Strong cravings: The sufferer has extreme cravings for alcohol. Loss of control: Disengaging control, over how much, when to start and when to stop drinking.
Alcoholism does not progress in strictly definable stages, as medicine used to ame; mild as well as severe dependence, physical addiction, or habitual drinking are not domino effects that progress linearly. The Munich Alcoholism Test is much more informative than the classification of certain "drinking types. It consists of only four questions:
1. "Have you tried (unsuccessfully) to limit your consumption??" 2. "If other people have criticized your drinking behavior and thus angered you?" 3. "Have you ever felt guilty about your consumption??" 4. "Have you ever had a drink right after getting out of bed to 'get going' or calm down?"
If the affected person answers at least two questions with yes, a dependence is probably present. If all questions are answered with a yes, acute alcohol dependence is highly probable.
Change of character
Long-term abuse changes the personality. Motivation, performance, memory and drive become increasingly impaired. Sufferers suffer from jealousy with delusional tendencies, without "normals" recognizing a trigger; this jealousy relates not only to their love partner, but also to friends, parents, siblings, even strangers – and it can become dangerous.
Alcohol addiction results in changes of character, which are not infrequently accompanied by social isolation. (Image: DBPics/fotolia.com)
Affected persons dangerously injured their best friends because they were jealous of a third person who was sitting at the table and got along well with the best friend. More than a third of all cases of domestic violence result from alcohol abuse.
The jealousy delusion is accompanied by paranoia, for example, the fixed idea that two people talking at the bar were plotting against the sufferer.
The jealousy mania of addicts destroys families, puts the sick in jail and their victims in the hospital – or in the cemetery.
Edgar Allan Poe, who himself suffered from the problem, masterfully sketched such a change of nature in the story "The Black Cat": a respectable man, who loves animals as much as his wife, becomes addicted to alcohol and develops a paranoid loathing of his cat. He kills the animal, but a new cat appears that looks like a copy of the old one. In his madness, he goes after the cat with an axe, slaying his wife who stands between them.
The sick person yells at the mailman who is delivering a package for the neighbor; he vacillates between being elated and saddened to death. He cries because of invented memories.
Only when intoxicated, and later in the phases in between, does his socially balanced behavior break down – with relatives, friends, acquaintances as well as with complete strangers: For example, he falls around strangers' necks and treats close friends as if they were air. He neglects body-. Housing hygiene. He oversteps limits that he previously observed: He drives drunk, and he urinates in public.
Psychosis and depression accompany many years of alcohol abuse. Most of the time, the affected person suppresses the fact that these are primarily consequences of the alcohol. In advanced alcoholism, these psychoses also characterize the "sober" state.
Finally, in the case of Korsakov's syndrome, the alcohol has destroyed essential areas of the brain. The brain replaces the missing memories with inventions. Friends feel "blindsided" when the ill person now accuses them of things they never did, or does not recognize these friends, tells of trips to countries he has never been to, and, above all, at every opportunity picks fights over events that exist only in his imagination.
Above all, the sick person lies when it comes to his addiction. He develops strategies to firstly get the substance, and secondly to conceal it. A wicked joke goes: "Guys, I'm going out with the dog for a minute." "What do you mean, you don't have a dog?."
He hides booze in the aftershave bottle. He projects and laments about the alleged or real addiction problem of others. He plans various stops to get to the substance under any circumstances. He invites others to get drunk together in order to pretend normality.
When he gets fired from his job because of his problem, he invents other reasons. If he misses appointments because of the intoxication, he blames others.
Relatives and friends who keep in touch with him become co-alcoholics. If they massively confront him with his problem, he breaks off the relationship. If they play along, they cover up his addiction. They invent excuses when he lies drunk in bed, they buy him liquor at the kiosk, and they affirm "everything is fine" when third parties ask about the condition of the sick person.
