Reality Of Alcoholism Essay, Research Paper
This study will provide a critical analysis of David R. Rudy’s Becoming Alcoholic: Alcoholics Anonymous and the Reality of Alcoholism.
While Rudy’s perspective is certainly marked by an appreciation for the benefits of Alcoholics Anonymous for alcoholics who seek sobriety, he is nevertheless objective and balanced in his analysis of AA. As Rudy writes in the Notes section of his book, “Nearly half of the reviews that addressed my relationship to AA charged that I had gone ‘native’ [i.e., fallen under the spell of AA and lost scientific objectivity] while the other half argued that I have been superficial or ethnocentric [i.e., failed to deeply enough appreciate the worth of AA]. I interpret such disagreement as support that I have successfully straddled the middle of the road” (Rudy 134).
The perspective of Rudy is relatively unique in that he truly seems to seek such middle-of-the-road objectivity, in comparison to other works which seem to openly argue for or against AA as the primary avenue for recovery from alcoholism. Rudy offers the reader criticisms of AA, while at the same time making clear that there are indeed many benefits presented to alcoholics by AA, benefits which are not yet available from other sources. Rudy’s objectivity is emphasized by his honesty about his own feelings.
For example, it is an important, even crucial, element of the researcher’s effectiveness in dealing with groups that he be seen by the members of that group as at least an objective observer. If he is seen as an outsider, the members of the group will be less likely to be honest with him or to behave as they would if such a perceived outsider were not present. Rudy writes that, “Just when I felt ‘accepted’ in the field [i.e., in his field research into AA], an experience occurred that questioned my empathy skills.” Rudy was coming out of an AA meeting when he was approached by two inebriated individuals coming out of a bar nearby. One of the drunks shouted, “Hey, maybe we should try some of that AA stuff! . . . . There’s one of them now, right there.” Rudy had an experience which shows that no matter how objective he believed himself to be, no matter how much he might scientifically note the benefits of AA, no matter how much he might have been “accepted” by the actual members of the group, he was still not able to allow himself to be seen as one of the group by even these two drunken outsiders: “Before they turned and walked away, we briefly looked at each other. The words were forming on my lips, ‘But I’m not really one of them, I’m just . . .’” (Rudy 134).
This honesty about his own inherent, unavoidable, and even subconscious biases does not disqualify Rudy as a scientific observer, but rather causes the reader to be even more open to his analysis and findings, for we know that the author has faced and acknowledged his own fears and biases. Certainly Rudy’s approach and perspective are made unique by such honesty, which is not commonly found in scholarly research which too often seems to want to give the impression that it was created by a superior being or a mechanical force whose utter objectivity should never be questioned.
Such an aboveboard approach to the material is crucial in the study of alcoholism and Alcoholics Anonymous, due to the fact that there are a great number of areas of controversy and debate and uncertainty with respect to the definition of alcoholism itself, as well as with respect to the nature of AA as an effective means of dealing with alcoholism.
The theoretical approach of Rudy is that of symbolic interactionism: “Both the conception of deviance and social control underlying the present research as well as the theoretical underpinnings of participant observation and life histories draw heavily from a symbolic interactionist perspective. The symbolic interactionist perspective conceives humans as living in symbolic as well as physical environments, and it emphasizes that humans are stimulated to act by symbolic as well as by physical stimuli” (Rudy 119-120).
This theoretical perspective is especially useful, again, because it deals with the importance of symbols in human affairs and because AA is an organization which deals in spiritual matters, matters which are themselves more conducive to symbolic rather than concrete study.
If we briefly look at two other researchers’ perspectives, we can better appreciate the efforts of Rudy to remain in the “middle of the road” in his study of AA and alcoholism. Erich Goode, in Drugs in American Society, amazingly makes only three mentions of AA–and one of those “mentions,” listed in the index, is not even on the page the author claims. The other two mentions are included in the personal account of a recovering alcoholics That account first rejects AA, then seems to accept it as a path to sobriety, but after that it is not mentioned again (Goode 135-136). It is as if Goode refuses to recognize the organization and the spiritual path which have had more effect on bringing alcoholics into sobriety and keeping them there than any other organization or path. Every reputable alcohol and/or drug rehabilitation program in the country is deeply indebted to AA for its methods and philosophy, but Goode, writing a 320-page book on drugs in America, has only two insignificant references to AA.
