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THE THIRTEENTH STEP
by Jules Griffon
Psychiatric
researchers now say a drunk can drink again – without
going back to the gutter
Can
the “cured” alcoholic ever safely touch another
drink? Can the confirmed boozer ever hope to taper off to
ordinary social drinking? Is a “Thirteenth Step”
possible for the “arrested” rum-hound? Or is
the gloomy prospect of total abstinence the only salvation
for the lush? Is alcoholism a real physical allergy, and
does that one first drink inevitably have to trigger a chain
reaction in the serious tippler?
Don’t answer that. You may be wrong. The men in the
white coats have been working on this problem, which is
admittedly a crucial, possibly life-and-death question for
several million drinking Americans – and they believe
they have finally come up with some answers.
With all due respect to Alcoholics Anonymous, the WCTU and
other dedicated abstinence groups, the latest psychiatric
research definitely does offer hope that the wino who succeeds
in picking himself up from Skid Row can once again enjoy
a few cocktails at the Ritz, or even go on a Saturday night
binge, without necessarily landing right back in the gutter.
However, if you’re a booze-fighter and you have been
winning your battle, you’d better read the rest of
this article bounding gleefully off to the corner grog shop…
To drink or not to drink is a question that has plagued
mankind ever happier glow from drinking fermented apple
juice, and get in less trouble than he had by nibbling at
the raw fruit that Eve insisted he try.
All sorts of people, from philosophers to stew-bums, have
argued both sides of the alcohol question since the dawn
of civilization. One can cite volumes of authoritative opinions
to support either view, pro or con. Even the Bible doesn’t
give much help. Take your choice:
| Wine
is a mocker, strong drink is raging. |
| -Proverbs
XX., 1 |
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Drink
no longer water, but use as a little wine for thy
stomach’s sake and thine often infirmities. |
-I
Timothy v., 23 |
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| Woe
to them that rise up early in the morning, that they
may follow strong drink. |
-
Isaiah v., 11 |
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| Drink
thy wine with a merry heart. |
-
Ecclesiastes ii,13 |
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Today,
in the light of modern science plus the accumulated wisdom
of the ages, we know a lot more about alcohol and human
nature than did Adam and his immediate descendants. But
despite the millions of dollars and the millions of laboratory
man-hours spent on research, the basic cause and cure of
what we call alcoholism are still no more known than those
of the common cold. Learned authorities can’t even
agree on whether it’s a disease or a state of mind.
We
drinkers have enjoyed a brief respite from the pointing
finger, since the Demon Cigarette has taken the spotlight
away from poor old John Barleycorn as the nation’s
Number One health menace.
But the hard fact remains that some 19.5 million American
males and females, or about 10 per cent of the total population,
are what the medicos politely call alcohol-dependent-and
five per cent, or about 9.7 millions are real bottle-nursing
alcoholics. That’s a lot of lushes, brother! We spend
from 11 to 12 billion dollars annually on alcohol, and its
consumption is constantly on the increase. The alcoholic
population of New York State, to take just one example,
is growing by 20,000 annually.
Spurred by statistics on the dangerous upcurve of alcoholism
and its attendant evils of broken lives, broken homes, lost
jobs, lost work-hours, crime, traffic fatalities and all
the rest, more and more attention is being paid of late
to finding ways and means to stamp out or at least cut down
this ancient and costly social blight.
Fortunately,
we’ve advanced quite a way and become a bit more mature
since the naïve days of little more than a generation
ago, when the tragic Volstead Act was voted into law with
the starry-eyed idea that National Prohibition, the “noble
experiment” that fizzled, would be the cure-all for
drunkenness.
We’ve also progressed a mite since the times of the
fire-and-brimstone temperance crusaders, when Carrie Nation,
the terror of bartenders in the Gay Nineties, used to smash
up saloons with an axe.
Today’s more enlightened reformers, by and large,
no longer insist on throwing out the baby with the bath
water. From banning all booze at the source, the emphasis
has shifted toward eradicating the abuse of the right to
drink. The spotlight is on treating and trying to cure the
individual “alcoholic,” and the immediate tactical
target is to find out just what makes him tick.
