I’m a big fan of contradictions. Where they occur – in social movements, in ideology, in programs of action – they tend to highlight the underlying compositional character of human enterprises. Thus contradictions also provide occasions where the contributing strands of such enterprises may be more easily separated out for examination. (Comedians, of course, love contradictions too – because they highlight our foolishness as a species.) Below, I examine an intriguing contradiction lodged in one of the deep assumptions of the modern alcoholism movement.
The alcoholism movement sought to popularize the notion that alcoholism was a disease or illness phenomenon. In that sense – and understood at face value — the movement also sought to medicalize alcoholism. Yet, Alcoholics Anonymous, whose emergence was arguably the deep underlying force in the development of the alcoholism movement, offered an essentially lay and spiritually oriented approach to alcoholism. Moreover, whereas a fully medicalized view of alcoholism might promote the appropriateness of alcoholism treatment as offered, say, by psychiatrists, other M.D.s, psychologists of various stripes, and hospitals and clinics, A.A. arguably emerged in response to the past failures of these medical efforts respecting alcoholism’s treatment; A.A. offered an alternative to alcoholism’s past medical handling. Hence, (a) if A.A. was the institution that, deep down, drove the modern alcoholism movement and (b) if the movement’s ideological centerpiece, the disease concept of alcoholism, sought to medicalize alcoholism, then, and therefore, (c) A.A. was fostering (albeit indirectly) an idea that ran counter to its own program and philosophy. Go figure!