How Psychology and AA Can Help
There are many ways in which a professional and/ or their helping organisation can become more effective in dealing with clients with alcohol related problems.
Your calm understanding and non-judgemental attitude, even when confronted with difficult, or even aggressive. problem drinkers, will go a long way in making your interaction easier for you and more effective for your patient/ client.
A little about dealing with difficult and/or aggressive people here
Understand defense mechanisms and the person’s need for hope!
We expect someone with measles to have spots
Expect someone with alcoholism to be in denial (i.e. be defensive in their interactions)
Denial is one of the symptoms of any life-threatening disease, that makes recovery difficult. Alcohol is a powerful drug, and addiction is a serious problem as with any other drug addiction.
Professionals have an authority that can be used, but not for trying to “scare” people into getting sober.
Fear, anxiety and depression are often underneath the drinking and “risk-taking /lack of self-care” indicates using alcohol as a type of “suicide” – maybe slow in many cases, but fast in others.
That does not mean avoiding the tough conversations in a fact-of-the-matter way, when the timing is appropriate. (i.e. not when drunk, as they may be unlikely to remember the conversation,)
Professionals can accept that denial and other defense mechanisms go hand-in-hand with alcoholism and plan ways to use their role to:
discuss the seriousness of the problem the person has
let that sink in a little
but at the same time convincingly offer hope
For example: Saying “Whilst it is not easy, it is very possible to recover from this condition, by stopping drinking, and living a fulfilling sober life and “reminding the person they “are worth making the effort for.”
It is important to realise that defensive mechanisms have unconscious components
The other defense mechanism are:
minimisation (yes, I have a problem, but it is only small)
rationalisation (yes I have a problem because x,y,z which when fixed will mean no problem)
intellectualisation (yes I can see that, but I don’t have any feelings / don’t care about that)
projection (yes there is a problem but it’s your problem/ fault etc, so you need to do something)
hostility (being angry makes people back-off so I don’t need to consider the issue).
lying (because it is still too overwhelming to consider stopping drinking, feel ashamed, “avoiding negative feelings or consequences due to fear of rejection, insecurity, social status, coping with trauma, substance abuse”) Note - More on lying as a defense mechanism.
These are all ways the mind/psyche keeps the person safe from the enormity of a problem that they cannot see a way out of.
Address society’s bias that alcoholism is self-inflicted
But people who drink too much only have themselves to blame, don’t they? is a common sentiment.
“No man is an island” - Our functioning as adults is dependent on a whole complex range of factors:
Our parent’s race, culture and genetics, pre-natal biology, family of origin patterns of communicating and managing stress, early parenting, childhood experiences, family and community resources, education and training opportunities
… and luck.
Being at the right place at the right time.
And as more understanding about trans-generational trauma comes to light, being at the wrong time in history also has its impacts.
Most of these factors have been beyond our personal choice.
Besides - whatever the cause - blame is unhelpful.
Encouraging people to accept responsibility for their actions as an adult is the more helpful approach.
And one that our society holds us all accountable for, whether we like that or not.
How AA may help
AA has had a lot of bad press too.
Certainly AA cannot and does not try to offer specialist care, nor do a lot of the other services that alcoholics and their families need. So in that sense AA has shortcomings - that would be the same for many, if not all community services.
However, AA has also be subjected to prejudice (against abstinence, religion etc.), contempt prior to open-minded examination, and bias based up a lack of information and understanding.
The stories told in AA meetings help people break through their defense mechanisms because they get hope by seeing practical proof of people living contented lives without drinking.
It is common for a person to refuse to admit or accept that he or she is an alcoholic - particularly as the word “alcoholic” is not well understood - and erroneously has connotations of skid-row people.
In today's context, alcohol addiction, alcohol disorder, substance misuse, alcohol dependency etc. are preferred by the helping professions - but really this is alcoholism under more acceptable terms.
This may assist communication but does not remove the enormous life change faced by alcoholics at any stage of their progressive condition.
