We hear much sympathetic talk of the "disease of alcoholism." This is only in a sense true. It is not a case of helpless chance, for the difficulty has been manufactured and developed by man himself. The alcoholic, mentally weakened by the reaction of the stimulant, is of all people most likely to exhibit that most striking evidence of weakness--a craving for sympathy rather than for blame. Habitual alcoholics continually plead for sympathy with mothers, fathers, wives, and friends; and too often they are granted not only pity, but, what is worse, toleration. The sanatorium promoters and proprietors of fake cures continually harp on alcoholism as a disease; and even a few scientists, who should know better, have been misled into an acceptance of this theory. Doctors should be the first to knock from under their patients the psychologically harmful props of the heredity theories.
The first thing a physician must do when dealing with an alcoholic is to cut every string of excuse which lies between him and his habit. He must leave nothing of this sort to which the drinker may cling. Sickness, worry, unhappy circumstances of whatever sort must immediately be eliminated as excuses for alcoholic indulgence. If they are not, the patient, although he may gain for a time the mastery over his habit, will presently be certain to find an excuse in his own mind to justify a return to it. Then will come a new downfall. There must be no reservations either in the attitude of the doctor or his patient or in the mental attitude of the patient toward himself.
The possibilities of medical help for the alcoholic have been exhausted when the patient has been freed from the effect of the stimulant and put in a physical condition wherein he feels no inclination toward more alcohol. Great psychological assistance may accompany this definite medical treatment when the patient's physical craving for alcohol has once been eliminated if the physician brings him into a mental state which gives him confidence in his own ability to keep away from stimulants in the future.
I cannot too strongly emphasize the fact that no cure exists, or ever will exist, for alcoholism. Its effects may be eliminated, and the victim's physical condition become so greatly improved that weakness will not make him yearn for stimulation; but this does not constitute a cure. Nothing except a man's own mind, whether the treatment extends over six weeks, six months, or six years, can ever relieve him of the danger of a relapse into alcoholism. In most cases a definite medical treatment is the intelligent beginning of help, but no medical treatment, no matter how successful, can compass that victory which a man must win by means of his own determination.