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Thursday, January 16, 2014

Are De-Cured People TSM Failures?

Question:  What do we conclude about TSM when someone says he/she was cured by TSM but is then observed to be drunk?

Answer:  Nothing at all.

We know that pharmacological extinction with naltrexone doesn't cure everyone.  There are 10% whose addiction works by some means other than opioid receptors and 20% who don't follow the protocol to a cure.  Such people don't usually claim to be cured, though, so that's not what we're talking about here.

There are also people who do completely extinguish the addiction but later drink without naltrexone and relearn the addiction.  There's no easy way to count that number, but we know they exist.  There are no statistics, but there are enough reliable anecdotes that we know there must be some.

There are also plenty of former AA members drinking away, either after leaving AA or in secret.  The existence of some such people, in unknown numbers, shouldn't lead us to conclude anything about TSM or about AA.

We should all realize that it's much, much easier to relearn a once-learned behavior than it was to learn it in the first place.  The "cured" term can be misleading.  Some people think that they took care of the problem and are now able to drink without an opioid blocker, that they are like other people.

Intuition tells me that people who became addicted during adulthood (that is, who didn't drink addictively from the beginning) may be more prone to this error, because they will want to be the way they used to be.  They don't enjoy drinking on naltrexone, they once enjoyed drinking without problems, they have cured the addiction which was causing problems, so why not go back to old habits?

It may be a tempting line of thought, but it's not sound.  Once the opioid reinforcement reappears, the addiction will probably reappear as well.  Obvious though it may seem when considered dispassionately, there are those who do slide back into addiction this way.

This is not the fault of behavioral conditioning.  Behavioral conditioning is just a thing; it can't be at fault or not at fault.  Becoming addicted again is entirely the responsibility of the person who chose to take that risk.

Were these people ever cured?  Yes, if at one point the behavior was completely extinguished.  That's not a failure of the Sinclair Method.  That's a bad decision on the part of the cured person.  Being cured puts us back in control, but it doesn't rescue us if we make bad decisions.  If we use our control to put ourselves back in a position to lose control, that's entirely on us.

Back to our original question . . . .

Question:  What do we conclude about TSM when someone says he/she was cured by TSM but is then observed to be drunk?
Answer:  Nothing at all.

Anyone, lifelong normal drinker or cured TSM graduate, may drink too much on a particular occasion.  If a TSM graduate is observed to be drunk often, or in an inappropriate situation such as at work, then that person is probably no longer cured . . . but that doesn't mean the person was never cured in the first place.  It simply means that that person has made bad choices which led back to addiction.

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