1
Alcohol Addiction
ON ALCOHOL ADDICTION: THE IMAGINAL AND THE REAL
Running Head: Alcohol Addiction
David Johnston
ABSTRACT
In this paper I discuss the nature of alcoholism taking both an imaginal and realistic perspective. I argue that the therapist needs to be alert to the possibility that the client’s behavioural symptoms are related to alcoholism, and to intervene when judged necessary. For an alcoholic, only when the drinking has stopped can genuine psychological work begin. I also acknowledge the value of Alcoholics Anonymous, with its ethically oriented twelve step program and twelve traditions, and provision of community. Recovery comes with the possibility of developing an ethically mature reflective ego, while some recovering alcoholics are able to consciously embark on the individuation process. I end the paper recommending that ways be studied to integrate the Dionysian element into alcoholic therapeutic communities, perhaps through ritual dance, use of masks, drama, etc.
ON ACHOLOL ADDICTION:
THE IMAGINAL AND THE REAL
Introduction
This is a paper on alcohol addiction, where the alcohol referred to is ethyl alcohol (ethanol, CH3, CH2, OH), which is the characteristic and essential ingredient of the alcoholic beverage. (J. George Strachan, 1982). Although my view is essentially based on Jung’s (as reported in Bauer. 1982) observation that desire for alcohol is a low-level thirst for wholeness, I ground my analysis on the existential reality of the alcoholic. First, I define alcoholism and indicate how widespread it is. I then discuss cultural conditions that encourage the use of alcohol, directly or indirectly. Next, I discuss some spiritual, emotional and physical factors that might predispose one to become addicted to alcohol, or affect one’s behaviour as an alcoholic. These considerations represent the realistic side of the equation. Then I discuss the disease from an archetypal angle. Finally, I make some suggestions on introducing a Dionysian dimension to the ongoing alcoholic healing process.
The Nature of Alcoholism
For purposes of this essay, I define alcoholism as a treatable, yet chronic and progressive illness consisting of interrelating “physical, emotional, social and spiritual components (J. George, Strachan, 1987 p.54,55).” It involves increasing physical sensitivity to alcohol and is an allergy of the body, in addition to being an obsession of the mind. Here it is important to realize that there are generally three different types of alcoholics. There are those who drink regularly and perhaps heavily, those who drink steadily, under control most of the time, and the periodic alcoholic who may abstain for weeks and months at a time (J. George Strachan, 1982).
Strachan (1982, p.55) suggests that dependency on alcohol or alcoholism is indicated when there is “a progressive loss of ability to drink according to personal intent and when “drinking progressively interferes with normal relationships at home, work … and in other interpersonal relationships.” One can add, too, that alcoholism may eventually affect work itself, especially that of a creative nature (Leonard 1989). Thus there are several dimensions to alcohol addiction that centre around the fact the once an alcoholic, human willpower is powerless against an obsession for alcohol.
For this reason, the only requirement for membership in Alcoholics Anonymous is an honest desire to stop drinking, as indicated in the third tradition (Appendix 2) (as reported in Bauer, 1982), while sobriety becomes the most important thing in the life of an alcoholic (Walker, 1989). Being a member of this organization, which defines itself as “a fellowship of men and women who share their experience, strength and hope with each other that may solve their common problems and help others to recover from alcoholism---(as reported in J. George Strachan, 1982, p.274),” can help considerably.
The first three steps in its twelve step program (Appendix 1) reflect the organization’s collective wisdom on the required attitude to have to stop imbibing (as reported in Bauer, 1982). They are: (1) to admit their powerlessness over alcohol, (2) to believe that a power greater than oneself restores sanity and (3) to turn one’s will over to the care of God as one understands Him. The first concern for an active alcoholic, and a treating therapist, is for the drinking to stop. Only then can other questions of a more psychological nature be addressed.
