Addiction Myth #2 — alcoholics are addiction experts

Addiction differs from such DSM-IV disorders as, say, schizophrenia, in that having the condition qualifies a person as an expert. “What alcohol does to me is reality,” alcoholics believe, “and so I know all about alcoholism.” Susan Cheever, who added her not especially insightful 1999 book, Note Found in a Bottle, to the massive first-person literature on alcoholism, is considered an alcoholism expert. In truth, Ms. Cheevers’ condition actually expresses her, and our cultural, confusion about alcoholism.

On a broader scale, Americans believe that the drinking they see around them is how all humans experience alcohol. Human beings are social animals pluperfect. What they and the people they know do is the way the world is. And this myopia is nowhere more apparent than with alcohol. The three major determinants of people’s drinking experiences are: (1) the people they know (friends and family), (2) their social class and cultural group, (3) their historic era.

Cheever seems to recognize the social causes of her problem in the New York Times post, Proof, when she described wanton and destructive drinking at the parties she used to frequent. These experiences represented the impact of all major social factors in Cheever’s life – social group, family, historic era. While she and her friends once drank with abandon, however, Cheever and the United States are now undergoing an anti-alcohol cultural wave. That the Times publishes so many Proof posts by recovering alcoholics and active problem drinkers is actually proof of one thing: we are undergoing a national reaction against drinking.

Per our current cultural view of addiction, Cheever considers herself an unavoidable victim of the disease of alcoholism – her heritage MADE her an alcoholic. Reviewing her biographical memoir about her father, novelist John Cheever, Home Before Dark, Goodreads declared, “Anyone not convinced of a genetic trait for alcoholism should read this. Cheever’s father, mother and brother were all heavy drinkers if not frank alcoholics.” Obviously, therefore, the Cheever family are genetic alcoholics.

But this distinctly American view is not consistent with Cheever’s own descriptions, nor with scientific material she relates. In her post to the Proof blog, Cheever describes Bruce Alexander’s famous Rat Park experiment, where animals were habituated to narcotics in an isolated cage, then placed in a large enclosure with other rats and rodent amusements (e.g., a ferris wheel). The addicted rats totally eschewed morphine solution in favor of plain drinking water in Rat Park. This does not support a disease perspective on addictions, as I made clear in The Meaning of Addiction. If simple-minded animals respond to a rich, socially-engaging setting by quitting narcotics cold rat, then how much more likely is human drinking and drug-taking to reflect people’s social milieus?

Cheever feels her book will warn others like her of the dangers of alcohol and enable them to avoid the traps she fell into. But the existence of so many similar volumes before hers (including such best-sellers in recent memory as Jill Robinson’s Bed Time Story and Caroline Knapp’s Drinking: A Love Story) without a notable reduction in alcoholism suggests her hopes won’t be realized. Indeed, remarkably, while Americans drink less currently, more of them report having alcoholic symptoms (with which Americans are now well familiar)!

How is this paradox possible? The vision of inescapable alcoholism Cheever depicts is not one that is universally shared – in some cultures the whole idea is completely absent. Here’s the rub – cultures without this image have lower alcoholism rates. In his book The Natural History of Alcoholism, George Vaillant found when following the lives of inner-city Boston men from adolescence to seniority that Irish-Americans in his sample were almost ten times as likely to become alcoholic as their Italian, Jewish, and Greek neighbors!

The Irish Americans Vaillant studied had an extravagant view of alcohol. According to Vaillant: “It is consistent with Irish culture to see the use of alcohol in terms of black or white, good or evil, drunkenness or complete abstinence.” Conveying the idea of alcohol’s irresistible power, and in fact drinking that way, is to convince people their drinking is uncontrollable and to encourage such drinking. Here’s the irony: to the extent that people read and believe views like Cheever’s – make them a part of their internal baggage like they are a part of Cheever’s – they will be susceptible to alcoholism.