(A message I sent family on 26 April 2006.)
Disease, or sin?
To the best of my knowledge, the “disease theory of alcoholism” began with Dr. Robert Silkworth, at the time of St. Thomas Hospital in Akron, Ohio, coincident with the beginnings of A.A. “Dr. Bob” referred to the condition as an “allergy”; for whatever reason, these folks’ bodies respond to this substance differently than others’ do.
This theory and its ramifications are, today, largely taken for granted throughout the scientific world. Whatever the disease’s cause, behavioral strategies are needed, too, if the subject is to manage the disease and live a normal life. The same is just as true of diabetes or near-sightedness or hay fever.
The competing view, that drinking problems reflect sin or some kind of moral deficiency, still has its grip on the popular mind. The predicaments that problem drinkers create for themselves and for others, are bad enough in and of themselves without the added burden of this stigma. My late father insisted until his last lucid day, that it was all a question of “will power.” I remember visiting Mom at home sometime prior to 1990, and finding on the bookshelf different books by Hazen G. Werner, an Ohio Methodist bishop whom my father fervently admired, and finding certain passages that my father had marked wherein the author discounted the disease theory and blamed it all instead on, as it were, sin. I shook my head at the untold, needless damage such words do.
I now believe my father’s terms were correct, but his definitions of them were wrong. I now believe that alcoholism reflects a disease of the will — the will being the faculty that chooses what one wants, chooses what one feels. On the one hand, for 98% of people 98% of the time, this faculty is “asleep,” or completely subconscious; people have no awareness that it even exists; and so those interventions wherein it “wakes up” and acts, are experienced has having been done by a “Higher Power.” On the other hand, there are interrelations and connections between spirit and flesh, between what one may desire and the tools one has on hand, that remain a complete mystery.
Different forms of the disease
… have been identified, and different “classes” of stories one hears in A.A. have been substantiated in the laboratory. It’s a question of different genes that may be at work in different people, all with the same effect that these folks’ bodies don’t metabolize ethanol the same way those folks’ do.
For starters, for example, some folks drink “to get in” and others “to get out.” Some folks are problem drinkers from the moment they first ingest any ethanol at all (Birth? Age 4? Age 12?); others, like me, have no problem with the stuff at all until an abrupt change occurs, typically in middle age.
One gene has been identified that has different effects in men and women. In men, this gene results in continuous, chronic discomfort from which ethanol provides the only known relief. These are the guys who tell stories like this:
I was 14 years old, and a couple buddies and me had got this fifth of whisky, so we went out behind the barn to check it out. None of us had ever tasted any liquor before, ever. Bill took a swig and coughed real hard, and shook his head and gave Frank the bottle. Frank took a swig and coughed real hard, and shook his head and gave me the bottle. I drank the whole thing down as if it were iced tea. I didn’t cough at all. And for the first time in my life, I felt like a whole person.
When the same gene appears in women, the result is hypochondria. The same chronic discomfort is present; but ethanol provides no relief.
It’s well known that alcoholism is a progressive disease: it gets worse over time. Less well known is that the disease itself continues to get worse regardless of whether one’s drinking or not.
It had been known for decades that a problem drinker who attains sobriety and then, perhaps years later, resumes drinking; will quickly to decay to the same point as if the person had never quit drinking at all.
The “organic” or biological basis for this was discovered circa 1990. There are certain structures, I suppose everyone has them, on the “brain stem,” which over time, in persons who possess the alcoholic genes, grow; they become “nodules,” and continue to grow throughout life. These appear to control the dysfunctional metabolism of ethanol, such that as they grow, so also grows the amount of ethanol one must consume to obtain a given effect; also the degree of impairment to the will; etc., etc.
Time travel. Another puzzling feature of the disease is that the “active” problem drinker is fundamentally a different person, somehow, from the same person in sobriety. At such time as the disease process becomes “active” — say, as happened with one of my students, at age 14 in 1982 — all development of the sober personality comes to a halt, and does not resume until sobriety is restored. If, for example, the student in question attained this in 1998, then he would have found himself a 14-year-old personality in a 30-year old body, and seeing the 1998 world through 1982 eyes. I’ve heard stories of how these guys seek to live on fast-forward until they catch up — progressing through 18-year-old impulses and interests, 24-year-old impulses, and so on.
It happened to me
As happens with some forms of the disease, I was a “normal” drinker all my adult life until, quite abruptly, sometime in 1993, something changed. My alcohol intake skyrocketed, and other symptoms of the disease began to appear.
Dehydration. The first change that I managed to actually notice, was that enigmatically, drinking made me thirsty. Well, immediately, the easiest response to that is to drink more. Of the same stuff, that is. The fastest way for me to sober up, on any given occasion, was to merely switch from drinking beer or whatever, to drinking water. THIS WAS NEW.
Drying out. I drank pretty steadily from 1993 to 1995. Once I began attending A.A., it was still six months before I quit drinking completely. In other words, I was still drinking at that time.
H.A.L.T. A.A. equips a person with many, many tools to help obtain and maintain sobriety. I mention now just one. They have a slogan, “H.A.L.T.: don’t let yourself become hungry, angry, lonely or tired.” Any one of those conditions can produce an impulse to drink; if the condition presents, fix it. Hungry? Eat. Angry? Deal with it. Lonely? Go find some people. Tired? Take a nap. Fix it.
In those days when I was first seeking to stop drinking, I found it necessary to take a snack to work with me every day, and eat the snack just before day’s end. For if I was hungry on the commute home, I discovered, I would not get off the bus and go straight home. Instead, I would swing past the liquor store en route. The daily snack at quitting time, fixed that.
Today. Since 1995, I have had several occasions of heavy drinking, that might last up to six months at a time. As I write this now, an impulse to get drunk is rare for me, and is usually easily overcome by recalling that drinking was, for me, a complete waste of money and of time (I typically drank at home at night, when I could have been doing housework or working on hobbies. But you can’t get anything done, really, while you’re blitzed or passed out.) In contrast to many people, however, complete abstinence is not a feature of “my program.” I still let myself get s*it-faced two or three times a year, specifically and only at family or church holiday parties. That’s it.
Common sense is useless. The turmoil that the disease of alcoholism inflicts upon a family is such that loved ones will wind up wanting to try anything, including prayer. There are ways to go about it — actually, a great deal is known and much research has been done on just this subject — but they prove to be beyond the scope of this writing. “First Things First,” another A.A. slogan: the processes that work are not at all what one might think from common sense. On the contrary, on this point, as on so many other points in dealing with this disease, common sense is useless.
Al-Anon is an organization designed for alcoholics’ loved ones,
and is the only place I know of that teaches what does work.
It’s available worldwide, 24/7, no farther from you than a phone call or mouse click.
The First Thing a loved one needs to do, to deal with the disease, is to
start attending Al-Anon meetings and learning what does work.
I do believe Jesus taught on these techniques and issues. I do believe he ministered daily to addicts and others. The Twelve themselves, however, and those for whom the Christian Scriptures were written, did not personally have these issues, and so for the most part those teachings have been lost. For the most part. Crucial vestiges of them have been preserved in the Synoptic Gospels. The best place to learn about them is from within the Twelve Steps movement, beginning by attending A.A. or Al-Anon.
(Originally posted 11/30/13.)
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