Understanding the Jellinek Curve

by | Nov 16, 2015 | Addiction, Treatment | 0 comments

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EM-Jellinek-Curve-Moral-Physical-Decline

Meet E.M. Jellinek, the man who conceived our current understanding of the moral and physical decline of alcoholism. (Current Biography, 1947)

Addiction treatment is a confusing time in a person’s life. As a new patient attempts to organize themselves and come to grips with their surroundings, they may find themselves wondering how they got there in the first place. When did life get so out of hand? When did the joy of knocking back a few brews at the occasional party spiral into a daily habit?

Did this addiction stem from genetics? Is it a disease, or just a few bad choices? All of these questions are valid, but they can be quite troubling. Everyone has their own answers, but the Jellinek Curve may be the closest thing we have to a singular representation for the arc of addiction in a person’s life.

Most people probably haven’t heard of the Jellinek Curve before, but it’s a useful thing to understand. Below, we’ll provide you with a bit of information about what it is, where it came from, and how we can use it to better understand our addictions. We hope that this information may prove useful to your recovery.

What is the Jellinek Curve?

amethyst recovery

Looking at the Jellinek Curve, many of us can easily recall our own journey through each of these many stages. (Public domain illustration via Indiana government website)

The Jellinek Curve is basically a thorough outline of the decline of an addict or alcoholic as they descend into active addiction, followed by another thorough outline of their path through recovery. Addiction is broken into three major phases (the Crucial Phase, the Chronic Phase, and Rehabilitation), although there have been other versions of the chart which have added or simply changed phases in accordance with the publishers’ beliefs.

Even the shape of the curve has meaning. At the start of the Jellinek Curve, we are leveled out, only occasionally engaging in some mild relief drinking. (Note that “drinking” can easily be replaced with “drug use” without sacrificing the validity of the Jellinek Curve.)

As our drinking becomes more constant and our alcohol tolerance increases, the curve begins to drop into decline. This is when we start drinking enough to experience blackouts. Our dependence increases, and we will feel more urgency in taking the first drink.

Urgency & Decline

This urgency will be heightened by the fact that we are often drinking in secret at this point, and we must, therefore, take our first drink whenever the opportunity presents itself. As our dishonesty worsens, we will feel guiltier about our actions but will feel less able to discuss them.

As our condition worsens, we will experience blackouts more frequently. We will start making more excuses for our drinking, especially when we are around others who may be taking a few drinks themselves. As we dive deeper into the Crucial Phase, we will become more grandiose and sometimes quite aggressive.

On the flipside, we will also feel greater remorse for our actions. We may try to control our substance abuse, but we will often fail. We will make promises to others and to ourselves, and we may even try a geographical cure, but these efforts will be futile. As we begin to lose interest in all else, we may encounter mounting legal issues.

Signs Of Addiction

Several signs of addiction may become clear to others, such as economic troubles, problems at work, avoidance of friends and family, loss of appetite, and early morning tremors that can only be staved off by the hair of the dog that bit us.

As our addiction begins to deteriorate us both physically and morally, we will find ourselves at wit’s end. Resentments against others may grip us to the point of irrational anger, and we will often take leave of our inhibitions.

To make matters worse, our tolerance will begin to decrease and we will become more intoxicated for greater periods of time. This is when, according to the Jellinek Curve, we will start moving toward the Chronic Phase. Most of our friends at this point will likely be other addicts.

The Chronic Phase

As we enter the Chronic Phase, we will not be in great shape. Our thinking will be greatly impaired. We will be gripped by numerous fears, some of which are indefinable yet ever-present. We will be prone to inaction in most cases, except for when those actions allow us to continue our obsessive drinking.

We may have some vague spiritual desires, but we will ultimately exhaust all alibis for our behavior and admit defeat. At this point, we will enter a vicious loop of excessive drinking. By all appearances, we will be doomed to stay in that loop until our addiction kills us.

But the Jellinek Curve depicts us exiting this cycle, provided we have an honest desire for help. Once we accept alcoholism as a disease and cease our drinking, we can arrest our addiction. As we enter recovery, we will meet others who have learned to lead normal and happy lives.

We will learn to take our personal inventory and examine our spiritual needs as we learn to refocus our thinking in a positive way. We will be met with new hope, and we will be given a physical overhaul as we receive proper treatment and start group therapy. This is when we enter the Rehabilitation stretch of the Jellinek Curve.

