"EXPLANATORY MODELS OF 'ALCOHOLISM' AND/OR 'ADDICTION"

Uni-dimentional Models

1.   Psychodynamic Model: any number of intra-psychic conflicts 

     might lead to fixation at or regression to the "oral dependent" 

     stage of development; alcohol provides oral gratification.

2.   Social Learning Model: drinking behaviors are learned as a part of

     socialization and then are reinforced.

3.   Tension Reduction: anxiety/stress leads to alcoholism or addiction which is

     a "secondary" phenomenon.

4.   Disease Model (Jellinek): mixed etiology has five identified "types" of

     alcoholics.

Multi-dimensional Model

Biopsychosocial Model: explanatory model implicates numerous biologic,

psychologic, and social factors as being responsible for a "disease" of

addiction.

SOME COMMON MODELS ABOUT ALCOHOLISM

1. The Impaired Model

Definition: An alcoholic is a drunk, souse, toper, tippler, soak, lush. When he/she gets drunk, he/she is plastered, bombed, stoned, tight, oiled.

Etiology. Some people are just that way for unknown reasons.

Behavior. Drunks are repulsive and dirty; nice people do not like to get close to them. Sometimes they are comical they fall down, talk to lamp posts, try their door key in the wrong house, get their words mixed up, and so forth. But it is wrong to laugh at them and make fun of them because they cannot help it.

2. The "Dry" Moral Model

Definition. Alcoholism is a moral failing, not an illness. It is the natural penalty for drinking.

Etiology. Alcoholism occurs because drinking occurs. Some strong-willed people can apparently drink without becoming alcoholics. but the social risk in drinking is too great to allow any acceptance.

Behavior. The alcoholic behaves immorally because he/she drinks.

Treatment. There are many ways to try to get an alcoholic to stop drinking, including forcing church attendance, firing him/her from the job, pouring whiskey down the sink, marrying him/her off to someone strong enough to control him/her, divorce, shunning him/her, ridiculing him/her, giving him/her aversion treatments, and so forth. In short, behavior therapy. Fines and jail sentences may help.

Prognosis The prognosis is poor unless a way is found to threaten alcoholics or punish them so that they stop drinking. The only hope is to make alcohol unavailable. Young drinkers should have the example of the alcoholic before them.

3. The "Wet" Moral Model

Definition. Alcoholics are drinkers who do not obey the rules of the drinking society. They behave badly when drunk, and they cannot hold their liquor. Alcoholism is an unacceptable form of drinking behavior.

Etiology. It is a mystery why some people who drink become alcoholics.

Behavior. The behavior of alcoholics is anti-social. They spoil the happy, congenial occasions that social drinking can provide.

Treatment. Everybody in the drinking society including the alcoholic knows how to treat alcoholics: by juggling around rewards and punishments. A spouse may refuse sex, refuse to speak, withhold the family money, reduce housekeeping standards. His/her doctor may give him/her hell, tell the alcoholic to grow up and not be a crybaby, and so on.

Prognosis. If only the right formula of rewards and punishments could be found, everything would be all right. Otherwise, prognosis is gloomy.

4. The Alcoholics Anonymous Model

Definition. Alcoholism is an incurable, progressive, and often fatal disease Alcohol is a poison to an alcoholic though not to others. An alcoholic is a person whose life has become intolerable through the use of alcohol AA is a close community of those afflicted with this disease

Etiology. Alcoholics are emotionally impaired people who drink to compensate for their inadequacies and then, because of their body chemistry become addicted to alcohol, creating a circular process of further inadequacy and further drinking.

Behavior. At the height of his/her drinking career, the behavior of the alcoholic derives largely from the need to get enough to drink to control withdrawal symptoms. Earlier variety of behavior is due to complex physical, mental, and/or spiritual problems of an enduring nature.

Treatment. The best treatment for an alcoholic is permanent, continuous involvement in AA.

Prognosis. With the help of AA, alcoholism can be arrested although never cured. Without AA, the prognosis is usually hopeless.

5. The Psychoanalytic Model

Definition. Alcoholism is a symptom of a deep, underlying neurosis. Alcoholics are addictive personalities.

Etiology. Since the alcoholic is an infantile person, the key to understanding his/her inability to achieve maturity lies in early emotional experiences.

