Doug has been a longtime supporter of this substack.
He commented on my Alcohol stack, which piqued my curiosity which led me to discover he had written several books on Alcoholism. He is a subject matter expert.
I grew up around alcohol, lots of it, so I invited Doug to an interview.
As you will see, he has put a tremendous effort into the response, for which I’m very grateful.
There is plenty to learn and reflect on here.
With thanks to Doug Thorburn.
1. Could you briefly explain how your personal experiences led you to become an expert in the field of alcoholism and addiction?
Great question.
To understand how my personal experiences influenced my journey, one must understand my Psychological Type. I am an INTJ (Introverted iNtuitive Thinking Judger). The NT Temperament, which comprises four Types including the INTJ, is driven by an insatiable curiosity and need to acquire knowledge, wisdom, and competencies. INTJs are “outside the box” thinkers and scientists at heart. We ask questions others do not and excel at connecting dots between seemingly disparate topics. We integrate ideas with ease, and we are superb at pattern recognition.
That does not mean we readily connect dots when young, however, especially when growing up in a dysfunctional family.
My father was an alcoholic. Behaviours emanating from his substance addiction were relatively benign. He yelled and even screamed on occasion and was unreasonable at times. But he loved his family, even if we were second to the drug (as is true for every family of a psychoactive drug addict). Growing up, I did not understand that, despite my father’s relatively mild misbehaviours, our family was dysfunctional. Nor did I link the dysfunction to his heavy drinking.
Much later I learned that all children of alcoholics feel abandoned in different ways, as a function of their Type. As an INTJ, I felt intellectually abandoned; my Feeler sister (an NF, another of the four Temperaments) felt emotionally abandoned. Dad’s mild misbehaviours helped me to understand that alcoholism takes countless forms, from the benign to the horrific, with one common thread that we’ll get to.
I was in the throes of divorce in my early 40s when I got involved with a woman who feigned recovery. I was naively unconcerned over this and did not realize, as often as she told me she hated lies, that she was lying about this and much more. I was concerned that, although highly intelligent, she acted somewhat crazy and irrational between moments of extraordinary lucidity, deep discussions, excitement, and fun. It was a tumultuous relationship for which I sought counselling. She used the sessions to blame me for all our problems which, I later learned, is typical behaviour addicts engage in.
Neither of the two therapists we counselled over two years ever suggested the possibility she was not sober. Early in my research I realized this was evidence that few therapists, unless they are chemical dependency experts, understand the fundamentals of addiction.
I never smelled booze on her—addicts know how to hide the smell. She added vodka to her morning coffee and covered up the odour with perfume and mouthwash. Recovering alcoholics admit they are the world’s greatest liars. Indeed. I finally figured out she was lying about her sobriety, as addicts do when threatened with the loss of the enabler(s) and their perceived “right” to drink. I told her if she wanted to continue our relationship, she had to attend Alcoholics Anonymous meetings and that I would go with her to ensure her attendance. Little did I know at the time that going with her to meetings would not change her behaviour, so long as there was at least one enabler in her life.
At AA, I heard stories of benign to horrific misbehaviours in recovering alcoholics’ past lives. While the ex-fiancée quickly stopped attending, I kept going. I was learning that addicts could often be identified from non-drinking behaviours alone. I realized I could use such knowledge to protect myself from addicts, both personally and professionally.
I began reading the great books on alcoholism, looking for one on misbehaviours as a clue to addiction. I found only one writer who wrote about alcoholics and their misbehaviours as an indication of addiction, James Graham, in The Secret History of Alcoholism. His main career, like mine, was not in the field of addiction. He linked alcoholism mostly to vile behaviours, along with a few relatively benign ones. But I was finding many important and common misbehaviours he did not address. Crucially, also, he did not discuss behaviours that can be linked to psychoactive drugs other than alcohol.
I realized that my perspective, made possible by my unique personality type and thinking, might allow me to add something of value to his body of work. I knew the odds that others of the same Type going through what I did were remote. I slowly realized that, despite the fact I was not a recovering addict, psychologist or psychiatrist, if I did not write a book on behavioural indications of alcohol and other-drug addiction, especially the very early stages, it might never get written. A few years later my first book, Drunks, Drugs & Debits: How to Recognize Addicts and Avoid Financial Abuse, was published.
2. In your books, you often discuss the early stages of alcoholism. Can you describe some key signs that indicate someone might be in this early stage?
Early in my journey I realized the commonly accepted definition of alcoholism, “a loss of control over use,” was grossly deficient. Loss of control over use is a late-stage symptom. I asked, what does it look like in the early stages? It appears as destructive behaviours, especially directed at others.
Vernon Johnson’s I’ll Quit Tomorrow describes distortions of perception and memory, which every alcoholic experiences to one degree or another. One of two key distortions, “euphoric recall,” causes the alcoholic to view everything he or she says and does through self-favouring lenses. James Graham reported that alcoholics have hugely inflated egos, an inordinately large sense of self-importance. I integrated the two ideas: if everything one says or does is good and right and nothing bad or wrong, one must see themselves as Godlike. Euphoric recall, then, results in egomania.
Egomania, in turn, gives the addict the perceived right to control others. Since one way to control is through abuse, early signs of alcoholism manifest as psychological, financial, and/or physical abuse. Alcoholics control their victims mostly through emotional and verbal abuse. While alcoholism usually does not escalate to physical abuse such as domestic violence, rape, and murder, these crimes are nearly always perpetrated by alcohol/other-drug addicts. Therein lies the seeming mystery of 17 to 34-year-old violent criminals, who are nearly always early stage psychoactive drug addicts.
