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Answers to some Questions about Alcoholism
My presence on the web extends to quite a few places beyond just my web sites. One of those places is a site called Expertscentral (that I am no longer involved with) where people can post questions for "experts" to answer. I have gotten some pretty strange and interesting questions posed to me there. The latest one came in Thursday night with some very urgent questions about alcoholism. The person sent a whole list of questions to be answered - and then only moments later posted another question about where she could get her answers immediately.
Her first set of questions were quite a challenge to give short answers to - so I didn't even try. I answered her second question first and told her I would get back to her on the others in a day or two. I answered those questions this morning (April 15, 2000) and now am creating this web page for those questions and answers because some of them deal with information I have not previously discussed on this site.
Her questions are in this color, while my answers are in black. Blue text indicates thoughts I have added as I put this page together.
First message
I am sorry but i have a couple of questions. please get back to me as soon as possible, thank you
1. Why would alcoholism be considered an addiction to you?
2. Why would alcoholism be considered a disease to you?
3. In your own opinion do you think alcoholism is a disease or an addiction, and why?
4. What have been the most cases (having it being an addiction or a disease)?
5. What is the effects on the person themselves, family, and friends?
6. What is the treatment for alcoholism?
7. What are the bodily effects on someone?
8. How/when was alcohol first developed?
9. What do you think should be done to reduce the amount of drinking in the United States of America?
Second message
Where can i talk to an expert about alcoholism tonight and get some good answers?
Your first question is (questions are) not some that can be answered in a few minutes - and I do not have time to do them justice tonight. Within the next day or two I will find some time to answer them. In the meantime check out About.com's Alcoholism page (on my links page) and you may find a forum or chat room or some place where you can talk to somebody or read some on alcoholism.
- Robert
Dear ____,
I got some time to answer your questions early this morning. Sorry about the delay but as you will see, they were not questions that I thought could be answered quickly with a few words. Here they are:
I am sorry but i have a couple of questions. please get back to me as soon as possible, thank you
1. Why would alcoholism be considered an addiction to you?
I personally would consider alcoholism an addiction because when I was drinking it was in reaction to some deeply held belief that it was not possible to live life without alcohol and drugs. Which means I had a compulsive psychological dependence on alcohol and drugs. I also had a compulsive physiological dependence on alcohol due to genetic factors. An alcoholic is born with a hereditary, genetic predisposition to addiction having to do with brain chemistry. The factors that go into that brain chemistry dynamic dictate that alcoholism is a progressive condition - which means the way the alcoholic reacts to and processes alcohol in his system changes and degenerates over time.
I believe that alcoholism is incurable - and that if I were to go back to drinking after almost 16 and 1/2 years without a drink, my physiological reaction to alcohol would be worse than it was when I quit because of the progressive nature of the brain chemistry components of the disease.
There are different varieties of alcoholics. Some are daily, maintenance drinkers - who may drink a little (or a lot) every day whereas some alcoholics go long periods of time between drinks. Some alcoholics drink just enough to "take the edge off" and may never appear drunk or have any overtly negative consequences (i.e. drunk driving, losing jobs, etc.) The consequences they suffer are emotional and spiritual, so do not often show on the surface.
One of the major indicators that a person is an alcoholic in my opinion, is that when they decide they are not alcoholic they have a drink to celebrate. Some one who is not an alcoholic has no compelling reason to drink - and most non alcoholics do not ever have to wonder if they are alcoholic.
I believe that many people may have a period where they have abused alcohol in their lives - like late teens, early twenties - which does not necessarily make them alcoholic. It is the history of drinking over years that is indicative of alcoholism. It is the compulsive nature of the drinking that marks it as an addiction.
This compulsive nature of an alcoholic's reaction to alcohol is marked by the dynamic that once the substance is introduced to an alcoholic's body it can set off a craving for more. That means that once in a while, once a week/month/whatever, an alcoholic starts drinking with the intention of having two beers and ends up drinking themselves into passing out. This is a form of Russian Roulette that an alcoholic plays. They may be able to control their drinking 90 % of the time, but they can never be sure when that compulsive craving will take control - when that happens they are liable to wake up in strange places not having any idea what happened or how they got there or rather they killed someone on the freeway the night before.
Some alcoholics go months or even years between binges. Some of the most miserable people on this planet are dry alcoholics - that is, alcoholics who are not drinking using will power, but are really miserable because of it.
2. Why would alcoholism be considered a disease to you?
I believe that a disease is a disturbance in a natural process - literally dis-ease, a lack of ease, of harmony.
