'I'm an Alcohol Addiction Counselor, These Are the Worst Things I've Seen'

Many people who work in addiction treatment have a personal story to tell of how it relates to their life. In my case, I had a brother who was a chronic alcoholic.

For most of his adult life, he was involved in drinking. It was very sad to see his life, how it evolved and how it ended up. He died early in his life, in his mid-50s, and it was a lonely death. That affected me, as I was close to him. But there's not much I could have done for him because he chose not to get help.

Over the course of my 42-year career, I have developed outpatient alcohol substance abuse centers, inpatient centers, and worked in rehabilitation centers. I do a lot of alcohol evaluations for drunk driving, which I take very seriously because I don't want to read that one day one of my patients, that I said was fine, kills somebody in a car accident. I have a community obligation.

I treat patients that are dealing with alcoholism. Predominantly I treat them through talking therapy and getting them involved in self-help groups, although, in some cases, they will also require medical intervention.

The tendency to relapse is very great, even after outpatient or inpatient care. I'm limited in terms of what I can do. That's why the patient's involvement in some kind of support system, like Alcoholics Anonymous (AA), is critical to their ongoing recovery.

I was involved in the early development of outpatient treatment for alcohol and drugs. I also worked in inpatient treatment for many years. Most of the stays were less than a month. They'd do psychoeducational training, in learning about the disease of alcoholism, group therapy, individual therapy, and counseling sessions with their family. It's a very powerful intervention.

There's no set age group for my patients. You have adolescent groups, middle-aged and elderly people. There's no distinction in socioeconomic groups, either, because the CEO of a corporation is no different from the guy that's the blue-collar worker in that corporation, in terms of addiction issues.

In the old days, in white-collar professions, you had cocktail lunches and people went out for business lunches. In those areas, drinking on the job was accepted—until it becomes dysfunctional, and your productivity diminishes.

I saw many patients involved with the stock exchange who were addicted to cocaine and were functional alcoholics. But they were not an exclusive group. I have seen patients from every socio-economic level: Construction workers, politicians, pilots, athletes, and even clergy. No group is excluded or immune from this disease.

The greatest consequence is the loss of family, where the wife kicks out the husband—or vice versa, it's not a gender issue—and they're basically homeless. I've seen very successful people go from rags to riches, from riches to rags. They blew everything and lost everything about them—their self-esteem, their sense of identity, their job, and so forth.

The following, however, are the patients that stand out most clearly to me.

The man who stayed in denial

I had a patient who was a very successful businessman—an entrepreneur, in his mid-40s, who had had years of drinking but had disguised it very well, saying he was "just entertaining his clients."

But the drinking became more severe, he became violent with his family, especially his wife. He didn't really care what happened. He ran around, having affairs and so on. He was blowing money left and right, and they were on the verge of losing their home. He lost his business as his clients began to go elsewhere.

His wife left him, and his kids wanted very little to do with him. It was at this point that he came to me. He was there because his family made him go. He wasn't all that motivated, and his behavior was not consistent with his promises to his family. He would be good for a couple of weeks, maybe a month, and then go back to drinking.

At some point, he phased out. He decided he was just going to live his life, and he didn't really recognize that this was a major issue, even though all these things collapsed, there was always a rationale for it—it was his wife's fault, it was this and that. It was everyone's fault but his own, which is part of their denial system. His wife ended up divorcing him, and now he lives alone in a little studio.

This is not an atypical situation. In my experience, relapse is more predominant than success stories. That's, without a doubt, the most challenging part of my job.

The woman who lost her son

I recently saw a lady who had a history of alcoholism and was trying to reconnect with her son. Her son is now in his 30s and has his own child.

In sessions, he would always mention that he'd had to deal with his mother's alcoholism over the years and how, as an only child, he had had to mature way beyond his age. He talked about the pain of that and having to watch out for his mother and make sure she didn't drink. She would have sustained periods of abstinence and then, following an emotional event or situation, she would go back to drinking and he would have to intervene. It was sad, following this dynamic between the two of them.

I saw them for several years and I thought that we were doing pretty well in establishing a good relationship between the two of them. They'd come together once a week, take walks, do all that, and then it collapsed.

More recently, his mother had a long period of abstinence again, and she was involved in meetings and so on with AA. But, even so, he always feared that she would come into the house, where he lived with his wife and child, and that she would drink and disrupt his lifestyle.

So, not too long ago, he cut her out. He said, "I'm not dealing with you anymore." And that devastated her. She just lost him and lost her access to her grandchild. It was very sad to see. I've seen a lot of that, a lot of those stories.

The ones who make a full recovery

I've seen thousands and thousands of patients, so I've seen many who have done well in their lives and continued to do so.

There was a police officer, for instance, who was again a chronic alcoholic. He had his ups and downs—again, always revolving around family, and sometimes the job. But he was able to accept the fact that he had a drinking problem—which was a triumph in itself, because, in my experience, people in blue tend to be somewhat guarded about their personal lives given the nature of their work.

But his wife again had threatened to divorce him and sell the house, which was a wake-up call. He began to accept the fact that his drinking was affecting him as a person, and his family life. He worked at it and did well. It's now been two years, and he has not gone back to drinking.

Being in recovery is about more than not drinking, as you can abstain from drinking but still have what we call "alcoholic attitude," where the other behaviors are the same but you just don't drink.

I would say that a recovered person, or someone in recovery, is someone who is trying to deal with their drinking, as well as their behavioral issues, to make them more understanding of the people around them.

Dr. Shafer Zysman is a credentialed OASAS practitioner. He is evaluated with alcoholevaluation.com and has a private practice in Bay Shore, Long Island, New York.

All views expressed in this article are the author's own.

As told to Newsweek's My Turn deputy editor, Katie Russell.

Do you have a unique experience or personal story to share? Email the My Turn team at myturn@newsweek.com