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Alcoholism vs. Cancer: Remission and Reactions.

10 June 2014

There was some discussion last night on twitter about talking to kids about alcoholism and discussing how the disease has impacted families. I wasn’t especially involved in the conversation, and didn’t follow all of it. But I have discovered that alcoholism and addiction have not missed the twitter science community. They don’t miss any community. In part because so many people are susceptible to addictions. In part because one alcoholic, one addict, impacts so very many people.

I feel like I want to announce, I am available to talk to people about alcoholism! Is that ego? Do I have something worth saying? Would being an alcoholic in recovery willing to speak openly about what it is like to be an alcoholic in recovery mean anything to people? There are a lot of things we talk about in AA meetings that make us laugh but which are really not funny to other people. Crimes we commit. Horrors we see and do. Should those things be presented in other contexts? Should I mock-up a faux-grave mournful and contrite attitude? I don’t know.

But one question that got asked that I found interesting was again about how alcohol is different from cancer. I wrote once about it here, but this time the question is different. As @tehbride says in the comments on that post, people continue to view alcoholism differently from other diseases even when the sufferer is in remission. People view cancer survivors as heroic battlers who overcame a terminal illness, but we often continue to see alcoholics in recovery as teetering on the edge of relapse, weak-willed and suspect.

I know nothing about cancer. I’ve never had it. I’ve only had one person close to me be diagnosed, and her outcome was never in doubt from the moment of her diagnosis. While there’s doubt about how much a positive attitude influences outcomes in cancer patients, praising people for courage and commitment during the grueling process of cancer treatment seems fair and reasonable to me.  Going through potentially-fatal ordeals and coming out the other side with one’s psyche intact is impressive.

But alcoholism is different. And in this case, it’s different for a couple of important reasons. At the core, alcoholism is different because of its behavioral component. Both the disease and the treatment (at least naively) are behavioral: we drink alcohol and we get drunk; we stop drinking alcohol and we stop getting drunk. Anyone who’s read this blog long, or has any alcoholic in recovery in their life, knows that it’s more complicated than that, but at the coarsest level, that’s true.

Alcoholism is different because we don’t beat alcoholism. People beat cancer. Physicians and surgeons beat cancer. Pharmacists beat cancer. They do it all the time. I didn’t beat alcoholism. I still have it. I’m not in control of it. I haven’t defeated it. Alcoholism beat me. I lost. We don’t fight alcohol, or we lose. We have to give up, and surrender. If I were fighting alcoholism, I’d be drinking. It is through surrendering to my disease that I have found a way into remission. I am an alcoholic. I no longer have to drink.

But I have found that many people, especially those who have been present for most of my journey, do, in fact, praise me and my efforts. I don’t want to deny that recovery from alcoholism is a lot of work. I’ve worked like hell at it. But it is still not to my own credit. There’s no victory here. There is simply maintenance. Sometimes I’m vaguely uncomfortable with praise. Sometimes I really love it and want more. I have a complicated relationship with recognition.

When a cancer patient enters remission, we seem to tell them, “Go! Be free and happy and love life and live to the fullest!” When an alcoholic enters remission, we seem to tell them, “Glad to see you’re doing better. Do you really think you can never drink again? Are you cured now? Do you miss it? How long do you have to go to those AA classes?” Or the worst, the deeply condescending, “Good for you!” the way you’d praise a toddler for shitting in a plastic bowl. I’ve only ever gotten that from social work students. I wanted to tell them to quit their studies, immediately.

And you know, I’d usually rather have the questions than people telling me that I bravely battled a terminal illness and won. Because my disease has gone nowhere. It is patient and cunning. And thinking I’ve defeated it is the first step back towards active alcoholism.

So, how should you treat the alcoholic in your life who has found recovery? However it feels right to you. We don’t, in general, try to dictate how other people react to us. Trying to dictate how other people behave leads us to resentment. And resentment is fatal to alcoholics. But it’s ok to be suspicious of an alcoholic in early sobriety: we’ve probably been lying to you for years and years. It takes time for us recover our sense of honesty and our ability to see the harms we’ve done.

