this knowledge. In other words, they are willing victims to their disease. Other alcoholics, who have not had information or help, have the knowledge in them somewhere, but it is clouded by their disassociation from reality, their denial and the other disease processes.
As in most things to do with human nature, the question of the degree of responsibility alcoholics have their behaviour in recovery is a grey area, dependent very much on the individual and how the disease processes operate within each person. However there is no doubt that strategies most helpful in bringing about recovery are those which will bring alcoholics to accept responsibility for their actions to the same degree that other people do if they behave badly or wrongly.
Your relationship with the alcoholic
Most people living with an alcoholic experience enormous confusion. 'She was sort of there, but not really,' says Max, the husband of a recovering alcoholic. 'I could have a sensible, reasonable and rational conversation with my wife. Later, she'd deny we ever had it, or, take the opposite viewpoint. I gave up extracting promises about her drinking because she couldn't keep them. At the time she made them I'm sure she was sincere. Realising alcoholism was a disease helped me understand why these things happen.'
'Another thing I learned to accept was that she wasn't the person I married. I used to feel as if she had to be in their somewhere, that underneath all the drama and nastiness that goes on with alcoholism, she was still there. And it was hard to accept that she wasn't, especially since I get flashes of it now and then. She was a practising alcoholic and that was that.'
When an alcoholic recovers, part of the old personality comes back. But alcoholism destroys the original personality. To rebuild it, fundamental changes have to take place. But the changes in a recovering alcoholic are positive, with an emphasis on self honesty and learning to deal with reality.
Recovery from alcoholism
Understanding alcoholism, you will begin to see the alcoholic in a different light. It is an important step for you and towards the recovery of the alcoholic.
'Once I accepted alcoholism as a disease, it changed my perspective on things,' said Max. 'I still found my wife very difficult to live with as a practising alcoholic, but I didn't get locked into her behaviour. Knowing it was a sickness that she was suffering, I felt a lot less bitter towards her. As a disease, she couldn't control it and neither could I. Little changes had quite dramatic effects. I remember one night she walked in with a flagon. Usually, I say something sarcastic, indicate my disapproval or start a shouting match just to vent my frustration. I just said Hello and asked her how she was. She kept coming back into the lounge room to check my reaction. Later, she told me was at that point she really started thinking about herself. Instead of having a shouting match about how justified she was in drinking, she was left with herself and her flagon.'
The feeling of 'me and him', 'me against her' or 'me against it' discussed in the last chapter, is the feeling Max was able to let go of because he understood the disease of alcoholism. He realised it made no more sense to be against alcoholism, than it would to be against measles. Once Max ceased to be locked into a struggle with his wife's addiction, she was left to deal with it herself and took the first steps towards recovery.
Understanding continues to be important, even where the alcoholic is recovering. Christine, who was mentioned in the last chapter, was locked into her husband's alcoholism. When the husband eventually got into recovery, she really wanted to help: 'actually, a bit more than that. I wanted to manage it. I'd read up on alcoholism so I was the family expert. He got sober, I believe, largely because I stopped confronting him with the problem and I stopped protecting him from the consequences. But when he got sober, I was in there again, boots and all. Go to this meeting, do this, do that. He kept busting. Finally, someone pointed out what I was doing and I told him, "it's your decision whether you get sober. It has nothing to do with me." He drank out of control for a month, then he got himself into hospital and has been sober ever since. It was a good lesson for me. You can't make anyone sober.'
Summary: remind yourself of these important points
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What you believe about alcoholism and addiction affects the way you behave.
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You don't have to force yourself to believe alcoholism or addiction is a disease. As you work at understanding it, this will be obvious.
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The unrecovered alcoholic is operating from the base of profound delusion, even when sober and apparently normal.
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To the unrecovered alcoholic, reality seems optional.
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Most alcoholics are not on Skid Row.
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Its silly to blame the addict or alcoholic for having a disease
http://www.jimmaclaine.com/Chapter%202.htm
**Used with permission
Taken From The Book "When Someone You Love Is Addicted To Alcohol Or Drugs"
In the last chapter, we began to look at your deeper attitudes and the way they determine how you react to the alcoholic or the addict in your life. One important step in changing attitudes is finding out the facts. This chapter is devoted to helping your really understand alcoholism and addiction. Alcoholism is used as the model, but, if the person you are concerned about is addicted to illegal drugs or pills, don't skip this chapter or only read Chapter 3. Everything described here in relation to alcoholism applies equally to these other addictions. There is a huge amount of research on alcoholism, far more and going back far longer than for any of the other major addictions. The research on other major addictions confirms what has been discovered through research on alcoholism. So, although I mention alcoholism more frequently, my clinical experience is that the basic addictive process is remarkably similar across alcohol, prescription drugs, illicit drugs and addictive gambling.
