stanton peele, north-america’s grand-daddy of progressive (and controversial) views on addiction, has this to say about success with overcoming alcoholism.
The most important single prognostic variable associated with remission among alcoholics who attend alcohol clinics is having something to lose if they continue to abuse alcohol…. Patients cited changed life circumstances rather than clinic intervention as most important to their abstinence…. Improved working and housing conditions made a difference in 40 percent of good outcomes, intrapsychic change in 32 percent, improved marriage in 32 percent, and a single 3-hour session of advice and education about drinking… in 35 percent. (quoting George Vaillant, in The Natural History of Alcoholism)
These results apply in all situations-in other words, more than the type of therapy, or even whether the person enters therapy, the best chance for recovery is due to the number and quality of the person’s attachments to life. Having people that care about them, including family, friends, and community involvements; having activities of every sort that they find meaningful; having work skills, opportunities, and involvement; and so on predict whether people will have the motivation and resources to overcome alcoholism. They have both more to lose and more to counteract the appeal of the addiction.
while i don’t quite see eye-to-eye with stanton peele regarding AA and other 12-step programs, i would defintely agree with him regarding the above.
life circumstances are much stronger than any specific therapeutic approach in terms of motivating a person to change any kind of addictive behaviour. it is the job of a good counsellor or therapist to draw attention to and enhance these motivating factors, for example by helping the person reach out more to their support network, assisting with the intrapsychic change that vaillant talks about, supporting activities such as hobbies, creative endeavours, volunteering, etc.
my job can also be to help people find AA groups that work for them. some of them are very dysfunctional and fundamentalist and therefore not helpful. others are absolutely amazing and, contrary to peele’s opinion (and/or experience?), very empowering.
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