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What's the most important factor in overcoming alcoholism?

Dear Stanton:

Does the amount or extent of what there is to lose in one's life (successful career, loved ones, money, respect, etc.) have an impact on helping an alcoholic to recover? At the risk of overstating, if an alcoholic realizes how much is at stake personally and/or professionally, has this been shown to be a positive incentive for cessation of alcohol abuse?

Thank you in advance for your guidance.

Best regards,
Jason


Dear Jason:

I couldn't put it better myself. To quote George Vaillant, in The Natural History of Alcoholism, refering particularly to Baekeland et al. (1975):

The most important single prognostic variable associated with remission among alcoholics who attend alcohol clinics is having something to lose if they continue to abuse alcohol.... Patients cited changed life circumstances rather than clinic intervention as most important to their abstinence.... Improved working and housing conditions made a difference in 40 percent of good outcomes, intrapsychic change in 32 percent, improved marriage in 32 percent, and a single 3-hour session of advice and education about drinking... in 35 percent.

These results apply in all situations-in other words, more than the type of therapy, or even whether the person enters therapy, the best chance for recovery is due to the number and quality of the person's attachments to life. Having people that care about them, including family, friends, and community involvements; having activities of every sort that they find meaningful; having work skills, opportunities, and involvement; and so on predict whether people will have the motivation and resources to overcome alcoholism. They have both more to lose and more to counteract the appeal of the addiction.

References

Baekeland, F., Lundwall, L., & Kissin, B. (1975). Methods for the treatment of chronic alcoholism: A critical appraisal. In R. J. Gibbons, Y. Israel, H. Kalant, R. E. Popham, W. Schmidt, & R. G. Smart (Eds.), Research advances in alcohol and drug problems (Vol. 2, pp. 247-327). New York: Wiley.

Vaillant, G. E. (1983). The natural history of alcoholism. Cambridge, MA: Harvard University Press.

Best,
Stanton

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