Wednesday, February 3, 2010

New EAP Professionals and Orientation to Alcoholism (Ouch!)

It is safe to say that discussing alcoholism with any professional in the treatment field, EAP field, or other helping industry will generate some argument and controversy. Just wait. If you are new to the field, you'll soon be indoctrinated with one of these cocktail conversations.

It's one of the "elephants in the living room" of the helping profession. One out of four people has an addict in their family, and myth and mythology over thousands of years keeps intervention, treatment, and recovery confusing and controversial.

From non-M.D. psychologists who are selected to be the U.S. Supreme Court consultants, who then push the idea that alcoholism is not a disease, to best selling authors telling us how alcoholics can drink safely, there is simply no shortage of information and "new thought" about alcoholism that continues to undermine the legitimacy of this disease and how it should be managed.

Of course, if you have worked directly with alcoholics in treatment, you are prized material for being hired as an EAP staffer. It means you have been in the trenches, faced the defense mechanisms, and hopefully have been mentored by recovering persons (if you are not recovering yourself) who adhere to abstinence principles and 12-step programming as the most effective way to manage this chronic disease.

(It is truly amazing that when I blog on this topic, I get rabid members of Rational Recovery threatening to turn off my free speech rights with their conspiracy theories about AA.)

If you are new to the EAP field, and have not been in the trenches of alcoholism, there are few things you need to know.

First, don't think that understanding alcoholism or writing about it as new EAP professional will be an easy scrabble. The economics and politics of alcoholism diagnosis, causation, treatment, and ongoing recovery are profound , convoluted, and continue unabated.

Before you get into a discussion about alcoholism, do a few things that are really critical to your edification and orientation.

1. Go to a dozen or so open AA meetings and get oriented to "recovery think". Know what recovering people read, and have your own library of this material. (Also purchase alternative and controversial materials that argue against AA so you can see their rationalization and desperation to avoid what AA is about.) Memorize the twelve steps. You don't want to be caught unable to converse about the 5th step, the 4th step, or the conflict in treatment programs that push patients to go to the 4th step instead sticking with only the first three. (See what I mean?)

Not having this information will also cause issues with your clients who will expect for you to know more than they do about recovery initially.

2. Visit the Web site of the American Society on Addiction Medicine at There is a ton of stuff on this site. Read their position papers. This association represents about four thousand medical doctors who are the leading authorities on addictive disease, alcoholism, and its treatment. They don't get a lot of press. Probably because they get a lot of folks upset who would otherwise report on their opinions. There is a simple explanation: Science and research simply don't mix well with the popular culture, which has a 5000 year head start ahead of them.

It is popular culture that drives belief systems about the disease. You need to separate the wheat from the shaft if you are going to work in this field effectively.

There a lot of people making money off of alcoholics. Whether it's trying to do psychotherapy with them while they are still drinking or drugging, selling them gimmicks, pushing alternative group therapies and "not-necessarily-abstinence" groups, pop-psych ideas about how to drink normally, etc., there is no end to the influx of confusion and interference that keeps alcoholism from being accepted by everyone (like cancer) that it is an authentic, chronic disease that requires abstinence to arrest its progression.

3. Read "Under the Influence" by James Milam and Katherine Ketchum. Still about $5.95 a paperback copy, it is a fascinating book that explains alcoholism as a chronic, genetically based illness so well, it is hard to put it down. Not sure if the author's original, self-published book, 'The Emergent Comprehensive Concept of Alcoholism" is still around, but if you find it, it will blow your mind about the economics and the forces in our larger society that have a vested interest in your not believing that this is a true disease.

Okay that's enough to blog about today, don't you think!