Rational Recovery for alcoholics vs AA

thaiboxerken said:
When I was a squid, in the Navy, I was an alcoholic. I drank in the morning, evening and during the day and I'd show up to work drunk.. but hiding it well. Then, one day, I decided that it's probably not a good thing to be drunk all of the time. So, I stopped getting drunk all of the time. Now, I drink in moderation and have no problem simply because I made the choice. Of course, since I had the will to change, some will say that I simply wasn't an alcoholic.
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Were you ever actually diagnosed as being an alcoholic.

Drinking a lot when you're in the service is pretty common & doesn't necessarily make you an alcoholic.
 
I was never diagnosed as an alcoholic, but what's it take to be diagnosed? Is being drunk for months at a time enough?
 
thaiboxerken said:
I was never diagnosed as an alcoholic, but what's it take to be diagnosed? Is being drunk for months at a time enough?
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There is no such thing as a medical diagnosis of "alcoholism" per se. There are two general categories of substance-use diagnosis that are relevant: substance dependence and substance abuse.

Substance dependence is basically defined by whether there is tolerance/increasing usage, whether stopping use of the substance causes a withdrawal syndrome, and also whether there are physical, social or occupational consequences to the usage.

Substance abuse is not very well defined medically. It's basically a catchall meaning "I don't think this patient's use of this substance reaches the level of depencence, but I still think it's a problem."

FWIW, I'm currently in my psych rotation and our course director's specialty is in treating addicts. He does send people to AA sometimes, also uses non-AA group therapy, and he says one of the most important things to remember is that the patient doesn't have to "hit bottom" before they get better. Personally, I don't care for the AA philosophy or for their non-transparency, but I'm not sure anything really works all that well.
 
lionking said:
I hope I can replicate your experience. I recently heard a therapist say that it would be possible for an alcoholic to resume moderate drinking, but only after abstinance of at least 12 months, and I suppose that's where people fall over. So after 12 months or so I will give it a go. If I cannot sustain moderate drinking, at least I know I can give up again.
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Good luck on that. Not that it's impossible, but I will just mention that I had a friend who was an alcoholic, and after a very close call with DT's etc, and detox, and some AA, he remained sober for about 8 years. Then he resumed "moderate" drinking, and that was, basically, the end. He died a few years later, under very unfortunate circumstances. He might as well have put a gun to his head. The reason I bring this up is that I observed that what he thought was moderate never was. "Only one drink" was a tumblerful. I've heard the same said of some people who have difficulty losing weight. "One helping," etc. seems to have a different meaning. I mention this not to suggest that it's impossible to resume some kind of moderate drinking in the future, but to remind you that it is easy to deceive yourself if there's still something in you that wants more than what is truly "moderate."
 
There isn't any perfect recovery program. Those willing to tolerate some imperfection, accept some guidance, and make some effort will probably do just fine with AA. Those who aren't are less likely to succeed with AA, or RR, or anything else. Observations made during seventeen years of continuous sobriety in AA incline me to generalize that those predisposed to substance abuse tend to have trouble with those things. This might go a long way toward explaining recurrent relapse, regardless of the approach to treatment.
 
bruto said:
Good luck on that. Not that it's impossible, but I will just mention that I had a friend who was an alcoholic, and after a very close call with DT's etc, and detox, and some AA, he remained sober for about 8 years. Then he resumed "moderate" drinking, and that was, basically, the end. He died a few years later, under very unfortunate circumstances. He might as well have put a gun to his head. The reason I bring this up is that I observed that what he thought was moderate never was. "Only one drink" was a tumblerful. I've heard the same said of some people who have difficulty losing weight. "One helping," etc. seems to have a different meaning. I mention this not to suggest that it's impossible to resume some kind of moderate drinking in the future, but to remind you that it is easy to deceive yourself if there's still something in you that wants more than what is truly "moderate."
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Thanks. I respect your advice.
 
andyandy said:
AVRT stands for "addictive voice recognition therapy" and is espoused by Rational Recovery - like the AA insofar as it's for alcoholics, but seemingly diametrically opposed to the methods to be used....

here they provide a brief summary of AVRT (it just sounds a bit like cognitive behavioural therapy to me....)

http://www.rational.org/html_public_area/course_avrt.html


the RR is rather critical of the AA



and rather bombastic in its tone....

http://www.rational.org/faq.html

so.....is there any consensus on addiction counselling? What method is most effective?

personally, after reading the RRs FAQ, i'd be tempted to take my chances with a supreme being :)
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Yeah Trimpey is rather critical og God and AA, and does not like the spiritual aspects of AA. They both come down to the same thing, you have to chose not to use. they both feel that if you use , you will relaspe. I have found this to be true myself, if I use I will always return to the prior level of use and problems very rapidly, but then if I don't use I return to the level of not-use and the functioning very quickely as well. I don't advocate relapse , it is dangerous.