In terms of alcoholism, the first time that anyone ever came up with a way of successfully treating alcoholism was when Alcoholics Anonymous was founded and started treating alcoholism as a disease rather than a moral problem or character flaw. Using the disease model of treating alcoholism brought relief and a new life to millions of alcoholics long before the AMA decided to classify Alcoholism as a disease in the late 60s. Since that time there have been a wealth of scientific studies proving that there are genetic and hereditary components of alcoholism.
I also believe that the physical components of alcoholism are not the most important factors in this disease. I believe that it is an emotional, mental, and spiritual disease with physiological components. Just treating the physical components is not enough to allow an alcoholic to lead a happy, relaxed life. It is vitally important in my view to treat the emotional, mental, and spiritual components as well.
I also personally believe that all physical disease is a product of emotional, mental, and spiritual dis-harmony. And further that emotional and mental disease is a result of Spiritual dis-harmony and dis-connection. In my belief this includes hereditary and genetically transmitted diseases - including alcoholism, which I believe are the product of many generations of Spiritual dis-harmony and dis-connection. This is my personal belief which you could read more about on my web site.
3. In your own opinion do you think alcoholism is a disease or an addiction, and why?
I believe that all addictions are a form of disease. Some diseases involve addiction. It is not an either or question. We are not talking about apples and oranges here - we are talking about apples and fruit.
4. What have been the most cases (having it being an addiction or a disease)?
As I said it is both.
As I was proofing these answer after posting them on the expertscentral site, I realized that there was another aspect to this question that I could have addressed - and may actually have been more in line with what she was asking. Because she was asking specifically about alcohol, I didn't think of this aspect until after I had posted the answers. I decided against spending any more time on my answers for that site but have decided to add the extra thoughts here.
And because life is unfolding perfectly - with no accidents, coincidences, or mistakes - I have a reference to address this aspect of the question that is just perfect. The very same night that these questions came in, but prior to me seeing them, I was walking through the living room while my roommate was getting his nightly fix of the X-Files. I watch very little TV, and when I do it is usually just for a few moments while I am eating, or is some event I want to see. I have over the years had certain programs that I do get emotionally involved with. I usually limit that level of emotional involvement to two programs and the X Files is not one of them.
But as I was walking through I heard one of the characters say something to the other that was a classic line. Scully said to Moulder, "He saw those things because he was disturbed." Moulder's reply was, "Ah, but did he see those things because he was disturbed or was he disturbed because he saw them." My immediate reply was to say, "That, is the question." (My Shakespearian training. ;-)
So, to paraphrase, the question here is: Do people become alcoholic because they drink or do they drink because they are alcoholic? And the next question after that is: Do people become addicts because they take drugs or do they take drugs because they have a genetic predisposition to addiction/disease?
I will answer both questions on a personal level and then give a larger answer to both.
As I said, this may have been more of the intent of the question the person was posing, but it did not register with me at first because of my personal experience. I am a recovering alcoholic. I believe - I know - that I was born with a genetic predisposition to alcoholism/addiction. I got drunk the very first time I had the opportunity to get drunk and had a black out. Many alcoholics do not experience black outs until the later stages of their drinking. A black out is when someone loses consciousness - some part of the brain quits functioning - but they are still walking and talking and driving, and will have no recollection (or only flashes of fragments of memories) of it the next day. (Having had black outs is one of the strongest indicators of alcoholism diagnostically.)
That is what happened to me the first time I got drunk and continued to happen with increasing frequency for the almost 18 years that I drank. It is what researchers are now referring to as a Type A alcoholic. I am convinced that the only way I could have avoided being an alcoholic would have been to never take a drink. I also believe, that had I not discovered alcohol I would have killed myself before I was 21. I was full of so much pain, was so terrified of life because of the rigid, perfectionistic, black and white perspective I had learned growing up - and was so full of toxic shame, so sure that I was unworthy, unlovable, and truly a defective person - that I would never have survived without alcohol. Alcohol saved my life.
Someone who is born with a genetic predisposition to alcoholism finds relief in alcohol that they can't find anywhere else - until they get into recovery. I can not tell you how many alcoholics I have heard describe their first experience with alcohol as feeling ok for the first time in their life. We all find ways to cope with the trauma of life, an alcoholic drinks because he/she is an alcoholic. If a person is not an alcoholic, then they find other ways - food, work, relationships, etc.
So, my belief is that alcoholics do not become alcoholics because they drank a lot for many years but rather drank because that was the coping mechanism of choice for their physiology. I cannot imagine someone drinking enough for long enough to get physically addicted to alcohol, without the predisposition.