State,
federal and local government health and welfare agencies,
big private foundations, universities, medical and sociological
research groups, and nationwide industries-including even
a segment of the liquor industry-have teamed up in a concerted
and determined drive on alcoholism. The current campaign
is sparked not by moral ideals but by the cold, businesslike
realization that there is simply no place nor time for the
bumbling drunkard in today’s stepped-up Space Age
economy. He costs society too much. He can no longer be
coddled. He has to go.
The
California State Legislature at this writing is near final
passage of a bill greatly expanding and reorganizing the
state’s Alcoholic Rehabilitation Program. The McTeer
Bill, considered a model for other states, sets up a special
Division of Alcoholism under the Department of Public Health,
and provides increased state financial support for locally-operated
alcoholic clinics. The long range plan contemplates “comprehensive
and integrated local programs, subject to State Health Department
approval, for the prevention, treatment and control of alcoholism.”
Research
labs are probing deeply into the problem of the problem
drinker. Not long ago, University of California scientists
spent 14 adventurous days pouring large quantities of vodka
down the not unreceptive gullets of two “volunteers,”
recruited through an employment office with the guarantee
that they were 100-proof alcoholics. EEG recordings of the
subject’s brain-waves, while apparently in a drunken
stupor, showed that behind their closed eyelids, their brains
were “teeming with ideational activity”-the
antithesis of the supposed sedative effect of alcohol.
A research team in the VA’s psychopharmacology Research
Lab at Sepulveda, California, recently used 70 stray cats
in an experiment to determine the effects of alcohol on
different personality types. Both the “anxious-withdrawn”
and the “out-going-aggressive” types of kitties
were quickly put to sleep by a moderate dose of grog, while
the felines classified as “normal” stayed perfectly
alert on the same amount, and “often seemed to take
more interest in their surroundings.”
Similar studies are going on all over the country-notably
at Rutgers, Yale, and several other universities. It was
recently proposed that the federal government should put
a special bottle tax on liquor, the revenue to be earmarked
for "organized research on alcoholism including all
its aspects.”
Amid
all this furor of concern over the Anti-Social Behavior
of the American Drunk, and the conflicting theories on the
nature of “alcoholism” itself, one constant
factor has come into more and more prominence in the past
decade or so; the phenomenal success of Alcoholics Anonymous
in rehabilitating thousands of men and women who had been
given up as hopeless.
Started
in Akron, Ohio, in 1935 by a New York stockbroker and an
Akron physician who had lick his own drinking problems by
achieving a spiritual rebirth, AA now numbers more than
300,000 members through-out the world. As of 1963, there
were over 10,000 local AA groups in 80 countries-most of
them, of course, in the U.S.
A.A. is described as “a fellowship of men and women
who share their experience, strength, and hope with each
other, that they may solve their common problems and help
others to recover from alcoholism. The only requirement
for membership is a desire to stop drinking. The primary
purpose is to stay sober and help other alcoholics achieve
sobriety.”
While
it includes members of all religions and many of no religion
at all, AA’s basic concept is a religious one in the
broadest sense. The alcoholic, according to the AA book,
must start with the First Step: admitting that he is “powerless
over alcohol, that his life has become unmanageable.”
Secondly, he must come to the belief that only “a
Power greater than himself” can “restore him
to sanity.”
If the would-be AA doesn’t sincerely feel these convictions
deep down inside, he is fooling nobody but himself; he has
little hope of advancing to the Twelfth and final Step,
which is: “Having had a spiritual awakening as the
result of these steps, we tried to carry this message to
alcoholics, and to practice these principles in all our
affairs.”
AA’s
spectacular success in weaning several hundred thousand
lushes away from the bottle and returning them to normal
productive lives is a fact that can’t be disputed.
Admittedly neither medicine, psychology, nor organized religion
can boast anywhere near such a record.
