What You Can Change . . . And What You Can't*: The Complete Guide to Successful Self-Improvement (37 page)

When I read the intensely passionate literature on whether total abstinence or a return to social drinking should be the goal of recovery, I decided to get his opinion. I had dinner with him at his bar. I told him that the literature showed, quite definitively, that a fraction of recovered alcoholics can return to social drinking. His view was uncomplicated. “I hope they keep this a secret from the rest.”

Paul’s reaction makes a good deal of sense to me. First, the facts: Some fraction of recovered alcoholics are able to return to drinking without major problems like binges, blackouts, and violence. Just how small this minority is is a matter of debate. George Vaillant found that between 5 and 15 percent of his alcoholics returned to social drinking. In a twenty-year follow-up of Swedish alcoholics, 25 percent had become social drinkers and only 20 percent were abstainers. Fewer than this percentage of severe alcoholics are likely to become social drinkers, and only the alcoholics with the fewest major problems seem able to take this route. When the most severe alcoholics recover, they do so by total abstinence. By Paul’s logic, the possibility of social drinking should be kept secret from them.
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Controversy still reigns about whether—in the long run—controlled drinking works as well as abstinence. In 1972, two bold alcohol researchers, Mark and Linda Sobell, published successful results of a controlled-drinking program. Numerous defenders of AA scorched the Sobells. Mary Pendery and her colleagues, for example, argued that the Sobells’ results, looked at more closely ten years later, were grim: For example, a number of the “successes” had died, probably of alcoholism. But in turn, Pendery has been attacked for failing to mention that in the Sobells’ abstinence control group, a number had died in the ten intervening years. And so it goes. The issue is still unsettled.
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Surely, the goal of total abstinence has one main virtue. Believing in it keeps severe alcoholics on the path most likely to lead to recovery. Even if it is true that some alcoholics can recover and still drink a little, the goal of total abstinence, like the disease label, is probably a good tactic.

The goal of abstinence has one disadvantage, however. When the alcoholic believes that taking a single drink means he has fallen back into his old habit, one lapse can bring down his house of cards. A binge becomes very likely. In one study, the total-abstinence goal was compared to the controlled-drinking goal. After a year, the two groups had the same rate of abstinence—about one-third. But among the nonabstinent (the “failures”), the abstinence treatment resulted in three times as much drinking as the controlled-drinking approach.
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Many people who eventually recover from alcoholism slip occasionally along the way. Rather than viewing this as “I’m in relapse,” “My disease has won,” or “I’ve lost it,” there is a more optimistic way of thinking. A slip can instead be seen as a temporary setback triggered by external events, not as a lack of willpower. Lapses are opportunities to learn better how to cope, not signs that the alcoholic is once more powerless before his disease.
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The abstinence goal accords with the myth that alcoholics suffer from uncontrollable drinking. But in the natural course of alcoholism, alcoholics frequently control their drinking—in the short run: Sometimes one drink leads to the next and the next, but on some occasions the alcoholic chooses to stop. Alcoholics frequently control how much they drink—not drinking right before a job interview, for example. Most alcoholics have gone on the wagon several times but have eventually fallen off. The problem is not that one drink
always
leads to loss of control, but that in the long run, most alcoholics start drinking again—even after repeated successful control of drinking. Alcoholism has immense momentum, but total loss of control is not an accurate description.

Change: Alcohol, Cigarettes, Drugs

Alcohol presents a picture similar to that of most commonly abused drugs: cigarettes, cocaine, and opiates. First, some people are very vulnerable to any one of these appetites, probably for genetic reasons. There is no evidence, however, of an “addictive” personality that is vulnerable to
all
of them. Second, in the natural course of things, if the abuse is severe, fewer than half (only a third for alcohol) will be able to give it up. This means the problem is certainly not incurable, but the outlook is not rosy. Third, no medical or psychological treatment yet devised much improves on the natural recovery rate. If your first impulse is to get expensive hospital treatment, psychotherapy, or medication, think again. There is no secret expertise about alcoholism. Family, friends, and support that provides pressure and hope—not the least being AA, religion, and work—and, crucially, the individual himself are the site of the cure.

Heavy drinking, it must always be remembered, is a way of life. When, for example, the alcoholic goes to a party, he sees the party in different terms than the rest of us do. “How well stocked is the bar?” “Isn’t that my neighbor’s brother-in-law? He will surely snitch.” “I wonder if my old crony Tom is coming, so we can make the rounds afterward?” Heavy drinking is no less a way of life than bookishness for an intellectual, politics for a senator, or love of Jesus for a fundamentalist Christian. Giving it up is not a matter of doing without a hobby. It is closer to doing without the self.
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In America, slavery was once part of the southern way of life. It was believed to be constitutional, and southerners felt their sense of self violated when abolitionists tried to take it away. Yet slavery is a terrible institution. Wife beaters and their battered spouses have a way of life, one that is also terrible. Being a way of life does not make something right or good or benign.

Heavy drinking is a bad way of life. It destroys the individual and those he loves. There is nothing to be said in its favor. These are old saws. But what is new is the emerging fact that individuals cannot do all that much about this way of life once it has taken hold. After a lifetime of trying, about one-third of alcoholics escape it. One-third escaping such a debilitating condition is a real accomplishment, but it is the other two-thirds that constitute the major tragedy. Drugs (with the possible new exception of naltrexone), psychotherapy, AA, inpatient treatment, and willpower all show only the slightest victories—at best—for that two-thirds.

