“The Conversation” is a weekly series on women and drinking. If you missed the introductory post, you can read it here. I am a health and addiction recovery coach and researcher who has firsthand experience with this topic; I am not a medical doctor, counselor or psychologist. All ideas proposed are up for discussion and debate- it's one of the best ways we can find new solutions and evolve.
Tina* was the kind of girl you could always count on for a fun time. We met when we were both waitresses at the landmark Coffee Shop in Manhattan’s Union Square, and we immediately discovered that we had something else in common- we both relished getting blitzed toward the close of our work shift and were always smooth about not getting caught. After we'd punch out the clock, we’d race over to the East Village together and spend the rest of our evening drinking at a handful of dive bars until closing time- ones that would serve underage charmers like us. Our party came to an abrupt end when, after barely a few months at Coffee Shop, we were both dismissed. I didn’t see Tina again until a few years later, when I ran into her at the 24-hour diner where she worked as I was brunching with a friend. I surveyed her face- sunken cheeks spotted with acne, circles under her drowsy eyes, collar popped on a grubby shirt- while we exchanged an awkward acknowledgment, and I remember thinking to myself,
What were our differences? She was a young black woman from the Bronx, I was a Connecticut-born WASP without the usual privileges attached. She was serving up eggs at a rundown greasy spoon, while I was racking up student loan debt at a fancy university. She was relatively honest in her presentation to the world, while I was a liar in a Betsey Johnson frock who spent money I didn’t have on dresses and martinis that I certainly didn’t need. She’d always been “balls to the wall.” I was measured, careful, rehearsed. And yet, we were both heading in a similar direction.
Have you ever had this thought cross your mind about a person you don’t truly understand while out at a friend’s party or a wedding or a company meeting? I know I have, at several points in my life. The colleague at work who’s always hungover, who’s always calling out sick. The melodramatic, co-dependent buddy who just can’t seem to keep it together. That Facebook friend who posts photos of cocktails several times a week, with hashtags like #roughday and #thirsty. The lover who stumbles home well past midnight after yet another business outing, who wakes you up by vomiting. It’s the easiest way to dismiss a behavior that unsettles us because that behavior hits too close to home, or because it looks like us, or because it confronts us with something that seems incomprehensible, alien, uncouth.
So, what’s an “alcoholic?” This often misused and outdated term came into our lexicon way back in 1852 to describe a person who was addicted to alcohol and who could no longer control their consumption, nor the harmful outcomes resulting from it. Much like the designations “lunatic asylum” or “mentally retarded,” “alcoholic” was retired quite a while ago and is no longer found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which sets the standard for criteria and language to be used by mental health professionals, researchers, insurance providers and pharmaceutical companies. “Alcoholism” has been replaced instead with “Alcohol Use Disorder,” a phrase implying an issue that flows along a spectrum (your experience and mileage may vary), rather than a disease (you either have it or you don’t). Unfortunately, journalists, recovery programs, and the general public have not received the memo- labeling someone an “alcoholic” may be as inaccurate, inappropriate and backwards as placing the “R” word on a child with dyslexia or ADHD- or any other challenge, for that matter. Compounding this issue in our language and, of course, our thinking- as one shapes the other- is the fact that the primary method of treatment prescribed by hospitals, doctors and courts is Alcoholics Anonymous, which more or less encourages its participants to pat a label on themselves like a gold-foil badge: “my name is so-and-so and I’m an alcoholic.”
I know the drill well because I’ve said that sentence myself at least a few hundred times over the years, which has created just as much peace within me as it has turmoil. When we are labeled, that mark initially makes it a lot easier to find our place in the world, even if that place costs us, over time, our ability to flourish, transform and grow. Sadly, I still use the word on occasion- about myself and in describing the experiences of others- if only because it makes it so much easier to carry on with a conversation or get to the point, rather than delving into its history and myriad offenses. “Alcoholic” is what most people know. It’s what we’ve learned to get comfortable with. And, I owe a great deal to AA, just as millions of others do. In its context, saying, "I'm an alcoholic," becomes nearly as easy as, "my name's Aimee and I'm a Taurus."
But, what would happen to the way we view, treat and discuss excessive or problem drinking if we changed the language we use in describing it, and in describing all the millions who are impacted by it? How would treatment for those with an ALCOHOL USE DISORDER evolve and improve if we honored the spectrum as well as each individual's unique experience, rather than framing it in black and white? By alleviating sufferers from the yoke of stigma- and I cannot help but think of Hester Prynne's scarlet red patch embroidered in gold with the big letter "A"- are we then finally encouraging them to heal and become healers themselves? Or, must we brand them in order to keep them humbled and in line? I don't have the answer, but what I do know is that I'm doing my absolute best to adopt this more progressive terminology as a way to acknowledge the dignity and POTENTIAL of those who are wishing to change their relationship with alcohol, those who have already changed it, and to also respect my own growth.
I stopped fully identifying with the term "alcoholic" a few years ago- a divorce that was actually quite conflicted. I remember saying it aloud following my name, and feeling my throat constrict. This constriction had happened again and again- it felt as though I was no longer telling the truth about who I was, and I had a lot more to discover about who I was to become. I needed to make room for that. In this shift- one that isn't yet complete and may never be- I've discovered a world of difference in living as a thriver, in comparison to existing as a survivor.
So, I'll pose the question once again- what would happen if we released the term "alcoholic" from our world and all the ideas that go along with it, and instead began to work with and through the knowledge, language and discoveries of more recent times? Estimates show that only around 15 percent of people with an alcohol use disorder receive treatment and that most people who drink too much are not alcohol dependent. If we went about discussing it in a more accurate and progressive manner, how many more would finally get the help they need?
Thank you for reading. I'd love to hear your thoughts on this topic, and as I mentioned earlier, all points are up for discussion or debate. I do not propose to have or offer all the answers, so if you disagree with me or feel that something needs more explanation, please say so. I'm here to learn as well! In the next installment of "The Conversation," I'll be exploring how one can identify an addiction or alcohol use disorder. What's the difference between someone who likes to party and someone who drinks too much? How and when does drinking become a problem?
*Names have been changed.