A recent article in the New York Times, It’s the Holidays. How About Just One?, (Jim Atkinson, December 8, 2008) caught our attention. The author, an alcoholic with 16 years of sobriety, describes the cultural discourse that supports and encourages the over-use of alcohol at most events during the holidays. The readers, in this case two family therapists at Cottonwood Tucson, were interested to better understand why people continue to drink, or go back to drinking, despite seriously devastating consequences (Vicki) and for a perspective on moderation versus abstinence (Dan). Atkinson addressed both issues.

According to Atkinson the same social message heard by the addicted and non-addicted brain is interpreted differently. The fundamental struggles of alcoholics, he believes, include the euphoric recall of drinking and the tendency to use the moderate drinking versus total abstinence arguments to support the alcoholic’s denial. It was a well-written article combining research and anecdotal information. While we did not come away with therapeutic strategies guaranteed to guide alcoholics safely through the holidays, we did come away with respect and awareness.

Jim Atkinson’s courage to address the elephant in the room is to be respected. The most difficult family experiences occur when addiction is present and unidentified. The family members walk around the issues without naming the root problem. The feelings and difficulties become chaotic despite efforts at a cover-up; the addiction exerts great influence on interactions. Atkinson addresses that elephant by saying that our culture promotes irresponsible drinking during the holidays. He explores how people understand their own addiction, the addiction of others, and the dilemma of whether a recovering alcoholic can ever have “just one.” What he doesn’t say is that once an individual is engaging in inappropriate drinking the same culture that encouraged drinking in the beginning is quick to condemn and shame individuals for their lack of “judgment.” It is easier to point fingers when we deny our part in the responsibility of promoting irresponsible drinking.

I (Dan) was struck by the author’s perspective on the need for total abstinence. Rationalizing one drink is not an option for him. His experience is that when he begins rationalizing moderation he will have increasing difficulty in maintaining moderation. It supports the current thinking of my colleagues and I that alcoholism is a progressive disease that does not stay at a minimal use level; recovery is an all or nothing choice, even during the holidays.

There is comfort in a community of others who understand the disease and have found their own systems of surviving the holidays and maintaining their sobriety. We appreciate all of the bloggers, many of whom present themselves as persons in recovery, who contributed their own experience, strength and hope to the discussion. It provides safety; a community available and willing to support progress, and a community where struggle is accepted and not judged. The unique and unpredictable trajectory of alcohol for each alcoholic is clear from Atkinson’s work. For many people, parties and alcohol go hand in hand, blurring alcohol consumption and the social quality of the gathering. Many of the bloggers talked of needing to differentiate the alcohol from the social gathering. Separating holiday parties and alcohol can be difficult, yet necessary for sobriety and ultimately recovery. People discover their own path. Cottonwood Tucson uses a holistic approach to recovery, evaluating each individual and addiction, and any co-occuring disorders at intake, so that a comprehensive program takes into account those individual differences. And personal accounts such as this article by Atkinson provides the information that research does not typically include; information from the front line. In the end, the alcoholic is a critical member of the treatment team. Personal awareness of one’s own best way to achieve stable sobriety is the best guide for getting safely through the holidays.

Vicki L. Loyer-Carlson, Ph.D., LMFT
vloyer-carlson@cottonwoodrecovery.com

Daniel Cook, LMSW
dcook@cottonwoodrecovery.com

Cottonwood Tucson
4110 W. Sweetwater Drive
Tucson, AZ 85745
(888) 727-0441
www.cottonwoodrecovery.com

Here is a link to the article: