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I have battled alcoholism for many years as well. I have been through two rehabs and hundreds of AA meetings. Hpwever, I found it more helpful to view addiction as a lifestyle choice than as a disease. Once I could own up to the fact that I chose to go down that path, I could just as easily realize that I had the ability to make better choices. It never did sit well with me to see myself as being compelled against my will.  That would have been an easy excuse for relapsing. I believe, that with a little bit of support and a lot of soul searching, a person can learn to stand on their own two feet. Anyway, that's what worked for me. This approach has kept me sober for the last ten years. 

The Indian wrote to Princess1: 

You mentioned people who go back to "the same situation".   In one sense, this may be true.  But  a big part of rehab is learning how to avoid situations that are risky, and also what to do when those cravings start to hit.  If someone chooses to ignore this, then  yes, they have made a bad choice.  But it's on them, not the rehab.  

Prschuster: 

One problem I have had with "relapse prevention" is that the emphasis is on constant avoidance of risky situations. This can lead to consigning yourself to living life in a protective bubble. People cannot grow if they always avoid risks in life. One thing that helped me was to get myself used to ordinary situations and to deal with those cravings by dissociating your inner feelings from your surroundings. In other words, one must recognize that the real "relapse trigger" is the associations you make in your mind. And NO, I don't spend all my free time hanging out at bars. That would be stupid. But, by the same token, I don't flee from every alcohol-related event as if it were the plague. I can go to parties with friends who drink moderately, and learn to get along just fine sipping on my glass of soda. However, I have dropped my former problem-drinking friends. That's just common sense. The disease model puts too much emphasis upon "denial" and "cravings", as if these things can never be fully overcome (hence: progressive, chronic disease). 

The Indian: 

Also -- and this is the biggest misconception -- the disease model does NOT give people a free pass to blame their actions on addiction!  In fact, a big part of recovery relates to taking full responsibility for all choices that have harmed others, and then making amends.    

Prschuster: 

The disease model puts too much emphasis on the role of brain chemistry, or "self will run riot", or some other condition which compels us to drink. As a result, the person in "recovery" wastes a lot of energy with diversions. They obsess over character defects that are said to cause the alcoholism, and go through endless inventories, while they ignore the main defect - the act of drinking itself. That is where the primary responsibility should go. I mean, the people I have harmed when drinking, were harmed because I took that drink. The drinking was the cause. The thoughtless actions of a drunk, or the irritability of a person who is hung over, are just spin offs of the drinking itself. I am more responsible for having taken that first drink than I am for the things I did when I was too wasted to know what I did, or too hung over to react appropriately. Also, brain chemistry does not make a person act a certain way. It only predisposes one to drink in order to medicate themselves because their serotonin or dopamine levels are out of wack. Again, it is the drinking which causes the problems - rather than a disease which causes the drinking. 

The Indian: 

The reason the disease model is important is because alcoholism isn't caused by drinking too much.  And the difference between an alcoholic and a non-alcoholic has nothing to do with how much they consume.  It has to do with what happens to them when they consume.  For an alcoholic, the body begins adapting to the alcohol from the very first sip.  

Prschuster: 

I am not all that sure that anyone is immune to becoming alcoholic just because they don't have the metabolism or brain chemistry of an alcoholic. I could go on & on about serotonin, dopamine, GABA, liver enzymes etc.. But anyone who drinks alcoholically long enough will get the DTs. Anyone can get into the habit of using booze to deal with their problems. Just because some folks are more susceptible to the effects of alcohol, it doesn't hold that others can't destroy their lives by drinking, if they do it often enough for the wrong reasons. Again, the disease model is too limited, with all this talk of biogenetic factors. Even the reports of structural changes in the brain of an alcoholic haven't been shown to cause permanent cravings. We all know that it "gets better", something that flies in the face of notions about "chronic, progressive disease" models. 

Of course there is no mention of AA.. Remember tradition 10: "...the AA name ought never be drawn into public controversy". It has been a consistent policy to never mention AA or NA at all in any of the televised programs about recovery, including "Intervention", and many others that have been presented to the general public. I believe this anonymity is meant to protect AA/NA from any repercussions in case scandals or failures become associated with a rehab center or client etc... Also, tradition 11 speaks of "attraction rather than promotion", which may be compromised if the AA/NA name were advertised openly. I find it to be disengenuous that the obvious connection between AA/NA and rehabs, like "New River Cove", is being concealed, even as the facility itself gets free advertising from programs like Dr Phil. But again, I believe it is engineered to protect AA/NA from possible bad publicity or controversy. 