'I don't understand it…'
Alcoholism is not only a destructive condition, it is also puzzling and confusing. It's not surprising that people have lots of different, often conflicting views about it. Here are some commonly expressed views:
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'He's always been a bit moody, hard to get close to. I thought the drink gave him relief and let him loosen up, so I ignored the nastiness that came out.'
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'I thought it was something wrong with me – you know, that I couldn't' give him the support or the love he needed and that's why he looked for comfort in the booze.'
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'Her Dad died when she was ten and she went to live with different relatives. She seemed so vulnerable – it made me fall in love with her. She's always been so insecure and moody. Drink let her escape.'
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'He tried to give up a couple of times. I hate to say it about my son, but he's not a stayer. No bloody willpower.'
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'I reckon that wife of his would drive anyone to drink.'
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'It's all the drink around nowadays. Started in her teens and it became a habit. Wouldn't have happened in my day.'
Your beliefs affect your behaviour
The people quoted above have a range of different beliefs and attitudes about the behaviour of alcoholics in their lives. The man who feels his son has no willpower is angry with him. The husband of the woman whose father died at an early age sees the problems stemming from an insecure childhood. He believes it's important that he's sympathetic and supportive. Looking through the quotes above, imagining the people, you'll begin to see that your view of alcoholism will have a major influence on how you react to the alcoholic and how you behave. For instance, the person who regarded the drinking as the fault of the alcoholic's wife, would tend to see the alcoholic as the victim, whose problem would disappear if only his wife did. The person who feels it wouldn't have happened in his day, probably lumps alcoholism together with anything else he regards as a modern–day evil. Obviously, all these different views can't be right. For this reason, it's extremely important to have an accurate, factual understanding of the condition.
Probably, living with alcoholism, all sorts of different views and explanations have occurred to you about why the person drinks. You may be loath to even call it alcoholism. Maybe you have one dominant view, but often people have no clear idea, just a mixture of different feelings and beliefs.
If you believe alcoholics are simply weak–willed people, you are likely to feel that your alcoholic should make an effort and pull his socks up. Perhaps you're convinced she could stop if you really tried. Maybe, if you see it as a weakness, you see yourself as having to provide the willpower and support to stop the drinking.
One of the most common beliefs is that alcoholism is caused by a deep–seated or childhood problem. If you believe this, you will try to be sympathetic and understanding of the person's 'need' for relief. But it could change your attitude to know that most people with unresolved problems do not become alcoholic. Many alcoholics do have unresolved problems, as well as alcoholism. Some alcoholics had these before the onset of alcoholism. Some developed problems during their drinking. But most alcoholics who go into therapy to resolve these sorts of problems continue their pattern of compulsive drinking. And it's important to remember that a large proportion of alcoholics have no particular problems, other than those which are part of alcoholism.
Having wrong or inaccurate beliefs about alcoholism will not only be damaging to you, but will usually also make an easier for the alcoholic person to continue on a downward path. In one way or another, alcoholics will justify their position, or make you into the wowser who's stopping them drinking. The truth – knowing what to do and how to behave, will help you enormously. Knowing the facts about alcoholism will put you in a position which will increase the chances of the alcoholic recovering.
What is alcoholism?
Alcoholism can be broadly defined in the following way: alcoholism is when a person continues to drink in spite of the consequences which are contrary to that person's own values, standards, interests and common sense. This simple definition makes sense to most people and it is important to keep it in mind. But to really understand alcoholism, you need to look at it in more depth. In the next few pages, you'll be given the key facts about alcoholism. Then, we will explore at even greater depth how this affects the alcoholic, the sort of person he or she becomes and some of the results of this.
Alcoholism creates abnormal behaviour
When trying to understand the addictive behaviour of a loved one, most people tend to think: 'Why does from he or she do it?' This preoccupation with the question 'What makes them do it?' is an important one. But to gain understanding of what has happened to your loved one, there is an even more important question: 'Why don't they stop?' An addicted person behaves in a way that no normal person would even though when sober or straight he or she can seem as normal as everyone else.
