ALCOHOLICS ARE JUST LIKE YOU AND ME EXCEPT THAT THEY’VE DISCOVERED ALCOHOL

By Philip Marchand

There is no health in us, according to the teenagers who get drunk has doubled over the Book of Common Prayer. That reference is, of past twenty years. course, to the spiritual corruption of fallen Encouraging male teenagers, at least, is humanity, but it might as well be to North the persistent macho image around drinking. If American society in the late twentieth century, a the thought of a man’s drinking heavily were society overwhelmingly addicted to drugs of disgusting, Dean Martin would never come on various descriptions. A curious situation, as a lush. But the thought is not disgusting. A certainly. In this society, few members have any “hard drinking” man is still a slightly romantic reason to fear the traditional scourges of figure, usually, “hard living” and “two fisted” as humanity – famine, plague, the devastation of well. (Although, curiously enough, belligerent war, even backbreaking physical labor. The drunks are usually timid and rather submissive citizens do not live under any blatant tyranny or when sober.) Women have no such terror. There is no obvious reason why most of encouragements, since a hard-drinking woman them should feel deeply unhappy. But it is true has never been a charming figure in popular nonetheless, that the people in this society who mythology – she’s either sad and lonely or feel vigorous and free, who do not flee regularly somebody like a rich heiress in a Palm Beach from the grim business of life into some opiate – mansion with a voice like Lauren Bacall’s. (This drugs or television or gluttonous consumption of does not prevent women from drinking, of food – are a minority. One of the most common course, but it may inhibit them from seeking of these opiates, and socially, the most treatment – it is only in the past year or so, for dangerous of them all, is alcohol. Nothing example, that woman have been joining indicates the depths of unhappiness in the Alcoholics Anonymous in numbers nearly equal society more than the fact that the alcoholism to men.) within it is becoming more widespread every Alcoholism may be our largest drug year. problem, then, not only because it is the most In 1963 there were about 237,000 total readily available drug in our society, but alcoholics in Canada. Ten years later, there because our culture seems to have an were about 525,000. That means that in 1963 ambivalent attitude towards alcoholism. for every 100,000 Canadians over the age of Drunkards are disgusting, but on the other hand twenty there were 2,190 alcoholics; in 1973 boys will be boys – if you’re an Irishmen and a there were 3,850. Alcoholics, specifically male poet, for example, it’s almost obligatory to be a alcoholics – may be defined as those who boisterous and winning drunk. In some special consume more than fifteen centiliters of absolute grows I like the Canadian Armed Forces, or alcohol every day, which means about fourteen teenagers in northern mining towns, heavy ounces of whisky, thirty-two ounces of wine, or drinking is so much a part of expected behaviour nine bottles of beer. Another index, the sale of that an abstemious drinker, not to mention a alcoholic beverages, is equally discomforting. teetotaler, runs the risk of being an outcast. The total annual volume sold in Canada Even when drinking is not openly increased, of course, is accounted for by our encouraged, it is still fatally easy, in all social growing number of youthful drinkers. In the groups, for a man or woman to become an United States the Director of the National alcoholic without ever becoming noticed as a Institute on Alcohol Abuse and alcoholism has person with a problem. The alcoholic, unlike the informed us that the number of American junkie or the speed freak, can indulge his vice in the best social situations and still fit in like the

