When Joe has a few too many beers and stands on the table telling dirty jokes, he's the life of the party. But when Jane overdoes it, well, is that any way for a lady to act?
That, says psychiatrist Dr. James Pursch, is the reason why few women admit their drinking problems and still fewer seek help. Pursch, known as "the celebrity alcohol doctor," has treated such notables as former first lady Betty Ford, Billy Carter, former senator Herman Talmadge and astronaut Edwin (Buzz) Aldrin. Currently he is the medical director of Comprehensive Care Corp., which operates 70 alcohol rehabilitation centers nationwide, several of which are in the Washington D.C. area.. About 40,000 people a year become involved with the CompCare system. Most of them are men.
"The stigma that affects alcoholics affects women much more strongly," says Pursch. "The woman alcoholic realizes this and therefore is a closet drinker, concealing her need for the bottle."
When her family eventually realizes the problem, he says, they cover for her. Her friends ignore it. Even her doctor will not confront the issue. Instead, he gives her drugs and she becomes what Pursch calls "a chemical gourmet." "The husband goes on preparing the meals, the children keep doing the dishes, " he says. "Finally the man gets disgusted and leaves, taking the children with him."
Women will rarely abandon an alcoholic partner, notes Pursch. "Yet when she's the one who is sick, she ends up without her family and without any income."
The women who do go to CompCare are older and sicker than the male patients. "They are harder to treat. The disease has damaged them more severely mentally and physically."
CompCare is an intensive inpatient treatment program, involving family, friends and employers. The more people close to the alcoholic who understand the illness, Pursch says, the more effective treatment becomes. "The alcoholic needs to be educated and those who care about him need to be educated, as well. They often don't like to admit there is a problem anymore than the alcoholic does. The husband or the boss at the company picnic can no longer turn his back when he sees the alcoholic take that first drink, hoping that she'll stop there."
Pursch disagrees with one of the basic concepts of Alcoholics Anonymous -- an alcoholic cannot be forced to seek help. He advocates early detection and intervention. "No one volunteers to get well from alcoholism. The person has to have the rug pulled from under him. Waiting for the alcoholic to hit rock bottom is watching someone commit suicide slowly."
When a family member or friend of the alcoholic goes to Pursch, they plan an intervention meeting. Usually when the alcoholic realizes she is not alone, that people care and want to help her recover, she will agree to treatment. The progam, covered by most insurance plans, is voluntary, and the patient may leave at any time. Pursch reports a success rate as high as 90 percent.
In addition to intervention, Pursch recommends alcoholism prevention. "If we did not condone the drunken state, if we mutually frowned on being toxic, it would be more difficult to be alcoholic. Instead we encourage each other into alcoholism by pushing drinking and drinking traditions. Happy hours, cocktail parties, drinks before dinner, drinks after dinner."
But, for a friend or family member of someone who has become an alcoholic, Pursch suggests "love and patience." Women, he says, need even more understanding from those around her. "For them, the guilt is deeper and the embarrassment is greater. There are so many of these women suffering alone with the vaccuum in one hand, the bottle in the other."