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Governing disease, governing desire : subtitle subjectivity and the logic of recovery in Alcoholics Anonymous Vrecko, Scott 2002

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GOVERNING DISEASE, GOVERNING DESIRE: SUBJECTIVITY AND THE LOGIC OF RECOVERY IN ALCOHOLICS ANONYMOUS by Scott Vrecko .A., The U n i v e r s i t y of B r i t i s h Columbia, 19 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES (Department of Anthropology and Sociology) We accept t h i s t h e s i s as conforming to the re q u i r e d standard THE UNIVERSITY OF BRITISH COLUMBIA August 2002 © Scott Vrecko, 2002 In p resen t ing this thesis in partial fu l f i lment of the requ i rements f o r an advanced d e g r e e at the Univers i ty o f British C o l u m b i a , I agree that t h e Library shall make it f ree ly available f o r re ference and study. I fu r ther agree that permiss ion fo r extens ive c o p y i n g o f this thesis f o r scholar ly purposes may be g ran ted by t h e head o f m y d e p a r t m e n t o r by his o r her representat ives. It is u n d e r s t o o d that c o p y i n g o r pub l i ca t i on o f this thesis fo r f inancial gain shall n o t be a l l owed w i t h o u t m y w r i t t e n permiss ion . D e p a r t m e n t c The Univers i ty o f Brit ish C o l u m b i a Vancouver , Canada DE-6 (2/88) ABSTRACT Through an examination of A l c o h o l i c s Anonymous (AA), t h i s t h e s i s i n v e s t i g a t e s the o r i g i n s and i m p l i c a t i o n s of an a l c o h o l i c s u b j e c t i v i t y that seems to n e c e s s i t a t e the establishment of c e r t a i n regimes ' of governance, both by a l c o h o l i c s themselves and by agents of s o c i a l r e g u l a t i o n or co o r d i n a t i o n . Based on h i s t o r i c a l research, t e x t u a l a n a l y s i s of primary documents, and p a r t i c i p a n t observation s t u d i e s , i t challenges p r e v a i l i n g accounts of AA, the dominant modality of alc o h o l i s m treatment i n North America, as an e x c l u s i v e l y s p i r i t u a l or e t h i c a l program. Instead, i t demonstrates that since the 1930s, i n conjunction with medical, p s y c h o l o g i c a l , p s y c h i a t r i c , and s o c i a l work d i s c i p l i n e s , AA has produced a c o n c e p t u a l i z a t i o n of problem d r i n k e r s as i n h e r e n t l y p a t h o l o g i c a l i n d i v i d u a l s -a l c o h o l i c s - and a corresponding r e g u l a t o r y regime to t r e a t t h i s pathology. The recovery program of AA i s ther e f o r e examined as a b i f u r c a t e d technology of governmentality, comprised of d i s c i p l i n a r y and se l f - g o v e r n i n g techniques. i i TABLE OF CONTENTS /Abstract i i T a b l e o f Cont< n t s i i i CHAPTER I • INTRODUCTION 1 The F i x - t i o n o f A d d i c t i o n 1 Methodology 21 CHAPTER I I HOMO ALC0H0LUS: THE ORIGINS OF A SPECIES. . . 33 G e n e a l o g i c a l Developments 33 I d e n t i f y i n g A l c o h o l u s 52 CHAPTER I I I THE GOVERNANCE OF ALCOHOLISM IN AA 7 8 AA's Twelve S t e p s : The C o n s t i t u t i o n o f S u b j e c t i v i t y 78 The F u l f i l l m e n t (s) o f Recovery 105 CHAPTER IV CONCLUSION : . 127 The C u l t u r a l L o g i c o f AA 127 C o n c l u d i n g Remarks 136 BIBLIOGRAPHY 140 iii C H A P T E R I : INTRODUCTION THE FIX-TION OF ADDICTION The " a d d i c t " i s a f a m i l i a r personage to i n h a b i t a n t s of Western i n d u s t r i a l i z e d s o c i e t i e s . As we l e a r n from t e l e v i s i o n and f i l m , from newspapers and magazines, people with a d d i c t i o n s are our brothers, our s i s t e r s , our parents, our bosses; they are c e l e b r i t i e s and p o l i t i c i a n s - even c l e r g y members. But not only do we probably know an " a h o l i c " of one s o r t or another (choc-, shop-, work-, rage-, being j u s t a few of the p o s s i b i l i t i e s ) , we ourselves are, according to many s e l f - h e l p experts, probably s u f f e r i n g from at l e a s t one a d d i c t i o n , whether to love, sex, the i n t e r n e t , or d i e t c o l a . The idea that one can become addicted to c e r t a i n psychoactive substances such as heroin, morphine, or cocaine i s by no means a recent development, and i s commonly accepted. However, i n the l a t t e r h a l f of the twentieth century the a d d i c t i o n concept expanded t o inc l u d e an e x t r a o r d i n a r i l y broad range of substances and a c t i v i t i e s t hat have not been observed to create p h y s i o l o g i c a l dependency. This expansion has created debate as to whether one "can" speak of a d d i c t i o n s to food, the i n t e r n e t , and 1 such, not only amongst medical and p s y c h i a t r i c experts, s e l f - h e l p gurus, and other i n d i v i d u a l s i n v o l v e d with the treatment of a d d i c t i o n s , but between academic researchers as w e l l . I suggest, however, that i n a d d i t i o n to questions about the p h y s i o l o g i c a l existence of a d d i c t i o n s and about whether such a d d i c t i o n s " e x i s t " or not, we need to ask questions about the beliefs people have about the nature of ad d i c t i o n s and the effects of these b e l i e f s on i n d i v i d u a l s . How have popular conceptions of a d d i c t i o n changed and expanded over time? How has the p r o l i f e r a t i o n of a d d i c t i o n s a l t e r e d the way i n d i v i d u a l s conceive of and regulate t h e i r d e s i r e s and impulses? What are the i m p l i c a t i o n s of a person i d e n t i f y i n g as an addict? These are some of the questions t h i s t h e s i s i n v e s t i g a t e s . Through an examination of A l c o h o l i c s Anonymous (AA) - the o r i g i n a l Twelve-Step program a f t e r which many other programs designed to a i d i n the recovery of the addict have been modeled - I examine the o r i g i n s and i m p l i c a t i o n s of an a l c o h o l i c (and by extension, a d d i c t i v e ) s u b j e c t i v i t y that seems to n e c e s s i t a t e the undertaking of c e r t a i n regimes of governance, both' by add i c t s / a l c o h o l i c s themselves and by agents of s o c i a l r e g u l a t i o n or c o o r d i n a t i o n . Further, I i n v e s t i g a t e how the Twelve-Step program of A l c o h o l i c s Anonymous, prominent i n 2 a l c o h o l i s m treatment, has i n f l u e n c e d contemporary conceptions of a d d i c t i o n and s e l f - c o n t r o l . I argue that AA and other twelve-step programs, along with medical, p s y c h o l o g i c a l , p s y c h i a t r i c , and s o c i a l work discourses, have, over the l a s t h a l f - c e n t u r y , c o n t r i b u t e d to the development of a society-wide r e g u l a t o r y ethos i n which i n d i v i d u a l s c o n s t a n t l y monitor themselves - and others - f o r signs of problematic behaviour and seek to c o n t r o l that behaviour with a number of d i s c i p l i n a r y and se l f - g o v e r n i n g techniques. My research can be s i t u a t e d p a r t l y w i t h i n a f i e l d of c r i t i c a l s o c i o l o g i c a l i n q u i r y of crime and deviance that has been w e l l e s t a b l i s h e d since at l e a s t the e a r l y 1970s. With the p u b l i c a t i o n of Taylor, Walton, and Young's The New Criminology: For A Social Theory of Deviance (1973), s o c i o l o g i s t s and c r i m i n o l o g i s t s i n c r e a s i n g l y began to r e o r i e n t t h e i r work from the c l a s s i c a l task of i d e n t i f y i n g deviance w i t h pathology and c r e a t i n g e f f i c i e n t methods of beha v i o u r - c o n t r o l i n order to ask more h i s t o r i c a l , s t r u c t u r a l , and s o c i a l questions that could demonstrate that deviance was " i n t i m a t e l y bound up" (Taylor, Walton,, and Young 1973: 273) with s o c i a l and economic forms of or g a n i z a t i o n . Thus, the "new c r i m i n o l o g i s t s " sought a 3 " f u l l y s o c i a l " theory of crime and deviance that grounds research i n s o c i a l i s t s o c i a l theory rather than i n b i o l o g i c a l or p s y c h o l o g i c a l paradigms. The c r i t i c a l modernist paradigm i n the study of deviance developed by the new c r i m i n o l o g i s t s o f f e r s an approach to the study of problematic behaviour that r e j e c t s a focus on c o r r e c t i o n a l i s m and c o n t r o l of deviance i n favour of an i n t e r e s t - b a s e d explanation of deviance. In doing so, i t f r e q u e n t l y challenges dominant (and often n a t u r a l i z e d ) discourses on s o c i a l and / or b i o l o g i c a l pathology; however, the s t r u c t u r a l preoccupation of t h i s paradigm sometimes r e s u l t s i n a f a i l u r e to i n v e s t i g a t e how language, symbols, and discourse shape, modify, and even create human perception and understanding. In response to these (and other) perceived shortcomings, s t r a i n s of c r i t i c a l theory emerged i n the 1970s that sought to abandon the r a t i o n a l , p r ogressive a n a l y s i s of s o c i a l i s t s o c i a l thought and took as t h e i r goal the study of the many ways i n which language fun c t i o n s to define r e a l i t y and the ways discourses, or apparatuses of language that express u n i f i e d canons of knowledge, c o n s t i t u t e and regulate i n d i v i d u a l s on a l o c a l , contingent b a s i s . These "postmodern" analyses g e n e r a l l y do not attempt to o f f e r a "theory" of crime or deviance, since 4 attempts to s i t u a t e the r e g u l a t i o n of human behaviour i n grand schemes such as c l a s s subordination through j u r i d i c a l apparatuses are thought to narrow the researcher's focus to p a r t i c u l a r i n d i v i d u a l s , c l a s s e s , r e l a t i o n s , and forms of power th a t , i n and of themselves, do not provide an adequate a n a l y s i s of contemporary s o c i e t y . Rather, arguing that the emergence, expansion, and c o n s o l i d a t i o n of e x t r a - s t a t e apparatuses has reduced the st a t e to j u s t one of the many agents i n a complex web of power r e l a t i o n s i n s o c i e t y (Dean 1999; Gordon 1980) they attempt to a r t i c u l a t e an " a n a l y t i c s " of power (Foucault 1980), the p r i n c i p l e goal of which i s e m p i r i c a l d e s c r i p t i o n . Given the complex d i s t r i b u t i o n and f u n c t i o n i n g of power i n modern s o c i e t i e s , i t fo l l o w s that i n d i v i d u a l s are dominated not only through the e x e r c i s e of power by st a t e a u t h o r i t i e s , but a l s o through t h e i r very existence w i t h i n various s o c i a l r e l a t i o n s h i p s . I n d i v i d u a l s ' r e a l i t i e s are mediated by a m u l t i p l i c i t y of discourses that c o n s t a n t l y attempt to " f i x " i d e n t i t y i n a v a r i e t y of ways ( i . e . , not only by a hegemonic sovereign discourse that functions e x c l u s i v e l y through j u r i d i c a l channels). I d e n t i t i e s , which are n e i t h e r p o s i t i v e nor i n t r i n s i c , but c u l t u r a l l y constructed, c o n s t i t u t e subject p o s i t i o n s that are formed 5 through a complex i n t e r a c t i o n of various d i s c u r s i v e spheres and s o c i a l p r a c t i c e s . These p o s i t i o n s are e s t a b l i s h e d both d i s c u r s i v e l y ( i n s o f a r as they are c h a r a c t e r i z e d and t r e a t e d by experts and a u t h o r i t i e s ) and e x i s t e n t i a l l y (to the extent that they experience t h e i r existence as a p a r t i c u l a r type of i n d i v i d u a l ) . In t h i s way, i n d i v i d u a l s are a r t i c u l a t e d to the s o c i a l world; they become attached, or f i x e d (and thus a l s o l i m i t e d ) , to a p a r t i c u l a r r e a l i t y . In so f a r as they seek to i n v e s t i g a t e how behaviour i s regulated, then, studies of deviance must concern themselves not only with the e x p l i c i t , c o d i f i e d laws of sovereign governments and t h e i r c o r r e l a t i v e s o c i a l norms, but a l s o with the deployment of d i s c u r s i v e apparatuses throughout the s o c i a l sphere. P r o f e s s i o n a l experts and academic a u t h o r i t i e s t h a t undertake the management of human l i f e and a c t i v i t y (most of t e n i n the imputed i n t e r e s t s of t h e i r s o c i e t i e s ) operate, to the extent that they f u n c t i o n outside and independent of the s t a t e , according to t h e i r own goals and concerns. The i n f l u e n c e of these a u t h o r i t i e s r e l i e s not on the "power to punish," which i s monopolized by the s t a t e , but on t h e i r a b i l i t y to s t r a t e g i c a l l y deploy knowledge toward s o c i a l l y l e g i t i m a t e ends. This deployment f r e q u e n t l y i n v o l v e s the c r e a t i o n , maintenance, or i n t e n s i f i c a t i o n , of 6 s u b j e c t i v i t e s ; p h y s i c i a n s , p s y c h i a t r i s t s , p s y c h o l o g i s t s , sex t h e r a p i s t s , educators, and s o c i a l workers a l l r e l y h e a v i l y on apparatuses of d i s c i p l i n a r y power that are e f f e c t i v e i n managing the s o c i a l only to the extent that they can cat e g o r i z e i n d i v i d u a l s and targ e t populations with s p e c i f i c regimes of management, education, treatment, and so f o r t h . I t i s p r e c i s e l y because d i s c i p l i n a r y a u t h o r i t i e s f u n c t i o n