Training to Be Sober

It seems, at first glance, to be a conventional cocktail lounge. There are soft lights, a polished mahogany bar and the murmur of drinkers' voices rising above unobtrusive music. But there is more to the scene than meets the eye. The drinks are free, a TV camera is videotaping the activities and electronic equipment under the bar is administering shocks to the patrons, most of whom are alcoholic patients at Patton State Hospital in San Bernardino, Calif., where the lounge has been installed.

Journey to Sobriety. Most doctors believe that the only alternative to alcoholism is abstinence. Yet the former Skid Rowers are encouraged to frequent the lounge. They are being conditioned either to give up liquor or become social drinkers. Their therapeutic imbibing was suggested by Psychologists Halmuth Schaefer and Mark Sobell, who disagree with the widely held belief that alcoholism is based on a physiological craving. Instead, they say, it is a psychological ailment, a learned response to stress. Unlike normal drinkers, who may react to anxiety by overeating, taking a walk around the block or hitting someone, the alcoholic has learned to find relief by reaching for a drink. What has been learned can be unlearned, Schaefer and Sobell insist. As proof, they point to their high cure rate, which is achieved with the aid of a harmless but painful technique: electric shocks for those who drink too much too fast.

At Patton State, alcoholics begin the five-week journey to sobriety by getting smashed. In the company of normal drinkers, they are allowed to order as many as 16 one-ounce drinks. Then they are given a nonelectric shock: a video-tape presentation of their drinking behavior. Most are dismayed to watch themselves ordering their drinks straight instead of mixed, gulping instead of sipping, and still tossing them off long after the normal drinkers have stopped.

Once a choice is made between working toward total abstinence or social drinking, the patients begin training. Each has electrodes attached to his hand. They can produce a shock when the bartender-therapist pushes a control button. Those who are to be abstainers know that they may receive a jolt every time they order drinks and a continuous shock as long as they have a glass in their hand: they are willing to risk the punishment to effect a cure. The would-be social drinker can consume as many as three mixed drinks without a shock --as long as he takes sips and makes each drink last at least 20 minutes. The shocks come at random--the drinkers never know when they will feel pain, but they do know that it could come after any infraction of the drinking rules. Sometimes, despite the pain, they continue to drink: at other times they put their drinks down.

Preliminary Results. Six months later, from 50% to 70% of the alcoholics trained to drink socially will do so or will abstain entirely. By comparison, only 10% to 20% of a group treated by conventional therapy could do the same. For the new abstainers, the apparent cure rate is 50%, compared with 20% to 25% in a control group. The researchers admit that their results are preliminary and that more patients may relapse as time goes on. But they have high hopes that many of the former alcoholics--having learned to associate drinking with real physical pain--will stay cured.

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