Sasha1972

So I've been doing some reading and self-education about addiction, and I'm really struggling with the idea of alcoholism as a disease. I get that there's a genetic predisposition, a predictable progression, physiological symptoms etc., that it can be diagnosed and treated medically, and so forth.

But I keep running up against the idea that addicts have choices that people with other diseases, like colitis or schizophrenia or whatever, don't have. Alcoholics don't need to drink - alcohol isn't oxygen or food. No one is forcing an alcoholic to drink - they are making a choice every time they open a bottle, even if they don't feel like it's a choice. It seems to me that there's a big difference between feeling like you're compelled to do something and actually being compelled to do that thing. I don't understand how people can keep engaging in behavior that they know is destructive to themselves and people around them, unless they're mentally ill to the point where they can't perceive reality.

Maybe I can't understand it because my brain isn't hardwired for addiction. I know there have been a couple of times in my life when I've realized I was drinking too much - one glass of wine with dinner had become two had become three - but to me the response was straightforward: don't have the second or third glass of wine, even though you really want it. I never felt like drinking was something over which I had no conscious control, so it's hard to understand how someone else could feel that way.

This is really getting in the way of me feeling any compassion for my very sick alcoholic ex, so any insight would be welcome! For recovering alcoholics on this board, I hope this doesn't come across as too harsh. I am genuinely trying to understand this for my own mental health.

AnvilheadII

while yes addicts do have a choice to use or stop - at some point anyways - what they do NOT have a choice over is the actual underlying addiction itself. once it's THERE? it's there. and it never goes away. so a person could CHOOSE to not drink for FORTY years, and if they drink again, the disease will pick right up where it left off as if they last drank yesterday.

the "disease" is what happens inside the addict/alcoholic WHEN they consume drugs or alcohol. it is something that doesn't happen to "normies". you know those people that can drink half a glass of wine and then LEAVE IT? people who can have a COUPLE cold ones on a hot saturday. a couple as in TWO? people who don't give a thought towards drinking...as in how long til i CAN drink? how MUCH can i drink?

and depending on where an addict IS on their slide into addiction, there are times where there just isn't a CHOICE. i remember when i was caught up in crack....the moment the thought of getting MORE hit, it was IMPOSSIBLE for me to change my mind. we called it the cracktor-beam.

it's a mental obsession coupled with a physical compulsion. when in the face of 1000 really good strong reasons NOT to drink, it just takes one stupid, lousy, wimpy excuse to do it anyway. deductive reason is out the window. common freaking sense is out the window. in fact, it's kind of a miracle anyone ever breaks free.

BUT WE DO. in the Big Book it's called a Moment of Clarity, or a Spiritual Awakening. those moments when the window opens ever so slightly, and we can SEE the dawn of reason. those moments when we get the CHANCE to make a different choice. not everyone takes that chance. i do know that if you pass those chances up too many times, you are likely to get to a point where they no longer come.

Sasha1972

"Normie"! That's my new word for today!

LexieCat

I think Anvil explained it pretty well. And the thing is, there ARE options for recovery. Part of the problem is, let's face it. Who wants to admit s/he is an addict and unable to stop her/himself from drinking? Doesn't that just bring up TONS of imagery and judgment on everyone's part? Who wants to think of her/himself as weak or needing help with something other people have no problem with? So just FACING it is a real bear. And even if you admit there's a "problem," to say you can't deal with it on your own is a whole other obstacle. I used to tell other people (in my "moderate drinking" support group--yes, there is such a thing, and it's full of alcoholics) that AA was for people who had to be TOLD how to deal with their problem, and we all patted ourselves on the back that nobody needed to TELL US how to do it.

And the other thing you need to understand is that once addiction has taken hold, it's incredibly difficult to stop. You don't feel NORMAL if your regular drinking is disrupted. And that's for-real physical, as well as psychological. I didn't feel physically and mentally "normal" for about a year. That's a LOOOONG time, when you know picking up one drink would relieve the discomfort.

LexieCat

And one other thought. Even if alcoholism isn't like most other "diseases," there are enough similarities to think of it as one. It's a useful analogy, IOW. I know when I was still drinking I was definitely sick. I also know that I'm only a drink away from a relapse. So for my purposes, thinking of myself as sick, with a condition that is in indefinite remission, is perfectly appropriate and a useful way to think about it.

DesertEyes

What helps me with the "disease" concept is to take away all the emotional trigers and look at it from a different perspective. I separate the person from the behavior.

In my case, it's my ex. When she was clean and sober, "in recovery" as they say, she was a lovely, delightful person. As long as she did not "slip", or "relapse" our relationship was a dream come true. There was no "disease" to be seen. Which is exactly what the medical people say.

