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Disease or flaw?

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Is alcoholism a disease or a character flaw?

I’m reading Ron Chernow’s Grant, a useful complement to Grant’s own personal memoirs. Grant’s memoirs are a must-read for leaders of all stripes, whether or not you have any interest in the Civil War. It’s also, fortunately enough, compellingly readable — so much so that Chernow’s book would be unnecessary except for three elements Grant didn’t write about:

(1) Read Grant’s memoirs and you’ll discover who he was. Chernow tries to explain why he was who he was. (2) Grant didn’t mention his presidency, which was more distinguished than most of us know, possibly because his throat cancer killed him a week after he delivered his manuscript. And (3) Grant did not mention his struggle with alcoholism, even though it played a prominent role in his personal history.

In your career as a leader and as a manager, it’s a statistical certainty you’ll find yourself dealing with substance-abusing employees. And while it’s doubtful any of them will bring as much drive and ability to their responsibilities as Grant did to his, the odds are better than even that most are capable of being valuable employees.

As a manager, how you deal with a substance-abusing employee is reasonably straightforward: You contact Human Resources and have them walk you through your responsibilities and boundaries. Or, you ignore the substance abuse and focus on job performance, on the grounds that as a manager your job is to get work out the door, in large part by making sure the men and women in your organization get their work out the door.

As a manager, if other employees complain to you about the situation, you ask whether it affects their ability to do their own work.

As a leader your responsibilities are considerably more complicated than that. I think your response has to start with the disease vs character flaw question.

I confess I’m old and judgmental enough that it’s hard to jettison the perception that addicts are weak-willed, pathetic when they aren’t harming anyone else, and bad people when they drive while under the influence.

Reinforcing this bias are those who find ways to overcome their addictions: If they can, why can’t everyone else? Which isn’t a fair assessment, as there’s no way of knowing whether someone who can’t has less willpower or a more profound compulsion.

Also reinforcing my bias: Research showing significant neurophysiological differences between psychopaths and the rest of us. I say reinforcing because I’m just not quite ready to say, to myself or anyone else, “Aw, that poor sociopath. If only he had a better amygdala! I feel for him.”

No, I don’t. Maybe I should, but I don’t.

The deeper we dig into the root causes of human behavior, the harder it is to differentiate between character flaws and psychological syndromes. Maybe that’s good. It’s certainly gives you as a leader a reason to fall back on the managerial solution of I don’t care who you are, just how you act while you’re on the job.

And yet.

One of my regrets is an employee I inherited when I took over a department early in my managerial career. He was an alcoholic, on the wagon when he first started reporting to me.

Then he started drinking again — moderately at first, but for a recovering alcoholic, moderation isn’t stable.

But he was what we now call a high-functioning alcoholic. His work performance remained satisfactory, and so I never once had a frank discussion with him about his drinking. It eventually killed him.

What would that conversation have entailed?

Not threats. He was doing his job well enough. Not “Speaking as your friend,” because he wasn’t my friend. We were friendly, but we weren’t the kind of close that gave me the right to discuss personal matters.

I’m pretty sure I should have let him know I was aware of the situation. I’m certain I should have reminded him that if he ever wanted help, the company had an employee assistance program and made sure he knew how to make use of it.

But he was an adult, and as an adult he had the right to make his own choices, whether or not they were choices I agreed with.

Life is all about choices. One of the interesting things about choices is that while we can and do make them, life doesn’t always let us choose what we have to make choices about.

So while it’s true that an alcoholic can choose to respond to their alcoholism by being a drunk, or by abstaining, that’s different from those of us who don’t have to make that choice in the first place.

Comments (10)

  • Knowing what to do and doing it are distinctly different things.

    I’m of an age where the prejudice was to blame the addict. We now, or at least by now ought to know that it’s a “little” more complex than that.

    The good leader has complex choices to make, allegiances to uphold. We know we can’t save everyone. We know we have a job to do. How you manage the tight rope walk rope says more about you than the people you manage.

    Also, to wax pedantic, psychopathy and sociopathy, though sharing many traits are different.

  • Half way through, I was about to chime in with ‘How could you blame those with alcohol problem?!?’ But that also didn’t sound quite like the Bob Lewis I’ve read for 2 decades. Your last 2 paragraphs were the major take-away – good job!

    • Thank you. And I’m sure you recognize the distinction: It’s all too easy to blame someone for lacking the will to deal with their alcohol problem while not blaming them for having it.

      Not that this is an appropriate thought process. It’s just a very easy one to fall into.

  • Got sober this time around age 28. Now 64 and still sober. (Thank you AA.)