Sometimes, addicts engage in financial abuse of others. As an Enrolled Agent tax professional I find that the root cause of financial injury—uncollectible debt, a child stealing the parents’ money (most often when nearing death), a stockbroker churning an account, the perpetrator of a Ponzi scheme or grifter—is invariably a psychoactive drug addict. I have proven alcoholism in many of the great con artists in history, including Charles Ponzi and, I think, Bernie Madoff. I can prove it in at least half of instances of well-publicized tax fraud, both public and those of which I am personally aware; after all, who other than an egomaniac would think they are more powerful than the U.S. government? “Half” doesn’t seem that outlandish until we realize that’s 500% more than the 10% of the U.S. population afflicted with alcoholism. While that may seem crazy, I bet I’d prove it’s 80% if I were able to dig deep enough into the lives of con artists and tax cheats.
Relatively mundane examples of early-stage alcohol/other-drug addiction include cutting in line at the grocery store or on the road at an exit, to back-stabbing at work, to stealing from an employer. If an employer is flouting the law or abusing employees, or a tenant is abusing a landlord (and vice-versa), there is nearly always an addict involved. But misbehaviours in early stage addicts can get much worse. Almost 100% of domestic violence and animal abuse is committed by alcohol or other psychoactive drug addicts. Many recovering addict felons have told me 100% of their fellow felons are psychoactive drug addicts; I would argue it’s likely 90%. I am hard pressed to find a murderer or despot who is not one, especially of the serial or mass murdering kind. Ted Bundy, John Wayne Gacy and Jeffrey Dahmer were alcoholics. Josef Stalin and the Kim’s of North Korea were/are alcoholics; Adolf Hitler was on amphetamines, and Mao Zedong was a barbiturate addict.
The key signs of early-stage alcohol or other-drug addiction, then, is abuse of others, from the relatively benign to monstrous. These behaviours manifest long before the late stages, when the addict is mostly interested in simply getting their fix.
3. How does alcoholism in its early stages differ from the more commonly understood latter stages of the disease?
Early-to middle-stage alcoholics are functional. An estimated 95% of alcoholics function well for nearly all of their drinking careers, especially if they are not using other drugs. I have rarely identified a likely alcoholic based on the common late-stage symptom of “loss of control over use” because we are rarely privy to those symptoms. Alcoholics in the middle stages of their disease might be using so much they are never sober, yet are so functional they drive an average of 1,000 to 2,000 times before being popped for a DUI. Before grasping this fundamental tenet of alcoholism, I knew people for decades who I did not figure out were alcoholics until they were over 80. One of these, an 82-year-old retired stuntman, drove his motorcycle to my office 70 miles from his home to drop off his tax papers. After chatting a bit, I smelled alcohol on his breath. After he died a couple years later at 84 his nephew confirmed alcoholism and told me stories of his many alcoholism-fueled escapades. A decades-long client committed suicide at 82; since I think suicide is linked to alcoholism 70-80% of the time (much higher than the 30% to which it is attributed in the literature), I asked his son, a friend of mine, about the possibility. His response: oh, Doug, I knew never to go see the folks after 5 pm, when arguments would invariably ensue.
The latter stages of the disease are characterized by loss of job, family, or reputation (often by an arrest). They may end up on the street, although that is rare.
I realized the problem was the enabling. I found no recovering addict who “tried sobriety,” as recovering addicts put it, without being forced to try sobriety by credible threat or actual loss of job, freedom, family, or other privilege. Only then does the addict “hit bottom:” Others must force addicts into making a decision to get sober. But I’m getting ahead of the story.
4. You've mentioned the concept of 'euphoric recall' in addicts. Could you explain this in layperson's terms and its impact on an addict's behaviour and perception?
As mentioned, the addict recalls euphorically, which is to say she remembers everything through self-favouring lenses. They think everything they do and say is good and right and nothing bad or wrong. As we observe behaviours, we can see they must think they are gods which, in recovery, they confirm (but often, I learned, only by digging hard in interviews). Cops call it the “Supreme Being Complex.”
The ramifications and explanatory power in both personal relations and current events are mind-numbing. If they are perfect, addicts cannot be to blame for anything that goes wrong in their lives; you are to blame. This is the root cause of much gaslighting, which can be used for propaganda purposes but also may simply reflect their perceptions. Psychoactive drug addiction is likely the root cause of the “blame game.” I strongly suspect if I were able to dig deep enough by interviewing those close to politicians and other public figures who play this game, using it to wield power over others, I’d prove addiction in most of them.
This blame game is rooted in euphoric recall. Because the commonly accepted definition of alcoholism requires observing the late stage symptoms characterized by loss of control over use, the average spouse does not begin to suspect alcoholism in the other spouse for nearly ten years. If the non-addicted spouse understood alcoholism, they could identify possible addiction in their partner when the alcoholic repeatedly wrongly blamed them, their child, their friend, or the dog for whatever troubles they are going through.
5. Your work often intersects with financial abuse related to addiction. What are some warning signs that a loved one's financial troubles might be linked to addiction?
Serious financial troubles occur, of course, without addiction. However, they are generally not repeated or continuous. A bankruptcy is not a definitive indication of addiction; many great, serial entrepreneurs have gone bankrupt. But it gets my antennae up because risk taking behaviours are part and parcel of addiction (an extreme case of this was Evel Knievel). While risk taking can lead to extraordinary financial success, it can also result in financial collapse.
