Table Of ContentUnderstanding and Counseling the Alcoholic
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Understanding and Counseling the Alcoholic by
Howard J. Clinebell, Jr.
Howard J. Clinebell, Jr. Is Professor of Pastoral Counseling at the School of Theology at Claremont, California
(1977). He is a member of the American Association of Marriage and Family Counselors, and the American
Association of Pastoral Counselors. He is a licensed marriage, child and family counselor in the State of
California. This book is the Revised and Enlarged Edition published by Abingdon Press, Nashville, 10th
Printing, 1990. Used by permission. This material ws prepared for Religion Online by Richard V. Kendall.
This book is written for the person, professional or lay, who wishes to apply religious resources
more effectively to the problem of alcoholism. It deals with what to teach concerning
alcoholism and how to handle the alcoholic who comes seeking counsel.
Part I - Understanding the Problem of
Alcoholism
Chapter 1: What Is an Alcoholic?
This chapter provides a working definition of alcoholism, then describes the types and
developmental pattern of alcoholism, the problem of the woman alcoholic, and the size and
seriousness of the problem.
Chapter 2: What Are the Causes of Alcoholism?
This chapter reviews the causative factors involved in alcoholism as they operate on three
levels: (1) Biochemical and psychological factors. (2) Availability of alcohol and its
attractiveness as determined by social attitudes, and (3) Physiological changes as well as
cultural attitudes. Alcohol provides a "pseudo-solution "to problems and anxieties. It is when
this collapses, the alcoholic turns to religious solutions.
Part II - Some Religious Approaches to
Alcoholism
Chapter 3: How Religion Has Been Used to Help Homeless Alcoholics
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Dr. Clinebell takes a practical look at the evangelistic-authoritarian approaches of the rescue
mission and the Salvation Army as they seek to help the alcoholic.
Chapter 4: The Emmanuel Movement -- Religion Plus Psychotherapy
Continuing the author's study in the psychology of applied religion, the now discontinued
Emmanuel Movement had many elements of theory and practice worth emulating. It was the
first church-sponsored psycho-religious clinic.
Chapter 5: Alcoholics Anonymous -- Our Greatest Resource
Continuing the practical orientation of the opening chapters, Dr. Clinebell describes in detail the
way in which Alcoholics Anonymous began and grew,, and how it applies the insights of
psychology and religion effectively to the sickness called alcoholism.
Chapter 6: The Psychodynamics of a Religious Approach to
Alcoholism
This chapter discusses the distinctive contribution which can be made by a religious approach to
alcoholism in contrast to a non-religious approach.
Part III: The Minister's Approach to Alcoholism
Chapter 7: The Ethical Problem in Alcoholism
A stumbling-block to many clergymen in dealing with alcoholism is the issue of the ethical
problem: sin vs. sickness; the problem of responsibility.
Chapter 8 - Laying the Groundwork for Counseling Alcoholics
This chapter covers some preliminary considerations for a minister who intends to counsel
alcoholics: his attitude, goals, preparation and resources.
Chapter 9 - The Process of Counseling with Alcoholics: Relationship
and Motivation
The counseling relationship involves the motivation and attitudes of both the counselor and the
Alcoholic. This chapter provides some specific guidance in these areas.
Chapter 10: Process of Counseling with Alcoholics Moving Toward
Recovery
Part of the process of counseling with alcoholics is helping increase their understanding of their
addictive illness. This includes help from AA, assistance from a medical expert, learning how to
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Understanding and Counseling the Alcoholic
interrupt the addictive cycle, helping the person develop a new way of life without alcohol, and
helping further his/her spiritual growth.
Chapter 11: Helping the Family of the Alcoholic
This chapter focuses on counseling the family of the alcoholic, dealing with the family crisis,
using the resources of Al-Anon, and helping the children of alcoholics.
Chapter 12 The Prevention of Alcoholism
This chapter reviews the three levels on which alcoholic sickness can be prevented by the
counselor and religious community: At the grass roots, through the influencing of symptom
selection, and through early detection and treatment.
Chapter 13 -An Alcoholism Strategy for the Congregation
This chapter discusses the role of the Religious Community in dealing with alcoholism.
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Understanding and Counseling the Alcoholic
return to religion-online
Understanding and Counseling the Alcoholic by
Howard J. Clinebell, Jr.