Unlike other drugs, alcohol is socially accepted, cheap and available everywhere. (Image: Jacob Lund/fotolia.com)
Acute alcohol intoxication
Acute alcohol intoxication limits awareness, perception and behavior. The drunkard is disinhibited, his attention diminishes (drowsiness), he loses his ability to judge situations, his performance decreases. He instigates quarrels and quickly feels provoked without cause.
His gait is unsteady (he staggers), his speech is blurred (he slurs), his eyes twitch, his face turns red, as does his conjunctiva. Alcohol intoxication also causes blood prere to drop and the body to hypothermia.
In the past, doctors classified a plethora of alcoholic types. Today, the biographies of the individuals are in the foreground instead. Politicians, teachers and journalists suffer from the disease, as do construction workers and the unemployed, young and old, men and women.
Cloninger defined two types in 1981. Type I is characterized by the milieu. The sick person grows up in an environment in which drinking is part of it, be it as a proof of masculinity, be it because the pub is the place of social gathering, be it because the liquor bottle is on the table when there are visitors. A "gentleman's deck" for a beer and a grain at the bar, or the "construction worker's breakfast," meaning a case of beer, elevate alcohol to a social ritual.
The "Type-I" drinks to belong. He generally behaves passively. Is dependent on rewards. For example, he swears about his job, but instead of changing it, he drinks liquor during his lunch break.
He puts himself in the victim role: the system, the boss, the parents are to blame that he does not lead the life he wants to lead. Instead of taking steps to realize his dreams, he bathes himself in self-pity: "I couldn't bear it without alcohol." Instead of working on his own goals, he makes his well-being dependent on the praise of others, and such a "reward" is also promised by the drug.
The more difficult the social situation is, and the less recognition the sufferer receives, the more severe the illness becomes. Genetic dispositions hardly play a role. For type I alcoholics, psychotherapy promises success, paving the way to self-responsibility. Alcohol is a symptom for them, the core of their problem is the fear of a self-determined life.
The "Type-II" is almost always a man. His father was already addicted to alcohol and he starts drinking very early. The mother often does not have an alcohol problem. This type needs alcohol and other stimuli to put him in a euphoric mood – he often lives multitoxically. He speeds by car, he balances on bridge railings, he is present at every questionable dare.
Most likely there is a genetic disposition in these patients. Some of these type II alcoholics show a dissocial personality disorder in the clinical sense, and psychotherapy is of very little use, since they themselves do not suffer from their behavior.
A third group probably also has a genetic disposition to alcohol, but does not behave antisocially. These sufferers are also magnetically attracted to alcohol because it makes them feel euphoric.
Alcohol has a relaxing effect because it inhibits NMDA receptors and stimulates GABA receptors. The body releases dopamine and endorphins. However, this stimulation falls asleep with long-term consumption, and more and more alcohol is needed to bring about relaxation.
Withdrawal is painful because nerve cells previously suppressed by the substance occupy the space without being in balance. This means: fear up to sheer horror, trembling, hallucinations and convulsions. Sick people drink alcohol again to turn off these symptoms.
New studies suggest that a genetic disposition may underlie addiction. This sounds abstract and concretely means that the brain of the person so at risk links alcohol to the pleasure centers.
Morally insensitive therapies are of no use at all here. Confronting the sufferer with the consequences of his or her alcohol abuse, accusing him or her of having a weak will, and asking him or her to "grit his or her teeth," as it were, rather leads the sufferer into a vicious circle. His unconscious keeps pushing him in the direction of the drug, just as it leads the unaffected to the warm radiator in winter. The unconscious cannot be influenced willfully.
These patients in particular need an environment in which they do not come into contact with the alcohol trigger.
In the case of abuse and social triggers, however, psychotherapies and ways of self-help promise success. However, the will to get out of the addiction must be there – and with it the awareness of the problem.
Alcoholism is an addictive disease that can be cured. (Image: Syda Productions/fotolia.com)
In order to get a socially or psychologically, but not genetically triggered alcoholism under control, the will is the first deciding factor.
New studies show that people do not succeed in doing anything they do not want to do. So the first question the person has to ask himself is whether he wants to stop drinking at all.
