Are You a Real Alcoholic?
Are You a Real Alcoholic?
Alcoholics Anonymous meetings can feature gruesome horror stories: drunkalogues about dozens of rehabs, broken families, bankruptcies, suicide attempts, emergency rooms, delirium tremens, liver disease. Coming out of a blackout while driving 90 miles on hour. Coming out of a blackout in a sleazy motel room with a stranger on the other side of the bed. Jail time, sadistic judges and dangerous halfway houses.
“When I drink, I tend to break out in handcuffs,” goes a popular joke. In their shares, alcoholics talk about having committed crimes ranging from burglary to domestic violence to murder. Women often recall being abused or raped when they were drinking.
I sit there, sip my coffee, and sometimes I think, “Maybe I’m not an alcoholic after all.”
What is an alcoholic anyway? Webster’s defines an alcoholic as “a person who is dependent on alcohol [and] who drinks compulsively and in such a way that his drinking is damaging to himself, to his way of life and to those about him.” According to Alcoholics Anonymous, an alcoholic is someone who has “no mental defense against the first drink.”
“You are an alcoholic if you say you are an alcoholic” is hardly a scientific diagnosis.
But what about those of us whose alcoholism lacks high drama and a long list of symptoms? I have what is called in recovery circles a “white wine” story. At the end of my drinking days, 20 years ago, I had succeeded in limiting my input to white wine. I did not, I thought, drink very much; in relation to my husband, who drank vodka screwdrivers for breakfast, I was practically sober. I didn’t fall down. I had no car accidents or run-ins with the police. I woke up every morning and took good care of my two children—ages ten and three. I made my daughter a box lunch and walked her to school. No one ever suggested to me that I drank too much. The only reason I ended up in Alcoholics Anonymous was to audit the course I hoped my husband would enroll in.
But under the influence of these AA meeting, a curious thing happened: I stopped drinking. Since I didn’t admit that I was an alcoholic—the “real” alcoholic in our household was my husband, after all—pride and stubbornness helped me stop along with the buoyant support I found in the meetings in spite of myself. Soon I noticed that I began to feel better. I had been severely depressed, a condition whose cause I laid off, in the vague way of the depressive, to the difficult circumstances of my life. There were many days when my life seemed unbearable. I did not connect my quiet drinking to my quiet desperation. What I did not know at the time is that alcohol is a powerful depressant, and as the duration of my sobriety lengthened, my depression lifted. Life became manageable.
“My life is better when I don’t drink,” I remember hearing a woman in AA say. “So I don’t drink.” This seemed to sum up perfectly my kind of alcoholism, if indeed I was an alcoholic.
Still, the compulsion, the uncontrollable craving, described routinely in AA meetings was familiar to me because I had it with food and, to a lesser degree, with shopping, although not with alcohol. I understood that I was probably an addict; many times I had promised myself I would not eat or buy something, only to find myself doing it anyway, too much, too often.
People like me rarely go to rehabs or get mandated by judges or live in halfway houses; we are an unobtrusive group of alcoholics who can offer up, when necessary, only tame, even boring, drunkalogues. Sometimes we come to AA from Al Anon, where we assume that, since we don’t drink the way our husband, father or child drinks, we are not an alcoholic. Sometimes we come, as I did, through another twelve-step program. My first addiction–to food—led me to Overeaters Anonymous before I came to AA. As unbelievable as it now seems, I had an OA sponsor who told me that when I was hungry I should…have a drink! It took me years to understand that if I don’t drink, I have a better chance of figuring out how much of my behavior is addictive and what to do about it.
It is often said that alcoholism is a self-diagnosed disease, but isn’t that a kind of copout? If it’s a chronic, progressive disease, as most experts agree, shouldn’t it have measurable symptoms and numerical benchmarks like other medical conditions? When does a person cross the invisible line from controlled (recreational, social, low-risk, etc.) drinking to alcoholism?
A casual survey of the official medical authorities reveals efforts to clarify and quantify, but so far the results do not exactly add up. The public health officials at the National Institute on Alcohol Abuse and Alcoholism measure “at-risk or heavy drinking” as more than four drinks a day for men and three for women. The neuroscientists at the National Institute on Drug Abuse define alcoholism as, like other substance addictions, a disorder that impairs certain pathways and regions of the brain, resulting in an increasing inability to control alcohol use.
The psychiatrists behind the DSM IV say that alcoholism requires three of the following symptoms: tolerance; withdrawal; taking in greater amounts or over a longer time course than intended; desire, or unsuccessful attempts, to cut down or control use; great deal of time spent obtaining, using or recovering from use; social, occupational or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae. (Controversy over a broader definition proposed for the upcoming DSM V, including adding craving and combining dependence and abuse, is already at a fever pitch.)
I had an Overeaters Anonymous sponsor who told me that when I was hungry I should…have a drink!
“You are an alcoholic if you say you are an alcoholic” is hardly a scientific basis for diagnosis and treatment. AA solves this problem by welcoming everyone who wants to be there; the only criteria for inclusion is a desire to stop drinking. Often that desire is fleeting and comes when you have had a few too many drinks, but that’s OK with AA.
Lately our culture seems to have turned up the volume on just about everything, as if only by screaming can anyone be heard. Life is louder, darker, wilder, more dangerous and more extreme. This mood of excess has even infiltrated some of the rooms of AA. We often feel impelled to describe recovery as redemption—“I once was lost and now am found”—and redemption stories are measured by the drama of the despair before the redemption.
Susan Cheever, a regular columnist for The Fix, is the author of many books, including the memoirs Home Before Dark and Note Found in a Bottle, and the biography My Name Is Bill: Bill Wilson—His Life and the Creation of Alcoholics Anonymous.