But I assure you Shellye was definitely exposed to the 12-steps of AA, and advised to go to meetings & get a sponsor. Remember, Dr Phil assigned a "sober coach" for her. That, in my estimation, is a euphemism for sponsor. So don't worry about Shellye getting into a 12-step progam. It is obvious that she has been pointed in that direction. It's just that you will never hear much about the program in public discussions. Skirting the traditions by blatantly advertising the rehab centers or interventionist services are geared toward bringing more & more people into the program of AA/NA without ever having to mention the 12-step program. I think it's sneaky and dishonest, but that's how politics is done. 

So what is a disease? NCADD & ASAM, two organizations which push the disease model, define disease as "an involuntary disability". That may indeed include body or brain chemistry. It may also include cirrhosis of the liver & other organ damage caused by drinking. Yet the decision to take that first drink is still a voluntary choice. The problem I have with the disease model is that it tries to include the behavior of drinking  with these other medical conditions (brain chemistry & organ damage). I know that the psychological maneuver of "denial" is employed to bolster the argument for including bending one's elbow in the disease process. But I don't buy it. Diabetics don't need a 12-step program to fight the urge to eat sugar, and I don't believe alcoholics need such a program to learn how to live life without drinking. And I do know it is hard to quit drinking. It was for me. A support group helps, and there are many different types of groups beside AA. The important thing is that I don't think it is helpful to conflate the "involuntary disability" of having a disease with the voluntary decision to have a drink. 

Hello Indian, your reply to my last post was in defense of the disease model. Now you are recommending a "spiritual program" for this "biogenetic disease of the mind, body & spirit". This is tantamount to faith healing. It's the type of thing I'd expect from Benny Hinn or Pat Robertson. How mainstream is that view? BTW, I do not buy the assertion that AA/NA  is the best method. There is too much contention about the methodology used in the studies that have been done, and my own observations & experiences tell me that the 12-step program has an outcome no better than other approaches. It's a revolving door in every sense of the word. I say, let each person look at all the options and decide which one works best for them. 

Actually, this topic is not about how people quit drinking. AA/NA are brought up, though, because: 

1) the show focused on a 12-step intervention by Dr Phil, 

2) many posters make it abundantly clear that they recommend AA/NA as a solution to addiction, 

3) the medical model & familiar slogans are often refered to in their posts. 

If it were a simple matter of people sharing their experiences, it would be a different matter. But it's bound to end up being a controversial subject. 

For example, I quit drinking for good on Aug 10th 1996, in detox, after about 20 or 30 previous detox visits and one stay at a rehab. It was a simple one-step decision, but it took years to get to the point where I was willing to make that decision. So I checked directly into my 2nd rehab because I was told that it was the best way to stay sober. As with the first rehab, I was told that working the steps would help my spiritual progress (but not perfection) and help prevent relapse. So I went to a few hundred meetings. Then I heard about Rational Rcovery (RR). Needless to say, they told me that AA had it all backwards. To make a long story  short (not to mention the obligatory drunkalogue) I stopped worrying about doing perpetual moral inventories, and stopped trying to figure out what kind of Higher Power an agnostic is supposed to have. I just reaffirmed my commitment to putting the plug in the jug and said to myself: "I will never drink again". The more I assert that phrase, and say it like I mean it, the more solid my commitment becomes to sobriety.  

I know that AA welcomes all kinds of people at first, but I have found out that they certainly don't support those who question some of the "suggested steps". I am not going to get much support by saying that the term, Higher Power, means nothing to me in the context of quitting an addiction. My personal religious beliefs have no room for "Providence", as alluded to on the first page of the 12x12. But anyway, the point is that there is a definite program in AA, and those who do not work it or who question it or who find other methods at variance with the steps, are not going to feel as welcome as those who work a thorough program. It would be more accurate to say that AA welcomes everyone at first, but that it offers social support only to those who follow the program as it is presented. Subtle social pressure, rather than outright mandates, is usually applied to those who do not conform, and I have experienced the "silent treatment" by members. That is, when I say something not in line with the program, I get ignored and they stop speaking to me. With that kind of non-support, I felt that it was time to move on and find my own circle of friends who weren't in the program... but whatever works... that's the main thing. 

