“Alcohol Use Disorder”
As is often the case in life, we change a label and consider it progress. Occasionally it’s even true, but if that doesn’t lead to changes in how the re-named condition is treated, then it’s hard to pretend any progress has been made.
Such is the case with renaming “alcoholism” as “Alcohol Use Disorder” (click on the link for diagnostic criteria).
The creation of this new label was the American Psychological Association’s tentative step towards eliminating the “disease” concept of self-medication with alcohol and to begin to recognize degrees of over consumption which, to a certain extent, would dictate treatment methods.
Good luck with that.
Over 90% of treatment programs remain wedded to the AA disease model which labels you as either an “alcoholic” or and “alcoholic in denial” regardless of your degree of use including, astonishingly, even those who don’t drink (labeled “dry drunks”).
The reason for this stubborn adherence to a model created in the 1950s is that it doesn’t work. It remains a brilliantly designed scam that insures that vulnerable people and their families can be repeatedly conned into paying for AA meetings which, as you know, are available for free.
However, increasingly you do have choices, difficult as they may be to find.
As an organization, for those of you who like/need groups, SMART Recovery offers an alternative based in Cognitive Behavioral Therapy (CBT) which both addresses many of the underlying causes of your self-medication but which also suggests that you can out-grow your reliance on alcohol or SMART. That is a revolutionary advancement over the life-long “in recovery” label which really is the definition of a “dry drunk.”
Of course there are also a slowly growing number of programs and individual practitioners who will help you use CBT and other research based solutions to assist you in managing your own habit breaking and the replacement of self-medication with actual coping skills that lead to an enhanced life, not one diminished by allegiance to a cult.
Yes, there are people whose immaturity means that they will need the security of conforming to trinkets, bumper sticker slogans, and isolation from normal people and life. But, if you were one of them, you wouldn’t be reading this, would you?
Self-Medication With AA
When people exchange hanging out in bars for hanging out at meetings there must be benefits. One of the things we always ask clients to do is it write up a list of the benefits they get from drinking. It’s interesting how these tend to match the benefits Steppers get from meeting.
Anxiety reduction. Alcohol is the best anxiety reducing drug ever found. But Meeting are to. Meetings absolve you, for example, from guilt driven anxiety about your drinking because you are continuously reassured that it isn’t your fault or responsibility. You are powerless over your disease.
Escape. Where you used to escape to bars, or you room, now you can escape untenable conditions at home by hiding out in meetings instead. Even better, you can’t be criticized for neglecting your spouse, family, etc., because you are “working your program.” How convenient.
Passive-aggression. Drinking is a really great FU towards a controlling spouse, parent, family member or even community. Again, meetings provide an excuse to avoid and evade not just abusive relationships, but doing anything about them.
Notice the theme here. Whether it’s drinking or meetings, the commonality is avoid, avoid, avoid. If you’d stop avoiding and start acquiring actual coping skills: CBT, Assertiveness Training, Diet and Exercise Management, Healthy Personal and Professional Relationships, and so on, you wouldn’t need to avoid.
That’s called being recovered – it’s also called growing up.