It has been estimated recently that 40 percent of the inhabitants of the United States who are of drinking age use alcoholic beverages.1 In view of the abundant evidence that alcohol is harmful, it is surprising that such a high percentage of the population of an enlightened nation indulges in intoxicants. There must be an underlying reason why alcohol is attractive, else so many people would not risk the consequences of its use.
At first thought it might seem that people drink because they enjoy the taste of alcohol. Fondness for a given taste is surely the basis for preferences among other beverages. But not so with alcoholic drinks. Observe the facial expressions of persons sitting at a bar, and you will discern an almost painful response to the swallowing of each draft. Alcohol itself does not have a pleasant taste. In fact, the blending of liquors is an attempt to dis guise the objectionable taste of the alcohol. Non alcoholic drinks are much more palatable than those which contain alcohol. But drinkers demand more than flavor. What was the reaction to alcohol-free beverages during the years of national prohibition? A demand for beverages containing alcohol. So, it is not the taste of liquor that makes it attractive—it is its alcohol content!
Why do people drink? Not to quench an ordinary thirst. Spirituous liquors irritate the mouth, the esophagus, and the stomach so markedly that many a person has resorted to drinking egg whites in a desperate attempt to soothe the severe burning which follows indulgence.
Why do people drink? Not because of an inherited thirst for alcohol, for "there are nowadays no representatives of the view that alcohol addiction itself can be directly inherited." 2 Of course the child quickly learns to imitate the attitudes and customs of his parents, but the thirst for alcohol as such cannot be passed from parent to child.
Why do people drink? Some say they drink "because it is the smart thing to do," or "because my friends drink, and I don't care to be a piker." Many a parent has tried to console himself and excuse his wayward son by explaining that "he fell into bad company and learned to drink." Admittedly, the example of companions has its influence in persuading a person to continue the use of alcohol. There is a social or convivial factor in alcoholism. But even the "social drinker" has to pay such a high price in lost efficiency, lost self-respect, and condemnation by his elders that it is hard to believe the desire to be a "good fellow" is, in itself, an adequate explanation for drinking.
It is of fundamental importance to know why people drink, for it is difficult, if not impossible, to assist a person in overcoming his alcohol addiction unless one first possesses a clear understanding of the basic reason why alcohol is attractive. Once this reason is comprehended, however, it is possible to help the alcoholic.
As a foundation for an understanding of why people drink, consider the case of the father of three children who took recourse to alcohol after he had failed in business.3 This man, himself an only child, had been reared by an indulgent mother and an unsympathetic father. He became spoiled and found it difficult to make proper adjustments in school and get along well with his schoolmates. After college, about the time the United States entered the first World War, he joined the Army. Then, for the first time in his life, he experienced the satisfaction that comes from doing a job well. By the time the war was over he had been promoted to the rank of captain and was enjoying his assignment so thoroughly that he almost hated to see the war end.
After the war he was married and attempted to establish a business. During the first six years of married life three children—all girls—were born. By this time the business was going so poorly that he was forced to abandon it. And this in spite of the fact that he and his wife had invested all their combined financial reserves. In an attempt to relieve the situation, the wife now-started a business of her own, and was successful from the start.
Any man resents having his wife beat him at his own game, but this resentment was particularly acute. Here was a man who as a child had been very dependent on his mother, and as an adult found himself the only male in a family of five, with his wife making the living. The situation was so humiliating that he began to long:
for the days when he had been an Army captain. So he began to drink, meanwhile keeping company with former Army comrades, and reliving the events of the war. He soon became so dependent on alcohol for surcease from his embarrassment resulting from his inability to support his family that he indulged in solitary drinking and spent much time in phantasy regarding his former achievements. Whenever he became sober, the realization of his failure was forced upon him by his own observations and by his wife's unkind remarks. So he remained intoxicated a great deal of the time, for while intoxicated he was unaware of his inadequacies.
This is only one case, but it illustrates what is probably the most important reason why people drink—to escape from unpleasant reality.
