The High-Functioning Alcoholic

It is true that the social stigma attached to a particular disease can add to the shaming that keeps sufferers from treatment, and addiction is no exception. But it is also true that some social stigmas serve a useful role in a healthy society when they identify behaviors that are unacceptable, and should remain so. Advocates of the disease model of addiction often have difficulty seeing the useful aspects of stigma in addiction. Errant behavior associated with the loss of control in addiction should carry a social stigma because such behavior hurts people. And social disapproval often plays a role in breaking down the defenses of the user. In environments where that social stigma is absent or winked at, such as in some college drinking environments, substance abuse problems flourish. I was amazed at the reaction to Michael Phelps's recent pot smoking episode. Commentators were falling all over themselves to say how Phelps should be given some slack because, after all, he's just a kid and blah blah blah. No, Michael Phelps uses an illegal drug, and that should be stigmatized. One other point: in a world where exhibiting one's private life on the internet is embraced as "empowerment," it's no surprise that people who choose anonymity for there medical condition are criticized.

I think that this article is addressing one of the most important aspects of both mental health, and overall wellness today, which is that the stigma attached to these problems acts as a barrier to help. Jerry's comment got me thinking about the usefullness of stigma. I think there is something to be said for creating a negative affiliation for behavious that harm the self or others, but the problem is that this kind of creation of shame or disgrace creates a much stonger barrier to actually get help and to help others. I think that the goal should be more about not creating an encouraging envrionment (i.e frat row at college), rather than creating a disgraceful association. We know people are going to make bad choices and get into rough spots. What we need is to ensure that they do not feel disgraced in admitting that, and more importanty, doing something about it. Unfortunately this takes a lot of time and effort from our society as a whole, so providing anonymous solutions as a stepping stone, I think, is a vital service. And once people are educated, whether through therapy, a 12 step program, or other social services, then they should be encouraged to share their story, as this works towards that environment of education, not stigma.

The use of stigma against the alcoholic is effective, if at all, essentially only at the prevention stage of this situation, i.e., before alcoholism takes hold. Once alcoholism has taken hold, the attempts to aggressively condemn alcoholics by stigma attacks will not assist in recovery, it may in fact prevent them from getting help (as Eric Shaw expressed in his comment above).

Oftentimes, alcoholic behaviors are judged as a moral issue, but the truth is that alcohol is calling the shots when they drink. Therefore, it is important to note that alcoholics have a mental health condition and that does not excuse their harmful behavior, it simply explains it. When alcoholics get sober, they often express extreme remorse for their drunken actions that harmed others and they know that the way they behaved was unacceptable. However, they were not making conscious decisions while under the influence.

Research conducted in 2007 by the National Institute for Alcohol Abuse and Alcoholism (NIAAA) concluded that only 24% of alcoholics actually received treatment, meaning that 19 million alcoholics went untreated. A research study on barriers to treatment for alcoholism published in the Journal of Studies on Alcohol concluded that "being to embarrassed to tell anyone" was a factor in preventing alcoholics from seeking help. Therefore, the social stigma about "being" an alcoholic has been shown to impede treatment and therefore, in the end benefits no one.

www.highfunctioningalcoholic.com

Anonymity in AA is good in some cases I guess, but in the long haul of sobriety you can't hide it. In my opinion this would jeopardize my sobriety. Besides, everyone in my family and all my friends with and without drinking and drugging problems knew me to well. I guess I could have moved out of town altogether but this would be like running from the problem which doesn't work.

I have been very open about my sobriety from the beginning. I go out of my way if need be to let anyone know I'm a "Grateful Recovering Alcoholic" and God willing, always will be! If you can't be open about your addiction then maybe at some point you will try hiding it...again, or is this why you want to hide it now? Gee, maybe I'm on to something here. Think about it?

I had a split second brain-siege in Texas on Friday. I was in a store looking for a bottle of water and right there it was, cold beer and plenty of it. I thought, wonder what it tastes like, Grabbed my bottle of water and was gone just as quick as the thought was. Of course after years of sobriety it does get much easier.