The first thing sufferers need to be aware of is that they have a problem. Then it is necessary to fix the advantages and disadvantages of the drug in black and white. Demonization is just as useless here as convincing oneself of a feeling of guilt. Both lead at best to a "guilty conscience", and a guilty conscience only means continuing to do the same thing as before and feeling even worse about it.
Making up your mind is already self-help. Alcoholics reach for the bottle in order to numb themselves, i.e. not to consciously decide for or against something, not to tackle challenges and to unconsciously place themselves in a victim role.
An advertising machine that constantly suggests we can have it all and be it all if we only want to, prevents such clear decisions from being made. Because a decision always means deciding against a variety of alternatives. Those who decide pay a price, and they should make that price clear from the outset.
There is, or at least was, positive stimulus to drink. A table on which the person concerned contrasts the positive sides of the addictive substance with the negative ones is the basis for paving the way out of addiction – or continuing to drink.
The positive side could say, for example: With alcohol, I forget my problems; I relax; I talk to people, lose my shyness; intoxication makes dull days colorful; drinking is part of the fabric of my life.
On the negative side: binge drinking destroys my friendships; I feel ashamed of what I do; I drink away my professional potential; I get fat and sick; my performance declines; I don't enjoy the day; I waste money I could use wisely; my character changes to a caricature of myself.
Next comes an unsparing "chronicle" of positive and negative incidents caused by the addiction: Did I discover new things while drunk?? Did I develop a perspective while intoxicated that I didn't have otherwise? Have I lost my driver's license, what important relationships broke down because of drinking, etc?..
Based on this chronicle, the person can classify his alcoholic career. When did the first film break occur?? When did he lose control? When did values he had set for himself no longer play a role?
The rule of thumb of such a pro and con dialogue is: the more severe the disease, the more the positive stimuli of consumption disappear. For example, if the positive side says "I meet new people more easily," but I am already so deep in addiction that the new people, like the old people, run away from me, then the positive aspect has dissipated.
The affected person now writes down which situations lead him to reach for the bottle: stress, or concrete fear, for example going to a club? These triggers already point the way to healing, namely changing habits.
If, according to one sufferer, he can only tolerate the people in a particular club when drunk, the realization may now dawn as to why he goes to a place he dislikes in the first place.
If he overcomes his shyness with the drug, he can practice this soberly by smiling at or addressing strangers in a targeted manner.
This writing down in black and white also exposes the constant excuses. The sick person can, for example, realize that his excuse that he is constantly being seduced because there is beer and wine to buy everywhere is invalid if he walks for miles at night to get his dose.
But once the triggers have been identified, such as fear in strange company, loneliness or stress, there are a lot of alternatives: relaxation exercises, changing one's perspective, trying something completely new, even if it's just riding a bicycle through previously unknown streets, or consciously doing something good for oneself that isn't called alcohol.
The sufferer can go to groups that help – such as Alcoholics Anonymous – and talk openly about his problems there, call friends with whom he has had no contact for a long time because of the addiction, tell his relatives that he has understood his problem. Addicts are usually surprised at how much help they receive when they accept it.
Useful habits / Positive goals
If biological dispositions do not play a role, but the habit or milieu does, then the affected person can develop useful habits. The conscious will must be there, but the unconscious hangs on to it like a log on the leg.
Our unconscious behaves in an "arch-conservative" way. It stores past experiences and changes functioning systems only very slowly. Habits are patterns stored in the unconscious, and in the sick person this pattern is unfortunately kiosk alcohol, pub alcohol, club alcohol, supermarket alcohol.
These habits must be consciously changed. For example, a sufferer who, out of habit, "hits the slopes" on Saturday night, may start drinking every Sunday morning at 7.00 ride the bike for an hour in the forest (where there is no kiosk). For this he has to go to bed earlier on Saturday.
Or he may keep his old trip to the kiosk, but now get a chocolate bar and a bottle of Coke every time he goes. It is a good idea to practice fixed rituals and to charge them with (positive) symbols.
