I believe that we must acknowledge Alcoholics Anonymous for this change in emphasis in psychological and psychiatric treatment. “Simple solutions for complex problems” has been a cornerstone of the Fellowship’s approach in dealing with the often overwhelming problems existing in the life of the Alcoholic as he or she finally seeks help after years of destructive drinking.
Where to start? What’s the cause? Where to begin? It’s all seems so complicated and daunting! Multiple issues, requiring complex and heavy-duty therapy. He/she appeals to the AA group at their first meeting. And the group’s reply? This group of seasoned experts reply with a chorus of “keep it simple: just stop drinking!”. But I can’t, I need to know the cause? I must uncover the causes and identify the psychological forces that are driving my self destructive behaviour. Otherwise, how can I stop? They repeat “Just stop drinking” and by doing this you deal with the problem and the rest will follow.
And so the shift of emphasis in this generation. An approach that in the past that would appear to be restrictive. Just dealing with the symptom! Yet dealing with the symptom behaviour is now the solution rather than the time-consuming search for background conflicts and stresses. Examples: “I worry myself into a depressed state” Then change the way you think,- cognitive therapy. “I have problems with my behaviour” Why not behaviour therapy? Or more recent reports from the psychiatric literature, That describe how blocking a persons ability to furrow their brow with Botox injections, gives relief from anxiety and even depression. Or stretching ones facial muscles (used for smiling) by biting on a pencil results in a feeling of relaxation. Or role modelling oneself on a relaxed person you happen to know, and over time one acquires a sense of being relaxed and free from anxiety. I could go on and on with further examples.
What we have learned is that solutions though simple, can be surprisingly effective. Yet, it is a mistake to think that because a solution is simple that is easy to execute. How often I have heard “Doctor you make It all so simple”. I reply “yes it is simple, but believe me it’s not easy” for the alcoholic to stop drinking. A simple idea but a most difficult step to take and one that may require a lot of support.
As a psychiatrist it has been my experience that simple solutions work. Regarding recovery: the issue is not that simple solutions don’t work, rather, it is getting people to do the things they know they need to do to get better.
And more about this later!
Karl O’Sullivan MD