|
|
|
Alcohol-Related Disorders:
Psychotherapy's Role in Effective Treatment
For many people, drinking alcohol is nothing
more than a pleasant way to relax. People with alcohol-related disorders drink to excess,
endangering both themselves and those around them. This question-and-answer fact sheet
explains how psychotherapy can help people recover from these potentially life-threatening
disorders.
When does drinking become a problem?
What causes alcohol-related disorders?
How do alcohol-related disorders affect people?
Can psychological treatment help the body, too?
When should someone seek help?
How can a psychologist help?
Does treatment really work?
When does drinking become a problem?
For most adults, moderate alcohol use-no more than two
drinks a day for men and one for women and older people-is relatively harmless. (A
"drink" consists of 1.5 ounces of spirits, 5 ounces of wine or 12 ounces of
beer, which contain equal amounts of alcohol.) Moderate use, however, lies at one end of a
continuum that moves through alcohol abuse to alcohol dependence:
- Alcohol abuse is a drinking pattern that results in adverse
consequences that are both significant and recurrent. Alcohol abusers may fail to fulfill
major school, work or family obligations. They may have drinking-related legal problems,
such as drunk driving arrests. They may have relationship problems related to their
drinking.
- People with alcoholism-technically known as alcohol dependence-have
become compulsive in their alcohol use. Although they can control their drinking at times,
they are often unable to stop once they start. As their tolerance increases, they may need
more and more alcohol to achieve the same "high." Or they may become physically
dependent on alcohol, suffering withdrawal symptoms such as nausea, sweating,
restlessness, irritability, tremors and even hallucinations and convulsions when they stop
after a period of heavy drinking. It doesn't matter what kind of alcohol someone drinks or
even how much: alcohol dependent people simply lack reliable control over their drinking.
According to the National Institute on Alcohol Abuse and Alcoholism
(NIAAA), one in 13 American adults is an alcohol abuser or alcoholic at any given time. A
1997 government survey revealed that drinking problems are also common among younger
Americans-despite the fact that most states outlaw drinking under age 21. Almost five
million youths aged 12 to 20 engage in binge drinking, for example, with females downing
at least four drinks on a single occasion and males at least five.
Back to top
What causes alcohol-related disorders?
Problem drinking has multiple causes, with genetic, physiological, psychological and
social factors all playing a role. For some alcohol abusers, psychological traits such as
impulsiveness, low self-esteem and a need for approval prompt inappropriate drinking.
Others drink as a way of coping with emotional pain. Still others use alcohol to
"medicate" psychological disorders. Once people begin drinking excessively, the
problem can perpetuate itself. Heavy drinking can cause physiological changes that make
more drinking the only way to avoid discomfort.
Genetic factors render some people especially vulnerable to alcohol dependence. (Contrary
to myth, being able to "hold your liquor" means you're probably more at risk-not
less.) Yet a family history of alcoholism doesn't mean that children of alcoholics will
automatically grow up to become alcoholics themselves. Environmental factors such as peer
pressure and the easy availability of alcohol can also play key roles. Although
alcohol-related disorders can strike anyone, poverty and physical or sexual abuse also
increase the odds.
Back to top
How do alcohol-related disorders affect
people?
While small amounts of alcohol may have some beneficial physical effects, heavy drinking
can cause serious health problems and even death. In fact, 100,000 Americans die from
alcohol-related causes each year. Short-term effects include distorted perceptions, memory
loss, hangovers and black-outs. Many problems aren't apparent until they become serious,
however. Over the long term, heavy drinking can cause impotence, stomach ailments,
cardiovascular problems, cancer, central nervous system damage, serious memory loss and
liver cirrhosis. It also increases the chances of dying from automobile accidents,
homicide and suicide. Although men are much more likely than women to develop alcoholism,
women's health suffers more even at lower levels of consumption.
Although moderate drinking may result in relaxation and euphoria, heavy drinking also has
a very negative impact on mental health. In fact, alcohol abuse and alcoholism can worsen
existing conditions, such as depression or schizophrenia, or induce new problems, such as
serious memory loss, depression or anxiety.
People with alcohol-related disorders don't just hurt themselves, however. According to
NIAAA, more than half of Americans have at least one close relative with a drinking
problem. The results can be devastating. Spouses are more likely to face domestic
violence. Children are more likely to develop psychological problems, suffer physical and
sexual abuse and neglect and-because of the combination of genetic vulnerability and
social learning-grow up to be alcoholics. Women who drink during pregnancy run a serious
risk of damaging their fetuses. It's not just relatives who suffer. Heavy drinkers often
kill strangers through accidents or homicide.
Back to top
When should someone seek help?
Because some in our society view alcohol-related disorders as a sign of moral weakness,
individuals often hide their drinking or deny they have a problem. How can you tell if you
or someone you know is in trouble? Signs of a possible problem include having friends or
relatives express concern, being annoyed when people criticize your drinking, feeling
guilty about your drinking and thinking that you should cut down but finding yourself
unable to do so. Needing a morning drink to steady your nerves or relieve a hangover is
another warning sign.
Alcoholics usually can't stop drinking through willpower alone. Most need outside help.
They may need medically supervised detoxification to avoid potentially life-threatening
withdrawal symptoms such as seizures, for instance. Depending on the problem's severity,
treatment can take place during office visits, hospital stays or residential treatment
programs. Once people are stabilized, they need help resolving psychological issues that
may be associated with problem drinking.
Back to top
How can a psychologist help?
Psychologists play a vital role in the successful treatment of alcohol-related disorders,
serving as integral members of the multidisciplinary team that may be required to provide
care. Be sure to choose a psychologist who is experienced in working with alcohol-related
disorders. To improve the chances of recovery, seek help early.
Using individual or group psychotherapy, psychologists can help people address
psychological issues involved in their drinking. They can help people boost their
motivation, identify situations that trigger drinking and learn new coping methods. They
can also provide referrals to self-help groups such as Alcoholics Anonymous, a crucial
part of any recovery program. The treatment process doesn't end once drinking does,
however. To help prevent relapses, psychologists typically keep working with people as
they begin new lives. Even after formal treatment ends, many people seek additional
support through continued involvement in self-help groups.
Treatment can't occur in a vacuum. Because families influence both drinking and recovery,
marital and family therapy are also key. Psychologists can help families repair
relationships and navigate the complex transitions that occur as recovery begins. They can
help families understand alcoholism and learn how to support family members in recovery.
And they can refer family members to self-help groups such as Al-Anon and Alateen.
Back to top
Does treatment really work?
Yes. Evidence strongly suggests that many people-especially those with jobs, families and
other forms of social stability-recover after their first attempt. Not everyone is so
fortunate. Some cycle between relapse and recovery several times before achieving
long-term sobriety. What's important is for the person to stop drinking again and get
additional support.
While alcoholism is treatable, so far no cure has been found. That means people remain
susceptible to relapses even after they've been sober for a long time. Reducing alcohol
consumption doesn't work. Most experts agree that the goal should be complete avoidance of
alcohol.
Alcohol-related disorders can severely impair people's functioning and health. But the
prospects for long-term recovery are good for people who seek help from appropriate
sources. Qualified psychologists with experience in this area can help those who suffer
from alcohol-related disorders stop drinking and start regaining control of their lives.
Back to top
The American Psychological Association Practice Directorate and the APA College of
Professional Psychology gratefully acknowledge the assistance of Peter E. Nathan, PhD;
John Wallace, PhD; and Joan Zweben, PhD, in developing this fact sheet.
January 1999
This document may be reproduced in its entirety without modifications.
|
|
