to be or not to be - an alcoholic
Member
Join Date: Oct 2013
Location: Midwest
Posts: 4,860
For me, until I acknowledged I was an alcoholic, I found many "other terms" and an equal number of reasons not to do anything about it. Accepting it finally gave me the impetus to get well.
To each his or her own....
To each his or her own....
EndGame
Join Date: Jun 2013
Location: New York, NY
Posts: 4,677
Originally Posted by zerothehero 
AA suggests members identify themselves as alcoholics, as in, "I'm Zero and I'm an alcoholic. I think AA wants people to claim it in such a way that they remind themselves that they are different and cannot manage life with alcohol. It kind of implies that you either ARE or ARE NOT an alcoholic; that it's a disease that you either HAVE or you DON'T.
Interestingly, the DSM V defines "alcohol use disorder" but does not use the term "alcoholic." In other words, psychotherapists are not officially using the term "alcoholic" as a disease or diagnosis.
Recently, I was reading in a book about MBRP (Mindfulness Based Relapse Prevention) that they do NOT encourage participants to identify as alcoholics or addicts. Their reasoning is that alcohol use disorder is more of a continuum. Some simply must abstain or their lives careen out of control. Others often abuse alcohol and seek to cut back, and of these folks, some are able to and others are not. So, they seem to play with the notion of relapse. For some, one drink would be a relapse. For others, one drink is just one drink, but a bender would be a relapse. They're less dogmatic about it, I guess you could say. They also seem to be bucking the idea of labeling people. Because substance use disorders exist on a continuum, there is no reason to label oneself, and doing so could possibly cause psychological harm.
My point is there doesn't seem to be a consensus. AA assumes alcoholism is a thing - a disease. Others, including many in the mental health community, clearly are not convinced.
Any thoughts?
Interestingly, the DSM V defines "alcohol use disorder" but does not use the term "alcoholic." In other words, psychotherapists are not officially using the term "alcoholic" as a disease or diagnosis.
Recently, I was reading in a book about MBRP (Mindfulness Based Relapse Prevention) that they do NOT encourage participants to identify as alcoholics or addicts. Their reasoning is that alcohol use disorder is more of a continuum. Some simply must abstain or their lives careen out of control. Others often abuse alcohol and seek to cut back, and of these folks, some are able to and others are not. So, they seem to play with the notion of relapse. For some, one drink would be a relapse. For others, one drink is just one drink, but a bender would be a relapse. They're less dogmatic about it, I guess you could say. They also seem to be bucking the idea of labeling people. Because substance use disorders exist on a continuum, there is no reason to label oneself, and doing so could possibly cause psychological harm.
My point is there doesn't seem to be a consensus. AA assumes alcoholism is a thing - a disease. Others, including many in the mental health community, clearly are not convinced.
Any thoughts?
A therapist is different than a friend, a relative or a lover. Being completely objective is both impossible and undesirable, and creating a safe place for the person is paramount. We're not there to entertain or to otherwise make people feel good. We're there to help walk people through their inner lives, usually in ways that they never imagined. It's not magic. It takes years of education, training and experience. And then you throw out all the books, and you treat people for who they are, which includes trusting that they can survive learning who they are without all the self-defeating embellishments. The fact that we often don't use the term 'alcoholic' doesn't mean that no one we see is an alcoholic in the traditional sense of that word.
From there, and when things go well, the person is ready to see herself as she truly is without relying on defensive projections that have a history of numbing and muting who she truly is. Those projections invariably come from a very fragile, often traumatic, place. We typically don't use words such as 'alcoholic' unless the person uses it first, or unless there is a good reason to do so. A process very similar to what I've described often takes place on the road to lasting recovery when things go well. We are not completely who we are when we're drinking; we're left to both build and discover who we are when we're sober.
I'm not an evangelist for any particular type of recovery program. I know what I did to get sober, and other people know what they did to get sober. I'm skeptical about a system that conveniently places 'alcoholism' or 'alcohol use disorder' on a continuum, or calls it something different to satisfy those who object to labels that carry a stigma, as some sort of unnecessary compromise that has little if any benefit for those who suffer. (Since it's become politically correct to dismiss unwanted labels, there's a whole 'nother level of persuasion going on here as well.) But rather than make things clearer, it only muddies the water.
