Michael S. Levy - Take Control of Your Drinking: A Practical Guide to Alcohol Moderation, Sobriety, and When to Get Professional Help

TAKE CONTROL OF YOUR DRINKING

SECOND EDITION

A PRACTICAL GUIDE TO
Alcohol Moderation, Sobriety, and When to Get Professional Help

Michael S. Levy

Note to the Reader: This book is not meant to substitute for medical care of people who have depression or other mental disorders, and treatment should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the individual and his or her physician. My book has been written to help with that dialogue.

Drug dosage: The author and publisher have made reasonable efforts to determine that the selection of drugs discussed in this text conform to the practices of the general medical community. The medications described do not necessarily have specific approval by the US Food and Drug Administration for use in the diseases for which they are recommended. In view of ongoing research, changes in governmental regulation, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert of each drug for any change in indications and dosage and for warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently used drug.

2007, 2021 Johns Hopkins University Press

All rights reserved. Published 2021

Printed in the United States of America on acid-free paper

9 8 7 6 5 4 3 2 1

Reproduction in whole or in part without written permission from Johns Hopkins University Press is strictly prohibited.

Johns Hopkins University Press

2715 North Charles Street

Baltimore, Maryland 21218-4363

www.press.jhu.edu

Library of Congress Cataloging-in-Publication Data

Names: Levy, Michael S., 1953 author.

Title: Take control of your drinking : a practical guide to alcohol moderation, sobriety, and when to get professional help / Michael S. Levy.

Description: Second edition. | Baltimore : Johns Hopkins University Press, 2021. | Revised edition of: Take control of your drinkingand you may not need to quit. 2007. | Includes bibliographical references and index.

Identifiers: LCCN 2020009000 | ISBN 9781421439433 (hardcover) | ISBN 9781421439440 (paperback) | ISBN 9781421439457 (ebook)

Subjects: LCSH: Drinking of alcoholic beverages. | Temperance. | AlcoholismTreatment.

Classification: LCC HV5035 .L48 2021 | DDC 613.81dc23

LC record available at https://lccn.loc.gov/2020009000

A catalog record for this book is available from the British Library.

Special discounts are available for bulk purchases of this book. For more information, please contact Special Sales at specialsales@press.jhu.edu.

Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible.

TAKE CONTROL OF YOUR DRINKING

About 30 years ago, I started working with people who were hurting themselves by drinking too much. At that time, the three most important principles I was taught were (1) people had to admit that they had the disease of alcoholism; (2) people had to stop drinking entirely; and (3) people had to get treatment if they were going to stop alcohol from ruining their lives. And treatment in most every case meant going to Alcoholics Anonymous (AA) meetings because AA was the only approach believed to work. If people wouldnt admit they had a disease, or they refused to stop drinking, or they simply wouldnt go to AA meetings, this was a sign of their denial, or their unwillingness to admit they had a drinking problem. This thinking still persists in some circles today.

The AA expression Keep it simple, stupid applied not only to the alcoholic but also to the professional who was treating the alcoholic. Dont do anything fancy or differentjust get the alcoholic to admit that he or she is an alcoholic, get the person to stop drinking, and get the person to go to 90 meetings in 90 days.

I was even told that I shouldnt treat alcoholics with psychotherapy. Exploring how drinking may have something to do with patients emotional life conflicted with the idea that their problem with alcohol was a primary disease that had nothing to do with anything else, especially their psychological life. The message I received was that seeing alcoholics in therapy instead of insisting they go to AA meetings would simply increase their denial and foster the idea that they didnt have a disease.

Unfortunately, I found that many people resisted one or more of these well-intended suggestions. Some reported that they had checked out the AA scene, but it just wasnt for them. They told me that instead of going to meetings, they preferred to spend their time doing something more fun than listening to alcoholics talk about their problems. Some even said that they hated AA meetings. Their reasons included not liking the spiritual overtones in AA meetings and not liking the rigid approach often recommended in AA. Sometimes they told me that AA meetings made them feel more unhappy when they heard such painful and depressing life stories. Others seemed to be private people who didnt like the public exposure of going to meetings. And others even told me that going to meetings made them want to drink more. Rather than hearing all of the talk about drinking and the problems drinking caused, these people wanted to put their alcohol problems behind them and not be constantly reminded of them.

What was most interesting to me was that many of these people admitted that they had an alcohol problem, and they didnt seem to be in denial. They just didnt like going to meetings. They preferred working with a therapist on an individual basis. What was I to do? Refuse to see them, or should I work with them in the manner they wanted? And what if I continued to see them, and they continued to drink? Was I doing them a disservice by seeing them in therapy? Was I making things worse and giving them the wrong care?

There were some people who refused to admit that they had the disease of alcoholism. They told me that they didnt like being labeled an alcoholic. This label made them feel as though something was terribly wrong with them. On the other hand, they could admit that they had a drinking problem, and they acknowledged that they often drank too much. Some viewed their problem with alcohol simply as a bad habit that they had learned over time.

In my opinion, many of these people werent in denial. Although refusing to acknowledge the idea that they were alcoholics was, for some, a way to minimize their problem, for others this was not true. Many knew that they had to do something about their drinking and that drinking was clearly a problem for them. They just didnt like being labeled an alcoholic. This forced me to question how important it was for people with a drinking problem to admit they had the disease of alcoholism. Wasnt it fine for people to view their alcohol problem however they wished? Wasnt it more important for people to develop a plan to address their drinking than to get them to believe a particular concept? Who cares what they call their problem? More important is that they do something about it.

I worked with some people who wanted to try to moderate or control their drinking instead of choosing to become abstinent. I was totally unprepared for this, as everything I had learned told me that people needed to stop drinking completely in order to get better. In fact, I had learned that the wish to moderate ones drinking was the most blatant form of denial because it represented a refusal to acknowledge powerlessness over alcohol consumption. The whole notion of alcoholism is that people cannot moderate their drinking and must become abstinent to get better. Trying to control drinking was a clear sign: these people were not admitting they had a drinking problem, and they were still in denial.