Page 105 - PhD GT

behaviour which involves physical or psychological pathology, from excessive drinking which does not involve such pathology. Jellinek described a discrete group of people who, after several years of excessive drinking, may progress to the pathological or disease state of alcoholism characterised by loss of control over the intake of alcohol. These “alcohol addicts” were distinguished from “habitual symptomatic excessive drinkers” by virtue of this phenomenon of loss of control (see Jellinek 1952 for a summary of his lectures to the Yale Summer School of Alcohol Studies on the subject). Jellinek described this phenomenon as:
“any drinking of alcohol (that) starts a chain reaction which is felt by the drinker as a physical demand for alcohol.....it lasts until the drinker is too intoxicated or too sick to ingest more alcohol. The physical discomfort following this drinking behaviour is contrary to the object of the drinker, which is merely to feel ‘different’....” (Jellinek 1952 p. 679)
This definition suggests that, once established, loss of control inevitably follows the ingestion of alcohol; nonetheless “felt by the drinker...” implies a subjective state. The loss of control phenomenon was described as definitive of the onset of the “crucial phase”, when the addictive phases replace the symptomatic phases. Although Jellinek claimed that only a proportion of people with drinking characteristic of each stage would progress to the next, there is nonetheless an implication of a predetermining factor which was yet to be established. No claim was made regarding the etiology of the condition and several possible sources were suggested; but a source there must be as, he claimed, people who reached the point of drinking with loss of control formed a distinct group; some people could drink excessively all their lives and never develop loss of control. Jellinek also recognised the way in which individual drinking patterns, determined by individual need, would be superimposed upon culturally formed drinking patterns which might put them at risk in different ways. He further acknowledged the fact that the development of loss of control drinking proceeded at a different pace in different individuals and was likely to develop faster in women (though since he described his survey as being administered to men it is probable that this observation, replicated as it has been, is based upon a smaller sample).
Having described the phases of alcohol addiction, Jellinek (1960) went on to propose a typology of alcoholics which distinguished disease states from non-disease states. In this typology
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