I was impressed by this eloquent account of a life afflicted by chronic alcoholism and the many problems it can create:

It’s by an award-winning investigative journalist who himself experienced more than his fair share of trouble due to drinking — including a stint in jail that paradoxically helped launch his recovery.

It’s a familiar pattern to counselors. Again and again, someone pulls himself out of a catastrophic dilemma, only to turn around later and jump right back into the mouth of the alcoholic volcano.

He describes the process: following a period of successful sobriety, “… a familiar voice returned, one that told me my fortune had changed and I could now have it all: the family, the career and the booze. .. a decision that quickly upturned everything I’d accomplished in the six years since I’d left jail. And this time it nearly cost my life.”

I remember one expert remarking that it wasn’t unusual for someone to require seven treatment episodes in order to  establish a stable recovery. If true, I suspect that’s because so many people enter treatment not to change their behavior but to avoid some consequence of their drinking — if they weren’t ordered by a judge, there’s some other form of outside pressure.

In such situations, it’s “here comes treatment, ready or not.” As it turned out, they weren’t ready.

Better luck next time.

George Vaillant noted that alcoholism was best described in terms of the problems it creates in someone’s life than by the amount of alcohol they consume. In other words, there exist heavy drinkers who don’t appear to be alcoholic, and infrequent drinkers who most certainly do. That reminded me of Jellinek’s original typology, where problem drinking was divided into five types, of which only two he considered a disease.

The first was marked by loss of control and multiple life problems. The second by so-called “maintenance” drinking.

Early members of AA, it’s said, fell mostly into the first category. Their personal stories reflected that.

There was a decades-long effort to identify an ‘alcoholic personality type’. As far as I know, it was unsuccessful. Certain personality disorders do correlate strongly with alcoholism (I’m thinking antisocial type), as do certain psychiatric conditions, such as bipolar disorder. Still, no one has managed to pinpoint a unique ‘alcoholic’ personality type, and not for lack of trying.

Could be, as one expert observed, that alcoholism takes people from different backgrounds and of different character types, and causes them to behave in very similar ways.

Perhaps that’s why people in long term recovery strike me as such a diverse group. The way they go about recovering from addiction ultimately reflects that.

Here’s something I wrote on that subject a few years ago. It suggests that every clinician can benefit from a healthy dose of professional humility.