Consider the fact addicts must, because of egomania, wield power over others. There are two main ways addicts do this: abusing others and overachieving. What better way to wield power than by becoming an extraordinary overachiever? They wield power over family, friends, fans, patients, customers, employees, and constituents. In one of life’s great ironies, alcoholism-fuelled egomania increases the odds of overachieving because the addict must win, regardless of cost. Arguably the world’s greatest athlete, Jim Thorpe, died unhappy and poor, his health and finances ravaged by alcoholism. This best explains the financial difficulties of many great athletes, entertainers, media icons and businessmen. Many heroes are alcoholics, including Winston Churchill, whose financial life was a mess.
Many would suggest the addict became successful before they began drinking addictively. This contradicts the timing: the average alcoholic triggers their alcoholism during their first drinking episode, average age 13. Thorpe, like so many other greats in their fields, probably became great not just because they were born with the requisite potential skills, but also because of alcoholism-fueled egomania.
But the numbers of less successful alcoholics are much greater, simply because only a few of us have the requisite abilities of the greats in history. Bankruptcy is an excellent clue to substance addiction because addicts likely declare bankruptcy far more frequently than do non-addicts. (In the United States, one can wipe the financial slate clean via Chapter 7 bankruptcy once every seven years.) Because of the need to flout their egos, they are more likely to overspend. They are often the big man at the bar, buying a round for everyone. They are more likely to purchase a car or truck or home they cannot afford. They will buy the most expensive gifts. Some addicts hiding financial frauds have been large non-profit donors. An entertainment attorney told me of a major star who, he said, “got sober” and stopped her heroin addiction, but he could not understand how she could still go out on $100,000 weekend shopping sprees. I told him she must be drinking. After a long discussion I disavowed him of the idea that drinking did not count as “addiction.”
Author of Deadly Odds, Mike Brubaker, told me he figures half of compulsive gamblers are alcoholics, and he was not looking for that connection. I think it’s more than half and those that are not are children of alcohol/other-drug addicts. And of course, every compulsive gambler’s life is in financial disarray. I strongly suspect similar odds for compulsive shoppers and spenders. Those who borrow from Peter to pay Paul are, more likely than not, alcoholics.
Being late in paying one’s bills is also an excellent indicator. A former client was thinking about returning to our tax practice after a seven-year hiatus. She asked about a deduction for rehab costs for her dependent son and I asked her to hang on a minute. I quickly found her payment record and asked, “Do you know you never paid our invoice until at least three months passed?” “No!” After a brief silence, she meekly asked, “Did I really delay paying you for months?” I responded yes, and added, “Rehab costs are deductible for you as well.” A grateful recovering alcoholic, she has been our client—again—for years. And now she always pays her bill timely.
6. What inspired you to link alcoholism and drug addiction with major historical events and figures?
James Graham’s work initially inspired it, although I took it further. I concluded one cannot understand history, current events, or most biographies of those who make history without understanding alcoholism.
Graham linked alcoholism to many key figures, from Stalin to Senator Joe McCarthy, John Wilkes Booth to James Earl Ray (who assassinated Martin Luther King, Jr.), and spies from Kim Philby to Christopher Boyce. I began looking at current events and history for signs of addiction in famous people. I was able to prove alcoholism in many instances where journalists and historians were not looking for it, much less identifying it, from Bruce Ivins (the scientist who mailed anthrax) to Karl Marx.
Graham and I disagreed about one key figure: Adolf Hitler. He thought his stepfather Alois Hitler’s alcoholism could make Adolf Hitler the monster he was. I told my greatest mentor I thought there had to be more to the story. He insisted Hitler the younger was not an alcoholic.
Indeed, he was not. However, Leonard L. and Renate Heston made what I think an incontrovertible case for Hitler’s amphetamine addiction in their masterpiece of investigative journalism, The Medical Casebook of Adolf Hitler. Amphetamines, supplied by his Doctor Morrel, best explains why he became crazier over time after he triggered that addiction, which was certainly by 1936. It did not explain his writing Mein Kampf long before, but he was a heavy caffeine user, probably by the late 1920s, reportedly consuming as much as the equivalent of ten coffees per day. How to come down from that to be able to sleep? Barbiturates, which had been compounded by the early 1920s. They are alcohol in pill form for the alcoholic. (Barbiturate addict Mao Zedong provides evidence for the damage such confirmed addicts can do.)
7. From your perspective, how does addiction influence an individual's likelihood to engage in criminal or unethical behaviours?
Addiction is connected to criminal and unethical behaviours because alcoholism causes egomania. This is the reason psychoactive drug addiction is at the root of 80-90% of criminal and extreme unethical behaviours.
Some non-addicts admit to having committed such misbehaviours. True enough, but rarely in serial fashion.
DUIs and driving behaviours have been extensively studied by the U.S. National Highway Safety Traffic Administration. Its studies proved that half of tailgating is committed by drivers legally under the influence (.08% Blood Alcohol Level in the United States) and 35% of illegal U-turns are DUIs. While we’ve all tailgated and made illegal U-turns, why would such a high percentage be linked to addiction? Because alcohol and other-drug addicts do it much more frequently.