The widespread nature of the impact of alcoholism on individuals and society suggests the need for the psychotherapeutic community to be both concerned and involved. Most estimates conservatively indicate that there are some eleven million alcoholics in the United States and Canada above age twenty, about five percent of the population (J. George Strachan, 1982). They include people from all walks of life, all religions and all social classes. Moreover, consumption trends are up significantly. Whereas prior to 1980, an estimated one user in fifteen would become an alcoholic, in the 1980’s it became one in nine. In addition, on average, people are becoming alcoholic at a significantly younger age, estimated to be in the early fifty’s in 1960 and the mid-thirty’s by the 1980’s. Moreover, more women are becoming alcoholic; one woman to six or eight men in the 1960’s compared to one woman to three or two men by the 1980’s. Finally, a conservatively estimated five other people at home, socially, or at work are directly affected by each alcoholic’s drinking and behavioural patterns. That is to say the disease, in one way or another, directly affects at least some fifty-five million North Americans.
There is considerable evidence to suggest that alcoholism can be arrested at an earlier phase of the illness than is the case when one simply waits for the alcoholic “to hit bottom” and voluntarily enter a therapeutic program (Elkin, 1990, Strachan 1982). In this regard, Elkin (1990) holds the opinion that roughly ninety percent of alcoholics have not “hit bottom” and that they won’t voluntary enter a therapeutic alcohol program. Being cognizant of Jellinek’s (as reported in Strachan, 1982) four progressive phases to alcoholism, the pre-alcoholic phase, the premonitory phase, the crucial phase and the chronic phase, can help identify the individual’s degree of alcoholism. It can also be used as a didactic tool to educate the alcoholic or potential alcoholic.
It is fairly common knowledge that alcoholics have to reach “rock bottom” before being able to surrender to a “higher power” and stop drinking. Few realize, however, that there can be a “high bottom” where drinking is stopped at a relatively early stage in the disease. It therefore behoves therapists [and family members] to be alert to the possibility of their client’s behavioural patterns being affected by alcohol dependency and intervening as deemed necessary.
Why People turn to Alcohol and become Alcoholic
There are several interrelating dimensions as to why people turn to alcohol and become addicted that need to be considered. They include cultural, spiritual, psycho-emotional and physical factors. I consider each of these dimensions in turn.
Cultural Factors: An Overview
To begin to understand why alcoholism has become an endemic in Western society, it is helpful to have an overview on the cultural forces at play. The unfolding of the Western psyche has resulted in a wide split between consciousness and its instinctual roots. Although there has been a gain in heightened awareness and greater complexity of life, there has been progressive erosion in the connection with archetypal energies. That is to say, there has been both an ever-widening separation between consciousness and the deeper Self or wholeness and centre of being, and between individual and community, resulting in alienation and isolation.
The result of the gathering disunity in the Western soul is widespread unfocussed anxiety as an existential condition. If anything, this situation is exacerbated in North America, where the psychic foundations of civilized life are based on a way of thinking of a psyche that was already sundered from its source. By that I mean that it is founded on intellectual reason that has gradually degenerated under the influence of scientific, technological and economic forces. Using an analogy from Alcoholics Anonymous’ own literature, it has led to a condition where the ego has been inflated to the point of “self- will run riot.”
Given such an existential condition, it is no wonder that people increasingly turn to alcohol and other drugs for compensation. Indeed, contemporary consumer society acts as a kind of general anaesthetic, offering as it does so many temptations to escape from pain. Furthermore, and more specifically, medical practice and pharmaceutical advertising suggests that taking drugs for ailments, even psychological stress and anxiety, is normal. In addition, seductive advertising and other marketing practices are liberally used to induce people to consume alcohol. Finally, the use or alcohol is considered to be so normal that people’s behaviour, when under its influence, is excused on both personal grounds and even, to a degree, in face of the law (Elkin, 1990).
