When we define 'alcoholism' as a psychogenic dependence on or a physiological addiction to ethanol, manif ested by the inability of the alcoholic consistently to control either the start of drinking ('craving') or its termination once started ('addiction', 'loss of control') the diagnosis or the process of identifying alcoholism by consideration of the auto — and hetero-anamnesis, early and late symptoms etc. still leaves us with many unsolved problems. Some of these difficulties are discuseed. One need not be an adherent to psychoanalysis and its verbalizations to recognize the importance of early childhood reactions. It is the parental home where the reactions of the individual are tested first. There is however no such thing like a specific pre-alcoholic personality. This was recognized in the Netherlands as early as 1934 (Hazelhoff and Horst).
Cause and effect are mixed up by many investigators.
Many of the symptoms which are described as predisposing towards alcoholism are but secondary traits.
A number of different types are attracted to excessive drinking as a means of solving the various problems of life.
There are two schools of thought: some believe that people become alcoholics because of their physiological make-up (e.g. allergie reactions), others believe that this happens because of their psychological make-up.
The behavior of the alcoholic cannot be explained by heredity only. It is necessary to study the complicated development of his life, his family and work situation, group behavior, drinking history, economic and cultural factors.