Motivation Conflicts of the Alcohol Addict

Publisher Website
Google Scholar
Abstract
A high intake of alcohol does not in itself constitute alcoholism. When, however, intake is qualified by "excessive" or other words with similar connotation, a judgement has been made is based on qualitative as well as quantitative observations. Excess is equated with alcoholism and the drinker is prompted to moderate his drinking. For the alcohol addict this is impossible since any drinking leads to excessive drinking. Even though the addict may drink for pleasure, each drinking bout ends in pain and displeasure. At this point drinking takes on an aversive quality since it is associated with pain. Abstinence ensues when the pain is stronger than the pleasure. Drinking is paired with pain and this pairing must be reinforced in order to sustain the need for abstinence. But abstinence in itself tends to prevent such a reinforcement and the aversive response is extinguished. Drinking can now be resumed since the contemplated pleasure outweighs the pain, at least for a time. Binges, abstinent interludes and periods of moderate drinking thus represent stages in the alcoholic''s cyclic response to conflicting motivation. Various treatment modalities-Alcoholics Anonymous, conditioned aversion, alcohol-reaction causing drugs and psychotherapy-are examined in terms of this theoretical formulation. It is concluded that any treatment program which depends for its success on the maintenance of abstinence must provide some method which reinforces the need for abstinence.