In 2009, BioMed Central Psychiatry published an article that investigated the process by which alcoholics progressively give up – or fail to give up – alcohol.
The authors of this article interviewed nine alcoholics who had managed to abstain from alcohol use for over a year and twenty-three alcohol-dependent inpatients at a local hospital.
From these interviews, the authors were able to find a common process of alcohol-dependence and alcohol-abstinence. The process of abstaining from alcohol was described in three stages: the IAA cycle, Turning Point, and Ongoing Process.
The IAA cycle, which is an abbreviation of the Indulgence, Ambivalence, Attempt cycle, is the first stage of alcohol abstinence.
During the Indulgence phase of this the IAA cycle, alcoholics recognize that they have lost control over the use of alcohol. Although the alcoholic during this phase recognizes that alcohol has this power over his or her life, there is not a recognition of the deleterious effects of alcohol consumption until the Ambivalence phase. During the Ambivalence phase, alcoholics begin to feel a need to quit using alcohol, but are unable to resist the craving for alcohol. It is not until the Attempt phase of the IAA cycle that alcoholics make a serious effort to stop drinking. If the effort to maintain alcohol abstinence fails, which occurs more often than not, then the individual reverts back to the Indulgence or Ambivalence phase.
Often, the Turning Point stage does not occur until numerous attempts are made to stop drinking. According to the authors, the Turning Point represents “rock bottom” for the alcoholic. By this point, alcohol has had an extremely damaging effect on the alcoholics personal life and relationships. This state of despair provides the alcoholic with a motivation to quit that was not present during the IAA cycle. After the Turning Point, the alcoholic is willing to seek help from others or enter into alcohol treatment if need be.
“Strength from others’ support, self-prompting, and self-help and helping others and all are essential for the success of any attempt to remain abstinent,” as the authors of this article explain.
During the Ongoing Process stage of alcohol abstinence, alcoholics find support in family members and friends, as well as support groups such as Alcoholics Anonymous, to help them stay abstinent. This process does not end. Alcoholics must maintain these systems of support in order to prevent themselves from relapsing back into alcohol addiction.
Reference:
Mei-Yu Yeh, Hui-Lian Che & Shu-Mei Wu. (2009). An ongoing process: A qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence. BMC Psychiatry 2009, 9:76. Full text: https://www.biomedcentral.com/1471-244X/9/76