What does AA mean by the “disease’ of Alcoholism?
In a very general way there are three parts that combine to make up the Alcoholics Anonymous “Disease Model”. These include a mental obsession, “allergy” and what is described as the phenomenon of craving. Once armed with this basic understanding an abnormal drinker can apply the concept to their own behavior. In doing so they may come to identify themselves as afflicted with the disease and once accepted can begin the process of changing. A typical example in how this process might work is as follows.
DJ exits the freeway from a grinding commute from a hateful job in cube city. The only thing on his mind is how a tall Tanqueray and Tonics (T-n-T) would feel coursing through his blood. The image of a sweat beaded glass filled with bubbles, ice and lime coupled with the camaraderie in the bar produced a smile of relief. He knew it would reset his mood. He felt the anticipatory excitement. Remembering that he doesn’t want to get wasted but wants to get home at a reasonable hour and in reasonable shape, DJ devises a plan to stay sensible. He locks his wallet in the glove compartment after taking out $20 dollars and his ID. The twenty will buy two tall T-n-T’s leaving him with enough money for a generous tip. The first drink slides right on down and he heaves a sigh of relief taking his first full breath of the day. The tensions of a stressful day melt away. He orders the second drink as a random guy next to him invites him to play a game of pool. The two get chatting and when his new friends goes to make change for the table buy’s DJ a pint of beer. They finish their game while talking about all kinds of things including the joy of sailing. They are having such an enjoyable time that DJ remembers that as a gentleman it was his obligation to buy the next round. He goes out to the car and retrieves his wallet. He withdrew $100 from the bars ATM. Buying the next round the guys resumed their game and big talk about chartering a boat to Catalina just after the Spring Break when the prices drop. Later in the evening when the bar tender called out for “Last Call”, DJ was stunned that so many hours had passed. Getting ready to leave DJ noticed his new friend found engaged with a potential sex partner and abandoned DJ with a new focus. DJ gets into his car to drive home and rolls down the window. Places his hands on 10 and 2 and keeps his focus on the landing strip of lane markers guiding him. He shakes his head and breathes the cold air remembering now why he had locked his wallet in the car earlier. He feels a cold adrenaline panic remembering his previous two DUI’s. He hits the steering wheel and shakes his head in disgust with himself. Getting home he falls into the book case struggling to get out of his clothes in order to get into bed knowing that waking for work comes in four hours.
DJ’s self-delusion, or mental obsession, is that he would be able to control the events of the night by limiting his access to cash. He believed the idea that he would be able to leave once done with his two drinks. Then the metaphorical allergy activates with the first drink and produces that “sense of ease and comfort” known to all regular drinkers. Once the allergy is activated it became less likely that DJ would remember his decision to restrict his drinking. Instead the new friend and companion gave DJ the incentive to change his mind and stay because he was having fun. Skipping over the reasons this change happens the reality is that DJ didn’t remember when he retrieved his wallet why he had locked it in the car. He just knew he was obliged to repay the kindness of his new friend by buying a round of drinks. This is what might be referred to as the phenomenon of craving where the drink was making the decisions for him. When the potential alcoholic reads this and Identifies with the lack of follow through or discipline they may come to believe the dynamic operating in their own behavior and consider how often have they “changed their mind” when they promised themselves some limit? In the chapter entitled “More About Alcoholism” from the Book Alcoholics Anonymous, the statement is consolidated into a brief sentence. “The idea that somehow, someday he will control and enjoy his drinking is the great obsession for every abnormal drinker.”