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A Drinking Culture
Let me get you a little dividend
As we begin to deal in detail with the progressive emotional distress of alcoholism, the fact that we can now be specific is worth noting. There has been very little precise information on the course of the disease. Virtually all of us in our society have been exposed to alcoholism in some form or other, and it has caused us great consternation and confusion. We have had no handle or method for approaching it which was specific enough so that we could take directions and set goals. Alcoholism has been as a health problem both too complex and too idiosyncratic to handle within the framework of conventional medical care.
Our approach at the Institute has been strictly pragmatic. We have not been out to prove any theory. We were simply given the opportunity to observe literally thousands of alcoholics, their families, and the other people surrounding them. All our trained and experienced personnel shared their observations, and we came up with the discovery that alcoholics showed certain specific conditions with a remarkable consistency. Such applied research then led to the development of experimental programs designed to try to meet these conditions and cope with them. As the years passed, we continued to use and refine the programs that worked in practice. Nearly two decades of such efforts are reported in this book.
First, we noted that physical addiction with its withdrawal problems could be quite safely handled in a qualified medical setting. The process of detoxification is essentially thesubstitution of some other chemical for alcohol while the toxic effects of the alcohol subside. This process is generally completed within a few days. We can take care of the physical addiction with relative ease; the burden of the harmful dependency is psychological. Breaking through the psychological addiction is a much more complex and difficult problem.
Nevertheless, our continuing experience with increasing numbers of cases suggested that this condition could be accurately described in terms of a special kind of emotional distress found to be present in all of them. In order to illustrate this universal emotional pattern of alcoholism we used the Feeling Chart. This is essentially a straightline graph where all human emotions can be represented. The mood swings which are the emotional symptoms of alcoholism are shown on successive graphs, as we trace the inevitable deterioration of the self-image of the suffering alcoholic.
In Figure I below, human feelings are registered graphically from left to right. The most painful feelings at the far left merge into less painful ones, which shade into normal feelings, and ultimately build to ecstatic emotions or the euphoria depicted at the far right of the graph. Thus the feelings range from suicidal despair to ecstasy. Theoretically, everybody is somewhere on this graph at any given moment. Since we all have mood swings, in a lifetime any of us would move over a large part of this spectrum. According to the law of averages, most of us would occupy the center of the graph during most of the days and years of our lives.
We have arbitrarily divided all human emotion into three feeling areas. We are not suggesting that the population is divided in this way. We do not know exactly how many human beings would fall into each category. But for the purpose of illustrating the dynamics of alcoholism or mood swings, the chart can be useful to us as a tool. Moods range from "I'm no damn good," up through "I'm okay," to "I'm blissful." We can assume that the great majority of persons are emotionally more or less comfortable, and therefore in the middle of the chart. A significant fraction of the population live in chronic emotional pain and need help. While there are fewer profoundly or ecstatically happy people, at any one time they do exist. The question of how many there are in each category is not important. Inexplicably, alcoholism seems to hit approximately 10 percent of each of these groups as we roughly define them in considering our patients' earlier histories the desolate and the joyful alike. One might think that people in chronic emotional pain would become alcoholic in disproportionate numbers, and on the other hand, that productive, well-adjusted individuals with integrated personalities would have a powerful immunity. On the basis of the thousands of alcoholics we have observed, this is not true of the conditions that precede their active alcoholism.
Joe loses his wife, becomes distraught with grief and starts drinking heavily. He becomes helplessly alcoholic as a result. But Harry and Tom, who are also inconsolable with grief and who also try to drown their sorrows, do not become alcoholic. Since we cannot anticipate who will take the downward, disastrous path, the only productive way to study the disease is to consider thousands who already have a harmful dependency and retrace their progress into alcoholism. Before the onset of the disease, their emotional backgrounds are different. After they have contracted the illness, however, it becomes more and more apparent that the pattern of emotional distress is universal, and that chemically dependent people not only show the same pathology, but respond to the same treatment. We use the Feeling Chart to record the drinking experience of the alcoholic from the first phase, or introduction to ethyl alcohol, to the first instance of emotional cost which signals the onset of the disease, and finally to the last, fatal stage which may be either slow or rapid suicide.
The first two phases on the Feeling Chart, discovering or learning the mood swing and seeking the mood swing, are entirely pleasant and benign. They describe the experiences of all drinkers, not just alcoholics. The individual is introduced to some beverage containing ethyl alcohol (wine, beer, or distilled spirits), and in our culture this will likely be very early in life. It may be beer or liquor from the parents' supply...I'll Quit Tomorrow copyright © by Vernon E. Johnson. Reprinted by permission of HarperCollins Publishers, Inc. All Rights reserved. Available now wherever books are sold.