My skepticism includes a suspicion around someone trying to create a "treatment-deprived" population that doesn't need treatment. It wouldn't be the first time. It also attracts people who have real problems who hope against hope that they don't have a problem and, instead, only need to look at their addictions from a different perspective.
We can do whatever we want with what addiction is and is not. Change the words we use to describe it, make the terms of recovery more user-friendly and, as happens all the time, come up with the latest and greatest treatment that will not only attract those who need treatment, but those who don't. And that will sometimes be used to convince those who have a problem that they have nothing to worry about.
It all comes down to the same thing. If you think you have a problem, then you need to do something about it.
waking down
Thread Starter
Join Date: Dec 2013
Posts: 4,641
Originally Posted by Dave42001
Zero, I was just courious how much soberity time you have? It doesn't say on your signature.. Thanks for all the words of wisdom!
I do think there is value in the simplicity of just saying, "I'm an alcoholic so I can never drink again." There's no doubt that has saved lives.
As for me, there is no doubt that I meet criteria for alcohol abuse disorder even though I didn't suffer the consequences others have endured, and my drinking was relatively moderate compared to many on this forum. That's where I find the definition of alcoholism intriguing, and the question of whether or not it is the disease many have claimed it to be, or a continuum of criteria with varied levels of severity for specific individuals.
I was one who could and did moderate until I became miserable, and in retrospect, I don't think it was alcohol that made me miserable as much as my own thinking around being so stuck and trapped in my life. Hard to explain, but my alcohol abuse took a dive in part because I was miserable, and then I was more miserable because I was drinking too much.
It is true that the concept of a continuum of severity can imply that abstinence is not required for someone like me, for example. MBRP does not require, but recommends, total abstinence. While it has occurred to me that now that I am not miserable I could possibly return to moderation, I don't see that as an option. I'm happy to be clean and sober and have no intention of risking a return to using, and I credit that largely to mindfulness practices. Mindfulness has provided the mental stability necessary to suspend a desire for alcohol and other highs. That's kind of the point of MBRP.
I guess part of what I'm exploring is methods or techniques to help people who perhaps do not view themselves as alcoholics but who admit they drink more than is recommended or healthy and want to learn alternative coping strategies for stress, anger, frustration, anxiety, or other types of mental or emotional distress. I'm thinking in terms of preventing people from hitting bottom.
Most would say I didn't hit bottom. I surely could have sunk lower. The anxiety and emotional turmoil I experienced in early sobriety was partly about detoxing, but more about facing my life head on without the use of alcohol as a sedative. I had to learn to love myself again, stop beating myself up and calling myself a loser, stop resenting my choices and the people who I felt were my oppressors, and resolve some long-buried issues related to trauma and abuse in my early life.
Alcoholic? Maybe (if such a thing exists). Someone who used alcohol to relax, and then abused alcohol to escape, and then became dependent because I had come to a point where the escape was preferred to reality? Definitely.
Sobriety has allowed me to learn to meditate, and meditation has allowed me to accept myself and my life, which, truth be told is currently not much different than it was when I was drinking. I'm still "trapped" in all the ways I thought I was trapped back when I was drinking (job, mortgage, finances...). The only thing that has truly changed is how I perceive it all.
EndGame
Join Date: Jun 2013
Location: New York, NY
Posts: 4,677
There are, without a doubt, differences of severity within the diagnosis of alcohol use disorder, just as there are differences in severity in anxiety and depression. The major criteria for me are tolerance, loss of control, cravings and withdrawal. From all I've seen, done and learned, I don't think there is any going back after losing control. Even after twenty five years of abstinence, it didn't take me very long to get back to, and then surpass by a wide margin, where I was when I stopped.
I'm all for learning how to manage life and all that comes with it, and there are plenty of ways to do this. I've been doing it myself. I'm also mindful that for many people it's enough to just stop drinking. I don't believe that I would have I remained sober if all I did was put down the drink.
I'm all for learning how to manage life and all that comes with it, and there are plenty of ways to do this. I've been doing it myself. I'm also mindful that for many people it's enough to just stop drinking. I don't believe that I would have I remained sober if all I did was put down the drink.
