Change Your Thinking: And You May Not Need to Quit!


Buy It Now!

Local author tackles problem drinking strategies
(June 2008 Issue)

“Take Control of Your Drinking – And You May Not Need to Quit”
By Michael S. Levy, Ph.D.
The Johns Hopkins University Press
Baltimore, Md., 2007

By Paul Efthim, Ph.D.

Local psychologist Michael S. Levy, Ph.D. chose a provocative title for his new book: "Take Control of Your Drinking - And You May Not Need to Quit." Taking a self-help approach, Levy notes that 75 percent of people with alcohol problems who recover do so without any formal treatment. He has produced a fine resource for those willing to take a look at their relationship with the bottle.

Levy has written extensively on substance abuse treatment. He serves as director of clinical treatment services at CAB Health & Recovery Services in Salem, Mass., holds teaching appointments at Cambridge Health Alliance and Harvard Medical School and maintains a private practice in Andover, Mass.

The book is structured around the longstanding abstinence vs. moderation controversy: Can problem drinking be converted into controlled, non-problem drinking?

Levy's answer is based on both research and clinical experience. He acknowledges that individuals often first want or need to try moderation be-fore committing to seek abstinence. Despite AA doctrine, some problem drinkers do seem to be able to moderate their intake. Therefore, his book provides extensive guidelines so readers can decide whether to choose moderation or abstinence.

As clinicians, we may tend to assess our patients' level of drinking based on volume consumed. (This can be quite helpful sometimes. If we sus-pect a drinking problem, we might ask, "How much beer can you drink in a day? Three cases? Four?" The patient might answer, "No way, are you kidding? I can't possibly drink more than a case-and-a-half." We work from there.)

However, Levy points out that the two of the most important assessment questions are related to quality, not quantity, of drinking. First, can the person consistently predict how much he or she will drink and what will happen once drinking begins? Secondly, does the person continue drinking in spite of harmful consequences? Readers are prompted to address these two questions as part of an initial self-assessment.

Next, the author presents theories on the causes of problem drinking, including the disease model and the learned behavior perspective. He then describes the phenomenon of ambivalence and leads the reader through an exploration of the pros and cons of their relationship with alcohol. Guidelines help readers determine whether medical help is necessary and whether it is wise to even consider moderation.

Readers learn about techniques for moderation and relapse prevention. Information about professional treatment is presented, along with a critical review of self-help groups such as AA, SMART Recovery, Rational Recovery, SOS and Women for Sobriety.

The book's tone is perfect, at once compassionate and challenging: "If you cannot consistently moderate your drinking, you need to accept this, move on and work to achieve abstinence." Levy shares ample case material and also does a nice job helping readers learn how to think about their drinking habits in great detail.

As Howard Shaffer, a master teacher on alcohol treatment, reminds us, "There are many pathways into addiction and many pathways out of ad-diction." This book is a fine illustration of Shaffer's point. You can recommend this well-written volume with confidence to patients who drink exces-sively but who are not alcohol dependent.

Paul Efthim, Ph.D. is a licensed psychologist in full-time practice in Brookline, Mass. He holds faculty appointments at the Massachusetts School of Professional Psychology and the Boston Institute for Psychotherapy.