However,
another indisputable fact is that a great many more thousands
of drinking people, even though they realize their problems
and seek help, shy away from AA because of its “cold
turkey” insistence on total abstinence, on complete
surrender of one’s former bibulous ways. This is basic
with AA; it’s a foregone conclusion that you can’t
hope to follow the program and are wasting your time, unless
you give up drinking entirely, for good and all.
And now, to further complicate the picture, comes a scholarly
team of top-level psychiatric researchers from the University
of Cincinnati College of Medicine, with the news that their
study definitely shows that some alcoholics can be cured
– rather than merely “arrested” –
which is all that AA claims to do. In other words, there
is a “Thirteenth Step.”
The quasi-mystical belief that no recovered alcoholic can
ever again take a drink safely without hitting skids was
challenged by Drs. E. Mansell Pattison, E.B. Headley, L.A.
Gottschalk and G.C. Gleser, in a report presented to the
121st Annual Meeting of the American Psychiatric Association
in New York a few months ago. (The first three named are
MD’s the fourth a Ph.d. Dr. Pattison who read the
report, is now a Research Fellow of the National Institute
of Mental Health in Washington).
Their block-busting research paper, modestly entitled The
Relation of Drinking Patterns to Over-all Health in Successfully
Treated Alcoholics, was based on a painstaking and thorough
fellowship study of 32 patients at the Alcoholism Clinic,
Division of Mental Health, Cincinnati Health Department.
The implication, of course, is that the 32 men picked at
random for study are typical of many thousands more, both
men and women.
“An
untested assumption,” the doctors said in their preamble,
“is that the successfully rehabilitated alcoholic
can never drink again, and that he is not successfully rehabilitated
if he is still using alcohol. A clinical report by Davies
in 1962 on the return to normal drinking by eight addictive
alcoholics was followed by a furor of published protests
of disbelief.
“Subsequently
Pattison reviewed the evaluative literature on alcoholism
treatment and found seven clinical reports which described
groups of treated alcoholics who had returned to some degree
of successful drinking.
“In
light of these clinical findings, this study was designed
to test the hypothesis that successfully treated alcoholics
who engage in non-pathological drinking are as healthy mentally,
socially, vocationally, and physically, as abstinent ex-alcoholics.”
Note that the report deals with “non-path-ological”
drinking. This means that ex-patients who
returned to compulsive drinking, or got into self-destructive
predicaments again by their drinking, were not counted as
“successes.”
The sampling on which the study was based consisted of 32
male alcoholics discharged as “improved” from
the Cincinnati Alcoholism Clinic during 1962-63; all these
patients were seen for 10 or more psychotherapy sessions
and had been discharged at least one year.
(The
sample was drawn from a total of 252 discharged patients.
Not included were patients discharged from treatment less
than one year before the follow-up study – because
checkups had indicated that “the probability of loss
of abstinence is highest during the first six months after
discharge, and that after the first year, adjustment appears
fairly stabilized.”)
Complicated scales were set up to assess the various aspects
of physical health, interpersonal health, and vocational
health, from interview data; a “drinking scale score”
was devised to reflect drinking quantity, behavior, and
consequences. As the study progressed, the following sample
was divided into three groups: abstinent, normal drinkers,
and pathological drinkers. Some improvement was found in
all three groups; the abstinent and the normal drinkers
naturally had improved more than those who had returned
to pathological tippling.
From the mass of data accumulated, the following case reports,
among others, were cited as typical of patients who had
returned to normal drinking:
Case
No. 1. This 36-year-old white male machinist had drunk heavily
since he was a teen-ager. Although he worked steadily, his
drinking became a compulsive daily routine. His job was
threatened and his marriage disrupted. He was seen in individual
therapy in the Clinic for over two years, during which time
he worked out the divorce from his first wife and remarried.
He was interviewed two years after termination.
He
was happy with his new wife and young children, but wished
that he could provide more for them. He paid alimony for
his first family, which he felt was just. He described his
drinking as definitely changing in pattern during the course
of therapy. He now drinks about once a week and never experiences
any compulsion to drink more. However he occasionally feels
like drinking when he feels depressed over finances. He
felt that the Clinic had helped him to see his problems
and work them out.
