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The Many Faces of Alcoholism and - We Wish - Treatment

Aug 18, 2007
Fifteen years ago I first heard the term pseudo-egalitarianism, false equality, from Dr. Steve Schroeder-Davis in Minneapolis. At the time he was speaking about "dumbing down" education so as to penalize the academically gifted. Through the course of my work with people suffering from alcohol related problems I encountered another face of the same form of denial - institutionalized insistence that people are the same even when they obviously aren't, and that a condition is best treated by only one, usually unsuccessful, approach. Ignorance and fear would seem to be the propelling forces in both cases but neither the gifted, nor clients, nor society are very well served by programs founded on either.

People's abilities, whether athletic, intellectual, musical, emotional, and so on, are not equal and we all know it. We may hate it, but we know it. To pretend otherwise is to ignore primary factors in the successful diagnosis and treatment of any condition, alcohol dependence included. Failure to incorporate strengths, abilities, and, yes, differences, dooms many a client to depression and despair that could have been avoided.

Why the monolithic approach? The development of current treatment practices evolved from the marketing of AA's 12 Steps, an approach that worked for a group of alcoholics who'd failed at the other approaches used in the 1930's. These approaches hadn't failed everyone, only a subset who became the group from which most current practice is derived.

Once established, the programs themselves also became philosophically incestuous with those who experienced success becoming the true believers who trained the next generation of "counselors," and those who did not find success on a 12 Step basis stayed, understandably, quiet about their failures. Through this winnowing process programs became ever more homogeneous and clients found themselves in a revolving door with few alternatives available. This has gone on through fifty tears of repetition while the other approaches have been lost, ridiculed, suppressed, or simply ignored.

Lately, however, other models have begun to appear or re-appear, programs rooted in medical and cognitive/behavioral approaches. Programs whose philosophy is client centered, not dogma centered. Politically incorrect, some even tread on the forbidden ground of moderation. The commonality here, if there is one, is the idea that clients are best served in matching them to strategies that take advantage of their strengths while extinguishing their alcohol abuse, dependence, or addiction. The end product is an ex-drunk in the same sense that many of us are ex-smokers. It's something we were, or did, but is no longer a factor in our lives.

While this is a welcome change it isn't an easy one. Client specific counseling requires focus, knowledge, a willingness to experiment, and the freedom to suggest unorthodox solutions. In short, it requires conscientious providers who aren't linked to one narrow philosophy or approach.

If you are looking for help don't sell yourself short by settling for one standardized possibility. Allow yourself the better option of selecting from a number of diverse options. That way you are most apt to find a program that will match your needs and expectations, a sure way to help generate and maintain the motivation that is the number one predictor of success.
About the Author
Dr. Edward Wilson has been developing and providing alternative alcohol counseling including moderation, since 1990. He is co-founder and Clinical Director of Your Empowering Solutions, Inc. located in suburban Los Angeles. You can learn more about Dr. Wilson's innovative work in 12 step alternatives for alcohol problems by visiting his website.
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