imageThe Times runs a regular blog called Proof which engages discussions of the good and bad, the pleasure and danger, of alcohol. The current postis by Jim Atkinson, who wrote a book about drinking, then after years (decades) discovered he was an alcoholic who needed to go to AA and abstain to recover. He figures he had a natural tolerance for alcohol that led him to drink so much for such a long period that he couldn't avoid being an alcoholic. This explanation of his addiction doesn't make sense.

Here's Atkinson's (and the NIAAA's) version of reality:

I personally have come to believe in a construction proposed by Dr. Mark Willenbring, director of the division of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, which . . . argues that the main thing that alcoholics share is a natural tolerance for alcohol, which leads them to overindulge without knowing it. Repeated overindulgence, in turn, changes their brain chemistry. . .

What if you had a great tolerance for alcohol, so that you could drink more than most people for many years? Would that be how you spent your time? What would motivate you to do so?

Atkinson describes his social life:

. . . . during my 20's, when everyone was drinking pretty heavily, I could still drink my friends under the table and inspire compliments from them for it. On one occasion, a bunch of us gathered at a friend's apartment to watch a Dallas Cowboys football game. The drinking was heavy and mixed - from beer to scotch and back again, as I recall. At one point late in the fourth quarter, I noticed that all of my buddies had passed out - leaving only me to watch the Cowboys lose while I happily mixed a nightcap.

Do you - or did you - attend many social functions where everyone passed out? If you did, do you think a friend or lover might have suggested that you re-evaluate how you spent your time, and perhaps diversify your interests? Maybe go to some museums, or movies, or lectures. But Atkinson didn't alter his behavior after his 20's. Instead, "My natural tolerance is probably why, in the mid-80's I was able to score a nice book contract to write The View from Nowhere, a fairly shameless nationwide pub crawl in search of America's best hard drinking bars." Does Atkinson's use of "shameless" indicate that perhaps he had nagging misgivings about his behavior? But he doesn't say so here.

Would you feel comfortable spending night after night in hard-drinking bars? I know many people who wouldn't, including thankfully my three children. My youngest is a college junior in New York City who has many opportunities - and venues - for partying but who seems to prefer to spend her time in other ways.  I like to think values like those favoring thinking and positive activity, accomplishing school goals and not wasting her parents' money and others she was taught helped to innoculate her.

Atkinson never discusses such values. He seems to lack that level of discourse, or psychological insight. Despite his ability to gorge great quantities of alcohol, he seems not to have reflected over the decades of his drinking and drunkenness about why he drank so much, what it meant about his life, whether there were better ways to live, whether this was healthy, etc. Or maybe he did, but he doesn't mention any of that in his lengthy post.

Atkinson believes that alcoholics are all characterized by his great tolerance for alcohol. But research does not support this idea. (For a common-sense counter-example, think of Native Americans, who have among the lowest tolerances for alcohol on earth, and among the highest alcoholism rates.) But here is something else he says is true of alcoholics, at least the ones he meets at AA: "every time I enter an Alcoholics Anonymous room, I am struck by a more or less uniform look of cosmic bafflement on the faces of my fellow addicts. How in the world did this happen?" (his italics).

Like Atkinson, they are mystified by their situation. Isn't that striking, after years and decades of drinking, drunkenness, hanging with people who pass out and in hard-drinking bars? I posted to my blog a description of my Life Process Program for alcoholism and addiction as an alternative to the kind of uncontrollable, biological, disease model Atkinson posits. The LPP involves reviving people's values (like those Atkinson suppressed in those bars), rehearsing interpersonal and life skills (like communicating with people when you and they aren't intoxicated), and contemplating life issues and plans. I think addicts lack these things - just as Atkinson's post noticeably ignores them in his life.

Just in case you want to ask, "How many people testify that your approach saved their lives?", here's one that was just posted at my video on You Tube, Alcoholism Is Not a Disease: "The disease concept is a great excuse for poor choices! Alcoholism is not a disease and I am living proof of that. I read Stanton's book seventeen years ago and haven't touched a drop since that time." I'm glad for this man, just as I'm glad Atkinson is sober, at the same time that his comment shows that there are alternative approaches to Atkinson's. But it is on science, psychology, empirical effectiveness - as my blog entrée indicated - as well as on common sense that we must all rest our cases.

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