A different variety of alcoholism is that occurring in people who, once they have started to drink, cannot stop but must go on until all their money is spent or their supplies are finished or until accident or unconsciousness supervene. Such drinkers can have abstinent periods but as soon as they begin to drink again they cannot limit the quantity. This pattern has been aptly named ‹“loss of control’. In mild cases the amount of drink taken may gradually increase for several days after a period of abstinence. Eventually, however, even in these cases drunkenness is reached. Another variant, which stops short of the full picture, occurs when some social self-restraint can operate although drunkenness has been reached; the alcoholic retains sufficient foresight and manages to desist in spite of there being drink still available. A married schoolteacher of 45 worked for five days each week without drinking. Every Friday as soon as school ended she would start drinking gin to such an extent that by nightfall she was very intoxicated, very outgoing and talking excessively. She misbehaved socially and abused her husband, accusing him of paying her too little attention. Next morning she would be unaware of the disturbance she had caused in her own and her friends’ homes. She continued to drink during Saturday and became drunk and forgetful once more; on Sunday morning she would wake feeling remorseful and apprehensive and although she began to drink straight away she did not let herself get quite drunk. By Monday morning she was able to go to school and do her work for the ensuing week. She was more fortunate than most of those who suffer from loss of control. They are powerless to prevent their spells from going on to prolonged drunkenness. Invariably they suffer from withdrawal symptoms, for they have become physiologically dependent on alcohol and it is very common for them not to be able to remember the later events of the spell of drinking even though they did not lose consciousness. Compulsive alcoholics are the mainstay of Alcoholics Anonymous. It is easy to see how they haAte developed the idea that alcohol is a specific poison for them on the basis of a prior physical sensitivity. The view is incorrect; but, since the alcoholic later becomes physiologically dependent, his idea that alcohol is a poison may fairly sustain him in his straggle for abstinence.
Between crescendos of drinking the compulsive alcoholic may remain abstinent for periods of some days. A stranger meeting him at such a time would not credit that he was an alcohol addict. Although this type of alcoholic finds temporary sobriety bearable, as soon as he has one drink a train of events is set in motion. He is compelled to continue drinking until his physical reactions, some serious disease or injury, or his mounting terror of the consequences if he continues, force him to stop. The alcoholic caught up in this furious progress can no longer choose between leaving off or continuing to drink.
The alcoholic who drinks in this pattern gets himself into serious social difficulties. His drunken behaviour repels. He alienates and antagonizes those who come into contact with him, relatives, friends and workmates, even when they are anxious to be helpful to him.