Now drugs, I am not sure of. There are drugs that are very physically addictive - heroin or the benzodiazapenes, Valium and such, to name only a couple - they cause a powerful physiological addiction. And there are conditions where I could see someone starting to use those very addictive drugs to combat physical pain or emotional trauma that might not involve a predisposition. So, though I could say that alcoholics drink because they have the genetic predisposition, I could not state that categorically about drug addiction. And I could be wrong about it in terms of alcohol also. Maybe someone suffering from enough pain for long enough could use alcohol as a pain killer for long enough to get physiologically addicted to it. I can not be sure. Some expert huh? (I mention what I think of the term expert in the link to expertscentral on my links page.)
The bottom line, and the larger answer, is that it really does not matter. It truly does not matter if the chicken came first or the egg. What matters is what can be done to help an alcoholic or addict let go of their drug of choice and learn to live without that crutch. I probably got a little flip with my answer to the persons questions because it was such a codependent thing to do - splitting hairs like that. Is it an addiction or a disease? Which is it more often? I mean, is this someone intellectualizing and analyzing away in order to not have to deal with feelings or what? So, maybe I was a little irritated with the questions (because they are the kind of intellectual nit picking that I did in early recovery. ;-) As I point out to you all quite frequently, I am very human and capable of screwing up. That is part of my job, to role model that it is ok to be human - it is in fact, the only choice we have on this level at the moment (even though we Truly are Spiritual Beings and not humans at all except temporarily.) So, if I hear from the person again, I will make an amends for being flip. It is all perfect somehow after all. ;-)
And because life is unfolding perfectly - with no accidents, coincidences, or mistakes - I have a reference to address this aspect of the question that is just perfect. The very same night that these questions came in, but prior to me seeing them, I was walking through the living room while my roommate was getting his nightly fix of the X-Files. I watch very little TV, and when I do it is usually just for a few moments while I am eating, or is some event I want to see. I have over the years had certain programs that I do get emotionally involved with. I usually limit that level of emotional involvement to two programs and the X Files is not one of them.
But as I was walking through I heard one of the characters say something to the other that was a classic line. Scully said to Moulder, "He saw those things because he was disturbed." Moulder's reply was, "Ah, but did he see those things because he was disturbed or was he disturbed because he saw them." My immediate reply was to say, "That, is the question." (My Shakespearian training. ;-)
So, to paraphrase, the question here is: Do people become alcoholic because they drink or do they drink because they are alcoholic? And the next question after that is: Do people become addicts because they take drugs or do they take drugs because they have a genetic predisposition to addiction/disease?
I will answer both questions on a personal level and then give a larger answer to both.
As I said, this may have been more of the intent of the question the person was posing, but it did not register with me at first because of my personal experience. I am a recovering alcoholic. I believe - I know - that I was born with a genetic predisposition to alcoholism/addiction. I got drunk the very first time I had the opportunity to get drunk and had a black out. Many alcoholics do not experience black outs until the later stages of their drinking. A black out is when someone loses consciousness - some part of the brain quits functioning - but they are still walking and talking and driving, and will have no recollection (or only flashes of fragments of memories) of it the next day. (Having had black outs is one of the strongest indicators of alcoholism diagnostically.)
That is what happened to me the first time I got drunk and continued to happen with increasing frequency for the almost 18 years that I drank. It is what researchers are now referring to as a Type A alcoholic. I am convinced that the only way I could have avoided being an alcoholic would have been to never take a drink. I also believe, that had I not discovered alcohol I would have killed myself before I was 21. I was full of so much pain, was so terrified of life because of the rigid, perfectionistic, black and white perspective I had learned growing up - and was so full of toxic shame, so sure that I was unworthy, unlovable, and truly a defective person - that I would never have survived without alcohol. Alcohol saved my life.
Someone who is born with a genetic predisposition to alcoholism finds relief in alcohol that they can't find anywhere else - until they get into recovery. I can not tell you how many alcoholics I have heard describe their first experience with alcohol as feeling ok for the first time in their life. We all find ways to cope with the trauma of life, an alcoholic drinks because he/she is an alcoholic. If a person is not an alcoholic, then they find other ways - food, work, relationships, etc.
So, my belief is that alcoholics do not become alcoholics because they drank a lot for many years but rather drank because that was the coping mechanism of choice for their physiology. I cannot imagine someone drinking enough for long enough to get physically addicted to alcohol, without the predisposition.
