The Drinking Cycle of an Alcoholic

tomrue 17 April 1998

^{This short article seems to capture the "Jellinek model" of alcoholism, known to many who are familiar with the curricula of present-day rehabilitation centers, as it existed in 1950. Not until 1960 did Jellinek publish his comprehensive book The Disease Concept of Alcoholism which set the stage for the acceptance of the disease model first by the American Psychiatric Association in 1965 and the American Medical Association in 1966. This early description of E.J. Jellinek's findings does not include widely recognized graphic generally associated with his name (see below). This article, dated Spring 1950, in my view presents as too arbitrary the "average age" for the various milestones in would eventually become widely accepted as the disease of alcoholism. This magazine was mailed to me in June 2004 by my friend David Shaw of Santa Cruz, California. As a literary work created prior to 1978, pursuant to the U.S. Copyright Act of 1976 it is believed to have passed into the public domain 28 years following its publication. It is posted here for historical interest and to present the essential concepts of chronicity and progression of the disease as framed by one who helped to transform the field of alcoholism treatment during the middle of the last century just as the A.A. movement was beginning to take root. -TR}

The Drinking Cycle of the Alcoholic

An early description of the Jellinek model

From Your Marriage magazine, Spring 1950

ALCOHOLICS - like other human beings - do not conform to an unvarying behavior pattern. But they come close enough so that some very shrewd observations can be made upon successive stages in a drinker's life that lead to alcoholism. Such an analysis, published in the Quarterly Journal of Studies on Alcohol, has been made by E. M. Jellinek, Sc.D., based upon a drinking-habits questionnaire circulated to members by Alcoholics Anonymous. Sequences in the making of an alcoholic advance, in a general way, along this time schedule:

	Average Age
	25 years	Signs that drinking has been excessive for some time. Begin to have "blackouts," obliteration of memory or occurrences following drinking. Not yet alcoholics.
	27 years	Find they are drinking more than intended; start out with intention of a couple of drinks but wind up cockeyed.
	29 years	Rationalization of excessive drinking; is convinced he gets drunk for good reason, not because of inability to control.
	30 years	Starts taking drink in morning as a pick-me-up. Portent of coming "benders."
	31-33 years	"Benders" well established. Acute compulsive phase of alcoholism begins.
	34 years	On average, two years after onset of "benders" begins to react with unreasonable resentment to anything contrary to personal wishes.
	37 years	Physical involvements show up; medical assistance sought; first time in hospital for some alcoholic bodily disorder.
	39 years	Rationalization system breaks down. Alcoholic admits he; cannot control his drinking, realizes he is "licked."
	41 years	Reaches what he later considers to have been his "lowest point." It was within a year of this low-point period that those answering the questionnaire joined A.A.

Dr. Jellinek's analysis is not intended to be definitive - the questionnaire, he suggests, might well have asked pertinent questions that were omitted by its authors. Too, the questionnaire represented only 95 men, all members of Alcoholics Anonymous, a specialized group whose members have admitted inability to control alcohol without help. As such, the answers may not be typical of other alcoholics who continue drinking unregenerately until the end. The findings are, however, of importance in suggesting some general underlying pattern of advancement into alcoholism.

Here is a graphic of the "Jellinek chart" as the model is most often presented today in many rehabilitation centers, which can generally be applied just to alcohol but to all drugs, showing the downward slope of the disease followed by the upward path of recovery. In this version, the progress of the alcoholic's life is demarcated by events and losses rather than arbitrary numbers of years as shown above.

CLICK THE SMALL IMAGE ABOVE FOR AN ENLARGED VIEW.

The Drinking Cycle of an Alcoholic

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