Still Under the Influence

Beyond the Influence : Understanding and Defeating Alcoholism
by Katherine Ketcham

Alcoholism is a disease. It's time we started treating it like one.

Science has offered undisputed proof that alcoholism is a disease rather than a weakness of character, yet millions of alcoholics continue to suffer due to inappropriate treatment. Now the co-author of the modern classic Under the Influence has teamed up with prominent alcoholism experts to provide new answers to this national epidemic.

Based on the latest scientific research, Beyond the Influence clearly explains the neurological nature of the disease and reveals why some people drink addictively and others do not. It also spells out what needs to be done to treat alcoholism, including:

• Steps to take for an intervention
• How to find the right treatment program
• Which psychological approaches work best
• Why spirituality is essential to recovery
• New insights into relapse prevention
• What you should know about diet, exercise, and nontraditional treatments such as acupuncture

Provocative and eye-opening, compelling and compassionate, Beyond the Influence is not only a message of hope for alcoholics — it is a blueprint for saving lives.

Beyond the Influence explains that alcoholism is a disease of the body, not a weakness of character. Drawing on the latest scientific studies, the authors present new research on the central role of genetics and neurotransmitters in addiction. Continuing where the prior book left off, it also includes:

Steps for diagnosis and intervention, plus ways to prevent relapses Various treatment models, including inpatient and out-patient programs and a review of new drug treatments The most effective types of psychological counseling The critical role of nutrition Non-traditional healing methods for recovery The importance of a spiritual component to recovery

The authors also critique our nation's alcoholism policies, including education and prevention programs, efforts to curtail college bingeing and underage drinking, and the advertising and marketing strategies of the alcohol industry.

Chapter 1

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.

— Schopenhauer

Don't remember where I was flying to, but was taken off the plane in Twin Cities, ambulanced to Hennepin County Detox — nightmare — went to Hazelden from there — started stealing, then drinking — then to detox center in Hastings, Minnesota. Scotty picked me up, got drunk at his home nearby, had to leave on bus to Madison, got drunk couldn't stay at Sharon's. My wallet stolen that night. Tried to sleep outside at Ray's old apt. Neighbors called. Woke up in detox. Began series of staying with AA people.

Ran out of places to go, no insurance, no halfway house, no money. Went to D.C. — stayed sober one month.

Terry McGovern wrote these words in her journal when she was forty-three years old. Two years later she was dead. Around 8:30 p.m. on December 14, 1994, Terry left the Crystal Corner Bar in Madison, Wisconsin, and wandered into an unlit parking lot, where she either fell or lay down in the snow and froze to death. Her body was discovered around noon the next day. The coroner's report stated that death was due to "hypothermia while in a state of extreme intoxication."

Many of us will hear Terry McGovern's story and shake our heads in dismay — perhaps even in disgust. Why, we wonder, did this gentle, intelligent, much-loved daughter of former senator and presidential candidate George McGovern choose to kill herself with booze? How did she get caught up in such a self-destructive way of life when she was so talented and privileged, surrounded by people who loved her and wanted to help her? What, exactly, was wrong with her? What demons possessed her?

The answers to these questions are hotly debated by those who insist that alcoholism is a primary, progressive, physiological disease and those who argue that alcoholism is not a true medical disease at all but a symptom of underlying psychological and emotional problems to which the individual responds by engaging in increasingly self-destructive behavior. The disease theorists engage in vociferous exchanges with those who do not see alcoholism as a disease, and each side carefully amasses research studies and dramatic anecdotes to fortify its position.

After the smoke clears, little if anything seems to have been resolved. Witnessing the bitter disagreements among experts, most of us end up bewildered by the conflicting theories. If alcoholism is a behavior, what quirk of personality or circumstance would lead good, decent, intelligent people such as Terry McGovern to destroy everything in their lives for alcohol? Are alcoholics inherently weak, selfish, emotionally immature individuals?

If, on the other hand, alcoholism is a disease, why do its victims suffer from such intense guilt, shame, and self-loathing? Why can some diagnosed alcoholics return to "moderate" or "controlled" drinking for weeks or even months? Why do some alcoholics stop drinking and recover with no treatment at all? And why are psychological counseling and spirituality considered such important elements of recovery?

These questions and the contentious debates they engender lead many people to throw up their hands, concluding as the Supreme Court did in April 1988, that alcoholism is a consequence of "willful misconduct."

Alcoholism is not a mysterious illness, nor is it "willful misconduct." Alcoholism is a true medical disease rooted in abnormalities in brain chemistry — biochemical aberrations that are inherited by the great majority of alcoholics and, in some cases, acquired through intense and sustained exposure to alcohol and other drugs. When the alcoholic drinks, something different happens. This difference between alcoholics and nonalcoholics is not created by personality disorders, emotional instability, character defects, or traumatic circumstances; it is a difference in the way the alcoholic's body responds to the drug alcohol.

Physiology, not psychology, determines whether one drinker will become addicted to alcohol and another will not. This is not theory but fact, based on thousands of research studies detailing the nature, causes, and progression of this ancient yet perpetually misunderstood disease. More than fifty years of experimentation and investigation by distinguished scientists in such diverse fields as neurology, biochemistry, pharmacology, and psychology have provided the basic facts needed to understand the drug alcohol and the disease it creates in biologically susceptible individuals. We know what this disease is, we know how to treat it, and we know how to prevent it. The knowledge is in our hands.

Copyright © 2000 by Katherine Ketcham and William F. Asbury with Mel Schulstad and Arthur P. Ciaramicoli, Ed.D, Ph.D.. Excerpted by permission of Bantam, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

About the Author

Katherine Ketcham is the author of nine nonfiction books, including five on alcoholism.