Many spouses have committed adultery. Once. But in serial fashion? None of this is 100%, but I’d wager that, because adultery is a way of wielding power over the other spouse, it’s committed far more frequently by addicts. Addiction shows up in divorce statistics, unofficial though they may be: addiction experts think 40% of divorces involve an alcoholic; if someone has been divorced four times, the odds of alcoholism in that person are at least 85%. Elizabeth Taylor was married seven times which, alone, tells me she was alcoholic. In fact, she could reportedly drink Richard Burton, quite the alcoholic himself, under the table.
8. Can you elaborate on how addiction can distort an individual's sense of self-importance or egomania, and the consequences of this distortion?
As noted, alcoholism causes the key distortion of perception known as euphoric recall. This in turn causes the alcoholic to view all they do through self-favouring lenses, which inexorably leads to egomania. Their mindset shifts from, “I can’t get away with that!” to, after enough drinks, “Of course I can get away with that!” The consequences range from becoming extraordinarily successful, a positive for both the addict and, often, society, to horrific abuse of others. The question I have long asked, is psychoactive drug addiction a net positive for humanity? Because natural selection rewards certain attributes, I suspect it is. But you generally do not want to live with, be under the thumb of, or do business with such a person.
9. What are the most common misconceptions about alcoholism that you encounter, and how do you address them?
A few years after publishing my first book, Drunks, Drugs & Debits: How to Recognize Addicts and Avoid Financial Abuse, I realized too many could not offer “uncompromising tough love,” a phrase I coined, due to the stigma of alcoholism. Yet such tough love is the essential prerequisite for inspiring in the addict a need to make the decision to try sobriety. I realized we cannot eliminate the stigma of addiction without debunking the pervasive myths. This led to my book focusing on just one aspect of “Drunks,” the myths of addiction. “Alcoholism Myths and Realities: Removing the Stigma of Society’s Most Destructive Disease,” described 118 such myths.
The most common myth is that alcoholics lack willpower. Yet, if an alcoholic wants her drink, nothing will stop her. The question is, why, when so much damage is done to others? It’s partly a result of euphoric recall, which precludes alcoholics from seeing the damage they cause. It is also partly a result of the fact they experience the drug differently than do non-addicts, which is something that cannot be seen or understood. We view life through our own experiences; the experience of non-addicts with the drug alcohol is vastly different from that of the addict. Many non-addicts can barely walk at a .12 Blood Alcohol Level; the addict is barely getting started at a .16 BAL. Non-addicts often experience terrible hangovers after drinking heavily, something many addicts never experience. Non-addicts may get a bit “looser,” while the addict’s personality changes at fundamental levels when under the influence (which, due to a build-up of egomania, can extend to periods when they are not drinking or using). If a non-addict ever has a blackout, during which time events do not enter the memory, the experience is enough to prevent him from ever again drinking so much. The addict checks out the bumper of his car to ensure there is no blood and, finding none, figures he must have had a great time and is ready to do it again.
The other most pervasive myths revolve around the idea that a person is in too great of shape, too smart, too good looking, or too successful to be an alcoholic. This idea is rooted in the useless definition of alcoholism promulgated by the Diagnostic and Statistical Manual Disorders (DSM), which defines alcoholism as a loss of control over use. Early stage symptoms include extraordinary success, maintaining over-the-top good looks (think: Elizabeth Taylor) and good physique (think: Jane Fonda and Jean-Claude Van Damme, the latter of whom has been married five times), which help the addict wield power over others. But since plenty of non-addicts take good care of themselves, we need at least one serious negative behaviour pattern to give us high odds of alcoholism. I had a perfect gentleman client always coming to my office for his tax preparation and planning with the finest suit and perfectly coiffed hair and shoes; the only negative clue was he lost his job as an outside salesman (think: three-martini lunches) at age 60 and never worked again. He was not fabulously wealthy but had what he told me was a wonderful wine collection, with some 5,000 bottles. Those were subtle clues for which I would even today not take too seriously, but after he died his nephews told me the wine had turned to vinegar. I was incredulous and asked if he might have been an alcoholic who had gone into late-stage alcoholism; they both laughed and said, “Absolutely.” I asked what early-stage behaviours might have indicated abuse of others; they told me, “Serial don Juanism,” which is one of the many ways men to wield power over women.
10. In your experience, what are some effective strategies for family, friends, and employers to intervene in the early stages of addiction?
Numbers matter.
An intervention rarely works one-on-one. The defenses of the addict, rooted in distorted perceptions, are too powerful to overcome. They are incapable of believing alcohol or other drugs are a problem. However, when done in groups, aided by a good professional interventionist, addicts’ family and friends can get addicts into a program of recovery 95-98% of the time. Intervention professionals often suggest eight to ten close family, friends, and associates for optimal results.
Whether an intervention leads to long-term sobriety is another question. Probably most do not, because addicts do not believe the “threats” (promises) those involved in the intervention make: they will stop protecting the addict from the consequences of misbehaviours, without compromise (except to prevent death and, perhaps, serious injury) and they will do so with a clear conscience. The problem is they cannot ensure others not attending the intervention will offer such tough love.
This is not to say some addicts will not stop drinking or using with a one-on-one, or simply on their own. I have known some who went cold turkey and stayed sober for decades. This occasionally occurs when a spouse, loved one or doctor makes it clear they have a choice of them/their life, or the drug.
The problem in such instances is ego-deflation, which AA is designed for, or religion, which can help the addict realize there is a power higher than himself.
