I’ve been in recovery more than two years now and feel I have a pretty good handle on that aspect of my problems. But I recently entered a program for PTSD and the first thing the therapist wanted to know was why I drank. I told her because I was an alcoholic and that’s what we do. She refused to accept that and implied I was still in denial. What do you think?”

Why do alcoholics drink? Billions of man-hours have been devoted to that question. Partly because of the traditional view of alcoholism as a self-induced disorder. Which led to the question: why would anyone volunteer to be an alcoholic?

Psychoanalysis answered: Because of deep seated conflicts rooted in childhood. Early behaviorists blamed it on conditioning. Family therapists called the alcoholic an ‘identified patient’ in a dysfunctional family system. Early AA literature attributed it to physical allergy plus mental obsession. Rehab counselors liked to tell their alcoholic patients it was because they drank for effect.

As if other drinkers didn’t.

Dr. Jim Milam (Under the Influence) pointed out that alcoholics began drinking for the same reasons everybody else did — to relax, to feel good, as part of social occasions, sometimes to sedate themselves or aid sleep. The unique motive — to quell the pain of withdrawal symptoms — wasn’t there at the onset of alcoholism.

You can see his point. In a drinking culture, are we ever at a total loss for reasons to drink?

Today we have more information about what happens in the brain when alcohol is introduced. There are multiple theories involving endorphins, dopamine, GABA, etc. Still no practical way to differentiate the alcoholic from the nonalcoholic, however. At least, that has reached my ears.

A better question might be — why do some drinkers become alcoholic when tens of millions more, drinking for approximately the same reasons, do not?

My suggestion: If you’re happy with your program of recovery, find another therapist who believes in letting the client direct the course of therapy.