The AA big book is the book itself Alcoholics Anonymous. Before AA was formed a number of people found a way they could get sober and stay sober, in effect recover from alcoholism.
One of the things they decided they needed to do was to write a book detailing their experiences, both of drinking and of recovery. This they did and published the book. For a number of reasons they decided to call the book Alcoholics Anonymous.
From this book the organisation took its name, and meetings that were happening began to call themselves groups or meetings of Alcoholics Anonymous.
Why the big book
The description of the book as the big book came simply from the fact that the first edition was printed on very thick paper. This was to give the impression to the people who were paying for the book, recovering alcoholics, that they were getting real value for money.
What is the big book
The reason, or the main reason the book was written was to put in writing the experience of the early members of AA. At the time of writing there were two groups in America, one in New York and one in Akron. It was estimated that without some form of literature to spread the message it would take hundreds of years to even reach most major cities in the US. There was a degree of urgency that was needed, and it was agreed that a book was the best way of meeting this need.
The significance of that decision had ramifications that no one could have imagined. Most important perhaps was that it established the principle that AA is and was a body of experience. It set out that experience so that other people could benefit from it. It gave people the freedom to look at and understand AA’s experience, and then use that experience in any way they felt it could work for them.
This is hugely important. AA did not set out any creed or belief system, or try to convince or convert people about what they should or should not do, by way of drinking or staying sober. It really was a very courageous approach. Sadly, much of AA today does not necessarily see it as a body of experience. People often tend to fluctuate to various degrees of fundamentalism, and there are real concerns around issues of control and coercion.
Whatever the day-to-day practicalities are of AA, the fact that the book exists and was written, and continues to be used how it was written, reinforces this essential principle that AA is a body of experience.
This principle can quite literally be a lifesaver for a number of people. It should also ensure, however fragile, that AA continues to offer a degree of freedom, both from alcohol, but also from other people and their belief systems.
An intervention usually takes place when it is believed the situation is so serious that there is nothing else that can be done. The process is usually instigated by family or friends of the person who has an alcohol or drug problem. The nature of an intervention can vary quite a lot, but there are normally some common elements.
People who perform interventions take great pains to stress they should not be confrontational. The intent is to show the person the extent to which that addiction or alcoholism is real. This is done through family and friends sharing, writing letters, showing photographs etc. The individual concerned then understands the nature of the problem, and is willing to seek help to get better.
This type of scenario sounds very plausible, but there are some problems with it.
Anyone who is an alcoholic will have a particular mindset about their drinking.One element will be a belief system that alcohol is the only thing that is holding them together. It is likely this belief system will get deeper the worse things get, both internally and externally.
This is something that is very difficult for someone who is not an alcoholic to understand.
The complexity of active alcoholism and drug addiction means that trying to help someone can be quite difficult. It is a bit of a cliche, but still true, to say that the person needs to accept that they have a problem and that they need help. What is even more true is that that acknowledgement has to come from within them.
An alcoholic or drug addict will have a completely different view of how they need to use alcohol or drugs than someone who is not an alcoholic or an addict.
The dangers of an intervention
Whilst that are some scenarios where an intervention possibly could be justified, on the whole the process is fraught with danger. The person that the intervention is focused on is likely to feel cornered, possibly trapped and certainly under a great deal of pressure. They may give in to this pressure and agree they need help. They may go into rehab, and they may get sober.
There is an underlying issue that will be hugely important, but will possibly go unnoticed for a long period of time. That is that they did not make the decision for themselves that they had a problem and needed help. The decision was effectively made for them by other people, and they essentially went along with it.
The significance of this cannot be overstated. Any long-term recovery has to be rooted in a gut level feeling that they cannot do it any more. It is an internal dynamic that has to be genuine and authentic. Whatever horrors may be presented to them by way of evidence from family and friends, this evidence it only likely to make them feel worse.
An intervention is not a reality check. It is a process advocated by people who feel there is nothing more they can do, and something has to be done to force a situation to change. The real danger is that this presented as an opportunity for an alcoholic to get better. What it does in reality is tear down a mask that someone has put up to keep themselves safe.
It is a cardinal rule of all types of psychology, that people who use masks to defend themselves have to be able to take them down from within. Tearing them down from the outside can be cruel and callous. For an alcoholic or drug addict, it seems more complex because the mask itself is so destructive. The reality is the same however.
However tempting an intervention may seem, the solution that offers is normally an illusion. The desire for recovery has to come from within, not be forced on someone by outside pressure.
Alcoholics Anonymous and other 12 step organizations use several different readings and sayings that help members.
Some of these sayings are best known at meetings, others in the literature.
Perhaps the best-known of these is a prayer, commonly referred to as the serenity prayer. It may be one of the first things someone learns in rehab
There is a full version of the prayer, but AA tends to use a shortened version of it that reads as follows.
God grant me the serenity to accept the things I cannot change, courage to change the things I can and wisdom to know the difference.
This prayer is sometimes used at the beginning of meetings and sometimes used to close meetings at the end.
Also, it has become a common prayer that many people use in times of difficulty. It is particularly easy prey for people to remember and get used to.
Like any prayer, its meaning depends to a large extent depends upon the person who is using it.
Their interpretation of what it says to them and how it makes them feel is important. Any prayer should in effect make the person think, what is this saying to me about me.
For many people in AA, the serenity prayer can be a bit of a mantra.
People are often advised simply to repeat it over and over again.
This can be done when people are new, or at any time in their recovery. The simplicity of the prayer and the fact that it is regularly used at meetings makes it much more accessible for many people.
There are three basic elements to the structure of the prayer. People find these different and helpful.
The first element is about asking for acceptance of things that you cannot change. This is acknowledging some degree of powerlessness over events outside your control.
