Many problem drinkers are unable to admit to this problem. The cry for help may therefore come from someone close who suffers as a result. The cry often comes at a time when he or she is unable to cope any longer with the drinker. As such, the drinker may self-righteously feel they do not have a problem as they had been drinking like this for years. They may resist treatment and often blame others for problems. Many marriages fail at this point. One spouse can no longer tolerate the alcohol and the alcoholic refuses to take responsibility. This makes treatment of alcoholics extremely difficult.
It is important for people to understand the stages of recovery and that each stage carries challenges that some alcoholics will not overcome. Five stages of recovery are discussed: pre-contemplation, contemplation, preparation, action and maintenance.1
In the pre-contemplation stage, the alcohol problem has not yet been identified let alone accepted by the alcoholic. During this stage, their defences, most notably denial are strong. They actively reject any notion of alcohol problems and show anger towards anyone suggesting a problem. They reject treatment and may rely on the support of their drinking buddies to affirm they do not have a problem.
In the contemplation stage, the alcoholic toys with and finally accepts they have a problem with alcoholism. This acceptance can be overwhelming, at times leading to depression and/or anxiety. These intense feelings must be expected and planned for as part of a treatment process.
In the preparation stage, the alcoholic learns what treatment is necessary in order to recover. Depending on the severity, this can include detoxification, inpatient or outpatient counselling and marital and/or family therapy and even prescribed medications.
The next stage, action, is when the treatment plan is implemented and activities are undertaken to address the alcoholism. The support of family and sober friends is crucial here as alcoholics learn to defend themselves, not from admitting alcoholism, but from being pulled back towards drinking by former drinking buddies. Also crucial at this stage is developing an understanding of one's own family history that may have been contributory to drinking.
The final stage involves relapse prevention and is referred to as maintenance. This stage can be life-long. One of the best-known maintenance programs is Alcoholics Anonymous (AA). This program is based upon a self-help, group model. Members meet regularly to manage the challenges of sobriety.
Recovery from alcohol starts with clear, blunt information from friends and family and by trained professionals such as physicians, social workers or psychologists. Some family and even some professionals beat around the bush when confronting an alcoholic. This is music to the alcoholic's ears. Fuzzy messages allow them to maintain their denial. Thus, one must clearly and fully confront the alcoholic. Clear messages leave no wiggle room.
If you think your spouse has a problem with alcohol:
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1. DiClemente, C.C., Bellino, L.E. and Neavins, T.M. Motivation for Change and Alcoholism Treatment. National Institute on Alcohol Abuse and Alcoholism. Alcohol Research and Health .23:2. 1999.
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