Part I - Understanding the Problem of Alcoholism
Howard J. Clinebell, Jr. Is Professor of Pastoral Counseling at the School of Theology at Claremont, California
(1977). He is a member of the American Association of Marriage and Family Counselors, and the American
Association of Pastoral Counselors. He is a licensed marriage, child and family counselor in the State of
California. This book is the Revised and Enlarged Edition published by Abingdon Press, Nashville, 10th
Printing, 1990. Used by permission. This material ws prepared for Religion Online by Richard V. Kendall.
Chapter 1: What Is an Alcoholic?
Have you ever known an alcoholic? Have you ever tried to help such a person? Almost everyone
reading this page can answer the first question in the affirmative. Many can do the same for the
second. For few problems are as widespread as alcoholism. Directly or indirectly, most adults
have had some experience with this perplexing sickness. It may have touched one’s immediate
family; or it may have been experienced in an employee, a fellow worker, a friend or the friend
of a friend, a distant relative, or a chance acquaintance. In a survey conducted in the state of
Washington, 72 percent of the sample population had known at least one alcoholic. 1. Of these,
40.5 percent had been related as close friends or relatives of the alcoholic they had known.
Anyone whose work brings him into intimate touch with people is painfully acquainted with the
problem of alcoholism. Ministers, physicians, psychotherapists, social workers, and others
whose work includes helping people in trouble have the problem thrust at them many times in
the course of their professional activity As I think back over my own professional experience, I
am impressed by the variety of such encounters. I think, for example, of Mr. K., who stopped
after choir practice to chat and during the conversation worked around to unburdening his soul
of the grim story of his wife’s recent spree. I think of Mrs. L., who phoned to ask if I could help
persuade her alcoholic husband to see a psychiatrist. I think of Bill, a member of the youth
group, who came to tell of the trouble his family had been having with an alcoholic uncle who,
though abstinent in AA, continued to be difficult to live with. I think of Joe, a promising young
man of twenty-nine, who saw that his drinking was out of hand and, in desperation appealed for
help. I think of Mr. B., a respectably dressed stranger who came to the parsonage door with a
convincing story about needing a loan to redeem his tools which he had been forced to pawn
during a prolonged illness. On investigation, his story proved to be a clever alcoholic ruse. I
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Understanding and Counseling the Alcoholic
think of Mr. P., a business executive and church member, who after many years of periodic
binges had been happily sober in AA for three years. I think of Mr. L., talented artist and
frequent patron of the city hospital’s alcoholic ward, who could not admit that he had an
alcoholic problem. I think of Mac, a member of another religious faith, who used to knock on
my door every few weeks, asking for a "loan." (I had made the mistake of following the course
of least resistance and had given him a small sum on the first occasion.) Each time Mac came, he
looked more like death -- a condition toward which he was slipping with tragic alacrity. I think
of Bert, a young man from a disturbed home, who consistently arrived at senior youth meetings
with alcohol on his breath. I think of Mrs. R., a parishioner whom I felt sure was having serious
trouble with alcohol, but who was expert on hiding the fact from everyone including herself.
Any clergyman, physician, or social worker could duplicate and double this list.
As I write, I think of these and others who have crossed my path bearing an alcoholic cross. I
think of the times I have felt completely helpless in the face of this problem -- the times I have
failed -- the feelings of frustration that have accompanied the failures. I also recall the
satisfaction that has attended the experiences in which I have been able to make even a meager
contribution toward bettering a tragic situation.
Few problems have been so baffling in nature as alcoholism. Until recent years, little has been
known about either the causes or cures of alcoholism. Much of what had been written had been
of a propagandistic nature with only a flimsy foundation of objective facts. Many of the so-
called cures were relatively ineffective. In some cases they were outright deceptions involving
despicable exploitation of human misery. An atmosphere of hopelessness has clung to the
problem. For many, it still clings. In the Washington state survey mentioned above, 53.3 percent
of the sample population had never known an alcoholic who had recovered.
Alcoholism is still a baffling problem, but developments in recent years have brought the
dawning of a new hope. A dozen or more scientific disciplines have focused their research eyes
on the problem, bringing new understanding. Most important of all, from the standpoint of the
alcoholic and his family, is the hope engendered by the wonderful success of AA.
