Pastoral Counseling and the Alcoholic
A Study Paper of the Lutheran Church in America, by Conrad L. Bergendoff, M.A., M.Div., no date
There are today, by conservative estimates, 9,000,000 alcoholics
in the United States. If one assumes that each alcoholic affects
the lives of at least three other people in a critical manner, we
are faced with a problem of monumental proportions.
Alcoholism, the third leading cause of death in the United
States, is a moral and spiritual problem, as well as physical and
The pastor has both assets and liabilities in dealing with the
alcoholic. The pastor generally occupies a privileged position in
the community and "is often the first person to whom the alcoholic
and his or her family turn when it becomes evident that drinking
has become a problem."
Unfortunately, the pastor is often an "enabler," a person who,
by failing to be confrontive, "enables" the alcoholic to continue
on a disastrous course. A study by the University of Iowa indicates
that there is generally a seven year time span between the onset of
alcoholism and the first appearance of a client at a treatment
center. This means that a number of people, including clergy, have
probably suspected incipient alcoholism, but for whatever reason,
have said little.
It is Vernon Johnson's view that even creating a crisis may, in
the long run, be more beneficial to the alcoholic than diplomatic
What is the pastor's role in regard to alcoholism? Certainly it
is not judgmental. Howard Clinebell has made a survey of 146
ministers who attended the Yale School of Alcohol Studies and
discovered the following: those ministers who viewed alcoholism as
simply a sin were approached for help by an average of only 2.3
persons annually, whereas those who felt alcoholism was a sickness
received overtures for help from an average of 9.3 persons
annually. Clinebell also discovered that ministers who took a rigid
stand against all forms of drinking and who promoted prohibition
"saw only one-fourth as many alcoholics during the course of a
year's counseling ministry as the minister who advocated no
particular position for others to adhere to in this matter."
The first and perhaps most important task of the pastor is
accurate knowledge of the nature of alcoholism and of the
Alcoholism is a serious compulsive disease which gets
progressively worse if drinking continues. Unchecked, it is fatal.
Any approach which ignores these facts is doomed to failure. The
alcoholic cannot "taper off," and cannot invent some spurious kind
of "controlled drinking." He, or she, must stop drinking
But how is this achieved? A wise and courageous minister will be
quick to detect signs of alcoholism: loss of time at work,
financial problems, marital problems, legal problems -- possibly
occurring in a family that has previously known none of these.
Since only 2 to 5% of alcoholics are on skid row, it is obvious
that the rest are in all the remaining strata of society. A letter
from the President of the Lutheran Church in America to the clergy
of that denomination states, "Alcoholism affects one family out of
every five in the average Lutheran parish." This means that
alcoholism is all around us; we do not need to look far.
However, realizing the magnitude of the problem by itself does
nothing to solve it. Joseph Kellerman, executive director of the
Charlotte, North Carolina Council on Alcoholism, quotes a statement
by a physician which illustrates the importance of having a
constructive attitude to the problem. "A Boy Scout with a bottle of
aspirin, a pup tent, understanding and compassion can effect better
treatment for an alcoholic than a doctor with the finest medical
means if he is hostile and prejudiced against the patient."
Kellerman, himself a clergyman, then comments, "If this is true of
the doctor, how much more of the minister."
There are no miraculous cures for alcoholism. It is a complex
problem. The alcoholic is frequently armed with elaborate defense
mechanisms and is highly skilled at self-deceit. Furthermore,
alcohol, for the alcoholic, is addictive. The incipient alcoholic
soon drinks excessively "whenever drinking occurs. He has lost the
freedom of choice."
One of the first goals of treatment, therefore, is endeavoring
to have the client take Step 1 of Alcoholics Anonymous (AA), which
is the admission of powerlessness over alcohol, and the realization
that life has become unmanageable. Few people wish to admit
powerlessness over anything, but most leaders in the field feel
that unless alcoholics are willing to take Step 1 and to take
drastic measures to change their lives, further drinking is
inevitable. The minister may early detect, or suspect, alcoholism
in a family, but probably will not be able, alone, to bring an
alcoholic to such an admission of powerlessness.
The pastor, however, who occupies a position of trust in a
congregation, has several tools available. First is AA. Many
alcoholics have been helped by AA alone. AA is tough, supportive,
and non-judgmental, three ingredients that seem to work for the
alcoholic, whether male or female.
