Page 106 - PhD GT

loss of control was the defining characteristic of “gamma alcoholics”, one of the two sub-types described as disease states. He contrasted these with “delta alcoholics” whose defining characteristic was the inability to abstain from drinking. Loss of control was then defined by Jellinek (1960) as the event where:
“the ingestion of one alcoholic drink sets up a chain reaction so that they are unable to adhere to their intention to have 'one or two drinks only' but continue to ingest more and more...” (Jellinek 1960 p. 41)
In this later definition, Jellinek has introduced the idea that there is a discrepancy between behaviour and intention. While seeming to avoid attributing causation, Jellinek (1960) described loss of control as occurring in the context of acquired increased tolerance to alcohol and two aspects of this phenomenon are relevant here: withdrawal symptoms can occur within a drinking bout, causing discomfort and being relieved by further drinking; secondly he noted the empirical finding that impairment of psychological functioning diminished as a result of increased tolerance as did experience of a euphoric effect. Reduction in the euphoric effect is greater when the blood alcohol level is descending compared to the same level when it is ascending and this loss of effect is accompanied by feelings of dysphoria which again will be attempted to be alleviated by further drinking. Jellinek concluded:
“The drinking bout in the presence of loss of control differs greatly from one in which the drinker gets drunk deliberately” (Jellinek 1960 p. 146)
The observed phenomenon of loss of control has remained central to discussions of the nature of alcohol and drug dependence as has the question of the loss or reduction of freedom described by Jellinek and, for many observers, implicit in the state. Debating this question of freedom of choice, Edwards and Gross (1976) alluded to a spectrum of situations in which the observed phenomenon of loss of control might occur. As a result, they questioned whether loss of control was the appropriate term:
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