I found the post below from BPS Research Digest (a website that posts recent developments in psychology research) on alcoholism interesting. People in the field often talk about the disease model of alcoholism - is it like diabetes, a disease that cannot be cured and over which the "patient" has no control or is it more a "disease" of attitude - that somehow choice is involved in a way that it is not in the case of diabetes? Researcher and author Wray Herbert, writes about that debate in a way that I think tries to meld the two views into one - the link being the brain and the way the brain works. It is often said that alcoholism is an insidious disease - I think Wray Herbert is exploring what that means. ( For the direction he is going with this see the last paragraph below....
"When I first entered the rooms of Alcoholics Anonymous some years ago, one of the long-timers—a rough guy, with more than two decades of sobriety—pulled me aside after a meeting to share his personal view of alcoholism. We were in a bright, hard-floored church basement that carried the sound, and his half-whisper made the words sound a bit conspiratorial: 'I figure everyone is given a share of booze to drink in his life. You can drink it any way you want, and most people spread theirs out over a lifetime. But I drank all mine up. I was a glutton.'
Glutton. It’s not a word you hear much at all these days. In fact, when he uttered the archaic word, my mind rushed to the English literary giants of long ago—the diarist Pepys and Dr. Johnson—consuming enormous quantities of mutton and fowl, and paying with gouty, swollen toes. Those literary gluttons seem to be a thing of the past, and the word has fallen into disuse, too. You certainly don’t hear it in recovery circles, and indeed most sober alcoholics would likely reject this old-timer’s view of the disorder. You’re much more likely to hear alcoholism described as a medical disease, or a spiritual crisis.
But I like the idea of alcoholic gluttony. It rang true to me back then, and it still does. It cuts through a lot of hair-splitting debate and gets right to the heart of the matter: lack of self-control. Call it what you like, but at the end of the day there’s no getting away from the behavior—the excessiveness, the lack of restraint, the—yes—gluttony.
Yet labeling alcoholism as gluttony does not make it simple to understand. Indeed, alcoholic gluttony is maddeningly complex, and in a way this vice—this deadly sin—captures human nature in all its irrational nuance. Looking back now, I believe that my career as a science journalist has paralleled my drinking career; my unfolding relationship with alcoholic gluttony shaped the questions I asked, and how I asked them.
My scientific interest in boozing preceded my own excesses, because my father died a full-blown alcoholic. But my memories from childhood were not of a reckless man, but rather a vibrant, engaged man—a hiker, a sailor, an educator. Then somewhere along the way things changed, for no obvious reason. There was no tragic trigger, just the usual disappointments, and he drank more and more. I recall sitting at his kitchen table late in his life, and he was drinking Passport Scotch disguised with OJ—his drink of choice—and thinking: He’s chosen this path freely, with full understanding of the tradeoffs. But I watched him clinically and warily, because I knew I carried some of his genes, and his transformation reflected back on me.
As I watched my father’s alcoholism progress—and then my own—I began asking other questions: Do we have a brain disease? Are there particular neurotransmitters run amok. I read widely in the literature about genetics and addiction and stress, about suspect neurotransmitters, and brain anatomy related to pleasure and risk and will, and even wrote a newsweekly cover story on the interplay of genetics and misfortune. None of this got me very far. Alcoholism appears to run in families, and many experts believe there are genes—probably a handful of them—underlying the disorder. There are candidate brain chemicals and structures. So I probably inherited a propensity of some kind. But so what? As one geneticist explained to me years ago, there is no elbow-bending gene. That is, no genetic or neuroscience findings will ever alter the fact that alcoholics—at every stage of their drinking history—are making decisions. Every time we pick up a bottle or pour a finger of whiskey, it’s a choice—it’s the option we’re freely selecting, at least for that moment.
So I moved on from what I now saw as a reductionist neuro-genetic view of alcoholism to an interest in cognitive psychology. Specifically, I wanted to know how we make decisions and judgments and choices, and why so many of our choices are not in our own best interest. Ironically, my preoccupation with irrational decision making coincided with a sharp spike in my own drinking. I was increasingly isolated in my alcoholism—skipping my favorite watering holes for a bottle at home; I drank at lunch every day, and often in the morning. The “holidays” I took from booze were more and more difficult. My drinking life wasn’t feeling like a choice—but I had no other way to explain it. I couldn’t blame it on anyone else. Even self-destructive decisions are decisions, and I began devouring the scientific literature on emotions and distorted thinking, looking for an explanation for my own poor life choices.
And that’s where I am today. My research as a science journalist led me to the study of cognitive biases—the heuristic traps that, once helpful, now lead us all too often into perilous territory. I focused on irrational thinking, and as my own head cleared in my chosen sobriety, I explored all kinds of distorted thinking—culminating in a book on the topic, called On Second Thought. On Second Thought is about the surprisingly automated lives we live—often at the price of our happiness—and it’s also a guide of sorts to more deliberate thinking. It’s not about alcoholic gluttony, but the title could well describe my own questioning of my own harmful life choices—and the change I made.
My next project—in the works—is on alcoholic gluttony. In the course of researching and writing On Second Thought—I was sober by then—I kept stumbling on psychological science that illuminates the process of recovering from alcoholism. Much of it is counterintuitive—the need for powerlessness, the dangers of self-reliance, the power of moral inventory and honesty. Many recovering alcoholics see the steps of recovery as a spiritual path, with no need for scientific explanation. I don’t argue with that, but I also think there’s a breed of sober alcoholics who are curious about the workings of the mind as it chooses—first a destructive path, then a life-changing one. They are the audience for the next book. Let’s call them recovering gluttons."
--
This post comes from the BPS Research Digest's Sin Week. Each day for Seven days BPS posted a confession, a new sin and a way to be good. The posts coincide with the publication of a feature-length article on the psychology behind the Seven Deadly Sins in this month's Psychologist magazine.
This is really interesting - I totally agree with him. I for the most part don't like the "reductionist neuro-genetic view" of alcoholism, mental illness, other addictions, etc. It's never the complete picture.
ReplyDelete"Even self-destructive decisions are decisions"
Glad you are posting again!