Philip Flores, on the other hand, in Group Psychotherapy with Addicted Populations, openly advocates AA as the primary road to sobriety as well as spiritual growth for alcoholics seeking recovery, and defends AA against its detractors. For example, Flores writes, in response to the charge that AA “promulgates a simplistic, naive disease concept of alcoholism”: “AA’s concept of alcoholism as a disease is neither simplistic not naive . . . . While the original (AA) hypothesis that alcoholism was an allergy has never been proven, many of today’s biologically oriented researchers . . . still hold to the disease concept, as does the American Medical Association . . . . Many members . . . are more concerned about the effectiveness of utilizing the disease concept rather than engaging in polemics about whether alcoholism fits the right criteria for the true definition of disease” (Flores 212-213).
Clearly, Rudy does demonstrate a willingness and an ability to tread the middle ground of reasonable objectivity in comparison to the perspectives of Goode, who ignores AA almost entirely, and Flores, who is an open and bold advocate of the means and principles of AA.
Concerning the methodological approach of Rudy, the author declares that “Methodological techniques . . . are tools that shape, define, and focus research strategies. The methodological techniques utilized in studying the process of becoming alcoholic and the events leading to membership in AA were participant observation and in-depth interviewing in the form of topical life histories. These techniques are effective in understanding the world as the actor experiences it and are conducive to providing processual explanations of phenomena” (Rudy 119).
Not only do methodologies shape, define, and focus research strategies, they are also shaped by the nature and material of the research itself. Issues of alcoholism, of the definition of alcoholism, of the nature and effectiveness of Alcoholics Anonymous, of the nature of group dynamics, of the nature of recovery itself, particularly when that recovery is based on what AA refers to as “spiritual progress”–all of these issues and aspects of the research at hand require a certain set of methodologies. After all, the scientific method relies on measurement–if there is nothing which yields to measurement, then there simply is no scientific method. Measurement approaches and theories obviously vary, and the more fluid and dynamic and open to interpretation the material at hand (such as alcoholism and Alcoholics Anonymous), the more flexible and fluid the methodologies must necessarily be.
Rudy recognizes this, and his methodologies are appropriate as a result–participant observation and in-depth interviewing. Nevertheless, as appropriate as the methodologies may be, they depend on the insight of the researcher, as well as on the honesty of the subjects, for their significance and accuracy. The measurement of alcoholism and the nature of AA in dealing with alcoholics does not focus on the precise and specific quantities of a particular moment, but rather
The strengths of Rudy’s symbolic interactionist theoretical approach, and his use of participant observation and in-depth interviewing methodologies, are that they are appropriate to the material at hand, and that they will yield the most and most useful data for analysis. On the other hand, the same theory and methodologies are weak because the data they yield will be so fluid and open to interpretation and so reliant on the intuition of the researcher and the candidness of the subjects. The weakness, obviously, is rooted more in the dynamic nature of the material under study than in the theory and methodologies selected.
Rudy essentially finds his experiences with and in Alcoholics Anonymous impressive with respect to validating the ideas and practices of AA. Rudy concludes that AA seems to have the best and most effective answers to alcoholism in society today, and that other, more legalistic and restrictive approaches have not had a significant effect: “Perhaps once we understand that ‘law making is not behavior making’ and that television commercials, product labeling, and drug education programs in our schools still leave us with an alcohol problem, we will begin to think about drinking and drinking problems differently and explore, in a variety of settings, those basic interpersonal ties and responsibilities that tend to grow within Alcoholics Anonymous” (Rudy 115).
As mentioned, Goode’s book is hardly appropriate as a basis for comparison with Rudy’s book, primarily because Goode deals in an utterly superficial way with AA, if it can be said that he deals at all with AA. The two books do deal,with the nature of alcoholism, however, and here we have the basis for contrast. Whereas Rudy essentially agrees with AA that alcoholism is most effectively treated when seen as a disease (from which the alcoholic never fully recovers, but can achieve an ongoing recovery through complete abstinence and the practice of the principles of the AA program), Goode presents an array of perspectives, never focusing on any one of them, and then essentially rejecting the AA view that an alcoholic can never drink without the return of the disease in a full-blown fashion. The very language of Goode indicates his underlying assumptions. He writes, for example, of “recovered” alcoholics (as if there were such beings), and claims that “very little is conclusively agreed upon in this field” (Goode 131). In fact, the vast majority of the professionals in the field wholeheartedly agree on the disease model of alcoholism, and practice in their recovery programs the fundamentals of AA, including the Twelve Steps and the AA insistence that a spiritual need lies at the heart of recovery.