Once she took that first step over the line she became a completely different person. Which is also what the medical people say. It becomes a matter of chemicals, not personality. If she had taken some kind of anesthesia used for surgery she would be passed out, regardless of how much will power she tried.

Knowing that helps me get a bit of "detachment" from the crazy roller coaster. I am not dealing with a rational person, after the "slip", I'm dealing with a bag of chemicals having a melt-down.

This also frees me from having to understand her. The only reason I "understand" things is to control them. That is one of my own "character defects". If I could truly understand her addiction I could show her how to change. I have never felt the need to understand people who parachute, or climb up a cliff, or scuba dive with sharks. I think they need therapy, in my humble opinion, but I never think any more about it.

It is only when I fall in love with an addict that my need to control becomes a problem, and along with it an obsession to understand.

Maybe there's a disease of "al-anoid-ism". Up until I go out on a date with the shark-swimming, parachuting, adrenalin addict I have a choice. After the first date just look out below because here comes the emotional train-wreck. Me!

Mike

AnvilheadII

only thing i'd add to DesertEyes statement is that addicts will still want to jump out of a perfectly good airplane even if the LAST TIME they did so the parachute failed to OPEN.

cuz it will be different THIS TIME!

Sasha1972

Thanks everyone. This is so helpful in understanding what this "disease" looks like from the inside. My ex was/is a mean and angry drunk, and the only way I can square this with the decent and reasonable person who comes out sometimes is by thinking of addiction as something which has literally changed his brain. (In the year beforeI left, I was busy googling "brain tumor" and "traumatic head injury" because I couldn't think of what else would account for this awful person I had to deal with. He drinks all the time, but that can't be the problem because he says he's not an alcoholic and he should know, right?). He's been through several rehabs and keeps going back to drinking, which is incomprehensible to me. But as Anvilhead says, if all it takes is "one stupid, lousy, wimpy excuse" to justify the first drink and then it's down the rabbit hole... he's got lots of lousy excuses, given the circumstances that put him into rehab (relationships, career, health, finances all falling apart).

DesertEyes' idea that when dealing with an alcoholic you're dealing with "a bag of chemicals having a meltdown, not a personality" also helps. He won't act like a rational person because the rational-person part of his brain is offline, until he stays away from alcohol for good, and maybe not even then.

I'm realizing that I have a strong drive to understand, to analyze, to reason, to explain, to persuade ... and that is no use to me at all in this situation. I need to work on letting go of that and just dealing with the things I need to deal with, which are the things involving our daughter. The current craziness is addiction talking, not the person I (thought I) married.

LexieCat

Damn right, and the failure to open last time is the fault of whoever packed the damn parachute (which typically would be, um, the spouse/partner).

LexieCat

Bingo--you just had an insight that takes some of us YEARS to realize. This problem is not amenable to logic. And for a lot of really SMART alcoholics (raising hand), that's one more obstacle. We think we have to figure out WHY we drink before we put it down. Which is exactly ass-backwards. I've often heard "in the rooms" that there are very few people who aren't smart enough to recover, but there are plenty that are too smart.

tomsteve

the big book of alcoholics anonymous uses the word "disease" once:
From it stem all forms of spiritual disease, for we have been not only mentally and physically ill, we have been spiritually sick.

meaning, the disease concept rests in the mind and spirit of the alcoholic.

at one time, inhad the power of choice over whether i drank or not. then i crossed the line into full blown alcoholism - i lost the power of choice. no matter how much i didnt want to drink, no matter how hard i fought, i couldnt not drink.
i had to have that moment of clarity that anvillhead mentions in order to WANT to stop drinking. that moment happened 11 or so years after i crossed into full blown alcoholism.
in those 11 years, i had a couple times i stopped drinking-the longest stretch i can recall being aboht 30 days. the 1 thing that i STILL had those times-the mental obsession. the problem was all i did was stop drinking. my thinking and actions were still the sameas when i was drinking- a dry drunk

PhoenixJ

Million upon million around the world are addicted to something. Whether it is a choice or no- it is understanding the effects and damage, then proactively doing something about it with support is what counts. To judge- does not help the addicted or those who cop the flack for their behaviour. Yourself included.

LexieCat

Actually, I think the term "allergy" is used more often in the BB! That, of course, is inaccurate, too, but also a useful analogy.

PhoenixJ

I meant, there- that YOU are the one who cops the damage btw.

Fusion

Hi Sasha, I was the alcoholic wife and my husband struggled with the disease concept too, because we bought into the AA disease concept and I tried and tried and worked the AA steps, to no avail.

It was only when I joined SR last year, after trying other programs, SMART, Buddhism, hypnotherapy etc., that I discovered the Secular Connections sub-forum and then, the Rational Recovery AVRT threads.

Quite simply, it saved my life, by placing the power of choice back in my hands. My own free-will was mine to use once more. And I chose that I will never drink again and I will never change my mind, no matter what.

