The Alcoholic Society

Addiction and Recovery of the Self

Reece McGee

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351486125
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Offering a unique theoretical foundation to understanding the lived experience of the active alcoholic, Denzin asserts that alcoholism is a disease in which negative emotions divide the self into warring, inner factions, fueled and distorted by alcoholic intoxication. The work is solidly anchored in a long-term study of the socialization experiences that began in alcoholism treatment centers and continue in Alcoholics Anonymous recovery programs. It covers the treatment process, the restructuring of self, the alcoholic's interaction with his recovery treatment program, and the modalities of self-transcendence that result from treatment.

1
INTRODUCTION:
Studying Alcoholism, Interpreting Recovery

Hell is our natural home. We have lost everything. We live in fear of living. Alcohol was our only friend. We found ourselves in alcohol and then it turned against us and tried to kill us. No other friend would do that to you. But we kept on drinking because we had to [Female alcoholic, 58 years old, sobriety date unknown].

I used to have to drink every day. Now I don’t have to. I’m an alcoholic, sure, but I’m a recovering alcoholic [Recovering alcoholic, sober 8 years, male, 35 years old occupation, lawyer].

In this study I examine a basic question: How do ordinary men and women live and experience the alcoholic self active alcoholism produces? I understand alcoholism to be a self-destructive form of activity in which the drinker compulsively drinks beyond the point where he or she can stop drinking for any extended period of time, even if he or she wants to. I adopt the point of view of those self-defined alcoholics who bring their lived experiences to the tables and meeting rooms of Alcoholics Anonymous. I assume that each alcoholic is a universal singular, epitomizing in his or her lifetime the experiences of all alcoholics (see Sartre, 1981: vi).

Alcoholism has, since 1955, been designated as a form of physical, as well as mental, illness by the American Medical Association. An inquiry into alcoholism is also a study in mental illness, but into a form of mental illness to which alcoholics give special meaning. The practicing alcoholic may be said to live an emotionally divided self (James, 1961; Denzin, 1984a). This, then, is a phenomenological study in biography and society, for it joins the private problems of alcoholics with the public discourse and the public experience that surrounds alcoholism’s presence in American society (Bertaux, 1981; Gusfield, 1981; Mills, 1959; Beauchamp, 1980; Madsen, 1974).

Alcohol is the most abused chemical substance in the world (Royce, 1981). According to a recent psychiatric, epidemiological survey, 13.6% of Americans at some time in their lives have suffered from alcohol abuse and alcohol dependence (New York Times, 1983). In the United States some 9 million people are estimated to be alcoholics and a recent Gallup poll estimates that one-third of Americans have a drinking problem. The “mental illness” associated with alcohol abuse is thought to rank second to depression as the most prevalent mental disorder in American society. The human and economic costs of alcoholism are incalculable, and are barely reflected in the statistical facts that record alcoholic-related suicides, broken marriages and families, loss of work productivity, ruined lives, personal degradation, and the loss of self, income, sanity, and physical health (Cockerham, 1981: 169). Alcoholism, alcohol, and alcoholics touch the lives of one out of seven Americans at some point in their lifetimes.

Alcohol Use in the United States

It is estimated that 7 out of 10 Americans drink, at least occasionally (Royce, 1981: 3). In a survey of the incidence of problem drinking in the United States conducted in 1967, Cahalan found that 43% of the men and 21% of the women who drank had experienced serious problems directly related to the drinking of alcohol at some time in their lives (Johnson, 1973: 183; Cahalan, 1970). Having, or having had, problems related to alcohol use is, then, if not a personal experience of the individual who drinks, at least a problem he or she is aware that others have had.

