For the past two and a half years, I’ve been working as a counsellor in an alcohol agency, helping people change their drinking patterns, in the East End of London. The experience has enriched my life and taught me a lot about people, their strengths and their weaknesses. I’ve also come to realise a few things about alcohol use and abuse, that aren’t what I would have expected.

To start with, everyone has the same idea of what an “alcoholic” is. He (it’s always a “he”) is an old guy with a bottle in a brown paper bag, and he’s wearing a scruffy old overcoat that stinks of piss and he sleeps on park benches.
There’s something about the prevalence of this bogey-man image in our psyche that says something about us – social creatures that we are, the one thing that terrifies us, spurs us into action, gets us to knock on the door of the alcohol agency, is the prospect of being an outcast.
People come as much for practical advice as they do to ease the nagging fear that they are in the grip of some mysterious process that is propelling them to the status of complete derelict and pariah.
The really important thing to see, however, is that those who have had a raw deal from society, who have had terrible childhoods with no safety net, or who have had to cope with loss or injustice, may be unconsciously drawn to living out the life of the outcast, in bitter judgment on the shit they’ve had to endure.
In other words, if one ignores the political and existential force behind such a drive to “self-destruction” and exile, one ignores a person’s spark of individuality, what their perspective is on what hurt them, their story. All of us have a raging tramp inside us somewhere, but most of us have enough resources and support not to let him take over.
Secondly, alcohol’s primary effect, neurologically, is to dis-inhibit. As much as we can blame alcohol for undesirable behaviour – fighting, having risky sex, gossipping, having affairs, fucking up at work, accidents, blacking out and forgetting, the truth is that none of it is alcohol’s “fault” – it merely allows the shadowy parts of us that are normally subdued or repressed out to play. And it’s different for every individual.
Part of the healing process – a concept that is hard to quantify, but usually involves a holistic acceptance of the good and bad bits of us – is often acknowledging that we are angry, we do have powerful sex drives, we hate our job and want to change it to something more meaningful, we don’t like our squeaky-clean, fake or timid personalities, we don’t like having to please others all the time, and we don’t want to face what is painful, what is haunting us.
When we stop drinking, we have to face all that stuff and deal with it in a different way. It can be a rough time, like an emotional roller-coaster, until we settle down and adapt to living with our complexity and feelings in a different, more conscious way.
Thirdly, our culture can be very cruel to those who change their drinking patterns. I’ve heard so many stories of how defensive and subtly abusive a group of former drinking buddies can be to the person who’s newly sober in their midst – but because they’re drunk they can’t see their hostility, their desire to punish the one who’s challenging the tribal drug of choice. The compulsion to push alcohol down the sober person’s throat becomes an almost menacing challenge for the group, under the guise of being generous, not taking no for an answer. The disillusionment that the newly sober person feels about their friends can be very hard to bear, and often such a person has to find new friends. That can be a very sad and difficult process.
Fourth, willpower is not usually what is required when stopping drinking. Drinkers are usually incredibly hard on themselves to begin with, with savage inner critics making their life hell. Adding another imperative to cut down or to stop drinking is usually doomed to fail. Far more effective is giving yourself permission to pamper yourself, to indulge in good food and hobbies and music and loads of rest.
Drinking is, primarily, enjoyable, at least for the first one or two drinks – and if we stop doing something we enjoy, we need to do something else in its place. Often finding out what that is can be tricky – but unless another activity that gives us meaning or fun is found, drink will remain the only route to pleasure. And human nature being what it is, we will always seek out pleasure when we’re in distress.
Fifth, alcohol is a major depressant. In fact, in my experience, stopping drinking alcohol completely has the same effect as going on an anti-depressant like Prozac – roughly the same kick-in period of about three weeks before a definite lightening of mood, an ability to cope, a desire to tackle things.
Over the years, I’ve come to know the distinct flavour of alcohol-induced depression – “poor me”, a tremulous wail, a rawness, a morbidity, a sort of hand-wringing, writhing self-loathing. It’s so powerful emotionally that I’m surprised people don’t name it more often – perhaps because we tend not to connect our emotions with what we ingest, we imagine they’re somehow separate from us, that they’re not in our control. And I’m not talking a hangover here, the headache and dehydration – everyone talks/jokes about them – but the innermost feelings of misery that get left undiscussed. Either one sits it through for a few days, until it lifts naturally, or one has another drink that night to cheer up – and so the cycle begins.
Sixth, there is a difference between chemical dependency and psychological dependency. I would urge any of you, if you drink heavily, not to get chemically dependent – it’s horrific to stop, and at that level of intake, the paranoia and the panic attacks and the liver-rotting are things that take a long time to recover from. To avoid getting dependent, don’t drink for at least two days in a row, every week. The liver can and does recuperate, if given a chance, and not bombarded with toxin. If you do this, then you “only” have to face the psychological dependency, should you wish to cut down to healthy levels at some stage in the future – which, although no picnic, is perfectly possible.
Which brings me to my last point, perhaps a controversial one. I don’t believe that alcoholism is a disease, and have mixed feelings about the 12-step approach to alcohol abuse, as in Alcoholics Anonymous. The best thing about AA is the support network it provides for people, the willingness of fellow human beings to give freely of their time to help others in the initial raw and scary stage of sobriety. This brings out the best in people, and for those who have powerful self-destructive drives that are let loose when they drink, the way the group members can rally round and help someone fearing a relapse and return to such behaviour is admirable. Lives are saved by the AA.
My problem with the 12-step method is that it is a discourse that has at its roots Christian notions of original sin and shame, the belief that one is a bad person. I believe that addictive behaviour can mask a deep sensitivity and a desire for spiritual connection and meaning, and once one takes the mask away, a whole new vista can emerge, that, in some traditions, including the AA, is called a spiritual awakening.
The important question should be then: what belief system serves me best? What faith? I question the psychological health of a group that believes itself to be diseased, and whose sole topic for discussion is that disease, week in, week out, year in, year out. In the same way I question a group of people who believe themselves to be sinners. The constant reminder of one’s status as diseased, and the constant appeals for redemption through loyalty to, and the promotion of, the AA programme itself, can lead to the paradoxical state where alcohol remains forefront in a person’s life long after their pressing, temporary need for support has passed.
I find that the clients I get who have absorbed the ethos of AA often have very low confidence in themselves, don’t believe they can change their lives (because they’ve been told they are “powerless” over their addiction, their disease, their moral well-being) and they beat themselves up for relapsing, for having unwelcome feelings and thoughts – exactly like a self-flagellating Catholic, repeatedly coming to confession.
Bless you my child, you are not a sinner. You’ve done the best you can, and you can do better if you put your mind to it. And if you stop drinking, and stop feeling ashamed for your “bad” feelings, and give them back to where they rightly belong – the society that failed you – then maybe something might get changed. That doesn’t mean wallowing in self-pity or blaming others. It means activating, getting creative, getting political. Doing something about it. When people stop drinking, they usually have more energy than they know what to do with. And it’s usually a volatile, revolutionary spirit.
Something that originates in a religious tradition is usually concerned primarily with social control and maintenance. That isn’t necessarily anything to do with individual happiness or good mental health. Society is dis-eased, and betrays its children, generation after generation. The status quo in society is maintained when its adult wounded children are drinking and feeling no pain, or guilt-ridden, diseased and ashamed, listing their character defects in group confessions.
Society needs to listen to its raging tramps. Society needs to change.