Claude M. Steiner - Games Alcoholics Play

Thats Dr. Claude Steiners message in his astonishing best-seller that gives new hope to problem drinkers and their families. With his treatment for Americas biggest health problem, which the Los Angeles Times has called amazingly successful, he has cured many problem drinkers who have come to him for help. Now he summarizes his approach and tells how it works:

Why alcoholism is not a diseaseand why treating an alcoholic as sick may do more harm than good.

How people choose a role in early age that may turn them into alcoholics.

The three distinct types of alcoholics and the different games they play.

How the alcoholic can unmake the decision and become truly cured.

A Ballantine Book
Published by The Random House Publishing Group
Copyright 1971 by Claude Steiner

Identity: Youth and Crisis by Erik H. Erickson, copyright 1968 by W. W. Norton & Company, Inc. Austen Riggs Monograph No. 7; extracts reprinted by permission of the author and publisher.

All rights reserved.

Published in the United States by Ballantine Books, an imprint of The Random House Publishing Group, a division of Random House, Inc. New York, and simultaneously in Canada by Random House of Canada Limited Toronto.

Ballantine and colophon are registered trademarks of Random House, Inc.

www.ballantinebooks.com

Library of Congress Catalog Card Number: 74-139254

eISBN: 978-0-307-78382-0

This edition published by arrangement with Grove Press, Inc.

v3.1

To my mother, Vally,
Who told me what to do
And my father, Willy,
Who showed me how.

T HE WORD alcoholic is only about a hundred years old (1856). It is one of those words ending in ic used by clinicians to mean a non-person, like schizophrenic and psychotic. What Dr. Steiner has done here is give back to alcoholics their membership cards in the human race.

In general, the less people know about a subject, the longer it takes them to explain it. E=mC2 tells us more about the universe than the whole Alexandrian library did, and a prescription for penicillin is a better solution for pneumonia than all the medieval universities in Europe had to offer. The vast literature on alcoholism is with few exceptions an apology for not being able to do much about it. Two of the most important exceptions are the Twelve Steps of Alcoholics Anonymous, which tell how to do something about it, and this book, which does likewise.

Transactional analysis is a new approach to the problem. Through its consistent theory, it offers a way of organizing observations toward new discoveries and cogent methods of treatment. Dr. Steiner is a pioneer in transactional analysis, a keen and intelligent observer, and an experienced clinician in the field of intoxicants. Even before he reveals his therapeutic strategies, he discusses two sets of observations which are each in themselves important contributions that cannot be overlooked by any serious student. The first is the classification of alcoholics into three different types according to the transactions they engage in. As with all game descriptions, the value of this lies in the recognition factor. Anyone, layman or professional, who has to deal with heavy drinkers personally or clinically, will be able to recognize and distinguish between the three types which Steiner aptly calls Drunk and Proud, Lush, and Wino. It is this very aptness which makes his observations so incisive.

A second important nosological distinction is his discussion of withdrawal panic and its psychological basis, as distinct from withdrawal sickness. By courageously persisting in his therapeutic efforts beyond the point where most other clinicians retreat, he brings the patient out of what first appears to be a psychosis. To my knowledge, this distinction has never been made before, nor can withdrawal panic be adequately accounted for without a clear understanding of structural analysis. Thus two side issues to the main subject of how to treat alcoholics with psychotherapy become in fact substantial and original discoveries.

Dr. Steiner also introduces the reader, almost in passing, to two other valuable ideas which may be new to those who are not familiar with the recent progress of transactional analysis. These are the Drama Triangle of Karpman, which succinctly portrays the role switches that can take place in the alcoholic games (as well as in other games and in literature and drama), and the theoretical basis for and therapeutic value of protection as described by Crossman.

Thus Steiner first lays a sound theoretical and clinical groundwork before he comes to the core of this book, which tells of the actual therapeutic operations required to break up the alcoholic games and script, operations which, in short, allow the patient to stop drinking. There, with true professionalism, he tells not only what to do, but also what not to do.

Dr. Steiner first summarized these ideas in an article in the Quarterly Journal of Studies on Alcohol. There they aroused a rather tempestuous controversy, but most of the criticisms were ad hominem rather than ad rem, and some of these epithets were directed at myself as well. I can only say that I am proud to be placed beside him in this regard, to have had some hand in the matter, and to have the privilege of writing this Foreword. The indications are that script analysis, properly studied, understood, and applied, is the most effective scientific psychotherapeutic approach to date in the treatment of the alcoholic, and this has been demonstrated by others besides Dr. Steiner. The only way to test this statement is for clinicians to learn the principles of script analysis thoroughly, and apply them conscientiously and powerfully for a year or two in their own practices. They will have to learn the difference between switching roles in the game (Alcoholics Anonymous), making progress (other conventional psychotherapies), and breaking up the game itself and the script on which it is based. This book tells them firmly, gently, and benevolently, but with proper clinical objectivity, how to do the last. It also gives the therapist permission to enjoy his work, which is, I think, a unique contribution of the transactional approach, having the added value that it also permits the patient to enjoy his treatment. Cough medicines taste better these days than they used to, and so should psychotherapy.

Eric Berne, M.D.
1970

T HIS BOOK is primarily an extension of the theory and practice of transactional analysis into the specific area of scripts. In addition, it is hoped that it will provide lay and professional readers with information leading to the understanding and more effective treatment of alcoholism and other addictions. The theoretical background for this book is summarized in . Readers who wish a more thorough background in transactional analysis should read Eric Bernes books, Transactional Analysis in Psychotherapy and Games People Play; for those especially interested in group treatment, The Structure and Dynamics of Organizations and Groups