A social text has been written that positions the problem or alcoholic drinker squarely within a matrix of medical, social, scientific, personal, economic, and ideological beliefs that performs two symbolic moves simultaneously (see Johnson, 1973). First, alcohol use is part of the experience of being a normal American, male or female, during the first two-thirds of the twentieth century. Second, alcohol abuse, although associated with selfhood, freedom, and the status symbolism of the new middle class (Johnson, 1973), must be dissociated from the self of the abuser. Alcoholism, being a disease or an illness, is not the responsibility of the drinker. Yet, the ethos of self-responsibility and self-control that permeates American culture makes alcoholism the personal responsibility of the drinker who abuses alcohol. This subtle interpretation of alcoholism as an illness, which has the self at its center, escapes general public understanding. Hence, although the popularization of the disease or medical conception of alcoholism has spread throughout American society, it remains an illness that is not like other illnesses or diseases (diabetes, cancer) the individual may incur. It is not a purely medical or biological problem. This understanding remains in place, despite the efforts by the American Medical Association, the National Council on Alcoholism, the World Health Organization, the National Institution on Alcoholism and Alcohol Abuse, and Alcoholics Anonymous to persuade the public otherwise (Beauchamp, 1980: 22-48; A.A. 1957: 235-251; see also Blane, 1968; Chafetez and Yoerg, 1977).

This vicious ambiguity that surrounds the American attitude toward the self and the disease called alcoholism is revealed in the Mulford and Miller survey of 1964 in which they asked a random sample of respondents to give their personal views of the alcoholic. Of the sample, 65% said the alcoholic was sick. There were 60% who said the alcoholic was weak willed, and 31% who said alcoholics were morally weak. Only 24% said the alcoholic was sick, without using any of the other labels (Johnson, 1973: 146; Mulford and Miller, 1964). Being weak willed and morally weak are two meanings directly associated with strength of self and with self-will or willpower. Vaillant’s (1983: 1-11) most recent review of the meanings surrounding the disease concept of alcoholism confirm the Mulford and Miller (1964) and Mulford (1970) findings.

The American alcoholic, then, at least since the 1960s, has been perceived as being sick, as suffering from an illness or a disease, but lacking willpower and self-will. The disease or illness conception of alcoholism has not succeeded in removing the stigma of self from the conduct of the alcoholic who has alcoholism (see Beauchamp, 1980: 68; Kurtz, 1979: 199-230; Levine, 1978: 160).

The alcoholic typically has been contrasted with the normal social drinker (Beauchamp, 1980). The normal social drinker apparently possesses skills, powers, and immunities that allow him or her to drink within the range of normal conduct that our culture prescribes. That is, the normal social drinker does not have socially defined problems with alcohol. These problems do not exist because of attributes he or she possesses. These abilities are in the individual and in the terminology that culture and science use to describe his or her use of alcohol. Locating the ability to control or not to control alcohol in the individual shifts attention away from the culture, the social groups, and the historical social structures the person inherits from society. By positioning the normal social drinker midway between the problem, alcoholic drinker and the person who abstains, American society has driven its obsession with self-control into the mind of every man and woman who comes in contact with alcohol. That is, control is a personal phenomenon that can be manipulated by willpower and the methods of modern behavioral science. The mythical social drinker who drinks normally thus epitomizes America’s relationship with alcohol, alcoholism, and the alcoholic.

Situating this Study

The “alcpholism” that the alcoholic confronts on a daily basis is experienced as a relationship with the world. Consequently, it must be studied interactionally and interpretively as a structure of experience that is produced and reproduced, over and over again, in the lived experiences of the “alcoholic” man or woman.

As a study in lived experience, this investigation necessarily becomes an examination of temporality, emotionality, and interaction. That is, the alcoholic’s being in the world is temporal. Alcohol alters his or her inner stream of emotional, temporal experiences. The alcoholic’s interactional experiences with others are woven through an alcoholically altered inner stream of consciousness. The alcoholic confronts “reality” from the vantage point of the social world of alcohol, which, like the world of emotionality, is a separate province of reality (Denzin, 1984a: 95). Although embedded in the everyday life world, the world of alcohol stands distinct from that world. Yet when in the world that alcohol gives him or her, the drinker takes that world everywhere. The alcoholic cannot just walk away from it, as one might walk away from the work or family worlds one also occupies. Like the world of emotion, the world of alcohol shatters the taken-for-granted assumptions of the everyday world, rendering its assumptions and presuppositions meaningless and irrelevant.

Alcoholism and alcohol cut through every structure of the subject’s life, leaving nothing in his or her world untouched. Consequently, a study of the self of the recovering or practicing alcoholic becomes an inquiry into the meaning of existence as existence is lived by the man or woman who places alcohol between himself or herself and the world of others. This investigation is an extended essay on the understanding of what I term “alcoholic existence.” By disclosing the meanings of existence as seen from the point of view of the recovering alcoholic, I hope to shed light on what it means to live at this moment in the twentieth century. The active alcoholic is a person who, for some extended period of his or her life, approaches the world through an altered state of consciousness.

