The Language of the Heart

A Cultural History of the Recovery Movement from Alcoholics Anonymous to Oprah Winfrey

Trysh Travis

• Publisher: The University of North Carolina Press
• Year: 2010
• Print ISBN: 9781469607306, 9780807833193
• eBook ISBN: 9780807898703
• Topic: Social Sciences
• Subtopic: Linguistics
• Index: Social Sciences

In The Language of the Heart, Trysh Travis explores the rich cultural history of Alcoholics Anonymous (AA) and its offshoots and the larger “recovery movement” that has grown out of them. Moving from AA’s beginnings in the mid-1930s as a men’s fellowship that met in church basements to the thoroughly commercialized addiction treatment centers of today, Travis chronicles the development of recovery and examines its relationship to the broad American tradition of self-help, highlighting the roles that gender, mysticism, and bibliotherapy have played in that development.

PART ONE

Addiction and Recovery

CHAPTER ONE

The Metaphor of Disease

When she was diagnosed with cancer in 1977, cultural critic Susan Sontag did what comes naturally to intellectuals faced with complicated and unnerving circumstances : she turned to writing. Illness as Metaphor was her attempt to better understand her experiences as a patient by exploring the extra-clinical discourses about cancer and tuberculosis that had helped to make those diseases cognizable to generations of sufferers and caregivers alike.¹ In a host of literary works, as well as in the language of fashion, military strategy, and urban planning, Sontag discerned a set of connotations and assumptions about the “nature” of TB and cancer that acknowledged their corporeal manifestations, but ultimately had little to do with them. Thanks largely to the nineteenth-century Romantics and their followers, tuberculosis had become in the popular mind a “disease of liquids ... and of air” that affected the “upper, spiritualized body” (13, 17). It “was thought to come from too much passion, afflicting the restless and the sensual”; its victims were “sensitive, passive people who are not quite life-loving enough to survive” (21, 25). Cancer, on the other hand, was a disease of the “opaque body,” caused by “insufficient passion [and] afflicting those who are sexually repressed, inhibited, unspontaneous, incapable of expressing anger” (12, 21). While TB had been a disease of the Bohemian city, cancer was a disease of “middle-class life” amid suburban sprawl (15), of all that was “most ferociously energetic” in modernity, as well as what was most corrupt and polluted (68-71).

Sontag argued that the connotations of both diseases—their literary as opposed to their material existence—had real consequences. Woven inextricably into the rhetorical and conceptual fabric of culture, they conditioned diagnosis and treatment, symptom progression and mortality rates. Her aim in explicating this intangible dimension of disease, she stated flatly, was “liberation”; she believed “the most truthful way of regarding illness—and the healthiest way of being ill—is one most purified of, most resistant to, metaphoric thinking” (4, 3). But the terms of her own project suggested how difficult such purification and resistance might be. Scores of examples demonstrated that the labor of constructing disease through language went on in every precinct of culture, and the omnipresence of disease imagery was only compounded by its evocativeness and imprecision. The fundamentally nonrational appeal of the image of disease, Sontag was forced to concede, endowed it with great power, since few people are willing “to apply that quixotic, highly polemical strategy, ‘against interpretation,’ to the real world” (102). The sick and the healthy alike, as well as the institutions that sought to bridge the gaps between them, at some level preferred to derive their understanding of disease from what Sontag called the “lurid metaphors” with which “the kingdom of the ill ... has been landscaped” (4).

Sontag’s attention to the nature and purpose of metaphor was absent from a flurry of popular books that appeared in the late 1980s and early 1990s to deride what psychologist Stanton Peele called “the diseasing of America.” Peele’s book of that name (1989), along with his 1991 The Truth about Addiction and Recovery, joined works like Herbert Fingarette’s HeavyDrinking: TheMyth of Alcoholism as a Disease (1988), Charles Sykes’s A Nation of Victims, Wendy Kaminer’s I’m Dysfunctional, You’re Dysfunctional, and Jack Trimpey’s The Small Book: A Revolutionary Alternative for OvercomingAlcohol andDrugDependence (all 1992) to attack the disease concept of addiction. Developed over the course of half a century, this theory holds that addiction “is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.”² The recommended course of treatment typically includes detoxification, followed by total abstinence and an admission of powerlessness over the addictive substance, which is usually concretized by ongoing commitment to a 12-Step program. The disease critics assailed both grassroots groups like Alcoholics Anonymous and the interlocking arms of the medical and social service organizations that formed the professional addiction treatment industry, and derided the idea of addiction as a disease—like the discourses of cancer and TB that Sontag had traced—for being simultaneously ubiquitous and vague. “Few people,” Herbert Fingarette noted, can articulate all the presuppositions of the disease concept, “and many people either do not believe every detail of the doctrine or hold some beliefs inconsistent with it.” Nevertheless, “versions of the classic disease concept remain a dominant theme in the public’s thinking.”³