AA uses the mystic stuff as something to do while you are not using but it still comes down to the same thing. The Big Choice as Trimpey calls it, don't use. the rest is standard cognitive behavioral therapy. I like to use it along with a strong relapse prevention/avoidance model.

In AA they call it 'stinking thinking' in CBT you call it 'addicted thinking'.

All substance progemas have about the same success rate unless they are nine month residential programs, some people just don't want to change. Even when they get run over by thier behaviors.
 
Fnord said:
Personally, I've not known any addict to be completely recovered. Either they replace one addiction with another, or they eventually revert to the original addiction. That is, if their original addictions hadn't so ruined their health so much that they didn't die first.

Addictions have chemical, as well as behavioral, components. Simply addressing one side will not "cure" the addict. However, the A.A. 12-step model seems to work for most of the addicts, most of the time, for most of the rest of their lives. "Five minutes at a time" is about as good as anything else. Or as bad.
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All hail eris! ( :) )



I find that AA and NA has the worst record because of the number of people who are forced to attend. They don't really participate, they just go to get the signature, and wait out there probabtion.

I have known many clean addicts who have never returned to use. One who even injected alcohol (gin) to maximise his buzz when his bottle was low. The standard relapse rate is sbout 60%, and some people get better, some people never do get better at not using.
 
lionking said:
I couldn't get into AA because of the "higher authority" stuff, but gave up an excessive drinking habit (I still have problems admitting to the "A" word) three months ago. The chemical dependancy cannot be underestimated in my opinion. I found this harder than the social aspects (we have a drinking culture in Australia) or the general craving.

At the expense of sounding I'm on Oprah, it's still a daily struggle and I avoid parties and pubs, but what gets me by is that I keep telling myself that alcohol has been more of an enemy than a friend. Corny, I know.

I hope to get back to so-called controlled drinking, so that I can enjoy the social and relaxing benefits of alcohol, without drinking to excess, but will go without for the time being. Confession over.
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Just some silly advice, don't drown yourself in the shallow water. "Redrinking" only works on those who have an abuse problem, not a dependancy. If I start to tell myself "A little won't hurt" then I will be in addicted thinking mode. If i say, I can use but I don't like the consequence, I choose not to use: that works better for me.
 
Look! A big can of worms!

thaiboxerken said:
Then AA saying that alcoholism is a disease is not founded on any science at all, right?
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That question can cause so much confusion and controversy, it is unbelievable. You could start an entire topic about it, and it might run forever, with all kinds of other issues thrown into the mix. Is gambling-sex-violence-internet-chocolate-smoking-foodaholism a disease? Sexaholics, chocoholics, nicoholics, gamblaholics, is internet addiction a disease? Is smoking cigs a disease?

What is a disease? How do you define it? (more important, who gets to define it?) If it is a disease, then is it also a crime to have it? If Alcoholism is a disease, can it be treated with medicine? Is it genetic? Can you avoid it? The Supreme Court has ruled on it, Doctors fight over it, especially for funding, research has been faked about it, (the Constitution of the United States was amended over it, twice, just to make sure the severity of the problem is understood), treatment centers, Courts, MADD, lawyers, AA, Religion, Corporations, they all have a hand in the fight. And it is a fight, I'm not using rhetoric.

If you say yes, there is a lot to back it up, if you say no, there is a lot to back it up.

http://www.physiciansnews.com/commentary/298wp.html
http://en.wikipedia.org/wiki/Alcoholism#Identification_and_diagnosis
http://209.161.33.50/dictionary/alcoholism
http://www.healthline.com/adamconte...alcoholism&utm_medium=mw&utm_campaign=article
http://www.peele.net/faq/disease.html
http://www.gmu.edu/facstaff/facultyfacts/1-1/alcohsm.html
http://www.baldwinresearch.com/alcoholism.cfm
http://wings.buffalo.edu/law/bclc/web/nydavis1.htm
http://www.schaler.net/1988oct25.html
http://www.indiana.edu/~engs/cbook/chap6.html
http://www.time.com/time/magazine/article/0,9171,841325,00.html
http://www.duiblog.com/2006/09/

And about a million other web pages on this, just for a start. I am tempted to start a topic on it, but just don't have the nerve. While on one hand, the disease concept might help, on the other, it is shown to cause harm.

