"SLIPS"
Do alcoholics suffer from "Alcoholic Behavior" or are
they simply victims of
human nature?
by the late William D. Silkworth, M.D.
The mystery of slips is not as deep as it
may appear. While it does seem odd
that an alcoholic who has restored himself to a dignified
place among his
fellow men, and continued dry for years, should suddenly
throw all his
happiness overboard and find himself in mortal peril of
drowning in liquor -
often the reason is very simple.
People are inclined to say, "There is something
peculiar about alcoholics.
They may seem to be well, yet at any moment they may turn
back to their old
ways. You can never be sure. "This is largely twaddle.
The alcoholic is a
sick person. Under the technique of Alcoholics Anonymous he
gets well, that
is to say his disease is arrested. There is nothing
unpredictable about him
any more than there is anything weird about a person who has
arrested
diabetes.
Let's get it clear, once and for all, that alcoholics are
human beings just
like other human beings - then we can safeguard ourselves
intelligently
against most of the slips. Both in professional and lay
circles there is a
tendency to label everything that an alcoholic may do as
"alcoholic
behavior." The truth is it is simply human nature. It
is very wrong to
consider many of the personality traits observed in liquor
addicts as
peculiar to the alcoholic. Emotional and mental quirks are
classified as
symptoms of alcoholism merely because alcoholics have them,
yet these same
quirks can be found among non-alcoholics also. Actually they
are symptoms of
mankind; ORDINARY PEOPLE. Of course, the alcoholic himself
tends to think of
himself as different, someone special, with unique
tendencies and reactions.
Many psychiatrists, doctors, and therapists carry the same
idea to extremes
in their analyses and treatment of alcoholics. Sometimes
they make a
complicated mystery of a condition which is found in all
human beings,
whether they drink whiskey or buttermilk.
To be sure, alcoholism, like every other disease, does
manifest itself in
some unique ways. It does have a number of baffling
peculiarities which
differ from all other diseases. At the same time, many of
the symptoms and
much of the behavior of alcoholism are closely paralleled
and even
duplicated in other diseases.
The alcoholic "slip," as it is known in Alcoholics
Anonymous, furnishes a
perfect example of how human nature can be mistaken for
alcoholic behavior.
"SLIPS" IDENTIFIED
The "slip is a relapse! It is a relapse that occurs
after the alcoholic has
stopped drinking and started on the AA program of recovery.
"Slips" usually
occur in the early stages of the alcoholic's AA
indoctrination, before he
has had time to learn enough of the AA technique and AA
philosophy to give
him solid footing. But "slips" may also occur
after the alcoholic has been a
member of AA for many months, or even after several years,
and it is in this
kind, above all, that one finds a marked similarity between
the alcoholic's
behavior and "normal" victims of other diseases.
No one is startled by the fact that relapses are not
uncommon among arrested
tubercular patients. But there is a startling fact - the
cause is often the
same as the cause which leads to "slips" for the
alcoholic. It happens this
way: When a tubercular patient recovers sufficiently to be
released from the
sanitarium, the doctor gives him careful directions for the
way he is to
live when he gets home. He must be in bed every night by,
say, eight
o'clock. He must drink plenty of milk. He must refrain from
smoking. He must
obey other stringent rules. For the first several months,
perhaps for
several years, the patient follows directions. But as his
strength increases
and he feels fully recovered, he becomes slack. There may
come the night
when he decides he can stay up until ten o'clock. When he
does this, nothing
untoward happens. The next day he still feels good. He does
it again. Soon
he is disregarding the directions given him when he left the
sanitarium.
Eventually he has a relapse.
IN CARDIAC CASES
The same tragedy can be found in cardiac cases. After the
heart attack, the
patient is put on a strict rest schedule. Frightened, he
naturally follows
directions obediently for a long time. He, too, goes to bed
early, avoids
exercise such as walking up stairs, quits smoking, and leads
a Spartan life.
Eventually, though, there comes a day after he had been
feeling good for
months, or several years, and has recovered from his fright.
If the elevator
is out of repair one day, he walks up three flights of
stairs. Or he decides
to go to a party - or do just a little smoking, or take a
cocktail or two.
If no serious after-affects follow the first departure from
the rigorous
schedule prescribed, he may try it again until he suffers a
relapse.
In both cardiac and tubercular cases, the acts which led to
the relapse were
preceded by wrong thinking. The patient in each case
rationalized himself
out of a sense of his own perilous reality. He deliberately
turned away from
his own knowledge of the fact he had been the victim of a
serious disease.
He grew over-confident. He decided he didn't have to follow
directions.
Now that is precisely what happens with the alcoholic - the
arrested
alcoholic, or the alcoholic in AA who has had a
"slip." Obviously he decides
again to take a drink some time before he actually takes it.
He starts
thinking wrong before he actually embarks on the course
leading to a "slip."
NOT ALCOHOLIC BEHAVIOR
There is no more reason to charge the "slip" to
alcoholic behavior than
there is to lay a tubercular relapse to tubercular behavior
or a second
heart attack to cardiac behavior.
The alcoholic "slip" is not a symptom of a
psychotic condition. There is
nothing "screwy" about it at all. The patient
didn't follow directions. And
that's human nature! It's life! It's happening all the time,
not merely
among alcoholics, but among all kinds of people. The
preventive is plain.
The patient must have full knowledge of his condition, keep
in mind the
facts of his case and the nature of his disease, and follow
orders.
For the alcoholic, AA offers some directions. A vital
factor, or ingredient,
of the preventive, especially for the alcoholic, is
sustained emotion. The
alcoholic who learns some of the technique or the mechanics
of AA but misses
the philosophy or the spirit, may get tired of following
directions - not
because he is alcoholic but because he is human. Rules and
regulations irk
almost anyone, because they are restraining, prohibitive,
negative. The
philosophy of AA however, is positive and provides ample
sustained emotion -
a sustained desire to follow directions voluntarily.
PSYCHOLOGY NO DIFFERENT
In any event, the psychology of the alcoholic is not as
different as some
people try to make it. The alcoholic has problems peculiar
to him perhaps,
in that he has been put on the defensive and consequently
has developed
nervous frustrations. But in many instances there is no more
reason to be
talking about the "alcoholic mind" than there is
to try to describe
something called the "cardiac mind," or the
"TB mind." I think we will help
the alcoholic more if we can first recognize that he is
primarily a human
being - afflicted with human nature.
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