How do professionals become alcoholics?

I interviewed a number of professionals, a substance abuse counselor and a member of the clergy on how professionals became addicted to alcohol. Here are their observations.

Are professionals unique? Each party took pains to stress the pervasive nature of alcoholism. It has a strong genetic component and predisposition. The people affected by alcoholism come from every walk of society. Two individuals had a history of hard drinking during their professional training. It started with a student-drinking culture and it continued for years until they came to terms with it. The third described a gradual descent into alcoholism that took place over 15 to 20 years.

I mentioned the high stress associated with his profession and my informant replied in effect, "So what? There are a lot of different ways of dealing with stress besides drinking."

There is a progression to the disease, an addictive process, which runs its course no matter who you are. My informants gave short shrift to professional status being special cases. This is about drinking, not about what they do. No excuses. Sorry.

"Man take drink, drink take drink, drink take man." - Chinese proverb.

A common expression among alcoholics: "One drink is too many, a thousand is not enough."

"In every town, there are regulars at the local watering hole. Some are alcoholics, some are not. They are regulars because it is fun. The bar isn't the cause. People know themselves if they need a drink. We are no different from any other chemically dependent person."

"Alcoholics select friends who use just like they do. They don't socialize with light or moderate drinkers. Their friends won't say anything."

We did speculate on contributing factors that might delay the recognition of the problem. One was the egomania and self-centeredness of people who are "experts" - in medicine, law, academia, the church, etc. - on other people's problems. They are supposed to have their own act together.

"It's the 'play God' thing. This self-centeredness is rewarded. They are successful, adored, and feel entitled. They lose perspective on who they are."

"I am supposed to be an expert. I can't have these problems."

"Where can they go for help? It takes courage to show up in another professional's office. They try to fix it themselves. They make promises and fail. They beat themselves up when they do."

My informants talked about other causes: the extra money, the social opportunities, the job demands, being on the road, the lack of accountability - essentially being judges of their work without much peer review and, significantly, their reputations.

"I was the boss. Who could fire me?"

"How can I take time out? I have to be in court. I don't have the time (to go for treatment). What will happen to my reputation?"

"The family has the same kind of defenses (covering up a reputation) the alcoholic has."

"I vacillated between feeling powerful and powerless. If I had a success, I would celebrate. If I were unsuccessful, I would drown my sorrows."

The progression of alcoholism. The disease progresses and the motives for drinking change. The drinking is no longer to have fun, but to overcome the inner pain they are experiencing.

"Alcoholics don't drink for the fun of getting drunk; they drink because they can't stand being sober. I couldn't stand to be sober - the anxiety, the indescribable tension I felt. I would have a couple of drinks and off I would go. Alcoholics don't know that after a certain period of time (after treatment), they lose the desire to drink."

"I would no longer buy liters and fifths. I would buy half-gallons."

"Alcoholics think they are invisible. When you are stumbling around drunk, people don't look at you as the good ole boy. They see it for what it is. They just don't say anything."

"I had this terrible fear of being miserable for the rest of my life. It is hard to believe you can live a happy life and not drink."

"First people drink to feel good. With time and steady drinking, their baseline feeling changes to feeling bad. Then they drink to feel good and then return to feeling bad. Finally, they are feeling bad, they drink to feel normal, they return to feeling bad."

"Alcohol is a depressant. You numb out. You forget. When the effects wear off, the problems are still there."

"The problem was life. I was trying to dull the pain. Pain was to be avoided."

"I felt alone - fear. Fear of never being enough, never doing enough."

"I used alcohol to get high. It drops you back down to depression."

"I used to think everyone does it. Now that I am sober, it is not that big of a number."

"I didn't give a hoot about anyone else. I couldn't operate without it. It affects your thinking. I would cultivate situations to get an excuse to drink."

Do you recognize some of your own thoughts? If so, look at yourself in the mirror and do something about it. Others have.

Val Farmer is a clinical psychologist specializing in family business consultation and mediation with farm families. He lives in Wildwood, Mo., and can be contacted through his Web site, www.valfarmer.com .