Now drugs, I am not sure of. There are drugs that are very physically addictive - heroin or the benzodiazapenes, Valium and such, to name only a couple - they cause a powerful physiological addiction. And there are conditions where I could see someone starting to use those very addictive drugs to combat physical pain or emotional trauma that might not involve a predisposition. So, though I could say that alcoholics drink because they have the genetic predisposition, I could not state that categorically about drug addiction. And I could be wrong about it in terms of alcohol also. Maybe someone suffering from enough pain for long enough could use alcohol as a pain killer for long enough to get physiologically addicted to it. I can not be sure. Some expert huh? (I mention what I think of the term expert in the link to expertscentral on my links page.)
The bottom line, and the larger answer, is that it really does not matter. It truly does not matter if the chicken came first or the egg. What matters is what can be done to help an alcoholic or addict let go of their drug of choice and learn to live without that crutch. I probably got a little flip with my answer to the persons questions because it was such a codependent thing to do - splitting hairs like that. Is it an addiction or a disease? Which is it more often? I mean, is this someone intellectualizing and analyzing away in order to not have to deal with feelings or what? So, maybe I was a little irritated with the questions (because they are the kind of intellectual nit picking that I did in early recovery. ;-) As I point out to you all quite frequently, I am very human and capable of screwing up. That is part of my job, to role model that it is ok to be human - it is in fact, the only choice we have on this level at the moment (even though we Truly are Spiritual Beings and not humans at all except temporarily.) So, if I hear from the person again, I will make an amends for being flip. It is all perfect somehow after all. ;-)
5. What is the effects on the person themselves, family, and friends?
The effects on the person are fatal. Alcoholism is a fatal disease if not treated. It may kill the spirit and heart many years before it actually kills the body, but it does cause death. It causes great dysfunction in the family that results in emotional wounds that are passed on for generations.
Alcoholism itself actually has a pattern of skipping generations in terms of its hereditary nature - but the emotional wounds inflicted on someone who lives with, and especially someone who grows up with, alcoholism leave scars that can totally control a persons life long after the alcoholic is dead.
The Adult Child of Alcoholic Syndrome, which I believe is the same dynamic as the Adult Child of Dysfunctional Family Syndrome or Codependence, is in fact a form of Post Traumatic Stress Disorder or Delayed Stress Syndrome. This is a disease in and of itself, and can produce psychological addictions such as workaholism, religious addiction, sexual/relationship/love addictions (which are really 3 different things), eating disorders (which in turn then become physiological compulsions), etc. It can also lead to depression, panic disorder, fear of intimacy, relationship phobia, etc.
To an alcoholic his/her best friend is alcohol. No one is more important to an alcoholic than alcohol - not family, not friends. The more that family and friends try to fix the alcoholic the sicker they get because their disease of codependence is progressing.
Just as it is impossible to Love someone enough to make them Love themselves - so too, it is impossible to get someone else sober. The more love an alcoholic is given, the more likely he/she is to drink since she/he hates him/her self and does not feel worthy. The most Loving thing friends and families can do for an alcoholic is to quit enabling them by rescuing them from consequences. Tough love with strong boundaries is Truly the most Loving thing that loved ones can do for an alcoholic. This can be very difficult, because sometimes the alcoholic's path is to die of alcoholism. (See my article about my friend - Death of an Alcoholic.) If that is their path, then there is nothing anyone can do to save them from themselves.
It is possible to do interventions on alcoholics/addicts. I got clean and sober because of an intervention that my family did on me. Ultimately, however, the person must choose to get sober them self. No amount of intervention can save an alcoholic from them self. The person must get willing to change, and no one can force that on someone else. Often, it takes the shock of losing all of his/her enablers to get an alcoholic to wake up to the reality of his/her life and become willing to change.
It is possible to do interventions on alcoholics/addicts. I got clean and sober because of an intervention that my family did on me. Ultimately, however, the person must choose to get sober them self. No amount of intervention can save an alcoholic from them self. The person must get willing to change, and no one can force that on someone else. Often, it takes the shock of losing all of his/her enablers to get an alcoholic to wake up to the reality of his/her life and become willing to change.
6. What is the treatment for alcoholism?
There are numerous treatments that are now being tried for alcoholism. Some are effective in treating some of the symptoms of alcoholism - but in my belief none will really work without treating the core dis-harmony which I believe is Spiritual.
In my opinion, recovery from alcoholism needs to treat the mental, emotional, and spiritual components of the disease - and the most effective approach is a Spiritually based program for learning how to live life. Alcoholics Anonymous is, of course, the preeminent program for dealing with alcoholism - and I believe still the best. AA can however, be problematic for some people because of a lack of/resistance to dealing with and healing emotional wounds that is sometimes found in AA. The Twelve Step Spiritual Program in my opinion is the best approach to dealing with any addiction, and most any disease. It provides a formula for integrating the Spiritual into the physical that facilitates learning how to live life in a way that can bring some happiness and peace into a difficult journey.