Spiritual Considerations
Anthropologist Gregory Bateson’s (1972) challenging paper entitled “The Cybernetics of ‘Self:’ A Theory on Alcoholism” speaks directly to alcohol addiction in relation to the existential condition of contemporary Western culture. He argues that, when sober, active alcoholics are acting in the paradigm of contemporary culture. That is to say, when they struggle with whether or not to imbibe they are caught within a dualistic frame of mind, which drives people to drink in the first place. Hence, the double bind where alcoholics, who believe they can control their drinking,find encouragement to do so. They are inevitably proven wrong and realize that the only solution is to surrender to a “greater power.” The alcoholic’s actual style of sobriety itself, argues Bateson (1972), contains error or pathology, based as it is on will power and self control. Indeed, he observes that intoxication itself provides some “subjective correction to this error (p. 310)” and that by drinking, the alcoholic takes a shortcut to a partially “more correct [non-dualistic] state of mind (p. 309).” Bateson goes on to argue that, in its insistence on the need to surrender to a “greater power,” Alcoholics Anonymous breaks the “myth of self power(p. 313)” and offers a more correct non-dualistic epistemology. As such, alcoholism is placed within the self, that is to say, one’s sense of identity, authenticity and integrity and is not experienced as something outside with which to struggle.
Bateson’s explorations are similar to Jung’s earlier insightful observations regarding alcoholism. In his oft-quoted letter to Bill W, co-founder of Alcoholics Anonymous, he notes that “craving for alcohol [is] the equivalent, on a low level, of the spiritual thirst of our being for wholeness (as reported in Bauer, 1982, p.p. 126, 127).” To illustrate his point, Jung quotes the forty second psalm, which reads “as the hart panteth after the water brooks so panteth my soul after thee, 0 God (as reported in Hyde, 1975 & 1986, p. 3).” In the same letter, he writes that “alcohol in latin is spiritus”--- and “the helpful formula therefore is: “spiritus contra spiritum” (Jung, as reported in Bauer, 1982, p.127). Like Bateson, Jung sees salvation for the alcoholic resides in accepting a more holistic epistemology, one that embraces a spiritual reality.
It is interesting to speculate on what that might mean in practical reality. Jung is referring here specifically to an illuminating experience of Roland H, another founding member of Alcoholics Anonymous. In the same letter, he also observes that the “evil principal prevailing in this world” needs to be counteracted by “real religious insight or by the protective wall of human community (p.127). At this point, I will only note that Alcoholics Anonymous admirably serves the purpose of aiding these eventualities. It provides a program that encourages insight as well as consisting of a community of people suffering the same ailment.
Elsewhere, Jung (as reported in Bauer, 1972) makes other observations that adds a deeper dimension to the nature of the spiritual ailment that people seek to correct through alcohol. He refers to the “divine intoxication” experienced through natural Dionysian exuberance which the church progressively excluded from religious experience (p.45). He observes that Dionysus was turned into the Devil and, writes Bauer (1982), “instead of divine intoxication we end up with addiction and alcoholism possessions by the dark side of the neglected archetype (p.45).”
The spiritual malaise of contemporary people predisposing them towards alcohol addiction results from the rejection of the Dionysian element from ritual life, which is to say bodily-based instinctual and ecstatic expression. Although religious insight may be enough to turn the active alcoholic away from drinking, the cultural dynamic that predisposes the contemporary Occidental to need alcohol in the first place is essentially one result of a gaping separation from deep instinctual roots and a lack of ritual container for them.
Psycho-Emotional Factors
Although alcohol addiction is essentially a reflection of a deep seated spiritual malaise, there are psychological and emotional factors that also enter the equation. The majority of people in this society never become alcoholics and those that do generally suffer from similar psychological liabilities, based on fixation at an early stage of psychological development. Kessel and Walton (as reported in Bauer, 1982) argue that oral fixation is common to all alcoholics resulting in possessiveness and excessive dependency on others. Meninger (as reported in J. B. Lippincott, 1986) adds that alcoholics have never outgrown a child’s attitude that takes the world through the mouth to destroy anything that resists its demands.
Alcoholics are generally deprived of maternal nurturing and suffer from a negative mother complex. Bauer (1982) observes that alcoholic women are father’s daughters, wounded in their primordial femininity. Jellinik (as reported in J. B. Lippincott, 1966) notes that, in general, pre-alcoholics suffer from a low capacity to live with and handle tension.
