[lit-ideas] Re: Is alcoholism a disease or a life-style choice?
- From: "phatic" <phatics@xxxxxxxxxxx>
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Sat, 27 Mar 2004 22:24:49 +0000
"You see, it's not your fault. It's nothing to be ashamed of."
Miles Davis, "It never entered my mind"
***
Dear luborowik@xxxxxxxxxxxxx and all.
Welcome and thanks for an informative mail. I've been trying to join this
thread before, but suffered an email breakdown, with consecutive bouts of
self-pity-wallowing and other kinds of abusive behaviour. (To Self and
other.)
Ok, it's not that I like to pick a fight with MDs, but as a Certified
Lunatic I can't but chip in here. I wanted to comment on:
"In a patient with comorbid depression and addiction, denial can
interfere with the acceptance of one or both disorders."
Well, this calls for a story. A first person narrative of a comorbid
depressed and addicted person who DENIES IT. The challenge (and readerly
quest) would of course to allow the reader/author (extradiegetic or
implied level of narration) to read into the diegetic level (the
subject/patient) something the subject would deny the existence of. There
must be some authoritative discourse on the extradiegetic level that
would be absent at the diegetic level, and the subject must not be
allowed to have the final say.
"The patient may feel that she is not really an addict after all ("I only
drank because I was depressed")..."
Funny you should mention it, cause Zizek brings up this effect in his
essay on The Fragile Absolute (q.v.). He discusses, on page 9 (that's
about as far as I've gotten in it yet), a process he calls "global
reflexivization/mediatization", whereby Jungian, Kleinian, Lacaninan
"interpretations of symptoms" become "symptoms which themselves are
Jungian, Kleinian, Lacanian", and "whose reailty involves implicit
reference to some psychoanalytic theory." I can't stop there, though.
Zizek is on a roll:
"The unfortunate result of this global reflexivization of interpretation
(everything becomes interpretation; the Unconcious interprets itself) is
that the analyst's interpretation itself loses its performative 'symbolic
efficiency', leaving the symptom intact in the immediacy of its idiotic
_jouissance_."
The patient who identifies as "depressed" seems to know an awful lot
about these psychoanalytic categories? Do we have a case here where the
therapist becomes sidelined when the client reappropriates her tools?
<snip>
"...and only has to take antidepressant medications without working a
program of recovery. On the other hand, she may reject treatment of
depression and rely only on addiction treatment for her mental health
("when I'm sober, I will no longer feel depressed"). Denial of either
illness can lead to relapse and demoralization; clinicians must
consistently reinforce that the patient has 2 chronic conditions, both of
which require different types of treatment."
There may be grounds for making a distinction, I tend to agree.
> What is true is that excessive alcohol consumption produces tolerance
> [leading to needing more to get the same 'fix'] and withdrawal
> [creating craving for more alcohol]. This unavoidable physiological
> process is a major
> part of alcohol problems it seems to me, whatever psychological
> analysis might also be offered.
This is something I wanted to comment on earlier. I agree, provided
you/one/the subject/client/patient/lunatic wants to Give It Up (cf.
Kafka), ie. Quit. If not, there's always over-identification. Zizek
again:
Instead of taking a "defensive stance, allowing the enemy to define the
terrain of the struggle, what one should do is to reverse the strategy by
FULLY ENDORSING WHAT ONE IS ACCUSED OF: yes, there IS a direct lineage
from Christianity to Marxism; yes, Christianity and Marxism SHOULD fight
on the same side of the barricade against the onslaught of new
spiritualisms -- the authentic Christian legacy is much too precious to
be left to fundamentalist freaks." (2)
Oh, man. It should be added that Zizek elsewhere alludes to the
obsessive-compulsive symptom as a chief effect of the structuring LACK of
capitalism. (Hence it's perversion is EXCESS, cf. Linda Williams
HARDCORE, ch.5 on The Fetish in Marx and Freud.)
"why people drink and use drugs until their complete self-destruction?--
and I'm not even trying to address the impact drug dependence has in the
social life of those patients."
tell me about it. i have to run around a whole day sometimes to get me
drugs. its a bloody hassle. legalize it. lots of research shows that it
entirely possible to keep up a regular daytime job while on herion. it's
the price and the conditions in which its mostly peddled that's the issue
here. a lot could be done with that if it had been legalized. let's
distinguish drug use from some other issues in society. not everything is
drug use, not even for a user. i guess i wonder about the specificity of
alcohol as a toxicant.
"Denial may be the main point. Or perhaps the society just don't give
physicians the amount of credibility they like to think they have. Maybe
this is another question for future discussion."
Cf. quote from Zizek, the "analyst's interpretation itself loses its
performative 'symbolic efficiency', leaving the symptom intact."
> I have to admit that the issue bothers me more than intersts me.
Same here.
Have a nice weekend.
Later,
phatic
--
phatic
phatics@xxxxxxxxxxx
http://phatic.blogspot.com/
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