lilE cAll Llcl( ALCOH(ILISM REP,RI’N NEw TIYIN LENS CAMERAS

I *.’i L..r.u ! irU..:.i,l.-1,..J.. r ,” .i’i,f’t,1″,,.,, ‘d TS f;I’c?t lii THE MYSTERY Or HUnnAN,rWlNS ,o”i ,. r!r.ihri:r4+ J’4t{. !–_ :, ri i?r:r. .’,;l:^j

::,+ CO.ORDINATED ATTACK on problem drinking, developed by bers (left to right) Miss Irma Hertzfeldt, Dr. Leon A. Greenberg, :’.j Yale Plan Clinic, is symbolized here by a patient and staft mem- Dr. Giorgio Lolli, Raymonil G. McCarthy, and Mrs. Eilith Lisansky. i=:: i;:,:: a, ri:

Wb Can Lick Alcoholism CLINIC PLAN OFFERS IIOPE FOR WORLD’S LEAST UNDERSTOOD SICK PEOPLE by Carlton Brmnn ?-rt o MANy AMERTcANS. the alcoholic is The Lost l4leehend, Still, many share delinquent, a person of weak moral I u co*ic char”cter,- They call him the reaction of the man who left the character. They feel that only pure souse, stewbum, lush, and dipso; they theater and said to his companion: cussedness keeps him from “handling say he is tight, plastered, stewed, fried, “I’m swearing off right now! You’ll his liquor.” There are even many alco. or sauced. In recent years, Americans never catch me going to another movie.” holics who do not recognize that they have been exposed to a great deal of To many other Americans, the alco- are alcoholics, and feel privileged to uriting about the problem of alcohol- holic is a subject for moral censure. look scornfully upon the people tfiey ism, and to a serious novel and movie, ‘They class him as a sinner, a social consider alcoholics.

44

utilize all that science knon’s about alcoholisrn in rnedicine, psvclliatr\,, socioiogy, and allied fields. Cornpr-ehensive ALCOHOLIC progranls of treaunent, preleltion, and I}ANGEa, SIGNALS rehabilitation have been rrorked out Dr. Abraham Myerson, Boston and tested irr clinical pl’actice. lrllich psychiatrist” says -vou are an alco. can leduce the casualties of alcoholisrn holic dependent arrd in peril if: b1, one half or nore v’ltereler thcv al’e 1. Iou enjoy a partl’ only rvhen thorougirly applied. But these plans l’ill there is liquor present, so that you not rvork anvrvltere unless eloups of can release your social instincts. iudi’r’iduals in states, cities, ancl com- 2. You long for the time of day munities becone au.are of the serious- rrhen you can drink. ness of alcoholistn, and raise fur-rds and 3. You corrsider drink necessary plan proglarns to deal n,ith it as a ma- to relaxation and enjoyment. 4. You tum reflexively to alcohol jor public health problem. each day to ovel’come anxiety, dis- Hou llany -4lcaholics? gusl, faligue. or fruslralion. 5. Your drinking goal is some- The Iacts about alcoholism concern thing other than the drink itself. eler\’one as intimatel,v as the [acts about Dr. E. M. Je]linek. director ol healt disease. c,urcer. tuber6r.rlosis, ina Yale’s Surnmer School of Aicoholic Iantile parallsis. Tire numller of per- Studies, says an incipient alcoholic sons in this country rnedicalll, classified is the dlinker t’ho: as chronic alcoholics. ra’ho have devel- L Gulps his clrinks. opecl phvsrcal or rnental disorclers as a 2. Sneaks a few on the side, conseqlrence of prolonged 1621,y drink- 3. S’orries about his liquor coning, is 50 per cerlt higher than tile num- sumption. bel o[ knorrn suffer-ers from tuberculosis. 4. Stops talhing about his drinking. -\nd it is a fact o{ central importance 5. Begins to forget rvhat hapthat no one. rvhether at present a tee- l)ened during his “lost weekends.” totajer. a moderate, or a “sociai” drinker, can be positive of a lifelong personal inrnr-rnit1, to alcoholism. Of I00,000,000 Americans of drink- .r\Icoholisrn is also a social problem oI ing age (15 vears and older), an esti- incalculable masnitude. Experienced rnated 58,250.000 use some form of al- Sah’ation .{rmy lvorkers estinlate that coholic be\.erage, to some extent. The 90 per cent of the down-and-outers .rvho gleat maiority oI these, some 54,500,000, come to them lor help have .been keep themseh,es mainly rvithin the bror.rsht there by excessive clrinking. In categor)’ of safe and moderate drinkers, Neu, York City, one third of the rnen ancl as snch are no part of the public and one tenth o[ the r’yornen u,ho rake health program. But a minority of a1l their marital difEculties to Domestic clrinking –\rnericans, about 3,750,000, Relations Court are alcoholics; so are ale classifiecl as excessir,e clriukels, or 95 per cent of all those corrrmitted to inebliates, ancl r’r,ithin this group 750,- the \’Vorkhonse and l5 per cent of those 000 or 800,000 are knor,r,n, on the basis given pet-ritentiarl, sentences. Officials ol hospital and court records, to be of an Industrial Conlerence or-r .-\lcoclironic alcoirolics. Of all excessive drink- holism held ir-r Chicago this l\,Iarch ers, one in six is a \voman. estinrated that alcoholic employees cost industrl, S1.000.000,000 in production Sarnple studies recently conducted by and 24.0(X).000 nran-hours of n’ork per Rutgers University at Nerv Brunsrvick, ),ear. Boarcis of education find that N. J., indicate that 50 per cent of the parental alcoholisrn is a frequent factor American public erroneously believe in absenccs ancl behar.ior proirlerns of that an alcoholic can stop drinking if school chiiclren, as it is in juvenile he rvants to; that only one in five prop- clelinqueno,. Estinrates oI trzrflrc accierly views the alcoholic as a sick person. dents involving drinking by drivers and This.lack of pubiic ur-rderstancling is 1:eclestrians lan’ lrorn l0 to 50 per cent the chief obstacle in the way o[ an of the total, cannot l:e sumnrarized in effective attack on alcoholism, rvhich nation-wi(le ternls ltecause of local vari- Dr. Lawrence I(olb, nteclical director o[ ations ancl inaccuracies in the reporting the U. S. Public He alth seryice, has oI accidents. ranked as America’s fourth greatest pub- The problem o[ a]coholism looms lic health problem. large not onh, in terms of the nurnber This is not to say that science has of people it affects, but also because it found a miraculous nerv cure for alco- is such a conrplicatecl rnatter, hal,ing so holism and that only pul;lic prejuclice many ir-rtangible ar-rd unsolved elements. and indifference keep it frorn lteirrg To scientists concerned with the .probapplied. There is no one r-rel,’ finding, 1em, the alcoholic is a sick person, 11o or group of findir-rgs, rvhich pronrises an more deservine of moral blame or ridi easv soiution. But there do exist today, D-tt. IiOWARD \[. HAGGARD directeil cule than sufferers from any illness. as never before, plans of atrack ‘rvirich pioneer research in alcoholism at Yale. But alcoholism is not a separate, cleariy CONTINUED ON NEXT PAGE 45