However, for many alcoholics, AA alone is not enough. A
treatment center which recognizes the complex character of
alcoholism may be needed. The male alcoholic, for example,
frequently has the assertive level of a high school freshman. He
may need training in assertiveness. There may be a marital conflict
which will need couples counseling. The alert pastor will know when
to refer to a treatment center.
Before referral takes place, however, there are several
questions that must be answered. The first of these and perhaps the
most difficult is how may the alcoholic be identified? It is
important to recognize, to begin with, that amount consumed does
not necessarily have anything to do with whether a person is an
alcoholic. Loss of control is probably a better criterion of
alcoholism than amount. As Robert Hammond has described, "Once he
(the alcoholic) starts drinking, he may no more control his
compulsion to continue drinking than the tuberculosis patient can
voluntarily control his coughing."
Associated with loss of control is a very simple definition,
"the person uses alcohol to the extent that it interferes with
living a successful life."
Granted, one may debate the meaning of the word "successful,"
but if the result of drinking is that a person is in trouble
socially, spiritually, economically, medically, there is a
reasonable suspicion that the person is, in fact, an alcoholic.
Chronic abuse of alcohol also tends to cause mental disorder.
Whether this is the area of a degeneration of the ethical sense or
increasing fits of rage and delusion, there is almost always an
emotional concomitant to the physical addiction.
One good clue to identifying the alcoholic is this: if drinking
causes continuing difficulty in any area of life -- job, family,
health, or financial -- the person needs assistance.
This leads to a second important question. How does one give
assistance? Most alcoholics will deny that alcohol is a problem,
even in the face of overwhelming evidence to the contrary. One or
more crises may be inevitable before the alcoholic is even willing
to consider the possibility that alcohol is a problem in his or her
life. It takes a kind of "tough love" both to induce the alcoholic
to seek treatment and to give appropriate pastoral support after
the alcoholic has assented to treatment.
There is a danger that the pastor, in relating to the alcoholic,
may err either by an oversolicitousness, which may interfere with
the treatment process, or by non-involvement to the point of
ignoring the alcoholic. Either extreme is inimical to the
Only one in three alcoholics is able to maintain sobriety for a
year. Hence, it is imperative that anyone dealing in a professional
manner with the alcoholic understand the difficulty in moving from
an alcoholic way of life to a sober way of living. Sober living is
not joyless living, but to the alcoholic in initial stages of
recovery it may appear so. The pastor should appreciate the
normality of wide mood swings in the first stages of recovery. For
example, a sudden surge of religious feeling may demonstrate
itself. Enthusiasms of various kinds may surface. Value systems may
undergo radical upheaval.
The understanding minister will bear with all this, recognizing
that change is inevitable if the recovery process is to be
THE PASTOR'S OPPORTUNITY
It is important to recognize that self. insight in regard to the
problem of alcoholism is negligible. The alcoholic tends to lose
contact with his or her emotional life. Defense systems grow so
that the person can survive in the face of mounting difficulties.
The greater the pain, the higher and more rigid the defense
becomes. The point is reached when the alcoholic does not know what
is happening inside, and becomes a victim of his or her own defense
mechanisms. Naturally, a whole host of negative emotions have now
developed: anxiety, guilt, shame, and remorse among them. Little
wonder that Alcoholics Anonymous advises the alcoholic, "One day at
a time." Emotions like that are not reversed easily, and the
recovering alcoholic must, above all else, learn patience.
An old Puritan saying was that, "Man proposes, God disposes."
And, indeed, the circumstances that bring any individual alcoholic
to treatment have a certain ring of inevitability to them.
Regardless of one's theology, however, certain specific things have
to be done by specific individuals before intervention becomes
For example, the choosing of a good treatment center. If
requested by a family to assist in choosing a treatment center, the
minister should discover what kind of treatment services are
available. A comprehensive program should include detoxification,
inpatient, outpatient, emergency, and consultation services.
Some knowledge of what a treatment center does is also helpful.
Does the center have a full-time physician for the medical aspects
of alcoholism? Is the facility cooperative with the churches in the
area? Are the counselors well trained?
The recognition of alcoholism is of little consequence unless
the treatment center to which a person is referred is well
qualified to assist alcoholics both to assess their predicament and
to give some hope that a sober way of life can be more challenging
and ultimately more fruitful than to continue drinking. This is a
difficult task, for the alcoholic, at the onset of treatment, is
generally tense and depressed, lonely and discouraged.
