to be or not to be - an alcoholic
waking down
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Join Date: Dec 2013
Posts: 4,641
to be or not to be - an alcoholic
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?
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Join Date: Jan 2015
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I'll use the word "alcoholic" among people who understand what I mean, but even then rarely, and only in the past tense for me. To me alcoholic is someone past that fuzzy threshold where abstinence is the only way out, but it is absolutely a continuum disorder, and not everyone with an alcohol problem needs to abstain permanently. The word also has a lot of baggage and connotations among people who are not and have never been addicted to alcohol.
I prefer "chemically dependent" to "alcoholic", but even that is a continuum.
I prefer "chemically dependent" to "alcoholic", but even that is a continuum.
waking down
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Join Date: Dec 2013
Posts: 4,641
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.
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Join Date: Jan 2014
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The question I have is: is there a scientific point of no return on this scale? Because the longer I have been paying attention, the more I see that the problem often lies with people who think they can return to "normal drinking", but can't, and that's also the reason they can't get sober, losing massive amounts of time, and often more.
Not saying the idea of a continuum is wrong (taking into account that our position on the scale is dynamic, and tends to go towards the right instead of the left...), but I probably saved my life in labelling myself an alcoholic, and thus making it crystal clear to myself action was needed. Sure, anecdotal, not scientific, but as much as I love the scientific method, I prefer to be stubborn in this particular personal case.
Not saying the idea of a continuum is wrong (taking into account that our position on the scale is dynamic, and tends to go towards the right instead of the left...), but I probably saved my life in labelling myself an alcoholic, and thus making it crystal clear to myself action was needed. Sure, anecdotal, not scientific, but as much as I love the scientific method, I prefer to be stubborn in this particular personal case.
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Originally Posted by stevieg46 
Bluedog do others not want to give up drinking permanently ?
I should have also stated that if you feel alcohol is a problem, I believe you should look to quit permanently. The AA doors are always open. But for someone still looking to "learn" to moderate, I can only speak from personal experience that I was never able to.
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Choices, consequences. Denial, consequences. Expectations, resentments, consequences.
Drinking didn't work, so I became willing to do whatever it took, labels were meaningless.
Drinking didn't work, so I became willing to do whatever it took, labels were meaningless.
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Join Date: Sep 2005
Location: Houston, TX
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Originally Posted by zerothehero
I found the passage from Mindfulness-Based Relapse Prevention for Addictive Behaviors that I thought might interest folks:
...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...
...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...
(o:
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Originally Posted by bluedog97
The OP specifically addressed AA. I was responding to the claim by JeffreyAK that alcohol problems are on a continuum and that abstinence is not always the answer.
I should have also stated that if you feel alcohol is a problem, I believe you should look to quit permanently. The AA doors are always open. But for someone still looking to "learn" to moderate, I can only speak from personal experience that I was never able to.
I should have also stated that if you feel alcohol is a problem, I believe you should look to quit permanently. The AA doors are always open. But for someone still looking to "learn" to moderate, I can only speak from personal experience that I was never able to.
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Join Date: Apr 2015
Posts: 770
I use to label myself an alcoholic now I label myself as someone with substance abuse issues. In a lot of ways it doesn't matter, I love the saying 'labels are for cans', but if it helps you choose a method to recover than I can understand why people like to think about these things. I don't have a problem with the alcoholic label, some people do, I say it's fluid, like my recovery I've needed different things at different times.
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