s E CAN LICK ALCOHOLISNl–4ontittueu defrned disease entity. No single cause or group of causes can be assigned to it. It is confined to no one group of ALCOIIOL IIOES people within our population. No single course o[ therapy can be applied uni Enter the blood, stream, at a rapid Prouiile reliel. quickly but tem- versally to a1l alcoholics. Science is still rate. through the stomach and intes’ porarily, Irom many painful physical unable to point with certaintv to those tines. It is carried by the circulation and psychological conditions, by dull- indivicluai traits of physical and psyto all parts of the body. The greater ing perception of pain, cold, and dis- chological make-up ‘lvhich combine to the weight of the drinker, the more comfort. make a smal1 percerltage of all drinkers diluted is a given quantity of alcohol Relieoe anxiety and tension through peculiariy susceptible to alcoholism. in his blood stream. Hence, other fac- its anesthetic action on the higher Until quite recentlv, those concerned tors being equal, a healy Person can centers of the nervous system. drink more than a lighter one rtithout Stimu.late ap petite by increasing rvith the r,arious aspects of alcoholism reaching the same degree of itrtoxica- flow of gastric juices, rvhel taken itr -sociologists, phvsiologists, psychiation. But, independent of weight, moderate quantities. In large quan- trists, educators. religious leadersvariations in metabolic processes and tities, alcohol interleres rvith or stops tended to appl’oach the problem as speps.ychological balance produce rvide digestion, cialists in their separate fields. trVithin variations in individual reactions. Prouiile calories (210 per ounce b1- the past ferr’ vears, a nev’ point o[ vier,r- Act upon the brain and central lveight ). but delivers no vitamins. has been emerging among these people. nervous system, slowing dorvn reac- rninerals. or proteins, and may im- It is that alcoholism is a medical, psytion time. perception. and reflexes, but pede their absorption. Therefore, it is chological, social, Iegal, ancl moral probrvithout ph-vsically affecting tissues. It . a {ood. though an inadequate one. lem, but that it is none of these alone. acts first upon the centers controlling lyhich. taken in amounts dispropor- A dozen years ago, there ‘was no inrjuilgment and inhibition; next, it af- tionate to other elements in the diet. over long periods of time, leads to portant national orgaDization that was fects speech, muscular co-ordination, and vision. diseases of dietary defrciency. utilizing the tools of science in a concerted attack on alcoholisrn. Today. there are two central agencies, the Yale Plan on Alcoholism, ancl the Research * ** Council on Probierns oI Alcohol, which are carrying out intensive studies, clinical work, and campaigns of public . ALCOIIOL DOES NOT education in all phases of problem drinking. In addition, there is the nou, lncrease efficiency or ability to per- disorder rvith burning sersations and form mental or physical work of any pain in legs. eventual paralysis in legs well-known “volrrntary fellowship” of sort. It may, in individuals excessively and armsI or “beer heart.” an en. Alcoholics Anonymous, which in its 12 hampered by inhibitions and anxie’ largement of the heart and rveakening years oI existence has gathered a memties, enable them to accomplish tasks of its muscles. Identical srrnptoms irre bership of 60,000 rehabilitated alcothey hold back from. but not as effi- found in Oriental beriberi. a diet- holics and contiiblrted to the underciently as they could if their mental deficienc-v disease: tlle same treat- stancling of excessive drinking. block were removed by psychotherapy. ment rrith \ritamin 81 produces cure. Act as a stimulant, although, by re- Make you lar. b1- itself. But it is The Scientific Approach ducing consciousness of fatigue, it quickly oxidized and converted into seems to stimulate. caloric energy, Thus. rvhile the energy Scientific work in this field is dividerl Act as a aphrod,isiac, except to the in alcohol is rapidl-v burned up. other into trvo main approaches. One is conextent that it lessens inhibitions. food taken in rnay be stored as fat. cerned with fincling factors in the bio- Cause insanity, epilepsy, neurosis, Cure colds, although it will make logical and psvchological make-up of or glandular disturbance. In cases the patient feel better” perhaps help inclividuals ‘lvhich n-ra1, givc them a preof phychosis, and perhaps in all others, him to get relaxation and sleep rvhich alcoholism is a symptom of an un- rvill aid in recovery” if he stays in disposition totarcl alcoirolism. The secderlying disturbance, not its cause. bed. Ileavy drinkers. rvhose resist- ond approach is that o[ r,orking out Delirium tremens (which affect 4 per ance is lorvered by- generirlly poor methods of trexting alcoholisrr in clincent of alcoholics) and other rare heahh habits. die of prr.umonia len ics rvhich rvill utilize ali the knowleclse “alcoholic psychoses” are reeognized times more ofien than others. of scierrtific l’e\errcll. In thc prxcticei as symptoms of vitamin deficiency Differ in efiect accortling to the rvork o[ the tl,o nrain grouPs in the and lespond to high-vitamin therapy. beverage consumed. except slightly. fielcl, these approaches are combined. Cause alcoholism, any more than The concentration of alcohol ranges The Research Council, rvhich is affilisugar cautes diabetes. Indivitlual idio. from 3 to 20 per cent in brerved and ated rvith the American :\ssociation for syncracies, physiological, psychologi- fermented beverages ibeer antl rvine) the -{dvancement of Science. is cur’cal, or both, caase inordinate cravings to 50 per cent (100 proof) and rently cerrvinq on e cerrrplrign to raise for alcohol, low resistance to its higher in whiskey. gin. rum, brar;tly. $200.000 a year to set up a series oI efiects. and other distilled spirits. If “hard Injure the heart or kidneys or con- liquor” is diluted to the same con- combined research and treatrnent centribnte to hardening of the arteries. centration as beer or wine. it rvill ters in alcoholisnr in Ieadine medical Cause cinhosis of the liver, which have virtually the same physiological scirools throughout ihe country. One is a diet-deficiency disease attacking effect. Vegetable substances, inclutling such center, at Nerv Yorli Hospital-Cor- B per cent of alcoholics. vitarnirrs. are found in beer and wines. nell t\,Iedical College, has completecl Cause ulcers, which are generally The effects of these ingredients are the first year o[ a five-year plan financecX recognized as a psychosomatic ail- rninor. Absorption of alcohol in anv bv a $150,000 grant frorl the Council. ment. Moderate drinkers tend to de- form is delayed by presence of food in Some of these funds have been convelop them less often than non- the stornach; hence I drink before din. tributed by the liquor industry. This drinkers. ner acts more quickly thau one during project, under the direction of Dr. Os- Cause polyne,uropdthy, a nervous dinner. kar Diethelm, co-ordinates research in the varied fields of psychiatry, internal medicine, physiology, pharmacologv, bio-

HE.{RTBE-{TS OF RATS injerted rtith alcohol are listened to Leon A. Greenberg. Such research has helped to establish efiects at fale Laboratorl’ of .\ppli.’d Phlsiologr’ b1′ Assistarrt Profes-‘or of s:rrious concentrations of rrlcohol in the ltutnatr blood stream.

