Writings and Philosophies of
Alcoholism is Not a Disease:
Challenging Mainstream Andro-Centric Science
By Wanda M. Woodward, Ph.D.
Recently a very competent, seasoned mental health professional referred to alcoholism as a "disease." I did say that I disagreed which elicited a response from the person that she could show me "a lot of research" to support the claim. When I rebounded with a resounding answer stating that it didn't matter how much research she provided, I still would not believe that alcoholism is a "disease," she retorted defensively asking if I believed alcoholism was a "moral weakness." I said I did not. She then quickly dismissed me. Such verbal exchanges are common in the mental health field which is rife with different and competing theoretical models and assumptions. Let me outline my arguments as to why I oppose the mainstream belief that alcoholism is a "disease."
First, the mental health field is full of differing theories, opinions, and contradictory research outcomes. For decades, no one dared challenge Freudian psychoanalytic thought without being ostracized, demeaned, and devalued. As Einstein once said, it takes creativity and a lot of courage to oppose accepted paradigms. History is replete with examples of people opposing an accepted "mainstream" paradigm and suffering substantial negative consequences which highlights that just because a lot of people say something is the truth, does not necessarily make it so. Bruno was beheaded by the Infallible Fathers of the Catholic Church because he dared present evidence that the earth was not the center of the universe. Gallileo was threatened with beheading if he didn't stop teaching the same theory. Since the theory of the earth being the center of the universe allowed men to make the claim that the male gender was the center of the universe, the heliocentric theory was too threatening to both religion and males, both of which had unchecked power.
Second, when referring to "science" and "research," the question to ask is: Whose science and whose research? So-called "science" and its joint partner "research" is decidedly value biased as this has been pointed out by feminists, social constructivists, and those who espouse the validity and importance of qualitative research. Just because "science" publishes something, does not mean it is infallible truth, nor does it require that I conform to its so-called "truth." We have numerous examples throughout history in which those in positions of authority (all males, of course) have told the public either an untruth or a half truth. Medical doctors in the nineteenth century and early twentieth century used science to espouse positions and make claims which had the effect of maintaining patriarchal norms and embedding social norms of female deviance into the collective psyche. The 19th century is replete with male researchers who attempted to use their so-called "scientific research" to argue for the inferiority of females. Perhaps nowhere is that more notably recognized than in the argument that males were intellectually superior to females because their brains were larger. As noted in Anne Fausto-Sterling's Myths of Gender: Biological Theories About Women and Men, this contradicted what was later referred to as the "elephant problem" in which, if size of brain was a determinant of intelligence, elephants and whales would be vastly more intelligent---clearly not the case. It was later understood that brain mass had more to do with the different overall weight and size of the body of each gender. As Fausto-Sterling points out in her book, the French naturalist, George Cuvier, argued that the size of the cranial to the facial bones decided intelligence. This presented "the bird problem" since, if this were accurate, birds would be more intelligent than humans. These instances of discredited "scientific truths" are legion in the medical field. As we can see, with time, many of these so-called "scientific truths" were found to be gender-biased and andro-centric, and it was found that the methodological process was flawed. Hormone Replacement Therapy was touted by the mostly male medical establishment in the late 1980s and 1990s as the preferred medical solution for discomfort from the symptoms of menopause. It was also believed that it would help reduce heart disease and bone fractures. After years of research, however, it was found that taking HRT increases the risk for blood clots and strokes as well as breast, uterine, and ovarian cancer. The number of heart attacks increased in those women taking HRT. Yet medicine touted HRT as a certain treatment for reduction of symptoms for menopause for years. Untruths and half truths are not uncommon in science.
Third, it is well documented that science has been used for political purposes. Three U.S. Surgeon Generals testified in 2006 of how the government forced them to change science to suit political needs. Furthermore, this corruption of science was committed by a Surgeon General under Presidents Reagan, Clinton, and most egregiously under George W. Bush. So how many other so-called "scientific" outcomes have been published as propaganda to convince an unwitting public to meet political needs, in other words, to elicit conformity to authority so followers will accept a precept that benefits those in power while, in many cases, actually harm society?