The second element is about asking for the power to change the things that you can control, and the third element is asking for help in knowing the difference between the two.
The value of the structure is that it embodies one of the most important principles in AA recovery. Acknowledging the difference between the things you can change, and the things you cannot is not simply a matter of semantics.
It is about reinforcing your real sense of power and control over your own life.
This is done by focusing energies on things that are within your control, and not outside of it.
This is particularly important for members of AA. Many of them have grown up in what is known as an alcoholic home. One of the key effects of growing up in such a home is that you reverse this whole principle.
Most alcoholics have a strong sense of feeling responsible for things that are outside of their control and at the same time little control over their own lives.
This is one factor in their understanding of their alcoholism. For many active alcoholics, alcohol seems to give them this sense of control. Although it is an illusion, it is often preferable to their reality.
The serenity prayer is not the main way that people tend to change or reverse this sense of responsibility. That is a much longer process and simply saying a prayer.
In many ways, the whole nature of 12 step recovery is about this process. The value of the serenity prayer is that it embodies this process in a few simple words.
It can be used as a stop-gap and a very important way to buy yourself some time.
Anyone looking for a Christian rehab will generally be doing so for one of two reasons.
The first reason is that they want a rehab that is purely faith-based or Bible based, the second reason is that they want a more traditional rehab, but one that is focused on spirituality and/or a Christian based approach to addiction recovery.
The issue of spirituality and belief in God has been at the core of recovery from alcoholism since the early experiences of Alcoholics Anonymous members. It has also been one of the defining issues in terms of both helping people and alienating people from the process of recovery.
As with any approach to recovery, it is important that the person looking for help has some clear understanding of what to look for. Any rehab offering help must comply with certain local and national requirements and regulations. A rehab should also employ a significant number of qualified clinical staff who can help assess the individual entering rehab to see if there is a need for a medical detox.
The rehab should also be able to either oversee such a medical detox if needed, or have other arrangements with a local clinical facility who can oversee the detox on their behalf. This is crucially important for any rehab as many people entering rehab will be withdrawing from the effects of alcohol and/or drugs, and this needs to be managed in a safe and secure clinical environment.
Once any detox has been done, the work of the rehab is to help the individual to understand the nature of alcoholism and other types of addiction, and to give individuals some grounding in the various approaches to recovery that the rehab advocates to help the individual rebuild their lives in the context of staying clean and sober both in rehab and once they have left.
The majority of rehabs will take a therapeutic approach that is based on the 12th program of Alcoholics Anonymous. A number of rehabs will also offer a wide range of other addiction treatment programs that should be clinically based, that should be evidence-based and should be based on extensive experience of what works.
A Christian-based rehab is normally a rehab that very specifically refers to itself as being Christian-based or faith-based. It very clearly sets out its addiction treatment program as being based on a belief that Jesus Christ, and belief in Jesus Christ is the only real source of salvation, and that this belief will be central to all the therapeutic work that is done in this type of rehab.
A Christian rehab can vary quite widely as to its structure and type of environment where this work will be done. Some Christian rehabs will opt for the traditional thirty-day model that most normal rehabs offer, with varying degrees of structure and rigidity in terms of living environment, personal possessions, access to phones and Internet etc.
Other Christian rehabs will offer a much more controlled and rigid environment, and although they are open and upfront about this, this model should be considered carefully before entry into it. Often this type of Christian rehab will offer an extensive and free recovery process with a enrolment period of up to 9 months.
There is likely to be a very strict regime where there is no personal contact with the outside world, no direct contact with anyone at all.
This type of Christian rehab very tightly controls the behaviour, the information and the environment that the individual will live in for these nine months. After the nine months is finished the individual will be expected to continue as part of the broader church that will be associated with the rehab and contribute to it in various ways.
This type of environment can at times be quite cult like, and should be guarded against. Any rehab should be freely entered into, and the client should also have the option or freedom to leave if they don’t like it. A rehab is not a prison, and whilst leaving early can have serious complications and consequences, it is nevertheless a freedom that the client should retain.
A Christian rehab that is faith-based and focuses exclusively on a biblical approach to recovery is a perfectly legitimate option for anyone seeking this. This type of rehab may or may not incorporate some of the approaches of Alcoholics Anonymous and other 12-step organisations.
Most Christian rehabs will offer fairly intensive levels of Christian counselling, as well as a fairly intensive structured programme of daily Bible study groups and prayer groups.
A number of Christian rehabs will also be linked to various churches, and these churches should offer additional support through prayer and pastoral work to the individual once they are in rehab, and once they have left.
A rehab or treatment center should employ a wide range of different health care professionals, who have extensive clinical experience in dealing with alcoholism and addiction.
If the rehab is basing some of its therapeutic treatments on the twelve step progarm of Alcoholics Anonymous, then it is usually helpful if some of the staff are in recovery themselves, often having been in rehab themselves at some point.
This assessment of clinical staffing levels should relate to number of staff, different disciplines, qualifications and experience.
This information should be available on the rehab’s website, along with inforemation about availability of medical staff (should be 24/7) and regularity of therapy / conselling sessions etc.
Below is a list of the main types of clinical and therapeutic staff normally employed in a rehab. In addition a rehab should employ a number of well trained admin staff who can help the client through the often complicated admissions and insurance verification process.
Therapists / Counsellors
Chi Kung / Tai Chi Teachers
Art Therapy Practitioners
Meditation / Mindfulness Practitioners
Transitional Living Worker
Rehabs are probably best know for dealing with two types of addiction, people who are addicted to alcohol, alcoholics, and people who are addicted to drugs, either prescribed or not. People who are addicted to both alcohol and drugs are commonly referred to as dual addicted.