The Old Way Of Life

As we emerge from the rubble of our old way of life, we will begin to appreciate the possibilities presented by the new one. Our fears of the unknown future will diminish.

We will learn to properly nourish ourselves both physically and spiritually, which will help jumpstart the return of our self-esteem and our capability for realistic thinking. Our desire for escape will leave us, replaced by the desire for healthier habits such as natural rest and sleep.

During this time, we will learn to treat addiction as a family disease. We will adjust to our family’s needs and develop a new circle of stable friends as we develop new interests and experience a rebirth of one’s ideals. Both family and friends will generally appreciate our efforts in recovery.

We will learn to face life with newfound courage and emotional control, applying real values to our actions. We will also gain the confidence of employers and begin taking steps toward economic stability. To paraphrase a highly insightful article from the comedy website Cracked, we will learn to become the tap instead of the bucket.

The Commitment To Contentment

As we learn to care for our hygiene and cast off our previous rationalizations for our old way of life, we will start to find contentment in sobriety. We may continue group therapy, or may simply develop a strong and sober support network to benefit from the mutual help of those we care about.

We will experience an increase in tolerance, not for alcohol but rather for life without it. At the final stretch of the Jellinek Curve, an “enlightened and interesting way of life opens up with the road ahead to higher levels than ever before.”

Quite fittingly, the curve does not level out again. It simply keeps rising.

Where Did It Come From?

Max-Glatt-Sitting-Jellinek-Curve

While Jellinek was responsible for the bulk of the research, the Jellinek Curve as we know it today can be largely attributed to the work of Max Glatt. (Sophie Evans/Oxford Journals)

The above summation of the Jellinek Curve indicates that no small amount of effort went into cataloging the many stages of addiction and recovery. In order to better our understanding of the Jellinek Curve and how it came to be, we may take a look at the work of Elvin Morton “Bunky” Jellinek, the man responsible for the curve. The Fix, a website specializing in news and information related to addiction and recovery, has been quite helpful in compiling a brief history of the Jellinek Curve.

According to The Fix, the work of physiologist and biostatistician E.M. Jellinek within the context of alcohol science began in 1939 when he was invited to work on the Carnegie Project.

Working under the RCPA (Research Council on the Problems of Alcohol), Jellinek developed an interest in addiction that led him to a job with the Yale Center for Alcohol Research. At this point, Jellinek’s experience as an alcohol researcher still left much to be desired. Nonetheless, he was quite interested in the science behind alcoholism and addiction.

It took about twelve years for the Jellinek Curve to become fully formulated, but it began with a 1946 study published by the Quarterly Journal of Studies on Alcoholentitled Phases in the Drinking History of Alcoholics: Analysis of a Survey Conducted by the Official Organ of Alcoholics Anonymous.

Grapevine, AA Magazine Survey

In this study, Jellinek looked at the answers to a survey published in the AA magazine Grapevine and determined that alcoholism might actually evolve over the course of a lengthy trajectory. At this point, the phases were still rudimentary, evolving from basic relief drinking to occasional benders and ending with the lowest point of addiction.

Jellinek’s 1946 study was not held in high regard. He used a sample size of fewer than 100 people, none of whom were women (he had access to the surveys of female participants, but simply discarded their data). Despite these limitations, however, Jellinek’s work was highly original.

It’s hard to imagine given the wide array of addiction demographics and statistics available to us today, but most researchers in the 1940s had not approached the subject of alcoholism through the lens of statistical analysis. Jellinek saw value in this approach, and he would keep working on his theories for many years to come.

Still pursuing the belief of addiction as a trajectory, Jellinek wrote an article called “Phases of Alcohol Addiction” in 1952. This time, he used a much larger sample—more than 2,000 alcoholics, though still no females—and administered a much more detailed survey. This time, his trajectory was much less rudimentary.

Stages Of Alcoholism

There were four clear stages of alcoholism. The first was the pre-alcoholic stage, characterized primarily by mere social drinking. At the second stage (the prodromal stage), a sense of dependency was developed. The third stage was the beginning of the true addiction, and the final stage was chronic drinking.

