Monday, August 4, 2008

Twelve Steps


Question

Terry asked: "Re-reading these symptoms, I have to ask - why isn't alcoholism considered mental illness? I forget to check back sometimes - so if you think this is legit - please email or do a post. Thanks.

This is the email I sent Terry (with the personal stuff removed.) And Terry, I think "forgetting to check back" could be considered a mental illness. Maybe passive-aggressive or attachment disorder. Hmmmmm, I'll have to think on that.


DSM-IV (Diagnostic and Statistical Manual) lists alcoholism as a mental illness. But it also lists about 299 other things as mental illness. I know of people who receive disability due to their alcoholism. Now how's that for having your cake and eating it too?? Get paid to drink.

I prefer not to define it that way. Like what you had in one of your posts about the lesbian who said she didn't care why she was the way she was, I also really don't care how I happened to become an alcoholic. The only thing I need to know is I can't drink.

We can give our faults all sorts of names and then the danger is those names become excuses. My ex-sister-in-law likes to say that my nephew drinks because of my brother. Hmmm, no - my nephew drinks 'cause he's a drunk. He's 42 years old. Time to quit blaming dear old Dad. Now, what's weird about this is my ex-sister-in-law is in the program and should know better.

I've seen new people in the program who start reading crap about their weirded out metabolism, genetic predisposition, and on and on. What they are really looking for is way to keep drinking.

My favorite story about this sort of thing was from Wayne Dyer before he got all New Agey. A lady came to him because she had a nail biting problem. She had been in therapy for 25 years to get to the bottom of this problem and heard Dr. Dyer was really good at helping people. After explaining her problem Wayne looked at her and asked, "has anyone suggested you keep your fingers out of your mouth?" Bingo! Problem solved.

So the DSM-IV says I'm mentally ill. Damn, Terry - I didn't need them to tell me that.

My motto? Crazy but not dangerous......

Adrienne

There are many disorders that that co-exist with alcoholism. Depression, bi-polar disorder, and one of my problems, Adult Attention Deficit Disorder, are just several of too many to list. None of these problems can be addressed until the alcoholic stops drinking. But as I said in the email, they cannot be used as an excuse. Having an awareness and good treatment for any of these disorders will certainly help you with your journey to sobriety.

As Catholics we are asked to have an awareness of our faults in order to work on correcting them. Beating up on ourselves or using them as an excuse for sinful behavior is not, nor ever was, the point. If that were true, God would not have given us the Sacrament of Reconciliation. He knows we will fail and He expects us to pick ourselves up, brush off the dirt, and get back to the process of "working out our salvation in fear and trembling."





Disclaimer: Certainly if someone is in a full-scale manic or depressive episode it would qualify as a "mitigating" circumstance. The more extreme cases of mental illness require the attention of a qualified physician and are not to judged harshly.


* * *
Don't forget to vote on my poll. See following post. Thanks!

5 comments:

irene said...

As a mental health professional, I have to add my two cents.

Let's start off with: there is no such thing as a "mental illness", and DSM-IV is a misleading fraud.

That doesn't mean that prolonged and severe alcoholism doesn't produce physical brain damage, and of a very characteristic sort. On the contrary, as I am sure you know. And yes, part of that damage causes a craving for alcohol.

The other conditions mentioned are also caused by or accompanied by brain damage of various sorts, in various locations. Like a broken leg, they should be treated when they occur. Indeed, the alcoholism may be secondary to the brain damage, in which case demanding that the person stop drinking first just leads to a downward spiral that may end fatally.

But generally you have been right on target. The alcoholic needs to stop drinking (admittedly hard to do and dangerous if done "cold turkey"), and all of his/her other manuevers are just ways to continue drinking.

Rita said...

I'm uneasy about alcoholism being treated as a "disease". This is a step down the line from calling it a "mental illness"..

In the UK, alcoholism was first called a disease by Dr Max Glatt (1950s). He developed successful treatment programmes based on the 12 Steps. Unfortunately, it gave some scientists the idea to look for the "magic key" of a genetic link to alcoholism.

Though the scientific evidence is not conclusive, some treatment practitioners here really do believe 1 in 10 carry the gene for alcoholism/addictive behaviour. I'm sure this is unhelpful, and heaven knows where future treatment strategies will go especially in our increasingly secular (unwilling to acknowledge a higher power society).

Jackie Parkes MJ said...

Well in our family you are either alcoholic, bi-polar or if you're lucky you get both! I'm NOT entirely joking!

BTW I do have a mental illness bi-polar affective disorder..have never had an alcoholic drink in my life..a lifetime Pioneer so don't know about alcoholic.

Fascinating post though.

irene said...

In loving clarification:

I too am uneasy about treating alcoholism as a disease. That is one of the problems with DSM-IV (and things aren't going to get any better in DSM-V). It is not a disease, there is no alcoholic germ, and we have no chemical or surgery that can "cure" it.

But that is not the same as saying alcohol does not damage the brain. It sure does, and because of the number of alcoholics in our society, it is one of the worst and most common causes of brain damage. (Please excuse me, I know I am preaching to the choir).

Ever since scientists figured out the basics of DNA chemistry (quite recently, really) we have been on yet another of our searches for the "magic bullet" for everything that ails us. But while there have been some suggestive studies reported, no one has managed to show that any gene "causes" alcoholism. I seriously doubt that anyone ever will.

Devout or secular, the 12 steps remain the most effective intervention (as distinguished from treatment) we have. So adrienne, please keep it up, you are doing wonderfully.

Rosario said...

As a person with a mental illness (OCD) I can say that the whole "taking as an excuse" is sadly, very very true.

Its so easy to say "I've been impatient/unkind/selfish because I have depression/OCD/anxiety disorder" than actually fighting the temptation to selfishnes.

Brain Chemical unbalances are very real and disruptive but like the story of the lady who bites her nails I believe that before trying to find the "deep emotional causes" first and foremost we need to adress the damaging behaviors and take full responsability for our actions.