“You got no chance, but use it” – Werner Herzog, movie title
The good news first - it is treatable (but really… alcoholism is a progressive and fatal disease). Alcoholics Anonymous calls it a “seemingly hopeless state of mind and body”. These days we don’t differentiate much between addictions to various substances – liquid, pill, or powder, legal or not, OTC or prescription. It doesn’t matter. It resides within - 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, he is most probably flooded with hopeless self-loathing. Treatment will be about reinstituting hope and a practicable long-term solution. Since most addicts are dealing with trauma and emotional vulnerabilities it is highly recommended to provide a structured and long-term supportive treatment program. It’s good to have a formula for psychic change and a safety net for fluctuating moods in early recovery.
Psychiatrist Dr. Harry M. Tiebout suggests in his famous paper (1953) that successful recovery requires surrender (which traditionally follows admission of defeat). He contrasts surrender with compliance, which would not suffice. If an alcoholic can understand that only complete abstinence will recover mental health and with that the chance for a good life, he may be willing to endure the confusion and suffering, while his brain undergoes a transformative process.
Working in recovery is all about service. We offer our experience, strength, and hope. We meet the addict where he is at on his path, rather than where we may think he ought to be. It’s not our job to fix him. We encourage him to embrace healing and growth, while taking responsibility for his actions. We offer unconditional love, compassion, support and much patience, while he struggles with mental ambivalence, disturbing thought process, and overwhelming emotional intensity during the early part of the journey.
Working with alcoholics can be heartbreaking, too, as some of them may unpredictably go back into denial. They change their minds halfway through the dire straights of life, dropping out when reality hits with the wreckage of the past. It has been said that relapse is part of recovery. That’s not necessarily true – although that’s the reason why prognosis for recovery can be questionable. The crucial factor is willingness to replace the death-defying commitment to the powers of destruction with the courageous surrender to life. What matters is that there is a solution - but it’s on him to hold on.
Addiction is the only disease where recovery rests entirely with the patient’s continuing self-diagnosis and surrender to the process. This commitment provides a fantastic prognosis as long as he stays with it “one day at a time.” Compared to living in the disease it’s not even difficult at all. But…“If a man doesn’t want to hear, no one can tell him.”