Alcohol abuse is the most frequent substance abuse and addiction issue that I see in my practice. I understand how a habit of heavy drinking gets started and takes root as a major pattern in one's life. I observe that heavy drinking is usually accompanied by bouts of anxiety, panic and depression. I work with my clients to help them understand their behavior and consider what they would like to change in their lives.

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Many clients come in with the belief that if they ever want to be healthy again, they probably need to join Alcoholics Anonymous (AA). Although AA has some positive aspects, there are well proven reasons why this approach fails many people. It is not just a question of whether one is seeking total abstinence or not -- which is what AA recommends -- it is a question of whether AA is truly effective for any form of recovery. The evidence strongly suggests that AA has very limited success. 

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As reported by Gabrielle Glaser in The Atlantic article, The Irrationality of Alcoholics Anonymous:

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"The history of AA is the story of how one approach to treatment took root before other options existed, inscribing itself on the national consciousness and crowding out dozens of newer methods that have since been shown to work better.

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A meticulous analysis of treatments, published more than a decade ago in The Handbook of Alcoholism Treatment Approaches but still considered one of the most comprehensive comparisons, ranks AA 38th out of 48 methods. At the top of the list are brief interventions by a medical professional; motivational enhancement, a form of counseling that aims to help people see the need to change; and acamprosate, a drug that eases cravings."

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AA supports the deterministic "disease model" of addiction. While the medical field wrongly largely thinks of addiction as a physical disease, AA treats addiction as essentially a moral disease that one has for life. Whether addiction is treated as a biological or moral disease, this idea is not based in the reality of human experience and therefore has negative effects on those who adopt it. Glaser explains:
 

"People with alcohol problems also suffer from higher-than-normal rates of mental-health issues, and research has shown that treating depression and anxiety with medication can reduce drinking. But AA is not equipped to address these issues—it is a support group whose leaders lack professional training—and some meetings are more accepting than others of the idea that members may need therapy and/or medication in addition to the group’s help.

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AA truisms have so infiltrated our culture that many people believe heavy drinkers cannot recover before they 'hit bottom.' Researchers I’ve talked with say that’s akin to offering antidepressants only to those who have attempted suicide, or prescribing insulin only after a patient has lapsed into a diabetic coma." 

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The approach that I use with my clients is based in the work of addiction specialist Stanton Peele and his book Recover! An Empowering Program to Help You Stop Thinking Like an Addict and Reclaim Your Life. I also recommend the related online program, Life Process Program to clients I'm working with.

As stated on Dr. Peele's website:
"Dr. Peele has shown that the disease model, which is promoted as lifting the burden of blame from those with addictions, in fact sentences millions of people to a lifetime of artificial limits.  People can—and most often do—outgrow their addictive patterns.  And the disease idea of addiction does nothing so much as confuse, oppose, and reject people’s self-empowerment made evident in this self-cure."

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Time after time, my clients have found themselves feeling more empowered by dropping the disease model and learning to think of their behavior and their potential in a new way. My humanistic, depth-oriented approach treats drinking like any other problem in life -- one that has causes related to our complex inner lives and the habits of thought, emotion and action that we've learned.

Resources:

NPR - Rethinking Alcohol: Can Heavy Drinkers Learn To Cut Back?