The High-Functioning Alcoholic

Understanding this Hidden Class of Alcoholics from a Professional and Personal View

The Various Ways High-Functioning Alcoholics Hit Bottom

What is "hitting bottom" for the high-functioning alcoholic?

"Only an alcoholic thinks that they need to hit a lower bottom in order to be alcoholic."                                                                                        ~sober alcoholic


Each alcoholic has a unique bottom, and some alcoholics report having several bottoms along the way that they have ignored. Generally, high-functioning alcoholics (HFAs) experience bottoms that are emotional and internal-including feelings of shame, remorse, loneliness and/or hopelessness. Some don't have a home or family to lose, which limits the type of bottom they may have. In contrast, lower functioning alcoholics often have bottoms that involve losing their jobs, family, friends and housing in addition to going through emotional suffering. These alcoholics go on for years denying that their lives are on a downward spiral, despite these losses. Some HFAs are lacking the "gift of desperation" that may motivate lower bottom alcoholics to get help. For others, high functioning only lasts until the disease progresses and the person cannot function anymore.

The following are exerpts from my book Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights.  Different types of bottoms are described along with the experiences of several HFAs who were interviewed.

For many HFAs, their failed efforts to control their drinking are the concrete proof they need for them to discover the depth of their addiction. Certain drinking experiences may then allow this reality to "sink in" and lead them to admit that they need help. One 31-year-old HFA considers that her final bottom was her relapse after months of sobriety that was "my first deliberate attempt at controlling drinking...I consciously attempted to drink a single shot of whisky, honestly thinking that I would be able to leave it alone because I found that particular type of alcohol distasteful. This first shot led to me drinking nearly the whole bottle in a very short time. I felt as if I was at the mercy of something compelling me to drink when I didn't want to."

Many HFAs report that their bottoms are primarily emotional. They may look well on the surface, but are struggling internally as a result of their drinking. One 24-year-old HFA recalls that she was stuck in a cycle of drinking to avoid anxiety and low self-esteem-her view of the world became completely negative. She feels that her true bottom was "The complete inability to connect with other human beings, feeling totally desperate and alone, wanting to stop drinking but not being able to and hating myself."

For some HFAs who are accustomed to success and are perfectionists by nature, their bottom may be subtle, but enough to prompt change. One student began to notice his straight "A's" slip to "B's" and this was an indication of the beginning of his bottom. Therefore, because he had such high standards for himself academically, it was clear when his drinking began to impact his performance and he sought help.

Being an HFA and hitting a low bottom are not mutually exclusive. In fact, some HFAs hit low bottoms and continue to relapse afterward. A 26-year-old HFA believed that a bottom had to be an experience "so bad and painful that you would know you couldn't drink again." She proved to herself that a low bottom does not guarantee sobriety. After 3 days of binging on alcohol, this graduate student attempted suicide. She woke up 3 days later to the cries of her parents as she lay in the intensive care unit of a hospital with tubes in her nose, arms and throat. However, "like a true alcoholic... I drank within 3 days of leaving the hospital and went to rehab for the following 22 days."

Other HFAs report that their bottom was neither something that they noticed at the time nor what would have motivated them to get help. These individuals were forced to address their alcoholism by their loved ones or by the law. One 58-year-old man confirmed that the only reason he agreed to a 30-day stay at an alcohol rehabilitation center was because of pressure from his wife. He had no intention of permanently staying in recovery. Looking back, he can see that he had previously hit bottoms that he had ignored and his wife had forced him to confront what would become his last bottom. In addition, HFAs can engage in high-risk behaviors such as drinking and driving that can result in jail, injury and/or the loss of a life.

HFAs often define themselves based on their careers, thus, the threat of losing their job can be enough to bring them to their bottom. A 53-year-old HFA describes that the last time he drank he became violent and started to hit lights and furniture in his house with a tennis racket. When his distraught wife approached him, he pushed her and then both his son and wife called the police. He was terrified that he would be kicked out of the military-which was his entire identity. He spent the night in jail and the next day was brought for a psychological assessment. For the first time he was able to admit that he was an alcoholic and was willing to do anything to save his family and career.

Some HFAs, through a moment of grace and spirituality, are inspired to reach out for help. A 63-year-old shares that her bottom was "slow in coming...it was like I was swimming in the dirty ocean floor of alcohol's wasteland for several months." She was facing devastating financial problems in her life that were not directly related to her alcoholism. "It was the typical way a high-functioning alcoholic suffers-the slow deterioration of personal values and quality of life structures-until the light bulb goes off." Her lifelong spiritual practices "kicked in" when she was reading a spiritual book that led her to conclude "my drinking was a lie and my pride was keeping it in place and I could no longer live this way."

The motivation that an alcoholic may have to get help once they hit bottom is often limited because their denial may return and they are back drinking alcoholically. Therefore, no matter how an HFA arrives at his or her bottom, it is imperative for the individual to take action at that time to reach out for help.

There are a variety of ways to obtain help for alcoholism and for more information please visit www.highfunctioningalcoholic.com and click on the "Resources" page.

Sarah Allen Benton, M.S., L.M.H.C., LPC, is a Licensed Mental Health Counselor and author of Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights.

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