Behavior. The behavior of the alcoholic is to be interpreted as a symbolic means of expressing unconscious conflict

Treatment. For alcoholism, as for all neurosis, psychotherapy is required.

Prognosis. The prognosis for alcoholics is not encouraging

6. The Family Interaction Model

Definition. Alcoholism, like drug addiction and schizophrenia, is best seen as a form of family interaction in which one person is assigned the role of the alcoholic while others play the complementary roles, such as the martyred wife, the neglected children, the disgraced parents, and so forth. As this deadly game is played by mutual consent, any attempt to remove the key factor, the alcoholic, is bound to create difficulties for the other family members, who will attempt to restore their former game.

Etiology. As these family games are circular and self-reinforcing, it is useless to inquire how it began. In general, the basic personality inadequacies are transferred from generation to generation. The behavior of the alcoholic and other family members is a series of moves in a continuous and long, drawn-out family game.

Treatment. Family therapy is the only treatment

Prognosis. Prognosis depends on the availability of family therapy. With it the prognosis is good; without it, poor.

7. The "Old" Medical Model

Definition. Alcoholism is a serious, progressive, and eventually fatal disease which is incurred by the immoral behavior of excessive drinking.

Etiology. The etiology of alcoholism is the excessive drinking of alcohol. The reason for the immoderate drinking is unknown. Alcoholics seem to be unable to control themselves.

Behavior. Alcoholics are destroying their lives and ruining their bodies by drinking so much, and this is immoral.

Treatment. The doctor's problem in the treatment of acute states of illness in alcoholism is the management of the patient in a toxic state. Attention must be given to systemic dehydration, cirrhosis of the liver, nutritional deficiencies, and so on.

Prognosis. The prognosis is poor because the patient will not care for himself/herself

8. The "New" Medical Model

Definition. Alcoholism is a progressive, often fatal disease, possibly hereditary. Alcoholics are ill people whose body chemistry is such that they can become addicted to alcohol. In emergency treatment, alcoholism must be distinguished from schizophrenia depressions, head injuries, and so forth.

Etiology. It appears that alcoholics may have a defect in metabolism, possibly involving one of the major amino acids. There are probably also psychological and sociocultural contributing factors.

Behavior. Much of the alcoholic's behavior stems from the alcoholic's need to control withdrawal symptoms.

Treatment. Any treatment which helps the alcoholic abstain from drinking is valuable, provided that it does not impair his/her health.

Prognosis. Prognosis at the present time is not good. However, there is hope that medical science will provide new information, new treatments, and preventive measures.

one

My mother is starting to know too much about me. I don’t like it. I didn’t even like nicolas to know too much about me. i don’t want anyone to know too much about my time table. About how i conduct myself. I'm not talking about the conduct in which you portray yourself in the social sense. The time when you are alone. When no one is looking. Now i am never alone. NEVER! It’s killing me. I don’t have room to express myself anymore. I remember writing to myself when i was in my room in surry hills and saying not matter what happens i will always have my room set up exactly how i want it and i will always have my room. I don’t have my bed i don’t have my bed.  I don’t have my table. However i still have all my belongings it’s just a matter of finding somewhere where i can put my things on display. Somewhere where i can fully express myself. How long must it take? I’m so tired already. I have exhausted all my tolerance for my family. I’m lying to every single person. Every person i meet, know and have known for some time. Everyone except Debrah. I have secrets. Things that only i know. I'm am managing to keep them. Keep them hidden. For how long? Forever? Will i ever meet someone who i feel i can truly tell everything. The absolute. Thats it, i have exposed myself to the full. Too much i wonder? If i ever did decide to tell someone everything expose all i wonder what the circumstances would be? I what context would i put myself on a pedestal. This is the first entry into my new computer and I'm writing it on the train. I on my way back to suburban hell as Benji would say. I had two beers at the claire this afternoon and i called Nicolas. He was brought to my attention because there was a guy at the Claire who looked very similar to him. I thought to myself he was very cute and i daydreamed about dating him. I was thinking if i did date him people would say he looks a lot like Nicolas. i Imagined Sam i don’t know why, but i thought of him saying it. Or even just thinking it first. I’m a bit tired Beer kinda makes me want to sleep, especially if I'm alone. I smoked a joint on the weekend for the first time in a long while. It  was nice. It’ six twenty five and going to shut my eyes on the train now. I feel sleepy and i don’t feel entirely comfortable writing on the train. I feel kinda silly and someone might me looking over my shoulder. Rest now Leah., rest. Oh but a good song just came on i will listen to it then i will shut my eyes. 