As both problems and rationalizations about the problems have
increased for the alcoholic, receptivity to the assistance of any
kind of counseling has probably diminished. The alcoholic,
immediately before treatment, is probably as emotionally isolated
as it is possible to be. The pastor will probably have to pull back
temporarily and allow treatment facility staff the freedom to
adequately assess and confront the alcoholic. However, in course of
treatment, the client is advised to take Step 5 of AA's 12 Steps:
"Admitted to God, to ourselves, and to another human being, the
exact nature of our wrongs." Clients should be encouraged to take
this step with ministers of their own choice. Many ministers have
performed this service.
Alcoholism is not only a major medical problem, it is a
spiritual problem. Pastors may be trained in many areas, but the
lonely travail of alcoholism may elude them unless they are
sensitive to its clues, prompt to intervene, and willing to refer
to a competent treatment center when necessary. The pastor, in good
conscience, cannot "pass by on the other side," but like the Good
Samaritan must be ready to bind up the wounds of anyone in
Alcoholism develops as part of a total life style. It may begin in
a hundred small ways: sneaking a drink, missing appointments, a
diminished awareness of one's surroundings. The actual addiction to
the chemical, ethyl alcohol, may be hard to spot. A person may
believe that, because one does not drink before 5 p.m., or drinks
only on weekends, or is too young, then alcoholism is not possible.
But these qualifications are myths. A far more important question
is: whether a person gets into any kind of difficulty, legal
problems (particularly those associated with driving while
intoxicated), financial problems or trouble on the job. These
problems may all be disguised, but if drinking excessively can be
linked with any of them, a drinking problem quite likely
If there is any suspicion of alcoholism, pastors should
immediately make themselves available to those persons and convey
an understanding attitude. They should also contact immediate
members of the families and elicit specific behaviors of the
incipient or actual alcoholic. Pastors should point out that, by
doing nothing, the family only postpones the inevitable. Alcoholism
is always progressive. A family reluctant to face the problem this
year may be faced with worse crises next year. A compassionate but
forceful minister may well make the difference in advising a
treatment center before a marriage breaks up, or a job is lost, or
a person is arrested for driving while intoxicated. One does not
"help" an alcoholic, one thrusts reality upon him or her. Vernon
Johnson argues that, `Every time you try to rescue an alcoholic,
you are delaying useful treatment."
No one wants to be an alcoholic, yet few alcoholics really want
to stop drinking. All kinds of techniques, therefore, will be used
to avoid or evade those who try to be of assistance. The steadfast
refusal of both a minister and significant members of an
alcoholic's family to allow any escape hatch is imperative.
How a pastor best deals with an alcoholic's family, whether the
person is a practicing alcoholic or a recovering alcoholic, may be
of crucial significance, for he or she may often have the
opportunity to become a successful catalyst in suggesting treatment
or in giving social and spiritual support.
As with any serious physical or mental problem, early detection
of alcoholism enhances the possibility of recovery. The pastor who
understands the nature of alcoholism and is unafraid of
constructive confrontation may well be a significant factor in
guiding a family through the difficult times that invariably go
Chaplain Conrad L. Bergendoff is one of many LCA pastors and lay
persons who are working with alcohol and other drug problems. Since
we do not know who most of them are, the Division for Mission in
North America (DMNA) is interested in receiving their names and
addresses, and descriptions of what they are doing. Please send
such information to the Rev. Cedric W. Tilberg, DMNA, 231 Madison
Avenue, New York, NY 10016.
The DMNA has had a staff working group interested in developing
churchwide program in this area of great concern. With the help of
representatives of two other churchwide agencies and four LCA
pastors who are specially engaged in dealing with alcohol and other
drug problems, the working group prepared a report to the DMNA
management committee. The report dealt with the size and nature of
these problems, issues facing the church, and suggestions for
action by the DMNA or other churchwide agencies. The division, in
its regular contacts with synodical committees on social ministry,
is promoting use of Alcoholism and Addiction, a study program
written by the Rev. Karl A. Schneider and produced by the Division
for Parish Services for private reading and congregational study
(Fortress Church Supply Stores, $3.50). The DMNA is also joining
with other denominations in an ecumenical approach.
These increasing activities reflect a conviction that the
churches have a crucial role to play in dealing with the pervasive
problems associated with alcohol and other drug abuse.