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priest at the Communion breakfast. These absolute alcohol on his pocket calculator, people are often the “functioning alcoholics” – starting at lunchtime, he might indeed come up Men and women whose daily consumption of with an alarming figure, but who bothers to alcohol is well above those fifteen centiliters, but count? The important thing, really, is that he’s who still have their families, their high-salaried steady on his toes -he’ll start to worry about his jobs, their position in society. They don’t fall into drinking when he slobbers on the hostess and alcoholic stupors, they never even become walks around with a lampshade on his head at involved in loud alcoholic scenes. They’re not parties. drunkards – most people, including themselves, The warning signs are by now well would never think of them even for a moment as known, but they are easily ignored by people like alcoholics. this lawyer. He usually has powerful Sooner or later, however, they run into rationalizations on hand to quiet the doubts. If he problems. A successful thirtyish lawyer, say, gets really jittery he can go on the wagon for a wakes up in the middle of the night in a state of couple of weeks and absolutely, definitely, prove approaching panic. He goes downstairs, notes to himself that he has no problem with liquor. the car parked in the garage, the children (Ignoring the fact that during these two or three sleeping in their rooms, the lights off in the weeks he is always mindful of the reward in kitchen and the living room. Only one thing store for him when he hops off the wagon keeps troubling him; he cannot remember going ignoring, too, the tranquilizers he turns to now to bed. He remembers the party he attended, and then to help him over the dry spell.) Usually but he doesn’t remember driving home in his such people continue for years before they start car, coming into the house, taking off his descending the long alcoholic slide into more clothes, and climbing into bed. He has suffered serious drinking –when their work definitely does a “black-out”, a mild case of amnesia. suffer and their family starts to fall apart from the As time goes on, he notices he suffers general unhappiness solidifying into outright more and more of these blackouts. He knows misery. It’s a melodrama too familiar, by now, to that it is a warning sign that he is drinking too recount in detail. much, that he may, in fact, be an “alcoholic.” But But it is still a North American he can always brush this thought aside. An melodrama that increasing numbers of people alcoholic is a woman who spends all day in bed regularly play out. The cost to society is with a bottle, who has spare mickeys of gin staggering. (A billion dollars a year to the hidden in the breadbox. Alcoholics are men like Canadian people, according to the LeDain the character Jimmy Cagney played in some Commission of Inquiry into the Non-Medical Use movie from the 1940’s, sweating and writhing on of Drugs.) Nobody is sure how to ease this cost. the floor from a bad case of delirium tremens. And the suspicion keeps arising in people who Alcoholics are not like him, a responsible person have to deal with the problem that the epidemic who plays bridge, goes to the Caribbean on skin of alcoholism, frightening though it is, may be diving holidays, and never gets drunk. just the most noticeable and dangerous form of Of course he would have to admit that by addiction in a society of many widespread the time eleven A.M. rolls around he becomes a addictions. In the end, all addictions – whatever little restless in his office, waiting for lunchtime their source – may be alike. and a few officially sanctioned martinis. And in This point will become more important in mid-afternoon he usually rewards himself for a future considerations of alcoholism. If it hard day – or consoles himself for a rotten one – generally accepted, the social view of alcoholism with a few drinks from the built-in bar in his will doubtless be revised – revised a second office, and then goes home and has a drink or time. The first great revision occurred sometime two before dinner, and then, while he’s getting in the 1930’s with the establishment of dressed for a party, he has another one, and of Alcoholics Anonymous. A.A. was heavily course at the party knocks back a few, and responsible for spreading the notion that coming home afterwards treats himself to a stiff alcoholism was an illness, and that drunkards nightcap. If he counted up all those centiliters of were not primarily moral failures who