Because alcoholism causes an inflated ego, abstinence by itself does not lead to sobriety. Ego deflation is the other essential component, without which we get a “dry drunk,” in which many of the misbehaviours (especially attitude) continue. This is where suggesting, “Let’s go to an AA meeting together” can help. Then, keep going, with or without the addict. You will learn and, with a bit of luck, the addict will continue, too, and stay sober. But be mindful that it can take years of meetings, camaraderie and reading the literature to get and stay truly sober.
11. How does alcoholism typically progress if it goes unchecked? What are the potential long-term consequences?
Unimpeded alcoholism ends in tragedy—either for someone with whom the addict comes into contact, or the addict him or herself.
When I hear or read about a tragedy, my antennae instantly go up. I ask and look for proof of addiction in someone involved; when able to dig deep enough I nearly always find it. Because most addiction in the early-to-middle stages of the disease goes undiagnosed, official statistics do not support my estimate that 80% of tragedies are caused by addiction in one or more people involved. For example, while official statistics suggest 30% of suicides are addiction related, I suspect the true number is in the 70-80% range if not higher; perhaps nearly 100% when we include addicts having driven close co-dependents crazy (think: the effects of gaslighting). Statistics show road-related deaths are caused by DUI 30% of the time; I suspect it is 70-80%. Not everyone involved in a DUI homicide is tested, many accidents are caused by an addict who was not directly involved, and many are probably caused by alcoholics between drinking or using episodes, when addicts can act crazier than when using. Some studies have shown industrial accidents are alcohol/other drug related about 70% of the time, which is also true of snowmobiling accidents, but these are the exceptions to studies that usually show, I think erroneously, much lower figures.
Once I get high odds or confirmation of addiction, I ask how many incidents were there for which close people or the law could have intervened, but did not? Usually, it is dozens if not hundreds. In 2012, Robert Bales, an American soldier, murdered 16 Afghanis in the middle of the night.
Thorburn Addiction Report ISSUE (preventragedy.com)
He was known as a drinker and frequented bars. I found several comments saying he was a great guy until, when drinking, he wasn’t. Because of the stigma of addiction and peoples’ reluctance to share information about misbehaviours or heavy drinking, 90% of the muck of addiction lies beneath the surface. That is the part, as with icebergs (“Titanic” excepted, as you recently reported), that ruins and destroys lives.
Consider how many opportunities there were to intervene in his life before tragedy happened. Because no one intervened, at least successfully, 16 innocent Afghanis are dead, and Bales is spending life in prison.
For every DUI that ends in death there are thousands of incidents of driving under the influence and, no doubt, dozens if not hundreds of other incidents in that addict’s life for which someone could have intervened but did not. Identifying addiction and then acting to end active use may hurt a few feelings. On the other hand, it can prevent tragedy.
12. You've spoken about the biological aspects of alcoholism. Can you explain how these biological factors contribute to the development of the disease?
The disease is genetic, which is the reason I refer to it as a “dis-ease.” In a way it is like Type 2 Diabetes. The diabetic can choose to devour carbs or go keto (or carnivore) and reduce or eliminate the need for insulin, thereby reducing the odds of numerous other maladies. The addict can choose to stop drinking or using. Tough love would work well for both: the diabetic might get reduced insurance coverage if he does not change his diet (but not to the greater carbs diet the American Diabetes Association advocates), or coverage will cost a whole lot more. Tell the addict no freedom, no early parole, no seeing the kids, no fixing the marriage, no job unless they stop using, with regular and random tests for years. Most diseases require caring, concern and what we all typically call “help” for the suffering person. Substance addiction is arguably the only disease, other than perhaps diabetes, that requires uncompromising tough love to effect a cure.
Not every child of an alcoholic inherits the disease. It skips some or many kids and generations. But the fact of addiction is you either get it, or you do not. Alcoholics do not choose whether to have the predisposition; they can only choose to drink, or not drink.
There are many pieces of evidence that alcoholism has nothing to do with environment. Nearly every recovering addict knows they triggered their addiction during the first drinking episode, average age 13. The ability to consume is much greater than that of non-addicts from the start. And there is the Danish twins study.
The twins study longitudinally followed 81 sets of identical twin brothers, one of whom was raised by the biological family with an alcoholic father and the other adopted out, raised in a non-alcoholic family. If addiction was environmental, the rate of addiction in the brothers raised in the alcoholic family would be much higher than that of the adopted brothers. Instead, the rate of addiction in the twins was equal, and five times that of the general population.
Environment obviously has nothing to do with determining whether one becomes an alcoholic.
The progression of the disease is, at least in part, related to environment. Josef Stalin could not have engaged in monstrous acts on the scale of murdering, or being responsible for the deaths, of millions were he not in a position to become the Supreme “Leader” of the former Soviet Union. Circumstances and upbringing also matter, as does underlying personality type (Myers-Briggs types). The virulence of what might be a strain of addiction may matter (Jeffrey Dahmer’s adopted parents seemed model parents; yet, he cannibalized his victims). Yet, there is no way I know of to predict the course of addiction in any one addict. All we know is, they are capable of anything. And I do mean anything.
13. In your view, what role does society play in either perpetuating or combating the stigma associated with alcoholism?
Myths create stigma. Stigma reduces the odds of diagnoses. Reduced diagnoses lead to an increase in the number of addicts who are never given a choice or “ultimatum” of family/loss of family, job/loss of job, freedom/incarceration. This reduces the numbers in recovery, which harms everyone, addict and non-addict alike.
