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Almost every culture has discovered the use of beverage alcohol. Since any sweet fluid will soon ferment when exposed to the yeast spores omnipresent in the air, spontaneous fermentation must have been a common occurrence. One might say that prehistoric peoples discovered alcohol early and often. Apparently, when they tasted the beers and wines produced by serendipity, they liked them. At any rate what was once produced by accident was soon produced intentionally, and the production of alcoholic beverages became one of humanity’s earliest technological achievements.
One reasonable conclusion that can be drawn from a perusal of the literature on alcoholism is that nobody knows what alcoholism is. An equally reasonable conclusion is that everybody knows what alcoholism is, but that they just happen not to agree.
In terms of solid, empirically verified, replicated knowledge, surprisingly little is known about alcoholism. Aside from the physiological evidence and some imprecise demographic findings, there are few hard facts about alcoholism. Some studies strongly suggest that there is a genetic component or predisposition to some forms of alcoholism; there are a handful of replicated empirical psychological findings; there are fewer than half a dozen longitudinal studies; and there is a limited body of known fact about special populations suffering from alcoholism. This chapter takes a look at what is known in each of these areas.
There are many theories about the etiology of alcoholism, ranging from the conviction that it results from sin to the belief that it is the result of a biochemical flaw. Recent evidence supports the belief that alcoholism results from a complex interaction of neurophysiological, psychological, sociological, pharmacological, cultural, political, and economic factors.
This chapter examines some of the most important of these theories ranging from Carl Jung’s spiritual account to conflict theories to learning theories to Robert Cloninger’s neurochemical tridimensional personality theory to stages-of-change theories. Complex, sometimes competing, sometimes complementary, this array of primarily psychological theory is fascinating. It also has profound clinical implications. As you read, think about ways, if it is possible, to integrate the various theories and consider how you might apply them to clinical work.