The main problem with your caveats about going outside AA is that the same could be said about the program of AA itself. That whole argument is based on casting doubts upon any alternative under the guise of being open to people following their own path. In other words, choose the path that works best for you, but be careful if you choose something beside AA. The tacit assumption is that AA is always the safe bet, as if there were no real danger of picking an abusive sponsor. Again, the assumption is that abuses within the program are relatively rare, while the dangers of trying out an alternative method are commonplace. So you are subtly contradicting yourself by saying people should follow their own paths, but they are taking extra risks if that path isn't based on a 12-step program. 

The Indian wrote to Steph: 

"And when you call her weak and say she's to be pitied -- this doesn't sound like someone who has been to AA!  Since when does this make someone weak?  Of course, she is fully responsible for her bad choices, but when someone is in the grip of a chemical dependency, they lose their ability to think rationally.  And that's because their body is screaming for the chemical!  If loved ones get in the way, the love gets trampled every time - that's the whole horror of addiction.  The love may be genuine, but that's irrelevant. " 

Prschuster: 

I agree that being in the throws of an addiction does not mean a person is weak. But it does indicate that they have a weakness in one area of their life. I had a weakness for alcohol, myself. My main disagreement with you, though, is your assertion that addiction makes a person lose their ability to think rationally. I say that addiction is where one loses their will to act responsibly. This is exactly where I part ways with the disease model. 

The disease model goes too far when it ventures beyond the physical manifestations of disease and includes the act of taking that first drink as a manifestation of the disease. It is called a "volitional disease". This diagnosis requires an imaginary mechanism which hijacks the thinking process to create a state of delusion, akin to what you'd expect from someone in the grips of a psychotic episode. And so, the psychological maneuver of "denial" is invented as a rationale for this disease theory of addiction. As a result, the loss of will to act responsibly, becomes reinterpreted as a loss of ability to think straight.  

In AA parlance, this is refered to as "stinking thinking". Of course, the next move is to prescribe a treatment plan for such a "volitional disease". Enter the 12-step recovery movement, complete with rehabs and court ordered attendance at meetings. This is all rationalized by the assumption that an alcoholic is incapable of realizing how destructive their drinking has become without intervention, so that their "self will" must inevitably fail them. This cult of denial even goes so far as to proclaim that alcoholism is a disease that convinces you that you don't have a disease. But let's go back to Shellye for a minute... 

She was definitely NOT oblivious to the harm that her drinking had caused. She had admitted that much to Dr Phil prior to her stay at New River Cove. She began to drink again after a whole month of sobriety. That was definitely long enough to get over any residual physical cravings for alcohol. She knew full well what the score was about her drinking. She was not hung over and jonesing for another drink. She just did not have the will to resist the temptation to resume her drinking. I understand the feeling. I've been through the same conundrum where I was not yet willing to give up my greatest source of comfort.  

I have no problem stating that it eventually takes an act of the will to make that hard decision to quit for good. No one can convince me that an alcoholic is incapable of making that decision. I feel good that I eventually made that hard decision for myself, and Shellye must take responsibility for her decision to take that first drink. In short, she had the ability to resist the temptation to drink again. She just didn't have the will to refrain from her learned behavior pattern. 

I know it would seem comforting to resign from the debating society and just share experiences, strength & hope, but differences are real. Saying that alcoholism is a disease has a lot of repercussions. The fact that the show emphasized the importance of going to that rehab in Belize, makes a statement. I've experienced all those things, and I say that what worked for me was to forget about all the recovery talk and just make up my mind to quit once and for all. I believe everyone has that power somewhere within them. It doesn't hurt to get help anywhere you can. It would be nice if more people knew that there were more options available than what they are told about. But I still believe  that it is more important to believe in yourself and to trust your own ability to heal. That's the strength and hope I would like to impart to others who are struggling with addiction. It is amazing, but what I once thought was impossible, has turned out to be doable. Well, that's my message of hope. I still don't think that airing our disagreements is counterproductive, though., as long as we are all upfront about our true experiences and thoughts about recovery. It does pain me to see someone in the throws of addiction. Thanks for your feedback. 

The irony of this whole thing is that religion & the "good book" are so often misused to justify the worst forms of hatred & prejudice. I've seen this done with both the Taliban & fundamentalists here in America. What possesses people to call upon the "word of God" (as they understand it) to excuse the evil that lurks within their own souls? I mean, I've never witnessed any of the gay people I've known to do anything to warrant such hatred & rejection.