By Sheldon Zimberg (auth.), Sheldon Zimberg M.D., John Wallace Ph.D., Sheila B. Blume M.D. (eds.)
Sodetal attitudes towards alcoholism are characterised through various kinds of denial, with disastrous own and sodal effects. Refusal to confess the level of alcoholism as a big nationwide ailment results in a public coverage which allocates quite few assets to analyze, prevention, remedy, or rehabilitation. On a person foundation, the combo of sodally authorized consuming and the stigma assigned to the persistent alcoholic leads to members blinding themselves to the life of the matter in relations, good friend, and self until eventually it has reached such a complicated or noticeable measure that denial is not any longer attainable. there's the 3rd form of denial, exemplified by means of healing de spair, which announces thatgaps in wisdom of the reason for alco holism are so nice and screw ups to regard alcoholics effectively so dra matic that there's no coverage that efforts will bring about a good final result. This denial is likely to be the main complicated since it re flects an angle of healing helplessness. It discourages households from looking support, and it reinfOlces the tendency of physidans and different human-services staff to miss the presence of alcoholism as they deal with its actual, sodal, and fiscal outcomes. Denial usually surrounds those that deal with alcoholics with an air of secrecy of wish lessness, which itself is a detrimental healing force.
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Additional info for Practical Approaches to Alcoholism Psychotherapy
Example text
Although their behavior while drinking may suggest otherwise, alcoholics do not Iike interpersonal conflict, nor do they handle it weIl; nor do they thrive in competitive relationships. As others have suggested, alcoholics do best in relationships characterized by complementarity rather than competition. Complementary relationships are those based upon satisfaction of reciprocally balanced needs. For example, a dominant person and submissive person would constitute a complementary relationship.
In psychotherapy generally, anxiety is often the price that is paid for increments in self-awareness and disdosure to others. Unfortunately, in a1coholics, anxiety is also one of the more important inner cues or "triggers" for drinking. It follows then that the most difficult task in a1coholism therapy is to lessen the denial and encourage increased self-awareness and disdosure while simultaneously keeping anxiety at minimal levels. " Moreover, the therapist must insure a therapeutic context in wh ich high levels of support are available as the dient uncovers aspects of self and disdoses these to others.
The therapist knowledgeable about W ORKING WITH THE PREFERRED DEFENSE STRUCTURE 27 alcoholics will turn this structure to the advantage of his dient and hirnself by selectively reinforcing and encouraging the defenses of the alcoholic dient. The central problem in therapy with the alcoholic is learning how to swing the PDS into the service of abstinence rather than continued drinking. EventuaHy, the alcoholic preferred defense structure must be dealt with directly if real changes in personality are to be achieved.