Some rehabs have broadened their scope of what they say addiction means, and offer treatment for a wide variety of addictions, some of which are listed below.
The rehab will take an approach that the individual is what they call an addictive personality, and use the particular addiction as a trigger.
This approach has allowed some rehabs to broaden their scope of who they treat enormously, which has many implications from a business point of view, and has rasied many ethical questions about what addiction really is and what it means, and whether or not some rehabs exploit that.
Alcohol Addiction / Abuse
Bath Salts Abuse
Most rehabs recommend, and most people follow, that anyone entering rehab goes to one that is a significant distance away from where they live, either in another state or in another country.
The logic behind this is that rehab is something of a bubble for a period of time, and it is better for the client / patient to be in this bubble away from their normal environment, home, family, work etc.
As a rehab is a clinical facility, and should oversee any medical detox and therapeutic work that needs doing, it is crucially important that you check the local accreditation and licensing requirements for where the rehab is located, and make sure the rehab fully complies.
This is a state by state list in the US where these requirements can be checked
Pray as you can, not as you can’t …….
Dom John Chapman OSB, Downside
‘Before AA, I judged myself by my intentions, while the world was judging me by my actions’
Alcoholics Anonymous, p418, 4ed.
‘The crucial lesson throughout my work is how to hold, contain and sustain people who have suffered immense atrocity and loss. Our society will be judged by how we respond to those to whom we owe nothing.’ – Helen Bamber
‘Run while you have the light of life ….. nobody who walks in the dark knows where he is going ……’
Prologue to Rule of St Benedict, John 12, 34
‘Spirituality, for me, means listening to the deeper levels of our experience with a sense that there is something completely trustworthy and good to be found there. In this listening, many recognise the life-giving presence of God in us, challenging and surprising us with new understanding and insight.’
Tom McGuinness SJ
‘We are not at peace with others because we are not at peace with ourselves. We are not at peace with ourselves because we are not at peace with God.’
“To be nobody but
yourself in a world
which is doing its best day and night to make you like
everybody else means to fight the hardest battle
which any human being can fight and never stop fighting.”
― E.E. Cummings
“Whoever fights monsters should see to it that in the process he does not become a monster” – Nietzsche
‘God I give to You all that I am and all that I will be for your healing and direction. Make new this day as I release all my worries and fears, knowing that you are by my side. Please help me to open myself to Your love, to allow Your love to heal my wounds, and to allow Your love to flow through me and from me to those around me. May your will be done this day and always. Amen’
‘When I stopped living in the problem and began living in the answer, the problem went away.’
Alcoholics Anonymous Big Book, p419 4ed.
“We found the Great Reality deep down within us.
In the last analysis it is only there that He may be found”
Alcoholics Anonymous Big Book p55
” Our book is meant to be suggestive only . We realize we know only a little.”
Alcoholics Anonymous Big Book, p164
Quotes are a very personal indicator of motivation and inspiration, hopefully you will find at least one of these helpful
For some people, the cost of rehab and finding out whether or not their health insurance will pay for it is one of the most stressful aspects of early recovery, both detox and after. Most rehabs are notoriously cagey anout how much they charge – they like you to ring first and talk to them about admission stuff – this is a classic sales hook that unfortunately the majority of rehabs use.
Hazelden, one of the main treatment centers providers, say that they estimate a cost of between $25000 and $30000 for a twenty eight day stay in one of their facilities. A few rehabs that do give make their charges public seem to indicate a similar figure. It is probably a fair assumption to usea working figure of $30000 for a twenty eight / thirty day stay in a residential rehab or treatment center.
There is also the so called luxury rehab market, rehabs often based in Malibu, where a similar period of treatmnet can cost upwards of $80000 for a similar residential stay.
Rehab and Health Insurance
Most rehabs , like hospitals , gear their costing towards health insurance, and use this as a marketing technique in their business model. There are a few things to be wary about.Insurance companies seem to work with rehabs on the basis of agreeing cover for the initial detox , if needed , and then for a few days afterwards.
The insurance company will then agree coverage with the rehab for a further bock of days , and do this on a rolling basis until they reach the twenty eight day / thirty day limit . The reason this is important is because if the insurance company declines to continue cover at any point during that period, either the client becomes liable for the remainder of the cost, or will have to leave rehab as soon as cover expires.
This is potentially damaging to the client for two main reasons. It creates uncertainty in the process, even if the client stays. If the client has to leave early, it distorts the whole recovery program, which will be geared to a twenty eight / thirty day regimen, with a structured discharge and aftercare program as an integral part of the program.
Health Insurance Costs
Even if the residential stay is covered by insurance, there are potentially other costs that need to be taken into account.A rehab may have an arrangement with a local hospital to oversee a medical detox, depending on the initial alcohol and drug assessment.
This may even include staying in the hospital itself for afew days. Check the detox arrangements of the rehab, and make sure all costs , including cost of medications are covered under the insurance plan.
Like all claims made under a health insurance policy, you will also probably have to pay any deductible and co-insurance charges that apply to the policy. If your employer pays for your health insurance, check with the rehab and / or insurance company the position regarding confidentiality both during and after rehab.
As with any health issue, but particularly with respect for treatment for alcoholism or other addictions, it is crucially important that there is clarity as to what the employer is told and by whom. This is also really important if the job or profession is one where an admission of a problem with alcohol or drugs could have a significant impact on their future career.
It is also important in this regard that anyone entering rehab is aware of any legal, moral or professional obligation they may have to tell their employer of their position. It may be appropriate in certain circumstances for them to take legal counsel prior to entry.