Member
Join Date: May 2012
Location: canada
Posts: 7,242
as long as i looked at severity (defined by what? losses incurred? volume drunk? frequency? presence of blackouts? jail? ) and thought myself powerful, i kept drinking.
being convinced it wasn't possible i had times before the first drink where i was powerless , i went on over and over trying to prove i had total control.
bust
that's when i could stop.
though i didn't use those AA-loaded words then. i just suddenly understood that it wasn't about the substance but about me.
i could have "sunk lower", too, consequence and volume-wise speaking, and boy am i glad i didn't.
i sunk as low as i needed to. for me. for thirty years.
trying to place myself on a continuum just kept me stuck.
being convinced it wasn't possible i had times before the first drink where i was powerless , i went on over and over trying to prove i had total control.
bust
that's when i could stop.
though i didn't use those AA-loaded words then. i just suddenly understood that it wasn't about the substance but about me.
i could have "sunk lower", too, consequence and volume-wise speaking, and boy am i glad i didn't.
i sunk as low as i needed to. for me. for thirty years.
trying to place myself on a continuum just kept me stuck.
now's the time
Join Date: Feb 2013
Posts: 2,181
Originally Posted by zerothehero
I
I guess part of what I'm exploring is methods or techniques to help people who perhaps do not view themselves as alcoholics but who admit they drink more than is recommended or healthy and want to learn alternative coping strategies for stress, anger, frustration, anxiety, or other types of mental or emotional distress. I'm thinking in terms of preventing people from hitting bottom.
I guess part of what I'm exploring is methods or techniques to help people who perhaps do not view themselves as alcoholics but who admit they drink more than is recommended or healthy and want to learn alternative coping strategies for stress, anger, frustration, anxiety, or other types of mental or emotional distress. I'm thinking in terms of preventing people from hitting bottom.
If the general conversation looked at sobriety and alcoholism as two independent things, I think more people might adopt sobriety without the need to "hit bottom". Knowing what I now know about sobriety and the way it impacts my creativity, relationship with self, and yes mindfulness and meditation, I think there are a lot of reasons that a person might benefit from it (forever or just for a period of time).
Member
Join Date: Jun 2010
Location: California
Posts: 2,693
The only term I use to describe myself is "non-drinker."
(Side note: I'm a classic, textbook alcoholic. Darn right. But I don't use this term).
But when I'm sober like I've been for almost two years, the alcoholism has no effect on my life except the not drinking part.
(Side note: I'm a classic, textbook alcoholic. Darn right. But I don't use this term).
But when I'm sober like I've been for almost two years, the alcoholism has no effect on my life except the not drinking part.
12 Step Recovered Alcoholic
Join Date: Apr 2012
Location: New Zealand
Posts: 6,613
I attended a talk given by the head of the alcohol and drug addiction research organisation on my home country a couple of years ago.
He introduced the term Alcohol Use Disorder and the way he explained it made perfect sense to me. He estimated that up to 20% of our population have a diagnosable AUD at any given time. It is a brain disease, and the condition has a very long tail, meaning that it goes on a scale from minor to severe.
Along that scale many if not most will make changes to their lives and AUD will be resolved. However there is a small percentage at the severe end for whom only "some kind of conversion experience is the only solution."
This chap was no friend of AA. Some thirty years ago he was instrumental in removing AA steps from the government funded treatment centres, which were later all closed down.
The thing that blew us all away was his opening statement. "It turns out AA was right all along" There is not much difference in what he said to what AA said in respect of how far down the path each of us has travelled, and whether or not we can get well by any particular means.
AUD is a very interesting definition and seems to fit the facts pretty well as far as I can see.
He introduced the term Alcohol Use Disorder and the way he explained it made perfect sense to me. He estimated that up to 20% of our population have a diagnosable AUD at any given time. It is a brain disease, and the condition has a very long tail, meaning that it goes on a scale from minor to severe.
Along that scale many if not most will make changes to their lives and AUD will be resolved. However there is a small percentage at the severe end for whom only "some kind of conversion experience is the only solution."
This chap was no friend of AA. Some thirty years ago he was instrumental in removing AA steps from the government funded treatment centres, which were later all closed down.
The thing that blew us all away was his opening statement. "It turns out AA was right all along" There is not much difference in what he said to what AA said in respect of how far down the path each of us has travelled, and whether or not we can get well by any particular means.