However the addicted person continues to choose to do something – that is, drink, take drugs, gamble – which he knows, through past experience, will result in consequences that are unpleasant and destructive. Normal people, on the contrary, did not continue to do things which cause distress to themselves and to others. If something is unnecessary and seriously harmful to oneself and others, no normal person would continue to do it. This is what is meant by 'out of control'. People who are unable to live their lives more or less in accord with their own values, standards and common sense, and no longer in control themselves. This point applies to all the major addictions – alcohol, prescription drugs, heroin, cocaine, marijuana and gambling.
But an alcoholic person does not have a pre–existing psychiatric abnormality that makes him drink. Nor was his personality abnormal before the alcoholic pattern of drinking began.
So it is not in these ways that the alcoholic fits into the definition of abnormal. The specific way in which an alcoholic is abnormal is that he does not regulate or adjust his behaviour in the way a normal person does. A normal person, finding he's having trouble with his drinking, moderates it. If he can't moderate it, he gives it away completely. Doing this is simple, basic sense.
Alcoholic people can't adjust their behaviour in this way. Although obviously unable to handle alcohol, they keep on drinking it. They may try switching drinks or setting times when they won't drink, but such remedies are short–lived and ineffective. Through alcoholism, they lose their ability to regulate or manage themselves in the way that most people do.
Alcoholism chemically changes personality
Most people know that too much alcohol causes serious physical damage – to the liver, the circulatory system, the digestive system and the brain. But even more devastating is the way alcoholism affects the personality. It reaches deep into the person and distorts fundamental processes. And then it takes over the person's conscious intellect and the thinking processes so that they are unable to think rationally about their problem. Even more frightening is that alcoholics are unaware that alcohol has this effect on them. You will find it useful to remember this. Your loved one's personality isn't changed just when he (or she) is drinking, it is changed even when he is sober. It is when he is sober that he picks up the first drink. If his personality was functioning normally, he would not do this.
How a chemical takes a person over
Alcoholism is different from other diseases in that it takes over the whole person, making profound changes, not only physically, but more importantly, emotionally and mentally. This is caused by the alcoholic taking in alcohol, which is, after all a chemical that changes the functioning of the brain.
Most modern medicinal drugs relieve pain or affect the workings of the body. They have various affects, but they do not take people over. When normal people drink alcohol it relaxes them and makes them less inhibited, but it doesn't totally take them over.
The difference with alcoholics is that alcohol provides something which is deeply satisfying to them at a level that others find hard to understand. The alcoholic uses alcohol to become intoxicated. This intoxication is so deeply rewarding to the alcoholic that alcohol becomes of paramount importance.
The intoxication effect
The alcoholic's brain is set up in such a way that he or she has a special and dangerous psychological response to alcohol. It doesn't just have the effect of making alcoholics looser, more relaxed, fuzzier and friendlier, as it does with most people. Here are some examples of alcoholics talking about the way alcohol made them feel:
Harry, forty: 'I can handle any problem that comes along when I drink. It's like I can channel my thoughts where I want to, feeling what ever I want to do. Other things, other people, just can't get in.'
Jenny, thirty–seven: 'The booze gave me courage. I felt like Superwoman. I could go out and do anything.'
Mark, twenty–eight: 'When I am sober, I think about being a good athlete, the when I drink, it comes alive and I really am the best. I am doing it.'
Peter, twenty–two: 'It coloured me in. I took the first drink and for the first time ever, I belonged to the human race. All those silly little things didn't worry me anymore.'
Judy, twenty–eight: 'It started the party for me and I thought it would never end. When it did, I couldn't believe it. I thought it must still be there and I kept looking in the bottle for it. I was living in my little room, too scared to go out for anything but my cheque and my grog.'
Powerful drug experiences
From the outside, the alcoholic is just a drunk. He isn't solving his problems, being a great athlete or being Superman. He is staggering round, probably at least a bit out of control. But inside, something very different is going on. Inside, everything that seems wrong, everything that seems at odds with the world, just dissolves and melts away. Nothing can hurt him, nothing can get him. He is what he wants to be and nothing matters.
For the alcoholic, fantasies and imaginings come alive and real in intoxication. Even knowing they aren't real doesn't matter one bit, because they seem as good as real. Intoxicated, alcoholics are separated from reality; above it, parallel to it, insulated from it – but never in it. Deep within them is a sense that they are whole, at one. It's and exhilarating feeling of being set free at last.
To the alcoholic, the intoxication effect is powerful and meaningful, and easy to repeat. Each instance cements the idea into the alcoholic's subconscious mind that he can rise above reality and be his true self. 'This is how I deserve to be... this is the real me,' is an idea planted at a very deep level. It becomes more than an idea or a belief; it becomes the deepest sense of self, part of the alcoholic's sense of identity. At this deep level, the person and the alcohol have become one.