Chelni!t1’\ . 1.r.r ch,’1,,3\ . li l)tl il l) t lil’r )l)r)l(‘t{\’. the l):rticnt’i right ltot to clrink”‘ eslirrlare based ou such a linlited grotlP In its fir’-t \rlrl. tllt ‘tlrtl’llrt’kttl rtith Dr. Dicthehrl’-\ Pfiltlxry aitlr is re- and period of time rr’t>rtlcl have little x )electrd tesr grouP,rt:5 P.itiellts .uirrch. FIe ha, l’cleased llo estitnate of scientific standittg. Clirricians in this tr’h,rre ttoLtttlrl plocluctile rr”er’,.rl li[e rht :ucccss o[ hi: prlrjecr in rehabilitat’ fieid are reluctant to sa)’that:rlcoholhlcl l-iecrr ir-l’i()tt5l\ tlirl’tlPteil irr tlic u’r’ ing thc fit’ri vtar’s test 3TouP, alld an isrn has l;eetr an’estecl iu au$ Patient of alcrtlt,rl. .\ll rtere 1:co1>le rrlt,i rrltuted rri lie hclPutl lill(1 u()lIc 1\’ll\ Irl Lltc ”tle|elitt” tr1;r. l:.litit tl)(n1 iill tllitiitl TIIEIItr] AIIE SIs IiINDS OF I}IIISI(ERS irtli,rcl ol i1,)1ll .t ltrr ricek. to rcr-cl’lrl lrtl)nth) rrr tltc h,,.1rit:ri. lli)(iL1’lt)ilI1l’ .llotlerate. Drinks slnall amouut. .-l.ddictite, inrpulsire. One whose life rh,rlough lrlir.li;11. Prrrlli.rti’it. :rtltl P.r- usu.lll) heverirges of lort rrlcoholie is clonrincted by’ use of alcohol, rr’ho ch,r1,r3-ital .ttr(lir.. etltl i,rll,rrr ittg’tll)cl’- colrterlt. Ireft,re ol rrith tueirl. irr taste cirnnot stalrd lrp to responsibilities or ri.rcl 1>tr)-.ll’lt]tl..,rl t1iut. l!”t. :ill(l r)(ctl- antl nrilrl eilect. Catt;trrp drinking clisappointlnetrts tsitlrrrut re(‘ouIse to rrith n,r feeling of rlsprivltiot.t. herrr’l drinkirtg. Cirtttrot give rrp alco’ l)iiii0illll tlirt.r1ri., \i,r’t ,)l lllr- lritlil’l1t{ tlabitud. .rociai. Dritrks praetitrrlll- hoi rolurrtltill’ eren rrhen lte ktrrx+s it ujllin.rlr kr’lrl to tltc itie:triirr.tl (,)lll-\c i-. lrarnring hinr and lte tlesires to give lutrl 3L.trltt.rt.tl i,, :t tl.ill.ili,,tl.li’t:tgt. daill lor “kick” rntl sr:rcial relaxation, uot suflirietrtl)’ti) illiut’e heLrlth. but it up. ,)l lt’olrl li,ut il, ‘is i,.tck.. rltttiirl ultith Chronic ulcoholic. Orre r.lro h:rs de’ crrough tr.r lte poteutialll” dangerous tiicr rPctti tti:llt. :ttttl 1ir'(k(‘lltl’ ill tlir autoulobile tit’irtr. \Ilr graduallf in’ veloped a hodl’ or ntental dis,rrder ii,,11rit,tl .ttttl i’t’rrltrtutl 1\,)I’k ()tlt\i(lc. rl’ealse lnloullt and so hecotrte: as a consequence oi pr()lotrged lreavl \ltet’ lurlirt3 il’rt li,r.piilrl. l)iiliLIlt) I:leatt or e.rcessir^e. Cnr get along drinking. {:lttcf lr l,,ll,,rr’ir1r l;rr:l-i’rl ,rf tl’ll’r.( l’, rtithrlut drirrkirrg il rle.ire: to. but lnebriute. -\cc,:,rtliug to ;uure defi’ titc rqlti.. luiit) ltilll l,rt r ilttk-tt1r: ltl- tlrirrks Iirr,re r1u:rutilies irnd flequertlll. nitious. intludes herr’1′, escessire. and hr>t r’r’cLlr. .rltrl c\rttttlrllr lttolltlll\. Rurrs sorne risk oI becourirrg addictive irnpulsive drinkers. -{n inehrilrte is q,r.jil r1,r’kcr’. licl1r thc 1r:rrit’tit 6nrl or imlrul;ivr tlrirtker. rtt,lre r-rf Ieeom’ not a chrortic alcoholic unles-. alco. .rtiltl’lk lrol’k .tll(l I Utl’t:tti(,)t. :rtltl t’;itttih irrg rhrouic altoholir’. holic disease i: presettt. Iilr11 lt’ictttls xl’e illstl’tlctc(l i, 1 ttPuct

