Is Alcoholism a Disease, a Defect of Character, or Something Else?
When I was young and had not yet taken a drink or a drug in my life, I did not understand what alcoholism really was.
I saw it portrayed in the media and I wondered why someone would let themselves become addicted to anything. In my naive opinion, I figured that these people must be very weak willed.
The joke was on me because later in life I would become addicted to drugs and alcohol after finally taking a single taste of them. I was off to the races and I lose complete control of my life in spite of the fact that I thought of myself has having strong will power. That did not seem to matter in the face of alcoholism.
So I drank alcohol and used drugs for several years before I finally reached a point of surrender. After reaching that point I was able to turn my life around and now I can look back and think objectively about what alcoholism really is. It can be a difficult thing to define in my opinion because alcoholism can be very complicated. Most people in recovery like to think of the solution (and the disease) as being very simple and straightforward. But I don’t really think that is accurate in my own experience. Addiction is messy.
The disease theory of addiction
For most of our history people believed that alcoholics were weak willed or simply morally bad people. They looked down on the alcoholic as someone who lacked self control, someone who must be morally compromised because all they want to do is sit around and drink all day. This was alcoholism has traditionally been viewed in the past.
Along came the AA program and changed all that, framing alcoholism as a disease instead of a moral failing.
In my opinion this helped a great deal and before this there was generally very little hope for anyone to recover from heavy drinking addiction. Now at least there could be a conversation. Now at least the alcoholic could lift the finger of blame a little bit and get some room to breathe. They still had to take responsibility for their recovery, but now at least they could claim that the disease was not something that they chose for themselves. Addiction is not my fault but I am responsible to recover. This led to positive action much more than simply casting blame on someone and declaring them to be a moral loss.
There are a great many people out there who do not believe that alcoholism is a disease. They argue quite a bit over this and they do not want alcoholism to be recognized as a disease at all. Such people almost never carry the label of “alcoholic” themselves, which is an important distinction. I was one of these people who denied the disease (in my youth) until I later became an alcoholic myself. I did not believe until the disease had clearly smacked me in the head with a wake up call of reality.
The strange double standard in AA: Disease theory, but moral solution?
There is an interesting double standard within the AA program. I don’t want to argue for or against AA necessarily, and I am not even arguing about whether or not alcoholism is a real disease or not. I just want to point out this double standard and let you become aware of it. You can draw your own conclusions of course.
The AA program and philosophy states that alcoholism is a disease and it is a physical “allergy” to alcohol. In the past people believed it was a moral failing and that the alcoholic was just lazy or a bad seed. But the disease theory came along and changed all that.
However, if you look at the 12 steps of AA, they treat the disease by having you address morality. For example, the steps have you take a moral inventory and do other things in order to improve yourself and your character. So the program claims that alcoholism is not a moral failing, but then the 12 steps encourage the alcoholic to improve their morality. What is going on here?
I don’t necessarily have an answer for that, although I have asked some people in the 12 step program who have several decades of sobriety. They gave me an answer but in all truth they sort of danced around with their logic in an attempt to discover the solution. In my opinion they failed to do so.
Now I am not making accusations here but I don’t feel like this is very consistent. Something tricky is going on here and I cannot put my finger on it. The disease exempts you from being morally bad, yet the solution in the steps is to analyze your moral character and then make improvements to it. Maybe someone out there can help us out and give a solid explanation for how this works in the comments? I would love to hear your analysis. (You can also come let us know in the forum).
How to be a good person in recovery, with or without a program of recovery
Is it possible to become a good person in recovery without a structured program that leads you through the steps?
I believe that it absolutely is possible, and I have tried to achieve just that in my own life.
There are more than one ways to move forward in recovery and build a new life.
One way is through the holistic approach. “Holistic” is not just a fancy term to try to misdirect people, I am actually talking about a comprehensive approach to your entire life.
So when we say “holistic” what we really mean is that you try to improve your health in multiple areas.
For example, your physical health. You might exercise, quit smoking cigarettes, quit drugs and alcohol, try to eat healthy foods, and so on.
But then you might look at your relationships and your emotional balance, and see if you can improve your health in that area as well. So you might eliminate a particularly toxic relationship that is no good for you and is knocking you off balance.
And you might pursue spiritual health as well through prayer or meditation or some other means. The point is, you would not limit yourself to just one type of personal growth. You would keep the door open to all sorts of new positive experiences, realizing that any change in your overall health can help to strengthen your sobriety as a whole. Relapse prevention is a holistic effort.
Most recovery programs try to get you to change from the inside out. This works great for some people but not for others. For example, the 12 steps attempt to shift your moral character so that your outside life will start to reflect these inner changes.
Does it work? Sure it works, but there is a more effective approach in my opinion. Perhaps this is assumed in traditional recovery programs, but I prefer to spell it out.
You should be working on two paths of growth in your recovery:
1) Internal growth – this is the kind of work that you do by working through the 12 steps of AA.
2) External growth – this is the kind of work that you do to make situation changes in your life. When you leave a relationship or change your job.
In order to have the most effective recovery I believe that you need to work on making both types of changes in your life. It is not enough to simply work on the internal part and focus only on spiritual growth. The holistic approach is much bigger than that and it includes an “external” focus as well where you can make important changes in your life situation.
What really keeps people sober anyway?
How can you find the motivation to get clean and sober?
What is the point at which you break through denial and really change your life?
And what actually keeps people clean and sober in the long run? Is it going to meetings every day? Is it working hard to rebuild moral character? Is it reliance on a higher power?