This is the world of the alcoholic, very real to him or her, but totally artificial, a chemically created delusion. Alcoholics take it to be real when it's not real at all. The experience is so powerful that they can't see the reality – that they are just drunks, people who are increasingly obsessed with drinking. Sober, the alcoholic is just waiting to enter that world again.
It's important to understand that alcoholics have no understanding of this process. They can't observe it and decide whether or not to go along with it. They have been infiltrated by it and undermined from within.
Nobody sets out to become alcoholic
Alcoholism results in the alcoholic losing virtually everything. Over time, the alcoholic will lose his or her friends, family, self–respect, emotional stability, health, jobs, money, home and, quite often, his or her life. All this, just for the sake of getting drunk! No one chooses to become the sort of person who will lose everything of value in life just for the sake of being drunk. To make such a devastating choice as this, you would have to be hooked on alcohol already.
Alcoholism is caused by an outside agent
Research in clinical experience has shown that prior to the onset of the alcoholism, most alcoholic people had normal personalities. Of course, this is not to say that some of them didn't have psychological problems. But having problems does not make someone abnormal. A chemical, alcohol sets going destructive internal processes which result in people being unable to adjust their behaviour in the normal way.
Alcoholism is progressive
At the start of their drinking careers, many alcoholics are indistinguishable from ordinary drinkers. Others are obviously in the grip of alcohol from the very beginning. However, whatever the pattern of this early drinking, the alcoholism begins to affect the person to a greater and greater degree, both in terms of personality and in terms of the consequences.
Alcoholism kills
The mortality rate among alcoholics is between two and four times as great as for other people of the same age. Alcohol poisoning, liver damage, accidents, suicide and gastric disease are just some of the ways alcoholism kills. It can cause serious brain damage that results in severe, irreversible, short–term memory loss. This condition, known as Korsakoff's Syndrome, usually results in institutionalisation.
Alcoholism is a disease
Alcoholism is condition which is destructive, which a person does not choose to have, cannot choose to be rid of and which is set going by an external agent. It is progressive and frequently terminal. Clearly, such a condition is a disease. Some people object to the word 'disease' – it can just as well be called an illness, sickness, psychiatric disorder or condition. But whatever term is used the underlying point remains: the addicted person is in the grip of a destructive process beyond his or her conscious control and understanding. Conservatively, it is estimated that alcoholism affects about 2% of the Australian population over 18, heroin addiction about 0.4% and gambling about 1%. Strong genetic factors are involved in becoming alcoholic.
Take the time to go over the above points a few times, making sure that you can accept addiction - to alcohol or anything else - is a disease and that you understand the reasons why this is so. It is a very important step for you to see this
Realising alcoholism is a disease
You may wonder why it's so important to understand that alcoholism is a disease. Let's look at a completely different situation. Imagine a mother who's dealing with a whingey, difficult toddler. She tries to humour him, to change his behaviour, but after a few days, she's fed up. Then she discovers the child is coming out in a rash and has a high temperature. It's measles. Obviously, the mother begins to feel very differently. She now understands why the child was being so difficult. Even though she might find the child's behaviour annoying, she would no longer blame the child. And she' d find out what she should do to help the child's recovery.
Alcoholism is much more complex, but these two principles still apply - it's an illness, and the person cannot be blamed for getting it, and the thing to do is to find out the appropriate way to handle the situation.
It's very natural to feel some confusion because the alcoholic you are dealing with is a person who, in a totally irresponsible way, is doing exactly what he or she wants. And, what's worse, he or she does it again and again, despite the consequences. It gets even more horrible - alcoholics will lie to you, manipulate you, pretend, bully and bluster to get their way. You realise that their tearful remorse is meaningless as the whole cycle is repeated again and again. Confronted with this, in spite of all the facts, saying it is a disease might seem like a cop-out. Perhaps you think you should see alcoholism is a disease, because this book says it is. Or perhaps a psychologist or a social worker told you it is and you feel these people must know. Maybe you feel guilty because you're harbouring a few doubts.
But as you read on I hope that you will develop your own personal understanding of how alcoholism is a disease or psychiatric disorder. As you relate the ideas in this book to your experience of your addicted loved one, apparent contradictions will disappear. You will see that the addicted person is like this because of the way his personality has been taken over. He or she may have become a weak person, but that is the result of the problem, not its cause.
