Alcoholism: The Volitional Disease
The Canned Response Letter
By: Officer S. Garry Nowak
Regarding your inquiry, here is my response:
I believe the best argument against disease model of alcoholism
is to look at alcoholism conversely. By looking at alcoholism conversely,
I mean this: Those who support the disease model of alcoholism
would want 'us' to believe that any one or combinations of the following
postulates are true. (I use the word postulate because as of this writing
there is no doctoral level study or research that has defined any etiology
for alcoholism; i.e., the causation of alcoholism is unknown. As
a small side point here, there are no warning labels on alcohol warning the
drinker that alcoholism may result similar to the warning labels on cigarettes
advising of the possibility of cancer resulting from smoking.)
'They' would want 'us' to believe that the etiology of alcoholism
may lie in the form of a disease entity. I would define a disease entity
as some sort of an infectious or invasive pathogen within the human body.
However, you are free to define disease as you see most appropriate.
'They' would want 'us' to believe that the etiology of alcoholism may lie
in genetics. Genetics is defined as the passing on of traits, heritable
factors, to the filial generation. (Genetics is immutable - try
volitionally changing your eye color, skin color, etc. It cannot be
'They' would want 'us' to believe that the etiology of alcoholism may
lie in neurotransmitters or somewhere within neurotransmission.
(Neurotransmission is as immutable via volitional efforts as are genetic
'They' would want 'us' to believe that the etiology of alcoholism may
lie in some neuro-chemical imbalance of the brain. (Again, brain
chemistry is not altered via volitional efforts)
NOTE: Feel free to ask any doctor, neurologist, etc., the
following question: Please tell 'me' what the correct chemical balance
of the human brain consists of? Accept an answer
that includes weights, percentages, or quantities. No
one can answer that question because no one knows the answer.
Secondly: to date best estimates are that only half of the neurotransmitters
have been discovered so no answer is even possible.
In essence, there is no such thing as a chemically balanced brain.
What 'they' would like you to believe is that since a patient's
behavior is somehow abnormal prior to taking a psychotropic drug AND
after taking said medication that patient's behavior is more normative or
controllable, his/her brain chemistry has subsequently been balanced.
Not true given the side effects of diarrhea, constipation, dry mouth, drooling,
sexual dysfunction, gastric disturbances, sleep disturbances, etc.
Those side effects represent some balancing of the brain. Why are these very
life disrupting side effects not considered to be imbalances of brain
IF you do not believe me, pay attention to the ads on TV. You will
hear the entire list in the 'fine print' at the end of the commercial.
You will hear the voice list them all very quickly and quietly. You
really have to pay attention to what the speaker is saying in order to hear
the warning about side effects. The warning is very easy to miss just as
is the fine print on any label. BUT, the important thing to note is that
the warnings of these side effects are there - as well as on the prescription
bottle itself. These are very serious side effects that are just as serious,
if not more serious, than the original condition for which the medication
is/was intended to treat.
Back to my response: All of the above represents either an invasive intrusion
within the alcoholic's body OR some biological
fault within the most basic nature of human composition (genetics,
neurotransmitters, neurotransmission, and/or a chemical imbalance of the
brain's bio-chemical nature).
Now I am going to add more fuel to the disease debate: Given that by
all statistical accounts the overwhelming majority of alcoholics (80% appears
as a very consistent AND acceptable figure in the research) become abstinent
without any third party assistance; i.e., the majority of alcoholics make
a decision to become abstinent and subsequently become abstinent. They
do not utilize AA, counseling, etc. So now, another very important question
must be asked and answered:
Exactly how does one volitionally alter the genetics, neurotransmitters,
neurotransmission, and/or a chemical imbalance of the brain in order to become
Now add to the number of alcoholics who become abstinent due to their own
personal volition the number of alcoholics who recover or remiss via AA,
counseling, clinics, interventions, etc. and the number of alcoholics who
recover exceeds 90%. The whole number of
drink-till-you-die type of alcoholic is very small when compared
to the number of alcholics who are able, capable, and have become abstinent
or otherwise remising their 'disease'.
So the question remains exactly how does one volitionally alter
one's faulty genetics, neurotransmitters, neurotransmission, and/or a chemical
imbalance of the brain?????
The answer is . . . (drum roll please) Neither genetics, neurotransmitters,
neurotransmission, and/or a chemical imbalance of the brain can be altered
through volition OR with the help of AA. The very significant point
here is it takes extremely intrusive, extremely high tech, cutting edge
technology to alter any of them.