An inner compass during this phase is provided by an alcohol diary. The person concerned starts it on the day he decides to quit the addiction. He keeps it like a "normal" diary, but focuses on his alcohol behavior.
First, when the urge to hit the bottle seems overwhelming, he can pick up the fountain pen and write about that very urge, but second, he also writes about anything else on his mind and frees himself from it by writing it down. Thirdly, he creates a treasure of his own life, because already after a few weeks the diary proves whether, and as a rule, how he changes.
To do this, it is advisable to involve witnesses, parents or friends, and to tell them: "I have recognized my problem and I will stop drinking alcohol (date). I will meet with you regularly in the near future and you will tell me honestly what you think about my condition."The addict has now made an agreement with himself and found witnesses. He cannot go back.
If the sick person does drink again in the first phase, he also writes this down without condemning himself, on the contrary, he tries to record this state as well, like a participant observer.
Psychotherapy or group therapy: There are many ways to get away from addiction. (Image: Denis Junker/fotolia.com)
Everything, whether it is going to Alcoholics Anonymous, psychotherapy, talking to parents, friends' reactions and promises to oneself, should be written down. If the first attempts to get away from addiction fail, that's not a problem. What distinguishes successful people from unsuccessful people is that they fail a hundred times before the unsuccessful even try.
The diary should definitely contain positive drafts of a future without alcohol and the person concerned should note down at least ten nice (sober) experiences every day and write down five successes. In addition, he can draw up a picture of how he imagines himself when alcohol no longer dominates his life. He can also keep a daily list of how much money he saved today by not spending money on alcohol and use it for meaningful projects. Or he confronts the events of the day with what he would have missed with alcohol.
Successes and experiences do not have to be grandiose: "I'm at 8.00 got up, washed the dishes first thing and transferred my rent" is just as much a success as "a chaffinch landed on the windowsill" is a nice experience. The trick to such record keeping is that it refocuses our unconscious mind.
The unconscious may be slow to break free of stored patterns, but when it adds new patterns, associations bubble up with these as well. Patients who develop such new and for them positive habits report unanimously about different phases. At first, the urge is extreme, and the new habits, such as wandering in the wall, seem like compulsive self-disciplining to them, but then new consciousnesses emerge, childhood desires resurface in everyday life, the focus turns to things that have nothing to do with alcohol.
In the best case, the alcohol diary becomes a precious adventure of self-knowledge.
Those who "only" suffer from alcohol abuse can also try controlled drinking by setting rules for themselves such as, "I don't drive my car to parties"; "I drink three soft drinks between each glass of alcohol"; "I ask my friends to tell me when I'm being abusive"; "I look for alternatives such as yoga, biking, or a warm bathtub when I'm overstimulated or stressed out." But if this controlled drinking does not work after multiple attempts, it is advisable to stop drinking altogether.
Essential to solve the addiction problem is not to take on too much. It is only about the alcohol for the time being. If I suffer from obesity, possibly due to the drug, eat unhealthily, smoke too much, exercise too little, or have a messie syndrome, I shouldn't try to solve everything at once – then failure is inevitable. As a rule, these other problems also decrease when I reorganize my life without addiction.
Whether abuse, psychological or physical dependence: those who free themselves from the drug retain the memory of "Lady Whisky" for a lifetime. All life experiences that we associate with alcohol are stored in the unconscious mind.
Especially dry alcoholics who were physically addicted are familiar with nostalgia for everything that has to do with intoxication. The best preparation for this "wistful feeling" is to consciously make the decision for a life without the drug, i.e. to realize beforehand that familiar living environments will no longer be there.
Paradoxical as it sounds; the point, as with all alternatives, is to appreciate living with addiction. Dry sufferers who present themselves as radical alcohol enemies are usually not happy people. They deny that the bottle of wine promised them comfort, thus throwing away an important part of their own life that their unconscious keeps reminding them of.