However, it's important to keep in mind that even though it's a disorder or disease, your loved one is not a helpless victim. He or she can't choose to just be free of it, but can choose to recognise the problem and seek help.
When self takes over
In chapter 1 it was explained how 'self' is the 'I' or 'me' of which we are aware in our thoughts, feelings and actions. It is through this self-image that we see ourselves, and it has a major influence on thoughts, feelings and behaviour. It is so much part of us, and it seems to be 'the real me' or 'the way I really am'. It provides a sense of identity, but, as was mentioned earlier, it is not an accurate representation of you as a person. For instance, someone who has a self-image of being not as good as everyone else, may, in fact, be an intelligent, capable and likeable person. But in some situations that they are more than capable of handling, these people feel inexplicably nervous and anxious. They may make apologetic remarks or give the impression they have to prove themselves. They will be unaware that this difficulty springs from self-image, because, to them, it is just the way they are.
Although 'self' is an extremely important part of your personality, it is certainly not the most important part of what you are as a person. Far more important are your basic values, your standards and your conscious understandings of yourself and your life. Using your intelligence and reason you can look to these to find out how to direct your life in a meaningful way. Self-image is implanted in the irrational part of the mind and is not a reliable basis from which to guide your life. Yet with many people, self can become too dominant and take over.
For instance, a woman feels she will be complete when she finds the right man. She has an inner image of herself as being inadequate and incomplete. For her, a relationship holds the promise of becoming complete. She pursues relationships desperately, not realising she's pursuing an image, an ideal that no reality could match.
A man may pursue sexual conquests in an obsessive fashion, not because he wants a meaningful relationship, but because each conquest validates his image of himself being wanted - on his own terms.
Many people have a strong feeling of something lacking built into their core self-image. They can become obsessively involved in religious cults, or in any activity which, the image, gives them a sense of being whole. The irony of it is that very often, as people, they are not lacking in any particular way at all. They only feel they are. With the alcoholic, the self becomes distorted, giving a very deep sense that the world of intoxication is the real one. It is very obvious to other people that this is distorted. But alcohol gives the alcoholic an experience of some impossible, total sense of completeness in the self when he or she is drinking. The person he or she is when sober seems, to the alcoholic, a pale version of the open ' real' person he or she can be drunk. In other words, the drink creates its own need by creating a paradise of the self.
Try and capture the sense of this. Just pause a moment, relax and start to get in touch with some of your more inward, secret, even partly forgotten dreams, feelings and desires. Bring up those feelings about what you could have been, what you deserve to be, what you would love to be or to have now, if only your very deepest wishes could be fulfilled.
Imagine there's a magic pill you can take and you start to be the way you've always wanted to be. Nothing, absolutely nothing, outside can touch you. Your secret longings, some you didn't even know your had, become a reality. Tension, uneasiness, divided feelings within you are replaced by a deep feeling of wholeness and oneness that no one can take away. This is deep within you, far more than a surface feeling. Just imagine the seductive power of such a pill.
Magnify that imagined affect, make it real, and that's what the magic bullet of alcohol does for the alcoholic. Normal drinkers don't get this profound effect. Certainly alcohol relaxes them, reduces their divisions, exaggerates their feelings about themselves and others. But it does not produce that experience of self being disassociated from reality that causes alcoholics to continue chasing the effect, while life falls apart around them.
Genetic factors
As stated earlier, alcoholism occurs primarily for genetic reasons. This has been shown in research studies. And commonsense makes it clear that only if someone has the sort of brain in which alcohol produces the effect of self being disassociated reality, can addiction develop. Whether you have a brain like this is a matter of genetics, not choice. Of course other factors are involved, but they will not result in addiction without this genetic factor.
Different patterns
Like most other diseases, alcoholism has many different patterns. It is not simply how much people drink, what they drink or even the effect on their behaviour. Alcoholics vary enormously - may have different personalities, different intelligence levels, different social backgrounds. Some have perfectly normal backgrounds, others have disrupted childhoods.
Some alcoholics are violent and dangerous, others are withdrawn and isolated. There are others who never seem outrageously drunk or out-of-control. They simply keep topped up to a level which maintains the way they want to feel.
Some alcoholics may be able to maintain a reasonably normal lifestyle for years and years. They keep going to work, often in responsible, or even demanding jobs. In their home life, they are able to maintain the everyday social niceties, although, because of the process going on within them, they are incapable of a deep or committed relationship. Their spouses or children are aware that something is wrong, but because the alcoholic is never forced to make a choice between alcohol and his or her family, the family remains blind to the fact that he or she would undoubtedly choose alcohol. In fact, in drinking, in living in their own world, alcoholics are choosing alcohol rather than their families, because they are rarely in a condition to relate to them normally.