As the disease sets in, psychological and emotional difficulties become exacerbated. Meninger (as reported in J. B. Lippincott, 1966) observes that chronic alcoholism is a form of self-destruction or suicide by inches. He notes that alcoholics suffer from a deep seated terror that they deny, along with feelings of insecurity, inferiority and low self-esteem. Strachen (1982) contends that they suffer from considerable intra-psychic conflicts and restlessness. In addition, he notes that alcoholics are narcissistically self-absorbed inasmuch as they are wrapped up in their own problems and concerns, indifferent to others.
Alcoholics are generally predisposed to alcoholism as a result of psychological and emotional trauma that stems back to early developmental experiences. Despite this, according to Bauer (1982), abstinence and recovery leads to personality transformation, not only of the alcoholic personality, but also the pre-alcoholic personality. The moral effort required to stop drinking and abstain, it seems, is part of a process that not only rehabilitates, but aids in developing a more stable ego, one capable of mature self-reflection and the capacity to make ethical decisions. Alcoholics Anonymous, with its twelve step program (Appendix 1) and twelve traditions (Appendix 2) can certainly assist the process. Psychological counselling and therapy may also help, in some cases, to take the process further.
The therapist needs be aware, however, that there are a large number of alcoholics, some thirty percent according to Schuckit (1990), who suffer from severe pathological problems, exhibiting either a depressive or bipolar affective disorder or an antisocial behavioural disorder. For these people, alcoholism is a secondary disorder superimposed on a severe pathology. In such cases, a considerable amount of therapy is required to function more or less free from pathological behaviour.
Biological and Physical Factors
But not everybody with the psychological predispositions indicated above become alcoholics. Many, perhaps most, don’t. There is a third factor that may predispose people to alcohol addiction or encourage addiction, and that is the biological and physical. Not only do alcoholics suffer with an obsession of the mind, but also an allergy of the body, although it may be that it develops through obsessive drinking and was not there from the beginning. However, my concern here is both with the pre-alcoholic that may have a physical predisposition to alcohol dependency as well as the craving of alcoholics themselves.
Schuckit (1990) notes that as alcoholism run strongly within families, there is probably a genetic factor involved. He suggests that as a “genetically influenced disorder” (p.69, 70) alcoholism has a rate of heritability similar to diabetes. In fact, because of the difficulty in isolating environmental factors, an important variable in the development of alcoholism, one needs to be cautious in coming to this conclusion. This rebuttal notwithstanding, the genetic theory stresses an underlying metabolic imbalance that involves interactions of the pituitary, adrenal and gonadal systems. At the core of this theory is the hypothesis that craving for alcohol is based on nutritional imbalance related to deficiency in the enzyme system (J. P. Lippincot, 1986). According to Breggin (1991), however, evidence supporting a biological/physiological cause for alcoholism is flimsy.
Alcohol consumption, nonetheless, does have a physical and biological effect and results in a cumulative loss of cells and nerve fibres in the cerebral cortex (Schubet, 1990). Heavy alcohol intake damages the cerebral cortex, impoverishing the ability to control drinking. Excessive drinking also eventually leads to eventual loss of tolerance to alcohol in the final chronic stages. In addition, heavy consumption of alcohol affects the brain cell metabolism so that the brain cells themselves crave its presence for optimal functioning. Physical sensitivity to alcohol, that for some may be genetically based, can become extremely far-reaching.
Motives for Drinking and the Effect of Alcohol on Behaviour
Alcohol is a central nervous system depressant that acts as an anaesthetic affecting almost all body systems (Schuckit, 1990). At progressively higher levels of blood-alcohol, different areas of the central nervous system and related areas or the brain are affected (Strachan, 1982). First, the cortex,which controls inhibitions, is affected then, the motor areas of the brain, and finally the mid-brain which controls affective behaviour comes under the depressive influence of alcohol. Next, the lower portion of the brain, which controls more primitive areas of the mind, is affected, beginning with the depression of sensory perception and leading to stupefaction and blackout. At even higher levels of alcohol, the heartbeat and breathing are affected, which could result in death.