Abstinence Versus Permissiveness in the Psychotherapy of Alcoholism

Abstract

I. Introduction THIS STUDY is the result of persistent differences of opinion among the psychiatric staff of the Washingtonian Hospital regarding the psychotherapist's attitude towards drinking during the course of therapy. Is total abstinence necessary for successful therapy, or can patients drink and still show improvement? This difference of opinion is long-standing in the alcoholism literature. A recent example is seen in two papers in the same issue of the Quarterly Journal for Studies on Alcohol by D. L. Davies³ and R. L. Moore,¹³ and in the ensuing discussion among alcoholism experts in subsequent issues of that journal. Stated simply, the so-called permissive approach holds that alcoholism should be treated as a character neurosis; the therapist does not take a stand for or against the patient's drinking, but rather attempts to understand its symptomatic meaning. According to this view, as treatment progresses and