The
next case was a bit more complicated, and went deeper into
the roots of the subject’s drinking:
Case
No. 2. This 30-year-old white male mechanic had drunk heavily
for 10 years. He felt that his alcoholism had started when
he was a lonely teen-ager in the Army. He went AWOL to marry
his fiancée, and afterward was plagued by guilt and
shame over his desperation and anger at his wife for seducing
him away from the Army duty. For the past six years he had
been unable to work steadily because of his heavy drinking,
and marital quarreling had led to their separation at the
time he came to the Clinic. He was depressed and suicidal.
He
was first seen individually and then jointly with his wife
for a total of 20 interviews. He and his wife felt that
they had learned to talk to each other and resolve long-harbored
grudges. He had always felt inhibited but now felt able
to express himself. Although he had stopped drinking for
a short while, he and his wife tried drinking together at
family gatherings, and he found that he now experienced
no compulsion to continue drinking, nor did he find that
drinking was desired or needed as a problem solving measure.
Now
comes a case history that you can quote to your bartender
friends, for their edification:
Case
No. 3. This 38-year-old white bartender had been a heavy
drinker all his life. He had drifted to various odd jobs
and eventually landed in jail subsequent to public intoxication
and marital quarrels.
He was divorced at the time he came to the Clinic on court
probation. He was seen for 28 interviews, but he is uncertain
that the Clinic was of much help. He feels that his severe
drinking was due to his marital problems.
When interviewed 20 months after termination he was happily
remarried, had two steady jobs, had saved a substantial
sum for a house, and was a contented family man.
Although a bartender, he never drank except at home, and
never got intoxicated. He used pseudo-masculine defenses,
was nervous, and overtly aggressive. Nevertheless he and
his family both agreed that alcohol was no longer a problem.
And
as for the man in the gray flannel suit:
Case
No. 4. This 26-year-old white insurance salesman had been
a compulsive drinker since age 17. His marriage had been
stormy and he accused his wife of running around with his
drinking partners. He had had many arrests and came to the
Clinic on court probation. He and his wife were seen jointly
for 15 interviews, but they did not feel that it was of
any help. They admitted that they had psychiatric problems,
but he felt that he wanted to be told what do to rather
than just examine his life.
However,
since attending the Clinic a dramatic change had occurred:
the couple had reconciled and were now working together
to develop a stable emotional and financial marriage situation.
He still drank occasionally, usually on the week ends, only
at home, and without any feelings of compulsivity. He thought
that he might be tempted to drink more than he ought, if
he was in a tavern with his buddies, because they would
pressure him. So he only drank at home. He has been working
successfully for the first time in his life, and has stable
family relationships.
“It
is evident,” the medicos commented, “that none
of these men received any long-term reconstructive type
of psychotherapy. In fact there was little change in terms
of personality dynamics. The same may also be said for most
of the normal drinkers reported in previous clinical studies.
“There
are those, of course, who will immediately claim that men
such as these were not truly addictive alcoholics or subject
to compulsive drinking. However by their own admission,
by our measuring methods, and by clinical standards, these
men were apparently as much addictive alcoholics as those
who were now abstinent and those who continue pathological
drinking. Likewise, the other clinical reports indicate
that the normal drinkers did not appear to differ from other
populations of addictive alcoholics.”
The
research report then went into various possible explanations
of the successful readjustment these men had made. Then
the doctors turned their clinical microscope on the other
side of the picture: ex-drinkers who had continued to stay
off the booze – but who were not doing so well in
other departments of life:
Case
No. 5. This 56-year-old white salesman had been a compulsive
drinker since age 18. He had asthma and stuttered. Although
deeply attached to his mother, he was angry with her for
her over-conscientious religious principles. He was continually
plagued by guilt feelings and still has difficulty expressing
his anger. He was treated in the Clinic for about five years
with both individual and group psychotherapy. Although he
had been abstinent for two years, he continually feared
a relapse.
