I prefer not to use the term “alcoholic” or “alcoholism” because I do not agree with the way these terms are commonly defined. Implied in the definition of alcoholism is a denial of an important aspect of our humanness, which is the ability to make choices. For those who believe the Bible, the idea that humans are sick rather than bad should be rejected as contrary to Scripture. Adam and Eve were not driven from the garden because they were sick but because they were bad. The story of the Bible reveals the choices that people make and how this affects their lives on earth, their relationship with God, and eventually their eternal destiny. The prophet Ezekiel rejected the notion that we can blame something or someone else for our behavior, “The soul who sins is the one who will die” (Ezekiel 18:20).
There is now a growing consensus in the mental health field that people can actually choose their behavior and that they are not controlled by their genes or environment. Many psychologists now argue that there are no predetermined and automatic responses to life events and the focus ought to be on how to change behavior by thinking differently. I am also in agreement with this new direction in psychology, and what cognitive psychologists now say about behavior, choice, and self-control is in general agreement with biblical teaching.
To see how the cognitive approach to mental health and behavior contrasts with the disease model of addiction, we must first define alcoholism according to the standard definition. Although there may be some variants to the disease model, they all have common themes. The definition used here is from the website of the National Council on Alcoholism and Drug Dependence (1990). The definition was approved by the Boards of Directors of the National Council on Alcoholism and Drug Dependence, Inc. and the American Society of Addiction Medicine in February of 1990.
Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic: impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. (1)
The disease component of this definition is later defined as “an involuntary disability.” Impaired control is further defined as “the inability to limit alcohol use or to consistently limit on any drinking occasion the duration of the episode, the quantity consumed, and/or the behavioral consequences of drinking.” Notice that the characterization of this disease is not described in terms of biology but behavior. No biology is mentioned in the definition, but a true disease would be described in biological rather than behavioral terms. Furthermore, there is no blood test or physical examination that can determine whether people will not control their behavior. Doctors may become experts about what alcohol does to the body after it is consumed, but this is not an explanation of the cause of the behavior.
J B Myers