Cultural and Sociological Aspects of Alcoholism and Substance Abuse

Barry Stimmel

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317840466
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

In this highly informative book on the sociocultural interactions between alcoholism and drug abuse, experts explore the relationship of such factors as ethnicity, family, religion, and gender to chemical abuse and address important implications for treatment.

Women, Alcohol, and Sexuality

Stephanie S. Covington, PhD

Janet Kohen, PhD

Stephanie Covington is a Consultant/Trainer and Clinician in Private Practice, La Jolla, California. Janet Kohen is with the Women’s Studies Department, San Diego State University. For reprints, contact: Stephanie S. Covington, PhD, 1129 Torrey Pines Road, La Jolla, CA 92037.

ABSTRACT. Neither women’s sexuality nor their alcohol use has been studied until recently. Research on the relationship between the two has been even more neglected. While the literature has acknowledged that sexual dysfunction and abuse may coexist with women’s alcoholism, the possibility that these may predate or lead to excessive alcohol use has not been investigated. This study explores sexual experience, dysfunction, and abuse among 35 alcoholic women and their paired nonalcoholic counterparts. Results suggest that both dysfunction and abuse may precede as well as accompany alcoholism. The findings indicate that issues of sexuality should be included in recovery programs for women because alcohol and sexual experience are linked in most of these alcoholic women’s lives.

Although the number of women who drink has doubled since World War II and the number of female alcoholics has correspondingly increased,¹ only in the past decade has the female alcoholic received much research attention.² Prior to that she was either ignored or assumed to be affected by the same etiology and treatment as the male alcoholic. A parallel exists in the field of research on female sexuality. Until recently there has been relatively little information available on female sexuality. What did exist was the product of male researchers, representing the male interpretation of how women should feel and behave. As a result of the neglect of women in both fields, only a handful of studies have investigated sexuality in the lives of alcoholic women. As Carpenter and Armenti noted, “Most experts comment on human sexual behavior and alcohol as though only males drink and have sexual interests.”³ The consequences are evident in treatment programs, most of which virtually ignore sexual dysfunction as an issue in the recovery of alcoholic women.⁴

Neglect of the relationship of female sexuality and alcoholism is surprising since throughout most of human history sexuality and alcohol have been related in various cultures.⁵ While the relationship between the two is often based on questionable, if not incorrect beliefs, the relationship is nonetheless a primary one. Sexuality, according to sex therapist Helen Singer Kaplan, is the integration of the biological, emotional, and spiritual aspects of one’s self.⁶ Alcohol affects all these aspects of a person as well. Since one’s sexuality is the expression of who one is and how one relates to others, alcohol use affects one of the most fundamental expressions of self.

ALCOHOL AND FEMALE SEXUALITY

The relationship between women’s sexuality and their alcohol use is a function of the social position of women within the society. Women’s socialization and the norms that govern their adult behavior have defined the boundaries between acceptable and unacceptable expression of women’s sexual and drinking behaviors. These boundaries and the cultural ideas that determine the form for expressing these two areas of human life are considerably different for women than for men. Passive or limited interest in both are valued for women while almost the opposite is true for men.^1,7 Quantity in both often brings respect for the man but distain for the woman. While both alcohol use and sexual interest have become more permissible for women in recent years, excess in either area results in more extreme and more negative disapproval for women than men.⁸

These two areas of female behavior are not just parallel in form of expected behavior and reaction to it, they are also interrelated. The salience of the relationship is expressed in one of the bases for extreme disapproval of intoxicated women. Such women are commonly viewed as sexually “promiscuous.”¹ Thus, negative reaction to the alcoholic woman compounds disapproval of her drinking with disapproval of her presumed excessive sexual interest. This disapproval can be expressed in a variety of ways. One is physical abuse, and alcoholic women report a high incidence of battering and abuse.^9,10

The cultural link between alcohol use and sexual expression by women has been formalized within academic literature. The disinhibition hypothesis is the prevailing view of how alcohol enhances sexual activity. As a central nervous system depressant, alcohol is theorized to depress higher brain functions that inhibit sexual behavior, thus reducing anxiety and fear.⁶ Several studies have documented women’s subjective experience of increased sexual enjoyment when drinking.^11,12 However, physiological research contradicts women’s subjective response. With alcohol ingestion, women’s physiological sexual arousal has been found to decrease and latency to orgasm has been found to increase. The women themselves also report increased difficulty of attaining orgasm and decrease in intensity of orgasm.^13,14

The disinhibition hypothesis fails to account for these physiological findings. Social learning may better explain the discrepancy between women’s subjective and their physiological sexual response.

If a woman learns to associate drinking with sex, this attitude leads her to expect that drinking will enhance her sexual enjoyment. Even though her sexual response is depressed, she can still interpret the sexual activity as enjoyable. However, this explanation may not fully explain the relationship between subjective and physiological sexual response for the chronic women drinker.

Research indicates not just a decrease in the sexual functioning of the chronic woman drinker but serious sexual dysfunction. Whitfield et al.⁴ reviewed clinical studies of alcohol and sexual dysfunction and listed a variety of physiological mechanisms induced by alcohol abuse that can produce impaired sexual functioning. In a study by Sholty,¹⁵ 67% of the alcoholic women in the sample reported their orgasmic experience had deteriorated after their drinking became a problem and 47% became anorgasmic. In studies of alcoholic women by Beckman¹² and Pinhas,¹⁶ in which comparison groups of nonalcoholic women were used, alcoholic women reported a higher level of generalized sexual dissatisfaction than their matched nonalcoholic controls. These latter two studies did not identify when sexual dysfunction began for these women relative to their drinking careers.

Because alcohol is frequently used as a means of coping with stressful life situations, identifying whether drinking problems or sexual difficulties came first becomes an important issue. Unfortunately, data on sexual dysfunction among problem drinking women often suffer from methodological limitations. Definitions of alcoholism and sexual dysfunction are often vague, and terminology such as “frigidity” and “promiscuity” reflects moral judgments and sexual stereotypes. Nevertheless, some research does suggest sexual dysfunction as a precipitating factor in alcohol abuse. Kinsey,¹⁷ for instance, found that 72% of alcoholic women had a history of “frigidity.” A number of investigators have found that women alcoholics identify marital problems, often including sexual difficulties, as initial reason for their problem drinking.^18,19,20,21

The same question of time order can be raised with regard to alcohol use and abuse experienced by problem drinking women. Earlier, abuse was suggested as a reaction to the intoxicated woman. However, a personal history of abuse may also be a precipitating factor in the lives of alcoholic women. Research on abuse among alcoholic women, like that on sexual dysfunction, offers few clues as to when the problem began. Some findings have suggested that abuse may precede drinking problems. Assuming that incest is concentrated among the young, several researchers have reported that 40–50% of the alcoholic women in their sample were incest victims.^22,23 Scott²⁴ reported that 70% of the study sample of battered wives were frequent drinkers.

Whether the abuse occurred before or after the onset of problem drinking, there is a relationship between abuse and sexual difficulties. It is highly obvious from accumulated data on physical and sexual abuse that there are gender differences betwe...