Wednesday, January 19, 2011

Could Alcoholism possibly be a mental health issue?

I never thought of myself as having a mental illness... all joking aside.  But... I've felt I didn't fit in to the norm of society somehow... and this describes me sober as well as drunk.  Now... I think few who have travelled the road I have would argue that there might just be something underlying... besides the alcohol.  Are you with me so far?

So... has anyone heard of MHFA?

Here is the Mental Health First Aid Action Plan;

Action A; assess for risk of suicide or harm

Action L; Listen nonjudgementally

Action G; Give reassurance and information

Action E; Encourage appropriate professional help

Action E; Encourage self help and other support strategies

So there's a first aid for mental situations as well as for physical situations. Let's look at alcoholism as being a mental health situation, shall we?

Mental health problems include; depression, anxiety, misuse of alcohol and drugs... and even food.

"Many people are not well informed about how to recognize mental health problems, how to respond, or what effective treatments are available. There are many myths and misunderstandings about mental health problems. Common myths include the idea that people with mental disorders are dangerous, that it is better to avoid psychiatric treatment, that people can use willpower to pull themselves out of mental health problems, and that only weak people have mental health problems. Lack of knowledge may result in denial and avoidance. With greater community knowledge about mental health problems, people will be able to recognize problems in others and be better prepared to offer support."

"There is a stigma associated with mental health problems. Stigma involves negative attitudes (prejudice) and negative behavior (discrimination). Stigma can lead people to hide their problems and delay seeking help. People are often ashamed to discuss mental health problems with family, friends, teachers, and/or work colleagues and may be reluctant to seek treatment and support because of concerns about what others will think. Stigma can lead to exclusion of people with mental health problems from employment, housing, social activities, and relationships. People with mental health problems can internalize the stigma and begin to believe the negative things others say about them. Better understanding of the expereinces of people with mental health problems can reduce stigma and discrimination. People with mental health problems may not have the insight that they need help or may be unaware that effective help is available. Some mental health problems can cloud a person's thinking and rational decision-making processes, or the person can be in such severe distress that they cannot take effective action."

So... is it not stigma and discriminaiton that we get from the anti/XAer camp?  They dare to judge us for supporting our "support strategy" and encouraging others to give it a shot.  They dare to mock us for having a less than cordial attitude to insults and vicious attacks on our character and motives.  They condemn us for our seeming proclivity to dwell on death, suicide, violence, destruction, etc.  "Stand with us on the firing line..."

What if...

What if  ... it was a mental illness... among other things?  What would this imply with current and past treatments of the over-indulgence of the mysterious elixir?  What would it imply with regards to the "disease model?"  Would it support it?  Compliment it?  Run contrary to it?

I could think in terms of what we have done right and wrong with regards to 12 step work in A.A.

My understanding of 12 step work in A.A. boils down to this;  Try to find out about the prospect's situation and their past history with booze.  Do they drink alcoholicly... aka show lack of control physically and mentally?  Are they receptive to learning what the definition of alcoholic drinking is and do they currently identify?  If so, does booze scare them?  Do they want to do something about their condition or do they just want to negotiate something to terms of their own... to bargain back for rights or things lost?  Do they want and need help?

But what if they don't exactly fit the A.A. description of the alcoholic?  What then?  Do we know where to send them or can we suggest they try something else?  Or... what if they are an alcoholic to the A.A. book's description and they do not/can not do our proposals for recovery for ... whatever reason?  Can we turn them lose and there again, steer them to seek "appropriate professional help?"

How do "we" know that our ducks are in a row?  How do we hold accountable those who set out to prey on and harm these vulnerable folks?  Well, it's been my experience that you don't.  As a boss I had used to tell me, "Give them enough rope, they'll hang themselves."  The anti/XAers would sure weigh in with a more drastic proposal; yeah, just torch A.A. to the ground.

How about let's see what's right about A.A. and look a little more closely at this MHFA model and see where it fits in.  Can it help us?  Can it help us help "them"?  Can it help bridge the gap between pro 12 Step and other methodologies?