not through overt coercion, but through systems of l i b e r a l management that seek to "help" (normalize / heal / teach / protect) i n d i v i d u a l s , that they are able to e n l i s t i n d i v i d u a l s i n systems of s e l f - r u l e . Discourses of h e a l t h , welfare, and other benevolent programs i n t e r s e c t with i n d i v i d u a l s at the l e v e l of everyday, l o c a l p r a c t i c e , and, by i n s e r t i n g t h e i r ordering c a p a c i t i e s i n t o independently operating s i t e s , perform functions of c o n t r o l and co o r d i n a t i o n that draw i n d i v i d u a l s i n t o power s i t u a t i o n s of which they themselves are fr e q u e n t l y bearers. D i s c i p l i n a r y power, then, creates a r e g u l a t o r y complex i n which i n d i v i d u a l s , who are the e f f e c t s of a power that c o n s t i t u t e s them as free subjects, also p a r t i c i p a t e i n t h e i r own domination (or i n m u l t i p l e forms of domination). The i n c r e a s i n g s i g n i f i c a n c e of power-knowledge i n contemporary Western democracies, of expert management, 7 d i s c i p l i n a r y power, and self-governance, however, has not r e s u l t e d , i n every instance, i n the impotence of the s t a t e ; or of agents who b e n e f i t from t r a d i t i o n a l forms of s o c i a l c o n t r o l . These new techniques and technologies may be used by • governments and / or those i n c o n t r o l of productive processes to augment t h e i r dominance - even at the same time that other, more formal means of c o n t r o l may be l e s s p r a c t i c a l or p o s s i b l e . While I b e l i e v e that one needs to be wary of analyses that search f o r monocausal explanations of deviance and d i f f e r e n c e , and that an approach which recognizes the m u l t i d i m e n s i o n a l i t y and indeterminacy of the s o c i a l i s e s s e n t i a l (cf. Laclau and Mouffe 1985), I a l s o b e l i e v e that the economy, the s t a t e , and c l a s s r e l a t i o n s need to be accounted f o r as s t r u c t u r i n g dimensions and determinants of contemporary c u l t u r e . Thus, the approach taken here, i n the study of deviant d r i n k e r s , i s to look at the i d e n t i t i e s of the a l c o h o l i c and the addict as fix-tions c u l t u r a l and p o l i t i c a l c o n s t r u c t i o n s ( f i c t i o n s ) that c o n s t i t u t e and impose meaning on (or f i x ) c r i m i n a l , deviant, and p a t h o l o g i c a l s u b j e c t i v i t i e s , thus rendering the s o c i a l and i n d i v i d u a l experience of a d d i c t i o n as " r e a l . " I m p l i c i t i n t h i s approach i s a deconstruction of these categories through an i d e n t i f i c a t i o n and e l u c i d a t i o n of the d i s c u r s i v e 8 s t r a t e g i e s and technologies inv o l v e d , the power e f f e c t s of f i x - t i o n s on i n d i v i d u a l s , and the r e l a t i o n s h i p between f i x -t i o n s and economic and j u r i d i c a l concerns. In general terms, my a n a l y s i s attempts to demonstrate how a r t i c u l a t i o n s of dominant discourses e s t a b l i s h forms of s u b j e c t i v i t y that allow problematic behaviours to be managed, contained, and correcte d - that i s , d i s c i p l i n e d -i n ways that help maintain c a p i t a l i s t economies at the same time that they aim to optimize h e a l t h , "normalcy," and w e l l -being. However, since s o c i a l f i x - t i o n s are not necessarily a s s o c i a t e d with s t r u c t u r a l functions - i . e . , i d e n t i t i e s and s u b j e c t i v i t i e s , which are d i s c u r s i v e and c u l t u r a l c r e a t i o n s , cannot be f u n c t i o n a l l y a t t r i b u t e d s o l e l y to the requirements of c a p i t a l I do not assume that such r e l a t i o n s h i p s n e c e s s a r i l y e x i s t . With s p e c i f i c reference to problem d r i n k i n g , I attempt to demonstrate the ways i n which conceptions of a d d i c t i o n - and p a r t i c u l a r l y a l c o h o l a d d i c t i o n - have developed as a r e s u l t of the i n t e r a c t i o n of s o c i a l , p o l i t i c a l , economic, and d i s c u r s i v e . f o r c e s , to produce the contemporary f i x - t i o n of al c o h o l i s m and the corresponding f i x - t i o n a l subject p o s i t i o n of the a l c o h o l i c . That i s , I seek to show how c e r t a i n i n d i v i d u a l s have come to be considered - and come to consider themselves - as 9 belonging to a category of persons who are d i s t i n g u i s h a b l e from the average, "normal" i n d i v i d u a l that can c o n t r o l h i s or her d e s i r e s f o r and impulses to d r i n k a l c o h o l u n p r o b l e m a t i c a l l y , and can meet h i s or her s o c i a l , economic, and personal r e s p o n s i b i l i t i e s , expectations, p o t e n t i a l , and so on. This process of " f i x i n g " a l c o h o l i c i d e n t i t i e s to i n d i v i d u a l s whose d r i n k i n g i s perceived as problematic r e l i e s on the c o n s t r u c t i o n of s o c i a l " a n d d i s c u r s i v e f i c t i o n s - a u t h o r i t a t i v e c u l t u r a l , p r o f e s s i o n a l , l e g a l , and s c i e n t i f i c s t o r i e s about the " t r u t h " of al c o h o l i s m - and requ i r e s problem d r i n k e r s to submit to a range of managerial or governmental apparatuses. That i s , they must conform to an array of gazes, techniques, and methods that aim to understand, manage, and c o r r e c t , so that these i n d i v i d u a l s can be r e i n s e r t e d i n t o s o c i a l l y u s e f u l , economically productive, p e r s o n a l l y f u l f i l l i n g r o l e s . I m p l i c i t i n such a c o n s t r u c t i o n i s t view of • alc o h o l i s m i s that the " d i s o r d e r " of alc o h o l i s m i s , q u i t e l i t e r a l l y , a d i s - o r d e r , a l a c k of i n t e g r a t i o n i n t o s o c i a l r u l e s , norms, and values. I t i s l a r g e l y f o r t h i s reason t h a t a l c o h o l i s m i s not j u s t a personal problem, but a s o c i a l one as w e l l ; i t re q u i r e s the deployment of p u b l i c , personal, i n s t i t u t i o n a l , and l e g a l resources both to render the problem v i s i b l e and, 10 u l t i m a t e l y , to reduce harm to the s o c i a l order caused by intemperance or overindulgence i n dri n k . In t h i s sense, the a l c o h o l i s m treatment I examine i n t h i s paper, namely the Twelve-Step program of A l c o h o l i c s Anonymous, can be considered as part of what, a f t e r E l i a s (1978), might be conceptualized as a " c i v i l i z i n g technology" which d i r e c t s i t s e l f at the containment of excessive d e s i r e and r e q u i r e s i n c r e a s i n g s e l f - r e s t r a i n t through the i n t e r n a l i z a t i o n of outer c o n s t r a i n t s . However, t h i s technology developed not only as a response to the growing importance of nationhood and requirements of modernization, to the need of governments and r u l i n g c l a s s e s to harness and maximize the biopower of t h e i r populace, but a l s o as a r e s u l t of a v a r i e t y of e f f e c t s of r e l i g i o u s , p o l i t i c a l , medical, and p s y c h i a t r i c processes. The p r o j e c t undertaken here, then, i s not t o i d e n t i f y the treatment methods of A l c o h o l i c s Anonymous with the programmatic a s p i r a t i o n s of s p e c i f i c agents of s o c i a l c o n t r o l . Rather, i t i s to i n t e r r o g a t e the more general and complex ways i n which i n d i v i d u a l s have become the subjects of expert d i s c i p l i n e s and l a y knowledges that seek to improve t h e i r (mental, moral, p h y s i c a l ) w e l l - b e i n g ; how, c o r r e l a t i v e l y , i n d i v i d u a l s come to be subjected to regimes 11 of improvement which re q u i r e both the e l i m i n a t i o n (or reduction) of and f o r t i f i c a t i o n against d e s i r e s , pleasures,, and a p p e t i t e s that are deemed dangerous or a n t i t h e t i c a l to images of s o c i a l and personal order; and the s p e c i f i c ways i n which i n d i v i d u a l s are themselves c a l l e d upon to e f f e c t those improvements, those changes i n thoughts, a t t i t u d e s , h e a l t h , and day-to-day l i v i n g . Thus, i n t h i s study I work towards developing an understanding of the p h y s i c a l , s o c i a l , and c u l t u r a l i n s t a n t i a t i o n s of d e s i r e i n contemporary North American s o c i e t y , using A l c o h o l i c s Anonymous as a case study i n order to provide concrete a n a l y t i c a l observations of the a r t i c u l a t i o n s of d e s i r e and dependence. Given the prominence of AA and other twelve-step programs i n North American c u l t u r e , i t i s s u r p r i s i n g that there i s r e l a t i v e l y l i t t l e s o c i a l science l i t e r a t u r e that stu d i e s AA and other twelve-step o r g a n i z a t i o n s from a c r i t i c a l s o c i o l o g i c a l p e r s p e c t i v e . More common i n the research on a d d i c t i o n recovery programs has been a psych- or social-work approach that focuses on such issues as determining the a t t r i t i o n rate of AA members, e s t a b l i s h i n g a c o r r e l a t i o n between meeting attendance and a l c o h o l abstinence, or using treatment groups to study s o c i a l p s y c h o l o g i c a l ' issues such as i n t e r a c t i o n norms or i d e n t i t y 12 formation (cf. Leach 1973; Emrick 1975; G r e i l and Rudy 1983; Turner and Saunders 1990). S o c i o l o g i c a l d i s c u s s i o n of TATA has u s u a l l y occurred w i t h i n the a n a l y s i s of broader issues such as a l c o h o l i s m or s o c i a l movements, and references to AA are seldom made on a systematic b a s i s ; references to other a d d i c t i o n treatment groups are even l e s s frequent. This i m p l i e s a widespread view that these groups do not c o n s t i t u t e a s o c i a l phenomenon that warrants study i n i t s own r i g h t . However, there are a small number of t e x t s that have provided a s o c i o l o g i c a l i n v e s t i g a t i o n , however b r i e f or t e n t a t i v e , of some aspects of AA and/or other twelve-step programs. In Twelve Step Programs: A Contemporary Quest for Meaning and Spiritual Renewal (1997), Ann Marie Minnick p o s i t s that the p r o l i f e r a t i o n and growth i n p o p u l a r i t y of twelve-step programs i n the l a t e twentieth century was a r e s u l t of an American " s p i r i t u a l and moral" c r i s i s (1997: 4) i n which i n d i v i d u a l s , d i s s a t i s f i e d with t r a d i t i o n a l r e l i g i o u s forms, sought a l t e r n a t i v e forms of moral guidance. Minnick a s s e r t s that AA i t s e l f was a product of the anomie and s o c i a l d i s r u p t i o n that occurred i n 1930s America as a consequence of the r a p i d c u l t u r a l changes brought about by i n d u s t r i a l i z a t i o n , u r b a n i z a t i o n , and the Great Depression. 13 "Given t h i s context of s o c i a l and c u l t u r a l d i s r u p t i o n , " Minnick contends, "the reasons why AA took the shape i t d i d becomes c l e a r e r , " p r o v i d i n g as i t d i d "a r e l i g i o u s a l t e r n a t i v e [...] f o r those d i s s a t i s f i e d with t r a d i t i o n a l answers" (1997: 26) . P r o b l e m a t i c a l l y , however, Minnick does not take the time to i n d i c a t e what she understands the "shape" of AA to be. Although she compares AA to t r a d i t i o n a l r e l i g i o u s o r g a n i z a t i o n s (both provide s p i r i t u a l and moral guidance to i n d i v i d u a l s ) , . Minnick does not include any account or a n a l y s i s of the norms, r e g u l a t i o n s , p r a c t i c e s , or p r i n c i p l e s of the o r g a n i z a t i o n . As a r e s u l t , the need to examine AA i n such a way that c r i t i c a l s o c i o l o g i s t s might consider e s s e n t i a l when studying other systems of moral r e g u l a t i o n , such as those of t r a d i t i o n a l r e l i g i o n s , i s obfuscated. Thus, Minnick does not attempt as I do here - an explanation of what sort of moral or e t h i c a l guidance AA o f f e r s i t s members; whether the ideology that forms the ba s i s f o r the or g a n i z a t i o n ' s moral guidance i s open to c o n t e s t a t i o n by members; or what s o r t s of techniques and technologies AA uses to guide i t s members - to "help" i t s members recover from alcoholism. 14 In Contested Meanings: The Construction of Alcohol Problems (1996), Joseph G u s f i e l d goes much f u r t h e r than Minnick i n questioning and problematizing the recovery l o g i c of A l c o h o l i c s Anonymous. Although he does not examine AA i n any systematic manner, he does make s e v e r a l i n s i g h t f u l observations about AA's use of medical / p a t h o l o g i c a l discourse and about how AA helped change the way i n which a l c o h o l problems were conceived i n North America. G u s f i e l d notes that the "problem" of alco h o l i s m i s a r e l a t i v e l y new one, which has gained widespread acceptance only since the 1930s. During and leading up to the P r o h i b i t i o n era, a l c o h o l r e l a t e d problems were associated not with problem i n d i v i d u a l s , but with a l c o h o l i t s e l f ; "demon-rum" and other s p i r i t s were b e l i e v e d to be i n need of r e g u l a t i o n . I t was only a f t e r the Repeal of P r o h i b i t i o n i n 1933 that the locus of blame f o r drunkenness s h i f t e d from the b o t t l e to the body. A l c o h o l i c s Anonymous, using then-current medical discourses that created standards f o r •normal and p a t h o l o g i c a l types of d r i n k i n g behaviour, helped i d e n t i f y (and create) the moral, medical, p s y c h o l o g i c a l , and p h y s i c a l category of alcoholism, a b i o l o g i c a l disease that without i n t e r v e n t i o n could u l t i m a t e l y r e s u l t i n death. 