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succumbed to the bottle through lack of important implication being challenged is that willpower but sufferers from a mysterious but there is something in the nature of alcohol itself very real disease, perhaps an “allergy” to booze the “subtle ease.” as A.A. writers call it – that or a metabolic imbalance or a chemical causes addiction. If this idea is false, reasons deficiency of some kind in the body. This was an those who question it, the possibility arises that entirely commendable achievement on A.A.’s alcoholism may have the same roots as the part. In effect, it immediately raised the status of behavior of a person who deals with life by alcoholics, at least in respectable circles. But the “TVing it,” getting glued to his set for forty hours A.A. view also raised a few questions. There is a week -or, for that matter, a person who goes still no way you can predict whether a child will on eating binges. have trouble with alcohol from a biochemical The people who are leading the attack examination of his or her body. And, practically on these very beliefs, and thereby intending to speaking, A.A. itself treats alcoholism more as a revise accepted notions of alcoholism, are those spiritual dilemma than a disease. (The key Trojans of the rat labyrinths, the behavioral notion of A.A. is that the first step towards psychologists. In a way it is inevitable that they recovery for any alcoholic lies in his admitting would stake out pieces of turf traditionally that he is powerless over alcohol, and that only associated with groups like A.A. The Alcoholics a reliance on a Higher Power – sometimes Anonymous approach – heartfelt, exhortatory, referred to as a Power greater than ourselves – spiritual-was bound, sooner or later, to clash can restore sanity to his life.) with the clinical, empirical human-engineering There were certain consequences of this approach of the psychologists. Nobody denies view. One of the consequences was that alcohol that A.A. has been the most effective group by itself became kind of personification of evil for far in dealing with alcoholics, and its unlikely that the alcoholic – a force in itself that has taken any government or private program in the hold of the sufferer’s life like a plague bacillus foreseeable future will help alcoholics give up and will not let go. As a writer in the Big Book, a their dependence on alcohol to the extent that kind of operating manual for A.A. says; A.A. has done. But ours may be a time when the “Remember that we deal with alcohol -cunning, most significant contributions to understanding baffling, powerful.” Other consequences are an alcoholism will come from other than A.A. insistence that an alcoholic can never take To the clinical psychologists alcoholism another drink as long as he lives (the fatal-glass- is not a medical problem but a learned behavior. of-beer syndrome) and the general feeling that “The way most psychologists would view many alcoholics cannot free themselves from excessive alcohol consumption,” says Howard this disease – this enticing, relentless disease Capell, a psychologist at the Addiction Research until they hit “rock bottom.” Foundation of Ontario, “is that, for whatever Today most theorists of alcoholism don’t reason, it’s something that’s learned, just the even bother to debate the question of whether way a lot of other things are learned, and that in alcoholism is a disease; when not even medical some sense it’s an adaptive response. A lot of doctors seem able to come up with an people thing that what it’s adaptive to is acceptable definition of “disease.” It hardly conditions of stress, and that what alcoholics are seems a fruitful topic for debate. That some of really doing is medicating themselves for the implications that have been widespread anxiety.” This in spite of the fact that it has been because of the general selling of alcoholism as a clinically demonstrated that large quantities of disease are now being challenged-the alcohol actually make a person less able to implications, chiefly, that a return to controlled handle tension, stress or anxiety. (But of course, drinking is always impossible for a true the first few drinks always do seem to lighten a “alcoholic,” and that a man cannot free himself man’s load – the only problem being that a man from the “disease” of alcoholism until the abyss who depends heavily on alcohol for this purpose beckons and he realizes that spiritual means are never knows when to stop.) the only means left to fight it. Perhaps the most In this view, alcohol is a kind of problem solving technique that is too easily and too

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accessible – despite its disastrous conseq- awareness of different choices, on that same uences – for the person to give up, once he has nervous system. Alcohol itself is not the learned to depend on it. Dr. Martha Sanchez- problem. It could just as well be Valium the Craig, who formerly directed a residence for alcoholic loved, if that alcoholic had grown up in alcoholics in Toronto for the Addiction Research a culture where there were two or three Valium Foundation speaks passionately for this view bars on every city block. Alcoholics, or “problem and its efficacy in treating alcoholics. It is a view drinkers,” once they are taught new responses that does, in its own way, invest the alcoholic to the painful stimuli that drove them to drink, with a certain amount of dignity. “Look,” she could conceivably even learn to drink points out, to say “you have a problems is very moderately again. different from saying You are sick.” To say, This suggestion infuriates many workers “everybody has problems, but you, in the field of alcoholism who feel that one of the unfortunately, have discovered alcohol.” “You greatest enemies of the recovering alcoholic is would feel more comfortable in knowing that you the delusion he often cherishes that one day he and I are not different. You have problems, I will be able to drink again – drink again and have problems, everybody has problems. But handle liquor like a gentleman. For alcoholics you have discovered alcohol.” one drink will always be too many and a million Dr. Sanchez-Craig tried a simple not enough. But sometimes the issue of just who experiment to shed some further light on the is, and who is not, an alcoholic becomes almost uses of this problem solving technique. “I sat metaphysical in its elusiveness and remoteness with numerous people and asked them to from specific, concrete touchstones. A.A. for describe in very specific terms the last time they example, insists that any “alcoholic” who drank in excess. This had to be in specific terms subsequently learns to drink moderately and –I held them to that. Second, I asked them how never goes on a binge for the test of his life was they felt about the event. How did they interpret not a true alcoholic in the first place – a it? How did they come to a decision to drink? formulation that obviously begs the whole How did they rationalize it? How did they feel the question. alcohol was going to function? Ninety-five per Part of the problem is that most cent of the respondents, according to Dr, alcoholics do not seek any form of treatment Sanchez-Craig, were reacting to what she until they are in their forties, in which case termed, using the odour-free language of the they’ve usually had about twenty hard-drinking social sciences, an “aversive” social situation – years behind them. If you have been drinking where the boss picked on them, or their lover heavily for that long, your brainstem is prettywalked out them. “They were feeling depressed, well shell-shocked anyway, and obviously not lonely, anxious – the negative feelings. The capable of resisting the lure of those first few thinking was rigid and catastrophic. They would drops of Alcohol. The critical question revolves think. This woman has rejected me. Therefore around young people in their twenties who are no one will ever love me. I will be alone for the clearly on the road to alcoholism. Dr. Gordon rest of my life.” Bell, president of the Donwood Institute in That people will turn to booze when they Toronto, a hospital that treats mostly alcoholic feel hit hard by life, or when they succumb to patients, concedes that “many of the patients what the A.A. folks term “stinking thinking” –the we’ve had, had they been fortunate enough to low, sweet descent into despair and self-pity – is come to us much earlier, would have had hardly news and yet if alcoholic behavior can be another alternative besides total abstinence. “If a traced back, as Dr. Sanchez-Craig and other program of teaching controlled drinking were psychologists feel it can, to this kind of habitual ever launched successfully, it would have a response, gradually imprinting itself on the great deal more impact on this group of budding nervous system of an alcoholic –the response of young alcoholics than programs that had total seeking relief from painful situations in the abstinence as their only aim. soothing touch of alcohol – then it may be Dr. Sanchez-Craig, who is very much possible to imprint new responses, new interested in such a program of controlled

