The stigma of alcoholism

A FEW THOUGHTS FROM MARTY MANN ON STIGMA

Few among you consider alcoholism a proper subject for open discussion, few among you would willingly label yourself, or a friend or colleague, an alcoholic, and even fewer would be able to recognize alcoholism early, when there is the best chance for recovery.

All of this is the result of stigma, a state of mind which we inherited from our Puritan and also our Victorian forebears; a state of mind which is essentially mindless since it overlooks all the things which have been learned; a state of mind which produces public attitudes that are anti-therapeutic to say the least. In bald language, stigma kills.

Stigma manifests itself in many ways; in false beliefs, such as that alcoholism is entirely a moral problem and alcoholics moral delinquents; or that alcoholism is simply a matter of will power and alcoholics are weaklings; or that alcoholism is a deliberate self-degradation and alcoholics are simply letting themselves slide downhill-“throwing their lives away,” or that alcoholism is only found on the Skid Rows of the nation and alcoholics are all homeless indigent derelicts-“Skid Row bums”; or finally, that alcoholism is a hopeless condition and alcoholics are all “hopelessdrunks” (spoken as one word).

The results of stigma are also many, and all are destructive. The family that has an alcoholic in its midst goes to great lengths to conceal this, and the fellow workers of the alcoholic-often including his immediate superiors-cover up for him, keep giving him “one more chance to straighten up.” The friends, neighbors and others in more casual contact with the alcoholic carefully look the other way. All are participating in a great conspiracy of silence, many of them in the mistaken belief that they are protecting the alcoholic when actually they are preventing him from getting help.

Stigma drives the alcoholic and his family underground, isolates them from their fellows, twists and distorts them psychologically as they cringe under the heavy burden of shame. They feel disgraced and so they hide-and keep quiet. A study of wives of recovered alcoholics made by the National Council on Alcoholism a few years ago showed that these wives had waited an average of eleven years after they first realized there was something seriously wrong, before talking to anyone about it: doctors, clergymen, lawyers or even their own families.

And none of them knew there was help available, or where to go to find it, all during those long painful years while their alcoholic’s illness was progressing and the losses due to it were mounting: money, jobs, homes, friends, and the well-being, both physical and psychological, of the children.

For contrary to another false belief fostered by stigma, the large majority of our alcoholic population is married, living at home, with children, and with a job. And the large majority of women alcoholics are housewives, even more easily hidden inside the home. Where they are career women, whether in the theater, the arts, or in business, their situation is comparable to that of the men…excepting that the stigma is twice as heavy and infinitely more cruel for a woman. So their underground existence is apt to start earlier and to continue longer, and their chances recovery have only recently begun to catch up with those for men.

Stigma also plays a part in the almost universal characteristic of the alcoholic: denial that he is one. Who has not heard someone who “drinks too much” declare flatly, “Who, me? Trouble with drinking? Nonsense, I can quit any time I want to.” Or use the even better known phrase, “I can take it or leave it alone.” The role of stigma in this denial is simple: no one willingly admits to being a moral delinquent, a weakling, or any other of the many misinformed characterizations that have for so long been applied to alcoholics.

How can we blame them? They too were brought up in ignorance of the facts. They too were brainwashed into the vast mythology that surrounds drinking and alcoholism. They too are usually lacking any useful information about this condition and its victims, and what can be done about them.

Many things are needed before all alcoholics at all stages of their illness will have a equal chance at recovery: things like good medical care, hospital beds, outpatient clinics, recovery centers or halfway houses. Most of all we need a new climate of understanding on the part of the public-and that means everyone.

(adapted from “A Matter of Life and Death,” an article that first appeared in 1970)