15 Rendering apparent the loose a l l i a n c e between AA and the emerging medical discourse of a l c o h o l i s m i s perhaps the most f r u i t f u l aspect of G u s f i e l d ' s work. G u s f i e l d demonstrates that m e d i c a l i z a t i o n of the a l c o h o l problem helped create a perception that i n d i v i d u a l s who drank p r o b l e m a t i c a l l y were i n need of help rather than condemnation. However, the present study p o s i t s that to e x p l a i n the changes that have occurred i n the c o n c e p t u a l i z a t i o n and treatment of a l c o h o l i s m i n North America s o l e l y - or even p r i m a r i l y - i n terms of i n c r e a s i n g m e d i c a l i z a t i o n i s to o v e r s i m p l i f y these developments. As I w i l l show, A l c o h o l i c s Anonymous was one of the many diverse s o c i a l technologies (a category which would inc l u d e psychoanalysis, d e t o x i f i c a t i o n centres, and a l c o h o l i s m -treatment f a c i l i t i e s ) that worked i n conjunction with one another and with a f f l i c t e d i n d i v i d u a l s to prevent the progression of the a l c o h o l i c "disease" i n a v a r i e t y of ways that were by no means e x c l u s i v e l y medical i n nature. Furthermore, while G u s f i e l d notes that the use of b i o l o g i c a l pathology helped to " c r e a t e " the a l c o h o l i c and to d e - v i l i f y problem d r i n k i n g at the same time that i t r e q u i r e d a l c o h o l i c s to submit to treatment f o r t h e i r i l l n e s s e s , he does not i n v e s t i g a t e the general nature of t h i s treatment, 16 or, more s p e c i f i c a l l y , the course of treatment o f f e r e d by AA. This, a l s o , i s part of the task that I undertake here. In Sobering Tales: Narratives of Alcoholism and Recovery (1998), Edmund O ' R e i l l y o f f e r s a t h o u g h t f u l , i f somewhat incomplete, i n v e s t i g a t i o n of a l c o h o l i s m treatment i n A l c o h o l i c s Anonymous. Proceeding from the understanding that " l i s t e n i n g to the s t o r i e s about a l c o h o l i s m may be the best means we have of comprehending and d e l i n e a t i n g the d i s o r d e r " (1998: 1), O ' R e i l l y analyzes s t o r i e s people t e l l about t h e i r experiences d e a l i n g with and "r e c o v e r i n g " from alcoholism. O ' R e i l l y devotes a s i g n i f i c a n t p o r t i o n of h i s study to the experience of the AA member, and examines, p r i m a r i l y by l e t t i n g the voices of AA members themselves "speak" i n h i s t e x t , the ways i n which the recovery p r a c t i c e s of AA shape and determine i n d i v i d u a l s ' experiences as a l c o h o l i c s . By analy z i n g and noting s i m i l a r i t i e s between the n a r r a t i v e s given by AA members, O ' R e i l l y o f f e r s a p i c t u r e of how AA works: through the l e a r n i n g of standard r h e t o r i c a l s t r u c t u r e s and norms, members come to share a common understanding of the nature of alcoholism, and, i n s o f a r as they i d e n t i f y as a l c o h o l i c s , of themselves. While t h i s p i c t u r e i s an i n t e r e s t i n g one that o f f e r s i n s i g h t on the experiences of AA members and t h e i r w e l l -/ / ; 17 s t r u c t u r e d path to recovery, i t i s u l t i m a t e l y an incomplete one, i n s o f a r as i t f a i l s to consider how the p r a c t i c e s of AA c o n s t i t u t e a system of s o c i a l and moral governance. Lauding the apparent absence of apparatuses of s o c i a l c o n t r o l such as p r i s o n s , h o s p i t a l s , c l i n i c s , and asylums i n t r e a t i n g a l c o h o l i c s , O ' R e i l l y observes that AA "takes no p o l i t i c a l p o s i t i o n , makes no move to i n t e r f e r e with i n s t i t u t i o n a l s t r u c t u r e s , but simply stands outside i t , a l t e r n a t i v e but not contrary"' (1998: 169). Here, O ' R e i l l y assumes that i f an o r g a n i z a t i o n does not profess an e x p l i c i t p o l i t i c a l p o s i t i o n " i t can somehow e x i s t " o u t s i d e " of p o l i t i c s , a p o l i t i c a l l y , and i n a vacuum from which power i s absent. The current study suggests the existence of a m i c r o - p o l i t i c s of alcoholism, a p o l i t i c s that functions beneath or alongside more v i s i b l e power struggles over how s t a t e apparatuses define and deal with problem d r i n k e r s , and attempts to provide a s o c i o - p o l i t i c a l a n a l y s i s of these aspects. In an essay on A l c o h o l i c s Anonymous i n Diseases, of the Will: Alcohol and the Dilemmas of Freedom (1998), Marianna Valverde, l i k e O ' R e i l l y , observes that AA f u n c t i o n s p r i m a r i l y through n o n - p r o f e s s i o n a l i z e d , l o w - c u l t u r a l c a p i t a l techniques; however, she does not ignore the n e c e s s i t y of 18 s u b j e c t i n g these p r a c t i c e s and p r i n c i p l e s to c r i t i c a l a n a l y s i s . Indeed, i t i s these techniques that are of primary i n t e r e s t to her: she notes that the s t r i k i n g and inn o v a t i v e feature of AA, emerging as i t d i d at the end of P r o h i b i t i o n , i s the f a c t that i t seeks not to govern the commodity of a l c o h o l but rather to govern the soul of the AA member. Accordingly, she sets out to sketch some of these techniques of governance and argues c o n v i n c i n g l y that the many pieces of f o l k knowledge that form the basis of AA's Twelve-Step recovery program c o n s t i t u t e a set of what Michel Foucault c a l l s techniques of the s e l f : " d a i l y e t h i c a l techniques designed to b u i l d up v i r t u e / v i r t u o u s h a b i t s " (1998 : 137) . However, while a s t u t e l y analyzing how AA employs technologies of the s e l f , Valverde does not adequately consider AA i n terms of d i s c i p l i n a r y techniques. That she b e l i e v e s that "one could e a s i l y study AA from the point of view of d i s c i p l i n e and n o r m a l i z a t i o n " (1998: 137), but chooses not to do so, suggests that the p r o j e c t i s not, i n her e s t i m a t i o n , one that i s worthwhile. In my view, an a n a l y s i s of how AA's p r i n c i p l e s and program create a f i e l d of power r e l a t i o n s that c o n s t r a i n , i n s t r u c t , punish, and reward i n d i v i d u a l s i n AA would be a worthwhile p r o j e c t , and 19 would not be s i m p l i s t i c or n e c e s s a r i l y "easy." Indeed, since I would argue that i t i s d i f f i c u l t , and perhaps a r b i t r a r y , to separate d i s c i p l i n a r y techniques from techniques of the s e l f (as Valverde i m p l i c i t l y does), i t might be a q u i t e complex - and f r u i t f u l - p r o j e c t to attempt to formulate an understanding of how the techniques of d i s c i p l i n e - medical discourses, d r i n k i n g r e g u l a t i o n s , drunkenness laws - act upon and i n f l u e n c e how i n d i v i d u a l s go about " b u i l d i n g up" v i r t u e through techniques of the s e l f . Foucault himself, a f t e r a l l , s t r e s s e s the importance of t a k i n g i n t o account both of these sets of techniques, and cautions that " i f one wants to analyze the genealogy of the subject i n Western c i v i l i z a t i o n , he [ s i c ] has to take i n t o account not only techniques of domination but a l s o techniques of the s e l f " (1993: 203-4). Another problem with Valverde's a n a l y s i s of AA i s t h a t , when compared with much of her other work on a l c o h o l consumption and other s o c i o l o g i c a l issues (e.g.., Valverde 1991, 1998), i t seems p e c u l i a r l y a h i s t o r i c a l , l a r g e l y i g n o r i n g the s o c i a l , h i s t o r i c a l , and economic forces at play that helped form the environment i n which AA and i t s techniques could f l o u r i s h i n North American s o c i e t i e s . I argue that AA's techniques of the s e l f , although based on 20 what would appear to be h i g h l y i n d i v i d u a l , e t h i c a l c o n s i d e r a t i o n s , are i n f a c t l i n k e d with broader s o c i a l , moral, and p o l i t i c a l concerns i n North American s o c i e t y . In order to i d e n t i f y and analyze these l i n k a g e s , to demonstrate the ways i n which personal experience w i t h i n AA (and, more g e n e r a l l y , one's existence as an a l c o h o l i c ) r e f l e c t s and i s in f l u e n c e d by c u l t u r a l and p o l i t i c a l l o g i c s , t h i s study r e l i e s on h i s t o r i c a l research, d i s c u r s i v e and t e x t u a l a n a l y s i s , as w e l l as ethnographic observation. METHODOLOGY Beyond the secondary l i t e r a t u r e that was r e f e r r e d to i n order to develop the h i s t o r i c a l overview of A l c o h o l i c s Anonymous and the changing discourses on a l c o h o l consumption, a d d i c t i o n , and alc o h o l i s m presented i n Chapter I I , t h i s study i s based p r i m a r i l y on the a v a i l a b l e l i t e r a t u r e p ublished by AA and i t s members and on p a r t i c i p a n t - o b s e r v a t i o n studies of a range of AA meetings. The primary research, which spanned approximately four months, was undertaken i n Vancouver, BC, and i t s surrounding regions. Between J u l y and October, 2001, I attended about 35 AA meetings that were held i n a v a r i e t y of ge o g r a p h i c a l l y and demographically diverse s e t t i n g s , from the urban 21 s e t t i n g s of downtown and East Vancouver to suburban c i t i e s such as Surrey and Coquitlam, and the p r i m a r i l y r u r a l areas of Abbotsford and M i s s i o n . In a d d i t i o n t o t h i s d i v e r s i t y , I attempted t o attend as wide a range of meetings as p o s s i b l e . For example, I attended meetings t h a t , i n the (comprehensive) d i r e c t o r y of meetings f o r the Greater Vancouver area, were i d e n t i f i e d as being o r i e n t e d toward (but not l i m i t e d to) i n d i v i d u a l s who were "Old-Timers," "French," "Spanish," and "gay." However, my s e l e c t i o n of meetings by no means c o n s i s t e d of a methodical or r e p r e s e n t a t i v e sample of the hundreds of meetings h e l d weekly i n B r i t i s h Columbia's Lower Mainland. Instead, I u s u a l l y s e l e c t e d AA meetings on the b a s i s of convenience, much as an AA member might. For .example, before making a t r i p to Coquitlam f o r a d e n t i s t ' s appointment, I c a l l e d Vancouver's AA intergroup o f f i c e (which works as a s o r t of h o t l i n e that i n d i v i d u a l s can c a l l f o r i n f o r m a t i o n on times and l o c a t i o n s of meetings) and asked to be r e f e r r e d to a meeting that was i n close p r o x i m i t y to the area I was to be i n , and that would take place s h o r t l y before or a f t e r my appointment. And again, i n s t e a d of random s e l e c t i o n , I often attended meetings that were recommended or mentioned by the AA members I spoke with 22 i n f o r m a l l y : speaking with AA members i n f o r m a l l y before and a f t e r meetings, I a l s o discovered that c e r t a i n meetings were known f o r a t t r a c t i n g a p a r t i c u l a r demographic ( d i f f e r e n t groups were v a r i o u s l y described to me as "young," "mostly Indian" ( a b o r i g i n a l ) , or having a "party atmosphere"), and I made a poin t of attending these whenever p o s s i b l e . Despite the variance of the meetings I attended i n terms of l o c a t i o n , times, and demographics, the meetings, which I describe below, were, with a few minor v a r i a t i o n s , conducted almost i d e n t i c a l l y i n o r g a n i z a t i o n a l and t e c h n i c a l matters. The most s i g n i f i c a n t divergence between meetings was the " f e e l i n g " or atmosphere of the gatherings. In meetings that were attended more or l e s s e x c l u s i v e l y by younger i n d i v i d u a l s , f o r example, there was a more s o c i a l and unreserved mood; as I discovered through conversations with AA members, many i n d i v i d u a l s end up meeting future partners i n AA, and t h i s seems td\ be the case e s p e c i a l l y i n younger meetings. Other meetings,' such as those that focused on an aspect of members' i d e n t i t y other than al c o h o l i s m (e.g., homosexuality or e t h n i c i t y ) , were d i s t i n g u i s h e d by a f e e l i n g of community that was n o t i c e a b l y stronger than most meetings that d i d not s p e c i f y a p a r t i c u l a r demographic; and members' s t o r i e s and t a l k often made references to s u f f e r i n g s that 23 would resonate with the experiences of i n d i v i d u a l s with l i k e i d e n t i t i e s (e.g., experiences of v i c i t m i z a t i o n due to homophobia or racism). My a n a l y s i s uses e x t r a c t s from a range of the many primary documents published by AA i n order to provide current members, prospective members, and the general p u b l i c w i t h an overview of the program, i t s b e l i e f s and h i s t o r y . I focus most h e a v i l y on the group's documentary centrepiece, Alcoholics Anonymous: The Story of How Thousands of Men and Women Have Recovered from Alcoholism (1939), the f i r s t p u b l i c a t i o n of AA, which includes a h i s t o r y of AA, a d e s c r i p t i o n of AA's conception of alcoholism, a d e t a i l e d account of recovery from alcoholism, and a larg e number of members' personal s t o r i e s of t h e i r experiences as a l c o h o l i c s . With reference to a v a r i e t y of other AA t e x t s , i n c l u d i n g books such as The L i t t l e Red Book: An Interpretation of the Twelve Steps of the Alcoholics Anonymous Program (1951), and Living Sober: Some Methods A.A. Members Have Used for Not Drinking (1998), as w e l l as sev e r a l i n f o r m a t i o n a l booklets and pamphlets, I. examine how AA discourse a r t i c u l a t e s the goals, claims, and foundations of A l c o h o l i c s Anonymous. 