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Abstinence – controlled drinking – normal drinking

Alcohol therapy goes “seemingly” also differently

In a Canadian study (Klingemann 2001) it was found that 78% of the affected persons overcome their alcohol problems without any help. Of these, 38-68% managed to reduce consumption to moderate drinking. Another study (Bischoff & Rumpf 2011) indicates a self healing rate of 53% but says nothing about the drinking styles achieved with it.

You can only wonder at the numbers of alcoholics changes and wonder if these people have made the changes because they were not in professional treatments. Likewise, in view of these figures, it should also be expected that the success rate in traditional addiction therapy should be at least as high, but the high relapse rates do not confirm this.

Whatever the context, these possibilities for change require that we consider alternative explanations and treatment options, as well as different target variants.

For this, it is necessary to distance ourselves critically from the traditional and dominated view and approach, as is still the case in our addiction care fund, financed by health and pension insurance, and to take other paths.

It is still the widespread notion that it is no longer possible to reconstruct alcohol dependency for those affected: “once an alcoholics, always an alcoholics!” We can not follow this paradigm!

There is still a long way to go and there is still the main therapeutic offer of addiction therapy, which requires strict abstinence. However, many patients do not venture into therapy for this reason, because they know that with the abstinence constraint the final departure from the alcohol is unavoidable. The performance never to be allowed to drink again is usually a terrible fear and melancholy with the person concerned, and they would give something else if they had the comforting prospect of at least to occasionally drink alcohol in an adequate quantity.

On the other hand, alcohol addiction creates in the long-term internally deep-rooted and isolated people who no longer want or can not believe in their own “normality”. The effects of long-term alcohol addiction can actually be described as “hellish” and prepare a victimful path of suffering for those affected and lead to undesirable dynamics with family, work and health. The path to the abstinence zone is therefore seldom actually made out of its own accord. In view of the high rate of relapse, therefore, it seems rather dubious to maintain the paradigm of abstinence as a top priority.

Despite all these remarks to abstinence, we would still like anyone who lives just abstinent want to finish this way of life. Abstinence is also certainly the healthiest way of dealing with alcohol and is fully respected by us as long as people themselves decide on their own drive and are satisfied with it, because after all, it brings the course of the alcohol sickness to a standstill.

But there are also countless people who fall with it again and again, despair of it and feel themselves sooner or later as inferior, useless and as a failure. The own self-esteem feeling goes to zero, further attempts to escape the alcohol are considered meaningless and no longer undertaken since a new failure is expected from the beginning.

And also the motto “once-alcoholics, always alcoholics!” Contributes demotively. Why should I continue to expose myself to this physical and mental agony, if from the beginning no cure is promised? It is not surprising if many people do not feel themselves to be aware of such an approach.

We think, in order to put an end to the alcohol dependency, the person concerned does not necessarily have to live abstinent, nor does he need the goal of abstinence at all. We think that for many, an actual cure is also possible in the presence of alcohol if alcoholic beverages are still allowed to be drunk in an adequate manner. This requires neither manipulative techniques nor products from the pharmaceutical industry. Rather, it requires an easy-to-use method that is based on the needs and abilities of the person concerned.

This does not mean that we reject total abstinence, on the contrary. However, we criticize the fact that it is impossible for all concerned to be “one and the same way”. In order to orient ourselves to the possibilities and abilities of those concerned and in order to create the greatest possible probability of success, we believe that facilities of the search aid should offer different therapy models at the same time.

Objective openness is certainly a modern approach that, however, we think it involves important advantages. To find the appropriate therapy model (or even a combination of such) with those affected and with the affected ones means to leave the freedom of choice to the client. This is crucial for the motivation and readiness of therapy and its subsequent course. This ultimately also benefits the therapist, who, according to modern understanding of the therapy, no longer wants to “overpopulate” his world image but wants to work with a highly motivated client. Being close to its possibilities and abilities, as well as involving the subjective reality and experience of the person concerned, means to mobilize internal forces and resources that contribute to the success or reduce the risk of failure.

Alcohol dependence essentially means that the person concerned has lost the ability to control the amount of alcohol consumed by himself over the years. This so-called “self-control” can only be re-learned, however, even if it is allowed to control itself! Parents also learn e.g. Fast, that you can teach a child to ride a bicycle when you hold the handlebars (for safety). It is only when you release the handlebars and the wheel that the child starts to gain control over the wheel – completely by itself!