As far as the spiritual approach; I think that more and more now, there is a need for acceptance and understanding of secular methods and there should be a way to bridge the gap between the two regardless of the recovery method.  This would of course require a cease-fire from both sides.  If you want/need to belong to a fundamental Christian-based 12 Step group, find one or create one.  If you want/need to belong to a secular 12 step or alternative recovery method, find one or create one.  In fact, if you're as secular and rebellious and you claim, I offer you this challenge; form and A.A. meeting and do whatever you want with the Alcoholic's Anonymous book, the steps, a 3' by 5' poster of Bill W, Dr Bob, and Dr. Silkworth and do what you want, so long as you don't "affect other groups or A.A. as a whole."  Drink beer and throw darts at Bill W, and then us the A.A. book for fire kindling if you'd like.  See if A.A.W.S. comes and breaks your meeting up.  I doubt it.  If it helps folks get sober and helps them to improve their lives, then great.  But if not, try something else.

I think I've covered a few thoughts.  Let's see if what I have so far generates some conversation.  If you say I'm too vulgar and over the top nasty and angry, then give me a smidgeon of credit for trying to think positive here.  If it's blood you want, You Got It!


  1. Interesting post on sending people where they need to go.

    The thing about the st crew is they don't want you to help menally ill people.

    They're bashing Chris R who is a huge advocate of sending people in AA to mental health professionals.

    I don't get the crew. They must honestly like living in the negative.

  2. No one really knows what alcoholism, actually. You can't even acceptable, universal definition of the condition. Yeah, AMA says it's a disease but Bill W. said in 1960 that AA won't call it that. But from all the research I've read over the years seems to point to both psychological and physical conditions that exist which differentiate us drunks from the other poor souls out there. So your question is a valid one.

    I don't think anyone can say alcoholism is a mental illness per se. (well, they can. But anyone can say anything. Look at the internet for proof of that) The shrinks call it a "maladjustment" in DSM IV. I'd rather be "maladjusted" than mentally ill personally. But the bottom line here is that there certainly seems to be psychological factors which contribute to the disease, and when we deal with helping others we need to consider the psychology involved.

    But I'm not a mental health expert, so I'm not really qualified to start treating this thing from the mental health angle. I'm an alcoholic. I help other alcoholics by sharing my experience in dealing with alcoholism. My primary purpose is to stay sober and help other alcoholics to the best of my ability. My ability doesn't include dealing with the mental health issues. But I think is an alcoholic goes through the 12 steps and the attendant character change and spiritual change that will result from that, then perhaps many of the mental health issues will disappear.

    Are there other programs out there that are successful in dealing with alcoholism? Yep! Does AA work for everyone? Nope. Even Bill Wilson acknowledged that on several occasions and stated that we don't have a monopoly on sobriety. So I don't have a problem with accepting that something else may work better for a particular individual. Bill also said that AA should always be evolving; so sure, taking a look at other programs to see if they can help is a good idea. But I look at these things from the standpoint of how they can compliment the 12 steps, not replace or modify them.

    For those who want to spend their time attacking other programs other than their own - go right ahead. I've got better things to do. AA works for me. Something else works better for you? Good. Glad you have a Plan B. It's too bad that those who walk out the doors saying that AA didn't work for them, when in fact they didn't work for themselves, don't have a Plan B.

  3. Well of course we're not doctors! But... what about this Mental Health First Aid thing? You'll see more and more of this stuff in the professional workplace and the community about us now. Mark my words.

    I agree with what you guys say... and thanks for weighing in on this. I've not got much time for the internet these nights and am studying for my CDL at work and other licenses associated with my work.

    But does it not just go to show you... the need for compassion and understanding in dealing with folks... well, like us? But instead, our adversaries try to cyber-bully us, then when they find we're fairly upright, salty, and thick-skinned individuals who will push back, they point their shame-spewing fingers at us and moan about how vulgar we are.

    In this work book put out by the MHFA here, it is mentioned that the only time the mentally afflicted person becomes violent to others or themselves is when they abuse alcohol and or drugs... statistically.

    So... what sane person, knowing full well the risks they take with regards to interacting with society, family, friends, etc... would risk harm on themselves and these other folks with a senseless indulgence in booze and/or drugs? None, right?

    There are so many potentially good times that I destroyed due to my over-indulgence. Sometimes I was not even willing to concede that I was not behaving as I should. So, was I just being an asshole? Sometimes, maybe. But not long term. I do believe that we do stupid things willfully... when we know no better or when we see no hope.

    The anti/XAers are legends in their own minds. I caught a glance of one of them stating to ftg that they should move your conversations over to the "community" pages so they could "pull the proAAers around by their ears" in the act of directing them to a place more appropriate for their coveted site. No ego needing smashed there, huh?