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drinking, insists that people who enrolled in it booth before he can take a drink, things like that; would have to meet very definite criteria – they a few “behavioral interventions” imposed upon would have to be young, intelligent, in good him. Enough behavioral intervention and you’ve health, strongly motivated to overcome these probably got the problem licked, supposing the drinking problems, and strongly attached to subject is not too far gone at the start of the things like jobs or families they knew they stood project. to lose from chronic heavy drinking. No one who Of course this means that you’ve got to has been abstinent for any length of time, even have many allies, agents so to speak, in your somebody who was under thirty, would be struggle to tinker with the environment of the submitted into the program. individual alcoholic. Dr. Capell sums up the The concept of controlled drinking for perspective of the behavioral therapist in this “problem drinkers” is one fruit of the approach to way; “When you start to talk about effective alcoholism that treats it as a learned response individual interventions you’re probably going to rather than a disease. Another fruit is the end up having to think of ways to intervene that concept of “constructive coercion” wherein involve more than just interaction between a alcoholics are confronted by their employers or patient and a therapist. Rather we’ll have to their spouses or someone else, who threatens recruit the environment. It’s probably the case, them with severe consequences if they don’t as with most things, that effective treatment will enter treatment for their alcoholism. According to involve more than one approach to the same this concept, you don’t have to wait for the individual but my basis is that behavioral alcoholic to recognize one morning, through the interventions of the type that experimentally mist of his pain, the awful unmistakable image of oriented psychologists advocate look like the his utter helplessness. This coercion implies, in way to go. They look like it to me because a way, that alcoholism is no big deal. It is based people have actually been able to demonstrate on the premise that people, unless their nervous their effectiveness, at least in the laboratory. The systems are completely warped, will respond the argument against that is, well, the laboratory way you want them to when you make it isn’t the real world. My counter argument to that absolutely clear to them what they have to do is, do you have something better? I mean, at and what will happen to them if they don’t do it. least, they’ve been able, in some cases, to show Clinical psychologists tend to feel that if you that if you’re clever enough to figure out for an could just apply constructive coercion to the individual how you can actually work on a alcoholic on a daily basis you would have the person’s environment to help them cope with means once and for all to reduce or eliminate his their drinking, it can have an effect. drinking problems. Arrange it so that the spouse has to spend fifteen minutes in an isolation

Source: Saturday Night, June 1978

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