The argument of Rudy is, essentially, that AA is correct in its description of alcoholism and recovery from alcoholism. Society’s approach on a political and governmental level indicates ongoing ignorance as to the nature of alcoholism and drug addiction, summed up in the “Just Say No” campaign. This means nothing to the alcoholic or drug addict, who will continue to drink and use drugs until his or her life “hits bottom.” He or she may use and/or drink unto death. “Just Say No” simply will not do as social policy if the country truly believes in a comprehensive and effective drug/alcohol program on a national level.
The “war on drugs” or “drug control” in any form will not stop the alcohol/drug program. Restriction of alcohol sales to individuals 18 or 21 has not kept children from obtaining alcohol, just as Prohibition did not work. Drug education is certainly a step in the right direction, but by itself it will prove no more effective than drug control through attacks on Colombian drug lords or destruction of alcohol commercials. All of these approaches are useful, but without the implementation on a national level of the principles and practices of Alcoholics Anonymous, those more superficial efforts will prove negligible in the fight against alcoholism and drug addiction.
To simply tell a youngster who is lonely and frightened and uncertain of his place in the world and perhaps unwilling even to go home after school to an abusive and/or alcoholic parent–to simply tell that child to “Just Say No” is to demonstrate an overwhelming ignorance about the nature of alcoholism and drug addiction.
It is vital that public policy be based on the increasingly accepted conclusion–endorsed by the sources consulted by Rudy–that alcoholism and drug addiction are diseases. The “Just Say No” approach implies that a person who says yes is somehow evil, or immoral, or weak. The disease concept frees the individual from responsibility for his disease–but does not free him from responsibility for his actions and, finally, for his recovery.
Rudy’s conclusions also should help lead to a public policy which increasingly relies on the communal nature of recovery. The “Just Say No” approach implies that it is an individual matter–both the use of alcohol and drugs and the refusal to use them. Rudy’s book explores the reasons behind the success of Alcoholics Anonymous, and those reasons in this context suggest that a communal rather than an individual approach is required.
After a list of personal explanations from recovering members of AA with respect to their lonely, desperate drinking experiences, Rudy writes that “The loneliness and isolation of these explanations are the exact opposite of the sharing, love, and involvement of the typical AA setting. AA members frequently describe in testimonials the warmth, intimacy, caring and sharing that typify the ‘fellowship of AA.’ Perhaps the AA society’s reestablishment of social relationships . . . indicates real social relations among many heavy drinkers . . . . Weakened interpersonal support systems, permissive and ambivalent sanctioning responses, normalization of deviant drinkers by others, and withdrawal are factors contributing toward the development of drinking problems” (Rudy 112).
With respect to public policy, then, based on Rudy’s conclusions it is vital that treatment programs emphasize the social elements of recovery. The individual alcoholic will very likely find it impossible to recover separate from a community of recovering alcoholics. This has been, at least, the experience of alcoholics who have found recovery success in Alcoholics Anonymous.
The symbolic interactionist theory of Rudy should also be adopted as the basis for public policy treatment and prevention programs. Essentially, we have covered the symbolic element of the theory–human affairs are composed of more than merely physical activities; they also include symbolic factors which, in this case, involve spiritual needs. The interactionist element emphasizes the collective nature of most human behavior. The argument with respect to alcoholism is that the individual drinks deviantly as a part of collective action, and he recovers as a part of collective action: “From an interactionist perspective, deviant designations are best viewed as outcomes or culminations of many collective actions between participants” (Rudy 95-96).
Treatment and prevention programs, then, should emphasize the communal, collective nature of both alcoholism/addiction and recovery from alcoholism/addiction. Certainly peer pressure plays a role in alcoholism/addiction, and peer pressure can also play a part in initiating recovery. The problem is that “Pressure” is not what works in AA, but, rather, group acceptance, group sharing, group involvement in positive, healthful activities. The individual may be bullied or pressured into using alcohol and drugs, but he will not be bullied or pressured into successful, long-term recovery. This must be, as in AA, a matter first and last of individual choice, individual responsibility, individual commitment–always within the communal environment such as is provided by Alcoholics Anonymous and such as is recommended by Rudy.
Flores, Philip J. Group Psychotherapy With Addicted Populations. New York: Haworth, 1988.
Goode, Erich. Drugs in American Society. New York: McGraw-Hill, 1989.
Rudy, David R. Becoming Alcoholic. Carbondale, IL: Southern Illinois U P, 1986.