AUD is a very interesting definition and seems to fit the facts pretty well as far as I can see.
Member
Join Date: Dec 2015
Location: UK
Posts: 113
Originally Posted by zerothehero
I guess part of what I'm exploring is methods or techniques to help people who perhaps do not view themselves as alcoholics but who admit they drink more than is recommended or healthy and want to learn alternative coping strategies for stress, anger, frustration, anxiety, or other types of mental or emotional distress. I'm thinking in terms of preventing people from hitting bottom.
* mindfulness
* distress tolerance
* emotion regulation
* interpersonal effectiveness
A bit more info: DBT Skills List
The "Dialectic" (two things in conflict or opposition) in Dialectical Behaviour Therapy shows up in different ways. One way is that the problems are not our fault and at the same time we can take responsibility for our recovery. Another way is how our own desires conflict, eg I want to be sober and I want a drink.
The alcoholism/disease idea doesn't work for me, and nor do the purely rational behavioural approaches. DBT has the extra dimension of validating the emotional aspects of psychological dependency, and working with those rather than trying to reason or will them away.
Member
Join Date: Mar 2014
Location: Colorado
Posts: 3,474
.
With ~2 1/4 Years in, I'm pretty much right where MelindaFlowers is at in Post #28 above.
Early on, I opted to simply call myself 'an Addict'. I did just about anything/everything out there over 42 Years, save Heroin. I found the term 'Alcoholic' limiting, and inaccurate when applied to me. Alcohol was only one of many Drugs.
When ingested any of the things I did, I did them to the max. And then some. In a like manner, when I hit Physical Therapy/Gym to bulk up Muscle to relieve excruciating Whiplash pain in 1990 on, I hit those Therapy Routines to the max. My 1,000 Watt Stereo is Studio-grade. This Retirement House I designed and built myself is beyond-Energy Efficient. About anything I do is over-the-top. That's just how I'm wired. After the usual efforts so many of us have made, I skipped Moderation attempts, and any proverbial deals with the Devil to keep using. I'm done. Because I have to be.
Adoption Papers suggest I'm 1/2 Scottish, and 1/2 Polish. A veritable Drinking/Drugging Machine by Genetic predetermination. So, I've skipped the Self Flagellation that I'm 'defective' somehow. I'm 6'1". I have fair Skin prone to Sunburn. I'll never be Horse Jockey size, or Tan on the Beach. Those are other comparable Genetic Characteristics that I view as 'the Hand I was dealt'; right along with a propensity for excess. Not much more to it than that, really.
Accepting who/what I am allowed me to get on with pragmatic Recovery Steps without a lot of Hand Wringing. I'm very grateful for this Personal Epiphany; made possible by insights here at SR. And by Recovered Pals.
This is all between me, and the Addict I see in my Bathroom Mirror. When I accepted that Terrestrial Responsibility, the straight line to Sobriety got much easier. That was my Conversion Experience. It's quite widespread, actually, within my Sober Peer Group.
The Buck stops here. That relentless realization is liberating.
.
With ~2 1/4 Years in, I'm pretty much right where MelindaFlowers is at in Post #28 above.
Early on, I opted to simply call myself 'an Addict'. I did just about anything/everything out there over 42 Years, save Heroin. I found the term 'Alcoholic' limiting, and inaccurate when applied to me. Alcohol was only one of many Drugs.
When ingested any of the things I did, I did them to the max. And then some. In a like manner, when I hit Physical Therapy/Gym to bulk up Muscle to relieve excruciating Whiplash pain in 1990 on, I hit those Therapy Routines to the max. My 1,000 Watt Stereo is Studio-grade. This Retirement House I designed and built myself is beyond-Energy Efficient. About anything I do is over-the-top. That's just how I'm wired. After the usual efforts so many of us have made, I skipped Moderation attempts, and any proverbial deals with the Devil to keep using. I'm done. Because I have to be.
Adoption Papers suggest I'm 1/2 Scottish, and 1/2 Polish. A veritable Drinking/Drugging Machine by Genetic predetermination. So, I've skipped the Self Flagellation that I'm 'defective' somehow. I'm 6'1". I have fair Skin prone to Sunburn. I'll never be Horse Jockey size, or Tan on the Beach. Those are other comparable Genetic Characteristics that I view as 'the Hand I was dealt'; right along with a propensity for excess. Not much more to it than that, really.