Rehab Costs – Additional
The figure quoted above is of $30000 for a twenty eight / thirty day residential stay in a rehab. Whatever the actual cost turns out to be, there will be additional charges or extras to consider. These are normally for things like additional medication and additional therapies, depending on what staff are employed at the rehab
It is just important to clarify at the outset with the rehab what additional costs, if any, there might be and agree them prior to to admission. Often a Christian rehab will charge less for long term accomodation, but it is likely to have conditions attached to it,
Health Insurance and Rehab Credit
Somr rehabs offer their own credit facilities, which should operate on similar terms to other financial institutions. If looking to borrow money from anyone to go into rehab, this should only be done as an absolutely last resort, and all other options should be considered carefully first.
Many many people get clean and sober by going straight to meetings of Alcoholica Anonymous and Narcotics Anonymous, which are completely free. This should certainly be tried first by anyone considering borrowing money to pay for rehab.
Emotional Sobriety is the title of an article written in the journal of Alcoholics Anonymous, known as the AA Grapevine, by one of its co-founders Bill W.
In the article, he writes at length about the need to address many of the underlying emotional drives that fuelled his alcoholism, and implied that this was in effect a stage that follows the initial phase of getting sober and staying sober.
Many people have interpreted this as meaning different things. Emotional sobriety is often used as a form of judgement as to how ‘well’ people are in sobriety, irrespective of how long they have been sober.
Other people will often compare what they call physical sobriety with emotional sobriety, implying that once physically sober the level with which people are able to adapt and integrate their lives into sobriety indicates a degree of wellness.
It is really important, to understand the thinking behind the term emotional sobriety, irrespective of how long anyone has been sober or not.
Firstly sobriety is about being sober, pure and simple. There are no degrees of it, there is no judgement about it in terms of wellness or not, or how well people cope with it or do not manage to.
Emotional sobriety should be thought of much more in terms of the underlying emotional drives that play a part in most people’s alcoholism.
Anyone getting sober, whether in a rehab or through a 12 step program or some other way, will soon begin to realise that once sober the real issue becomes how do people stay sober, whilst living with the emotional turmoil that most people feel is inside them.
The process of people understanding and making sense of their alcoholism is a really important one.
What is equally important is that they have the freedom to discover for themselves what this understanding and connection is between alcohol and their emotional states.
Most people would recognise that their alcoholism is a mix of an instinctive or instinctual need to drink, and the sense of relief or freedom that alcohol gives them once they have taken a drink or several.
Often this connection between the effect of alcohol and what it is affecting you within is only clear at a felt level. Once sober, it becomes clearer that the emotional states such as anger, fear, loneliness etc that are a common part of alcoholism play a major role as a trigger for the compulsion or obsession to drink.
Emotional Sobriety and AA
However people come to understand their emotional states, it is normally clear from early on either in rehab or in meetings of Alcoholics Anonymous that the main type of therapeutic/spiritual work that needs to be done, is on helping the individual stabilise their inner world, and as such prevent the reflex action of picking up a drink or feeling the need to have a drink.
This work on one’s inner world, on helping to stabilise one’s emotions and begin the process of feeling relatively at peace with oneself at some level begins the moment an individual gets sober, either in a rehab or in meetings of Alcoholics Anonymous. This is the real focus of emotional sobriety, the understanding and need to be at peace with yourself.
Many people will have heard of AA, and will associate it with people being able to stop drinking. Some of the most common questions people have about AA include :
– How do you define an alcoholic ?
– Is AA religious ?
– What are the 12 Steps of Alcoholics Anonymous ?
– What is a higher power in AA ?
– What are the principles of AA ?
Alcoholics Anonymous is an organisation that is generally well known, and a significant number of people will understand that its main focus is to help people stop drinking. That aside, many will not have any real idea what constitutes an alcoholic, or what the organisation Alcoholics Anonymous really does or how it developed.
The history and origins of Alcoholics Anonymous are well documented, not least by the organisation itself, as well as by many outside independent researchers and historians.It is worth clarifying that Alcoholics Anonymous is and always has been a completely independent organisation, funded entirely by its membership, without any links to any medical or governmental body or organisation.
Its independence is a critical part of its survival and much valued by its membership.This independence is a crucial part of understanding the integral relationship between Alcoholics Anonymous and many rehabs and treatment centers that exist.
This is largely because the majority of rehabs and treatment centres that offer an addiction treatment program have such a program rooted in part of the 12 step program that Alcoholics Anonymous pioneered and offers as its main recovery process, and adapted by other organisations.
It is also worth clarifying that a significant number of rehabs and treatment centres offer a programme that is in effect quite different from the program offered by Alcoholics Anonymous, but with certain similarities.
The independence of Alcoholics Anonymous is also important in the context that many rehabs and treatment centres will actively encourage clients whilst in rehab to attend meetings of AA, both during treatment and once they have left in the context of after-care and support.
Many rehabs and treatment centers will host meetings of Alcoholics Anonymous on site, with the AA group paying a rental fee or giving a donation of similar kind in order to maintain and arm’s-length relationship.
If the rehab does not offer meetings on its own premises, then it is likely to have close links with local AA groups in the nearby vicinity or community.Many people entering a rehab will assume that Alcoholics Anonymous is in some way a part of the rehab, or a part of the recovery program or the addiction treatment program that the rehab offers.
It may well take a while for the individual to make a distinction that AA is not part of the rehab, and this is an important distinction to make for the long-term sobriety of that individual.Alcoholics Anonymous is an independent organisation, that has many years experience of recovery from alcoholism that is completely independent of any rehab or treatment center.
Many people get sober and stay sober simply by going to meetings of Alcoholics Anonymous, and normally after a while beginning to use the experience of the 12 step program in their own lives as a way of healing their inner emotional turmoil and emotional drives.