He
believed that the clinic was of tremendous value in helping
him to understand himself. However, he believed that his
very active participation in Alcoholics Anonymous was the
main thing that kept him sober. His wife was a leader in
the Al-Anon movement. Although he enjoyed his sobriety,
he was plagued by many neurotic traits which interfered
with effective social functioning, and his wife sheltered
him. He remained very dependent and could neither assert
himself nor handle rage without developing psychosomatic
symptoms.
The
next case reflected similar emotional crippling, in a man
who was desperately hanging onto his sobriety as a life-preserver:
Case
No. 6. This 39-year-old white technician had always felt
inadequate and yet angry that superiors did not give him
adequate recognition. He had started drinking five years
previously over difficulties on the job. As the drinking
increased he almost had a nervous breakdown, but instead
drank himself to oblivion. He was on the verge of losing
his job and was in legal difficulties when he came to the
Clinic. He tested the therapist several times by coming
to the Clinic drunk. When he found out that he was still
accepted, he stopped drinking and had been abstinent for
two years.
At follow-up 19 months after discharge, he was working steadily
and his family adjustment was good. However he had many
anxiety attacks and psychosomatic symptoms. He frequently
felt depressed and asked the interviewer directly for help.
He had intense feelings of inadequacy, and although he was
performing well on the job he had continuing difficulties
with his superiors.
And
here was another fellow who wasn’t exactly to be envied
simply because he was able to lay off the grog:
Case
No. 7. This 48-year-old white public servant had been drinking
at an increasing pace over the past five years until he
drank continually on the job. He was on suspension when
he came to the Clinic. He was seen for 12 interviews during
which he stopped drinking and he had remained abstinent
for 19 months. He felt that the Clinic sessions were of
some help, but he felt that most importantly he wanted to
stop drinking.
On
interview 14 months after discharge, he was highly defensive
and used overt paranoid defenses. He grossly denied any
difficulties in any sector of his life. Yet his defensive
needs led to a furtive type of existence, continually covering
the tracks of his past difficulties, and maintaining a rigid
self-concealment which left little room for any social interaction.
The
psychiatric research team summed up its findings:
“The
conclusion to be drawn from these two groups of clinical
reports is that the criterion of abstinence is only one
of several variables which are relevant to assessing the
outcome of treatment of alcoholics. The presence of normal
drinking subsequent to therapy does not need to imply that
these patients are less well adjusted or less successfully
treated than those patients who are abstinent. Nor does
it follow that the patient who is abstinent has necessarily
achieved a return to normal living or adjustment…
“The
current research was not designed to evaluate the efficacy
of treatment, but rather to conduct a controlled design
study of the outcome of some treated alcoholics. The findings
of this study corroborate prior clinical reports that some
alcoholics do return to normal drinking. The characteristics
of these alcoholics remain to be determined, as well as
the reasons for their type of outcome. Thus these findings
do not necessarily imply a change in treatment philosophy.
“However,
it calls into question the assumption that abstinence is
always a requisite of successful therapy, and it also calls
into question that abstinence should always be the goal
of successful therapy. We would argue that abstinence as
a condition of treatment is a prescription which should
be used by the therapist with discretion, as with any other
therapeutic maneuver and that the goals of treatment, whether
abstinence, psycho-social rehabilitation, or characterological
changes, are goals which must be determined with each individual
patient.”
So
there it is, the Cincinnati research, summed up, has shown
that some alcoholics, successfully treated by the Clinic
by ordinary methods of psychotherapy, have achieved a normal
adjustment to life and are now able to indulge in social
drinking without disastrous effects. Conversely, some alcoholics,
similarly treated, who have remained strictly off the bottle
– including at least one who attends AA meetings regularly
– have not made such am adjustment, and remain ridden
by tensions and anxieties; the only achievement they can
point to is that they don’t drink anymore.