24 In the subsequent chapters of t h i s study, most of my f i n d i n g s are generated from a t e x t u a l and d i s c u r s i v e a n a l y s i s of the published AA documents. By l o o k i n g at what the l i t e r a t u r e published by AA groups says about a l c o h o l a d d i c t i o n , and about how i n d i v i d u a l s are taught to manage t h e i r a d d i c t i o n s - as w e l l as what a c t u a l AA members w r i t e about t h e i r experiences about alc o h o l i s m and AA - I generate an overview of the body of the t e c h n i c a l and common-sense understandings " a f f l i c t e d " i n d i v i d u a l s have of t h e i r c o n d i t i o n s . I a l s o analyse, i n some depth, the Twelve Steps of A l c o h o l i c s Anonymous, as w e l l as the personal n a r r a t i v e s provided i n AA l i t e r a t u r e . While attendance at AA meetings allowed me t o gather i n s i g h t about the a c t u a l i n d i v i d u a l s who i d e n t i f y as a d d i c t s and who undertake the program's regimes f o r recovery from t h e i r a d d i c t i o n s , my f i e l d w o r k observations guide my 'textual a n a l y s i s more than they appear as items of a n a l y s i s i n and of themselves. For example, the e n t i r e l i t e r a t u r e produced by AA i s much too prodigious to be analyzed i n t h i s study; indeed, even the m a t e r i a l contained i n the AA b i b l e or "Big Book," Alcoholics Anonymous, contains f a r more m a t e r i a l than can be t r e a t e d c l o s e l y here. By attending meetings, I developed an understanding of which t e x t s and passages are most 25 e p i s t e m i c a l l y c e n t r a l to AA and are most c l o s e l y read by AA members; and of what general t o p i c s and themes c o n s t i t u t e everyday ( i . e . , not j u s t " o f f i c i a l , " published) AA d i s c o u r s e . This understanding has allowed me t o focus my a t t e n t i o n on elements of the AA program that are most e s s e n t i a l to the study of a l c o h o l i c s u b j e c t i v i t y undertaken here. My a n a l y s i s r e l i e s p r i m a r i l y on the c r i t i c a l t h e o r i z a t i o n s of knowledge and power developed by Michel Foucault and other governmentality scholars who have developed a framework f o r h i s t o r i c a l s c h o l a r s h i p on the management of deviance and i d e n t i t y . This approach i s p a r t i c u l a r l y u s e f u l here because i t examines how thoughts and a c t i o n s of "everyday" i n d i v i d u a l s are governed by ways and forms of knowing that do not simply " e x i s t , " but are d i s c u r s i v e l y constructed. A n a l y t i c a l l y , Foucault separates h i s analyses i n t o the i n v e s t i g a t i o n of d i s c i p l i n a r y techniques, i n which bodies are studied, mapped, and re g u l a t e d by experts (and thus at the same time are a c t u a l l y being created by experts) and deviance i s c o r r e c t e d and "brought i n l i n e " with normalcy and the i n v e s t i g a t i o n of techniques of the s e l f , i n which the i n d i v i d u a l s d e l i m i t those parts of themselves that form "the object of t h e i r 26 moral p r a c t i c e , " define t h e i r p o s i t i o n s r e l a t i v e to the precepts they w i l l f o l l o w , and pursue c e r t a i n modes of being that conform with t h e i r e t h i c a l standards. However, I b e l i e v e that since d i s c i p l i n a r y techniques at l e a s t i n part c o n s t i t u t e the i n d i v i d u a l , and techniques of the s e l f r e q u i r e that same d i s c u r s i v e l y - c o n s t i t u t e d i n d i v i d u a l "to act upon himself, to monitor, test,.- improve, and transform h i m s e l f " (Foucault 1985: 28), the separation of the two sets of techniques i s somewhat a r t i f i c i a l . I f , fo r instance, i n the case of alcoholism and AA, one claimed "AA's techniques f o r governing the soul use n e i t h e r medical t o o l s ( o b j e c t i v i s t observation, d i a g n o s i s , etc.) nor the t o o l s of the psy scien c e s " (Valverde 1998: 140), and thus discounted the importance of d i s c i p l i n a r y technologies, one would be overlooking the important f a c t that there were d i s c i p l i n a r y medical and "psych" - not to mention moral -discourses on a l c o h o l that e x i s t e d prior to AA and i n part c o n s t i t u t e d the o r i g i n a l AA members' " a l c o h o l i s m . " Thus, I w i l l take s p e c i a l care to avoid using Foucault's analytical d i s t i n c t i o n as a t h e o r e t i c a l imperative or an e m p i r i c a l c l a i m about separate domains, and w i l l i n s t e a d seek to understand how techniques of d i s c i p l i n e and techniques of the s e l f are each i m p l i c a t e d i n the other, and how 27 i n d i v i d u a l s are p o s i t i o n e d i n such a way that they simultaneously e x e r c i s e and are subjected to power. I begin Chapter I I with a genealogical a n a l y s i s of "the a l c o h o l i c " and the concepts of alcoholism and a d d i c t i o n i n North America that extends from the c o l o n i a l p e r i o d up to the contemporary era, noting how these developments r e l a t e to r e l e v a n t s o c i a l , p o l i t i c a l , economic, and s c i e n t i f i c i s s u e s . Most s i g n i f i c a n t l y , I o u t l i n e the change that occurred i n the e a r l y twentieth century, i n which the s t o r y of problem d r i n k i n g , which had p r e v i o u s l y been t o l d i n terms of i n d i v i d u a l s ' l a c k of moral f o r t i t u d e and the i n t r i n s i c a l l y e v i l p r o p e r t i e s of a l c o h o l , was r e - w r i t t e n by p h y s i c i a n s and psych experts, whose account of compulsive d r i n k i n g r e l i e s on i n d i v i d u a l b i o l o g y and p h y s i o l o g i c a l a d d i c t i o n . This change i n authorship, which was accompanied (and, indeed, fostered) by the end of P r o h i b i t i o n , a l s o marked a t r a n s f e r i n "ownership" of problem d r i n k i n g : whereas "demon rum" and " h a b i t u a l drunkards" had been the concerns of the moral entrepreneurs of the Temperance movement, " a l c o h o l i s m , " or a d d i c t i o n to a l c o h o l , was p r i m a r i l y conceived of as issues of p u b l i c h e a l t h and p r i v a t e medicine. Accordingly, problem d r i n k e r s (and, i n the l a t t e r h a l f of the century, as the a d d i c t i o n concept 28 became i n c r e a s i n g l y i n f l u e n t i a l as an explanation not only of compulsive d r i n k i n g but of a v a r i e t y of other a c t i v i t i e s that i n d i v i d u a l s f e l t unable to c o n t r o l , other "addicts") became l e s s l i k e l y to be condemned and i n c r e a s i n g l y l i k e l y to r e c e i v e a t t e n t i o n from physicians or other t h e r a p e u t i c agents. This g e n e a l o g i c a l d e s c r i p t i o n i s accompanied by an h i s t o r i c a l account of the emergence and growth of AA's treatment program, beginning with the experiences of B i l l Wilson, a problem d r i n k e r who, i n the e a r l y 1930,s, came to conceive of h i s d r i n k i n g problem as the r e s u l t of .-a b i o l o g i c a l d e f i c i e n c y that could only be remedied by complete abstinence from a l c o h o l and the adoption of a s p i r i t u a l way of l i f e . I pay p a r t i c u l a r a t t e n t i o n to the ways i n which Wilson's b e l i e f s about the nature of al c o h o l i s m r e l y on a complex combination of medical / p h y s i o l o g i c a l , moral / s p i r i t u a l , and p s y c h o l o g i c a l elements, and how t h i s conception shaped Wilson's a l c o h o l i s m recovery program. This program e v e n t u a l l y came to be known as A l c o h o l i c s Anonymous and has since become the dominant method of t r e a t i n g a l c o h o l i s m i n North America as w e l l as a model f o r a multitude of other a d d i c t i o n - r e c o v e r y programs. 29 In the second h a l f of Chapter I I , I begin to analyze the emergence of a l c o h o l i c s u b j e c t i v i t y and the " b i r t h " of the a l c o h o l i c . With the r a p i d growth of AA and the expansion of al c o h o l i s m discourse, problem d r i n k e r s has come to be conceived of as making up a d i s t i n c t population of s i m i l a r l y a f f l i c t e d i n d i v i d u a l s . Through an array of p r a c t i c e s and techniques - v a r i o u s l y imposed on, suggested to, or w i l l i n g l y adopted by i n d i v i d u a l s who are perceived to have d r i n k i n g problems - or i d e n t i t y became f i x e d to " a l c o h o l i c s , " who are d i s t i n g u i s h e d from "normal" i n d i v i d u a l s i n many ways, such as b i o l o g i c a l c h a r a c t e r i s t i c s , p e r s o n a l i t y t r a i t s , l i f e courses, and so on. In AA, i n d i v i d u a l s have f o r the most part embraced t h i s f i x - t i o n , c o r r o b o r a t i n g i t with t h e i r own experiences, i n t e n s i f y i n g i t with s t o r i e s about, themselves and about a l c o h o l i s m i n general. Accordingly, AA members have developed a f i x - t i o n a l world: a recovery subculture with i t s own heroes, i t s own symbols and vocabulary, i t s own norms and r i t u a l s ; indeed, i t has produced an e n t i r e e x i s t e n t i a l imaginary, i n c l u d i n g a "design f o r l i v i n g " as an a l c o h o l a d d i c t . In Chapter I I I , I examine i n some d e t a i l the AA "way of l i f e , " the program of treatment that AA members undertake on 30 the b a s i s of t h e i r understandings about al c o h o l i s m and about themselves as a l c o h o l i c s . I read AA's recovery program i n terms of a governance of problematic a l c o h o l consumption, i n v e s t i g a t i n g how the Twelve Steps of AA engender d i s c i p l i n a r y mechanisms and technologies of the s e l f that are d i r e c t e d at alc o h o l i s m as problem of disease and of (excessive) d e s i r e or a p p e t i t e . These forms of governance, which are as concerned with s p i r i t u a l i t y and m o r a l i t y as much as they are with physiology or psychology, r e f l e c t the C h r i s t i a n , middle-class o r i g i n s of AA, i n s o f a r as they c u l t i v a t e not only the curtailment of problematic d r i n k i n g behaviour, but a l s o the adoption of values and goals of dominant c u l t u r a l i d e o l o g i e s i n North America. A l c o h o l i c s Anonymous aims to provide i t s members with a "high road to a new freedom," i n which recovering a l c o h o l i c s are more f a i t h f u l husbands and wives, more honest and hardworking employees, more devoted parents, and b e t t e r c i t i z e n s . In Chapter IV, I r e l a t e the governance of a l c o h o l i c s u b j e c t i v i t y i n A l c o h o l i c s Anonymous to broader m o d a l i t i e s of d e s i r e , deviance, and i d e n t i t y . I suggest that the s p e c i f i c ways i n which these m o d a l i t i e s are imbricated with one another i n AA r e f l e c t c e r t a i n dominant c u l t u r a l l o g i c s of contemporary North America, most notably the 31 s u b j e c t i f i c a t i o n of dependence, compulsion, and a d d i c t i o n (the a r t i c u l a t i o n of i n d i v i d u a l s as subjects of overwhelming desires) and the p a r a l l e l deployment of forms of s e l f - and d i s c i p l i n a r y c o n t r o l that allow i n d i v i d u a l s to l i v e "normal," "healthy," " f u l f i l l e d " l i v e s . I conclude the chapter, and my study, by i n d i c a t i n g some avenues of future s o c i o l o g i c a l research. 32 C H A P T E R I I : HOMO ALCOHOLUS: THE ORIGINS OF A S P E C I E S GENEALOGICAL DEVELOPMENTS The concepts of al c o h o l i s m and a d d i c t i o n are i n e x t r i c a b l y bound up with one another; not only because a l c o h o l i s m i s today considered a s p e c i f i c form of a d d i c t i o n ( i . e . , an a d d i c t i o n to alcohol) and because the concepts provided the d i s c u r s i v e antecedents f o r the genesis of "the a l c o h o l i c , " but a l s o because the term " a d d i c t i o n " was invented with only a l c o h o l (or the problematic consumption thereof) i n mind. F i r s t used i n the mid-nineteenth century by a French p h y s i c i a n to describe a p a t i e n t ' s heavy d r i n k i n g , " a d d i c t i o n " was an adaptation of the L a t i n addictus, which o r i g i n a l l y described a s i t u a t i o n i n which one gives oneself over to an i n t e r e s t or p u r s u i t to which one i s s t r o n g l y attached. Contrary to i t s modern d e r i v a t i v e s , addictus was not used i n reference to attachments to substances such as drugs or a l c o h o l , but rather to hobbies and other i n t e l l e c t u a l or l e i s u r e a c t i v i t i e s . Furthermore, i t d i d not represent a s t a t e of i l l n e s s or di s o r d e r that was considered harmful to the i n d i v i d u a l ; indeed, p r i o r to the 1800s, when such non-substance-related uses of the word were the norm, 33 the word was not used with p e j o r a t i v e connotations (Surratt 1999) . .