Society perpetuates the stigma because most people believe the lie promulgated by the manual of all “mental disorders,” the DSM, and therapists: that alcoholism is defined by a loss of control over use. Such loss of control denotes lack of willpower, which creates much of the stigma. If we redefine alcoholism as a genetic disorder that causes the afflicted person to biologically process the drug alcohol in such way as to cause that person to act badly some of the time, we eliminate the stigma.
When we stop viewing addicts as lacking willpower there will be many more addicts in recovery. When we understand that addicts have a genetic disorder that causes euphoric recall, leading to egomania, culminating in the need to wield power over others, it will be easier to say “no!” to addicts. This should occur long before the latter stages, when egomania has dissipated due to an inability to wield power over others, which is when the common drunk described by the DSM focuses exclusively on when, where and how to get his next fix.
14. You've mentioned the use of the Myers-Briggs Type Indicator in understanding addiction. How does personality type influence addictive behaviours?
As mentioned, most felons are addicts; felons have been largely typed as Guardians, or Sensory Judgers (SJs), concrete realists who usually follow rules. That would be incredibly ironic if true, which I strongly doubt. In my experience administering the Myers-Briggs Type Indicator I have found that more than half taking the Indicator answer the questions wrongly for their “true” innate Type. At least half, then, are misidentified. Inasmuch as few get competent feedback confirming their Type, most remain wrongly typed and is, I think, the reason why the Indicator is not taken as seriously as it should be.
There are many reasons half or more answer the questions different than true Type might suggest. If questions are answered while under stress, they will likely score as a very different Type than who they truly are. If they take the Indicator in “work” mode, they respond as they are “supposed” to, which may or may not accurately reflect who they really are. The iNtuitive Feeler (NF) Temperament comprises people pleasers; they may respond as a loved one, parent or close friend might. Yet, most loved ones, parents, and friends are entirely different Types than oneself. The idea that “opposites attract” is not just a cliché. There is a reason, evolutionarily speaking, why not only are parents rarely alike but their children are so often radically different both from each other and their parents: children can learn there are two sides to each dichotomous preference (I/E, N/S, T/F, J/P).
Another Temperament, Artisans, or Sensing Perceptives (SPs), is chameleon-like and often responds to the Indicator as they think they must under the circumstances. It’s no coincidence that this Temperament comprises most entertainers. They are fast on their feet and excel at tactical intelligence. But they can play dangerous games, including “delinquent,” which is an apt descriptor. The addicted SP likely comprises most felons, as well as many politicians, at least 20-25% of whom I suspect are addicts. Compare this with the 10% or so of Americans who are substance addicted.
The other Temperaments generally play less lethal games. Guardian, or Sensory Judging (SJ) addicts likely become cops (although there are plenty of Artisans among those), judges and prison guards. Guardians excel at logistics. Rational iNtuitive Thinking (NT) addicts, who excel in strategic intelligence, seek to control the minds of others by becoming philosophers, lawyers and politicians. Idealist iNtuitive Feeling (NF) addicts, who are the great diplomats and who excel at helping others, are probably more apt to seek control by treachery or conning others, because they are also the great communicators—and, as such, most able to pretend they are someone they are not. NFs comprise the truly great actors and orators—amphetamine addict Adolf Hitler was one, so even people pleasing Idealists can turn into monsters when addicted.
15. How might personality type influence recovery programs?
In Drunks, Drugs and Debits, I reported a study where addicts in recovery were matched with their “style” of therapist and aftercare setting. Researchers rated both therapists and addicts using similar descriptions, which roughly correlates with the Personality Types. When the addict was matched with therapist, or with aftercare setting, recovery rates were about 70%; without such matches, recovery rates were roughly 50%. When matched with both therapist and aftercare setting the recovery rate was 77%; when all three were mismatched, recovery was only 38%. The more matches, the higher the rate of recovery.
I observed that the Temperaments could be linked to each personality style rated for purposes of the study, which took place several years before David Keirsey wrote his masterpiece in 1978 on Temperament, Please Understand Me. One of the ratings included “impulsive” types, which roughly correlates with Keirsey’s Artisans (SPs). Another, “dependent and compliant,” might correlate with Keirsey’s Guardians (SJs). The third, “independent, questioning and self-assertive” describes the abstract Rational (NTs), and “interdependent, empathic and cognitively complex” beautifully describes the Idealist (NFs).
Unfortunately, as described above, most psychologists view Myers-Briggs and Keirseyan Temperament as “pop psychology” and, as a result, few take it seriously. The studies have not been replicated, much less attempted with more clearly defined Temperaments. Unfortunately, as schools are generally not designed to truly educate, rehab is rarely intended to cure alcoholism. It’s no accident that this is reminiscent of medicine, which many in your audience have been shocked to learn: the medical industrial complex does its best to ensure diseases are never truly cured.
16. What are some common challenges you've observed in diagnosing alcoholism, particularly in its early stages?
The dearth of education about behavioural signs of alcoholism, along with the stigma alcoholism carries, has led to an ignorance by parents, other family members and friends, which makes them incapable of diagnosing their child, friend, or love one as alcoholic. “My son is strong! He has tremendous willpower! He’s my son!”—is bandied about as if such attributes preclude one from becoming or being alcoholic.
