Addiction and recovery often follow a predictable pattern. The Jellinek Curve is a visual representation of the stages many people go through when grappling with a substance use problem. While the Jellinek Curve was originally created as a tool for explaining the trajectory of alcoholism, the visual arc has been modified and applied to many types of addiction.
In the early stages of addiction, it may be difficult to recognize that a person has a drug or alcohol problem. But as a person progresses further into addiction, the disease often develops in a predictable way.
The Jellinek Curve is a useful way to identify and understand where someone is along the progressive path of addiction. The U-shaped chart highlights notable symptoms through several common phases of addiction and recovery.
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Origins of the Jellinek Curve
The Jellinek Curve as we know it today is largely based on the work and findings of Elvin Morton Jellinek, a Yale University physiologist and one of the founders of the field of addiction science.
Throughout the 1940s, Jellinek headed up the Yale Summer School of Alcohol Studies. As part of his work, he surveyed thousands of people addicted to alcohol about their personal experiences. When he analyzed the results, he spotted a number of trends and patterns — including progressive changes that resulted in distinct behavioral patterns.
He used this information to delineate four phases of alcohol addiction. These phases — and the ever-worsening various physical and mental characteristics that accompany them — comprise the left, downward part of the U-shaped Jellinek Curve.
They also convinced Jellinek that alcoholism was a disease, not a moral shortcoming, and helped revolutionize the way alcoholism was approached and treated.
Several years later, Max Glatt, another pioneer in the field of alcoholism treatment, noticed that patients in recovery also had common experiences as they progressed through their recovery. He added his findings to Jellinek’s, creating the right, uphill slope of the U-shaped chart.
Though the research that contributed to the Jellinek chart originally applied just to alcoholism, today, it’s applied more broadly to addiction in general.
Phases of Addiction
According to Jellinek, people addicted to alcohol tend to pass through four progressive sequences. These include the “pre-alcoholism” phase, the “prodromal” phase, the “crucial” stage and finally, the “chronic” phase.
- Stage One: Pre-Alcoholic
In the pre-alcoholism phase, the individual drinks not just as a social activity, but because alcohol helps relieve psychological stress and tension. This is sometimes referred to as “early relief drinking.”
At this stage, a person may not experience or perceive any ill effects of their drinking. But eventually, they’ll need to drink more than before to experience the same pleasant effects. That’s because physiological changes are going on and the individual is developing a tolerance to alcohol.
- Stage Two: Prodromal (Early Alcoholic)
Other troubling physical signs and symptoms emerge as the individual enters the prodromal stage. Levels of consumption escalate and the individual may even gulp their first couple of drinks to hasten their buzz.
The individual may become abnormally preoccupied with drinking and recurrent blackouts may accompany drinking episodes.
At this point, the individual’s drinking problem still might not be readily apparent to others. Many people feel guilty about their behavior at this stage and will go to great lengths to hide their drinking patterns.
- Stage Three: Crucial Phase (Middle Alcoholic)
At this point, the person has lost control over their drinking and the damage of their drinking becomes evident. The person may try and rationalize their drinking, make excuses or even blame others.
At times, they may stop drinking entirely or alter their pattern of drinking, but they usually fail repeatedly. Negative emotions become the norm and they may lose interest in their family, job and hobbies. People often leave jobs or lose friendships in this phase.
The physical decline continues. At this stage, the individual is usually completely physically dependent on alcohol and may begin drinking in the morning. Poor nutrition is common and they may land in the hospital because of health problems.
- Stage Four: Chronic Phase (Late Alcoholic)
In the chronic phase, the individual engages in prolonged episodes of binge drinking, sometimes known as “benders.” The physical and mental decline continues and the person may experience impaired thinking or even have psychotic episodes.
At this point, their tolerance for alcohol actually declines and small amounts of alcohol cause marked inebriation. The person generally no longer experiences psychological relief from drinking at this stage, but their level of physical dependence is so high, they simply can’t stop. Indeed, stopping at this point would result in severe and life-threatening withdrawal symptoms.
- Rock Bottom
Jellinek didn’t include a fifth stage among his progressive phases, but the bottom of the U-curved chart is generally accepted as the terminal stage when the individual hits bottom.
Unfortunately, some people never escape this vicious cycle and continue to circle at the bottom until they die from the disease. For others, hitting rock bottom provides the impetus to seek help and start on the path to recovery.
That said, there is no single definition of what rock bottom is — and rock bottom may be different for everyone. For one person, rock bottom might mean landing in jail. For another, it might be a culmination of other negative consequences.
According to the Jellinek Curve, the road to recovery starts with an “honest desire for help.” Early in the rehab process, a person will learn that addiction is a treatable disease. They’ll also begin the crucial task of quitting the substance.
As they progress uphill, they’ll meet others who’ve recovered from addiction and are living “normal and happy” lives. Eventually, when the foggy thinking that accompanies drug and alcohol abuse subsides, healthy thinking will return.
The individual will perform an honest self-assessment of their life and of their own character. In Alcoholics Anonymous, a 12-step program for overcoming alcoholism, this is Step 4. This sort of inner reflection is not easy, but confronting your failures and shortcomings is a necessary step if you want to break out of old, unhealthy patterns and embrace a new life.
As the individual moves from rehabilitation into recovery, more positive physical and emotional changes typically emerge. The individual’s self-esteem will return, or even begin to form, and they’ll begin to appreciate their new way of life. They’ll develop new circles of friends who are stable and supportive and develop new interests.
Eventually, their desire to escape through drugs and alcohol will diminish and they’ll find contentment in sobriety.
While the recovery curve goes uphill, people can and do slip backward. It’s important, though, to remember that addiction is a chronic disease and relapse does not mean failure. If someone does experience a relapse, it is often just a temporary setback and doesn’t mean the recovery process has failed.
As for the Jellinek Curve, the chart is not an exact depiction of everyone’s experience. Rather, it’s more of a guideline to help people who are struggling with addiction and recovery. The visual arc of Jellinek’s Curve is a powerful educational tool that can help people better understand the disease they’re fighting and recognize that recovery is possible.
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