-. Today, " a d d i c t i o n " i s a complex term with m u l t i p l e meanings and connotations that vary according to s p e c i f i c users and contexts. For example, not only i s the term used d i f f e r e n t l y by p o l i t i c i a n s , n e u r o l o g i s t s , and a d d i c t s , i t may hold s e v e r a l d i f f e r e n t meanings f o r e i t h e r one of these agents. D i s c u r s i v e s h i f t s are e s p e c i a l l y prominent i n A l c o h o l i c s Anonymous, where m u l t i p l e " r e g i s t e r s of meaning" (Fraser and Gordon 1997) conceptualize a d d i c t i o n v a r i o u s l y as p h y s i o l o g i c a l / b i o l o g i c a l , mental / p s y c h o l o g i c a l , and moral / s p i r i t u a l . An understanding of these diverse s i g n i f i c a t i o n s of a d d i c t i o n (and alcoholism, i n s o f a r as a l c o h o l i s m i s understood to be an a d d i c t i o n to alcohol) i s e s s e n t i a l , since these terms c o n s t i t u t e "pre-named, pre-c l a s s i f i e d r e a l i t i e s " (Bourdieu 1991: 105) that describe and define experiences of compulsive d r i n k i n g , and must be negotiated by s o c i a l actors (cf. Williams 1976). In North America, the o r i g i n s of contemporary conceptions of problem d r i n k i n g as an a d d i c t i o n to a l c o h o l ( i . e . , alcoholism) can be traced to the l a t e eighteenth century. One of the co-signers of the American D e c l a r a t i o n of Independence and the " f a t h e r of American p s y c h i a t r y , " Dr. 34 Benjamin Rush was the f i r s t to surmise that problematic consumption of a l c o h o l could be a medical c o n d i t i o n rather than a matter of free w i l l ; he p r e s c r i b e d t o t a l abstinence as the only cure (Walters 1999; Kurtz and Kurtz 1986) . Although t h i s may have been the root of the disease concept of a l c o h o l i s m that was popu l a r i z e d more than a century l a t e r , i n the i n t e r v e n i n g p e r i o d Rush's ideas about " h a b i t u a l drunkenness" (he d i d not use the term " a d d i c t i o n " or "alcoholism") were not widely accepted. More prevalent i n North America u n t i l the end of the P r o h i b i t i o n era was the view, espoused by Protestants and p a r t i c u l a r l y Protestant temperance a c t i v i s t s , t h a t d r i n k i n g problems r e s u l t e d from a combination of s i n (moral weakness or a l a c k of w i l l power) and e v i l (the i n e b r i a t i n g - and tempting - q u a l i t i e s of "demon rum" and other s p i r i t s ) . Although drunkenness was a widespread occurrence and a cause of p u b l i c concern, i n d i v i d u a l drunkenness was regarded as r e s u l t i n g from an a c t i v e decision-making process (e.g., choosing between d r i n k i n g enough to become i n e b r i a t e d or s t a y i n g sober) rather than from any so r t of p a t h o l o g i c a l dependence on a l c o h o l . In t h i s p e r s p e c t i v e , a l c o h o l , a temptation of e v i l , posed an ever-present t h r e a t to every i n d i v i d u a l and, aggregately, to s o c i e t y . The s o l u t i o n , 35 then, was understood to be moral f o r t i f i c a t i o n and the establishment of l e g i s l a t i v e c o n t r o l s over the sa l e and use of a l c o h o l , and these a c t i v i t i e s were undertaken p r i m a r i l y by Protestant churches, who were the dominant "owners" of the problem of drunkenness i n the nineteenth and e a r l y t w e n t i e t h c e n t u r i e s ( G u s f i e l d 1996: 21). However, the demonization of a l c o h o l that occurred during the temperance movement should not be s i m p l i s t i c a l l y a t t r i b u t e d to the mere f a c t of the existence of a l c o h o l consumption w i t h i n a c u l t u r e of r e l i g i o u s a s c e t i c i s m ; p r i o r to the u r b a n i z a t i o n and r a p i d s o c i a l change that occurred i n the wake of the American I n d u s t r i a l Revolution, the use of a l c o h o l was w e l l i n t e g r a t e d i n t o c o l o n i a l s o c i e t y . Levine (1978) has demonstrated that the E n g l i s h c o l o n i a l s o c i e t i e s i n North America were decidedly "wet" during the seventeenth and eighteenth c e n t u r i e s , and that i n e b r i e t y only became conceptualized as a s o c i a l problem at the end of the eighteenth century as the United States began to i n d u s t r i a l i z e r a p i d l y and s i g n i f i c a n t numbers of r u r a l f o l k migrated to urban centres i n search of employment. These migrants - many of whom were young adul t s - oft e n l e f t behind c l o s e l y i n t e g r a t e d f a m i l i e s and communities, as w e l l as many of the infor m a l s o c i a l c o n t r o l s that had s t r u c t u r e d 36 t h e i r a g r a r i a n l i v e s . By the beginning of the nineteenth century, problem d r i n k i n g had become an issue of n a t i o n a l concern because of the p r e d i c t e d breakdown of s o c i a l and f a m i l i a l networks (Clark 1976). I t was around t h i s time, at the t u r n of the century, that the temperance movement gained momentum and a l c o h o l began to develop a r e p u t a t i o n as an i n h e r e n t l y e v i l substance. While temperance discourse came to c o n s t i t u t e the p r i n c i p a l current of s o c i : a l thought on a l c o h o l i n the f o l l o w i n g decades, these views by no means went uncontested. Through the nineteenth century, physicians and s c i e n t i s t s s t u d i e d problem d r i n k i n g from b i o l o g i c a l and psychological, r a t h e r than s t r i c t l y moral perspectives (although the focus s t i l l tended to be on v o l i t i o n and i t s dysfunction - e.g., h a b i t u a l i n e b r i a t i o n as "diseases of the w i l l " - rather than on any so r t of p h y s i o l o g i c a l dependence) (Valverde 1998). The Protestant temperance ethos was a l s o brought i n t o question with the l a r g e - s c a l e immigration of I r i s h C a t h o l i c s and German Lutherans i n t o the US, who brought to /American s o c i e t y a f a r more l i b e r a l view of a l c o h o l consumption than had h i t h e r t o e x i s t e d . Indeed, s t a t i n g that " P r o h i b i t i o n came as the culmination of the movement to reform the immigrant c u l t u r e s and at the height of the immigrant i n f l u x 37 i n t o the United S t a t e s " (1996: 94), G u s f i e l d suggests that the e s c a l a t i o n of the temperance movement's e f f o r t s at a l c o h o l r e g u l a t i o n were a response to an i n c r e a s i n g threat to the c u l t u r a l hegemony of Protestant a s c e t i c i s m . By the time the temperance movement succeeded i n e s t a b l i s h i n g a n a t i o n a l p r o h i b i t i o n on the manufacture and sa l e of a l c o h o l i c beverages i n 1920, the temperance ethos was already receding, and by the e a r l y 1930s was l a r g e l y considered old-fashioned. In 1933, P r o h i b i t i o n was repealed and the goal of n a t i o n a l temperance was l a i d to r e s t . As a l c o h o l issues f e l l from the arena of d i r e c t p o l i t i c a l c o n f l i c t w i t h i n the j u r i d i c a l sphere, the quest f o r new ways to deal with problem d r i n k i n g i n a way that would allow f o r the vast m a j o r i t y of a l c o h o l consumption (and production) to remain unproblematized began, as d i d a general r e o r i e n t a t i o n of s o c i a l thought towards a l c o h o l . Alcoholism as a medical problem was taken up by p h y s i c i a n s , "psych-" experts, and by problem d r i n k e r s themselves; and g r a d u a l l y the disease model of a l c o h o l i s m , i n which the cause of d r i n k i n g problems was l o c a t e d i n the being of c e r t a i n a f f l i c t e d i n d i v i d u a l s , became the dominant conception of problem d r i n k i n g . With the development of t h i s notion - that the source of problems caused by a l c o h o l consumption was to be found i n 38 the d r i n k e r him- or h e r s e l f - r e s p o n s i b i l i t y f o r the s o c i a l problems connected with d r i n k i n g was s h i f t e d from a l c o h o l as a commodity whose production and consumption r e q u i r e d s t r i c t r e g u l a t i o n or p r o h i b i t i o n to the a l c o h o l i c as a p a t h o l o g i c a l i n d i v i d u a l whose unique ( b i o l o g i c a l , p s y c h o l o g i c a l ) makeup rendered him or her unable to c o n t r o l h i s or her d r i n k i n g . Thus, a r a t h e r s i g n i f i c a n t paradigm s h i f t i n North American c u l t u r e occurred, i n which the very nature of a l c o h o l problems and how to deal with them changed. Problems that were once seen as the consequences of an i n e b r i a t i n g substance came to be viewed i n s t e a d as the re s u l t ' of the defects of i n d i v i d u a l s who, f o r one reason or another, could not p r o p e r l y "handle" or manage a l c o h o l . The task, then, was no longer to moderate "normal" d r i n k e r s ; these would n a t u r a l l y l i m i t t h e i r consumption of a l c o h o l to non-problematic l e v e l s . Rather, i t was to deal with those i n d i v i d u a l s who e x h i b i t e d signs of a l c o h o l a d d i c t i o n . In expert discourses and i n everyday speech, the term " h a b i t u a l i n e b r i e t y " was g r a d u a l l y replaced by " a l c o h o l i s m , " and the m o r a l i s t i c judgment that the chronic i n e b r i a t e was a sinner began to give way to t h e r a p e u t i c compassion f o r the a l c o h o l i c . This " c r u c i a l change i n the consciousness of Americans" ( G u s f i e l d 1 9 9 6 : . 1 9 3 ) was brought about from the 39 l a t e 1930s i n lar g e part by the "al c o h o l i s m movement," a l o o s e l y - a s s o c i a t e d group of i n d i v i d u a l s who were members of research o r g a n i z a t i o n s such as the Yale Center f o r A l c o h o l Studies, a l c o h o l treatment p r o f e s s i o n a l s , and / or " a l c o h o l i c s " themselves. In emphasizing a l c o h o l i s m as a p u b l i c h e a l t h i s s u e , the alc o h o l i s m movement d e f l e c t e d p o l i t i c a l questions about the acceptance or r e j e c t i o n of a l c o h o l as a commodity. Viewing d r i n k i n g excesses as rooted i n d i s e a s e - l i k e q u a l i t i e s of i n d i v i d u a l s , i t argued that a l c o h o l problems were pr o p e r l y the domain of medical epidemiology and personal h e a l t h care rather 1 than that of p o l i t i c i a n s and moral entrepreneurs. A th e r a p e u t i c o r i e n t a t i o n towards alcoholism that presented d r i n k i n g problems as belonging to s i c k i n d i v i d u a l s i n s t e a d of to a i l i n g s o c i e t i e s reduced the r e s p o n s i b i l i t y both of i n d i v i d u a l d r i n k e r s , and of companies who produced and / or s o l d a l c o h o l products. The formation, i n 1943, of the U.S. N a t i o n a l Committee f o r Education on Alcoholism, which was soon renamed the Na t i o n a l C o u n c i l on Alcoholism (NCA), marked the development of a more organized, a c t i v i s t movement. For decades, the NCA functioned as the main p o l i t i c a l arm of the al c o h o l i s m movement i n the United Sates, promoting the r e c o g n i t i o n of 40 a l c o h o l i s m as a p u b l i c h e a l t h r e s p o n s i b i l i t y and seeking government funding f o r treatment and research (Makela 1996). Although A l c o h o l i c s Anonymous r e f r a i n e d from i n v o l v i n g i t s e l f i n a c t i v i s m of the alcoholism movement, the s o c i a l and p o l i t i c a l changes that the alc o h o l i s m movement was able to make can be d i r e c t l y r e l a t e d to the existence and successes of AA - and v i c e versa. Despite t h e i r o r g a n i z a t i o n a l and i n s t i t u t i o n a l separation, AA and the al c o h o l i s m movement shared the "a l c o h o l i s m " p e r s p e c t i v e ; indeed, AA helped develop the very conception of al c o h o l i s m that the NCA and other a c t i v i s t s adopted. This should not be wholly s u r p r i s i n g , given the close linkages the founders of AA had to al c o h o l i s m treatment p r o f e s s i o n a l s . The man who o r i g i n a t e d the mutual-help program of AA, B i l l Wilson, was i n s t i t u t i o n a l i z e d numerous times as a r e s u l t of h i s d r i n k i n g before he discovered what was to be -not only f o r him but al s o f o r m i l l i o n s of others - the "nature" of h i s problem. Checked i n t o a "nationally-known h o s p i t a l f o r the mental and p h y s i c a l r e h a b i l i t a t i o n of a l c o h o l i c s " (AA 1976: 7), he came under the care of the pre-eminent p s y c h i a t r i s t Dr. W. S i l k