ABSTRACT
Maybe you are asking yourself why you should deal with a preface in just a chapter, one chapter among many in this handbook. Maybe you wish for “just the facts, ma’am”; maybe you think that giving the results of the latest randomized controlled studies on psychotherapy with alcoholdependent patients really are enough to provide clear guidelines. This might be a good way for other therapeutic strategies; however, in the case of psychotherapy, such an approach would not help you to make your interaction with an alcohol-dependent fellow human being a positive experience. So please bear with us and try to follow the reading rhythm of this chapter. The basis of psychotherapy is the interaction between at least two human beings: the patient and you, the therapist. This chapter will help you to free yourself of as much bias as possible when engaging in the therapist-patient exchange. You will be moved by the patient, you will participate in the pathology but also in the strengths and the resources and, finally, in the healing of the dependent patient. You will acquire knowledge that will enable you to do that without being swept away by the patient. The reward for your patience with this chapter will be that you will learn:
• How to interact with alcohol-dependent patients in an empathic manner • How to deal with your own negative feelings and thoughts that sometimes occur during
the therapeutic process
• How to deal with the patient without losing the crucial, clear, and unequivocal position • How not to risk becoming a — manipulated — player in the dynamic of addiction • How to retain a realistic hope in the improvement or healing of the patient despite the
occurrence of relapses • How to use relapses in a constructive way to help the patient
The caring, empathic approach to alcohol-dependent patients is one of the basics of psychotherapy that is very often talked about and which all too often is taken for granted. But how can you as a potential therapist gain such an attitude? Maybe you now think of previous, challenging situations: the intoxicated alcoholic in your office or in the emergency room who swore (in face of his having alcohol on his breath) not having touched liquor for weeks; maybe you remember the patient who had just recovered from acute pancreatitis or esophageal bleeding and swore that he had learned his lesson this time — only to reappear intoxicated a few days later. Or you remember that patient whom you could motivate to start rehabilitation — only to see him terminate it abruptly or declare, after having finished the program, that controlled drinking might be a suitable goal for him after all. In the face of all these experiences, how can you approach the next alcoholic patient — or the old one, for that matter — in an empathic manner? Do not look at the alcohol dependence and the way it has changed that patient; maybe it is worth looking at yourself and your motivation for becoming a therapist for a few moments.
