Monday, August 18, 2008

Types of Alcoholism

The term "alcoholic" has been used frequently in contemporary culture. Often the label itself may carry a certain "shock value", which, I suppose, could lead to a recently-labelled "alcoholic" contemplating more seriously a reduction in alcohol use. I always worry about labels, though, because I don't like the idea of being or sounding judgmental or critical (there is enough judgment and criticism in the world today, and in psychiatric illness a lot of extra judgment and criticism comes from one's own mind). Yet I do believe in the value of attempting to fearlessly speak the truth about things, even if they are truths that we don't necessarily want to hear.

Each person who has a drinking problem may have unique factors that have contributed.

Some researchers have categorized "alcoholism" into two types. Type I alcoholics may use alcohol as an attempt to treat anxiety, and are less likely to associate alcohol with thrill-seeking or fighting. Type II alcoholics may use alcohol spontaneously for thrill-seeking, and are more likely to have had alcohol-related problems with fighting, etc.

In my opinion, there is some support for subtyping alcoholism this way, but of course I think there is a much wider range of contributing or causative factors. I can think of some people who started out with a "type II" pattern as a teenager, but ended up in a "type I" pattern later on. Others may have a sort of mixture of "type I" and "type II" characteristics. For both subtypes there is probably a robust hereditary predisposition, some of the predisposing factors being direct (i.e. a predisposition to use alcohol excessively when available or a predisposition to react to alcohol in a certain way), and some of the predisposing factors being indirect (i.e. anxiety for type I, high thrill-seeking for type II).

Type I is more common, and is probably easier to treat, I think because there are underlying issues and needs that can be met in other healthier ways (e.g. treating anxiety, building healthier relationships, engaging in psychotherapy). Type II can be more challenging to treat, particularly because those with this type may be less likely to want treatment or change.

Here's another useful link with info about alcohol and addictions, from the Centre for Addiction and Mental Health:

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