Psychologizing Alcoholism

The psychological understanding of alcoholism requires understanding of the treatment modalities of alcoholism since the beginning of the last century. With its emphasis on the 12-step recovery principles, the movement of Alcoholic Anonymous (AA) and its relative treatment success in outcomes has maintained an unrivaled position in the treatment of alcoholics. AA has also created an anti-medical and depsychologizing tradition that has left little room today for medicine and psychiatry to intervene. Medical services have provided treatment and care only for the physical and mental complications of alcoholism, leaving addiction itself to the hands of AA. In addiction and recovery processes, however, psychological factors exert significant influences. The addictive personality that comes from typical cognitive, emotional, perceptive, and behavioral addictive changes is a challenging obstacle in every recovery process. It is vitally important for the recovering addicts to receive psychological help for their emotional vulnerabilities from drinking of long duration, and also for various problems in their personal characteristics that had existed before addiction. Relapse, in particular, depends largely on the failure of psychological adjustment. It is time to repsychologize alcoholism and to bring the treatment of alcoholism back to medicine. Psychiatry must develop comprehensive treatment strategies of a biopsychosociospiritual model for alcoholic patients.