rnetabolic machiuerr’, tlte rrav itr rrhich ilre bodl’ turns food into energr. rnake FOUB Tr:PES AI,COHOLIC it possible for some people to dt ink Cf,ABACTENISIICS heavill’ Ior uranv tears rvithuttt ever OF AI,COHOLICS shorving clinical symptonM[ alcohol’ Decadent drinkers occur in “The most imPortant thing I isnr. ancl inrpossible for othcrs to rlriuk families shou’ing gradual social. have learned about llcoholics.’ evcrl a little rr’ithout develrping an moral. and physical degeneration says Dr. Giorgio Lolli. medical inoltlinate and disa:tr,rtrs ct’it\ in3- lor director of the Yale Plan Clinic. over several generations. They alc,-rhol. Fle drie: not crrtttcrtc[ that lhe never come to true adult emotional “is that you can’t say one thing biochcnrical appt’oach alotte can ct.rn- and intellectual maturitl’ but use that characterizes all of them.” But he names some traits which are. qur-r alcoholilllr: he h()Pe! that it rr’ill alcohol, drugs, or a life of adsen. frequentll’ encountered. evcntrrallr cletcrlrtitre cet tailr dcftnite ture as compensations. phr:irrirgic:rl cltaracteti’tit\ rrhi(lt retl- lmpassioned drinkers are tense. Iulantile traits are dominant, in’ der’ son)e pe,,ple vultrcrublc t, r lhe emotionally unstable. and develop cluding the foll,rs’ing: a craving for intosication out lmpulsiteness; gft9115 o1 alr,.rhol. Srtch nrct:tb,rlic idio\\llcl’rciris, \\-il’ of ueed lor temporarv relief from Dependence, not onlY on tbe tlot’ tension. tle. but in other splreres. Conflicts iiams beliere\. lllav be inhcritctl. I-ltis Strrpid. spine/ess drinA’ers rrho arise from this feelirrg of depend’ d()e5 n()t tleau that alcoholi:rn i> a succumb to practicall.v an1′ form of ence, and a striving alraY from it hererlitat’r cli:ea:e-an ol(l-tu.lli,,l1e(l makeg some aPpear as the most tenptation. \-agrants. criminals. bugebrxr that has beelt rhot’,,ttghlr’ those of low-grade intellect. and independent of peoPle; sc()uted bv genetic science.-l’he tlrtr- deteriorated persons irom lortest Grandiose ideos, feelings of om’ 5r.urIl)ti( )rl ,,1 :tlc, ‘hol. evetr in crCc*i1e nipotence. particularly rshile drink’ social strata. Become addicted to ing. often givirrg rsaY to moods of quantitie\ ()\’er l()llg peri,rcit. cill.t\t) llo alcohol because it is the one form despair and feelings of inferiority dnmage tr) gel’ltl cells, attcl thtt. tL res of enjo-vment rthich is entirely during hangover Period. These not allect the genetic tuakc-rtp oI the passir,6. alternating curreDts reflect tlre ps-v’ chilclren,rf exce”ive clrinker’.. St:tti’tic. Sell.aggrandizittg drinA’ers be. chological eoncept of ambivalence, sirorr’ that oltlv abottt otre thirtl ,,I all come rtldicted to alcohol in process a pairing of one excessive emo’ alcoholit. c,rnte ftont ianrilie. :ltorriltg of building up their orrn rr.eak tional reaction rr’ith its opposite; a lrinh irtciclence of alcrtlt, rlirt|t ittttl rr.ill and rreak personalitl-. They Need tor reassurdnce, praise. etc.. crave po\rer and authoritl’. but rnerrtal illne.>. The arrd i\ (url)liir\ire(l from associates. Supplies to self’ have not the energl’ or abilitl’ to bet.rru.c in ert:rpplecial-rle rtttnrber qrf reach their ambitions and so reesteem come mairrl”r from outside alc,rholit p.ttiel)t). alcol.tolirut i: Iucrclr’ rrorld-ari indication of the alco- sort to alcohol as a nrethod of incirlental to their pt’inral’\ :riltncnt. building up their o\t’n ego. holic’s dependence; Tirese are slrnpt()nlatic” dlitrket’.. rvhrr Feelings ol reiectiott, linked to These four t1’pes make up Cim. early family diffir,ulties. The pres’ are drivetr to excessive u!e (,t:rl(,rh(,1 bal’s Classification. as quoted bv ence of a ver)’ dorninating parent b1 a psvchoris. ierirlus I)eur{)\i\. allrlr)- Dr. Carnel’ Landis. -{ssociate Pro. and a passive one is often found; cI’ine (li.tut’l)alt( t. )rgilllic illrrt… ()r ( fessor of .\bnormal Ps1..chologl’. Tendency tou’ard e.rcesses. irt epilcp’r. J’hcil clrinkins i: :r ,\\nrl)t,)m Columbia Lniversitl’. in his chap. other beharior besides drinking; oI tireil unclerlrirrg illness. ter. “Theories of -{lcoholic Per. High ambitions, often hidden, rorrality-.” in Alcohol. Siience. and .Socrier.r’. Landis calls this one of coupled rsi!h emotional bloeking Smrtll H ereditart Factor rrhich impairs ability to attain the most useful classilications of llost authr,rities c,’rrtsicler thrt there alcoholics rvho are not ps;-chotic. tlrem. mar be ronre hereclitarl iltctr,r in al’ t,,li,,li’rrr,’rttI tltlrt it i’ :l i!ll:tll,)ll(‘ .lll(l ditlrcrrlt ro iel):rl’.ttt: fr{)tli thc ‘]l txter until he hes gone rrithout alcnhol for arrcl 1e.s LIn(ler\t’)(xl PictLrt’c- ,,i hcr.tlitr’ manr chronic alcohr’r’lics shorl’an ina perir,d o[ .evera] \-ears and gires eri’ in rnentai ill11g.. of all tvpr.. I’htr srrfliciencl in ihe secretiolls of the deice ,rf having unclergrine a be.ic beliele 1|111 rr’hcn the chikllt’rt , ri :tl(,r- rrlltrurl g’lrrrri i a smell clut tless glend le-cclucrti()n th.rt elinritratcs his rrtc<l holics take t,-, clt’iIrk. th,.’ itt l1tttttt c , ri .irrinq,,n the kidnevt :inrilar t() thxi i,rr alcr,hol. IiLrr Diethelrrl’s stafi he\ an- eltYirrrnmerlt i. ‘{tll(rliiiI e 1itl .ll,)llgtr i, ‘rrrrtl n \1l1li.o11 i c1i.cxre. Tt’catrltctrt nouncetl one irr,ru.tisittg 6nrling: that il(tr)r thiln biol,reical inheliterrce. \\-het ‘.rith ltlt’r-n.ti :rnd !e\-ql.rnc1 ltortlrrlres crrt:rin r.rniclerrtificci sttll’tatttet in the rrrrr ire inhcrited is ltt ttlr.talrle cnn- irr. r’ielclerl clinical improvenrenl in irLrod are xpl)arentlv ars()ciitte(l \rith ,;1111irr11 riliith. il .trbjcrtetl t1, :t(l\ul’se \\’L- rr’erd petient!. rhe crei’inq for alcohol, as rrtll lrs rr’ith inflrrrnce.. is likelr to tlt-rt’1,’1r ;1[1,,]1,rl’ Flor.n the L’nilersitv of Chicaso. Pro- 1i1g ;111,rtir.rnal srates of telrsi,)11. ltllrictr’. isnr or rnental illner. nl,rl’c t’fu(lil1 thirlt fr-rsol EnrelirLl. .\nt.rn .1. Car’1son. pre.i- :rntl rcsctttrtcut, otltt:r. nrrt so predi.po.ed. (lanr lncl icientific direcror oi the S,me .)ther clttes iu the phr’ti,,logical \\’illir11n. Ielicyei. 1. 11,, r,rirtr’ 1r-r<linq ll.c.e:rrch C,runcil. rePorts that a rlitrekl rrere tc1>,,rtecl at tlle l11o.t l’cccrlt l'(\e:ll’clter\. thel lrotli lterr-ilit:rt r :ttrtl :r’,i,{r’rr-tlrl,,t it)e ga!. Previottslv uied t. :rrrnu:ri rlcctinq,rl tlre Researtlt [.,,tttl- environnrerttal furt,,ri art’ hiT hir .iqnifi’ lrlr:rch 1i,’rrr f,rr Ilakin.:’ rr-ltite itt’c:rc1. iil. in (lhicn:r,, lrt.t De<etnber. Ft’,,trt the cant attcl that “a otte-rirlcrl irl)l)r’,,:r( ir 1,, hls been founcl to m:lke pl’r)te irli lct :ti t-nilersitr-of -I-esas, Dr. Rrrger.T. \\-il- thc pr’,rlrlet.tr is forctl,rottttrl r,, lrrilrrrc’.’ :r ncrlrj poi.,rt.t, -\rtirnals havc cletel,rperl 1iams. prrrfes\(‘r ()f chenlistrv all(l (lil’uc’ -\i r biothemist. hii special .t-:tt’th is i,,lri trl:ir’rttr as a rerttlt rtf 1:eitr’l lecl tor r:f the liiocherrrical Irtstitutc. :rtr- f,l’ rr,ure bi,rchenrical meun:,f itltrrtilr’- lrlqe rrl,rtrnti of rr’hite lrreacl c,rtrteinnounced thet becattse of inrlir.idtrrl ins l){,tentixl rlco}r,rlicr. ltrrl 1t’otn tlt;r: irr( thc chetrical. It nrat be a contri’ r’lifferences in b,:ch’ chenristl r’. e l,xr p,,irrt. r,1 d6^1 6′[.ping pt’slcntilc rncl lrrrring [actoL. Carl:on ];elieles. in trtrliconcelltrlrti.n,:rI elcohol itr thc lrlootl t’crnccli:rl nreaiut’es. ing potenti:ri1v nttstal;le pet’s,rtts ittt,, i; enottgh to prodttce signs rrI itlt,,sira- The .eat’ch for a 1;hrii,rl,rgicrl lia;i. alt,rholics, tiolr in t.ultnr 1>cople. lr’hilc ri{her. tltlr’ [or nlc,rholisrrl is alsr) beinq cart’iccl ,tti I{:rnqine iar bevond this palticrrler ireve sever:rl tinles lts high r l)el(e11talae ip clinical ituciies tt the Nerr York 1]1gor’\’. Cl:illson inclicates that the rtill r,’irliout bec, rnring drtrttk. f-nivcriitl Colleq-e of ]letlicint:. utrrler oi r\e rlr,rholic p:rtit’nt aPPear: to be \\-il’!irrur irrli,-‘r’es that dillcrences in Dr’. J:rnre; .f . Srnith. FIe lep, )rr,! ihlrr t,.Cr,:,titrtutd on Page 62.1

