The Broken Self: Stumbling into alcoholism

ISBN-13: 9781502458452 / Angielski / Miękka / 2014 / 320 str.

Kurt David Nielsen Psyd

Opis

Alcoholism is a medical disease. Inherent in this definition, alcoholism is an illness that develops from chronic exposure to the chemical, ethanol. As such, it is an earned disease. Individuals are not born alcoholic, though certain risk factors, including heredity, environment, and personality traits, are all strong contributors to the likelihood of developing an alcohol use disorder. Yet, without the physical act of drinking alcohol with sufficient frequency and quantity, a person who may have a substantial number of those risk factors will never develop the disorder. Once the cycle of addiction has begun, it becomes progressively difficult to treat. Even for individuals who manage to maintain prolonged abstinence, the potential for relapse remains exceedingly high. However, as was stated earlier, the brain is astoundingly resilient and for many individuals with sufficient sobriety, the disease of alcoholism abates. This suggests that alcoholism is, in fact, a treatable condition. Yet, with such abysmal recovery rates, it remains a baffling disorder and, as is the wont of human reasoning, someone or something has to be to blame. In the current state of affairs, this blame resoundingly rests upon the shoulders of the alcoholic. And, because acquiring the illness is a direct result of the actions of the ill, does not this deductive logic hold true? The answer is simply, yes and no. Many, including professionals within the field, remain obstinate that the alcoholic is responsible for his or her undoing; and, more significantly, choice is the only necessary medicine that this individual need take to recover. Given the arguments presented in this paper, it is clear that alcoholism, as a diseased state, is less a matter of free will, and more a matter of basic survival instinct. As such, it has to be understood that what lies beneath conscious choice is a primordial network of subconscious processes; which, unfortunate but true, takes much of the wind out of the sail of free will. This "free will," at best, is only contingently free. This is ever more so in the case of the "hijacked" brain of the addict. To tell the alcoholic to just stop drinking parallels telling the type II diabetic to quit being so stubbornly resistant to insulin. It makes no more sense in the former as it does in the latter. And this is the first axiom that needs to be acknowledged (and accepted) in the efforts to reform a more realistic approach to the disease of alcoholism. Only in an accurate understanding of the problem will an effective solution be found. In this state of active addiction, choice is severely impaired. While this detail is by no means lost to current theory, the practical application in treatment approaches remains limited. This applies to social, legislative, and professional efforts alike. Separating the diseased from the disease is but the first step in the reconstruction process. Isolating this specific aspect of the syndrome will serve to better inform future research, policy, and interventions. Such focused efforts may begin to add some contrast to Vaillant's portrayal of alcoholism as a condition best understood in terms of grey. Pragmatically, however, the solution to the problem still necessitates stopping the drinking behavior. Undoubtedly, future efforts leading to a better understanding of the disease process itself holds much promise much in this regard; though, even at present, and by various means, many alcoholics do successfully stop drinking. Unfortunately, many of these individuals also begin drinking again. This introduces a second salient aspect of the syndrome, and one equally shrouded in a cloak of grey. Relapse remains a significant obstacle for the recovering individual and an ongoing impasse in the treatment process. No sooner is a patient, who is returned to their senses after some degree of sustained abstinence, back to the same debilitating cycle of behavior. How might this be