The AA reply, of course, would be that those who have successfully
returned to normal drinking were not real dyed-in-the-bourbon
alcoholics in the first place-they were simply “heavy
drinkers.” The AA book (Alcoholics Anonymous, AA World
Services, Inc., New York, 1935; second and revised edition
1955), goes fully into this aspect, stating flatly:
“We
have seen the truth demonstrated again and again: Once an
alcoholic, always an alcoholic. Commencing to drink after
a short period of sobriety, we are in a short time as bad
off as ever. If we are planning to stop drinking, there
must be no reservation of any kind, nor any lurking notion
that someday we will be immune to alcohol.”
The
Cincinnati researchers, however, have found that on the
basis of various personality tests plus physical examination,
those men who successfully took up drinking again, after
therapy, were no different from other addictive drinkers.
The
controversy is an old one, and we could go around in semantic
circles. Just what is an alcoholic? If a man drinks heavily
but continues to handle himself okay, or if he lays off
and then returns and doesn’t get into trouble, then
AA would say he was “not a true alcoholic.”
On the other hand, if he is “cured” of drinking,
later reverts to it, and lands back in the gutter-then he
is an alcoholic. Somehow this sort of reasoning seems like
putting the cart before the horse.
One primary aim of today’s research is to determine
whether the condition we call “alcoholism” is
an actual, specific disease, or a personality disorder-which
is not quite the same. Fortunately, today, we have more
or less discarded the old view of drunkenness as a moral
vice, to be cured by “will power”-by “pulling
yourself together.” The compulsive alcoholic can no
more lay off the bottle by “will power” than
can a man suffering from a cold simply make up his mind
that he’s going to stop coughing and sneezing. The
question is, does the alcoholic have a definite physical
disease that can be diagnosed and treated as such-or is
it that his total character, his personality, is maladjusted
and needs renovating?
Dr.
E.M. Jellinek, in his authoritative review The Disease Concept
of Alcoholism (Hillhouse Press, New Haven, 1960), points
out that around 1940, the phrase “new approach to
alcoholism” was coined, and that in the past 25 years
we have come a long way from the old days when the drunkard
was considered simply a no-good bum who could snap out of
it if he really wanted to.
The
AA view, oft repeated, is that alcoholism is “an obsession
of the mind coupled with an allergy of the body.”
This is the “disease” concept-but AA takes no
stock in cure by psychotherapy, auto-suggestion, or medical
drugs.
It
is AA’s dedicated belief that true alcoholism can
only be alleviated-the disease not cured but its symptoms
arrested-by a deeply felt spiritual experience, specifically
by complete surrender to the will of God. And AA has a strong
argument in the fact that this approached has worked for
thousands of people after everything else had failed. The
proof of the pudding, says AA, is in the eating.
Medicos on the other hand, while giving full credit to AA’s
fine work, do not believe that all alcoholics will necessarily
respond to the same sort of spiritual therapy. Further,
the doctors look toward curing the disease, or disorder,
by renovating the individual’s entire personality.
For that matter, AA likewise insists on a basic personality
change: with the proviso, however, at which many doctors
balk, that the rehabilitated person must never drink again.
Perhaps
it would be well to state at this point that neither this
writer nor this magazine have anything but admiration for
the great work done by Alcoholic Anonymous, and for the
phenomenal recoveries made by thousands of its members.
Neither are we urging abstainers to go back to drinking,
nor trying to give them excuses to do so. We are merely
presenting here the latest findings of high-level psychiatric
research, by men who are just as dedicated to eradicating
alcoholism as are the AA groups.
There
is not exactly a feud between AA and the psycho-therapists
(it is an AA tenet not to engage in controversy), but there
is a basic difference in approach. The Cincinnati researchers,
in their report, pointed out that psychiatrists in the past
have in general shied away from treating alcoholics, due
partly to the various headaches involved, and partly to
the pronounced lack of success. Dr. Pattison acknowledged
this frankly-and at the same time took a crack at AA-when
he said:
“In
part, due to psychiatric abdication, lay groups have taken
the lead in treatment, but not without detriment to scientifically
conceived treatment programs."
