PERSONAL VIEWS ON RECOVERY

PERSONAL VIEWS ON RECOVERY Personal Views Page

(This page will carry from time to time the personal views of some of our members on issues which they believe are important in the recovery process. Our present policy is that these authors will remain anonymous and will be limited to members of the Washington, D.C. Area SMART groups. They do not necessarily reflect positions either of the Washington, D.C. Area SMART groups, nor its National Headquarters. Comments are welcomed.)

A complete list of all previous essays is given at the bottom of this page.

Moderation or Abstinence for Problem Drinkers?

The recent good news is that there has lately been some nation-wide attention given to alternatives to Alcoholics Anonymous: last month's ABC Program, 20/20, devoted an hour to discussing the subject, and the Smithers Clinic in New York City recently announced it will abandon a straight 12-step program after 40-plus years (see the July 10, 2000 issue of New York Magazine).

The bad news is that this welcome new flexibility in attitude is almost always presented in terms of moderation or controlled drinking as the only alternative to lifelong abstinence promoted by AA. Totally left out of these discussions is the fact that there are programs such as SMART Recovery which facilitate abstinence without the encumbering spiritual and other baggage which AA and its 12 Steps carry with them.

For those interested in a definitive view of SMART Recovery's formal and official position on this issue, I refer you to the President's Column in the last SMART Recovery Newsletter, carried on the national SMART site at smartrecovery.org . What follows is one person's slightly differently-nuanced view of the issue.

It has always seemed to me that for someone with a serious drinking problem, that is, someone who has suffered substantial problems in personal relations, career, difficulties with the law, etc., that abstinence is the simplest choice to make about one's future drinking. Frequently, at least in the case of such difficulties as DUIs, this may in fact be legally required for some period of time. And of course, if the issue is drugs other than alcohol, consumption in most cases is illegal anyway. The important thing here is that the person choose this course for him/herself, whether required to do so or not. Lack of personal commitment is a good predictor of future failure.

But how does a person decide whether abstinence is the correct course? For those with a lifetime of drinking behind them, it seems almost impossible to envisage a world without alcohol. The beckoning prospect of controlled drinking, of moderate use, of a "harm reduction" goal, this last now very much an in-usage, is virtually irresistible. This assessment is extremely difficult to make in isolation; consideration in a group setting can be helpful, using analytical tools of logic and rationality.

SMART Recovery is one such setting, and in my view the best currently available. It is considered by many if not most of its members and coordinators as a means of helping people achieve abstinence once they have made that decision for themselves. My own view is that we should also view our role as helping people understand the advantages of abstinence over moderate or controlled drinking as part of the process of helping people make up their minds about whether to abstain or not, and then to support them in a decision for abstinence once they have made it. This is not to say that a decision not to abstain or a decision to abstain using other means (even self-help without any group affiliations) is wrong; merely that SMART Recovery is one support group for abstinence that can be beneficial to many who choose it.

One of the questions I frequently pose to people in groups I lead and attend is a simple one: what's so important about alcohol? Why is it so fundamental that they cannot consider leading their lives without it? In the balance sheet we frequently have people draw up listing the advantages and disadvantages of drinking, usually with a view to pinpointing not just the reasons for NOT drinking, but the reasons FOR drinking, people rarely give convincing evidence about their need for alcohol in their future lives (as opposed to why they did it in the past---to maintain friendships, to feel relaxed, to promote their business contacts, etc.).

I can recall in my years in the groups here only one instance of someone who told us convincingly that he saw great personal merit in drinking: he was a true wine connoisseur with long experience who truly savored the vintages he drank as part of his dining experiences. Because of difficulties with drinking, including several DWIs, he decided to abstain for a year before considering drinking again. (He eventually did, and ran into more trouble with his drinking.) So we encourage people to examine their reasons and critique them, usually using REBT methodology. This usually leads to an appreciation of the fact that abstinence is a legitimate choice for them.

Secondly, as part of this benefits-and-costs assessment, people can assess the damage which alcohol has done in their lives and consider whether this outweighs whatever advantages they see in drinking. Most people who quit or cut back on drinking on their own (and this, in spite of what one reads, is the vast majority of people) do so because they in their own minds have independently done just such an assessment and come to the conclusion that "it's not worth it." Here, people need to consider realistically where they fall on the scale of "problem drinking"-- minor, moderate, significant, severe, and so forth-- in assessing the cost of continuing to drink. The greater the cost of drinking, the greater the case for abstinence.

For those of us who have tried cutting back and failed, I offer yet another reason for choosing abstinence over controlled drinking: it's much, much simpler. Rather than having constantly day in and day out to make decisions about how much to drink or not to drink, it turns out to be far less mentally exhausting to have made a decision at the outset not to drink and leave it at that. For those unable to commit themselves to what seems a vast undertaking at the outset, an abstinence commitment with a given time frame, say a month, a year, can be helpful. What I and some others have found is NOT helpful is the AA approach of "A Day At A Time," where the decision to drink or abstain must be considered every day!

None of this is intended to convey the impression that I don't think moderation can work for some problem drinkers. I'm sure it can, although I suspect the number is far less than those who THINK it can work for them. Groups such as Moderation Management should be the focus for those who have already made such a decision. But for those who are considering their options at the outset---and not just those who have already decided to try a program of abstention---I believe SMART Recovery can provide a good forum for thinking through the question of abstinence vs. moderation. And unlike AA, we welcome those who still are considering as an option a program of controlled drinking for themselves, but are open-minded enough to be willing to consider the alternative of our own program of abstinence.

This is Essay No. 15, issued July, 2000.

Previous Essays

April, 2000--New Booklet on Research-Based Treatment

February, 2000--How Do We Stop Drinking: A Group Discussion

December, 1999--The Myth of "Self-Esteem" and Recovery

September, 1999--Religion and Recovery

July, 1999--Can People Who Are Not Committed to Abstinence Attend SMART Meetings?

March, 1999--Recovery Is Not a Four-Day Course in Rational Recovery

January, 1999--SMART Recovery in a Nutshell

November, 1998--Other Roads to Recovery

September, 1998--How I Re-Thought My Beliefs on My "Alcoholism"

July, 1998--Why Do People Join SMART Recovery?

May, 1998--A Critique of PBS' Bill Moyers on Addiction

March, 1998--Should People With Gambling or Overeating Disorders Be Welcome At SMART Meetings?

January, 1998--Differences Between SMART and AA

November, 1997--Fifty Ways to Recover

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