Alcoholism vs. Cancer: Remission and Reactions.

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.