7′

rnenrs in the ph1’siolog,r of alcohol, jusr t’her rte had founrl .,u:-ehat tire rvhich Dr. Horvard 1!’. Haggard and llert rr’a]’ of clealing rr.irh the problemr his associates in the Laboratnrr. ol .\p- .-,f alcolrol ii to tlr<kle tIcm a.s a total plied Phvsiologl’ beg’an arouncl 1930. l.,r,rblem unitiuq rll rpproaches,” Thev made important finclinq, ;rlrout For-the intcrr.tt.cl 1lr.nr;rn, the ntr-rs! the metabolism of alcohol atrcl irs ab. tlr’.rnr:rrit rr’,r1.1 ireirrS {l,,r1g lr,r. tlie \’:rlt sorpt.ion and oxidation in the ltodr.. Pl.rrr i. irr ir. Pil,’r ,lirri<” :rr \r.r, But Dr. Haggard. rrho beceme rlirectrir llaven. T-hi. clinic :rucl ,’ne. et Hartlord of the Laboratorl in l9ii8, sal. the im- r,’el’e \et up in tire s1:rrin,3-,rf l{).1 } tr.ith pottaltt neecl for eoing ber’,rncl thcre re- rire :ricl ‘,1 rhe (.,rnnrrticur Prison Asso. searches and gettine at the funclanrental ci:rti,rtr: rhr’ rrrana.qcrlcllt r)l tlie Hart. causes anrl the pr:rssible means of pre- l,rr”cl clirric liei,itrce l)een t:rken r\.ur rentiotl of alcoholism. i:r’ the f.,rnnecticut Contnris;ion r_rrl “\\-e got plentv oI leads rhat;ug- .\lcoh,rli.nr. lJoth clirrir. r.,.ere estrlr. gested a phvsiological basis for conr- 1i:hecl ni,t {,nlv i.) 6,r1.rr’.rith tlte los. ALCOHOLISITI pulsile drinking.” Hageard said re- nf inclr-rstrial manl){rw;r. through alcc,, (Continued front page 48) centlv. “But thet’ trere just leads. \lte h,rlirnr in (:”nltertiCut.. i,rrr rvith the coulcln’r find a rvav of applving rhem larger rim of h’orking r)ur ntethods for to the individual aicoholics. S,: ,r’e de- tlealine’itith tr\’o eisential prol:lern. cided to studl’ all aspects ol alclhr:lisnr encountered all ,rr.et. tht- c,-rutttn-: I iurportant to his recor,ery and rehabili- and the probierns of alcohril. In addi- \\’here t err rhe irrrlividrrrl in rhe conr. I

tation. “The hereditarv, the biochem- rion to our phvsiologists tve broueht in ntttnitv so for aicl. adyice. anci treatmenr ical, the nutritional, the neural. the a biometrician, an anthropoiogist, a cf alcoholirrl? ?l lll rthat methods can educational, and the social factors de- psvchologist. a sociologist. an economist. tlre comnrunitr rnort effectivelr. restore ternrining the srength and direction of and ‘rr’orket’s in other field;.” The yale ihe.ocill u\eluit)e.: of itr alcoholicallv the zai// af man are still obscure,” he biornetrician, Dr. E. lL inc:rprcirrred rrrerrrbcrii Br rrhar ntetli. sals, outlining the broad territory rrhich “fellinek. is norr. director of the Surnmer School ,tf .{,1- ‘,di crn i: lte.i prel.enr rlcoh,,lirm’: present-dav research in alcoholism is cohol Studies. associate editor of rhe setting out to explore, It is this broad, co-ordinated explora- Quarterly Journal of studies an .7lco. T he Quali fi ed Recor.erie.s

