A decade ago, presenters at the “New Perspectives” conference on Vancouver Island, British Columbia, noted at least 85% of all clients seeking help with alcohol abuse are being misdiagnosed and mistreated at virtually all of the treatment programs across Canada, the U.S., and Australia. How is this possible?
The problem is that 95% of these “programs” are based on the discredited AA/12-Step “disease” model which doesn’t differentiate between the misuse of alcohol, alcohol abuse, and alcohol dependence. This failure to accurately assess is then compounded by program staff that are, at best, poorly trained, and usually mis-trained – brainwashed into all of the 12 Step mythology.
The result? People with emerging alcohol problems are discouraged from getting help in the early stages when, as with any real disease, “curing” it is fairly easy. Additionally, those who are better advised to abstain are labeled and directed to follow a demeaning life-long regimen that isn’t just unnecessary, but counter-productive for the vast majority of those with alcohol problems.
What can you do?
Frankly, your choices are limited. You can look for programs that are “Non 12 Step” but many of these also adhere to the same disease model. Your best chance is to carefully find help that includes Cognitive Behavioral Therapy (CBT), anti-craving medication (Naltrexone) support, assertiveness training, professional staff who aren’t “in recovery,” and if anything, have fully recovered, and that offer real assessment rather than just lumping you in with everyone else as an “alcoholic” or, worse, an “alcoholic in denial.”
What should assessment consist of?
Good programs and counselors are more interested in strengths, abilities, and interests than in your faults and failings. They are also more interested in your current circumstances and future wishes than in your past. The best will spend very little time talking about alcohol beyond getting a picture of your particular drinking patterns.
Real assessment will focus on what conditions you are self-medicating. Once you get past the “disease” fallacy and move on to the “symptom” model you are on your way to addressing the mosaic of underlying problems which, when resolved, result in the symptomatic alcohol use going away.
Therefore, following assessment, which will look at aspects of your life ranging from your health to your work, education, family, social and recreational situation, you should be looking at how you want your life to be without inappropriate self-medication. Then you should be helped and coached to set goals, make priorities, and develop systems for achieving that life.
None of this should take all that long – certainly not more than 5 days of assessment and planning with another three months of weekly follow-up sessions. Do not be sucked into believing that you need 30, 60, or 90 days of residential “rehab” – less than 10% of current clients do and fewer than 15% of those will benefit from it. You do not, after all, need a vacation from reality – you need to fix whatever’s wrong and improve your real life in ways that leave no room, or reason, for misusing alcohol.
Again, do not fall into the “treatment traps” of being forever “in recovery;” maintaining an alcohol-focused life centered on endless meetings with people who are never going to sober up; adopting a self-fulfilling “alcoholic” label; and giving up your ability to manage your own life.
Remember, you aren’t powerless, you don’t have a disease, and you can leave problematic alcohol use behind – permanently.
You do have an understandable and learned short-term coping behavior using alcohol which has helped ease loneliness, boredom, anxiety, passivity, and various other emotional and physical pains, aches, and discomforts. You can learn and adopt better long-term solutions and coping skills that will make you happy to have left alcohol behind. You do not need, or want, labels, slogans, medallions, bumper stickers, drunkalogues, or public exposure.
You do need to be deprogrammed, educated, coached through internalizing Cognitive Behavioral Therapy (CBT), acquire some assertiveness training, understand dietary and exercise aspects, and learn what real support activities and groups consist of.
You also need to accumulate enough ammunition to fend off the Steppers and everyone else who has been contaminated with the “everyone knows” myths which pervade our culture, media, and public discussion. It’s to be hoped that your confidentiality has been maintained to a degree where none of these fruitless discussions will even occur. The problem there is that there is only one confidential, research-based, program provider in either the U.S. or Canada.
You can become an ex-drinker – or a “normal” drinker – just as people become ex-smokers. Been there, done that. Alcohol abuse is no longer a topic or activity of any interest.
If you’re ready to enhance your life, rather than to diminish it even further, there are options available. Real ones based on research and experience.
Don’t sell yourself short.