Accepting who/what I am allowed me to get on with pragmatic Recovery Steps without a lot of Hand Wringing. I'm very grateful for this Personal Epiphany; made possible by insights here at SR. And by Recovered Pals.
This is all between me, and the Addict I see in my Bathroom Mirror. When I accepted that Terrestrial Responsibility, the straight line to Sobriety got much easier. That was my Conversion Experience. It's quite widespread, actually, within my Sober Peer Group.
The Buck stops here. That relentless realization is liberating.
.
Trudgin
Join Date: Jul 2014
Posts: 6,348
The Big Book of AA has the word disease in it - once. Page 64 refers to a spiritual disease.
Many AA's say I am an alcoholic, my name is ________________. This identifier as an alcoholic for many comes before their name so as to remind them that they are first an alcoholic and nothing comes before sobriety.
Terror, bewilderment, frustration and despair are my bedfellows if I drink. Whatever one choose to call that today is pretty irrelevant to me - though the phrase incomprehensible demoralization accurately describes how it feels.
Many AA's say I am an alcoholic, my name is ________________. This identifier as an alcoholic for many comes before their name so as to remind them that they are first an alcoholic and nothing comes before sobriety.
Terror, bewilderment, frustration and despair are my bedfellows if I drink. Whatever one choose to call that today is pretty irrelevant to me - though the phrase incomprehensible demoralization accurately describes how it feels.
waking down
Thread Starter
Join Date: Dec 2013
Posts: 4,641
Originally Posted by Zeroine
In terms of methods or techniques, for me it's Dialectical Behaviour Therapy (DBT) skills every time. DBT was originally for people with Borderline Personality Disorder but the skills are now used by people with all sorts of other issues. It particularly addresses poor coping skills like substance abuse and self harm, by providing other tools to use instead. There are four areas that the skills cover:
* mindfulness
* distress tolerance
* emotion regulation
* interpersonal effectiveness
A bit more info: DBT Skills List
The "Dialectic" (two things in conflict or opposition) in Dialectical Behaviour Therapy shows up in different ways. One way is that the problems are not our fault and at the same time we can take responsibility for our recovery. Another way is how our own desires conflict, eg I want to be sober and I want a drink.
The alcoholism/disease idea doesn't work for me, and nor do the purely rational behavioural approaches. DBT has the extra dimension of validating the emotional aspects of psychological dependency, and working with those rather than trying to reason or will them away.
* mindfulness
* distress tolerance
* emotion regulation
* interpersonal effectiveness
A bit more info: DBT Skills List
The "Dialectic" (two things in conflict or opposition) in Dialectical Behaviour Therapy shows up in different ways. One way is that the problems are not our fault and at the same time we can take responsibility for our recovery. Another way is how our own desires conflict, eg I want to be sober and I want a drink.
The alcoholism/disease idea doesn't work for me, and nor do the purely rational behavioural approaches. DBT has the extra dimension of validating the emotional aspects of psychological dependency, and working with those rather than trying to reason or will them away.
Member
Join Date: Jun 2014
Posts: 2,775
Originally Posted by trachemys
Whatever works for you.
Roger that.
I heard a member say he wasn't powerless of alcohol. But he was powerless over what happened once he started to drink. Whatever.
If it works right on with the right on.
Member
Join Date: Nov 2015
Location: East Coast USA
Posts: 1,068
Lots of good information here. Thanks to everyone who posted so far. I have nothing smart to add to this conversation. The reason I am posting he is because I find this thread very interesting and would like to be able to find it in the future.
Member
Join Date: Mar 2016
Posts: 216
With modern scientific research, we have not been able to fully define an "alcoholic". The term is too subjective and there are too many variables. Science has not clearly found a cause and effect relationship between alcohol and alcoholics. Therefore we will see the medical field (which based their theories on rigorous scientific research) different than the teachings of AA in their definitions of alcoholic. There are many approaches and who are we to say which one is right. There still needs to be a lot more research and work studying the effects of alcohol in humans. What we can do for now is to try out different methods of treatment and find one that works for you in becoming your ideal self.
