Under the Influence: A Guide to the Myths and Realities of Alcoholism
by James Robert Milam, Katherine Ketcham

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Book Reviews of Under the Influence: A Guide to the Myths and Realities of Alcoholism

Book Review: A trail-blazing classic of informative literature
Summary: 5 Stars

I can say this because both my mother and father were alcoholics, and I know the only thing that kept me from joining them was the fact that I couldn't stand the headaches and nausea that came with "overindulgence." I apparently inherited the physiologic trait common to, e.g., Italian, Jewish and Asian peoples (there's a chart on p. 45 showing susceptibility by ethnicity) protecting me from alcoholism. It wasn't due to any superior morality or advanced character development on my part that I avoided the horror of alcoholism. It's more like having black skin that protects against skin cancer. Is black skin morally superior to white skin? Or, are sickle blood cells evidence of an elevated will to resist malaria? I don't think so. Thanks to this book I can see that I was lucky: I am not an alcoholic because my internal chemistry is not disrupted by alcohol as it is with alcoholics. That's it. Pure and simple.

Unfortunately many people, including--as this book points out--doctors, psychiatrists, members of the clergy, government officials and others in a position to help or hinder, still think of alcoholism in moralist and psychological terms. As Milan and Ketcham make clear this ignorant and prejudiced attitude not only doesn't help the alcoholic and his long-suffering family, it hinders treatment. The authors are vehement on this point. On page 195, for example, they write (citing Joseph Pursch): "...physician ignorance about alcoholism and prejudice toward alcoholics are the major obstacles to effective treatment." Strong words indeed, but not surprising. Most doctors were too busy in medical school to get an education, and too busy with patients (and I must say, climbing up the hill of worldly success) afterwards to catch up. This includes psychiatrists. As the authors point out these "professionals" routinely prescribed tranquilizers and other drugs pharmacologically similar to alcohol to alcoholics, drugs to which alcoholics have a cross-tolerance, a situation that not only led to a double addiction, but was, in some cases, life-threatening.

Professionals who offer counseling and psychotherapy to alcoholics are also taken to task by the authors: "Psychotherapy diverts attention from the physical causes of the disease, compounds the alcoholic's guilt and shame, and aggravates rather than alleviates his problems" (p. 14). "A[lcoholics] A[nonymous] members are all too aware of the condescension and judgmental attitudes about alcoholism which pervade the conventional health agencies. They have been drugged with tranquilizers and sedatives, have spent expensive and fruitless years in psychotherapy, and have endured indifferent and even hostile professional attitudes toward them and their disease" (p. 132).

So-called moral leaders of public opinion are also rightly chastised for their ignorance and lofty (and phony) moral tone. Ex-California Congressman Robert K. Dornan, who is quoted as seeing alcoholism as "an absence of self-discipline," and columnist Jack Anderson, who sees alcoholism as "a personal problem" are examples cited on page 7, although if the authors had wanted to, they could have filled volumes with such inanities. Government agencies are also in the thick of the stupidity. Particularly interesting (and telling) is this bit of sly of hand reported on pages 187-188: In the government-funded Rand Report of 1976 the term "recovery" was replaced with the broader term "remission" so that it would appear that some alcoholics were in "remission" although they were still swilling down something less than three ounces of pure alcohol per day. (Three ounces of alcohol is about what you'd get in 21 ounces of table wine or more than four cans of beer!) This allowed "treatment centers which embraced this definition of remission to claim up to 80 percent success rates--even though most of the alcoholics so labeled were still drinking."

Even Alcoholics Anonymous which the authors acknowledge several times as the best recovery program in existence, could use some updating based on the reality of the disease nature of alcoholism. Step four, for example, of the12-step program ("Made a searching and fearless moral inventory") could be modified to refer to the alcoholic's conduct AFTER detoxification and the recovery process. That way a clear distinction is made between behavior caused by alcoholism and behavior over which the alcoholic now has control.

One question: Now that the new millennium is upon us, have things gotten any better? Have the medical and counseling professions gotten the word on the true nature of alcoholism, and is the disease being treated as a disease? Not being in the field, I don't know; but I suspect that Katherine Ketcham's new book (which I am going to read next) Beyond the Influence: Understanding and Defeating Alcoholism (2000) will provide the answer.

Summary of Under the Influence: A Guide to the Myths and Realities of Alcoholism

Alcoholism Books

• Subjects > Health, Fitness & Dieting > Recovery > Alcoholism
• Religion & Spirituality > New Age
• Occult