An Interpretation of Medical and Psychiatric Approaches in the Treatment of Alcoholism

Abstract

Current medical and psychiatric theories of the etiology, dynamics and therapy of alcoholism indicate no general agreement. It is the opinion of most that the alcoholic drinks because of a physiological or psychological defect though the exact nature of the defect is not known or proved. A review of psychological theories suggests that the alcoholic drinks because of an insatiable inner need which results in anxiety, though there is much difference of opinion as to the source and nature of the anxiety. The conflict of the alcoholic can be schematized as consisting of two opposing forces[long dash]one, representing the desire to change, get well, and stop drinking; the other, to continue uncontrolled drinking. The forces that resist change are discussed. Defense mechanisms with special reference to those of the alcoholic are examined. Denial and projection are emphasized. The opposing forces that lead to sobriety and aid in resynthesizing life, e.g., therapy, are then discussed with details as to the specific role of the patient, his illness, the role of the therapist, the influence of the type of therapy and the setting of therapy.