Jellinek 2 has summarized the "'Reasons' for Drinking" as given by nineteen different authorities on the subject of alcoholism. The terminology used varies a great deal with the different authors, but it is striking to note how many of the proposed reasons are equivalent to the statement that alcohol enables the individual to escape from unpleasant reality. In fact, the term "escape" is used more frequently than any other single term.
Jellinek's summary of the various proposed reasons includes the attempt "to overcome shyness and awkwardness," "to escape from life's situations which the patient cannot face," "to find a way of rebelling," "to obtain pleasure," to serve as a "'pacifier' for physiological and psychological tensions," to "escape" from a "sense of inferiority," to promote "compensation," "to modify emotional experience such as fear or inferiority," "to evade pain," "to silence depressive effects," to permit "a flight from reality," to provide for "liberation of that part of the personality which is kept in check by convention," to provide "a means of securing—for however a short time—some way out of the prison house of reality back to the Golden Age," to provide "an escape from the responsibility and burden of mature emotional life and its decisions," to furnish "a means of realizing daydreams," to serve as a "pacifier for disappointment and rage," to "alleviate and narcotize the many mental conflicts," and to provide "an escape to the blissful state of infantile omnipotence."
Moore believes that alcohol addicts "drink not only to relieve psychologic distress but also to overcome symptoms resulting from the previous day's alcoholic intake." 4 Horton remarks that students of alcoholism are agreed that "the psychological functions of alcohol are determined primarily by its anesthetic effect. Chief among these functions are relief from pain and fatigue, and reduction of anxiety." 5
During the symposium on alcoholism held in December, 1940, in connection with the annual meeting of the American Association for the Advancement of Science, Dr. Charles H. Durfee, of Wakefield, Rhode Island, stated that "there is no such thing as a physiological craving for alcohol. . . . The craving is fundamentally psychologic, expressed in the need for relief from tension." 6
As proof that alcohol provides an escape from psychological tensions, the Business Men's Committee on Alcoholism, Bronxville, New York, quotes the Paris correspondent of the American Medical Association as follows: "During the second half of August, 1938, a time of political unrest when war clouds hovered low, the number of alcoholic addicts in the [Paris] police infirmary nearly doubled. . . . Toward the end of August, 1939, again under the pressure of national stress, the incidence of alcoholism rose. . . . At the Ville Evrard . . . cases of chronic alcoholism increased fourfold, beginning with May, 1940."
Granted that the principal reason for indulgence in alcohol is escape from an unpleasant environ mental situation, it is proper that mention should be made of those situations which cause the individual to desire to escape from reality. In many cases the cause of alcoholism can be dated back to an unfortunate childhood situation.
"The common pattern in these histories is one in which the psychological crime of parental loving dominance was perpetrated against the child. The after math is obvious. The time comes all too quickly when the child arrives at the chronological age at which society expects anod demands emotional maturity accompanied by adult behavior. The emotionally immature individual makes a sorry attempt to satisfy these demands by a few futile and inadequate gestures. He fails. Society begins to exact the penalty for such failure. Perhaps the remainder of the picture, its alcoholic component, is a matter of chance. But it is a chance in which the dice are loaded, since alcohol is not only the most rapidly acting solvent of unpleasant reality, but is also the most available and least socially reprehensible of the techniques for evading reality." 7