Every true friend in my life still tells me how much better they like me sober. Even I like me better. In fact, what got me in my third rehab was me waking one morning, looking in the mirror and saying, I hate what I see. At this point I realized I didn't like myself anymore. Guaranteed, you will have a problem if you don't like yourself and don't try to deal with it!

This article is spot on. The problem wiuth anonymity is that you don't get support from colleagues, etc..and that's dangerous. Also, you feel shame for your condition.
As for stigmatization, whoever wrote that is naive in the extreme. First, in youth there is no such stigma. To the contrary, one is stigmatized if one does not go along and drink like a fool.
Second, the writer is obviously entirely unfamiliar with real alcoholism. Alcoholics drink because they can't not drink.
We label and stigmatize folks with all forms of mental disease --judging them as though they chose to have their disease. it's morally indefensible and manifestly counterproductive to society. If people helped alcoholics instread of stigmatizing them, they'd have a better chance at sobriety--at great benefit to society.
Also, we know that alcoholism is at least in part genetic and is much more highly probable in individuals who were children of alcoholics, were neglected, abandoned or abused.
So, society ought to stigmatize these poor folks for their misfortune? Oh, the hubris and arrogance of the academic "healthy," awash in supposed superiority. When you get your diabetes/cancer/obesity/heart disease, I shall do my best not to stigmatize and label you, for no one, even one as insensitive and clueless as you deserves to be mistreated that way...

Nice article. You can't blame those people who are alcoholic to hide their status because for them its no use to share their condition because they think those people can not help them or they don't want to be stop.

Nice article. Its really hard to tell to others that you are an alcoholic person that is why some prefer to hide it out.

I completely agree that you cannot blame alcoholics from hiding their being alcoholic from others. I am really talking about those who are sober alcoholics and the fact that they still feel shame around being alcoholic even though they are getting help. There is still a huge stigma that is associated with being an alcoholic (sober or active) and in some cases it can prevent alcoholics from asking for help for fear of other's judgements.

I am a recovering (6 years sober) high-functioning alcoholic, as was my father. Although the term is one I've used myself, I'm so glad to hear about your book and the awareness it will create. I didn't get sober until I almost killed myself with alcohol but to the outside world I was a good employee, a good student, a good mother and wife, and an active volunteer in my community. One of the best things about my sobriety is the release from striving for perfection.

Thank you for your posting and encouragement in terms of increasing awareness about this issue. Congratulations on your sobriety. Your story is an example of the double life that high-functioning alcoholics lead and how things can look "perfect" on the outside, but internally they are struggling.

The people that P.R'ed their sobriety in early A.A. usually returned to drinking. Since, the Steps and Traditions were written after much tweaking they were based on the group's personal research. The reason for being Anonymous has nothing to do with the stigma of Alcoholism [see below]
Being Anonymous does not have anything to do with telling anyone you personally want to tell about your alcoholism.
Being Anonymous has everything to do with anonymity at the level of Press, TV, and Radio and in my opinion telling anyone about someone else's alcoholism.
So, writing a book about Alcoholics is OK- talking about yourself in recovery is OK but, talking about yourself in A.A. at the level of Press, Radio, TV is not OK.
That is why I am glad when treatment centers PR alcoholism in a way that does not violate the AA traditions but, lets the public know there are solutions.

Wine labels are important sources of information for consumers since they tell the type and origin of the wine.