Like Sontag, the disease critics were concerned about what they perceived to be a set of “fantasies,” “fictions,” “mystifications,” and “myths” that they believed exercised a negative effect in the world.⁴ Some of them were medical professionals disturbed by what they perceived to be shoddy science; others were cultural critics worried about the ways in which the concept of addiction as a disease deflected attention from larger social questions. Some wrote from a socially conservative perspective, enraged by the ways that the involuntary nature of “disease” seemed to moot questions of personal responsibility, while others came out of a left-wing tradition, arguing that medicalizing addiction conveniently overlooked deeper and more intractable questions of political economy and social inequality. All agreed, however, with Peele’s central contention: “The disease version of addiction does at least as much harm as good ... excusing crime, compelling people to undergo treatment, and wildly mixing up moral responsibility and disease diagnoses.”⁵

The disease critics’ combined works mounted a persuasive critique of the concept’s hegemony, but were less clear on explaining precisely how it had achieved its ascendancy. Populist authors like Peele invoked the specter of a conspiracy within the professional treatment community, which they believed had barred alternative conceptualizations of addiction from entering into the public discourse and tapping available funding streams. Mandarins like Kaminer and Sykes tended to fault the feckless public. But while most noted that media representations of addiction had played a role in popularizing the disease concept, none drew on Sontag’s earlier insight and sought to investigate the essentially literary and discursive nature of the disease metaphor they so reviled. The disease critics’ inattention to the cognitive, emotional, and practical work that the metaphor did for the individuals and the culture that embraced it severely undermined their ability to change the terms on which addiction is known and discussed. Two decades after their critical manifestoes, a perpetual fountain of memoirs and tabloid news stories, along with reality TV shows like Celebrity Rehab and Intervention, suggest that a broad cross-section of Americans continues to believe that addiction is a disease for which treatment and recovery are the only appropriate responses.⁶

The bulk of this book traces the cultural life of the disease metaphor of addiction’s counterpart—the similarly ill-defined and omnipresent concept of “recovery.” In preparation, this chapter examines the metaphorical dimensions of the disease concept that the critics of the 1980s and 1990s glossed over. My purpose here is not necessarily to debunk the disease concept; following Sontag, I take as my subject “not physical illness itself but the uses of illness as a figure or a metaphor” (3). With this in mind, this chapter examines why, how, and to what degree the founders and early members of Alcoholics Anonymous, physicians and psychiatrists, clergy, educators, employees of the criminal justice system, public relations experts, lobbyists, and policy makers came to endorse the particular understanding of the excessive consumption of alcohol that had come to be dominant by the end of the twentieth century.⁷ The persistent appeal of the disease metaphor cannot be understood apart from their various investments in it—investments that sometimes aligned and sometimes clashed, but that cumulatively bestowed upon the disease concept an apparently unshakeable degree of cultural legitimacy. That legitimacy was achieved by the individuals and organizations whose stories unfold in the pages that follow; together they succeeded in “landscaping” the twentieth-century United States with the metaphor of addiction as disease.⁸

FROM VICE TO NEUROSIS

Historians of alcoholism and addiction generally agree that the disease concept arose as a backlash against, or at least an exhaustion with, “the passionate, moralistic, and legislative social controversies of the hundred-year temperance-prohibition-repeal eras.”⁹ Prior to the twentieth century, American attitudes toward drink and drunkards were complicated, and a variety of ideas about how to deal with them competed for hegemony. The physician Benjamin Rush, generally recognized as the first American authority on drunkenness, argued in the late eighteenth century that people who have become addicted to spirits “should abstain from them suddenly and entirely. ‘Taste not, handle not, touch not’ should be inscribed upon every vessel in the house of a man who wishes to be cured of habits of intemperance.”¹⁰ However, by “spirits,” Rush meant only distilled liquors; like many early temperance advocates, he believed that cider, beer, and wine posed no threat. Advocates of “cold water temperance,” on the other hand, promoted total abstinence from all forms of alcohol and gleefully looked forward to the day when “all who are intemperate will ... be dead [and] the earth will be eased of an amazing evil.”¹¹ Also committed to total abstinence, but taking a somewhat different view of the habitual drunkard, were the physicians, neurologists, and proto-psychologists who would come to be called, by the late nineteenth century, “inebriety physicians.” These reformers—like J. Edward Turner, founder of the New York State Inebriate Asylum (1864), and his protégé Thomas Crothers, founder of the American Association for the Cure of Inebriates (1870)—believed that “inebriety was a disease and must be treated in hospitals the same as other diseases.”¹² These contradictory ideas, rooted in competing scientific frameworks, cultural norms, and moral schemas, jostled together in the popular imagination for much of the nineteenth century.