hol. and an acti\:e collalrr.rraror in all “\\-e’re not concerned here *.ith tion, rather than individual nerv find- of the rrork of rhe Yale plan, ings in separare frelds, that constitutes rvhether lou should clrink or not,” Dr. “\\-e rrent after the lerger qLreitions Haegerd sal’s, “\1’e’re concerned ivith the latest and most promising develop- o[ rrhv people drink,” Dr. Haggard said, ment. in the studl of alcoholism. The thoie people rlhose drinking interfere. ”rr’hv a ferr become llcoholics l.hile the rrith their livei. lr.ho l>ec,rme social idea of this co-ordination arose at fale gteat majoritr- dr,res not. rr”hat rlcohol Universitv. and its practical applica- Dr,rbleuri throuqir e\ce\:ive drinkine. does to pe,,ple pstch,rloeicallv as rr.ell as \\-e rranted to knolr rrhether it r..r. tions are best seen today in the rr’ork phlsicallr. \\’hen rre started the iumof the Yale Plan, a manl’-{aceted opera- fersible ro ser up r free clinic rrhere, ar nrer school. \r’e h’ere a little atraid of :r Coit to the cnmrnurritv o[ rltout Sl00 tion. rrhich is formallv knorr’n as the attracting special pleaderr ior.one point Section of Alcohol Studies of the Lab- :c’r prtierrt. 11’e (,,uld,{si :l l.etiopal)laof vierr’ or another. But ir’e fr.runcl rhat leco1 e11 , \\’e don’t talk rbout rtrrirrg oraton’ of \pplied Physiologl’, Yale rrhen people of varioui persuasioni got Unirersitv. .tlt,,h,,li,.. \\-e t.rl] ,,ur .it((r\ilrrl ti… together and law erch other’r pQint ol qrrrlifietl rec,)\trie\. -I’lie quali{icrtiol lierr’. thev sot a br,racler uncleritanding jr that rhe patient ruill irai.recor.ered Support lrom Liquor Industrl’ oI the pictulc.. Ther htd di\(ussilru ses- ‘nlr r. I,,rr.I r. fi: d,ri1′: r:)rr(h. iirl.,.,l. Some of the Yale Plan rvork is done sions outside of lectures, and discolered under agreement rrith the Connecticut Commission on .\lcoholism. a state agencv of rehabilitation anrl public edu- HELP FOR YOTiR TOS-\ I\ TACKLI\G .{LCOHOLIS}I cation establisired in l9{5. the first of its kind in this countlJi. The Cr:rnrnis. The follon’ing lgencies r-ill help \err York f ;. \, f. Di-ctrihutes re. sion currentlv derir,es funds of about indir.idunls, Iocrrl eomnrittee:, merl. ports of its research projeetsl aids in ical and social rroiker; rrith informr. the establishment nf model rrlcoholic 5200,000 per vear from higher licensing tion. speirkers. literature. entl plan; renters. incorporatitrg research. treat. fees, u’iiid’r representatires r:f the liquor of conrmrrnitr- action: ment. teaching. and rehahilitariol. bv inclustrt have acceptecl roluntarih, ro The \ational Comnittee lor Edu. est:rhlished hospital: ancl medicai par’ for the progrant. The Comrnission catiort ort,4lcoholisnt. Suite 15.t. \err gr(,ulls. is engagecl in a broad. long-range pro- f ork \r’a,lem1′ ,rf lledirine Build. The \ational Committee on Alco. graur lif eclucation. r’esearch. rrclttnenr ing. ! East I03rd Street. \er. fork hol Hvgiene. Inc,. l0il0 Park Ar.enue. in public clinics and l.rospitals. com. 19. \. f. Free literature eor.ering Baltirnore. ]Iarrland. Puhlishes bi. munitl selvices. atrd. ultirnatelr’. 1>re. general nature of alcolroli:nr irnd montlrlr’ ..llcohal Hvgiene. eontain. vention. Since l9{5. Utah, \\Iiscorrsin, deseril’ilrg horr,.onlnlupitier fal) ing reports on research done bs Ores()n. and the Di:trict of Coluntbia deal rtith it as rr puhlir irealth proL. menrber drrctors at Johtrs Hr:pkins Irave [o1lrnr,ed Connecticut’s lead in lem. Aids in settirrg np local afliliates arrd el:errhere: also a virrietv of tackling aicoholisrl as a specific pul:lic of the fationll {..nnrmittee. rrhich ]r,rr,kleti rdilresied to ::eneral ;udi. Irar-e alreadr heen established irr li ence and rrorker: in the field of health problenr. ancl otller .states are t. S. rities, -lr:.ti l: irgent ftr .ale r:f instiruting -similar leg;islation. al,:ohol h1’giene. publiratir,ns ol The Quarterlt !our- –l.lcoholics -4nontntcus, P. (j. Bor The Yale Plan cr:uclucrs dre Yale rral ol Strrdies on .llcohol. inr:luding -{;9. Grarrrl Cerrtral Anrrer. Ner. Suurmer School of .\lcohol Srudies. no.rr I.a1. Supplement Series. trr-elre hook- fork 1?. \. f. Distrihutes reprint: irr it.s sixth t’ear, rlhich gires an in. lets clearll’t,orerirrg nrost phlses of antl booklets deicriliinc irork of tensile course in all pl-rases irf alcohol- al’oht,l and alcoholisru, A.A. \\:ill aid indiriduals rri:hing to isnr tr: educ:rtors, social rr,orkers. and The Researclt Council on prob. get in touch with -{.,\. rroups in nthers professionalll, concerned rrith the lem.s al ,4lcahol.6fl Ea.t {2nd Street. their r-ir:irritr’, .iubiect. It is rhe outgrolvrh ol erperi

6? SCIE\CE 1T T L’STR-\TED

The Yale Plarl Clitlic is housecl in an old-fashioned red brick building which bears no resemblance to a hospital’ Patients are admitted without charge, resardless o[ their financial circumstailces. Some are brought or sellt in by mernbers oI their family, friends, doctors, or employers. Others, by arrangelrent with the Connecticut Commission on Alcoholism, are relerred to the clinic by the courts. And a good many others, w’ho turn out to be the most responsive to. treatment, come in of tlreir own accord, because theY are creatly concerned by the extent to which irinking interferes with their leading normal lives.

The Three Categories The medical director of the Yale Plan Clinic, Dr. Giorgio Lolli, heads a staft of ten. Besides himself, there are three other doctors (on part time), three social ‘tvorkers, a psychotherapist, a psychologist, and trvo secretaries’ The clinic has no hospital facilities; all patients are ambulatory cases. The clinic admits all applicants for at least a prelirninary interview, but because of its limited facilities and staff, because its function is that of experimental rnodel rather than a full-scale rehabilitation project, it cannot undertake to treat all applicants. For Practical PurPoses, the New Haven Clinic divides applicants on the basis of diagnosis into three categories: l. The sylrlPtomatic drinker, lvhose drinking is incidental to mental illness, severe endocrine disturbance, or epi- Iepsy. Since these patients do trot respond to treatment Ior alcoholism as such, they are referred to Psychiatrists, ‘ plivate physicians, mental-hygiene clinics, or hospitals, where their ur-rderlying illness can be treated. Perhaps l5 per ccnt of the total number of alcoholics are in this group. 2. The social misfit, “derelict” type of alcoholic, rvho is disqualified Ior famiiy life, hasn’t the emotional stability to hold a good job, is aPt to be so physically deteriorated and psychologically disolganized that only long irrstitutional care and social rehabilitation could redeem i-rim. These rnake up l5-20 per cent o[ those seen. For this type, the Yale Plan people would like tr> see custoclial therapeutic institutions established that would utilize all e1eruents of the co-ordinated approach. The clanger in jails and “inebriate farms,” as they have been constituted, is that they don’t make proper diagnoses, that they merely keep derelict alcoholics in custody, finally releasing them r.r,ithout any basic improvement in condition. 3. The true alcoholic, ‘tvith au impulsive drive to drink. People in this group show a variety of patterns in tireir drinking habits. Some go on (Continued on next page)

.I,LCOHOLIS]I even this 11111611 hope t.her are 011 to rr l'{:,{lrlar nreetings et rrhich members rell rather gnod start,” ‘:rf their orrn erpcriences as compulsil’e (Continued fron page 63) The next step in the Yale Plan pro- clrinkeri. and te-tifv to their rec{)l’er\ cedure is a thorough phvsical exrrlina- thri,Lrgh aclherence to the .{.\ plan. g>eliorlical binges. ererv rreek end. or tion to firrcl otrt i[ anv illness is present, Thir plen c.)n\ists of trr’elr’e frrrrlal irrcgtrlarly. Sonre get drunk evert night’ clue or not due 11v ;116rllnl. .\lioholic. ;tc1-,s. rrhirh rtrar ile rc<lrrecl r() ther(. Others are alrrays moderatelv under often shorr “ot’gan-neurogis” * nrplor.nr esientiels: ai the alcohrilic mu’t arlnrit the influence, have a constant concen’ -phvsical complaints l’hich arc :rppar- that lte ir P, rr,. c-r’le.> ovel alcrrh,rl artrl rration of alcohol in the bkrod but do enth’ of psvchological origin. S,rrne ol ieek helrr frrinr ,rut;irlc-: lil he rnu’t 11()t neceiisarilv short obriotts signs of these can be relieved br nre:dical treai- xtta-11]pr ii) llrllvze hi; lrcrs,rnalitr’. ar. rlrtrnkenness. ment. IJenze<lrine and dexedrin can knorr’ledge his t’rongs. make ar:rerrcls help to ol el’come rlepressecl itlr tc;. I l rr’hen p,ri;ible to pc,rple he has harured Handling o! Applicants n’redical labolatorv tests al’e necessar\’, c) he must plrce his depenclence u1>.rn lale Plan doctors do not holcl that ther are trsualll done else’rr’hcre. a hiehcr p()l\’el’. rthit h at fit’;t urar’ lrr, :tll alcoholics necessarilv fall into one -\lthotrgh the Yale Plan Cllinir: has met’clt the .\ \ ,,r’g:rnizetion, ltut ulti. ,rl these arbitrary categories. rrhich are no official corrnection rtith .\l<rrholic: matelv sh,,Lrlcl be (i,rcl ei he under- .\nonlnrotrs. it refers ;ome ol iti lrppli- st:rtrdi rhe ({)n(cpt: cl i hc ntust rr’ork at principalll useful in the hanclling of cants t() the local {roup (){ tirat associa- reheliilitetine other alcoholics, rpplicants, “Our distinction is made on rlre basis of rvhether I\’e think rre can tion, and in turn takes in patients re. r)r can’t help.” Dr, Lolli explains. “Our ferred to it br .\.\, L,rcrl qrotrp’ hotd E ff eet i r e Rphqbilitati ort