And, money. Money is the biggest enabler. Successful people in the early-to-middle stages are rarely diagnosed as alcoholics. “He could not possibly be an alcoholic! She’s too young!” Tell that to Judy Garland and countless other child actors. “He’s too successful!” Tell that to Mel Gibson or Ted Turner. “She could not possibly be an alcoholic! She’s too beautiful—and too successful!” Say that about Elizabeth Taylor or Marilyn Monroe before their drug addictions became common knowledge.
17. How can understanding the early signs of alcoholism help in preventing more serious addiction issues?
Serious addiction issues, including harming oneself and others, can begin at the onset. I would reword the question, how can understanding the early signs reduce the number of serious addiction issues?
Parents must learn all about addiction, especially if it runs in their families. There are five key pieces to the addiction puzzle that parents must grasp: one, addicts lie. A child telling you they are not drinking or using should never be believed if there are out of control behaviours. Two, misbehaviours give away the secret. Assume use and, therefore, active addiction if there are serious (or even a modicum of) bad behaviours. Three, children trigger their addiction usually during the first drinking or using episode which, as noted, is age 13. Many recovering addicts tell us they knew they were alcoholics at age 7 or 8 (actress Drew Barrymore). They are (almost) never too young. Four, logical consequences for misbehaviours must be meted out. The only way to drive an addict to “try sobriety” is to make drinking and using more painful than abstinence. Five, much more serious consequences may be required than a non-addict feels comfortable meting out, especially for caring and loving parents, because addicts derive such immense pleasure from use. As non-addicts, we cannot imagine the intensity of that pleasure, because drinking and using does so little for non-addicts, and the pain we must administer hurts us more than them.
The law could do a nearly infinite better job of coercing abstinence as a condition of early parole or other favourable treatment. Judges should tell every perp, “The reason you are in front of me is because you probably have the disease of substance addiction. The substance makes you think you are God and that your problems, therefore, are not of your own doing. It makes you think you have the right to abuse others. Therefore, if you stop using the Court will go much easier on you. We will test for all drugs, including the drug alcohol, regularly and randomly. To inspire in you a need to stay abstinent we will test for years. Should you fail one test, you will lose whatever freedoms this court grants. And, by the way, you might try AA or church to help keep you sober.” If judges did this at the earliest stages, there would be many more addicts getting and staying sober early in their disease. However, because addicts are responsible for upwards of 90% of all crime, a focus on getting addicts clean and sober would not be financially profitable for the criminal industrial complex. The problem is analogous to that of the medical industrial complex— keeping people sick and in treatment makes a hell of a lot more money than do cures. And the myths are as pervasive. Still, we can do our best to effectuate change.
18. What advice would you give to someone who suspects a loved one might be struggling with alcoholism?
Uncompromising tough love must be offered to the addict. But such love is not solely for the alcoholic; it’s for everyone they affect—family, friends, co-workers, and countless others because so much of the damage addicts cause is to people they don’t even know, due to accidents and crime.
When my mother read Drunks, Drugs and Debits, she observed, “You are telling me I should have left your alcoholic father. Then you would have been children from a broken home.” “No,” I responded, “we might have been children from a home with a recovering alcoholic.” I told her it was not her fault because she had no idea. They don’t teach this stuff in school or, as I learned, anywhere else.
If she had done this early, Dad might have had a far more productive and longer life. He appeared constantly drunk after about age 55, he could not keep a job, and he died at age 60 due to an alcoholism-induced fall. My sister felt emotionally abandoned; I was intellectually abandoned. Emotional growth of alcoholics stops the day they trigger their addiction; I suspect children of alcoholics grow emotionally at half the rate of peers whose parents are not alcoholics. When I figured this out shortly after age 40, I think my emotional growth spurted even if I am still likely 20 years behind emotionally, and perhaps intellectually, where I might have been. If dad had been inspired to try sobriety early on, everything would have been different—his longevity, my sister’s emotional well-being, my intellectual growth, my mother’s life after. (As it turns out, we all turned lemons into lemonade, but that’s a story for another time.)
19. In your books, you discuss the relationship between addiction and power. Can you delve into how addiction can drive individuals to seek power and control?
While I think we covered this extensively, I would add that Hayek’s observation that “The worst get to the top” is best explained by the fact that alcohol and other-drug addicts, because of their need to wield power over others, often get to the top. I suspect many top officials of various government agencies and large, corrupt non-government organizations (think: Moderna and Pfizer) are alcoholics. I discussed this in issue # 31 of my client letter:
Wealth Creation Strategies Issue #31
In which I discussed how, perhaps due to alcoholic damage to the higher brain centre, addicts can “connect” with others at a visceral level because the lower brain is intact.
20. How has your approach to identifying and addressing alcoholism been received within the medical and addiction communities?
In short, not well.
When I sent the pre-book galley of Drunks, Drugs and Debits to Haselton, the big alcoholism publisher, they responded with a note saying, “We have too many books like it.” Having come from outside the field I was concerned I missed something, despite having read at least a hundred books and papers during my research. I repeated this assertion to the two addiction doctors (Dr. Forest Tennant and Dr. G. Douglas Talbott) who provided testimonials for the book. Their responses were identical: “They must not have read your book.” Dr. Drew Pinsky left two messages telling me the book was fantastic and would do everything possible to support my work. However, Dr. Drew later declined through his publicist to provide an endorsement, because his publicist was concerned I might have written something objectionable, and Dr. Drew did not have time to read every word in the book. I spoke and provided qualifying continuing education (without having a formal credential) numerous times over several years to chemical dependency counsellors. Despite terrific reviews of my talks, there were no breakthroughs, and I was ultimately not invited back. I gave a 20-minute talk once to 50 police officers, including instructors. When you are a speaker, you know when you’re on, you know when you’re not. I was on. The result: resounding dead silence. Several officers independently approached me with questions, after which I asked each of them, “Was the dead silence because I gave a poor presentation?” They responded identically: “Oh, no. You hit too close to home.” Too many cops, their partners, family, and friends are alcoholics. I was not invited back.