When a destructive institution like slavery or wife beating will not be overthrown by the individuals it most hurts, we are justified in appealing to something more powerful than the self to overthrow it. Just as there is a higher morality than individual choice that makes slavery and wife beating wrong, so too with alcoholism. Few of our problems cry out more clearly for social control.

Social control has been tried, you say, and it failed. I agree: Prohibition, although it decreased alcohol-related illness, was a tremendous failure, and I do not propose reviving it. But how much alcohol is consumed and the rate of alcoholism are very sensitive to less-sweeping social control. Liquor taxes, for example, are low. They have not kept up with inflation over the last forty years. It is estimated that doubling the present federal tax would cut cirrhosis deaths by six thousand per year, to say nothing of the number of lives it would save on the highways. Reducing the number of liquor stores and bars, restricting advertising, raising age limits, and curtailing profits from the sale and manufacture of alcohol would all cut heavy drinking.
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When individuals are powerless to change a problem of the magnitude of alcoholism, it falls finally to the society to act.

I
T HAS
become fashionable to blame alcoholism on the way your parents raised you or on other misfortunes of childhood. The very unchangeability of alcoholism, in this view, testifies to the power that childhood events exert over adult life. In fact, all of the problems of adulthood examined in this book have been attributed to such events. In the next and final part, we look at whether your childhood exerts such a hold on your life today. At stake is nothing less than whether you are a prisoner of the past or are free to change.

PART FOUR

Growing Up—At Last

Freud considered that after age 45, psychoanalysis could do nothing for a neurotic: Jung was convinced that 45 was roughly the period of life when its immensely important second development began, and that this second period was concerned with matters which were, in the broadest sense, religious.

Many people are put off by this attitude. They want nothing to do with religion and are too lazy or too frightened to accept the notion that religion may mean something very different from orthodoxy. They attach themselves to the notion that Man is the center of all things, the highest development of life, and that when the individual consciousness is closed by death, that is, as far as they are concerned, the end of the matter. Man, as the instrument of some vastly greater Will, does not interest them, and they do not see their refusal as a limitation on their understanding.

Robertson Davies, “The Essential Jung”
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14

Shedding the Skins
of Childhood

W
HEN DOES TIME
stop for you? Does it happen when you are making love, playing with your children, speaking at a meeting, looking at a masterpiece, or when you yourself are painting? Where are you truly at home—on a golf course in Maui, reading in your study, planting delphiniums, at a Springsteen concert, serving coffee in a shelter for the homeless?

These questions are not trivial. You must ask them and listen to your own answers. For they are pivotal in a transition that many of you are now making: the transition from the first season to the second season of your life.

There are, I believe, only two great seasons in life: the season of expansion and the season of contraction. This chapter is about these two seasons. The season of expansion begins at birth. Your overriding task in this season is to discover the demands of the world as you find it and to fit yourself to those demands: schooling, finding a mate, having children, embracing the values of your place and time, embarking on your life’s work, and, if you are lucky, mastering it. Evolution has ensured that this will be an extrinsic season, your time for learning what is expected of you and then doing what is mandated from the outside.

I suspect that the average reader of this book is between the ages of thirty and forty-five. You, average reader, are now coming into “the height of your powers.” You are roughly halfway through life. You are at the time when the first season ends and the second season begins.

In the second season, your life will be defined not so much by the outside world as by certain realities that have been coalescing inside you. Your task during the season of contraction centers around what you learned during the season of expansion. You discovered then the activities, objects, and people you love, things that were not means to any end but ends in themselves. When you sensed them and suspected what they meant, you probably postponed pursuing them. Their song has become more insistent lately. The second season allows you to postpone no longer. You will rearrange your life to fit what you have discovered you are. From now until very late in life, when so many of your options will narrow, you will pursue what your inner world demands.

What drives the transition from one season to the next can be—but rarely is—the sense of completion that comes from total success. Sometimes it is “topping out”—going as high as you can or want to. It can be your children grown to independence. But completions need not be the motive force: Failure, frustration, or sheer boredom can be marvelously productive in thrusting you from one stage to the next. Either way, the upheaval comes. You slowly and subtly stop doing what you used to do, stop being what you used to be, stop salivating to the old stimuli: You find an excuse to miss a party so that you can sit home in front of a fire with your spouse; you start wearing sneakers to work; you stop going to movies with subtitles; you let your
New Yorker
subscription lapse; you go to church for the first time since childhood. You become less and less what others expect.

Responding at last to what is intrinsic can mean self-indulgence, frivolity, or even emptiness. But it need not. An astonishingly large part of what is truly you coincides with old notions like duty, service, generosity, and nurturance: helping to build a community center—by both laying bricks and raising funds; running for office; guiding young people—your grandchildren—to maturity; giving back much of what you have so arduously won.

It is perilously easy to fail at making this transition—to allow what happened to you in the first season to cripple you in the second. But success is common, contrary to those who would have us believe we are prisoners of childhood. Growth—even huge leaps—occurs throughout adulthood. I dedicate what follows to your change and to your growth.