Thursday, 17 November 2011

What's up Doc?

I was pleased to be invited to contribute to Petrie Hoskyn's show on Sunday afternoon in which she was reviewing an article from last weekend's Observer which had been talking about high functioning alcoholics.

I took the opportunity to think some more about the many functioning addicts and alcoholics I have come to know, both personally and professionally.  Functioning addicts look, after all, very much like you and I.  They continue to function and, as Petrie and I were discussing, they often function very well.  In most areas of their life.  But appearances can be deceiving.  To maintain such an appearance consumes a devastating amount of energy.  Which is usually what prompts such an individual to seek help.  It all works very well, until it doesn't. 

The article highlighted the prevalence of alcohol misuse and dependence amongst professionals, particularly doctors and lawyers.  The medical and legal professionals are well known for their fast pace, work hard-play hard ethos and culture.  They are also two of the most difficult fields in which to admit vulnerability, let alone show weakness. 

I have in recent years come to work with increasing numbers of professionals from all walks of life.  I am well versed in assessing those who have become experts in self assessment, self diagnosis and and self medication.  All too often the wheels of disciplinary action and professional standards have started rolling before such individuals approach me and herein lies the problem that is, I believe, common to anyone addressing an addiction issue:  shame.

Shame feeds denial, and denial feeds shame.  Those unfortunate individuals who might come to be recognised as functioning addicts are not, in fact, functioning, except in the art of deception.  They defend the illusory image that they are fine to such an extent that they may even start to believe it themselves.  Denial is self perpetuating and in order to escape their deep sense of shame, functioning addicts go to extraordinary lengths to keep anyone from guessing that they might have a problem. 

The statistics are frightening, but my fear is that they reveal at best a partial truth.  If it is estimated that somewhere between 15 and 24% those in the legal profession have a problematic relationship with alcohol, this may in fact be far higher because were you to take a straw poll standing in Chancery Lane on a Friday night, chances are you wouldn't get many admitting to having any problem with the amount they drink. 

1 in 15 healthcare professionals is said to develop an addiction problem.  The numbers worry me, as it is a population that have an almost pathological inability to seek help.  And not without reason, either.  There is a woefully inadequate provision of specialist support at present.  All too often, professionals who acknowledge their struggle are sent packing.  What is needed is less hype and more substance.  The right substance, of course. 


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