Based on past experience, there is no winning in this fight, only degrees of losing.
 
thaiboxerken said:
When I was a squid, in the Navy, I was an alcoholic. I drank in the morning, evening and during the day and I'd show up to work drunk.. but hiding it well. Then, one day, I decided that it's probably not a good thing to be drunk all of the time. So, I stopped getting drunk all of the time. Now, I drink in moderation and have no problem simply because I made the choice. Of course, since I had the will to change, some will say that I simply wasn't an alcoholic.
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That depends, if youfelt that you needed to use to function and it became your primary relationship, then you most likely had a dependancy. It is not uncommon for people to have severe substance abuse issues in the military or college.

Only yopu know for sure.

Alcoholics have the will to quit, it is the other stuff that gets in the way, the permission of addicted thinking.
 
andyandy said:
so.....is there any consensus on addiction counselling? What method is most effective?
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No consensus at all. The method that seems to work best, is to not drink, or take drugs.

As for Rational Recovery, it is a great help to some people, especially drug addicts, and anyone who has run smack into the nightmare of AA/NA, which is well documented.

There are other resources for anyone suffering drinking/drug addiction
http://www.aanottheonlyway.com/about-the-book/preface.php

http://www.unhooked.com/site/FAQ.htm

and for those looking for ammo against AA, there is
http://www.orange-papers.org/

- a blistering attack on AA, especially the religion and woo crap behind it.
 
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lionking said:
I hope I can replicate your experience. I recently heard a therapist say that it would be possible for an alcoholic to resume moderate drinking, but only after abstinance of at least 12 months, and I suppose that's where people fall over. So after 12 months or so I will give it a go. If I cannot sustain moderate drinking, at least I know I can give up again.
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As long as you feel you need to drink to socialise, then don't. (Cheap advice) If you have chosen the drink over relationships, if you have lost relationships over drink, if you have lost jobs over drink, if you have ever felt that you need a drink to function and deal with life, if you have ever had a blackout or a grey out, I recomend waiting at least 100 year before you drink.

relapse preventioon is much easier.
1. take care of yourself (See your doctor, eat right, get sleep, exercise, develop your social life)(This is the hard part.)
2. Avoid places, people and thoughts where you are likely to relapse, plan how you will deal with them in advance.(It is too late if you are already headed to the bar or liquor store)
3. When you are in a stituation where you are likely to relapse , get out and get help.
 
thaiboxerken said:
Then AA saying that alcoholism is a disease is not founded on any science at all, right?
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It depend on the definition of disaease, some pople have a biological vulnerability to substances, others have a physiocal dependancy, others have a messed up set of behaviors. For some just tghe firsat two are a disease others include the third.

The main point is to remove the moral stigma of addiction, it is a behavioral problem that has gotten out of control, it might have physical consequences.

Addiction does not require physical dependance, so for some disease may not be the best term.
 
Dancing David said:
All hail eris! ( :) )



I find that AA and NA has the worst record because of the number of people who are forced to attend. They don't really participate, they just go to get the signature, and wait out there probabtion.

I have known many clean addicts who have never returned to use. One who even injected alcohol (gin) to maximise his buzz when his bottle was low. The standard relapse rate is sbout 60%, and some people get better, some people never do get better at not using.
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Isn't NA a recruiting ground for the Co$?
 
Hafast said:
-As far as the religious aspects, if I remember correctly, you can have yourself as your higher power. There is no prescribed diety. The idea is to have something to hold onto to help get you through the tough times. If you believe that power is within you, then so it is. Yes, god is mentioned, I would guess that's mainly because most members, as in most of the public, believe in god. You won't be looked at as a horrible person if you say you don't believe in god (well, not by everyone).
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actually that is the only thing the higher power CANT be. You are helpless against addiction, remember? You can pick anything but yourself, which is kind of crap if you ask me. If anyone is going to stop you from doing something its YOU.

I was reading 'wasted', a book about a woman with long standing eating disorders. She went to aa to talk about it, and she said hearing she was powerless was very dangerous and helped her delve deeper into her eating disorder. 12 step is used for those behaviors too, because, like sex addiction, its an addictive behavior where the body is used to gain a high.
 
thaiboxerken said:
Then AA saying that alcoholism is a disease is not founded on any science at all, right?
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the idea that a behavior itself is a disease is absurd to me. I dont see how something people choose to do can be put in the same category as things like polio or chicken pox. Most people living with a chronic disease wish they could simply choose not to have it anymore and stick with it, but that simply isnt the case. If anything I would call it a disorder, because like other mental disorders psychological treatment is helpful to getting rid of the behavior.
 
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