There are many different meetings of Alcoholics Anonymous, and individuals have the freedom to try any specific meeting that they wish, until they find one that suits their needs. Again in the context of a rehab this is really important.
Rehabs and treatment centers have fairly strict rules and regulations regarding both admission to the rehab, and the type of behaviours and activities and dress code etc clients can conduct themselves in whilst in treatment.
Alcoholics Anonymous and Rehab
Rehabs normally defend these rules and regulations as being part of a structured environment within which the individual can begin to feel safe, and begin the process of their own recovery in an environment that is structured and has boundaries.
This obviously works for some people, and can present a real problem for others. In the context of Alcoholics Anonymous there are no rules or regulations. Anyone who feels they have a drink problem can turn up at a meeting of Alcoholics Anonymous and see if it is of help them.
Alcoholics Anonymous is often best seen and best understood when thought of as a body of experience going back many decades, that is effectively expressed through the literature of Alcoholics Anonymous, most notably in the book of the same name.
Any individual can use the experience of Alcoholics Anonymous in any way that they find helpful or not. AA, although not always seen as such, should be a real route to freedom, and an opportunity for people to begin the process of understanding whether or not they are alcoholics.
Such an understanding can give the individual a real sense of freedom in the context of understanding their lives, and a real sense of freedom in the context of being able to rebuild their life, both internally and externally.
Many people use of the terms alcohol, alcoholic and alcoholism almost interchangeably, and there is often a lot of confusion as to what these terms actually mean, and how they relate to each other. In the context of a rehab/treatment center it is really important to understand at some level what these terms mean in order to make sure that the rehab is addressing relevant addiction terms accordingly.
Most people are aware of what alcohol is, and the different types of alcohol. For many people alcohol is not a problem at all in their lives. Many people do not drink at all, either for religious reasons or social ones.
Other people drink moderately and have a sense of control or normality over their drinking.
These types of people are often referred to in the context of alcoholism as social drinkers. Social drinkers represent a large proportion of society who are able to safely consume different types of alcohol as and when they choose, with no significant impact on themselves or others.
For other people, alcohol can represent a serious problem in their lives. This can manifest itself often at an early age when people are in their teens, through to people in later life.
People’s patterns of drinking may differ significantly, but there is often a common thread in that other people start to be concerned about their drinking, and the actual impact of their drinking has a detrimental effect on their lives at some level.
It is worth making a distinction that not everyone who has a problem with alcohol is necessarily an alcoholic. That may well be people who have a problem with alcohol at different points in their lives who are able to stop on their own and see the damage that they are doing to themselves and others.
Making a distinction between an alcoholic and a non-alcoholic heavy drinker is an important distinction, not least because important considerations follow from both these patterns of drinking.
Someone who is a heavy drinker will most likely have become at some level addicted to alcohol as a consequence of continuous use. In the same way that someone becomes addicted to cigarettes, someone who is a heavy drinker will start drinking moderately and over time become more and more dependent on it.
This heavy drinking may well affect their lives, both their work lives and their family lives in some fairly obvious way. It is likely that once realised, the heavy drinker will be able to stop, although they will often need help and support from family, friends and possibly outside agencies.
Someone who is an alcoholic may outwardly displayed many of the same patterned behaviour and patterns of drinking as someone who is a heavy drinker. The real difference is likely to be an internal one, with the alcoholic having a significantly different mental and emotional attitude to alcohol and life.
There are many different patterns of alcoholics, and of alcoholism in general. It is probably safe to assume a few general pointers, although they should not be taken as a rigid definition.
Firstly, anyone of any age, status or background can become an alcoholic. There are no limits or prerequisites. Many people who are alcoholics grew up in alcoholic homes, and there is a widespread belief that there is some genetic component to people’s alcoholism.
Secondly, an alcoholic may well start off drinking at any age, and may start drinking as a social drinker as outlined above, and progress into active alcoholism at any point. Alternatively the alcoholic may start off drinking alcoholically, again at any age, and carry on drinking alcoholically for long as they are able to.
It is also safe to assume that someone who is an alcoholic reaches a point in their drinking when they are completely unable to stop on their own resources, and in most cases lose any will to try and stop as well. For a better understanding of the nature of alcoholism, it is suggested you read the book Alcoholics Anonymous, or attend open meetings of Alcoholics Anonymous.
In its simplest form, alcoholism refers to someone who is an alcoholic, in the same way that someone who is a diabetic is someone who has diabetes. This obviously is an oversimplification in one sense but does stress the point accordingly.
Whilst people have had drink problems for most of humanites time on earth, it is only relatively recently that alcoholism has been recognised as an illness, and as such people who drink alcoholically have been recognised as people who suffer from this illness, as opposed to people who have a moral weakness or lacking character.
In some ways this is a fairly spurious distinction, but is an important context for many people once they get sober. Alcoholism as an illness was recognised by certain members of the medical profession at the time that Alcoholics Anonymous was being formed, and the formation of this society gave significant growth to this belief, both within the medical profession and beyond.
Since then alcoholism is most often referred to as a disease, which has different implications to it being an illness, and has been generalised into a form of addiction in which alcohol and drug addiction and other forms of addiction are treated as the same issue.
This approach to treating alcoholism the same as other types of addiction has largely been formulated by rehabs and treatment centers, and is one that should be taken with much caution.
Alcoholism in its own right is probably best understood by people who are alcoholics themselves, and the relief in terms of understanding that it is a progressive illness gives many people a sense of context and reality that allows them to set in motion the process of recovery, and rebuild their lives both internally and externally.