Fourth, based upon considerable readings of the history of medicine and science as well as the sociopolitical history as pertains to science, I find it difficult to advocate for the medical establishment's "disease model" of alcoholism. My conviction is that alcoholism is no more a disease than is being addicted to cigarettes or chocolate. While acknowledging predispositions and the great difficulty in overcoming addiction, I believe that people can inherit a predisposition to become addicted. But tendencies are not diseases. Alcoholism can, and does, result in diseases such as cirrhosis of the liver and a host of others, but I refute the disease model. I believe that modeling plays a role in alcoholism just like it does in abuse. The fact that little boys are 10 times more likely to grow up and be abusive to their partners if they have observed their fathers beating their mothers is a type of modeling behavior. I believe children oftentimes model their parent's healthy or unhealthy coping skills. Alcoholism is a coping skill for many people unwilling to utilize other more healthy coping skills.
So what do I believe is behind the claim that alcoholism is a "disease"? I am persuaded that those in authority have used the propaganda that alcoholism is a "disease" for several reasons. First, because the vast majority of people who drink excessively or who are what would be defined as "alcoholics" are in denial of their problem, there is a history of this population not seeking treatment. Not only are they in denial because it is difficult to psychologically admit to a personal weakness, there is also the discomfort of acknowledging that one is irresponsible as a person, perhaps as a family financial provider, and as a poor spouse or parent. Add to this the long history of the perception that these people are immoral and are committing sins against their God as well as their family and friends, this adds another dimension. For these reasons, the history of alcoholism prior to the "disease model" of alcoholism is full of shame, guilt, and refusal to seek treatment. When understood from this trajectory, it is understandable that the field of medicine, psychiatry, and psychology would seek to develop a strategy that would allow for more people who have problems with alcohol to seek treatment.
On the other hand, as with many things in life, there are usually unfavorable repercussions to large scale shifts in paradigms. Acknowledging that the "disease model" has had some positive returns, what has also occurred is that some alcoholics now use the disease model as an excuse for escaping personal responsibility and externalizing blame for their "disease." While getting people into treatment is a worthy goal, the consequence of people forsaking personal responsibility for choosing to drink and use drugs is lamentable. The collective psyche of Western culture, particularly in America, is already fixated on an external locus of control when it comes to placing responsibility and generating accountability. In addition, the disease model has generated hundreds of millions of dollars for mental health providers and for the pharmaceutical companies that market drugs which are used to treat the symptoms of alcoholism.
Fifth, we now know that some pharmaceutical companies have published research findings in which certain data were intentionally not published. The data that has been suppressed are those data which run counter to the published data. More specifically, the suppressed data, if published, would result in devaluing or discrediting the research findings which, in turn, would have an unfavorable impact on the profits of the pharmaceutical industry. Most know of the "placebo effect" in which drug studies have been conducted to determine the efficacy of a particular drug. The control group who received the placebo drug fared as well, if not better, than the test group who received the drug. Some drug companies fail to publish this important finding. Psychology, ruled by males, has a history of not publishing confounding variables. It was a turning point when Carol Gilligan, the noted feminist who wrote In a Different Voice, pointed out that Lawrence Kohlberg's famous studies on morality in which he concluded that men were morally superior to women was a study conducted only on males! Even though he conducted studies exclusively with male subjects, he published findings and generated a theory of morality which included both males and females. Noting this research flaw, Gilligan conducted research on the morality of women and found that men were not morally superior to women, rather that women's sense of morality was relational and contextual based on an ethic of care while men's morality was based upon a system of absolutes. Who is to say which is morally superior? Sandra Harding, another noted feminist, has written a book on the andro-centric so-called "science," The Science Question in Feminism, in which she writes about the androcentrism in biology and social science. This calls into question the methodology of research studies in a world that remains andro-centric.
Sixth, if alcoholism is a disease, how does one account for those vast numbers of people who have alcoholism in their family history, yet vehemently choose to reject drinking and, therefore, they do not develop the "disease" of alcoholism? If alcoholism is a "disease," then ostensibly at least a portion of these people who reject drinking would develop alcoholism just as some people who never smoke a day in their lives develop lung cancer.
I believe it is important to question and challenge mainstream science instead of accepting everything as truth.