The problem of Alcoholism and its Treatment
For long in the history of mankind alcoholism was a moral problem, resulting from moral degradation and weakness of will power. Drinking Alcohol is just one of the several ways in which people wrongly react to stresses and strains which are too difficult for them to meet in the normal manner.
Alcohol addiction is as old as civilization
Drinking Alcohol is as old as civilization in India. There are sections in Indian society in which the use of alcohol is not only common but is also a sign of respectability, modernism and what not.
The use of alcohol is considered pathological if it is used in excess, if the individual cannot do without drinking, if its use is disapproved, by society, if it has injurious effects on the mind and body of its users.
Alcoholic psychosis is primarily a mental disorder of middle life. The number of men is greater than that of women. A very high percentage of them are either widowers or divorced. Among men the proportion of bachelors is greater than that of married people.
What Psychologists say about Alcoholism?
Psychologists explain the drinking habit by the purpose drinking serves. People drink alcohol to escape from worry, anxiety, responsibility and misery of life. Under the influence of drink, the timid feel brave and the unhappy feel cheerful. It helps to overcome frustrations and disappointments. All this may be true but it is not a complete explanation.
Everybody in this world has problems and worries. But why is it that only some take to drink to meet their problems and worries and others does not?
Alcoholism presented as repressed homosexuality
Many psychoanalysts explain alcoholism by repressed homosexuality. They argue that men drink alcohol excessively mostly in the company of other men and in such bouts they come in bodily contact with each other. In such bouts of excessive consumption of alcohol the repressed homosexuality of the alcoholics finds expression.
Alcoholism as partial suicide
One psychoanalyst K.M. Menninger puts forward an interesting theory. According to him addiction to alcohol is partial suicide. It is an attempt at self-destruction so that greater self-destruction may be avoided. He sees in the thwarting of his ambition, disappointments in love and business, threat of disgrace and the like a great danger to himself and indulges in milder self-destruction to avoid a greater one.
These and other theories are not complete explanation of why people drink but they throw a good deal of light on the problem.
They fail to account for individual differences in the use of alcohol and are too simple to be accepted as a satisfactory explanation of behaviour of alcoholics. The most striking fact about the use of alcohol is its great popularity in all cultures, regions and countries and among all classes of people.
Alcoholism is very popular
Many campaigns have been organized against it, many legal restrictions have been placed on its use, laws of prohibitions have been enacted, temperance societies have waged ceaseless war against its use and almost every religion has propagated against it and yet alcoholism is as popular as if was before.
The fault was with our interpretation of alcoholism.
We naively believe that drinking alcohol is just a matter of habit. Contrary to popular belief, alcohol is not a stimulant but a depressant.
Excessive alcohol intake attacks and paralyses the higher centers of the brain thus weakening their control on the lower centers. As this control weakens the primitive impulses and emotions of man, they are no longer restrained and get a free expression. Thus alcohol is a means of escaping from one’s rational and social self. Before drinking alcohol he was frustrated, depressed, anxious and bored but after drink he feels warm, vigorous, helpful and happy. He now feels quite capable of accomplishing tasks which he avoided. Drinking wine and other forms of alcohol produces a sense of security arid competence. Such a theory is more comprehensive than theories we have mentioned earlier.
Effects of Alcoholism
In general the effects of alcohol are very injurious. When the alcohol content of the blood rises to 0.3 percent, serious disturbances in movement, speech and vision are seen and thinking is confused. And when it rises to 0.5% the entire physiological and neural balance is upset and the person becomes unconscious. This unconsciousness in a way protects him from more serious consequences because he is prevented from consuming more alcohol which might bring about his death. The effects of alcohol vary with the individuals, their physical conditions, their personality, the amount of food he has already taken and the time for which he has been drinking. There are people who consume quite a large quantity of liquor but show no signs of intoxication and retain their bodily and intellectual alertness.
The actual effect of alcohol on the brain centers is not fully known but it does not seem to cause damage to the brain tissues. But it does seem to slow down the functioning of the brain.
In some people excessive consumption of alcohol may cause cirrhosis of liver but it does not have any harmful effect on other organs. Excessive indulgence over a period of time leads to abnormal behaviour, to psychotic reactions.
Some social factors contribute to the increase of alcoholism. How respectable is the drinking habit, how readily available the several varieties of liquor are will to some extent influence the amount of alcohol consumption in any society. In countries whew wine is manufactured from grapes and is found in abundance people will drink mostly because it is freely available and cheaply sold. Prohibition may not altogether stop the use of alcohol but it certainly has a preventive effect.
Indian Women are less susceptible to the temptation of liquor.
Women consume less alcohol due to their training or social pressure. The number of male alcoholics admitted to hospitals is four times larger than that of women. Among Indians there are certain social groups in which wine drinking at festivals and ceremonial occasions is socially approved.
Drinking is very common among motor and truck drivers and some large towns in India are faced with the problem of intoxicated drivers being a menace on roads particularly at night.
The alcoholic addicts drink to excess and cannot resist the desire to drink more and more; they damage their career and their families, they may develop cirrhosis of the liver.
Treatment of Alcohol addiction
Today the methods of treating alcoholism have undergone a basic change. Drinking is no longer considered the cause but the result of a person’s difficulties. The reactions and after effects of heavy and prolonged drinking may need medical treatment in the form of sedatives, hot baths, toning up the system by washing and resting his stomach and giving him nourishing diet. For chronic alcoholism efforts are made to improve the physical health of the patient by making up vitamin deficiency and removing organic defect if any. But a detailed course of psychotherapy is necessary to strengthen the individual’s defense against the miseries of life. This psychotherapy should be undertaken in a hospital so that the patient is removed from those stress situations in which he feels the urgent necessity of drinking and his physical and mental difficulties are well looked after.
Methods of psychotherapy for treatment
Methods of psychotherapy may be grouped under three heads.
In the first group we have the various forms of surface treatment such as suggestion, moral encouragement and persuasion and hypnosis. During the hypnotic state the patient is given a suggestion that he will not drink, that he will dislike drinking and that he will avoid alcohol and often obeys these suggestions on recovering from the hypnotic state. But these methods do not have any effect on the basic problems and difficulties of the patient which have led to alcohol addiction.
The second group of therapeutic methods consists of substitute emotions. Many rakes have turned a corner after coming in contact with religious and social reformers who gave them a new outlet for the expression of their emotions. Religious conversation, seeking joy choosing social service to the needy and the poor or joining social and political missions have deeply affected the personality of many alcohol addicts and induced them to seek satisfaction in activities other than drinking. A movement called Alcoholics Anonymous has gained considerable popularity and its programme and approach is fundamentally different from routine temperance societies.
The third group of psychotherapeutic methods aims at laying bare the root cause of drinking. People take to alcohol because it provides means of adjustment to stressful emotional and personal problems. Psychological treatment will bring out the real nature of such conflicts and difficulties, to strengthen the personality of the patient, to resolve conflicts and meet difficulties in a realistic manner and thus to get rid of them. Once the patient is made to understand what the complexion of his conflicts is and how they can best be resolved he will not resort to such artificial means of adjustment such as the use of alcohol.