A case-specific approach to the treatment of alcoholism: the application of control mastery theory to alcoholics anonymous and professional practice.

Effective treatment of alcoholism requires adopting a psychodynamically informed case-specific approach. Control mastery theory provides a powerful way to understand and treat the alcoholic patient. The theory posits that individuals hold unconscious pathogenic beliefs that contribute to the development and maintenance of alcoholism. The primary therapeutic goal is to create a safe atmosphere that enables patients to disabuse themselves of their maladaptive beliefs and their attendant guilt. In this way, patients become freer to more accurately test reality and thus more effectively pursue normal developmental goals. The treatment of the alcoholic patient progresses through phases, each of which poses different therapeutic challenges. The salient therapeutic tasks addressed in this article are denial, containing affect, relapse prevention, and Alcoholics Anonymous involvement. By understanding the individual's unique pathogenic belief system, the therapist is better equipped to help the patient through the generic phases and tasks of the recovery process.