On alcoholism

Pastoral Psychology -     

Toward a model for spirituality and alcoholism

Spirituality is a significant factor in recovery from alcoholism, whatever definition of this condition one may use. One aspect of alcohol abuse is its apparent relationship to the balance between brain hemispheres. Excessive use of alcohol anesthetizes the object-based, language-oriented functions of the left hemisphere, associated with an action mode of consciousness. This allows greater engagement of the right-hemisphere receptive mode, which is also associated with religious experience. A model of spirituality based on achieving a balance between hemisphere functions and modes of consciousness could provide a non-chemical alternative to excessive use of alcohol.     

Loneliness and adolescent alcoholism

This paper first shows how the feelings of separation anxiety, hostility, and loneliness are intrinsically related. In pursuing this line of thought, the views of Fromm-Reichmann, Fromm, and Erikson are synthesized. The foregoing emotions are then discussed within the context of Freud's speculative postulation of the "oceanic feeling." All these conceptual connections, in turn, are then analyzed as essential factors contributing to, and indeed determining, adolescent drinking disorders. Traumatic issues and conflicts, initially centered in the infant's sense of separation from the mother, are later reexperienced and revived during the critical period of adolescence as the child is confronted with a sense of separation from the family. The paper concludes with a more empirically oriented treatment of the concrete features exhibited in adolescent alcoholism.     

Suicide notes in alcoholism

Alcoholism is associated with a vast number of suicides. The most systematic study of suicide among alcoholics is the work of Eli Robins and George Murphy. The suicide notes in these studies have remained unanalyzed to date. The present analysis suggested that these suicide notes of alcoholics did not differ from those of nonalcoholics; core themes in their deaths are unbearable psychological pain, cognitive constriction, indirect expressions, rejection-aggression, and identification-aggression. Although caution is in order in accepting the null hypothesis, we can at least suggest that further study is needed.     

Couples at risk for transmission of alcoholism: protective influences

A two-generation, sociocultural model of the transmission of alcoholism in families was operationalized and tested. Sixty-eight married children of alcoholic parents and their spouses were interviewed regarding dinner-time and holiday ritual practices in their families of origin, and heritage and ritual practices in the couples' current generation. Coders rated transcribed interviews along 14 theory-derived predictor variables, nine for the family of origin and five for the current nuclear family. Multiple regression analysis was applied in a two-step hierarchical method, with the dependent variable being transmission of alcoholism to the couple. The 14 predictor variables contributed significantly (p less than .01) to the couple's alcoholism outcome. A general theme of selective disengagement and reengagement for couples in families at risk for alcoholism recurrence is discussed.     

A community-reinforcement approach to alcoholism

Several theoretical approaches to alcoholism exist. An opérant reinforcement approach was used in the present study to develop a new procedure that rearranged community reinforcers such as the job, family and social relations of the alcoholic such that drinking produced a time-out from a high density of reinforcement. The results showed that the alcoholics who received this Community-Reinforcement counseling drank less, worked more, spent more time with their families and out of institutions than did a matched control group of alcoholics who did not receive these procedures. This new approach appears to be an effective method of reducing alcoholism. An analysis in reinforcement terms is presented of the etiology, epidemiology, and treatment of alcoholism.     

Opioid antagonists and alcoholism treatment

The increasing evidence for a neurobiologic basis for alcoholism has spurred the search for pharmacologic agents to treat alcohol abuse. The complex set of symptoms and behaviors that characterizes alcoholism has been linked to dopaminergic and opioid neurotransmitter systems, suggesting that opioid antagonists, such as naltrexone, may alter the positive reinforcement effects and craving involved in alcoholism. Laboratory and clinical investigations of naltrexone have demonstrated the potential for this agent to reduce craving, increase the aversive effects of alcohol, decrease drinking days, and increase abstinence. While naltrexone and other opioid antagonists, such as nalmefene, may be effective components of an alcohol-treatment program, they should only be used in combination with psychosocial interventions, such as support groups and psychotherapy.