lralrdlinq of a patierrt itr’t cotning to -\lc,rholic: .\nr)n\ nloui clainrs a rc. the clinic varies greatlv according to co1’el’\’ tare of {r, ,nt 5(l to 75 per celt I his itate. If he’s itrst corling ottt of a oI t]r,rse tthr sir-e its nrethods a sinr:cre birrge, he mav need help in orercoming trial. rrrd rhe rnujiritr. ot scientific re. the effects of his halrgover. In all cases. searchers asree thar it is the most eflec. rr’e make an immediate attentpt to give tive .inslt. cotrrse r.rf rehabilitation. Dr. relief. Sedatives mav be used rrhen the Holalrl II:t–qat’d attribtrrci the srrrcc.. l)atient is jitten and nen’nus. In the of -\.\ irr l).u’t t() lhe ncerl of the alc’ieerll davs of treatment. rre rnav ld’ h.r]ir lr,r tresunt!tt thrt is unclelitanrl. rniniitet’ crude liver plus \:itanrin B. inq. t,ilelent. prrienr. enci ;erious. \\’hen the phvsical conrlition improves, “I{ri t irrrinetir,Ir\ lll’e u;cle.:. for the ;rnd Yitalrrin Il, catt help bring this alc,rlt,rlic lt:r. cleep rlirhin hin-r thi about, the need for alcohol diminishes, strolrqcrt ltelinc.,rl .duilt and re.pond’ i:ut nothing has been clone to clear up to tl)ellt rrith h, r.tilitr.” Haggard iar’r. the unclerlving conclition. To tackle “Thtr rrr onlv irrlrhrrr py,1i,i sl1x1 1,’ .his. ‘rre ure a varien’ of nteth,rcls. de- one rrnclcr.t:rncls lrinr. \ hirah !n,)r’:ii (r;’sral {ilzing pendirrg on tlte intlilidual. tone. ;-rri:.tchirrg. rltir r. lrinr rrrar. l-ht, “-\t an earlt point the pltielrt is / I I rrle,li,.t thrt itr 2nl+ .{.1).: qilt rl re:llr under)trnrling the rlcrr, ,

thua!h intet-r’ietr’ed l:r’ a st,cial rr’orker O ) r, Jtt,’rr ‘. ir-rP rrr”r. ‘r’- ltr,lir. rr’irrnir!'{ hi. ir,r}ll(lrrtre :rrtrl rr,. \”)rae! tllrl) triilt’l iil!e:. , 1llr,, ,iir’ ith iolne p’vchiatt’ic trainiltg. \\’ith- v,)t”.e rilto irr 10{i i-.,1rr.,.r1′.’; oPcl’:rli,)ll. ir r,[1g11 hc-]d in high derrc. our tntrqr)Dizing the Patient. lr’e lnA\’ evet l- ir,llf )lrilrt’i1r{,If-, bi- ex-ali,,h,,lit: r,’hr, :lct ,ri lxv therapirt. rnake a )tar!’t et getting his case histon’, L Trretrir’-fir’e Irr,rlr.!:ri ,i r”.t:- or grrruil rhtleiri.i. e. in \lcr-rhrilic- ]rii lrerkqr,rtrrrd, [antilt tirrttnt.ttntc.. Itttl \\-ijl l1s q.,11fi111yp;l 1,,1,.j1;,111’r, .-\llol1\ llt, ’11.. l’her lilri e been ihrotr,tlt ‘trnPl,,r’mcnt recol’cl. and r(rltle Pre- 3. -{}l1,r,’ri:r::tt’.lI rirl ;,,,r , {,lr: ,: ihe .xnrc erpt’ritnct rhenrirlvei: tlier linriDlrlr lt(,tC\ ()ll his trotrl.rles rvith irll trrirt’t’ia:.re- rrill Lt, tlre rl,irt-1 i:r t – ktt,,rr’lr’, :,::iin,t,l rrrr.i,’n.,ri dirrrrrr. tlrinking. Ii rre can’t get this infortla- chul t1″1re. in whirh the ,,r’iit !,’i,ru r tc!.ti. r’i.nlniP,ren(e.,it :auilr. tn(l of t’e- 1]15-, lrirtrt:” ,rt’ i: ihe d,’rili]lallt tion at firsi. rve postpone it to rr’eeks r(nUllrlltr. l’hti knDli. :rncl i,rr.4ive. iht: or months laler. llitl.t)itr1′. i -{lrrrrt 2.’i trt,l’ ,’etii ,i ;ti1 incr irrlrlr. ”lilr”: :rlit.r rlrt :Prcr’, rhcr tr ir l’r i x g(,- ir r I *i 1t 1,, ;.- 1! ,1 : r. l 111 1q