The issue of alcohol withdrawal, historically often referred to as dt’s, is a far more serious problem than the term dt’s often implies, and is an issue that needs to be understood and dealt with and managed safely when anyone is stopping drinking.
The issue of alcohol withdrawal will normally always refer to someone who is either an alcoholic, or someone who has a serious addiction to alcohol and is considered a heavy drinker, or a drinker who is at risk to themselves and possibly other people.
It is certainly possible that this person has also used drugs of some type, either prescription or non-description. This means that anyone who is an alcoholic who is looking to stop drinking needs to be aware that there are potential serious effects of stopping drinking suddenly, both from the drink itself and from the a combination of drink and any drugs they may have been using.
For many people who are considering stopping drinking in the context of being an alcoholic or a heavy drinker addicted to alcohol are likely to seek help in a rehab or a treatment center. This is a really important issue, and should be a major factor when considering which rehab treatment center to enter.
The issue is twofold. The rehab should have a fully qualified medical staff who are able to access whether or not the individual is at risk from alcohol withdrawal, and if they deem that individual to be at risk to manage the withdrawal in a safe and secure medical environment.
If the rehab itself does not have the staff and the facilities to do this, then it should have an arrangement with a local clinical facility such as a hospital who can oversee and perform such a withdrawal in a safe manner.
It is worth being aware that if a rehab does not have such facilities and staff on site and has to refer you to a local clinical facility, then the cost of that facility may well be an extra item for the individual to pay, and may well not be covered under their insurance.
Not everyone who stops drinking has problems in terms of alcohol withdrawal, it is very much an individual experience that needs to be assessed and monitored by qualified medical staff in a facility where they are able to do this.
Once this procedure has been assessed it is also really important that the rehab has qualified medical staff on site or on call 24/7 in the event that there are any problems that need to be addressed.
It is also worth mentioning that alcohol withdrawal is also often referred to as an alcohol detox, or a drug and alcohol detox or a medical detox. This is important, as many rehabs will offer what they refer to as an holistic detox, which is a completely different process to a medically supervised drug and/or alcohol detox.
A holistic detox is a name that excites many people because of the implications of it. What it really refers to is a cleansing process of the body and mind and spirit. This idea is appealing, and often people are drawn to this without any real understanding of what is actually involved.
An holistic detox can refer to anything from a number of therapy sessions, through to a mountain climbing course, through to colonic irrigation through to things such as a sweat lodge. Some of these processes are potentially quite dangerous, and great care should be taken before signing up to them.
Anyone who is considering giving up drinking on their own, i.e. not going through a rehab or a treatment center would be well advised to seek medical advice from a qualified medical practitioner before beginning the process.
Many people do safely stop drinking without any major side-effects, but the implications of suddenly giving up alcohol after many months or years of abuse of fairly obvious.
Many people decide to stop drinking by going to meetings of Alcoholics Anonymous, which allows them to carry on with their normal day to day life, assuming they have one.
Even so they should be well aware of the potential effects of alcohol withdrawal, and would be well advised to seek medical advice prior to stopping drinking, and at any point during the first few days or weeks of being sober if they are at all concerned about any aspect of their health that they become aware of once they are sober.
Many people use the word addiction almost quite loosly in a way to refer to people’s liking or obsession for virtually any substance, activity or behaviour. In normal everyday life the term addiction is often used jokingly, saying that someone is addicted to x, y or z, and it’s not really that much of a problem.
When it comes to dealing with addiction in the context of alcoholism and addiction to various types of drugs and other behaviours such as gambling etc, then it is really important to understand the gravity of what these conditions and situations refer to, and what help is available and where.
Addiction is a widespread term, and in the context of rehabs and treatment centers first came into being in the context of alcoholism in the formation of Alcoholics Anonymous. Alcoholism is often treated in the same context as other types of addiction, but this is normally a mistake and should be treated with caution.
Whilst it is difficult to generalise about alcoholism, and there are many types of it, it is properly fair to say that an alcoholic will drink because they are an alcoholic, not the other way round.
In other words, an alcoholic will not become addicted to alcohol in the same way that someone will become addicted to cigarettes, through a pattern of using an addictive substance that leads to a form of addiction that they cannot break.
A rehab or treatment center will offer addiction treatment programs for alcoholism, alcohol addiction and other types of addiction as well, and should be fully licensed and accreditted
Most rehabs will treat all of these types of addiction as essentially the same problem, and will focus on the individual as being the real problem, with the solution being helping the individual to change.
A rehab is likely to stress that the individual is something referred to as an addictive personality, and that their addiction is or was essentially about a drug of choice, be that alcohol or something else.
The advantage of this type of approach is that it can help the individual to realise that their real problem is within themselves, and thus is changeable either with the help of a 12 step program or through some other means.
A basic underpinning of this approach is that addiction itself is a disease, leading to the idea of an addictive personality and a drug of choice.
Again this may be helpful or not depending on the approach taken by the rehab, and at what level the individual feels it helps them make sense of their lives.
The issue of addiction is quite a complex one, and one that has undergone and continues to undergo much medical and social research.
When considering entering a rehab, it is worth bearing in mind what weight the rehab treatment center places on current clinical research, and how up-to-date that addiction treatment programs are in the context of modern day research.
Addiction and Rehab
A rehab or treatment center also often offer treatment for other types of addiction.
These can range from what is referred to as dual diagnosis, which means people who are alcoholics, addicted to alcohol as well as being addicted to various types of drugs both prescription and non-prescription, through to food, gambling, sexual addiction and addiction to the internet and video games.
It is worth being slightly cautious with any rehab that offers too broad a range of addiction specialities and addiction treatment programs.
