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a telephone interview with a depressed woman, "Virginia," suffering from an addiction treatment disorder

"I just got out of a hospital rehab program. I guess it didn't do me any good," she said, "I only stayed sober for ten days."

So I asked, "Why did you go into the program?"

"Because I'm an alcoholic," she said. "I got really bad and I needed help drying out. I hate living my life this way, but nothing works. I've been in two other rehabs in the last three years, and I've been to a lot of support meetings, but I always go back to drinking."

So I asked the question, "So, what's your plan this time?"

"That's why I'm calling you now. I still need some help," she answered.

I pressed a little. "What I am asking is what your plans are concerning your future use of alcohol."

She was perplexed. "Plans?"

"Yes, Virginia," I responded. "What is your plan with regard to your addiction to alcohol? Do you plan to stop drinking or do you plan to continue drinking?" I waited as her wheels turned.

Finally she answered, "I don't have a plan one way or the other."

So, I asked, "Is there anything about not having a plan to stop drinking that is interesting to you?"

"I'm not sure what you mean," she said.

I proceeded to draw out a rather bizarre picture. "What I mean, Virginia, is that you have been in three expensive hospital rehabs in the last three years, and you say you hate living in the chains of addiction. But when I ask what your plan is for the future use of alcohol, you come up blank. Isn't this a little strange?"

Sounding a little annoyed, she said, "Well, if I knew that I wasn't going to drink anymore, then I wouldn't be calling you now, would I?"

Pressing further, I said, "Of course not, and that is precisely why I have asked you this rather blunt question. You have a serious addiction that you say is ruining your life. And you placed this call to find a way to end it. Isn't this so?"

"Yes," she said, "this is so. But you are making it sound like I can just wish this problem away, and go on as if I wasn't an alcoholic."

I continued, "What did you learn last month during your last hospital rehab?"

"Learn?" she asked, puzzled. "I learned that I will never really recover from my alcoholism because it is a chronic illness. I will have to go to meetings for the rest of my life, and relapse is a normal part of recovery. I can spot signs of relapse by looking for feedback from others. If I don't go to meetings, I am probably in the process of relapse.

"I still have a long way to go with get ting my higher power together, and I have trouble with Step One, the powerless step. I still have trouble with that, and there's still some problems with my personal inventory that I will have to work out. I have no serenity, and my spiritual life is down. Life seems impossible when I look very far ahead, and that's what scares me. There, is that what you mean by what I learned?"

I leveled, "Yes. You just told me that you have no plan to recover from alcohol ism. You plan to flounder with your ad diction for years to come, experimenting with higher power ideas, playing games with the powerless idea, trying to prove to yourself that you're a decent person, and going to meetings that bore you stiff. And, very importantly, Virginia, you plan to relapse any time you feel like it."

A long silence ensued. Finally, she quietly said, "That is perfectly correct. And I feel like killing myself when I think of it."

"I suppose you've been thinking of getting rid of yourself for quite a while."

"Yes," she whispered.

"But obviously, you do something else instead. What do you do each and every time you think of killing yourself because your drinking problem seems endless?"

"I get drunk."

"And you have no plan to stop drinking. Isn't this strange, Virginia? Did any one in the hospital suggest that you stop drinking alcohol?"

"Yes, the pharmacist said I shouldn't mix alcohol with my antidepressants."

"So at least someone besides me thinks you can choose to not drink alcohol. But what do you think? Can you make a plan to stop drinking, for your own good?"

Annoyed once again, she said, "It's not realistic for me to just say I won't drink any more. This thing has destroyed others in my family -- my father, and two brothers. It is a disease that runs in the family and that's part of what's going on with me. You don't seem to understand. Have you ever been addicted to anything?"

"Yes, booze, for many years. And I also used to believe the same nonsense that you've been telling me for the last few minutes. I thought I had some disease that was making me drink, and that I was somehow destined to drink forever. But I learned better and got better by refusing any further use of alcohol. Yes, Virginia, there is a cure for alcoholism, and it's as old as the hills."

"A cure? You said a cure for the disease of alcoholism? There isn't any cure for it," she asserted. "The counselors at the hospital say we can only arrest it. Isn't the idea of a cure dangerous thinking?"

"Well, if you think that 'cure' means you can keep on drinking, perhaps. But what would your life be like if you never drank again?"

"I can't think of that," she said.

"Won't," I corrected. "You won't, be cause of your plan to drink forever. But go ahead, Virginia, take a peek, What would you be doing today if you hadn't been drinking for the last few years."

"I would be a graphics designer in Europe, where my ex-boyfriend lives. He would have me, but not in this condition." She recounted how her fiance finally gave up on their relationship be cause of her repeated relapses.

"So today is just an outcome of your past drinking, and you can see that your future, likewise, would have a much bet ter outcome if you stop drinking now. But do you want anything better than what's going on now?"

