Joe Sixpack: Normality, deviance, and the disease model of alcoholism

Abstract

The advantages of the disease model of alcoholism are well known, but the disadvantages have received little attention. The model's dominance has forestalled consideration of alternative and potentially valuable theories. It reinforces the value of normality even as it marks alcoholics as deviant. It suggests problem drinkers can diagnose themselves. These disadvantages are traceable to narrowly constructed scientific discourses: science-as-positivism, alcoholism-as-disease, and the individual-as-scientist. As a result, problem drinkers pondering a diagnosis of alcoholism emphasize the positivist concepts of central tendency, objectivity, and prediction/control. Positivism reinforces the value of normality even as a disease diagnosis threatens to mark the personal identity as deviant. In this circumstance, continuing to drink while manipulating drinking variables is rational. Alcoholism theory would benefit if researchers extended conceptualizations beyond the disease model. Alcoholism treatment would benefit if treatment professionals challenged social norms, emphasized subjectivity, and determined the parameters of the drinker’s self-control.