There is a belief that some rehabs use the term addiction or addictive personality much too broadly, and use it essentially as a catchall phrase that allows them to treat virtually anyone for virtually any problem that they can classify as an addiction.
Remember that the problem and solution in the context of a rehab or treatment center tends to be seen as that of an addictive personality with a drug of choice. This allows some rehabs to take an approach that has some questionable ethical and moral issues.
At the end of the day a rehab is a business, normally a very profitable business, and the more they can broaden their client base or their customer base the more profitable they will be, even rehabs that describe themselves as Christian rehabs
Addiction to alcohol, alcoholism and addiction to drugs and gambling and other types of serious problems are a major issue, and for many people a rehab or a treatment center is the first port of call that they will enter to seek help.
A rehab and especially the rehab staff is likely to help the individual understand some of the underlying emotional drives and issues that have fuelled thir addiction, and help give them a structure or program that will allow them to rebuild their life and offer them the chance to live a life that is essentially free from their addiction and their addictive behaviours.
People who ask or talk about rehab facilities often do so with a understandable but misguided idea that rehab is are a mix between an upmarket hotel and a country club, a sort of retreat with varying degrees of comfort or opportunities.
The reality is that rehabs differ widely in terms of the facilities that they offer to people, and that approach as to how the environment and addiction treatment programs should be offered to any individual who enters an inpatient rehab.
Traditionally, a rehab would treat someone who was an alcoholic or had a problem with alcohol, and their time spent in a rehab would consist of a medical detox if needed, followed by a period of different types of therapeutic treatment, often a mix of 12-step program ideas and meetings of Alcoholics Anonymous.
There would be a need some type of clinical facility, along with a modicum of comfort and very basic facilities.
The rise of treatment centers and rehabs has meant the growth of this industry, and a white approach that can differ considerably.
The initiators of the treatment center industry tried to strike a balance between providing an environment where the alcoholic could feel safe and secure, along with facilities treated them as someone who was trying to get well, rather than as a bad person.
At the same time, there was a belief that treatment centers and rehabs needed to be a fairly structured environment, and should be designed to focus the individual fully on their recovery process.
Rehabs and treatment centers take a number of different approaches. Some believe that a rehab should be a fairly spartan place, with very basic facilities and an entirely structured timetable from morning till night.
Some rehabs believe in an incredibly tight grip on what the individual can bring into rehab, and what they can and cannot do whilst there.
This can seem incredibly regulated some people, inevitably attracting some and alienating others.
There has been a growth in recent years of what can be termed luxury rehabs, which take almost an extreme opposite view. They believe that a rehab should essentially be the most serious and pleasant environment that someone can spend their time in, and that this is conducive to aiding in their recovery.
Both these approaches are somewhat of the extreme, and inevitably there are a wide number of different approaches in between.
There is no right and wrong approach to recovery, and every individual should approach a rehab based on what they feel is most appropriate to them.
The rehab facilities that are available should be outlined on the rehabs website, and rehab should be open to discussing what these facilities are, and how they help a client in their 12 step recovery.
Dual diagnosis is a term that specifically refers to people who would consider themselves both alcoholics and drug addicts, or people who have had problems with both alcohol and drugs. The term arose mainly in rehabs and treatment centers, and it is important to understand this context.
Initially treatment centers and rehabs treated people who had a problem with alcohol, whether they were turned alcoholics or problem drinkers, or people who had alcohol abuse issues. As this industry grew, people entered rehab who not only had problems with alcohol but with other substances including many narcotic drugs, and various behaviours.
Treatment centers and rehabs quickly picked up on this, and in the specific case of people who have problems with both alcohol and drugs they refer to them as being dual diagnosed. In addition, the rehab industry widened their scope of potential clients or a client base by beginning to define people as an addictive personality.
This meant that in effect, any individual who had any addiction to any substance or any type of addictive behaviour could be labelled as an addictive personality, and their particular addiction, whether substance or behaviour, could be labelled their drug of choice.
There are many people who believe that the terminology employed in the idea of an addictive personality and a drug of choice is simply to enhance the pool of people who can be susceptible to needing to go into treatment.
There are other people who defend the term addictive personality as being a reasonably good definition of some help an individual who has a number of differing emotional drives and issues which fuel that alcoholism or addiction.
Whatever someone’s take on the term dual diagnosis, in reality it simply means that it refers to someone who has a problem but with alcohol and drugs, or has had a problem with alcohol and drugs and is now clean and sober.
In terms of 12 step recovery, what it really means is that individual will have used both alcohol and drugs at different stages of the alcoholism and addiction, and probably recognises a need to keep clear of both in order to stay clean and sober.
People often ask what alcoholism symptoms, often at a way of trying to create a checklist of what constitutes an alcoholic, on the basis that a diagnosis will help confirm the illness in someone and lead to a recovery.
This approach has been fuelled in many ways by the acceptance in medical circles that alcoholism is an illness, often referred to also as a disease, and inevitably this will lead people to think that because alcoholism is an illness, there are obvious symptoms or signs of it that can be identified and labelled.
The reality of active alcoholism is much more difficult to define.
Anyone who lives with what has lived with or has been affected by someone else’s alcoholism will either be painfully aware of it, or completely in denial of it.
Often an individual or independent observer would be able to see that someone has a serious problem drink, either by their behaviour or that attempting to cover up their problems, or the inability to see their own truth about the problem.
Is worth pondering the recovery process of Alcoholics Anonymous to have a better understanding of how alcoholism can be understood and processed.
For someone who is an alcoholic themselves, Alcoholics Anonymous offers a wide range of literature details experience of Alcoholics Anonymous, and presents many stories and examples of people who identify as alcoholics.
The stories and people’s personal sharing is give the individual and opportunity, if they so choose, to identify and begin the process of realising that they themselves may be an alcoholic.