Alcoholic subjects find themselves, as Marx might say, inserted into a mode of existence and into a moment in history over which they have no control. Alcoholics find that history is going on behind their backs. Alcoholics drink in an attempt to control their relationship to these events that are occurring in front of and behind them. They find that they are the victims of their own actions and that their lives have lost meaning for them. They experience divided selves and hate themselves and everyone who surrounds them. As they alter their consciousness in order to change their beings and presences in the world, they find that the world destructively acts back on them.

“Normal” Time and Emotion

The alcoholic lives a dis-ease of time and emotion that is experienced as an uneasiness with self. This uneasiness is dealt with through alcoholic drinking. Alcohol obliterates or neutralizes the alcoholic’s fear of time and self. Fearful of time, the alcoholic dwells in the negative emotions of the past. Such self-feelings undercut and undermine the alcoholic’s ability to confront the present and the future in a straightforward manner.

In contrast to alcoholic time and emotion stands “normal” time and feeling. “Normal” temporality and “normal” emotionality conceptualize these processes in a reflective, purposive fashion. This allows the person to incorporate self-feelings and temporal experiences into ongoing action in a nondisruptive, non-self-destructive way. Normal emotionality does not dwell in the negativity of the past. It is not fearful of the present and the future. Normal emotionality does not undercut the self-structures of the person. Alcoholic emotionality does. Alcoholic temporality turns away from the present and leads to the production of negative emotional experiences, which further locate the alcoholic in the addictive cycle of drinking alcoholism turns upon.

An understanding of the alcoholic requires an interpretation of “normal” time and emotion, for the alcoholic attempts to achieve a state of “normalness” through the drinking act. Afraid of not being normal, the alcoholic drinks alcoholically so as to cover up this fear. The alcoholic hopes that the next drink will allow him or her to experience time and self-feeling in the way that normals do.

The Six Theses of Alcoholism

Six theses, or interpretive positions, structure my understanding of alcoholism (see Chapter 5 for an extended discussion of each). The first is the “Thesis of the Temporality of Self.” This thesis assumes that the alcoholic lives his or her experiences in the world primarily through the altered temporal consciousness that alcohol produces. This means that the alcoholic is always out of temporal synchronization with fellow interactants. Thought and emotional processes are dulled or sped up as a result of the alcohol consumed. Alcoholism is a disease of time.

The second thesis concerns the relational structures of the alcoholic’s self. It assumes that the alcoholic lives within alcohol-centered social relationships that have been distorted and twisted by the effects of alcohol on the alcoholic’s self. In contrast to more normal social relationships in which affection and love may bond two individuals, in the alcohol-centered relationship, alcohol becomes the object that joins interactants in a combative, competitive, negative, hostile relationship. The emotionality of self is the third thesis. As indicated above, alcoholism is a dis-ease of emotionality and self-feeling. The alcoholic experiences negative, painful emotions on a daily basis. Alcohol blunts the ability to feel emotionality. Feelings are always filtered through the altered temporal consciousness alcohol creates.

The fourth thesis is the “Thesis of Bad Faith.” I suggest that alcoholics and their significant others attempt to escape alcoholism by denying its existence. Structures of denial, self-deception, lying, and bad faith thus lie at the heart of the alcoholic’s alcoholism (see Sartre, 1956, on bad faith).

The fifth thesis is the “Thesis of Self-Control.” This thesis, following from the fourth, asserts that alcoholics believe they are in control of themselves and the world that surrounds them. As Bateson (1972a: 312) has argued, the alcoholic’s self-pride leads him or her to risk taking a drink, even when knowing that self-control will be lost. Pride in self ties the alcoholic into a competitive relationship with alcohol. The alcoholic drinks in order to prove self-control.

The sixth thesis is the “Thesis of Self-Surrender.” This interpretation argues that the alcoholic’s recovery begins when he or she surrenders to false self-pride, breaks through the systems of bad faith, and comes to accept his or her alcoholism. Until such surrender, recovery cannot begin. In this volume I take the alcoholic up to and through surrender. In the next volume in this series, I examine the recovery process that follows from surrender.

