Dependence and Will
- By bill dubin
- Published 02/26/2009
bill dubin
* Director of the Adult Clinic and Diagnostic Center in New York City * Chief of Service of the Intensive Care Unit at Manhattan Psychiatric Center * Director of Clinical Services of the Brown Schools, Ranch Treatment Center in Austin, TX * Currently in private practice in Austin, TX
Because intoxication provides an immediate payoff, it is corruptive. The desire for pleasure or relief from suffering causes some individuals to trade what is truly precious [health, wealth, or relationships] to maintain their access to alcohol. Some individuals pay dearly for their drinking problem, and once you develop a relationship with something that can deliver this immediate gratification it is deceptively difficult to escape. The long-term outcome statistics for people your age with a drinking problem are probably worse than you think.
The extraordinarily high relapse rates of conventional treatment programs for problem drinkers is sobering only for us treatment providers. For the problem drinker, ill advised treatment efforts can make things worse. for example, consider an individual who has been clean and sober during the 30-day rehab program. As the influence of the external sources of control (the therapeutic environment, support group) dissipate, they become less protective against the influence of local stressors and temptations grow. During a genuine crisis the abstract ideas discussed in meetings or during psycho-educational groups does not have much influence during the critical moments when irreversible errors are made. That fact that treatment outcome for problem drinkers is so dismal, suggests that whatever treatment they recieve leaves them unprepared to cope with situations that precipitate relapse.
This blog will offer a model of problem drinking and its treatment, which is quite contrary to the disease model of alcoholism and treatment programs based on the 12-Step model of Alcoholics Anonymous. In contrast to encouraging problem drinkers to admit they have a disease over which they are powerless, here the focus is precisely the opposite. This web site contains tools that can enhance the user's ability to exercise will.
A wide range of information and experiential invitations are available at no charge at www.psycharts.com. These tools can help high-functioning individuals follow their path of greatest advantage rather than yield in the direction of least resistance.