Many people believe the person they love can't be in alcoholic because he or she isn't living in the park, sucking on a metho bottle. But it's important to realise that the stereotype of the alcoholic is false. Only a very small percentage of alcoholics are on Skid Row.
There are bender drinkers and chronic drinkers. Some people drink alcoholically from the start. Others move into alcoholism over a period of years. Some alcoholics had a drinking pattern which means they are not actually physically hooked on alcohol, although this is unusual. But what they all have in common are the disease processes alcohol has set going in them. Once these processes are set going in a person, that person is increasingly under their control. Let's outlook at these processes.
The pathological self
Above, it was explained how alcohol takes over the core self. The effect of this on the person is profound. The alcoholics sees his or her 'real' self in intoxication. This inner world of self becomes the alcoholic's underlying reality - where he or she is untouchable. The sober self and actual reality are irritations to be put up with until the next drinking session. Although the alcoholic doesn't realise that, reality has become a whim that can be pushed aside.
Many alcoholics go through a phase where they can function quite well in some areas of living in spite of alcoholic drinking. But as you can see by now, they do so from the position of profound self-delusion - the delusion of what they see as their real self and the delusion that reality is optional.
All of us have some deluded attitudes and perspective that come from distortions in the self. And many non-alcoholic people see themselves and the world in a way which seriously distorts reality. The chemically created, pathological self of the alcoholic is an extreme example of how this delusion operates.
Every time the person drinks, this delusion is reinforced. The inner world of self takes a more and more dominant place in the person's awareness. In the normal personality, there's a balance between the self and the other things that go to make up a whole person. In the alcoholic, this balance is destroyed. The self takes over to a pathological extent.
The domination of the pathological self is the central problem of the alcoholic and because it tackles this, the Alcoholic Anonymous program is successful in helping alcoholics to achieve sobriety. The basic text of AA, the 'Big Book', Alcoholic Anonymous, makes reference to the need for the alcoholic to be relieved 'of the bondage of self' and the conviction that 'self, manifested in various ways, was what had defeated as.' The AA program offers the alcoholic a way to escape from the pathological self created by alcohol and to be able to use, once again, all faculties as a person.
Values, standards and commonsense are part of the sober self and reality. The alcoholic can feel the degradation, shame, physical pain and embarrassment when he or she drinks. But this remorse and concern is short-circuited by the knowledge that he or she can get away into the 'real' self whenever he or she wants to.
At times alcoholics will recognise drink is a problem, but they are partly shielded from this thought because, to them, reality is optional. Doing something about the drinking problem is going along with reality - something they don't have to do.
Take the case of Joe, a building subcontractor are of 45. He is alcoholic who drank for 15 years and has been sober for five: 'I grew up in a house where we had pretty firms standards. You got into debt, you paid your bills. You said you'd do something, you did it. When I got married, I stuck to those standards, until I began to drink heavily. Then, those sort of things gradually became irrelevant to me. My wife used to hassle me for the rent money and I'd say, "Why should we pay those bastards?" I'd undertake to do jobs and take the down payment. It'd never get done and I'd get very angry with people who hassled me. I'd tell them outrageous lies and feel quite justified. All these people making a fuss - it used to annoy me. I couldn't see what it had to do with me. Now, I think about the way I behaved and I'm horrified. I know it's the booze that did it to me, but at the time, there was no way I could see it. I did an about-face on all the things I believed in and I really felt the world was very unreasonable. You become a different person. The scary thing is that so few of us ever get back, because, when you're in the middle of that, you just can't see it.'
So, back to our question: 'Why don't they stop?' We now have an answer. Their genetically-determined brain response to alcoholic or drugs has made a permanent change in their personality. Through its action on the brain, the chemicals has made them unable to respond to obvious reality. This arises from changes in the deep part of their personality, which then result in changes to their conscious perspectives and thinking. Rather than helping them see how to come to grips with their problem, their conscious thinking processes now prevent them recognising that there is a problem. This inability to respond to obvious reality is a true psychiatric abnormality residing at all levels of the personality. The powerful psychoactive chemical (alcohol or other drug) has created a damaging abnormality that was not there before.
However, addicted people are still very much people, so still have all the ability to see and acknowledge that there is something wrong with them, and do something about it. But the addictive process means they will resist doing this, which is why your approach may tip the scales towards recovery.