Thanks,
shrink labels

I was looking for an article on this topic and the first place I checked was here and I was so pleased to find exactly what I needed to hear. I am going on 60 days of sobriety and am havin a really difficult time accepting that more people than I had originally told have found our that I am an alcoholic and go to AA. I told only my family and a few close friends, but somehow the "word" got out on the street and in the small town I grew up in, people feed off such gossip, especially when it comes as a surprise to them, that I ever had a problem with alcohol. Again, the stimga of alcoholism, I feel I want to defend myself, but I am realizing what I need to do is to continue to work the 12 steps so I can gain more confidence in my decision to get sober. Instead of thinking up a million different ways to explain my situation to aquaintances. I find myself obsessing over how I can get the message out to local high school's about HFA's or how spread the word on how one can in fact become alcoholic even though they weren't daily drinkers, didn't need to go to rehab and led very manageable lives from the outside. One doesn't need to have hit a low bottom to be alcoholic, instead the fear of what "could" happen in the future, could be "bottom" enough for one to want to get sober. Ok, you get my point, but these are the things that I am struggling with that this time. I look forward to the day where I am no longer embarrased and will be proud. I know I will get there too :) Thank you again Sarah, for another excellent article.

Thank you for your article, I appreciated reading it and got some good information from it. Anonymity is the spiritual foundation of the 12 Traditions in 12 step programs, and should never be disposed of.

Many seem to think that anonymity has its primary basis in a stigma associated with alcoholism. This certainly can not be ignored. While it would be nice to say, "let's just pretend like there isn't a stigma and I'll tell everyone I'm an alcoholic," that isn't always the best idea. In my experience, prudence must be used in situations where I might want to tell someone I'm a recovering alcoholic. For example, to go to a job interview and say, "oh, I also need these hours off because I'm an alcoholic and I go to A.A." might cause someone to not be able to make a living in their field of expertise or to have problems. In other cases, maybe it would work fine; I've heard of people who go into job interviews this way and get jobs, but not everyone is the same, and we should respect that. In addition, the matter becomes more important when it comes to drug addicts. I had a friend in N.A. who was a somewhat "high profile" business person, and he would go to a coffee shop in the morning with his colleagues, and folks from the 12 step fellowship would come up to him to say hello and talk while he was with his colleagues. Imagine the fun he would have in explaining to his business colleagues that he has been having problems with crack cocaine and now he goes to Narcotics Anonymous meetings every day, and has been clean for a couple weeks. Is that really harmless? I don't think it is!

Besides this superficial and self-centered level of personal stigma, however, comes the reputation and dignity of the 12 step program itself. If I told everyone I was in Alcoholics Anonymous, but acted in ways that were unkind, or simply "human" like others, it could send a message about the 12 step program. For example, someone might think that most people in A.A. are overweight, do not take care of their health, and are socially abrasive, if they ran into the right group of guys/gals who wanted to let the world know they are proud members of Alcoholics Anonymous. This could cause problems of pushing people away from the program who might otherwise not have any reason to not go check out meetings, where they would see that there can be a diverse crowd of members who they might relate to. So not only can breaking anonymity harm an individual member, but it can harm the fellowship as a whole. That is why it is important to consider.

To quote some literature, the Narcotics Anonymous book It Works How and Why states in Tradition 12:
"A spiritual experience cannot be bought or sold; it
can only be given away. The more we freely share that experience,
the more we strengthen the empathy that joins us together. This tra-
dition reminds us to place the principle of anonymous, selfless giv-
ing before whatever personal desires we may have for recognition or
reward."

In short, anonymity is the spiritual foundation of the 12 step fellowships' Traditions. Please remember this tradition is there for a good reason.

Thank you for your thorough response.
I completely agree that it is important for individuals to use proper judgment in terms of when and to whom they tell they are sober alcoholics- boundaries are part of healthy recovery. I would not encourage that people tell everyone, including a future employer that they are sober alcoholics just as I would not encourage them to tell a future employer that they are diabetic or that they have depression. This is personal information that does not need to be shared in that type of setting. The problem is that when it IS appropriate to reveal this information, those who are sober often feel shame and hide it as though they have "a scarlet letter"- when being sober should actually be something that people should be proud of.

I also agree that it is important to respect the traditions of A.A. including the 11th tradition of "Anonymity at the level of press, radio and film". For the reasons you described, it is important that anonymity is respected. However, on a personal level, it is up to an individual if they tell others that they are in A.A. If no one who is in A.A. tells friends or family that they are part of the program, then those who may need help may feel they are alone or not realize that there are members of their community who have recovered from alcoholism and who defy the "stereotype".