t,’ 1r,,ri tlit’ I)riltl’iiu’r.lirr) Ir’1,i,. atc :rlrle i.i uraintlrin their fullr’ unrler’. A Patient. fot o Sinner -1. p,rltgrrtttl’ uill h’, .,’,’ialll rr:,- .t.rrrrlirr’i .rrritrrtlu 1n(l :ln Lrnrl:.,r.,1 1,r,’r’e,1. Le.. t|:ttt lrr I’s;’ ,.p11; ,’i crinficlcnre.” “There are rrsualh’ a lot of clifhcrrltic; the arlult Ilral0 I)’)l)nlirti,,n ‘r’i1l rrhich reqr.rire immecliate ettentiotr- hirre the herrlth, intellia1,11, i,. 1111;| Re/isiorrs Elenrents lirnlil\ trr)ul)1s;. loss of job. lcgal and etrr,rti,,rtirl .trrlrilitt i,, lrritkt il firrnrr iai pt’obleuts. The socitl ‘ttorket’ -ur.,,t,-.,,i lilllgit!n1’U> tr).lrriirg,,. Ilur ‘.rnre problenr drinkels, pftrticurt:rrtr art or1(e to tn’to solre the InoSt But the;,1111.f 1111]i.- rrill h,.’ir: lr111 1fir r.g h’11r ) ilt’€. unabie to accci)! I)r’ciring of these antl relic\.e rlte ten- glr.irt /lelritlr’1. i,,r,.li-,’trrrirll \\’,,- tire reliqi,’tr. elenrt’rtr. ,,I the -\.\ 1>lair. .i,rn ihev cauie in the patient. \\’e im- nretr rlill flL,fe!’ t, irave rt 1,,tt’i pr{)\’e unle\p{rlriive [o it. \\’ith a Snral] l)re\\ uPoll ever’\’ applicant the lact illtettst in the ;trl,eri,’r. Mirlii- tliir!l per'( rnr:rgr ,rl tltt’.c’, th( \’irle Plan Clinir rhat \r’e consicler him a patierlr, not a a t”lrr,le irrtere.t in the rurr-,,i-tlr,r- uses the :tversion thel’xp\ or conditioncrl .inrrcr. It the petit’nt dr)csn’t:ltotr’An t1)ill ./,rt. i T{)d11\’ ielnitli’ l,rer-llt’f’ rellr:x nrethrxl x{ nn initial step, Thi. is heing esertetl 1r, lpq;1lj2g lroh’s- conri.ts ol .4irirre I l)xiirrlt r drink irr ilrmediate p;r’r.hosis or serious neurnsis {rrrr-: bttt our lrlit}r,< rlre -till trD calling for cleep therapr’, even these l’0.i:tirlrt, I crrnrbinrti,rn rritjl a rneclicine rrhich preliminrt’r’ :teps, esteblishins the fact ir. The age,rf p1111’1’j1gp l’iil !n’ prrrdtrcer 11:rrlrea: nltet’ iel’eIal strclr that hc is e patient ancl that sotne reliel l{‘$ered llr ab,rnt fir’e le*r-. T,” tre:itrllent\ ull :t\\,)(iltti, )n ii built u1.r ir in sight, hrre iortte therapetrtic effect. ditr’. tlr,, “i,lr.rrl” ‘ujtt ri rg,’ :rj,’ i- u’hich nrake’ rlcoh,rlic beverager di’, Our approeth is r vc-rv facttral one. \\’e :llr,rrlr fJ f,,l’tr’rrr’,,lt. rl,,”li aa txsteful. -r-t.t” ,’,.,g1lro(1 i\ uieful as ii clon’t prr,mi;e enlthittg. ancl rse tlon’t 2[t i,,r rrrelr., 7 7 nreani ol keeping x pirticnt a’tsar’ {fonr 1\’rnt patient: to PLonrise tts anvtlting. DB, J,\]IES l. llE\lrl ti. liqtr, ‘r for a pc’r’i,rd ,rl ltetki rrr ntonth.. \\-e give thenr evitlence th.rt l’c can rc- DIRE(1’OIl. \.\|’,r(l\-\I r\SfIl l lI- rrhen it nrlr.lre relrc\LC(1. brtt it clr,c’ liere thein oI sottte pain. l-tr p:r’cltolrrgi- f’OB IIt-lt-\f- liL’I–\’rI()]-S not clear up Ihe baiic rnal:rdjustr)’ren r .

cal or medic;rl nreans, anrl rr’hen ther gei It ii this l;asic rnele<ljuitment. a hichlr

iil SC.I[\C]E II-I-T’STR \TED

‘ indiridual matter in each case, rvhich the Yale group attempts to cope rrith as soon as possible through a variety of psvchotherapeutic approaches. After the cliagnortic stricll has been carried out. the staft il’ies to lit tlie tirerapist to the individual. If he clr’resn’t click rr’ith L)ne person, he is shifted to another. for a faloralrle reacti(,n to the therapist’s personalitv i) c()rlsidere.l highlv irrportallt ir1 holiling the patient’s faith in a coul’r€ (rf il’eatlnent. -\ social rror.ker’ mar i-ie eble to cL’al rrith some of the mo)t tr()ut)iei.,lne ])haies of the tase: a rloctor ryill be nerded lol othels-cli{ficultier ir-r the ie’xrral rPirele. for exaurple, The lav tlter:rpist. \Ir. Ravmotrtl G. llcClarthr’, L’\e( uti\ e clilector of the Iale Plan Clinic. tlkei oll patients rvho seem likelv iar 1’c’rp()nd rt’ell to a series o[ tlaill inlerlierr’r orer ;r period of ihree rnonths, tht’c,trgh r,-hich the patient clevelops insigirt into his problen and is le-educated into a satisfectorv pattern of living rlhicl:. erchr(les the use o[ alcohol. E.tact F igures L’nknorcn So Iar -i,:,me 1.0()0 patients have been seeo b)’ tlte nri, l’ale’ Plen clinics at Nerr Haven rnc[ Hertforcl. This figure inrlttdes svmprrmatic cirinket’s rrho have i;,een re{erreci elselliere. rncl tlrose l-ho hare kept llc) lnofe th:ttr otre airpointrulent. –\lxrlil l()0 r,f thenr rrere referrecl to the clinic: l;r tire courts. airrl o[ these, n{.)i l]lc]l’e tirlu ten Per cetlt came back i’or lrrlther intervierr’;. The Yale gr’oup :rre l’eluctxllt to give fi.rules releting to sriccels, Thel prefel ro telk of the “percentage in rr’irich rlie cirinking pattern Irrs beetr faloral-lh effected.” “Of th,:rse rr’ho have kept corning after rhe seconri ;rnd rhircl monrh.” sals Dr. l-olli. “al.ror-tt ;t) pel’ cent have been far orablv irffectecl, 1\-e cau’t evell guess htru’ rlanf irave staved entil’eh, off liquor. \\re hrcl rine parienr rrho rrent foL lu urtinths rrithout a drink, then l’ent ,rn a bin3,^e, end ceme back. \\’as he a lrilure.: No. His clr-inkins pattern had Ireen lavorablv alTecrccl. He had leaured tluring those 18 lnonrhs that he got rtlrlre enjovlllent out of life rrith0ut drinking than ir’ith it. \\’e can’t consicler ihat c,ne rekpse nekes a patient a f:rilure,” The Tinte l{‘ill Come “\\.e d6n’i har.e all the anst\.ers vet, b1’ anv nletlt!,” Lolii surns u1t. “But rre do feel that tie ele demonstrating that the ipecializeti clinic for aicoholics is the nrost effectile rrev ol lneetilrg the plobleni..\ncl rire lteit approaclt is a ri)tubine(i,.,tre-meclical, pst’ch,ILrgical, rt:li61ioui. rr,cial. The tirne l.ill conre 1

rr’hen the phr”iological bases o[ ak:oltol- i

irnl \i’ill l-re founcl, Then rre rvill l;e able i,) ptrr ;l ,,n Ptctli.l.r,r,irrg corrrli. -fitiget tioni, Perh:rP\ (()l’l’C-ct tlrenr rrrrrlitallv or., .tt least cr,rrrirrre pc,,Plc rrirh tlrc.e c,,rr- I

.liciorts thrt :rlc,ih,.rl is poisrrn for them.” I