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"Alcohol and Health, Alcoholism and Mental Health"
by Toby Rice Drews
by Toby Rice Drews
There is a persistent trend in mental-health treatment that can mis-direct people from receiving proper treatment for the fatal and progressive disease of alcoholism.
It is the idea that mental-health problems are the root cause of alcoholism. (You can see a detailed partial answer to that problem in the September, 2000, Recovery Tip of the Month. Just keep scrolling down this section, to get to that particular tip of the month.)
In the "Getting Them Sober, volume 3" book, there is a section chronicling the 350 secondary diseases to alcoholism. I included a sub-section on psychiatric problems that arise from, or are triggered by, alcoholism. What that means is that many mental-health problems that would otherwise be of minor consequence or just lie dormant, come to the fore and run rampant when triggered by alcoholism. (In the section of the book with the secondary diseases, there are also interviews with leading experts, including James Milam, author of the classic book, "Under the Influence", on why this triggering of secondary diseases happens.)
The good news is that for most persons, when they do get treatment, and attend A.A. on a regular basis-- those problems usually subside greatly or go away entirely. (This of course, is not true of alcoholics with major psychiatric illness in addition to their addiction. Then, they still need A.A., of course, but also usually need additional counseling/possible medications for their dual diagnosis).
But I want to emphasize that most alcoholics do not also have major mental illness! If they get and stay sober, their therapists and family members are delighted to see "a different person!". (This does not apply to people who are 'dry drunks'.... i.e., people who don't drink, but who do not go to A.A. Many of them don't drink, but keep the personality problems that wreak havoc on others and themselves.)
The real problem lies with the diagnosis and treatment of drinking alcoholics. There are literally millions of alcoholics who have died because their alcoholism was bypassed, and their secondary psychiatric illness was treated as their only primary illness. Their alcoholism was not seen as as a primary disease. Most of those drinking alcoholics did -- and continue to -- go to therapy to deal with their personality problems, which are looked upon as the root cause of their drinking. And many of them die (or go insane) because of it.
About 20 years ago, there was a line-drawing cartoon in the A.A. monthly magazine, the Grapevine, of three guys lowering their buddy into a grave, and the caption was something like, "It's too bad; he was doing so well in therapy. He just couldn't stop drinking."
This does NOT mean that personality problems should not be addressed. Certainly Al-Anon teaches family members how to deal with the junk that comes from the drinking. But, again, one must "get sober first" if deep and lasting personality changes can occur for most drinking alcoholics. And with A.A., most alcoholics DO have deep and lasting personality changes! Of course, many people need counseling after getting sober, in addition to A.A., but that doesn't keep one sober. Sobriety is the cornerstone. Without it, most other changes are not possible.
But all this raises a serious other question: Why are some family members so easily sidetracked into actually wanting to think that alcoholism is not the central core issue-- into wanting to agree, sometimes, with therapists who do not understand alcoholism-- that the drinking is not the main problem? I think that it is entirely understandable. We get so sick and tired of it all and we get to feeling that 'they'll never get sober' ... we want to believe that the problems that arise from the alcoholism are the main problems, and that if they can be taken care of, the drinking will wither away by itself. Unfortunately, lots of time and money and energy is often spent in therapy, pursuing this often-futile goal.
What is good to remember is that almost every family member who has a spouse or someone in A.A., has thought to themselves--- even the day before that person started A.A.--- that "they'll never make it." And there are over 3 million people in A.A. in the U.S. that belie that thought, thank goodness! Hazelden used to publish (it is out of print, the last I heard), a wonderful pamphlet about a drinking woman alcoholic who tells her husband that she'll go to therapy. So, she goes, and she continues the junk behavior and the drinking. And her husband complains. And she says, in essence, "what do you want?! I'm getting help!"
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