"That's why I called."

"Then, how about making a plan never to drink again?"

She hesitated, "I can't. It makes me feel too anxious. I just can't."

"Very good, Virginia," I said. "You are actually doing very well at what we do in Rational Recovery. Right now, you are feeling your addiction, and you are having conflicting thoughts about the use of alcohol. This is your ambivalence about drinking, something all addicted people have, On one hand, you'd like to stop drinking and get on with your life, but on the other hand, you're terrified of giving up alcohol. That part of you wants to drink forever."

Virginia sensed she was understanding something for the first time -- something extremely important. "Yes! You've hit it on the head again! At one level, I do want to flounder with this addiction forever, playing recovery games and relapsing from time to time, but I also want to get this be hind me and get on with my life. I'm sick and tired of being sick and tired. Right now, I have a strong desire to quit drinking for good. But I'm afraid to feel it too much, I may be in denial -- denying that my disease is chronic and incurable and progressive. If I relapse again, my hopes will be dashed, and I'll be more depressed than ever. But I do feel both ways. And I do want to get better. Right now!"

Most people who call Rational Recovery are facing the same dilemmas, and they are usually excited at the prospect of an actual cure from the ravages of addiction. So I made her an offer she would not likely refuse. "Okay, you're on. If you want to kick your addiction for good, here's the game plan. Ready?"

"Okay, go ahead."

"From now on, let's just say you plan never to drink again. Is that agreeable?"

"I'm open to that."

"Fine. But there's this voice in your head, right? And it says you can't do it -- that you're doomed to a life of drinking."

"You got that right."

"So let's just call that voice your Addictive Voice. It is the thinking that you do that argues incessantly for more drinking, and tells you how impossible it is for you to quit drinking for good. Get it?"

"Like there are two of me?"

"No. There is only one of you, and you plan to never drink again. But you have ideas and thoughts and images of drinking that you can spot and recognize. Those thoughts are yours, for sure, but they aren't you."

"Oh, that voice! The one that's telling me right now to have a drink once we hang up."

"You're doing it, Virginia! You are now practicing what we call Addictive Voice Recognition Technique and after only about ten minutes of talking about it. In Rational Recovery we call Addictive Voice Recognition Technique, 'AVRT' for short, and the letters almost spell out the word avert. You can completely recover from your addiction in a relatively short period of time by doing what you just did. Now, tell me what you think of AVRT so far."

She paused, then said, "Well, I can see it gives me some control, some of the time, but I doubt that I can always do that."

"Let me suggest, Virginia," I said, "that you may have just heard your Addictive Voice once again, but you failed to recognize it."

"I don't think so. No one's perfect, but I can probably use AVRT to do better at times. But I doubt that I can always resist the desire to drink."

"I hear your Addictive Voice right now, Virginia. It's saying, 'AVRT is cute, but I will still drink any old time I feel like it.' Do you see how your thinking leaves the door wide open to drinking any time you feel like it?"

"Now that you point it out, yes. I do see. This Addictive Voice, as you call it, is a real, uh..."

"Beast. We call it the Beast, because it doesn't care about anything but booze. It doesn't care about you or anything you value, including your relationship with your fiance, your career, your health, or anything at all. It will even tell you that life is so rotten that you may as well commit suicide, gambling that you will drink instead of going to the trouble of killing yourself. Its main weakness is that it is easily identified -- by what it wants -- and once it is recognized, it's defeated. Our definition of the Addictive Voice, or the Beast, is, 'Any thinking that supports any use of alcohol -- ever.' That's how I am able to identify your Addictive Voice here on the phone. It's easy for me to hear your Beast, and with a little practice, it will be just as easy for you."

Like others who learn about AVRT, Virginia responded with some very good feelings. "This gives me such a good feeling to learn about AVRT. It's a feeling of hope I haven't had for years. I actually feel like I can do something to help myself. Why haven't I heard of this before? I mean, with all the treatment I've had -- why isn't this information given in regular treatment programs?"

I told her, "Things are changing very rapidly in addiction care programs. Many are offering Rational Recovery by name. But America is going through a very bad time over addictions. The 12-step program of AA is being presented to the public through virtually every treatment program in the nation as a universal program -- one that will work for everyone. Al though AA helps many who choose it and appreciate its good points, it probably harms even more people who are not there by choice. They, just like you, find its message of disease and powerless ness not only useless, but actually harmful. And, as in your case, many people get caught in the jaws of defeatism when they find the 12-step program contrary to their values or unsuited to their needs."

Virginia then asked, "You know what this means?"

"What?"

"This means I'm not crazy."

"I'll bet that feels good."

"It's like a great weight has been lifted from me," Virginia said. "I now have hope. You can't imagine."

"Oh, yes I can. I was there, too. 'Bye now."

"Good Bye, and thanks for the start on AVRT."

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