I remember a couple I saw early in my professional career. She had an unusual fear of alcohol because of her family background, which included not only heavy alcohol use but also incest. Rather than going on to graduate school as he had planned, when she became pregnant they married. He was younger than she and overwhelmed by the responsibilities of a new pregnant wife and two small children. He took a city job working in the forestry division where all of his coworkers were 20 or more years his senior. They referred to him as the kid and he felt like that. Over time he began going out with them on Friday night. Then the trouble began. She was sure she had married an alcoholic. He got defensive and defiant about his drinking, feeling entitled to a night out with the boys after a hard week of physical labor.

When they came to me I agreed with him that her reaction to alcohol use was probably excessive. Then I asked him to examine his behavior using the alcohol-troubled person model. He easily recognized that family was important to him, but he was putting this group of men and their interests (drinking and cards) ahead of the needs of his wife and children. Moreover, his Friday night outings were expensive and their budget was already stretched. This was causing financial problems for them. Because he was out alone on Friday night their social life as a couple was negatively impacted as was his relationship with the children since Saturday was the one day he could spend time with them and he spent most of it recovering from the late night before.

When he looked at the issue from this perspective rather than from the pejorative attack on his behavior, he easily recognized that the night out with the boys was interfering with the quality of like he wanted for himself and his family. There were a number of positive outcomes from dealing with this problem. She was very appreciative he was willing to recognize the impact her family of origin had had on her and worked hard at modifying her blanket indictment of any use of alcohol. By the time the new baby was born, he had developed a solid relationship with the older two, which helped them accept a little brother.

Let’s take a look at the life areas individually. By adulthood, people have developed a value system by which they order their lives. When someone for whom honesty is an important value lies to cover up alcohol use, his or her moral quality of life is diminished by the use of alcohol. When one breaks the law in order to accommodate alcohol use, one has a problem with alcohol in the moral realm.

When alcohol comes before people, and the important relationships and responsibilities in one’s life, alcohol is causing a problem in the social area.

Alcohol is a mood and mind altering drug. It is a depressant drug, which can cause or increase depression, negatively impacting our emotional health.

When people think about the financial impact of alcohol use, they tend to think of losing jobs of drunken spending sprees. In fact, if you are salesman whose peers consistently make a hundred thousand dollars a year and you make 80 because of liquid lunches, late arrivals on Monday morning, early departures in the afternoon, you have reduced the quality of your life in the financial realm.

The physical implications of alcohol use will be a topic of another article, but in this context fairly moderate use of alcohol can negatively impact the quality of one’s physical health in the areas of nutrition, sleep and susceptibility to infection.

Anyone who uses alcohol ought to occasionally examine that use in light of its impact on the quality of life in the five important areas of life: moral, physical, financial, emotional and social. If alcohol use is causing a problem in any area, a change is in order. It may necessitate reducing the amount consumed, changing the pattern of drinking, or eliminating alcohol for a time. One does not need to be that bad in order to make a change, nor does one have to wait to be an alcoholic.

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