This was a complete transformation. I suffered a more than twenty year alcohol addiction, the last five of which, were all day every day. I'm a slight woman and I was drinking daily almost three bottles of wine/ fifth of vodka. Horrendous. But I found the power to stop drinking, my own self power, after learning a technique, here in SR.

Therefore, no, it isn't a disease. I've lost dear friends and family to cancer, a disease; and when the oncologists had no more treatments, they died.

Whereas I, as an alcohol addicted person, could cure myself by using my own self-will, after learning a technique. I'm thoroughly ashamed that I didn't learn and apply it years ago, when I first encountered it; but the 'addicted ' part of my brain discounted it. But this time around, I used my best thinking and applied it.

aliciagr

If my understanding is correct, the reason the term disease is used is because of how addiction affects the brain, There are various chemical changes going on, and you pointed out a good example when you mentioned its not a necessary like breathing air. To the addicted brain, the chemicals derived from the substances do feel like a necessity like breathing air. And the brain of course triggers urges, thoughts, feelings, emotions, and physical signs saying feed me,
As family what we see comes at the end of this with behaviors and sometimes signs of desperation from our partners.

One other thing not talked about a lot is that many people have underlying conditions and they basically begin to drink or use drugs to self medicate. Things like bipolar, or even severe anxieties and depression because those things also affect chemicals in the brain.

I dont have any trouble with the medical concepts of addiction as they make sense to me... I had an issue for a long time trying to reconcile how it could be a spiritual disease and I have just stopped considering as such. Having sessions along with my husband and the Addiction Medicine Doctor really helped me get a grasp on it all. And it does affect us as family members because I know Ive used my beliefs to help me find the emotional balance I needed. When I was able to understand it wasnt just a choice, and that its one illness that actually uses the brain against its victim... lying to them.. putting them into denial over the severity.... causing them to resist change, and discourages the idea they can live without the substance... so powerful... None of that had anything to do with picking a drug over me.

It also made me go back to what the doctors say in that this disease needs treatment sooner rather than later because it progresses in the brain and invades all the aspects of a persons life : physical, mental, emotional, spiritual/religious , social interactions, family relations... the longer it goes on the more damage it does to the person as a whole. And then the aftermath is cleaning all of that up and reconciling with your faith, family. But the good news is that so much can be reversed because the brain heals over time once the substances stop and the chemicals cease flooding the brain. The disease stops. What we were told is that brain function in most cases is re-routed back to normal function after a person stops.. this takes time and leaves a person vulnerable while the changes take place. The old pathways are littered with memories, triggers of people, places, things, feelings, .... this is why people relapse.. why my husband uses therapy to help him right now.... and also the Dr. said there is most likely always an increased risk for my husband because of the complexities and long memory of the brain.

Needabreak

I was never able to wrap my head around the idea of addiction being a disease, until I noticed that all addicts share so many of the same characteristics. All have different stories, but the behavior, the dysfunctional thought processes, the progression are so similar. In fact, the concept that one is "different" from other addicts has a name: "terminal uniqueness." So, like other diseases; alzheimers, schizophrenia, etc., there is a certain recognizable set of symptoms.

Those of us who love(d) an addict also often develop a certain set of symptoms that fall under another condition: codependency: many of us are drawn into these relationships with addicts by the codependent patterns that already exist within us. The two diseases can interact with each other, triggering each person's separate condition to become worse.

It still amazes me to read threads on this board where new people explain what is happening in their lives and are surprised to find so much recognition, so much commonality, from those of us who have already been through it.

joy7

Maia Szalavitz came out with a book last year called Unbroken Brain which talks about this very issue - moving away from the idea of addiction as being a disease, and instead as being a type of learning disorder. You might like it, I thought it definitely shed some insight into the condition in ways that seeing it as a disease didn't for me.

Forward12

The "disease" label has been been put on alcoholism mainly from AA, though in medical guidelines it's considered an abuse disorder.
I was watching a video with Dr. Drew recently and describes it at a mental health disorder, which I personally agree with.
Alcoholism, like many other mental health issues, does get worse over time left untreated. Though alcoholism has the simplest treatment in the world essentially, and that is to simply stop drinking. However when alcoholism has set itself in so bad, the thought of living life without alcohol is almost unthinkable.

FeelingGreat

I'm more in the genetic pre-disposition camp, and I've also realised there are many different types of A. I personally trained my brain to look for alcohol as relief for each day's little irritants . Unfortunately now I've rewired myself I know I can't go back to drinking moderately. All this didn't happen until circumstances permitted it in my 40s and 50s.

But I know there is a small sub-set of As who desperately want to stop, who try multiple times, and eventually drink themselves to death, knowing they're doing so. The disease model fits better for them.