Oh lover

I demand all. I expect nothing but the best, as you should from me. If you truly love me it should be a walk in the park. It’s easy. Nothing is hard; life is what you make it. Don’t complain to me if your bord, it’s not my fault only yours. I am every thing you could need you just have to discover your aspirations. What do you want? What don’t you want? Fuck me before I go insane! The temperature’s rising I can’t stand to feel the heat. Cool me down oh lover boy. Explore my sensual being.

it’s raining out side. that cigarettes and music are the only pleasures i have. such a cynical  way to view my situation. how shall i improve this. stand up to mum and do not let her walk all over me. i have being and sometimes it erupts into a fight. do not show mum too much of yourself. be secretive and hold your personal belongings close do not let anyone touch them. put things in order and be your self. go to gigs ant emerge yourself in the art world. go to every free gig possible and buy new clothes every week. do not let your guard down make sure you always feel sexy. never stop trying to be the best you can be and do not take note of other peoples criticisms. especially of those who clearly do not have the same ideologies as you. do not live life by the book because the book has such a narrow perception of what is normal. never stop loving yourself and the moment you do kill your self. life is not worth living if you cease to discover. cease to amaze others and become ugly. isolate yourself from those who have a detrimental effect on our true being. take note of others faults and use them within reason.  hiss at fascists and assert yourself. Always wonder and wander. Observe and put yourself in their position. Write Leah, write Leah, write Leah and do not stop ever. even when you cease to exist and your fingers are numb and bleeding. if things seem to turn to stone wait things out, be patient. Read Leah, read Leah, Read Leah never stop reading. read under the nights sky. read in the water then destroy the book. it’s fundamental to believe in the second coming. try to test out with communication. test it out and blame the other. when the hawks start to circle the pieces start to crumble unless we grow and strengthen our communication. here are the young men at your feet. i feel a sense of accomplishment. prey on their venerability life in just a game and you are winning. hold yourself tight and have conversations of fantasies but only with yourself. you choose to be here right now. get a hold of yourself and this experience and remind yourself you are not alone. the eternal being is always with you. pixie bell blair is always with you. it’s no illusion. 

Your day Leah! dream a little.