  4. AA's been around time and will be around long after we're gone. I don't care about Orange, MFHA, Peele, or any other critic of the program. The tradition says that we don't engage in public controversy, so I don't get into pissing contests with morons who don't know wtf they're talking about. Especially morons who aren't alcoholics and have nfi about the experience of alcoholism and recovery.

    Think about the fact that we're an unorganized organization with no rules, no leadership, no cohesion other than our mission of staying sober and helping other alcoholics to achieve sobriety. That's it. Simple. And it works.

    AA is the oldest, largest, most successful recovery program in existence. There are AA groups worldwide. The reason for all this is that AA works. Let the critics attack AA all they want. Maybe it keeps them off the streets or something. Maybe we're performing a public service by providing a platform for them to display their ignorance to the world. Don't consider these people as adversaries as they pose no real threat to our program. Instead look at them as inconsequential, misguided, perhaps "maladjusted". They're great examples of Plato's reflection that wise men speak because they have something to say; fools speak because they have to say something.

    I don't have the time nor the interest to listen or respond to their "intellectual" pronouncements and pseudo-analysis of recovery. I have meetings to go to, sponsees to work with, commitments to carry the message to other groups and my own sobriety to worry about.

  5. I think that alcoholism is a three-fold illness of the body, the mind, and the spirit, and that it must be treated holistically. I also know that some alcoholics suffer from other disorders and mental illnesses and that alcoholism exacerbates the mental illness and vice versa, therefore both must be treated for any treatment approach to be successful.

    I also see that all too often, mental health professional want to just throw meds, particularly benzodiazepines on the problem, treating the behavior instead of the root. They give alcoholics klonopin and atavan for anxiety, when anxiety just goes along with the territory. Alcoholics suffer from anxiety early in recovery because they are scared shitless of being sober.

    I was telling a co-worker, a gal who is a recovered addict and going to school to be a CDP about how I used to be. I'd try to get sober and after a while, people would be saying "Dude you should drink." I was page 52 personified. She told me that I sound like someone who could have benefited from meds. I told her that she sounds like someone who is learning shit in school. I also told her that I'm convinced that had I been given meds, I would be dead right now.

  6. In answer to the question "Could alcoholism possibly be a mental health issue?" I would say yes. But it isn't exclusively a mental & emotional health issue. If it was psychiatry would be the answer. Nor is it exclusively a physiological issue, if it was abstinence would solve the problem. And it isn't just a spiritual problem. If it was religion would be the answer. It does seem that for a good many of what I would call the "real deal alkies," that the spiritual malady must be addressed n order to straighten out mentally, physically, and emotionally. That is how it has been for me. Before I got sober I was diagnosed as bi-polar. I had also been told literally, that I was maladjusted to life and in full flight from reality-I was defiant, anti-social. and discontent in other words. But just like the book says, it didn't fully answer the question. It didn't answer the question of why I drank the way I drank and why, when sober, I was restless, irritable, and discontent. Why was I so angry and sensitive? Why couldn't stay focused in the here and now? Why can't I relate to others? I found the answer to those questions in Steps 4 through 9 and I grow in life through the practice of 10 & 11 along with a yearly journey through the steps. I still fall prey to those bedevilments (human problems, but it's been a long time since I threw an ash tray at someone in an A.A. meeting.

    Once again, any approach to alcoholism that doesn't address the whole person, no matter what approach it is will fall short.

  7. Jim :

    "Once again, any approach to alcoholism that doesn't address the whole person, no matter what approach it is will fall short. "

    Yeah. I agree. It's not just a matter of will power for me. It's also not just a matter of drying or or talking to a therapist or analyzing myself in a self help group.

    Is there a God that exists outside of our minds ? We'll never be able to prove that in this life. But the concept is real. And that concept has allowed me to not only stay sober one day at a time, but to live a better life than I ever could have imagined. Honestly. It's not a dream life or anything like that, but it's better on some fundamental level.

    So, I'm a believer. If I'm wrong, so what ?
    And THAT is what AA brought to the table for me. I needed it. And once I got on board with that I could get on board with the 'whole person' approach.

  8. Alcoholism can be a cause of depression. Therefore, it can be a symptom of mental illness (not in all cases). It's a coping mechanism. Depending on length and severity of alcohol abuse, neurologic damage may not be permanent, and abstinence nearly always leads to eventual recovery of normal mental function.
    Alcohol Rehab New York