There are organizations now that reject the Twelve Step approach of belief in a Higher Power - a rejection which I believe primarily stems from emotional wounds caused in childhood by Spiritual abuse from shame based religions. I will be posting a page soon that is going to be called Spirituality for Agnostics and Atheists to address some of that resistance.
7. What are the bodily effects on someone?
As I said, alcoholism is eventually a fatal disease. Drinking will destroy the brain, heart, liver, etc. Ironically, alcoholics will sometimes seem to age better than the codependents in their lives who try to control their drinking. It is not at all unusual to see an alcoholic who looks much younger than his/her spouse. (Alcohol is a preservative you know.) The damage is still being done on the inside however, even if it doesn't show on the outside.
And I want to make a point here, that like there are different varieties of alcoholics, there are also different varieties of codependence. All alcoholics are also codependent in my definition. Many of them are however the other extreme from the traditional codependent who is involved with an alcoholic - that is, many of them are counterdependent, which is just a different form of codependence, a different type of behavioral defense in reaction to childhood emotional wounds. The traditional codependent is one whose psychological addiction is in focusing on others. I talk about these varieties on my web site.
8. How/when was alcohol first developed?
Alcohol has been around as long as people have been. The earliest people found ways to ferment different natural substances to produce some type of mood altering intoxicant. I believe that there have also always been some individuals that reacted differently to alcohol, and as such alcohol abuse has been known throughout history. I believe Alcoholism as we know and understand it started to really evolve as an addictive disease with the changing of the fermentation process from a completely natural process to one that was augmented with the use of refined sugar. This happened in different parts of the world at different times, but has been going on for hundreds of years now. This again, is my opinion.
9. What do you think should be done to reduce the amount of drinking in the United States of America?
Drinking is a symptom not a cause. Of course, symptoms become causal and create more effects - as in the treatment of alcoholism, where it is very important for the person to stop the symptom of drinking before they can really address the causes.
But drinking is a symptom of a dysfunctional society. This society, and all cultures on the planet in my belief, are dysfunctional because the planet has evolved as an emotionally dishonest and repressive, Spiritually hostile environment because it has been based on false beliefs about the meaning and purpose of human existence. This was caused by planetary conditions which I talk about in my book Codependence: The Dance of Wounded Souls and on my web site.
If alcohol were suddenly no longer available, people would find some substitute - because the great majority of people on the planet do not know how to live. If you took away all of the substances and agents that people use to numb themselves so that they can endure life - alcohol, drugs (both illegal and legal), sugar, caffeine, nicotine, television, obsessions and compulsions of any variety (religion, exercise, computers, gambling, sports, relationship, sex, etc.) - the world would deteriorate in violence and chaos as all the repressed emotional energy exploded to the surface.
A society that believes that Prozac, homelessness, and billionaires are a natural part of the design of life as humans is a really sick society / a dis-eased culture - a very wounded bunch of human beings.
If everyone started working a twelve step program - had a Spiritual awakening and learned how to integrate Spiritual Truth into physical existence - then we would stop destroying ourselves, our neighbors, and the planet we live on.
I believe that a Transformational healing process has begun on the planet, that this Truly is a new age, where we are learning to heal ourselves and the planet. But it is a process that involves each individual healing themselves and learning to Love self. We are all connected to everyone and everything - the more we start waking up to that, healing the emotional wounds that have been inflicted upon us by dysfunctional civilizations, and tuning into the Truth of who we really are and why we are here - the healthier and more Loving society will become.
That is from the Cosmic perspective. From a personal perspective we need to focus on accepting the things we cannot change (other people and life), changing the things we can (our own attitudes, behaviors, and our relationship with our self), and accessing the clarity and wisdom to know the difference between what we have the power to change and what we do not.
From the tone and urgency of your questions, I would guess that you are a very capable, caring, and controlling codependent who is intent on fixing anything that is "wrong" in your world. You probably even grew up in an alcoholic home, and are now involved in a relationship with an alcoholic. (It is quite normal for Adult Children who grew up in alcoholic homes to marry alcoholics.) I would guess that my answers to your questions are probably not what you were looking for - but I would also venture to guess that they are what you needed. You probably will not recognize that right now. It may take a while for you to accept some of the things I have said here - or perhaps you never will. I do thank you for the questions however, because I am going to post these answers as a web page on my web site - and I am sure that there are many people that will benefit from them.
I will of course not mention your cyber name. I thank you for this opportunity and hope that you are open to hearing what I am saying.
- Robert