Once time has gone by, if we’re putting our lives back together and addressing the damage we’ve done? You still don’t have to forgive us. You don’t have to accept us back. But if you want to, and if you can? Then treat us as you would anyone else. And feel free to ask the questions. Most of use will be happy to share our experience, strength, and hope.

6 Comments leave one →
  1. 10 June 2014 08:07

    To be honest, I WANT you to speak out to nonAA audiences about what being an Alcoholic means. All of us that aren’t have to make huge assumptions about alcoholics that are based on prejudice and guessing.

    I also would not shy from stories the way they are given in AA. It shocks people, but is necessary.

    I listen to you for the same reason I listen to autistics-I want to know more but have to be taught.

  2. 10 June 2014 08:17

    Well said.
    I have spoken to people and a range in different scenarios. Teenagers at a youth club who of course sniggered when we started
    School talks to 13/14 year olds where really we just plant a seed.
    To staff at a couple of companies where cynically there’d been a drink related cost to the business and they simply were looking for a cheap way to say to their insurers and others they were doing something.
    To doctors in training… some of the worst! 20 year olds who think they know it all some of those exchanges have been frankly brutally frank

    I’m happy to stand up – it isn’t ego normally I’m just Furtheron Alcoholic at these, what matters is that others hear about different experiences that brought people to AA and what happened from there forward. You my friend would be a great advocate

  3. Ola permalink
    10 June 2014 08:30

    If you’re open to questions then I have one regarding AA and religion. I’m a hard line atheist. As a scientist I just cannot figure how anyone can both look at the world objectively through scientific eyes, and then also believe in magic sky fairies during the off hours. Science and religion are irreconcilable. They address totally different things, and it is misleading and naive to reduce the argument to “they’re just alternate ways of looking at the universe”.

    So, what religion-free alternatives to AA exist? There are certainly people out there (perhaps myself included) who may need some kind of help, but when that help comes with all the Jesus mumbo-jumbo baggage that AA brings, it’s a total non-starter. The typical response upon asking this question in the past, is an attempt by the AA adherents at conversion… all you need to do is let God into your life. Demeaning and naive.

    There HAS to be a social structure for individuals to get help without having to accept the existence of a magic sky fairy riding a unicorn that shits rainbow farts. In the same way that social structures such as “Sunday Assembly” are emerging to replace traditional churches with humanist gatherings, it would seem there’s a need for a humanist version of AA. Any 10 step program where one of the steps requires throwing your fundamental beliefs out the window in favor of a badly written middle-eastern work of fiction, is a frickin’ joke.

    • 10 June 2014 08:39

      Hi Ola, Thanks for the question. To answer, I know plenty of atheists in AA. Yes, you’d have to become comfortable with the language and the fact that there are many spiritual people around. But I have never seen anyone attempt to force another person to accept their own concept of a god. Sometimes you’ll hear people say something along the lines of “you need to get right with god”.

      You also hear: “Take what you need and leave the rest.” And I hope you know that AA is not Christian, and makes no reference to any specific god.(one criticism AA gets from the Christian community is that it is pagan!) We talk about “the god of your understanding”, but we are allowed to take it however we choose. Many people have non-supernatural higher power concepts. One you hear regularly is people talking about “Good Orderly Direction” instead of god. Or using the collective wisdom of the group and people who have been sober for generations now.

      There are even AA meetings in some cities specifically for atheists! But there are also humanist alternatives. I have not found any of them compelling.

      All this said: AA is not for everyone. It works for who it works for, which is those people willing to work the program. The program isn’t perfect, and it is simply suggested as a program of recovery. No one requires you to adhere to it – no one has any authority! And we’re very fond of saying, the only step you have to do perfectly is Step 1. No mention of god there.

  4. tehbride permalink
    10 June 2014 08:31

    Thanks dr24. That helps me get it. Yeah, that is different in important ways.

  5. Syd permalink
    10 June 2014 15:58

    Religion is one of the obstacles to success in Al-Anon, along with gossip and dominance. I think that there are plenty of meeting where it is understood that a person has a Higher Power, whatever that may be–for some it is the group, a sponsor, nature, etc. I thought that I was my wife’s Higher Power and that was a superb failure.

    I see so many successes in the rooms of AA and Al-Anon–people who were hopelessly lost and have found themselves. I am glad that you are part of the solution by sharing your E, S, and H here.

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