I was recently contacted by a reader of my website with the following:
“I am not sure if I understand your statement correctly? Are you saying that you can overcome alcoholism permanently?”
I began my reply with, “Yes, (name). Tens of thousands have. However, overcoming alcoholism permanently takes work, the work of reinventing yourself. It’s not a quick fix …”
In the DSM-IV alcohol dependence (alcoholism) is defined by one or more of the following conditions being present: craving alcohol, developing a high tolerance for alcohol, a loss of control when offered a drink or once drinking, or physical dependence. (If someone is physically dependent there may be major withdrawal symptoms like shaking and nausea, as well as psychological symptoms like panic and anxiety.)
The term alcoholism is broadly conceived to include problem drinking, which is defined by its effects. If a pattern of drinking leads to health, employment, education, legal, parenting or marital problems, it is problem drinking.
Only a small proportion of problem drinkers, however, become alcohol dependent.
A man might drink excessively to medicate his grief over a marriage failure, but never progress to becoming an alcoholic. His friends and family might see him as an alcoholic for a while, but then two or three years later he’s back to his old light-social-drinking self. He had recognized the negative effects of his drinking and done something about it.
The process began with his recognizing and acknowledging his drinking was becoming a problem. He undoubtedly reflected on his life, and then took steps to reinvent himself so he could have the life he wanted. He may or may not have sought professional help along the way. In the process of self-reflection and action, other changes undoubtedly rippled through his life. He may have remarried, changed jobs, moved or gone back to school. Some friends disappeared and others reconnected.
The broad process of permanent change is much the same for the full-blown alcoholic as for any problem drinker, and it begins with self-acknowledgment of the problem.
However, there are complications. If the alcoholic has not already stopped drinking, the withdrawal should be attempted only with medical supervision. (Severe alcoholics have died during withdrawal.) Long-term alcohol abuse has undoubtedly damaged/altered his brain. The cravings won’t disappear just by choice, and there may be lapses due to loss of control with certain triggers.
Fortunately, the brain is plastic, and with appropriate therapy, it can heal itself. This part of the healing process is the post-acute withdrawal phase, commonly known as the “dry drunk” phase.
If alcohol has been used to medicate physical or psychological pain, it is likely the brain changes have lowered his tolerance for pain. Over time the brain can recover from this too, but in the midst of healing the cure might often seem worse than the poison.
For the recovering alcoholic to stay focused on re-creating his life, to face and clear the ghosts of past trauma, and to deal with the wave of changes that usually accompany recovery may we’ll require skilled professional help.
The bottom line is, however, alcoholism can be overcome permanently.
But not all alcoholics dare to believe it and are willing or able to make the emotional, social, intellectual and financial commitments necessary to achieve it.
You can reach Registered Psychologist Dr. Neill Neill at 250-752-8684 or through his website www.neillneill.com/contact