w o r t h , who explained that Wilson was " s e r i o u s l y i l l , b o d i l y and mentally." Having p r e v i o u s l y a t t r i b u t e d h i s drunkenness to personal weakness 41 and i n s a n i t y , Wilson found comfort i n the knowledge about h i s c o n d i t i o n that he received from S i l k w o r t h , as h i s " i n c r e d i b l e behavior i n the face of a desperate d e s i r e to stop was explained" (AA 1976: 7). But while S i l k w o r t h was able to convince Wilson that he was s u f f e r i n g from a disease that was c h a r a c t e r i z e d by a p h y s i c a l i n a b i l i t y to r e s i s t a l c o h o l and a l s o a mental obsession with l i q u o r , Wilson was r e l u c t a n t to adopt the p r e s c r i b e d treatment. S i l k w o r t h advised h i s p a t i e n t that the disease of alcoholism, i n c u r a b l e as i t was, would l i k e l y lead to i n s a n i t y or death without the s t r i c t enforcement of medical d i s c i p l i n e that i n s t i t u t i o n a l i z a t i o n would make p o s s i b l e ; Wilson nevertheless chose to release himself from the h o s p i t a l he was being t r e a t e d i n , and to make another attempt at s o b r i e t y . Soon a f t e r r e t u r n i n g home, Wilson was c a l l e d upon by an o l d d r i n k i n g f r i e n d who had achieved s o b r i e t y through r e l i g i o u s conversion and a f f i l i a t i o n with the Oxford Group Movement, a worldwide o r g a n i s a t i o n ( o r i g i n a l l y known as the F i r s t Century C h r i s t i a n Fellowship) that was founded upon an attempt to recapture the q u a l i t y of C h r i s t i a n i t y as i t had e x i s t e d before the development of the organised church. Among the key a c t i v i t i e s of Oxford Groups was "s h a r i n g , " 42 open confessions of si n s at p u b l i c meetings (Orford 1985: 301-302). I t was through t a l k i n g with t h i s f r i e n d and l e a r n i n g about the Oxford Group's ideology that Wilson experienced h i s own s p i r i t u a l conversion and developed the idea t h a t , i n order to maintain s o b r i e t y , a l c o h o l i c s needed the a s s i s t a n c e of others s u f f e r i n g from the same c o n d i t i o n . Wilson developed a r e l a t i o n s h i p of mutual support with "Dr. Bob," another problem d r i n k e r and the co-founder of what e v e n t u a l l y became A l c o h o l i c s Anonymous. As Wilson and Dr. Bob began to work with other a l c o h o l i c s , a network of r e c i p r o c a l a s s i s t a n c e developed and r e g u l a r l y scheduled d i s c u s s i o n meetings emerged, f i r s t i n Akron, Ohio, and soon i n other areas of the eastern United States. A f t e r the membership of AA had grown to approximately one hundred members, a d e c i s i o n was made to create a w r i t t e n account of the program and i t s a c t i v i t i e s so that i n d i v i d u a l s outside of the groups' l i m i t e d geographical scope could employ AA's methods. The production of Alcoholics Anonymous (1939) r e s u l t e d i n the formulation of the famous Twelve Steps that r e q u i r e i n d i v i d u a l s to adopt a s p i r i t u a l (but not n e c e s s a r i l y r e l i g i o u s ) a t t i t u d e and approach to l i v i n g . Upon being v i s i t e d by h i s former p a t i e n t and observing a miraculous recovery, S i l k w o r t h was duly impressed. He 43 began to inform Wilson or another member of A l c o h o l i c s Anonymous when new p a t i e n t s with a l c o h o l - r e l a t e d i l l n e s s a r r i v e d i n h i s h o s p i t a l so that a meeting between the p a t i e n t and an AA member could take place. S i l k w o r t h a l s o agreed to w r i t e a supplement to the f i r s t (1939) e d i t i o n of Alcoholics Anonymous, presenting h i s expert opinion as to the nature of alcoholism, which had been a l t e r e d by h i s own observations of "hopeless" a l c o h o l i c s recovering without i n d e f i n i t e i n s t i t u t i o n a l i z a t i o n . In a p r e f a t o r y s e c t i o n of Alcoholics Anonymous e n t i t l e d "The Doctor's Opinion," the reader who may be s c e p t i c a l of the AA i s provided with an overview of the Twelve-Step program of recovery. Although he wri t e s a u t h o r i t a t i v e l y as "Medical D i r e c t o r of one of the olde s t h o s p i t a l s i n the country t r e a t i n g a l c o h o l i c and drug a d d i c t i o n " (AA 1976: xxv) , S i l k w o r t h ' s c h a r a c t e r i z a t i o n of a l c o h o l i s m and a l c o h o l i c s c l e a r l y r e l i e s on p s y c h o l o g i c a l , moral, and s p i r i t u a l elements i n a d d i t i o n to medical ones. S i l k w o r t h acknowledges that s t r i c t l y medical or p h y s i o l o g i c a l approaches to the treatment of alcoholism have so f a r proven i n s u f f i c i e n t : he and other doctors have r e a l i z e d f o r some time that "some form of moral psychology was of urgent importance to a l c o h o l i c s , " which he and h i s colleagues, with 44 t h e i r "ultra-modern standards" and " s c i e n t i f i c approach to e v e r y t h i n g , " have been unable to provide (AA 1976: xxv) . This f a i l u r e , perhaps, explains why the subsequent expl a n a t i o n of a l c o h o l i s m i s so variegated, r e l y i n g as i t does on c a t e g o r i e s of b i o l o g y , psychology, and morality.' S i l k w o r t h and h i s contemporaries i n the a l c o h o l i s m movement a t t r i b u t e a l c o h o l i s m to an a l l e r g y to a l c o h o l that renders i n d i v i d u a l s unable to use a l c o h o l s a f e l y i n any form at a l l . Although the p r e c i s e physiology of the a l l e r g y remains 1 u n s p e c i f i e d , S i l k w o r t h notes that the a l l e r g y helps f o s t e r an a l c o h o l i c habit which leads these " a l l e r g i c types" to lose t h e i r s e l f - c o n f i d e n c e and e f f i c a c y so that u l t i m a t e l y , " t h e i r problems p i l e up on them and become a s t o n i s h i n g l y d i f f i c u l t to s o l v e " (AA 1976: x x v i ) . He goes on to a l l u d e to a moral dimension of alcoholism, suggesting that the i n a b i l i t y to stop d r i n k i n g i s a matter of w i l l more than of b i o l o g y or psychology, w r i t i n g that "[m]en and women dri n k e s s e n t i a l l y because they l i k e the e f f e c t produced by a l c o h o l " (AA 1976: x x v i ) . Thus, S i l k w o r t h v a r i o u s l y suggests that a l c o h o l i c s d r i n k because of a p h y s i c a l compulsion, because of emotional i n s t a b i l i t y , and because of a moral weakness f o r the i n t o x i c a t i n g e f f e c t s of a l c o h o l . Once a f i r s t d r i n k has been taken, the a l c o h o l i c i s set upon 45 the path of "the well-known stages of a spree, emerging remorseful, with a f i r m r e s o l u t i o n not to d r i n k again." And yet, because they " l i k e the e f f e c t produced by a l c o h o l , " and because they see others d r i n k i n g with impunity, they e v e n t u a l l y s t a r t the c y c l e anew (AA 1976: x v i i ) . On the b a s i s of t h i s e t i o l o g y , S ilkworth's p r e s c r i b e d treatment f o r al c o h o l i s m combines medical, p s y c h o l o g i c a l , and moral treatment. The f i r s t task i s to " f r e e " an a l c o h o l i c from p h y s i c a l c r a ving f o r l i q u o r which requires "a d e f i n i t e h o s p i t a l procedure" (AA 1976: x x v i ) . However, a f t e r t h i s i n i t i a l stage of treatment i s completed, t r a d i t i o n a l medicine - i n c l u d i n g p s y c h i a t r y - has l i t t l e to o f f e r the a l c o h o l i c p a t i e n t , who requires an " e n t i r e psychic change" and "a few simple r u l e s " (AA 1976: x x v i i ) . Together these w i l l render the i n d i v i d u a l able to c o n t r o l the d e s i r e f o r a l c o h o l . And indeed, these are p r e c i s e l y what AA seeks to provide f o r the a l c o h o l i c . In deploying medical e x p e r t i s e to confirm i t s b a s i c b e l i e f s about alcoholism, AA d o u b t l e s s l y b o l s t e r s the c r e d i b i l i t y of i t s program. However, the r e l a t i o n s h i p between AA and medical experts i s more complex than simply an attempt by the former to acquire some of the p r e s t i g e of the l a t t e r . While the a u t h o r i t y of medical experts i s held 46 i n high enough regard, AA does not depend on the good w i l l or the co-operation of the medical f i e l d . Indeed, although AA borrows i t s fundamental understanding of the e t i o l o g y of al c o h o l i s m from medical experts, i t refuses to acknowledge that medical a u t h o r i t i e s have the a b i l i t y to diagnose or pr o p e r l y t r e a t alcoholism. Within A l c o h o l i c s Anonymous, personal experience i s valued over data or t h e o r i e s derived from expert observation or s c i e n t i f i c reasoning; and a d d i c t i o n to a l c o h o l , diagnosed by an i n d i v i d u a l him- or h e r s e l f , i s t r e a t e d with a program developed by recovering a l c o h o l i c s themselves. The account of the h i s t o r y of medicine i n the f i r s t h a l f of the twentieth century popular among many s o c i a l t h e o r i s t s - one which p a i n t s a p i c t u r e of s t e a d i l y i n c r e a s i n g l y m e d i c a l i z a t i o n and i n which medical experts c o n s t a n t l y seek to expand t h e i r i n f l u e n c e and power over new areas of human existence - would suggest that medical experts would have been eager to engage i n a so r t of " t u r f war" with AA over a l c o h o l i s m diagnosis and treatment; however, t h i s i s not what has occurred. Indeed, the American Medical A s s o c i a t i o n o r i g i n a l l y r e s i s t e d r e c o g n i z i n g a l c o h o l i s m as a disease. I t was only i n 1956, with the growth and apparent success of AA as w e l l as pressure from 47 research advocates of the alcoholism movement, that i t was persuaded to incl u d e a l c o h o l i s m as a medical c o n d i t i o n (Rice 1996; Denzin 1987). This r e c o g n i t i o n , along with the p u b l i c a t i o n of J e l l i n e k ' s h i g h l y i n f l u e n t i a l book, The Disease Concept of Alcoholism, i n 1960, e s t a b l i s h e d the hegemony of the a d d i c t i o n concept i n both popular thought and medical discourse on a l c o h o l . But while notions of p h y s i o l o g i c a l a d d i c t i o n and medical disease i n c r e a s i n g l y came to dominate understandings of the cause of alcoholism, there remained a moral f a c t o r i n the equation that determined why some i n d i v i d u a l s could not stop d r i n k i n g . Since medical experts could o f f e r no simple cure f o r al c o h o l i s m (and indeed, i t i s not apparent that they g e n e r a l l y b e l i e v e d one e x i s t e d ; a l c o h o l i s m was conceptualized by the American Medical A s s o c i a t i o n as both a p h y s i o l o g i c a l and mental i l l n e s s ) , the treatment that was most f r e q u e n t l y p r e s c r i b e d was complete abstinence from a l c o h o l . I n d i v i d u a l s who had no c o n t r o l over t h e i r alcoholism-prone c o n s t i t u t i o n s nevertheless had t o f i n d some way of c o n t r o l l i n g themselves, t h e i r h a b i t s , and t h e i r c ravings. C o n t r o l over a l c o h o l consumption could, of course, be achieved with the help or coercion of an e x t e r n a l agent, such as a judge sentencing a drunkenness offender to 48 i n c a r c e r a t i o n at a d e t o x i f i c a t i o n centre, but long term recovery u l t i m a t e l y required that a l c o h o l i c s summon t h e i r own personal r e g u l a t o r y strengths. During the decades immediately f o l l o w i n g the repeal of P r o h i b i t i o n , i n which s e v e r a l schemes f o r t r e a t i n g a l c o h o l i s m emerged, the Twelve-Step approach developed by the founders of A l c o h o l i c s Anonymous q u i c k l y e s t a b l i s h e d i t s e l f as the pre-eminent model f o r d e a l i n g with a d d i c t i o n to a l c o h o l . Favoured among medical and th e r a p e u t i c experts, the o r g a n i z a t i o n a l s o received popular approval, i n part due to p o s i t i v e media coverage. E s p e c i a l l y i n the l a t e 1930s and e a r l y 1940s, a r t i c l e s i n magazines and newspapers reported on how hundreds and even thousands of i n d i v i d u a l s had been "saved" from the dangers of al c o h o l i s m (which included estrangement from f r i e n d s and fa m i l y members, l o s s of employment, d e c l i n i n g p h y s i c a l and mental h e a l t h , and u l t i m a t e l y death); s u b s t a n t i a l increases i n membership r e s u l t e d . And although s c i e n t i f i c research i n t o a l c o h o l i s m continued ( p a r t i c u l a r l y i n hopes of d i s c o v e r i n g a pharmacological cure) , no s i g n i f i c a n t advancements or changes i n the treatment of a l c o h o l a d d i c t i o n appeared on the horizon, and many alc o h o l i s m treatment experts began e i t h e r to r e f e r p a t i e n t s to AA, or to adopt the "twelve-step 49 approach" themselves. While d e t o x i f i c a t i o n s e r v i c e s , h o s p i t a l care, and p s y c h o l o g i c a l therapy were not dispensed with a l t o g e t h e r , they became more or l e s s a n c i l l a r y treatments to A l c o h o l i c s Anonymous. With the p r i v a t e , , p u b l i c , and p r o f e s s i o n a l acclaim AA received i n the f i r s t decades of the program's existence f o r t r e a t i n g a l c o h o l a d d i c t i o n , i t i s perhaps not s u r p r i s i n g that the idea emerged that other a d d i c t i o n s could be t r e a t e d with a s i m i l a r twelve-step approach. This idea was p a r t i c u l a r l y w e l l received because medical models from the t u r n of the century had proposed that a d d i c t i o n s to d i f f e r e n t drugs (e.g., opium and morphine) were r e l a t e d to the same common disease that a l c o h o l i c s s u f f e r e d from. Gradually, a d d i c t s of various s o r t s began to form t h e i r own twelve-step treatment groups. In 1953, members of A l c o h o l i c s Anonymous who f e l t that they needed to deal with other drug problems and b e l i e v e d that AA's Twelve Steps could prove u s e f u l i n t h i s task, formed N a r c o t i c s Anonymous. Gamblers Anonymous was created i n 1957 and, three years a f t e r t h a t , Overeaters Anonymous.