This
is not the first time the difference between AA and orthodox
psychotherapy have been pinpointed. Back in 1935, a noted
psychiatrist, Dr. Harry M. Tiebout, of Greenwich, Connecticut,
in an address to the 20th Anniversary convention of AA in
St. Louis, told the assembled recovered alcoholics: “You
cannot afford to wear haloes simply because you have achieved
sobriety!”
Dr.
Tiebout, as vice-chairman of the Connecticut Commission
on Alcoholism and one of the first medical authorities to
endorse the AA program back in the late 30’s, was
entitled to speak with authority. He earnestly reminded
the AA’ers that “ego control will continue to
be a problem if you hope to remain sober.”
Citing 10 years of research into the problem of “ego
reduction” among alcoholics, the doctor cautioned
that “a return of the full-fledged ego can happen
at any time.”
“Years
of sobriety,” he said, “are no insurance against
its resurgence. No AA, regardless of his veteran status,
can ever relax his guard against the encroachments of a
reviving ego.”
Dr.
Tiebout gave credit to AA for stressing the concept of “surrender.”
“The function of this concept is clear,” he
said. “It produces a stopping of the runaway ego by
causing the individual to say, I quit, I give up my headstrong
ways, I’ve learned my lesson. Very often, for the
first time in that individual’s adult career, he has
encountered the necessary discipline which halts him in
his headlong pace.”
The
Connecticut psychiatrist didn’t go directly into the
business of total abstinence-but his point was that not
the mere giving up of liquor, but control of the headstrong,
selfish, self-destructive ego in all its aspects should
be the target of any therapy.
On
the subject of total abstinence, the Rev. Christopher M.
McElroy, O.Carm., of Oakland, New Jersey, spiritual director
of the Matt Talbot Legion, a Catholic temperance group,
recently wrote to the editor of America:
“…Many
consider that Alcoholics Anonymous is the answer to the
problem (of destructive drinking). And certainly, although
this organization has reached only 300,000 of the more than
five million alcoholics, it is much more effective than
pills or the pledge. I am afraid, however, that for the
general run of people, anti-alcoholism movements are doomed
to failure when they forsake the virtue of temperance and
accentuate abstinence. For then abstinence becomes a positive
virtue, and the taking of one drink becomes a vice.
“In
our day, the hard reality is that most Americans drink because
they like to-and want to. For 12 out of 13 of them, alcohol
will never be a problem, and we cannot impose abstinence
on them as a moral necessity.”
So,
the argument goes round and round. Perhaps one approach
to some answers is acceptance of the fact that all alcoholics
are not the same, and cannot be treated as such with any
success. Each one is an individual. AA may be the answer
for many excessive drinkers; for many others, it may not;
they may do better with standard psychotherapy. Still others
may life themselves by their own boot-straps. But it does
no constructive good to say that you’re not a “real
alcoholic” if, after a long period of abstinence,
you find you can safely take it or leave it alone.
Dr.
S.E. Bird of Mt. Sinai Hospital, Los Angeles, not long ago
told a meeting of the Southern California Psychiatric Society:
“Alcoholism
is a massive problem. The extent of our knowledge at present
is extremely limited. There is a tendency to think of all
alcoholism as the same thing-and it isn’t.”
Meantime, research work, to provide the basic material on
which theories can be built and more effective approaches
devised, go on in many directions. A UCLA research psychologist,
David Greiner, issued an appeal the other day for 100 men
with prison records, who have solved their drinking problem
through AA, to volunteer as guinea pigs in a deep probing
personality study.
“We
know that AA works, but not why,” Greiner said, “something
about AA changes lives-effects what we call a conversion
reaction. We want to find out what it is.”
A novel idea was proposed recently to a convention of top
college and university administrators, by Ira H. Cisin,
a Washington research sociologist. He proposed that courses
in “basic bourbon,” “introduction to martinis,”
and “sipping Scotch” should be given at the
college level-that American youth should be taught how to
drink without going overboard.
“Drinking
can be dangerous,” Cisin said, “and the young
deserve to be instructed in its uses, just as they are taught
how to swim and drive a car.”
Maybe
he has something there.
(Source:
REAL, September 1965)
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