Definition and Common SymptomsDepending on how it is defined, alcoholism affects up to 10% of all adult males, and perhaps half as many females. Alcoholism may be nearly life-long, starting in childhood or adolescence and continuing through the years. Or it may begin in adulthood during periods of depression or stress. In that case it may be an intermittent problem, with periods of control, abstinence and remission. Alcoholism may be defined as drinking any alcoholic beverage to the point of recurrent, persistent, or extreme physical or psychological impairment. While this and any other definition is subject to criticism, individuals with this problem may evidence one or more of the following:
Causes and Diagnosis Alcoholism is considered to derive from both genetic and social causes. The son of an alcoholic father is four times as likely to become alcoholic than one with a nonalcoholic father, even if the child is adopted and raised in a nonalcoholic family. Jews and Italians consistently have lower incidences of alcoholism than do Irish and American Indians, in many cultural settings, and no difference in alcohol metabolism has been identified to explain this. Thus a genetic element may play a role in some settings, along with complex familial, cultural, and psychologic factors. Initially, drinking in excess may be to relieve some physical or mental distress, but soon becomes self-perpetuating. The ability to distinguish social drinking from drinking as a social crutch becomes blurred. Eventually the symptoms mentioned above start to take over.
Treatment and Prognosis Conventional treatment involves acute alcohol withdrawal, followed by the rehabilitative phase. The initial phase of most programs, whether they are live-in residential programs or outpatient programs, is to help the patient accept the diagnosis. Resistance is common, and often the most difficult step to take, with many patients quitting the program at the beginning. Treatment involves replacing the alcohol with supportive group interactions, rebuilding of self-worth, firm but forgiving peer pressure not to drink, avoidance of situations of loneliness through accessibility to caring others at all times, and involvement in helping others at more acute stage of alcohol withdrawal than the patient himself. If one agrees that for many alcoholics the drinking has replaced people in his or her life, then treatment hinges on replacing the alcohol with people once again. While
most programs do not keep track of one-year relapse rates among
those they treat, it is generally agreed that rates of 25-30% are
typical. Given the fact that many alcoholics never seek aid, and
many who do never enter a formal program, the prognosis of this
disease with conventional treatment must be regarded as very poor.
It is against this background that the new development in treatment,
the advent of Neurofeedback Therapy with its fundamental
correction of the biology of addiction, is stirring excitement.
It is one thing to pass through conventional treatment to a "white-knuckle"
cure in which one continues to crave the substance of abuse even
while abstaining from its use. It is something else to eliminate
craving and to begin to experience normal satisfactions in life
including the opportunity to develop open and loving relationships
with others. Permanent abstinence is eventually the safest course,
and this is essential guaranteed by the effect of neurofeedback
therapy in resulting in illness--flu-like symptoms--and the loss
of the "high" in association with relapse. These effects, together
with the positive, rewarding satisfactions that move the life of
the alcoholic individual toward normalcy, combine to help in overcoming
addictive patterns. The poor prognosis seen in conventional alcoholism
treatment should not dissuade efforts to seek help for the addicted,
especially now that significant options exist. These treatments
are becoming more widely available--our group itself has trained
over 1000 professionals from across the US and around the world
in the use of this treatment protocol. |