I met many rehab operators. Only one got honest with me: “We don’t want to cure them; that would ruin our business.” As in medicine, the business model runs on treatment, and treatment again. Not cures.
If they wanted cures, they would educate the family, friends, and doctors. They would tell them in no uncertain terms to stop protecting the addict from consequences of misbehaviours. However painful consequences may appear to the non-addict, the addict needs much more pain than imaginable to the non-addict. The pain from use must be greater than the pain from non-use, and because the pleasure from use is so great the consequences must often be more severe than the non-addict can handle. Few impose such pain until it’s too late and divorce ensues, they are fired from jobs, or they maim or kill someone. Addiction communities outside of Alcoholic Anonymous do not do well financially by effecting cures, and the medical community has almost no training. The training they get is mostly wrong, and HIPAA rules preclude medical personnel from sharing with family, friends and employers any tentative diagnosis of addiction they might make.
21. Finally, what message do you most want to convey to the general public about alcoholism and addiction based on your extensive research and experience?
There are three key messages.
One, we must assume addiction in anyone engaging in serial misbehaviours, regardless of age, occupation, intelligence, financial status, or how wonderful the person may otherwise be. Never consider alcohol or other-drug addiction as an excuse; rather, assume it is the best explanation for bad behaviours.
Two, most addicts never experience pain greater than the pleasure from use and, as a result, never get and stay sober. And that pleasure is immense. Addicts think they are God. If you felt like God when you were drinking or using, you would not want to stop either. Therefore, pain is the addict’s only cure. Imposing consequences is also, then, the best medicine for those affected by the addict.
Pain is mitigated by enabling. Stop enabling. Offer uncompromising tough love. Do not believe those who claim, “The addict must hit bottom,” as if you are helpless. You can help them hit bottom. You want them sober because, not only do misbehaviours nearly always diminish and, over time, cease; long-time recovering addicts are mostly great people.
Three, do not think a seemingly hopeless addict will never get clean and sober. Yes, there are many failures, mainly due to the absence of promises of or actual imposition of logical and sure consequences. Addicts get sober because of consequences, and stay sober because they know, with certainty, they will lose family and friends, or freedom should they relapse. They relapse in part, too, because they are told, like the rest of us, it’s a question of willpower rather than that the predisposition is genetically determined. Hence, among the many myths is the idea they can control their use. Yes, for periods of time. But every study ever in which alcoholics were taught “controlled drinking” has ultimately failed utterly. The terrific 1947 essay by Dr. William D. Silkworth on relapse helps to understand not only why they relapse, but why “controlled use,” given enough time, is not possible.
Slips – by the late William D. Silkworth, M.D. (aawmig.org)
I intended my work to be the most comprehensive treatment of alcohol and other psycho-active drug addiction ever compiled. I think I succeeded. All the tools required are available in my four books to assist the non-addict in identifying likely alcoholism and offering uncompromising tough love with a clear conscience. However, as we’ve learned in medicine, we must act individually, in a decentralized way, where we can effectuate change.
Amazon.com: Doug Thorburn: books, biography, latest update
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I thought I knew all about alcoholism, as I come from a family littered with it. But this interview takes it to an all-new level. (I skim some of your emails, as there is usually soooo much to unpack, but this one I read start to finish.)
Lately I've been immersed in the work of Swedenborg. The main theme is about man's eternal choice - to chose the Call of the Spiritual, or to chose the Call of the Material. (My words, not his - his writings are far more eloquent.)
I've often wondered if alcoholism is in part the attempt to "silence" the ever-present call to the spiritual? Put-to-sleep that voice, and let the ego take over.
I'm one of the fortunate few who had a parent that fully embraced the 12 steps of AA. It happened late in his life, and it took several years of the work for him to fully embrace the humility/higher power aspect of it, but the transformation was unmistakable. It was like watching a human being do a complete 180. Seeing that, and experiencing that process, was instrumental in helping me make better choices. I'll be forever grateful for that part of my life.
On the "euphoric recall" subject I would humbly like to add that euphoric recall extends to adult children as well. It can be experienced as entering into repeated toxic relationships, and returning to said relationships after every blowup with the "What happened wasn't really all *THAT* bad, and he said loves me, and we have all this fun together, etc." Kind of like wearing hard-coded rose colored glasses.
Thanks so much for this great interview. I'll be sharing it with others.
I, like some other comments, have been surrounded by alcoholism my entire life. I have seen relatives go in and out of detox/rehab, to AA, and go sober on their own. Some are sober, some are still alcoholics and others have died as a direct result of their drinking. AA can work but it's also not for everyone. As a nutritionist, the one thing I want to point out, is that diet is critical during recovery. Many are fed highly refined, high carb diets in rehab and are quickly placed on meds for anxiety and depression (which may resolve once alcohol is removed and health restored making the drugs unnecessary). Many alcoholics are severely nutrient deficient, have liver issues and have a host of gut issues from drinking. Addressing these issues, can aid in a successful recovery but often gets overlooked.