Even in the face of powerful alcoholism, however, it seems impossible to control many people at first sight, because precisely the disturbed or lacking self-control is what makes the dependency so powerful. This is why most of the health insurance companies or pension insurers unfortunately only rely on therapy procedures that require external control. These include, for example, The so-called abstinence therapy (i.e., complete withdrawal of the alcohol) and also the so-called reduction therapy, in which attempts are made to slowly reduce the daily consumption of alcohol. Both types of therapy, particularly in the initial phase, require a high degree of external control (e.g., non-availability of any form of alcohol and the forced regulation of all places where it is consumed). These concepts, however, involve a considerable risk of relapse right from the moment when external control is completely eliminated. And that will be it anyway – already for cost reasons. The risk is therefore hardly manageable, because our society is now a drinking society and a self-controlled treatment of the alcohol by the person concerned could never be re-learned.

In the case of “forcible regulation” of these externally controlled forms of therapy, externally dogmatically acting but inwardly but ambivalent attitudes to the alcohol arise, because a life with alcohol would be actually preferred if the health and social situation caused by the alcohol was not so unbearable Would have been. Therefore, the alcohol must necessarily be dogmatically declared a “devil’s work”, so that the alcohol can be left out at all. It is exactly dogmatic and ambivalent attitudes, however, which easily break into one another and evoke relapse.

Self-controlled forms of therapy are rare because loss of control is the essential nature of the disease and self-control is just what needs to be learned again. The situation seems hopeless, but it is not! For there is actually, the self-controlled form of therapy: Intensiv-Therapy-Method

The form of therapy defines an individual percentage upper limit for the alcohol content of the drinks consumed. This is determined jointly, therapist and client, and is very closely aligned with the respective possibilities and abilities of the affected person.

In our opinion, this step, which has been worked out jointly by the therapist and those affected, is one of the most important steps to achieve a healthy success. For – and here comes the self-control in the game – the client may decide at any time how much he wants to consume of these alcoholic beverages. There are no requirements regarding the amount! In the medium term, however, the client’s alcohol consumption will rapidly decrease on average. After just a few weeks, daily alcohol doses can be reached under the current danger threshold of the DHS (German headquarters for addiction).

Although the first therapy success is usually quite rapid, the long-term continuation of the method and therapeutic follow-up for the duration of approximately 12 months (depending on the progress of the client) is strongly recommended, since an addiction-free life has many new opportunities, but also challenges The Depending on the wishes of the client, follow-up care may be carried out by means of telephone consultations or also by means of downstream individual sessions at longer intervals.

Intensiv-Therapy-Method is currently in a scientific evaluation phase. There is a cooperation with the Humboldt-Universität zu Berlin. For this purpose the drinking behavior is logged in the course of the method for voluntary subjects.

To support self-control, the method includes a novel addiction model, the so-called “Intoxication-entry-point”-Modell. This model assumes that there is an individual blood alcohol concentration (depending on sex, age, ethnicity, body weight, and health history) in each individual human being, from which a state of noise suddenly starts. Before this point, there is still the control over the alcohol consumption, but after the occurrence of the intoxication an increasing loss of control occurs. This specific concentration of blood alcohol is referred to in the model as a “Intoxication-entry-point”. The exit point is effective for the affected as well as the non-affected. The only difference is that those affected can no longer perceive this point, and consequently can no longer “slow down” it, even if they wanted it. Those who are not affected will notice exactly when it is concluded that they perceive this point. Affected persons, on the other hand, slip into the intoxication without any thought. They have literally forgotten the perception of the point. In addition, those affected by their unconsciously trained drinking behaviors skip the point properly. This is achieved by very fast drinking of the first alcoholic beverages or also by appropriate percentage selection. The people concerned “shoot” themselves into the intoxication!

The drinking according to the drinking conditions of Intensiv-Therapy-Method however, causes a creeping re-sensitization of the Intoxication entry point, which in a period of about one year leads to the affected person to regain this point again and regulate his drinking behavior again by himself! In the ideal case, the alcohol dependency can be completely cured in this way and the person concerned can, if he so desires, take even more cautious and moderate (!) normal alcoholic beverages.

Advantages of Intensiv-Therapy-Method:

  • Low-threshold entry (no fear of starting therapy)
  • Sustainable re-sensitization of the Intoxication entry point
  • No “trauma of eternal renunciation“
  • Alcohol is not demonized
  • Normal dealing with the (drinking) society, no exotic role
  • Significant reduction of existing drinking levels below the hazard threshold
  • Resolution of dependency

Author: Alexander Nowarra

17.02.2017

This post is also available in: German