Member
Join Date: Jun 2012
Location: Pacific Coast
Posts: 785
Originally Posted by alcoholics wife
With modern scientific research, we have not been able to fully define an "alcoholic". The term is too subjective and there are too many variables. Science has not clearly found a cause and effect relationship between alcohol and alcoholics. Therefore we will see the medical field (which based their theories on rigorous scientific research) different than the teachings of AA in their definitions of alcoholic. There are many approaches and who are we to say which one is right. There still needs to be a lot more research and work studying the effects of alcohol in humans. What we can do for now is to try out different methods of treatment and find one that works for you in becoming your ideal self.
I see people become frustrated when they concentrate too much on parsing out the differences between theories or terminology or programs or whatever.
Seems to me the old AA adage, "Focus on the similarities, not the differences," applies to a lot more than just initially identifying and accepting the problem.
Self recovered Self discovered
Join Date: Aug 2011
Location: Toronto Canada
Posts: 5,148
There is only one way alcohol affects my behaviour, and ever will, at any time in the future. I don't drink it.
If anyone thinks this makes me an alcoholic, or places me on some sort of alcohol use disorder spectrum, they can go ahead and do so. I don't.
It is liberating to be free of it. For good. There are important things that need doing.
If anyone thinks this makes me an alcoholic, or places me on some sort of alcohol use disorder spectrum, they can go ahead and do so. I don't.
It is liberating to be free of it. For good. There are important things that need doing.
NA Member - Atheist
Join Date: Feb 2016
Location: Middletown CT USA
Posts: 770
Originally Posted by NoelleR
This is the only part with which I disagree......my recovered friends and I were encouraged "use" the labels of 'alcoholic' and/or 'addict;' we were never encouraged to accept the "labels" of 'alcoholic' and/or 'addict' for ourselves. ...and since most of my recovered friends were Atheists, we were never encouraged to enlist the aid of higher power, of any kind...and yet here we all are some 30-45 years, still sober, in AA. Who'd-a-thunk-it.
(o:
(o:
Atheists recover too.
FWIW, my sponsor always says "my name is so and so and I'm an addict" (or alcoholic depending upon the venue). He taught me to say my name first, because I'm a person first and foremost.
In NA I'm an addict, in AA I'm an alcoholic. To me they're just words we use to describe a malady which is more than what the medical terminology suggests.
YMMV.
Member
Join Date: Jun 2015
Location: Nebraska
Posts: 106
Originally Posted by zerothehero
I found the passage from Mindfulness-Based Relapse Prevention for Addictive Behaviors that I thought might interest folks:
...12-step approaches are a combination of the disease and spiritual models of addiction, which view substance abuse and dependence as chronic, progressive diseases of the brain... Affected individuals are often encouraged to accept the label of "addict" or "alcoholic" and to admit "powerlessness" over their disease. They are encouraged to enlist the support of a higher power to aid them in their recovery. In contrast, the MBRP approach discourages the use of and identification with labels, positive or negative, encouraging instead an ongoing observation and acceptance of experience without ascribing value. Additionally, MBRP incorporates elements of cognitive-behavioral relapse prevention, which focus on empowering the individual through improving coping skills, exploring cognitive and behavioral antecedents of substance use, and increasing self-efficacy...to foster a sense of choice and agency, such that one's actions are arising from greater self-awareness, acceptance, and compassion.
...12-step approaches are a combination of the disease and spiritual models of addiction, which view substance abuse and dependence as chronic, progressive diseases of the brain... Affected individuals are often encouraged to accept the label of "addict" or "alcoholic" and to admit "powerlessness" over their disease. They are encouraged to enlist the support of a higher power to aid them in their recovery. In contrast, the MBRP approach discourages the use of and identification with labels, positive or negative, encouraging instead an ongoing observation and acceptance of experience without ascribing value. Additionally, MBRP incorporates elements of cognitive-behavioral relapse prevention, which focus on empowering the individual through improving coping skills, exploring cognitive and behavioral antecedents of substance use, and increasing self-efficacy...to foster a sense of choice and agency, such that one's actions are arising from greater self-awareness, acceptance, and compassion.
I think this MBRP approach is very similar to the AA I have been exposed to. If the only difference is not labeling yourself then okay! Go for it!
Find what works for you. It's all philosophy and taking things too seriously. and I'm saying this as a mental health professional!!
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