There is no area of human suffering in which religion has given a more convincing
demonstration of its therapeutic power than in the problem of alcoholism. For a long time it has
been recognized that religion has tremendous resources for dealing with the problem. In his
classic sermons on intemperance 2 published in 1827, Lyman Beecher made it clear that some
sort of religious experience was the best hope for the alcoholic. Even those who had no
professional interest in religion often shared this view. Around 1930 the director of a large
chemical company in America sought help for hi alcoholism from the famous Swiss
psychoanalyst Carl Gustav Jung. Dr. Jung went over his case very carefully and then told him
that nothing but a religious conversion could give him any lasting help. The man returned to
America where he received help in the Oxford Group Movement. Interestingly enough, he later
became one of the "pre-founders" of an amazing group that has given us the most convincing
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evidence of the therapeutic effectiveness of religion -- Alcoholics Anonymous. This group has
reclaimed from the scrap heap of society more than 375,000 "hopeless" alcoholics.
Our task in this volume will be to explore the ways in which religious resources may be used
with greatest effectiveness in dealing with alcoholism. By implication, we may throw some light
on religion as a resource for dealing with other human problems.
Recognizing the Problem
Whatever the problem, effective treatment depends on accurate recognition and diagnosis. For
this reason the first concern of those who would help alcoholics is to recognize and understand
the problem. Some time ago I attended a dinner and was seated beside a guest who plied me with
questions concerning alcoholism. During the conversation she raised this problem; "I am
concerned about a friend who seems to me to be drinking too much. How can I tell whether or
not he is an alcoholic?" In answering her query I pointed out that it is often difficult or even
impossible to be absolutely certain that a given person is afflicted with the alcoholic sickness,
but that there is a useful rule of thumb which often gives one a valid clue. Put in the form of a
question, it is this: Does the person’s drinking frequently or continuously interfere with his social
relations, his role in the family, his job, his finances, or his health? If so, the chances are that that
person is an alcoholic or on the verge of becoming one.
This simple test question can be rephrased as a useful definition of what is meant by the term
"alcoholic" in this book. An alcoholic is anyone whose drinking interferes frequently or
continuously with any of his important life adjustments and interpersonal relationships.
This definition points to the essential nature of alcoholic drinking which distinguishes it from
other kinds of drinking behavior. If a drinker who is not an alcoholic finds that his drinking is
interfering with his work, for instance, he will reduce his consumption. In contrast, the alcoholic
will usually not even recognize the causal relation between his drinking and his job trouble;
rather he will project the blame for his trouble on others. He cannot recognize the real cause of
his difficulty because alcohol is very important to him. To recognize it as the offender would
threaten the center around which he has organized his life. Even if he suspects that alcohol is a
cause of his trouble,
he will not be able to reduce his consumption for any extended period. This is because his
drinking is gradually becoming compulsive. He is driven by forces beyond his rational control.
For reasons not completely known, he is losing the power of choice when alcohol is involved.
The old phrase "driven to drink" can be accurately applied to him. He is driven by powerful
forces within himself. Once he begins to drink, he usually will not be able to stop until he is
"broke," unconscious, or until his digestive system revolts and refuses to take any more alcohol.
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Understanding and Counseling the Alcoholic
An alcoholic, then, is a person for whom one drink frequently touches off a chain reaction
leading to drinking that is excessive in the sense that it hampers his interpersonal life. It should
be noted that some alcoholics are able to control their drinking for a considerable period before it
results in a binge.
There are other indications which may be useful in recognizing incipient alcoholism. Anyone
who uses alcohol as a persistent means of interpersonal adjustment -- who drinks regularly to
allow himself to be more aggressive in his work or less shy at social functions -- is in danger. He
may be near the intangible line that separates non-pathological from compulsive drinking.
Again, anyone whose drinking behavior is in defiance of the standards of the group from which
he derives his sense of belonging is suspect, so far as alcoholism is concerned. Sneaking drinks
and drinking alone are two examples of such defiance. The fact that alcohol is more important to
him than it should be is shown by the fact that he is willing to risk rejection by his in-group in
order to satisfy his drinking demands.
Frequent drunkenness would seem to be the most obvious indication of alcoholism. A word of
caution is in order. All alcoholism is attended by drunkenness, but not all drunkenness is
indicative of alcoholism. Alcoholism and drunkenness are not synonymous. For example, what
has been called "rough recreational drinking" was much more common during frontier days than
today. Almost every weekend "the boys" would assemble to get and stay roaring drunk. This
was the accepted social pattern among some frontier groups, and although there was a great deal
of this kind of drunkenness, there was probably less alcoholism than there is today. This is not to
suggest rough recreational drinking as a solution to alcoholism, but simply to show that
drunkenness is not always a symptom of alcoholism. It is indicative of alcoholism when it
interferes with interpersonal functioning, or is in defiance of the drinking mores of one’s group.
