“You got no chance, but use it” – Werner Herzog, movie title

Alcoholism is a progressive and fatal disease. Alcoholics Anonymous calls it a “seemingly hopeless state of mind and body”. However, it is treatable – and that is the good news. These days we don’t differentiate much between addictions to various substances (liquid, powder, pill, il/legal, OTC/prescription). It is a chronic condition, which requires ongoing treatment. It is also a disease of perceptual distortion and commitment to oblivion, which is tricky when one “is driven by one hundred forms of fear, self-delusion, self-seeking, and self-pity” (AA big book pp 62).

At the time an alcoholic seeks treatment, she is usually flooded with hopelessness and self-loathing. Treatment is about reinstituting hope and a practicable long-term solution that seems acceptable. Since most addicts are dealing with issues stemming from ACE (=Adverse Childhood Experiences), PTSD (= Post-Traumatic Stress Disorder), and/or chemical imbalance (i.e. mood disorders), it is highly recommended to provide residential treatment (for the first 30 – 90 days), psychotherapy (to address underlying issues – intra-psychic and relational), and a 12-step program (AA, NA, SLAA, Al-Anon - which utilize a formula for psychic change).

The renowned psychiatrist Dr. Harry M. Tiebout suggests that ongoing recovery requires surrender to this new way (which traditionally follows admission of defeat). He contrasts surrender with compliance, which would not be sufficient. If an alcoholic can understand that only complete abstinence will recover mental health and with that the chance for a good life, she may be willing to endure the confusion and suffering, while her brain undergoes a transformative phase.

Working with alcoholics can be heartbreaking, too, as some of them change their minds halfway through the dire straights of early recovery and re-commit to denial. It has been said that relapse is part of recovery. That’s not necessarily true – although that’s the reason why prognosis for recovery may be questionable. The crucial factor is the so-called willingness to replace the death-defying surrender to the powers of destruction with the courage to engage in life. What matters is that she can recover if that’s what she wants. That is what makes all the difference.

Working in recovery is all about service. We offer our experience, strength, and hope, meet the patient where she is at on her path, rather than where we may think she ought to be. It’s not our job to fix her. We encourage her to embrace healing and growth. We support her in moving forward. We offer unconditional love, compassion, and… much patience.

“If a man doesn’t want to hear, no one can tell him” – quote, unknown author