Understanding how the alcoholic is pathologically out of touch with reality makes it clear that the alcoholic needs to come to a point where reality will cut through the delusion. This will be looked at in greater depth in a later chapter, but you can see now that it is no use appealing to or fighting with his or her real self. Unfortunately, this is what many people do, living in hope that the old self will, one day, show through this mess. The old self is in the mess somewhere, it's been permanently distorted and arranged. In recovery, the qualities that are in the alcoholic's nature as a person will be there, not as part of the old pathological self, but as part of the new sense of self that develops in recovery.
Obsession
The alcoholic is not aware of the deep, pathological changes going on within him, but he can be aware of any increasing preoccupation with alcohol, a preoccupation that develops into an obsession. No matter what's happening, the urge to drink lurks somewhere in the alcoholic's mind. Many alcoholics go through a phase where they don't resist this urge, but when they do, it is futile. In fact, the stronger the resistance, the stronger the urge, until the person finally gives in.
The alcoholic can't choose to rid his or her mind of the constant preoccupation with drink. It'll be there whether drinking or not: 'where's the next drink coming from?... I won't drink till after five o'clock... But will they really have enough booze at that party?... I'll stock up for the weekend... I'll suggest to drink at lunch... I won't drink when I get a new job'. The fighting, the struggle, the preoccupation are endless. When the alcoholic fights it, it gets worse and sooner or later, he or she is shown to be powerless against it. You can probably understand what this is like because you possibly have a similar preoccupation with the alcoholic's drinking and its effect on your life. 'How can I get him or her to stop?... What'll I do if he or she walks in with a flagon?' It starts to dominate your thoughts to the exclusion of other things and there are times, when try as you might, you can't stop thinking about it.
Denial and self-deception
Alcoholics usually lie or attempt to disguise their drinking. They may definitely dismiss criticisms or comments on alcohol consumption. They'll react angrily to helpful suggestions. The deep down the knowledge that there is something very wrong with the way they drink exists.
Although their sense of self is being taken over by alcohol, their intelligence, their values and commonsense are still in them somewhere. This means there is conflict at a deep level between the obsession with drink, their values and their commonsense. Automatically, self-deception and denial develop in them.
Self-deception is present as a natural tendency in all of us. It allows us to ignore, brush aside, twist or neutralise facts or ideas we don't want the like. It's a tendency which will cause a lot of problems in anyone if it gets out of hand. Alcoholics become absolute masters of it and at the same time, complete victims of it.
Personality deterioration
The disease processes of alcoholism lock into the negative aspects of personality and make them worse. In addition, constant drinking of large amounts of alcohol produces emotional and psychological disturbances. Fears, anxieties, brittle arrogance, resentment and aggression, low self-esteem, despair, social isolation and reactive depression are just a few of the things an alcoholic may suffer from.
Physical dependence
And alcoholic person doesn't continue to drink for physical reasons. But physical dependence causes the craving to go rampantly out-of-control and locks the alcoholic further into the disease. Physical dependence occurs when the body is so used to having alcohol that it has made a physiological adjustment to it. Then, if supply isn't kept up, the body starts to react and the person suffers from the discomfort of withdrawals. The solution, for the alcoholic, is to drink more.
Vicious cycle
These disease processes combine into a vicious cycle. The more successful denial is, the more the alcoholic drinks. The more he or she drinks, the greater the growth of the pathological self. This makes the desire to drink stronger and this leads to stronger denial and self deceit. As the disease progresses, what the person was or could have been is distorted, almost beyond recognition.
Is the alcoholic responsible for recovery?
You can see very clearly that alcoholism is a disease which a person is not responsible for having. The alcoholic is not aware of the processes going on within him or her. Knowing this lets you understand how an alcoholic can behave in a way that is so irresponsible. Alcoholics are not capable of stopping drinking or staying off alcohol without help. But they are capable at times, as the disease progresses, of recognising that they have a problem and need to seek help. In fact, people close to alcoholics need to behave in a way that brings them to a point that they must take responsibility for their actions.
There are times at which alcoholics and not so badly in the grip of the disease, when they are able to acknowledge that they should get help or that they are causing great suffering to those around them. On these occasions, alcoholics are being consciously and knowingly irresponsible in continuing to drink. They know they could choose to look for help. In the earlier phases of the disease, these occasions are rare. As the disease progresses, they become more common until the person may eventually seek help. The difficulty is, that as the disease progresses, the disease processes are working at a deeper level. The pathological denial of alcoholics is more developed. They are less in touch with reality. These processes are neutralising the concern that their own standards and values would otherwise generate in them, and which would lead them to seek help. That is why the approach of those around and can be a crucial factor.