    Speaking only for myself, prior to getting sober, I had many accolades from management and co-workers. Why? How? I was so fearful of being confronted about poor performance as a consequence of my drinking, that I worked twice as hard as the next guy to remain “above suspicion”.

    Fortunately for everyone, I was not in jobs that my being under the influence potentially endangered others — I wasn’t driving a vehicle or operating a crane or anything like that. (This is not an excuse, just an observation.)

    In my experience listening to thousands of addicts’ stories at meetings over the years, we are typically ashamed and embarrassed, yet still need to reach our own bottom. Discussing/confronting the situation with the employee could be the tipping point for some, but there is no way to predict the outcome. However, not addressing less than adequate performance is enabling the behavior, not to mention annoying co-workers who might have to be picking up the slack.

    Firm believer in the disease/abstinence concept. I’m not weak and need to become strong, but rather sick and need to remain well. (Note present tense here even after all these years.)

  • Once upon a time, I hired a programmer for an operating system maintenance job. Soon it became obvious that he was an alcoholic. Many days he would not show up for work, but on the days he did show up, he would work many hours overtime (without compensation) sometimes around the clock. He was amazingly productive. He never showed up drunk or drank on the job. We had a talk, about this pattern of work, and I agreed that as long as he was productive, I would shield him from both idle comments and attendance at project review meetings. He accomplished more in the 18 months he worked for me than any previous programmer assigned to that same project. This was a lesson for me in technical management. Focus on what is important.

  • “We were friendly, but we weren’t the kind of close that gave me the right to discuss personal matters.”

    True that it doesn’t give you the right, but in my view it’s not off-limits either, unless the employee doesn’t want to discuss it of course. In my experience, that is not often the case.

  • In terms of how to act as a manager towards an employee suffering from a personal affliction (whether medical or not), I think the two responses you portray are appropriate – if it doesn’t affect their work, either say nothing or say something supportive and offer resources.

    If it does affect their work, that’s a more complicated question, of course.

    Specifically regarding alcoholism – alcohol use disorder, as the current DSM names it – I found that the following article opened my eyes about the difficulties faced by sufferers in seeking treatment: https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/

    Treatment of alcohol abuse in the US is so dominated by AA and its particular approach that science and research and medical approaches have been almost completely ignored, even by doctors and the medical establishment. We like to think of ourselves as science- and evidence-based realists, but in many ways we’re no farther advanced than the 19th century, allowing our biases (“alcoholism is a personal flaw that can be overcome if you really want to”) to preclude effective methods of dealing with the issue.

    A few weeks I commented with a link to an article about how the medical treatment of the obese is affected by doctors’ own bias and wilful ignorance. In addition I’ve read several articles (from a variety of credible sources) over the years about women’s medical complaints (particularly pain) being discounted (and thus misdiagnosed) by physicians; likewise there’s been a long history – still occurring – of African Americans receiving significantly worse care, even under the same conditions (same disorder, same practitioner/institution, same access to insurance and financial resources).

    Identifying a problem, even a clear-cut medical one, is the first step. Finding and accessing treatment that works is frequently another problem altogether, even at workplaces that offer medical insurance and employee assistance programs.

    • Thanks. I think a lot of what you describe in your (excellent!) post does come down to the difficulty so many of us have finding even a blurry line that lets us preserve our notions of good character while accepting our increasing knowledge of how physiology affects how we think and behave.

      I remember quite a few years ago reading about a pedophile who, after being convicted and sentenced, was diagnosed with a brain tumor as part of his pre-incarceration physical.

      A neurosurgeon removed his tumor and his pedophilia went away. A few years later the tumor re-grew and his pedophilia returned.

      It’s awfully hard to think of him as a horrible human being, even though I’m adamant that pedophiles are horrible human beings.

  • Bravo. Excellent explanation.
    We each have our own cross to bear.
    My particular prejudice nowadays is the ADD-Ritalin folks. “Why can’t you just breathe deep and meditate and relax?” (because I can easily do stuff like that).
    For myself, I realize I’m the one that needs to take the deep breath and relax and remember we each hove our own issues and for all I know, the other folks are doing much better with their issues than I’m doing with mine.

  • When I first read this week’s column, I thought, “No problem.”

    First, accurately describe the behaviors that lead you to suspect an addiction issue with the employee, then go to HR to get company guidelines and available resources, and take it from there.

    But I think a better second step is to talk to several people with experience dealing with employees with an addiction issue, both in AA and out, and try to gain perspective from their experiences.
    As a manager, you don’t have to try to do it all by yourself. You just have to try to find the best answer for your situation.

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