I’m writing to you in regards to you’re day. What do you want  to do with it?  You have a number of options and i suggest you write them down. First you could go and buy a bottle of wine and a pack of cigarettes. Sit in a park somewhere and consume it and then make your way to the art gallery and be moved by art. This is a good option because it is cheap and time consuming. Second you could find a nice cafe and have lunch there. Buy a big lunch and relax. This option is not great because you will have no money for  anything else and it is not as time consuming as the first option. Also sitting along in a cafe while it can be enjoyable to watch others go by but then sense of loneliness  will set in and you will still have time to kill. Drinking bring the joys of me being my own best friend. However I am a little sick at the moment. It wouldn’t be very good for my recovery if i did decide to drink. I could sit in a pub somewhere and read the latest edition of brag magazine. This option can get very boring fast. I would rather consume some wine in a park possibly the domain and go to the art gallery. I don’t have very much money to burn I'm on a tight budget. So it’s setteled then thats what i will do with my day. Or! i could go to the movies. That was fun last week. I want to lose myself. I could buy a very cheap bottle of wine and go to the movies. Yes! Yes! This is a good option however i’m not sure if there is any good movies on at the moment. Anything i want to see. I mean i don’t want to be stuck watching a boring film film for two hours. I know, i call the cinema and see what’s on. However if i do decide to do this i won’t have any money for cigarettes. mmmmm???? OK i have $24 to spend. Nine dollars for cigarettes, six dollars for wine, five dollars for food, ten dollars for movie. Thats equals thirty dollars. I can’t afford that but that would be i deal. lets see if i can try and break it down. Well i can cut out the food and spend a dollar less on the bottle of wine. However five dollar bottle’s of wine are coming increasingly harder to find. I’ll see how i go. Furthermore a little bottle shop is hard to find in the city. I might have to travel to Broadway or Surry Hills. Aly walk with me by the raveonettes has become my new favorite song. It would be good to listen to it whist high on LSD. Or maybe drinking Champagne and smoking a joint with Ryan and lying on my bed with candles lit and wearing my slip and he is naked. We are not talking just lying there with one another. Then we walk down alley ways in the rain wearing black trench coats. Laughing and kissing and smoking cigarettes with a bottle of champagne in our hands. We are under the influence but happy and jubilant. We are kicking up the puddles at one another and there is a spring in our step. We stop to kiss and he presses be up against a wall that it covered in ivy. It’s starting to sprinkle and he says he loves me.  That is what i day dream about a lot. I think of Ryan everyday. I wonder how often he thinks of me. That is another thought i have. I wonder wonder, wonder wonder!! I wish i could ask him. I wish i knew. i know he goes through a million girls but i just hope that i am special. I think I'm special. I think Ryan is special. I love him. Does he love me? Did he ever love me? Have i pushed my luck with him. Why can’t i stop thinking of him? Why don’t i think of Nicolas nearly as much. Am i i not pretty enough for him? am i not as ambitious as he would like? Do i say the wrong things? Where did he think it would go? Why does any of this matter?? I don’t like been infatuated with a boy! I fact i hate it. I wish i was only infatuated by myself. I wish someone was infatuated by me. Not the other way around. All for love but none for all. Winter is setting in and i feel a little depressed already. All i want is some sweet sweet candy. I never wanted anything bad. Why is it so hard to find? I  also daydream about how i want to meet someone who is exactly like me. Some who is as cute as me. Someone who likes to drink asa much as a me. Someone who i can just be myself around. Someone who understand me. Someone who understands me because they feel it too. I want it to be a girl. I want us to have sex with each other. I want us to go on adventures together. I want us to give each other constructive criticism on each others art form. I believe that there s someone out there who feels the same in every aspect. Not only someone who is searching for a friend but someone who has the same ideals as me. I want to meet a girl who wants the same candy as i do. I believe it is possible. I seek it and i’ll be on the prowl until i get what i want. Furthermore at the same time try and improve myself and my life. My situation at the moment isn’t the best one.  I don’t imagine it will be too long. I must start writing in a dream journal. Iwill create one tonight. There is a cute boy sitting across from me. I think he is with his girlfriend but i don’t think he is too into her. He looks like he would be under my spell as soon as i spoke. Like Nicolas was when we first met. 

Sincerely yours,

kiss kiss and do tell

Just bollocks Leah, start over, I beg you!

antics

I’m wearing a well fitted tux with a cream satin blouse underneath and black heels. It’s ten o’clock in the morning and  Ryan is over at my house. he is sitting in my living room.  I'm walking back from the kitchen with water and i light a cigarette. I explain to Ryan that i am running on 24 hour time and i have not slept yet. I then offer him a vodka but he declines. i then receive  a phone call from Ben he says that he is going to come over and i ask him to bring some coffee. i then ask ryan if he wants one and he says sure then i ask ben to get four coffees. i say to ryan that my friend ben is going to come over and he says cool. We sit and chat for a little while and then ben arrives with the coffees. he walks straight into my house with out knocking as if it is very familiar and he has a level of comfort where he does not feel the need. ben then asks if i have any vodka and i say yes and i go to the kitchen to get it. i just bring the bottle no glasses. ben is standing and when i come back i play hard to get with the bottle of vodka. ben and i are laughing and he starts to tickle me. I'm laughing so much that i end up on the floor and ben continues to tickle me and then stops. we appear to be on coke. he is kneeling in front of me and he takes a swig of the vodka. he then passes it to me and i take a swig as well and whilst doing so i look up at ryan and our eyes connect. then my phone rings and is my psychiatrist and she says Leah you are late for you’re appointment she then goes on the say that she is not a general practitioner  and her time is very valuable and i should of cancelled. i then say i forgot and apologize. then i say i will call back to make another appointment. then say bye. ben then says ha! you have a psychiatrist.  I'm a troubled genius in a laughing tone. we both laugh. i then crawl over to ryan and sit at his feet and rest against his legs. i then turn to face him and i lift his shirt a little and kiss his hip. i then get up to go to the bathroom and while I'm gone ben says to ryan that leah speaks of you a lot, she loves you.  

Lust Lust Lust