Word: vaillants
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Dates: during 1980-1989
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...high number of children of alcoholics who become addicted, Vaillant believes, is due less to biological factors than to poor role models. Being raised in a warm, close-knit family does not lessen a child's chances of becoming an alcoholic, nor does coming from a family with many problems increase the risk. Vaillant is reluctant to make predictions about behavior, but believes that the best sign that a child may not develop into an alcoholic as an adult is an "ineffable" quality-ego strength-that seems to come from experiencing a sense of competence when the person...
...hottest argument among experts on alcoholism these days is over whether an alcoholic can ever again return to social drinking without inevitably suffering a relapse. Vaillant, who constantly repeats that alcoholism is a problem that can be described only in grays, not in black or white, says that it all depends on how sick the alcoholic is: "If you have a little bit of alcoholism, as if you have a little bit of diabetes, you can control it." But Vaillant warns, "By the time a clinician identifies a person as an alcoholic, it's almost always too late...
...immediate, desperate question for millions of Americans is neither why nor how a person becomes an alcoholic, but how to treat the affliction. The first step, writes Vaillant, is recognizing that alcoholism is "neither a psychological symptom nor some vague unnamed metabolic riddle waiting to be deciphered." It is not a sin, but a progressive disease that may take years to acquire, and from which it may take years to recover. Writes Vaillant: "The task is to convince the patient not that he or she is an alcoholic, but that he or she is a decent person...
...Some of Vaillant's most important, and controversial, conclusions about treating an alcoholic came as a surprise even to the author. Traditional psychiatric approaches may be helpful for treating accompanying symptoms, such as despair, paranoia or anxiety, he believes, but they are nearly useless in dealing with the underlying nature of alcoholism itself. In his book, he ruefully describes his own disillusionment with his profession's ability to cope with the disease. "I was working for the most exciting alcohol program in the world," he says. But the results at the clinic were no better than...
Other professionals agree with Vaillant's glum assessment. "We don't do anything adequately," admits Dr. Robert Millman, director of the Alcohol and Drug Abuse Service at Payne Whitney Psychiatric Clinic in New York City. Explains Dr. Blume of the N.C.A., who is a psychiatrist: "Psychiatrists have been trained that alcoholism is a problem which comes from early-childhood experiences, but aren't taught how to treat alcoholics. They go after these 'underlying causes,' treatment doesn't work, the alcoholic gets worse and the psychiatrist decides that the disease is intractable...