These were known as the crucial and chronic stages, names that are still seen in the Jellinek Curve used today. The stages were not charted out in the same fashion as they are today, but Jellinek’s theory itself had greatly evolved since 1946.

It was later in the 1950s that today’s Jellinek Curve was finally developed. And interestingly enough, it was not truly developed by Jellinek himself but rather by British psychiatrist Max Glatt. Having founded the Alcohol Treatment Unit at England’s Warlingham Park Hospital, Glatt was familiar with Jellinek’s work.

Jellinek’s Trajectory Of Alcoholic Decline

He noted that many patients not only had stories which fit Jellinek’s trajectory of alcoholic decline but that their stories of recovery displayed numerous similarities as well. Taking this into account, Glatt developed the Jellinek Curve by modifying Jellinek’s original research to include a rehabilitation stage.

As far as we can tell, Glatt did not actually name the Jellinek Curve. The name appears to have arisen after the publication of Glatt’s work. While it makes sense that many would give credit to Jellinek—after all, he did inspire a full half of Glatt’s chart—it is somewhat unfortunate that Glatt’s name has been omitted.

While Jellinek’s research into the trajectory of alcoholism was monumental in its time, Glatt’s research into the trajectory of rehabilitation maintains equal importance today. To understand our addiction would be a fruitless aim if there were no understanding of recovery to follow.

Thanks to Glatt, we can use Jellinek’s work to develop a keener understanding of our journey through addiction and recovery. And this is integral, as it is this understanding which will allow us to make full use of the Jellinek Curve in our recovery.

How Can We Use It?

Roller-Coaster-Jellinek-Curve

Some see addiction and recovery as more of a roller coaster with numerous ups and downs. Even so, it can still be helpful to understand Jellinek’s stages of addiction. (Brian Kinney/Shutterstock)

There are a few benefits we may reap from a better understanding of the Jellinek Curve, not the least of which is the ability to better recall the timeline our struggles. Looking backward through the haze of drugs and alcohol that comprised our daily living for so long a time, it can be difficult to make out the shapes of our experiences. As we analyze the Jellinek Curve, we may begin to recall various legs of our journey.

For those of us who are following an AA-based model of recovery, this recollection may service our fulfillment of the Twelve Steps. For instance, the Fourth Step requires us to take a detailed moral inventory.

Depending upon the specific requirements set before us by our sponsor or our treatment program, we will be required to inventory our resentments, our fears, and often the harm we have done to others. During the Eighth Step, we must certainly recall the harm we have done to others so that we may move on to Step Nine and begin making amends.

The Forming Of Lists

Some people may have trouble forming these lists, but one method of doing so may be to follow the trajectory of the Jellinek Curve and attempt to recall our actions throughout various stages of our addiction. These steps will still demand a great deal of self-reflection, but using the Jellinek Curve to chart out something of a timeline will make the process much easier.

The Jellinek Curve can also be used as a tool to bolster our attempt at relapse prevention. Many people like to carry their Fourth Step inventory or a list of character defects written during Step Six in their wallets, so that they may be reminded of their addiction should they ever attempt to open their wallet at a bar. If this does not suit you, then you may consider carrying a copy of the Jellinek Curve instead.

It may be a bit more spatially compatible with one’s wallet size, and it will still serve the purpose of acting as a reminder that drinking again will put you through the ringer. You will have, right there in the form of ink and paper, a perfect illustration of the decline you will experience through relapse and the uphill battle that must be fought to once again achieve contentment in sobriety.

The Jellinek Curve As A Symbol

More than anything, the Jellinek Curve should act as a symbol for why we should wish to remain sober. Some may disagree with the shape of the curve, the fact that it continues rising upward forever and ever. It certainly seems implausible; no one goes through the entirety of their life in such an elevated state.

But while we may take a step back in our recovery from time to time, and while we may face many challenges and hardships that will test our fortitude to its very limits, relapse is not the answer to these struggles. If we continue to do the right thing and to foster a mindset based on realistic thinking and real moral values, we can overcome these hardships. And in doing so, we will strengthen our belief in the value of our sobriety so that our spiritual journey may continue unimpeded.

Some may not see this sort of deeper meaning in the Jellinek Curve. To some, it is just a basic depiction of the manner in which some addicts and alcoholics experience addiction and recovery. But if you choose to use it for a greater purpose, it can be a highly useful tool. The choice is up to you.

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