This heterodoxy declined, however, toward the end of the century, as the push for national Prohibition became what Joseph Gusfield has described as a “symbolic crusade.” Outraged by the nature and the rapid pace of change in Gilded Age America—the influx of immigrants, the increased political power of women, and the rise of consumerism, all of which were linked to and manifested themselves in changes in drinking habits—white, native-born Protestants from the Midwest and South embraced antiliquor legislation as a chance “to assert the public dominance of old middle-class values.” Positions on all sides of the drink question hardened. “Dry” advocates asserted the “abstemious, ascetic qualities of American Protestantism” while “wets” championed a pluralist, cosmopolitan worldview in which “tolerance, good interpersonal relationships, and the ability to relax oneself and others are greatly prized.”¹³

The product of these starkly diverging worldviews was an incendiary language of vice, sin, and racial hysteria. To the Board of Temperance, Prohibition, and Public Morals of the Methodist Church, the liquor traffic was “the crime of crimes, the devil’s headquarters on earth, a ponderous second edition of hell, revised, enlarged, and illuminated.” The largest organization advocating national prohibition, the Anti-Saloon League, rallied its troops in its 1911 Yearbook by reminding them that they were involved in a “ ‘war—continued, relentless war.’ ”¹⁴ Even previously even-handed inebriety physicians joined in, moved by the belief that alcohol was a “racial poison,” capable of diluting the genetic stock of the ruling classes and thus undermining Western civilization. ¹⁵ They ceased to advocate for compassionate rehabilitation of chronic inebriates, and began to argue instead for their quarantine in public workhouses and mandatory sterilization. The eugenicist belief that certain populations were predisposed to alcohol abuse and related vices made sterilization seem more than justified as a public health measure: “It might be curative; it surely would be preventive, and better, by far ... than hav[ing them] beget a brood tainted with this curse of the world.”¹⁶

Anti-prohibition forces were equally vehement in their castigation of dry reformers, and they countered their adversaries’ moral outrage primarily with libertarian arguments. The Brewers’ and Distillers’ Association, one of the most powerful anti-prohibition lobbies, formed a National Protective Association that was quickly renamed the Personal Liberty League, and its members routinely took dry advocates to task for their “sumptuary and tyrannical” laws, antibusiness practices, and attempts to meddle in private life. Much wet propaganda focused on the economic disruption that would ensue with national prohibition. Its rootedness in facts and figures meant that while, in general, “in volume the wet propaganda probably equaled that of the drys ... in quality it was inferior.” However, the wets occasionally trafficked in more colorful invective. “A typical outburst,” according to historian Herbert Asbury, was the magazine Barrels and Bottles’ denunciation of the Anti-Saloon League as “the most arrogant organization of canting hypocrites and jesuitical grafters the world has ever known.”¹⁷

It was these fevered sentiments that led to the passage of the Volstead Act, banning the manufacture, sale, or transportation of intoxicating liquors in 1919, and they were not cooled when repeal came in 1933. The triumph of wet culture, or what sociologist Mariana Valverde has called “enlightened hedonism”—the urbane, secular, and pluralist culture of consumerist America—relegated dry forces to the position of a discarded remnant.¹⁸ From that position, they continued to rail against what they saw as government’s willingness to soften its stance on moral legislation, and to agitate stridently at the state and local levels for liquor control measures. As Gusfield notes, their declining political potency hardened into a sense of disenfranchisement and betrayal (which in some cases later fed into midcentury anticommunism) and lent their language a hysterical tone.¹⁹ Neither excessive drinking nor its personal and social costs vanished overnight with repeal, but by the 1930s, people who wanted to talk seriously about those things had begun to search for a new language with which to do so.²⁰

For a little while, at least, it seemed that the new jargon of psychoanalysis would fit the bill. Even before repeal, psychoanalysis had begun to establish itself as the ideal modern discourse through which to rethink excessive drinking; the proto-psychologists known as “alienists” had played an important role in the development of the American Association for the Cure of Inebriates.²¹ Lay therapist (and reformed drunkard) Courtney Baylor began to advance the idea of compulsive drinking as a form of neurosis as early as 1912. Workingwith NewThought minister Dr. Elwood Worcester in Boston’s Emmanuel Movement, he sought to cure the mental “tenseness” that drove people to drink through a variety of techniques pioneered by both analysts and mental healers: hypnosis, affirmation, guided relaxation, and so on.²² Baylor’s protégé Richard Peabody (another reformed inebriate) continued this approach in New York City, arguing that “the behavior of the alcoholic is [best] explained as an abnormal search for ego maximation or self-preservation,” and could thus be successfully treated by “hypnoidal suggestion.”²³

Worcester and Peabody’s spiritualist diagnostics would inspire later thinkers, but they were pushed to the margins of the debate over drinking in the rush to embrace the structures of Freudian symptomatology during the 1920s. Although many well-educated practitioners might have read the German language text when it appeared in 1908, the 1926 translation of Karl Abraham’s “Psychological Relations between Sexuality and Alcoholism” was the first in the United States to advance the theory that would become analytic gospel, namely tha...

Table of contents

• Title Page
• Copyright Page
• Table of Contents
• Dedication
• Praise
• Table of Figures
• GRATITUDE
• ABBREVIATIONS
• Introduction
• PART ONE - Addiction and Recovery
• PART TWO - Alcoholics Anonymous and Print Culture
• PART THREE - Politics and Spirit
• AFTERWORD
• APPENDIX A - Alcoholics Anonymous Membership
• APPENDIX B - Reprintings and Distribution of Alcoholics Anonymous
• NOTES
• BIBLIOGRAPHY