In my experience working with drinkers in online support groups what I have found is that people suffering from depression, anxiety, PTSD, social phobia and borderline personality disorder want some relief from their mental anguish. These people feel that if they could obtain some relief from their mental anguish then they could get a handle on their drinking and reduce it to non-problematic levels. Unfortunately it seems that the vast majority of mental health professionals insist on classifying alcoholism as a primary disease and hence they require of their clients a commitment to permanent abstinence. These mental health professionals also often require a six month period of alcohol abstinence from their clients before they will give their clients access to any mental health services.
The results of this can be devastating. We all know how frequently untreated conditions like depression can lead to suicide. Moreover, clinicians frequently demand that dual diagnosis clients attend AA meetings and even threaten to withhold psychotherapy or psychiatric medications unless the clients consent to attending these meetings.
The problem with this is that the content of AA meetings is liable to be extremely damaging to people with mental health issues such as depression, anxiety, PTSD, social phobia or borderline personality disorder. In the 12 x 12 Bill Wilson clearly defines AA as a program of ego deflation. But the people suffering from these disorders already have severely damaged egos. What they need is not an attack on the ego. What is needed is support to strengthen the ego.
People with co-occurring Antisocial Personality Disorder and alcohol problems may require a different approach than most others with mental health issues.
But most people with co-occurring mental health issues and drinking issues would be best served if mental health professionals were simply able to listen to what their clients feel that they need for themselves. What is needed is some relief from the mental anguish and support in their own personal choice of a drinking goal: whether that goal be harm reduction, abstinence, or moderation.
People could generally do better with less labeling and more recognition that they are people first--and that mental health issues and alcohol issues come second.
Please also visit our page:
Alcohol and Mental Health
And our page:
Antisocial Personality Disorder and Alcohol