In other cases of alcoholism the desire to escape from reality is not directly trace able to an unfortunate childhood. Many situations which arise during adult years are so stressing as to provide a strong temptation to find an easy way out. As mentioned before, one such situation is the tension resulting from the uncertainties of war. Jellinek claims that "anxieties, frustrations, and conflicts are the mainsprings of unconscious motivation for the moderate as well as the excessive drinker." 8 Lewis lists the fol lowing situations as being conducive to an escape into alcohol: "Business worries, domestic worries, grief from all sorts of adversities, and emotional situations caused by certain unavoidable environ mental elements." 9
Alcohol provides the escape from unpleasant reality by way of its depressing effect on the central nervous system. The individual thus becomes less aware of the distressing situation which confronts him. "Although the craving for alcohol may have had its origin in Social, domestic, economic, or other uncertainties, the paradoxical fact remains that the alcoholic feels secure when under the influence."10 Alcohol's "effect is that of deadening, or dulling, the keenness of perceptual functions, and mostly it induces lethargy in regard to the active projects of life, while at the same time the deep and primitive emotions play havoc with imagination." 11
The person who escapes from reality by way of alcohol "finds in alcohol a source of unreality, of dangerous make-believe, which protects him from 'the stings and arrows of outrageous fortune.' He is unwilling to take the bad along with the good and rather than run the risk of being hurt, he prefers not to live at all as other men live. Unfortunately, he does not see, until it is too late, that alcohol hurts him more in the long run, than he could possibly have been hurt by life and its experiences." 12
Alcohol does provide temporary escape from reality. But the treachery of indulgence in alcohol is that when the effects of the alcohol wear off, the individual realizes that his environmental situation is even worse than before he became intoxicated. Not only has the alcohol failed to relieve the unpleasant factor, whatever it was, but it has left its victim 'chagrined for having tried to find an escape rather than bravely facing the issue and attempting a rational solution. Also he is less able to devise a reasonable solution to his difficulty. It is therefore only natural that he repeat the indulgence, and thus perpetuate the stupor which gives him relief from his sense of in adequacy. Thus a vicious cycle is established which is most difficult to break. One indulgence demands another, until finally the victim loses all interest in making a proper adjustment in life.14
Thus far, the picture of alcoholism appears rather dark. The next article of the series, how ever, will be a discussion on "Help for the Alcoholic."
1 Lloyd Ackerman, Health and Hygiene, Jacques Cat-tell Press, 1943.
2 E. M. Jellinek, Alcohol Addiction and Chronic Alcoholism, Yale University Press, 1942.
3 Otis R. Rice, "Religion and the Church in Relation to Alcohol Addiction," Quarterly Journal of Studies on Alcohol, December, 1942, PP. 394-397.
4 Merrill Moore, "The Treatment of Alcoholism," New England Journal of Medicine, Sept. 28, 1939, PP. 489-493. 5 Donald Horton, "The Functions of Alcohol in Prim itive Societies: A Cross-Cultural Study," Quarterly Journal of Studies on Alcohol. September, 1943, PP. 199-320. Merrill Moore, "Alcoholism : Some Contemporary Opinions," New England Journal of Medicine, Vol. 224, 1941, pp. 884-887.
5 Edward A. Strecker, "Chronic Alcoholism : A Psychological Survey," Quarterly Journal of Studies on Alcohol, June, 1941, pp. 12-17.
6 E. M. Jellinek, "The Alcohol Problem: Formulations and Attitudes," Quarterly Journal of Studies on Alcohol, December, 1943, PP. 446-461.
7 Nolan D. C. Lewis, "Personality Factors in Alcoholic Addiction," Quarterly Journal of Studies on Alcohol, June, 1940, PP. 21-43.
8 S. L. Katzoff, "Psychological Aspects of Alcohol ism," The National Eclectic Medical Association Quar terly, Vol. 34, 1943, PP. 32-43. Quoted in abstract of article in Quarterly Journal of Studies on Alcohol, June, 1943, P. 117.
9 Allbion Roy King, The Psychology of Drunkenness (Mount Vernon, Iowa, Hawkeye-Record Press, 1943), p.
10 Edward A. Strecker, Are You a Social Drinker (Pennsylvania Liquor Control Board), p.
11 Eugene N. Boudreau, "The Medical and Social Challenge of Alcoholism," New York State Journal of Medicine, Dec. 15, 1941, PP. 2407-2414.
12 Paul Schilder, "The Psychogenesis of Alcoholism," Quarterly Journal of Studies on Alcohol, September, 1941, PP. 277-292.