In the United States, the only acceptable therapeutic modality for an alcoholic
suffering from alcoholism is Alcoholics Anonymous (A.A.). A.A. is
considered to be the only credible and/or valid therapeutic modality
for an alcoholic suffering from alcoholism. A.A. is reputed to be so
very successful that A.A.s 12-Step Treatment program has become the
paradigm for the overwhelming majority of alcohol treatment modalities in
the United States. Over 90% of addictive treatment modalities model
themselves after the AA 12-Step program in some form or another.
So now another very important question must be asked and answered:
How does Alcoholics Anonymous so positively affect the alcoholics
genetics, neurotransmitters, a chemical imbalance of brain chemistry, or
other possible invasive pathogen(s) that may comprise the disease
A.A. is comprised of disorganized (their descriptor, not mine), nonprofessional
(their descriptor, not mine), fellowship of 'true experts' (recovered/recovering
alcoholics, again, their descriptor, not mine) AND it is not required of
these true experts to possess any undergraduate, graduate, medical or Ph.D.
degrees; AND it is also true that none of these true experts are particularly
trained nor do they possess any experience in any psychotherapy or therapeutic
counseling; AND, not to be redundant, but the only 'credentialing' requirement
mandated by A.A. for becoming a 'true expert' is to once being a drunk (their
descriptor, not mine) and subsequent abstention via A.A.'s 12-Step treatment
modality; AND their therapeutic modality is a group therapeutic modality
primarily consisting of drunkalogs (war stories) and prayer.
Given the above indisputable facts regarding A.A. and their success
in treating alcoholism (their website clearly states that they are a treatment
modality for alcoholism), combined with the facts of what the disease model
of alcoholism proponents would like 'us' to believe, then a A.A.
member sustains the burden to answer the following
Given what A.A. consists of, please explain to me exactly how does
A.A. so positively affect the genetics, neurotransmitters, chemical imbalance
of brain chemistry, or any invasive disease pathogen within the alcoholics
biology, anatomy and/or physiology?
The answer remains as previously stated . . . AA can no more effect
one's genetics, neurotransmitters, neurotransmission, and/or a chemical imbalance
of the brain than can one alter any of them via volition.
As illustrated by the above fact pattern and question, to me it becomes quite
clear that alcoholism cannot be defined as a disease by any definition that
includes genetics, neurotransmitters, chemical imbalance of brain chemistry
or even an invasive pathogen(s). Why? Because there is nothing
within one's volition OR within the AA therapeutic modality that
has even the remotest of possibilities of affecting ones genetics,
neurotransmitters, chemical imbalance of brain chemistry, or any invasive
disease pathogen within human biology, anatomy and/or physiology.
I do not mean to disrespect A.A. anymore than I would disrespect one's religion
or one's belief in God. A.A. is not without its successes but it is
no where near 100% successful as Bill W. alleges in his Big Book. (Chapter
5 of The Big Book states in the first paragraph: Rarely have we
seen a person fail who has thoroughly followed our path . . .
absolutely, 100% false.)
Personally, I am in quest of a modality that positively deals with the remission
of alcoholism. In so doing, questions are raised which must be
answered. Religion is based on faith. In my opinion, alcoholism
in its own way is 'faith-based'. A.A. as a therapeutic modality
offers support in an open, verbal forum. This form of a psychotherapeutic
treatment is nothing more than a group therapy modality. This is most definitely
an accepted, mainstream modality. However, group therapy has never
been offered as a treatment for either a genetic error, poor neurotransmission,
or for an imbalance of brain chemistry. The idea that A.A. can somehow
alter one's genetic foundation, neurotransmission, or brain chemistry is
not possible nor does it even make sense.
What A.A. does offer for the successful member is to give support where support
is needed. It provides education by clearly illustrating via drunkalogs
how and where others have failed. A.A. is a therapeutic modality that
educates its membership in how to cope, adapt, and overcome one's perseverated,
maladaptive thinking pattern. AA is educational. It teaches one
how to adaptively think which subsequently alters one's behavior. Nothing
more. Nothing less.
In the case of alcoholism, empiricism (experience and observation) trumps
science and research. Why? Because as of this writing, there
is not one doctoral level study nor is there any credentialed medical research
that has definitively defined alcoholism as a disease or as even having a
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Last updated 2006/06/13