At some level, every alcoholic has the knowledge that there is something wrong and he or she needs help. Some alcoholics are actually aware of this at a conscious level, but choose to continue drinking. They know recovery is possible, have been involved in recovery programs and understand that there are things they can do which will lead to recovery, but they choose to ignore this knowledge. In other words, they are willing victims to their disease. Other alcoholics, who have not had information or help, have the knowledge in them somewhere, but it is clouded by their disassociation from reality, their denial and the other disease processes.
As in most things to do with human nature, the question of the degree of responsibility alcoholics have their behaviour in recovery is a grey area, dependent very much on the individual and how the disease processes operate within each person. However there is no doubt that strategies most helpful in bringing about recovery are those which will bring alcoholics to accept responsibility for their actions to the same degree that other people do if they behave badly or wrongly.
Your relationship with the alcoholic
Most people living with an alcoholic experience enormous confusion. 'She was sort of there, but not really,' says Max, the husband of a recovering alcoholic. 'I could have a sensible, reasonable and rational conversation with my wife. Later, she'd deny we ever had it, or, take the opposite viewpoint. I gave up extracting promises about her drinking because she couldn't keep them. At the time she made them I'm sure she was sincere. Realising alcoholism was a disease helped me understand why these things happen.'
'Another thing I learned to accept was that she wasn't the person I married. I used to feel as if she had to be in their somewhere, that underneath all the drama and nastiness that goes on with alcoholism, she was still there. And it was hard to accept that she wasn't, especially since I get flashes of it now and then. She was a practising alcoholic and that was that.'
When an alcoholic recovers, part of the old personality comes back. But alcoholism destroys the original personality. To rebuild it, fundamental changes have to take place. But the changes in a recovering alcoholic are positive, with an emphasis on self honesty and learning to deal with reality.
Recovery from alcoholism
Understanding alcoholism, you will begin to see the alcoholic in a different light. It is an important step for you and towards the recovery of the alcoholic.
'Once I accepted alcoholism as a disease, it changed my perspective on things,' said Max. 'I still found my wife very difficult to live with as a practising alcoholic, but I didn't get locked into her behaviour. Knowing it was a sickness that she was suffering, I felt a lot less bitter towards her. As a disease, she couldn't control it and neither could I. Little changes had quite dramatic effects. I remember one night she walked in with a flagon. Usually, I say something sarcastic, indicate my disapproval or start a shouting match just to vent my frustration. I just said Hello and asked her how she was. She kept coming back into the lounge room to check my reaction. Later, she told me was at that point she really started thinking about herself. Instead of having a shouting match about how justified she was in drinking, she was left with herself and her flagon.'
The feeling of 'me and him', 'me against her' or 'me against it' discussed in the last chapter, is the feeling Max was able to let go of because he understood the disease of alcoholism. He realised it made no more sense to be against alcoholism, than it would to be against measles. Once Max ceased to be locked into a struggle with his wife's addiction, she was left to deal with it herself and took the first steps towards recovery.
Understanding continues to be important, even where the alcoholic is recovering. Christine, who was mentioned in the last chapter, was locked into her husband's alcoholism. When the husband eventually got into recovery, she really wanted to help: 'actually, a bit more than that. I wanted to manage it. I'd read up on alcoholism so I was the family expert. He got sober, I believe, largely because I stopped confronting him with the problem and I stopped protecting him from the consequences. But when he got sober, I was in there again, boots and all. Go to this meeting, do this, do that. He kept busting. Finally, someone pointed out what I was doing and I told him, "it's your decision whether you get sober. It has nothing to do with me." He drank out of control for a month, then he got himself into hospital and has been sober ever since. It was a good lesson for me. You can't make anyone sober.'
Summary: remind yourself of these important points
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What you believe about alcoholism and addiction affects the way you behave.
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You don't have to force yourself to believe alcoholism or addiction is a disease. As you work at understanding it, this will be obvious.
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The unrecovered alcoholic is operating from the base of profound delusion, even when sober and apparently normal.
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To the unrecovered alcoholic, reality seems optional.
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Most alcoholics are not on Skid Row.
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Its silly to blame the addict or alcoholic for having a disease
http://www.jimmaclaine.com/Chapter%202.htm
**Used with permission