- With the formation of these groups, the concept of a d d i c t i o n began to expand beyond anything but the most broad - and c o n t r o v e r s i a l -medical d e f i n i t i o n s . However, s c i e n t i f i c and medical 50 approval was not the only f a c t o r i n determining conceptions of a d d i c t i o n during t h i s p e r iod: between the 1950s and the 1960s the study of a d d i c t i o n had become i n c r e a s i n g l y fuzzy and t h e o r e t i c a l l y problematic, e s p e c i a l l y with the emergence of the idea t h a t c e r t a i n a c t i v i t i e s or processes were a d d i c t i v e , and expert consensus on these issues d i d not e x i s t . In a d d i t i o n , the founders and members of twelve-step groups placed an emphasis on the s u b j e c t i v e knowledge of the " a d d i c t " over medical knowledge and thus were s a t i s f i e d that a substance or a c t i v i t y was " a d d i c t i v e " i f an i n d i v i d u a l f e l t he or she had l o s t command over i t . In the 1970s, ideas about what s o r t s of things could be a d d i c t i v e expanded f u r t h e r . Twelve-step programs f o r r e l a t i o n s h i p " a d d i c t i o n s " such as Co-Dependents Anonymous and Adult C h i l d r e n of A l c o h o l i c s began to p r o l i f e r a t e f o l l o w i n g the discovery, i n f i e l d of neurobiology, of endorphins (Walters 1999: 4). I d e n t i f i e d as morphine-like substances secreted n a t u r a l l y by the human body, endorphins allowed researchers to l i n k drug-based a d d i c t i o n s more c l o s e l y to " a c t i v i t y " or "process" a d d i c t i o n s , and to suggest that the l a t t e r categories might very w e l l have a p h y s i o l o g i c a l b a s i s . Meanwhile, other a d d i c t i o n "experts" p o s i t e d the idea that a d d i c t i o n s e x i s t e d "when a person's 51 attachment to a sensation, an object, or another person i s such as to lessen h i s [ s i c ] a p p r e c i a t i o n of and a b i l i t y to deal w i t h other t h i n g s i n the environment, or i n himself, so that he has become i n c r e a s i n g l y dependent on that experience as h i s only source of g r a t i f i c a t i o n " (Peele 1975: 57). I D E N T I F Y I N G ALCOHOLUS With the expansion of the disease concept of a d d i c t i o n , i n d i v i d u a l s who engaged i n a broad range of "problematic" a c t i v i t i e s (which .included overindulgence i n otherwise acceptable substances or behaviours) came to be understood as being c o n s t i t u t i o n a l l y d i f f e r e n t - at l e a s t i n a vague sense - from those "normal" i n d i v i d u a l s who possessed the powers and immunities that allowed them to consume substances and perform a c t i v i t i e s without developing any sor t • of compulsion. Of course, i t was not a new idea that c o n s t i t u t i o n a l d i f f e r e n c e s were at the center of an explanation of de v i a t i o n s from normalcy; nor was i t the f i r s t time that p h y s i c i a n s and s c i e n t i s t s had attempted to l i n k c o n s t i t u t i o n a l d i f f e r e n c e s with deviant identities. M i c h e l Foucault, f o r example, documents the c o n s t r u c t i o n of the modern homosexual not as the subject of c e r t a i n acts and impulses, but as an i d e n t i t y , a new "s p e c i e s , " based on a 52 medical, p s y c h o l o g i c a l , and p s y c h i a t r i c c a t e g o r i e s , i n the l a t e nineteenth century (1990: 42). What perhaps was new, however, was the extent to which the deviant population (problem d r i n k e r s and, l a t e r , problem gamblers, problem eaters, etc.) a c t i v e l y p a r t i c i p a t e d i n the formation of t h e i r own speciated i d e n t i t i e s around a diseased s t a t e of being. I f Foucault c o n v i n c i n g l y argues that the p r e c i s e time and place of the " b i r t h " of the homosexual can be i d e n t i f i e d (cf. Foucault 1990: 42), one might argue that the b i r t h of the a l c o h o l i c (and, by extension, the addict) can s i m i l a r l y be p inpointed: I t was i n 1932, i n a New York h o s p i t a l , that B i l l Wilson conceived himself as a new so r t of i n d i v i d u a l , a new species that we might c a l l Homo Alcoholus, whose being was d i s t i n c t from normal i n d i v i d u a l s . And yes, he conceived himself; or was at l e a s t a p a r t i c i p a n t i n h i s conception, j u s t as h i s a l c o h o l i c progeny, m i l l i o n s of AA members and other a l c o h o l i c s , p a r t i c i p a t e i n t h e i r own ( r e ) b i r t h s . I t i s i n d i s p u t a b l e that medical, and psych discourses were an important f a c t o r i n these conceptions, of course; as we have seen, AA's views on alcoholism and a l c o h o l i c s developed out of d i s c u s s i o n s between Wilson and h i s p h y s i c i a n . And yet, as Valverde notes, i t was AA that " f i r s t succeeded i n 53 t u r n i n g a disease i n t o a f u l l - f l e d g e d , l i f e l o n g s o c i a l i d e n t i t y " (1998: 122). I t should be noted, as w e l l , that the notion of an a l c o h o l i c species and lineage suggested above i s not merely a metaphor; i t has assumed, with the (admittedly i n d e f i n i t e ) a p p l i c a t i o n of t h e o r i e s of genetic propagation and h e r e d i t y to problem d r i n k i n g , a l i t e r a l n e s s that allows i n d i v i d u a l s to t r a c e t h e i r a l c o h o l i s m through consanguineous r e l a t i o n s . In AA meetings, f o r example, I heard speakers a l l u d e to the f a c t t h a t , since one or another of t h e i r r e l a t i v e s had been a l c o h o l i c , i t was not s u r p r i s i n g that they themselves manifested the disease. And even i f one's a l c o h o l i s m cannot be d e f i n i t i v e l y t r aced through one's genealogy, i n AA discourse as w e l l as i n dominant conceptions of a l c o h o l i s m i n North America, i t i s w e l l accepted t h a t , because of c e r t a i n b i o l o g i c a l c h a r a c t e r i s t i c s , one simply i s an a d d i c t , or one i s not. "Neither," according to o f f i c i a l AA discourse, "does there appear to be any kind of treatment which w i l l make a l c o h o l i c s of our kind l i k e other men. [...] P h y s i c i a n s who are f a m i l i a r with a l c o h o l i s m agree there i s no such t h i n g as making a normal d r i n k e r out of an a l c o h o l i c " (AA 1976: 30-31). A f f i n i t y to one or the other of these groups does not change; and there i s no cure that 54 w i l l render an i n d i v i d u a l "normal;" hence the saying, common i n AA, "once an a l c o h o l i c , always an a l c o h o l i c . " Even a f t e r an extended pe r i o d of s o b r i e t y , or a f t e r the de s i r e to d r i n k has been extinguished as f a r as the AA member can t e l l , s/he remains a l c o h o l i c . And although there may be i n d i v i d u a l s who re t u r n to normal d r i n k i n g a f t e r a pe r i o d of s o b r i e t y , AA exp l a i n s these instances as cases of m i s i d e n t i f i c a t i o n ( i . e . , the i n d i v i d u a l was never a true a l c o h o l i c ) or, more fr e q u e n t l y , as cases of d e n i a l or s e l f -deception i n which a l c o h o l i c s t r y to pretend they are normal: i t i s w e l l understood i n AA that one of the dangers of a l c o h o l i s m i s the d e s i r e to be able e v e n t u a l l y to r e t u r n to d r i n k i n g . The temptation to attempt to l i v e "normally," to pass as a regu l a r d r i n k e r , however, i s as f u t i l e f o r a l c o h o l i c s as i t would be f o r a homosexual to pass as s t r a i g h t or a l i g h t - s k i n n e d i n d i v i d u a l of A f r i c a n descent to pass as Caucasian with the i n t e n t i o n of changing t h e i r i n t r i n s i c -natures. AA i s unequivocal i n the b e l i e f that "there must be no r e s e r v a t i o n of any kind, nor any l u r k i n g notion that we [ a l c o h o l i c s ] w i l l be immune to a l c o h o l " (AA 1976: 33) i f one i s to remain on the "road to recovery." This i s why the term "recovering a l c o h o l i c " rather than "recovered a l c o h o l i c " i s used to describe a l c o h o l i c s who 55 have stopped a c t i v e l y d r i n k i n g : complete recovery i s simply not p o s s i b l e f o r true a l c o h o l i c s . I f , i n the species of Homo Alcoholus, one can d i s t i n g u i s h " a c t i v e " a l c o h o l i c s from " r e c o v e r i n g " a l c o h o l i c s , t h i s i s a d i s t i n c t i o n of achieved i d e n t i t y (as opposed to the g e n e t i c a l l y or p h y s i o l o g i c a l l y a s c r i b e d i d e n t i t y of " a l c o h o l i c " ) . A c t i v e and recovering a l c o h o l i c s d i f f e r from one another only i n s o f a r as they are at d i f f e r e n t p o i n t s i n t h e i r l i f e course; the former continues to d r i n k while the l a t t e r has entered a stage of abstinence from a l c o h o l . S i m i l a r l y , the " p o t e n t i a l a l c o h o l i c " i s d i f f e r e n t i a t e d from other a l c o h o l i c s only to the extent that h i s or her al c o h o l i s m remains asymptomatic, that i t has not manifested i t s e l f through d r i n k i n g - r e l a t e d problems. Although there may be i n d i v i d u a l s who remain p o t e n t i a l a l c o h o l i c s a l l t h e i r l i v e s (for example, i n d i v i d u a l s who never consume a l c o h o l ) , most sooner or l a t e r e x h i b i t i n c i p i e n t symptoms that develop i n t o a c t i v e alcoholism. In the f i r s t chapter of Alcoholics Anonymous, AA co-founder B i l l Wilson t e l l s h i s own sto r y , the p l o t of which f o l l o w s a t y p i c a l progression i n the d r i n k i n g career of the a l c o h o l i c , from p o t e n t i a l a l c o h o l i s m to a c t i v e alcoholism. 56 As a young man, Wilson i s introduced to a l c o h o l during m i l i t a r y s e r v i c e , and soon dr i n k becomes a regu l a r part of hi s l i f e . At t h i s e a r l y stage he drin k s with and f o r pleasure, and does not no t i c e a d i f f e r e n c e between h i s own d r i n k i n g behaviour and that of others. (Writing r e t r o s p e c t i v e l y , however, as a recovering a l c o h o l i c , he declares himself to have been a p o t e n t i a l a l c o h o l i c at t h i s point.) A f t e r r e t u r n i n g home from s e r v i c e and beginning a career as a stockbroker, h i s alc o h o l i s m begins to r e v e a l i t s e l f i n the form of minor drunken episodes that r e s u l t i n m a r i t a l problems, disputes with f r i e n d s , and t r o u b l e s at work. Although he manages these i n c i d e n t s reasonably w e l l f o r a number of years, e v e n t u a l l y Wilson's d r i n k i n g becomes almost constant; c o n f l i c t s with h i s wife, f r i e n d s , and colleagues e s c a l a t e , and h i s drunkenness causes f i n a n c i a l hardship to descend upon h i s fami l y . In t h i s p e r i o d of a c t i v e a lcoholism, however, he s t i l l deceives himself as to the true reasons f o r h i s t r o u b l e s ; i t i s only on the b r i n k of d e s t i t u t i o n and with a i l i n g h e a l t h that he r e a l i z e s h i s problems are drinking problems. But despite f i e r c e determination to stop d r i n k i n g , each attempt at s o b r i e t y f a i l s miserably i n another drunken binge. He r e a l i z e s he has l o s t the a b i l i t y to c o n t r o l h i s d r i n k i n g . 