Either of these indicates that the drinking is to a degree compulsive. Obviously a person who has
a susceptibility to alcoholism will be more apt to become afflicted in a social group that
encourages heavy drinking and drunkenness.
It is wise to remember that the alcoholic himself is often the last person to recognize that his
drinking is a problem. And yet, those who specialize in helping people are sometimes asked to
suggest aids to self-recognition of alcoholism. The literature of AA suggests:
We do not like to pronounce any individual an alcoholic, but you can quickly diagnose yourself.
Step over to the nearest barroom and try some controlled drinking. Try to drink and stop
abruptly. Try it more than once. It will not take long for you to decide, if you are honest with
yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your
condition. 3.
The point of this experiment is that an alcoholic usually cannot control his drinking for more
than a few successive occasions. (For this experiment to be reasonably conclusive, the person
should be able to stop after one or two drinks for at least a month.)
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The late Robert V. Scliger, a psychiatrist who worked extensively with alcoholics, offered this
checklist:
ARE YOU AN ALCOHOLIC?
To answer this question, ask yourself the following questions and answer them as honestly as
you can.
1. Do you lose time from work due to drinking?
2. Is drinking making your home life unhappy?
3. Do you drink because you are shy with other people?
4. Is drinking affecting your reputation?
5. Have you ever felt remorse after drinking?
6. Have you gotten into financial difficulties as a result of drinking?
7. Do you turn to lower companions and an inferior environment when drinking?
8. Does your drinking make you careless of your family’s welfare?
9. Has your ambition decreased since drinking?
10. Do you crave a drink at a definite time daily?
11. Do you want a drink the next morning?
12. Does drinking cause you to have difficulty sleeping?
13. Has your efficiency decreased since drinking?
14. Is drinking jeopardizing your job or business?
15. Do you drink to escape from worries or troubles?
16. Do you drink alone?
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17. Have you ever had a complete loss of memory as a result of drinking?
18. Has your physician ever treated you for drinking?
19. Do you drink to build up your self-confidence?
20. Have you ever been to a hospital or institution on account of drinking?" 4.
"Yes" answers to even a few questions such as these constitute a warning that trouble may be
ahead. There are two weaknesses to any scheme of self-recognition such as this. For one thing
the alcoholic is often a master in self-deception and, as such, he does not recognize alcohol as
the cause of the troubles listed. For another, the alcoholic may use such a list in a negative
fashion. For example, I remember a woman who had had a serious alcoholic problem for years
but who rationalized that she was not an alcoholic because she never drank in the morning.
Types of Alcoholics
One important reason why alcoholism is frequently difficult to recognize is that every case is
different. There is a baffling variety of types and degrees of the disorder, so that if one uses any
generalization as an infallible touchstone, he will be led astray in dealing with individuals. Some
sample case histories taken from the author’s files will highlight this point. Names and other
identifying data have been altered to preserve anonymity; the essentials, however, are
unchanged.
Sidney L. was born in a mid-western city forty-seven years ago. His father was mean-tempered
and harshly authoritarian. His mother died when Sidney was sixteen. He left school in the
seventh grade and worked at a series of unskilled jobs. He began drinking at fourteen; his
drinking was abnormal from the beginning. He began to drink in the mornings when he was
twenty-three. In a few years he had become the neighborhood drunk and was spending a
substantial share of his time "on the bum" living on Skid Rows around the country. At thirty he
was sent to a state hospital for his alcoholism. Between then and forty-three he was in the state
hospital eleven times. Between hospitalizations he lived in Salvation Army homes, missions, and
public parks. He drank whatever was available, including rubbing alcohol and "smoke" (wood
alcohol). He deteriorated physically, mentally, and morally. He suffered alcoholic hallucinations.
At forty-three he was pronounced "a hopeless chronic alcoholic -- a menace to himself and
society." He says, "I was living the life of oblivion. I had to beg to live. I was as helpless as a
one-year-old baby." He wanted to die but did not have the nerve to take his own life.
Alcoholics of Sidney’s type can be recognized readily from their grossly asocial behavior. The
Skid Row alcoholic who becomes open to help is sometimes called a "low-bottom" alcoholic,
indicating that he has reached a low point of social disintegration.
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Description:Understanding and Counseling the Alcoholic by. Howard J. Clinebell, Jr. Howard J. Clinebell, Jr. Is Professor of Pastoral Counseling at the School of
