The Jellinek Curve

No matter how far down the scale we have gone, we will see how our experience can benefit others. Those who are familiar with 12-Step recovery programs will recognize this statement as the fourth promise of AA. The downward spiral of addiction follows an inevitable path of self destruction, many features of which are shared in common. While everyone’s path may be different, the direction is always the same – down. Addiction presents as a continuous, unremitting series of losses.

For the purpose of discussion, the Jellinek Curve is illustrative. If you are unfamiliar with this particular depiction of addiction and recovery then a quick search of the internet will render a picture of the curve for you. Developed by E. M. Jellinek, it is a fairly good description of the behavioral and physiologic decline experienced by the active addict. The decline he describes is not a straight line. The decline may begin slowly at the outset, only to accelerate later. There may be many zigs and zags, hops and skips up or down the curve, or even pauses along the descent. The curve represents a scale of decline that becomes more severe with each passing phase or attribute. You will see listed both general and drug specific symptoms and behaviors that are the signposts of Addiction or Recovery.

On the left side of the downward slope is the Progression part of the curve which is marked by two phases, a Crucial Phase and a Chronic Phase. If you know anyone who is currently an active addict, or if you are currently one or have been one yourself dear reader, then you will recognize some of the signposts of this phase. Everyone starts out innocently enough, dabbling with alcohol or experimenting with drugs. But for some, occasional relief drinking or drug use will begin. This will progress to constant relief drinking or drug use which will lead to an increase in alcohol or drug tolerance. Surreptitious use, urgency of first use, increasing dependence, feelings of guilt, inability to stop using or drinking when others do are soon to follow. Loss of outside interests, geographical escapes, work and money troubles, unreasonable resentments, physical deterioration, moral deterioration, neglect of food and adequate rest continue the decline.

The Chronic phase is characterized by impaired thinking, indefinable fears, paranoia, vague spiritual desires, obsession with drinking or using, exhaustion of all alibis and action paralysis. At the very bottom of this phase obsessive drinking or drug use continues in a vicious cycle. There are only two ways out of this cycle for the addict, recovery or death. Millions have tried to find an easier softer way. There aren’t any. They all died of their disease.

As bad as the left side of the Jellinek Curve is, it pales in magnitude to the positive potential that awaits the addict seeking a sound recovery.  The left side is all about loss, the right side is all about gain. The right side of the curve is about Rehabilitation toward a full and lasting recovery. It is an ascending curve and it too is never a straight line up, but it is the only way out for drug free living. There may be many fitful and false starts, slips and slides on the way up. But to the rigorously honest, a new life and a new freedom is always found at the end, destination Recovery.

It begins with an honest desire for help on the part of the addict or alcoholic. The addict learns that addiction can be arrested, that it is a treatable illness. Acceptance of powerlessness over the addiction and a life unmanageable introduces the 12-Steps as a way to a better life. One that is whole and full of promise. Former addicts are met that seem normal and happy. Right thinking begins and spiritual needs are examined. There is an onset of new hope. Fears of an unknown future diminish, regular nourishment is taken, realistic thinking takes charge and the desire to escape fades away. A new circle of friends is developed a family members begin to notice a difference. Real values are embraced, there is an increase in emotional control and facts are now faced with courage and resolve. Economic stability and the confidence of employers returns. Rationalizations are recognized, tolerance of others increases and contentment in sobriety is achieved. All of this leads to a more interesting and enlightened way of living. Life opens up to higher levels. It is a miraculous transformation.

Every addict has a different bottom. One can leave the downward curve of addiction and cross over to the ascending curve of recovery at any time without hitting bottom first. It is much easier that way but for the addicted, it is definitely a road less traveled. Most slide pretty far down the scale before a willingness to change is adopted. Most addicts get into sobriety, not because they see the light but because they feel the heat coming from some quarter of their lives. But no matter how far down the scale someone has gone, the way out is always up. It is still a mystery to me why some get it and some don’t. Anyone in the program will feel the same way. That is why we in recovery are so grateful for our sobriety and it is in sobriety that we have seen how our experience can benefit others, no matter how far down the scale they have gone.

Written by

Clark Gaither, MD

2 Comments to “The Jellinek Curve”

  1. aidan says:

    The Jellinek Curve.

    Just read your article on the Jellinek Curve. Brilliant ,thank you.
    In recovery from alcohol addiction myself for almost four years,and loving every minute of it.

    • Clark Gaither, MD Clark Gaither, MD says:

      You are certainly welcome! Congratulations on your sobriety. I trust you are in a good program of recovery as well. Never forget “what is was like” and you will stay that way. I appreciate your comments Aidan!

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