Someone who is closely affected by another person’s alcoholism, either family or friends, then there is a separate concept organisation known as Al-Anon which will help the individual break out of that and measurement with the alcoholic or the alcoholic family and begin the process of re-establishing their lives as a separate person.
Once this process has started, then it is more likely the individual will gain some type of objectivity about the individual drinking and their alcoholism.
It is also were saying that Alcoholics Anonymous, along with other organisations, produces a wide range of literature that tries to explain alcoholism that is specifically geared to people who are not themselves alcoholics, but may well come into contact with people you are and who seek help.
Chemical dependency is a term that has come to be used with reference to almost any type of substance abuse or addiction to alcohol/drugs etc.
The original sense of addiction in the context of a 12-step recovery was an addiction to alcohol, normally referred to as alcoholism.
As an understanding that alcoholism was an illness grew in medical and therapeutic circles, treatment centers and rehabs began to treat people who they referred to as being dual diagnosed, that is that they had an addiction to some type of drug as well as a problem with alcohol.
Since then rehab’s and treatment centers have broadened their concept of addiction treatment programs to essentially deal with anyone who had any type of addiction, to any type of substance or behaviour.
This approach certainly has its critics, many will argue that seeing the individual as an addictive personality, and their chemical dependency or behaviour is simply a drug of choice is highly oversimplistic.
At the same time, most people who have had any dealings with anyone who is an alcoholic or addict, either active or in recovery, will happily testify that they have significant personality and identity problems that have undoubtedly fuelled that alcoholism or addiction.
The linkage between chemical dependency and addiction and rehabs is one that is important to seek an context.
It is very easy for someone unfamiliar with the world of 12-step recovery who is confronted with someone who has a terrible addiction to simply follow the dictates of a particular rehab or treatment center.
Sometimes time is of the essence, and it is often essential to get someone into a rehab or some type of detox program so that the health can be stabilised, at least in the short term.
The process of recovery from any type of addiction or alcoholism, in the context of 12 step recovery, can be done either in a rehab or by going to meetings of Alcoholics Anonymous or another 12 step organisation.
This process of 12 step recovery is by necessity a long-term process, and one undertaken by someone who had at some level either acknowledged their chemical dependency and are willing to try and deal with it, or are willing to acknowledge the life is a complete disaster and are willing to try and change it, even if they don’t know why.
Anyone entering a rehab for a problem with alcohol, commonly referred to as alcoholism or alcohol addiction would be well advised to be aware of the potential effects of alcohol withdrawal, sometimes referred to as a detox, historically referred to as the DT’s.
The effects of withdrawal from alcohol addiction or alcoholism can be severe in some people, and it is a good idea to make sure that anyone entering a rehab is clinically assessed, by experienced clinical staff to monitor the effects of withdrawal from alcohol.
One important aspect of alcoholism that is often not fully understood is that it is regarded commonly as what is termed a progressive illness.
There are sometimes a debate about whether alcoholism is a disease or an illness or a combination of nature or nurture, and people will have differing views on this question.
Too many people who have got sober using Alcoholics Anonymous, they are very aware that her own alcoholism is a progressive illness, and for many it is the progressive element that is really important.
ALCOHOL WITHDRAWAL ADDICTION
The progression of alcoholism in many people is not simply a issue of tolerance for alcohol, it is a description of both how their drinking has progressed over a period of time, how that emotional state has changed during that time, and how alcohol has become at the end of the drinking the only thing of real value, the only thing that needs to be protected and kept safe.
One of the reasons this is so important, is in terms of understanding the nature of alcoholism, and in truth the only people who probably really do understand it either active alcoholics themselves, or people who have got sober and would consider themselves to be alcoholics in recovery.
The nature of alcoholism as an illness can be quite varied and widespread, the progression of it is an element that people who are alcoholics will at some level be able to identify with, either in terms of the tolerance or lack of tolerance of their drinking, or a more general felt sense of their inner and outer world closing in on them, and alcohol remaining the only thing that is holding them together.
The 12 steps treatment program of Alcoholics Anonymous has become widely regarded as a yardstick for recovery from alcoholism, whether it be practised within the organisation of Alcoholics Anonymous, or in a rehab or treatment center.
The phrase 12 steps has become widely used, and often misinterpreted in terms of what they really mean.
This is important, because many rehabs and treatment centres often promote themselves as being 12-step based, which can mean a variety of different things.
Equally there are a number of rehabs and treatment centers that specifically promote themselves as being non-12-step based, and this has implications in terms of what they do offer as addiction treatment programs, and to what extent they are clinically-based or proven.
The original 12 step program of Alcoholics Anonymous can be found in its entirety in the book of the same name, and is widely available anyone to buy, borrow from their local library, or read online for free.
It should always be remembered that the 12 step program of Alcoholics Anonymous should be taken in context of its writing.
This means that it was written along with a number of descriptive chapters as a record of experience, of what the early members of Alcoholics Anonymous found worked for them.
12 STEPS TREATMENT
People are a perfect liberty to use any or all of the 12 step program in anyway that they find helpful or not.
A number of treatment centers and rehabs use a variation of the 12 step program, but do tend to promote it as if they were offering the benefits of the program as practised within Alcoholics Anonymous.
This can be slightly misleading, and can also be seen as taking advantage of people who are quite vulnerable and do not fully appreciate the difference between the two approaches.
In addition, a number of rehabs and treatment centers will be very supportive of 12 step programs such as Alcoholics Anonymous and Narcotics Anonymous and will actively encourage or insist there resident clients attend meetings of these organisations.
In this way a number of rehabs will align themselves with a 12 step recovery program.