The alcoholic is not going to turn their life around until they get completely sick and tired of their addiction. Once they reach this point then they will surrender and become willing to ask for help. The motivation comes from the desire to avoid misery, not from the desire for a better life. That is a minor distinction but an important one. Misery fuels recovery, at least in the beginning.
Many people want to know how they can help a family member who is struggling with alcoholism. The problem is that you cannot say or do anything directly that will motivate them to change. You can do plenty of stuff that might indirectly help to motivate them in the long run, this is known in Al-anon as “setting limits and boundaries.” If you stop enabling the person then this will move them closer to surrender, tiny bit by tiny bit. It doesn’t happen overnight.
How can you tell when a person is serious about recovery? Because they will take direction and advice and they will do what you suggest. This is a state of surrender.
After a person agrees to get help for their addiction they will generally go to treatment of some sort. Inpatient rehab is typical.
And it is not a challenge to stay clean and sober while in inpatient rehab. There are no temptations in rehab so the rate of success while staying in a controlled environment is quite high. However, the real challenge begins when the alcoholic leaves the safety and security of the rehab center. At that time they have to learn how to remain sober on their own.
And this is the point where we ask: “What is it that really keeps people sober?”
I was living in long term rehab and I asked this question of myself, over and over again.
At the time I was going to AA meetings every day and I was watching many of my peers in recovery relapse. They were going to meetings too. And so they question kept coming back to me: “What is really keeping these people sober? How does sobriety actually work?”
And so I wanted to deconstruct successful sobriety. I wanted to pick it apart and find the parts that were actually important.
Because let’s face it–when you get to early recovery and you go to a few AA meetings you are going to get absolutely overwhelmed with suggestions. If you wrote down every piece of advice that you received you would never be able to implement all of it.
Therefore you must prioritize and pick and choose what you are going to do for your recovery. You cannot possibly take every suggestion, read every piece of recovery literature, and do every little exercise or suggestion that is made to you.
This is the point that I was at in early recovery. I wanted to cut through all of these suggestions and find out what was really important for sobriety.
So I slowly started to explore recovery, to figure out what was keeping me sober and what was not really helping much.
Over time I eliminated the daily AA meetings. They were probably helping me to some extent but obviously they were not vital. And they represented a huge chunk of my time which could then be replaced with something else that was positive instead.
So instead of going to a meeting every single day, maybe I exercise now every day instead. This was not the exact decision that I made in early recovery, but looking back I can see that maybe I really did replace one with the other. And it worked.
Now does this mean that any aspiring alcoholic can just dump their daily AA meetings and hit the gym instead?
The key I think is that you have to take positive action.
Every single day in your recovery you have to build towards a new life, you have to keep pushing yourself to create success in your life. You can’t just coast through your recovery and expect for everything to work out. Just because you are sober does not mean that good things fall into your lap. You have to work at it.
This is true in AA just as this is true in any path that you choose in recovery. Being in AA and going to meetings does not give you a secret path to success in recovery. It still takes work. You can recover in AA but you can also recover outside of AA. Both paths require hard work. The only question is: How much structure do you want in your recovery? Do you enjoy spending time in AA meetings? For me the answer was: “I could be spending my time in better ways.” So I left the meetings and I made that happen. I actually took positive action. Most people who leave the meetings get lazy and simply relapse, because they did not actually do anything in order to benefit themselves in recovery. Sobriety takes work.
How to live your life in long term sobriety
In long term recovery you have two options:
1) One, you can become complacent and stop making positive changes in your life. If you do this then you will stop growing personally and you will drift closer and closer to relapse. You may or may not drink again but you can be sure that you will not be content and happy in this scenario.
2) Two, you might continue to push yourself to improve your life and your life situation on a daily basis. In this case you will not relapse and your life will also continue to improve over time. This is what real recovery should look like.
The first option is quite common and it does not always lead to physical relapse. Sometimes people just get complacent and they get stuck but they don’t actually pick up a drink. Obviously that is not a situation you want to be in.
In the second situation your life just keeps getting better and better.
You will actually wake up excited most days to see what the day will bring to you. Life will be exciting and fun again.
But this life of joy and happiness does not just happen because you no longer drink. You have to build this new life for yourself through hard work.
The work is described as such:
1) Working on your life, internally — fixing the shame, the guilt, the anger, the fear that lies within you. Working out your resentments and your self pity and forgiving others in your past.
2) Working on your life situation, externally — fixing your life in terms of your job, your relationships, your career, your finances, and so on. All the things on the outside of yourself that still have an impact on you. Working hard to minimize stress and eliminate chaos.
This work does not all happen overnight. It can take years and years.
But if you make a commitment to yourself that you are going to keep working to take positive action every day, then both of these things will continue to improve over time.
There are many people who get into recovery and they take two steps forward and then three steps back. You want to avoid doing that, obviously. The way to avoid it is to go slowly and to really learn a lesson from each thing that happens in your life. Deliberate growth takes consistent effort. Don’t keep repeating your past mistakes and expect for your life to improve.
It makes a lot of sense to treat alcoholism as a disease because then a solution becomes much more available. If you treat alcoholism as a moral failing then it can be really hard to find the motivation to change.
The idea behind the disease concept is simple:
You are not responsible for your disease (you did not choose to become alcoholic. It just happened). But you ARE responsible for your recovery.
Therefore this shifts your focus onto the solution. The problem is alcoholism, the solution is recovery.
What are you going to do for your recovery? You can’t do anything about the problem itself, you are what you are and alcohol was/is ruining your life.
So now it is time to talk about solutions.
In my opinion the solution is about taking positive action–both on the inside as well as on the outside.
What about you, do you believe that alcoholism is a physical disease, or more of a moral failing of character? Does it even matter? Let us know in the discussion forums. It only takes a second to register!