The Alcoholic Self

A basic premise organizes the Six Theses. Every alcoholic I observed drank to escape an inner emptiness of self. This emptiness, often traced to early family experiences of death, parental loss, sexual abuse, drug abuse, or alcoholism, was manifested in terms of a fundamental instability of self. In this regard the alcoholic grotesquely displays the inner narcissicism and tendency toward madness that Lacan (1977), Lasch (1983, 1985), and Kohut (1984) have located at the core of human existence. The self-other experiences, the self-ideals, and the ideal selves that the alcoholic pursues are largely imaginary and out of touch with the world of the real. Alcohol sustains these imaginary ideals. The alcoholic lives in the realm of the imaginary and this may be a troubled world of sexual and emotional relations that reflect the alcoholic’s unstable inner self. As a result of living in the realm of the imaginary, the alcoholic is unable to take the attitude of the other, to use Mead’s (1934) phrase. He or she is unable to enter into and find a place in a society of preexisting selves. His or her imaginary life will not permit this. Intense preoccupations with self shut the alcoholic off from others. Because alcohol’s psychological and physiological effects cannot be shared emotionally, the alcoholic’s self is cut off from the world of normal interaction with others (see Tiebout, 1954).

These six theses, and the basic premise that organizes them, are drawn from three sources. They are based on my reading of the scientific literature on alcoholism. They are contained, in different form, in Alcoholics Anonymous’s theory of alcoholism (see Chapter 3). Most important, they are grounded in my empirical materials.

Empirical Materials

I examine the stories of self that active and recovering alcoholics bring to Alcoholics Anonymous, a worldwide organization of recovering alcoholics whose estimated membership in 1985 was over 1 million in over 58,000 groups in 110 countries. My materials are drawn from a five-year period of study, primarily in a medium-sized community of 150,000 in the eastern part of the United States. I have observed the workings of A.A. in over 2,000 open and closed meetings. I have gathered observations from substance abuse treatment centers and detoxification programs. I have had discussions and interviews with active and recovering alcoholics and their family members who belong to Al-Anon and Alateen. I also have had conversations with treatment personnel, physicians, psychiatrists, social workers, hospital emergency room nurses, and alcoholism counselors who make it their business to work with alcoholics. I have firsthand experience with alcoholism in my own family.

In addition to these sources, I have examined the literature of Alcoholics Anonymous including The Big Book, or Alcoholics Anonymous (1976). Other sources include Twelve Steps and Twelve Traditions (1953), As Bill Sees It (1967), Came to Believe (1973), Living Sober (1975), Dr. Bob and the Good Oldtimers: A Biography, with Recollections of Early A.A. in the Midwest (1980), “Pass It On”: The Story of Bill Wilson and How the A.A. Message Reached the World (1984), Lois Remembers (1977), The Grapevine (the international monthly journal of Alcoholics Anonymous), Twenty-Four Hours a Day (Hazelton, 1975; this book is not authorized by A.A.), and numerous materials printed and distributed by the World Services Office of A.A.

The community or social world of alcoholics I observed numbered over 200 regular members who maintained near or continuous sobriety (as determined by self-report) by attending one or more meetings a week. Within this number there were 5 distinct groupings of recovering alcoholics. There was a core number of members (15) who had been sober over 10 years—one for 22 years—and the remainder averaging 14 years. These members were the “old-timers” in the A.A. community. There was a second group, with 50 members, who had been sober 5 to 10 years. The third group, numbering 40, had been sober from 2 to 5 years. The fifth group of 80 members had been sober less than a year, 45 for 6 months or more, 30 for 6 months or less. The most “s...

Table of contents

• Cover Page
• The Alcoholic Society
• copy
• Contents
• Introduction to the Transaction Edition
• Foreword
• Preface
• Acknowledgments
• 1. Introduction: Studying Alcoholism, Interpreting Recovery
• Part I Differing Views of Alcoholism
• Part II The Alcoholic Self
• Part III Treating the Alcoholic Self: An Ethnography of the Treatment Process
• Part IV A.A. and the Social Worlds of Recovery
• Glossary
• References
• Name Index
• Subject Index