57 Wilson's account of a c t i v e a l c o h o l i s m i s s i m i l a r to most AA members' s t o r i e s i n s o f a r as i t i s c h a r a c t e r i z e d by a twofold l a c k of c o n t r o l : the i n a b i l i t y to r e s i s t a l c o h o l ( i . e . , the " f i r s t drink") and, once having begun d r i n k i n g , the l o s s of c o n t r o l over himself and h i s behaviour. Loss of c o n t r o l i s so extreme i n most AA s t o r i e s that i t i s incomprehensible to anyone who, without r e a l i z i n g that a "strange i n s a n i t y " overtakes a l c o h o l i c s when they d r i n k , seeks to e x p l a i n the thoughts and actions of an a l c o h o l i c as those of a s t a b l e i n d i v i d u a l with a "normal" psychology. Even while acknowledging that some might object to the use of c a t e g o r i e s of psychosis to describe the a l c o h o l i c , the authors of Alcoholics Anonymous repeatedly r e i t e r a t e t h i s theme: "[W]e c a l l t h i s " - the i n a b i l i t y to stop d r i n k i n g despite the a n t i c i p a t i o n of serious negative consequences -" p l a i n i n s a n i t y . How can such a l a c k of p r o p o r t i o n , of the a b i l i t y to t h i n k s t r a i g h t , be c a l l e d anything else? [...] I t ' s strong language - but i s n ' t i t t r u e ? " (AA 1976: 37-38). While there are many other symptoms of a c t i v e alcoholism, AA does not s p e c i f y these i n any methodical system, such as the d i a g n o s t i c l i s t s i n medical manuals that are created to f a c i l i t a t e the i d e n t i f i c a t i o n of p a r t i c u l a r c o n d i t i o n s . In accordance with the c o n v i c t i o n that 58 a l c o h o l i s m i s a s u b j e c t i v e experience that cannot be recognized through i m p a r t i a l , h i e r a r c h i c a l observation, AA t e x t s provide only examples, rough sketches, and p a r t i a l d e s c r i p t i o n s of a c t i v e alcoholism that i n d i v i d u a l s who wonder i f they might be a l c o h o l i c can compare themselves t o . One can obtai n a general idea of AA's conception of the d i s t i n g u i s h i n g features of an a c t i v e a l c o h o l i c from reading Alcoholics Anonymous, but the authors themselves warn that while t h e i r d e s c r i p t i o n s should " i d e n t i f y him roughly," they do not present "a comprehensive p i c t u r e of the true a l c o h o l i c " (AA 1976: 22). Notwithstanding the authors' r e f u s a l to o f f e r an o b j e c t i v e d e f i n i t i o n of what an a l c o h o l i c i s or i s - not, a d i s t i n c t species of dr i n k e r emerges from the c h a r a c t e r i z a t i o n s that are o f f e r e d , a species separate from moderate and hard d r i n k e r s who, while perhaps d r i n k i n g e x c e s s i v e l y , can r e s i s t a l c o h o l when so requi r e d . In a key passage, the authors introduce t h e i r audience to Homo Alcoholus: Here i s the f e l l o w who has been p u z z l i n g you, e s p e c i a l l y i n h i s lack of c o n t r o l . He does absurd, i n c r e d i b l e , t r a g i c things while d r i n k i n g . He i s a r e a l Dr. J e k y l l and Mr. Hyde. He i s seldom m i l d l y 59 i n t o x i c a t e d . He i s always more or l e s s i n s a n e l y drunk. His d i s p o s i t i o n while d r i n k i n g resembles h i s normal nature but l i t t l e . He may be one of the f i n e s t f e l l o w s i n the world. Yet l e t him d r i n k f o r a day, and he f r e q u e n t l y becomes d i s g u s t i n g l y , and even dangerously a n t i - s o c i a l . He has a p o s i t i v e genius f o r g e t t i n g t i g h t at e x a c t l y the wrong moment, p a r t i c u l a r l y when some important d e c i s i o n must be made or engagement kept. He i s often p e r f e c t l y s e n s i b l e and w e l l balanced concerning everything except l i q u o r , but i n that respect he i s i n c r e d i b l y dishonest and s e l f i s h . He o f t e n possesses s p e c i a l a b i l i t i e s , s k i l l s , and a p t i t u d e s , and has a promising career ahead of him.- He uses h i s g i f t s to b u i l d up a b r i g h t outlook f o r h i s f a m i l y and himself, and then p u l l s the s t r u c t u r e down on h i s head by a senseless s e r i e s of sprees. He i s the f e l l o w who goes to bed so i n t o x i c a t e d he ought to sleep around the clock. Yet e a r l y next morning he searches madly f o r the b o t t l e he misplaced the night before. [...] As matters grow worse, he begins to use a combination of high-powered sedative and l i q u o r to q u i e t h i s nerves so he can go to work. [...] Then he 60 begins to appear at h o s p i t a l s . and sanitariums (AA 1976: 21-22). The p o r t r a y a l o f f e r e d here of a generic, a c t i v e a l c o h o l i c includes biases that are present throughout much of AA's l i t e r a t u r e , p a r t i c u l a r l y i n works published, l i k e the one c i t e d , i n the f i r s t few decades of the group's existence: The a l c o h o l i c i s a " f e l l o w " rather than a person who might be male or female; he i s a g i f t e d f a m i l y man with a b r i g h t outlook and a promising career ahead of him, and i s thus, i m p l i c i t l y , f u l l y able, heterosexual, m i d d l e - c l a s s , of working age. In a word, he i s "normal;" normal i n v i r t u a l l y every way save h i s alcoholism. Elsewhere, AA s t r e s s e s that a l c o h o l i s m a f f e c t s i n d i v i d u a l s i r r e s p e c t i v e of such demographic c h a r a c t e r i s t i c s as age, gender, c l a s s , and so on, and these biases seem to r e f l e c t the s o c i o - c u l t u r a l o v e r s i g h t s of the authors (who, f o r the most p a r t , d i d f i t the above d e s c r i p t i o n ) more than they i n d i c a t e any demographics AA g e n e r a l l y associates with alcoholism. Indeed, focusing p r i m a r i l y on the mental and moral c h a r a c t e r i s t i c s of a l c o h o l i c s - c h a r a c t e r i s t i c s that presumably transcend other b i o l o g i c a l and / or s o c i a l t r a i t s the above passage i s c o n s i s t e n t with AA's non-d i s c r i m i n a t i n g conception of alcoholism. 61 As the reader learns from the above d e s c r i p t i o n , the a c t i v e a l c o h o l i c i s d i f f i c u l t to understand without awareness that s/he i s addicted to a l c o h o l and cannot r e s i s t the compulsion to drin k . This, the i n a b i l i t y to ab s t a i n from a l c o h o l despite r e c o g n i t i o n of the f a c t that one i s i n f l i c t i n g i n j u r y on oneself and others, i s the primary symptom of a l c o h o l a d d i c t i o n . Once having begun a d r i n k i n g binge, an a c t i v e a l c o h o l i c w i l l l i k e l y continue consuming a l c o h o l i n l a r g e q u a n t i t i e s f o r days, weeks, or even months. Despite the memories of s u f f e r i n g and h u m i l i a t i o n that may have a r i s e n during former d r i n k i n g sprees, a l c o h o l i c s - f o r reasons even they do not know - take a d r i n k when the opportunity a r i s e s , only l a t e r to be f i l l e d w ith regret and remorse. The a b i l i t y to l e a r n from one's mistakes that even c h i l d r e n possess i s absent: "There i s a complete f a i l u r e of the type of defense that keeps one from p u t t i n g h i s hand on a hot stove" (AA 1976: 24). Alcoholism seems to produce many other s t a t e s i n i n d i v i d u a l s that i n d i c a t e immaturity or c h i l d i s h n e s s . Upon d r i n k i n g , a l c o h o l i c i n d i v i d u a l s are unable to f u l f i l l the expectations of t h e i r s o c i a l r o l e s and d u t i e s : they become a n t i - s o c i a l and unable to act p o l i t e l y , to consider the needs of others, to f u n c t i o n r e s p o n s i b l y at work, to care f o r fa m i l y members, or even to care f o r 62 themselves. This i s not, however, j u s t a lack of p s y c h o l o g i c a l development, i t i s a moral immaturity as w e l l ; elsewhere i n Alcoholics Anonymous the reader learns that a l c o h o l i c s are prone to such d e f i c i e n c i e s i n character as s e l f i s h n e s s , l a z i n e s s , senselessness, s e l f - p i t y , depression, and i r r a t i o n a l f e a r . While general d e s c r i p t i o n s of a c t i v e a l c o h o l i s m suggest that there might be some o b j e c t i v e b a s i s f o r i d e n t i f y i n g a l c o h o l i c s , the authors exhort t h e i r audience to r e s i s t l a b e l i n g any i n d i v i d u a l as such, no matter how problematic an i n d i v i d u a l ' s d r i n k i n g behaviour may be. Despite the f a c t that " [ i ] n a vague way t h e i r f a m i l i e s and f r i e n d s sense that these d r i n k e r s are abnormal" (AA 1976: 23), a l c o h o l i c s themselves are often much slower to acknowledge t h i s d i f f e r e n c e . And since many i n d i v i d u a l s s t r o n g l y oppose such an i d e n t i f i c a t i o n (at l e a s t i n i t i a l l y ) , i t i s often counterproductive to suggest to a problem d r i n k e r that s/he may be an a l c o h o l i c . S e l f - i d e n t i f i c a t i o n as an a l c o h o l i c i s u s u a l l y , according to general AA wisdom, an arduous and drawn out process, because "[m]any who are r e a l a l c o h o l i c s are not going t o b e l i e v e they are i n that c l a s s . By every form of s e l f - d e c e p t i o n and experimentation, they w i l l t r y to 63 prove themselves exceptions to the r u l e , t h e r e f o r e n o n a l c o h o l i c " (AA 1976: 31). Although i t may take years before a l c o h o l i c s begin to fathom t h e i r d i f f e r e n c e from normal d r i n k e r s , they are e v e n t u a l l y l i k e l y to be brought i n t o contact with AA by pressure from one or more sources. For example, f a m i l y members often exhort t h e i r loved ones who dri n k p r o b l e m a t i c a l l y to "get help;" A l c o h o l i c s Anonymous members are f r e q u e n t l y approached by d i s t r e s s e d parents, spouses, and c h i l d r e n of suspected a l c o h o l i c s . Health p r o f e s s i o n a l s may a l s o recommend AA as the best chance f o r recovery to i n d i v i d u a l s who d r i n k h e a v i l y and begin to s u f f e r a l c o h o l -r e l a t e d h e a l t h problems. More coercive means may be used to convince problem d r i n k e r s to consider AA as w e l l : i f d r i n k i n g i s causing a decrease i n p r o d u c t i v i t y , unacceptably high rates of absenteeism, or accidents i n the workplace, an employer may present the problematic i n d i v i d u a l with a choice between termin a t i o n or p a r t i c i p a t i o n i n AA meetings. J u r i d i c a l f o r c e , too, may compel someone to attend AA meetings; i n many North American l e g a l j u r i s d i c t i o n s , an i n d i v i d u a l a r r e s t e d and convicted on d r i n k i n g - r e l a t e d offenses such as impaired d r i v i n g or p u b l i c drunkenness 64 might have mandatory attendance of AA meetings included i n hi s or her sentence. Regardless of the means through which i n d i v i d u a l s come i n t o contact with AA, A l c o h o l i c s Anonymous recognizes that many react to t h e i r i n i t i a l exposure t o the o r g a n i z a t i o n ' s p r i n c i p l e s and ideas with i n d i f f e r e n c e , amusement, annoyance, or even h o s t i l i t y . In such cases, AA members g e n e r a l l y agree that i t i s best to not make contact with the "prospects" again u n t i l a l a t e r time when they are more re c e p t i v e to the ideas of the o r g a n i z a t i o n . I n d i v i d u a l s who are " t r u e " a l c o h o l i c s - the type AA seeks to help - sooner or l a t e r f i n d themselves i n s i t u a t i o n s of such desperation or hopelessness that they w i l l " h i t bottom" and a f f i r m that they want to q u i t d r i n k i n g f o r good and w i l l go to any length to do so. At that p o i n t , AA members w i l l r e l a t e t h e i r own experiences and i n t e r p r e t a t i o n s , w i t h the assumption that true a l c o h o l i c s w i l l recognize s i m i l a r i t i e s between t h e i r own d r i n k i n g and " a l c o h o l i c " d r i n k i n g ; and that they have many, i f not a l l , of the t r a i t s of an a l c o h o l i c . Such outcomes as the one below, described by a heavy d r i n k e r who had been approached by AA members while undergoing h o s p i t a l treatment, i s c h a r a c t e r i s t i c of the so r t of r e s u l t s AA members hope f o r : 65 Two members of A l c o h o l i c s Anonymous came to see me. They grinned, which I didn't l i k e so much, and then asked me i f I thought myself a l c o h o l i c and i f I were r e a l l y l i c k e d t h i s time. I had to concede both p r o p o s i t i o n s . They p i l e d on me heaps of evidence to the e f f e c t that an a l c o h o l i c m e n t a l i t y , such as I had e x h i b i t e d [...], was a hopeless c o n d i t i o n . They c i t e d cases out of t h e i r own experience by the dozen. This process snuffed out the l a s t f l i c k e r of c o n v i c t i o n that I could do the job [ q u i t t i n g d r i n k i n g ] myself (AA 1976: 42) . Although during h i s f i r s t contact with an AA member the man refused to b e l i e v e that he was an a l c o h o l i c , that he could not c o n t r o l h i s d r i n k i n g , e v e n t u a l l y he "had" to admit h i s c o n d i t i o n . As with most i n d i v i d u a l s who are contacted by AA members and e v e n t u a l l y adopt the i d e n t i t y of a l c o h o l i c , he was not forced or b u l l i e d i n t o admitting h i s alcoholism, but was presented with a case so persuasive that he could not dismiss i t . The i n f l u e n c e of AA members depends i n part on t h e i r well-apparent s i n c e r i t y and on the confidence they d i s p l a y of t h e i r c o n v i c t i o n s ; most AA members seem to have very l i t t l e doubt i n the v e r a c i t y of t h e i r views of the nature of 66 a l c o h o l i s m as w e l l as a genuine d e s i r e to help others they perceive to be a l c o h o l i c . However, success i n convincing problem d r i n k e r s to "concede" t h e i r a l c o h o l i s m i s most i n t i m a t e l y bound up with AA members' a b i l i t i e s to create an a l c o h o l i s m frame, a set of ideas, symbols, and l i n g u i s t i c devices that i n d i v i d u a l s can use to i n t e r p r e t t h e i r own d r i n k i n g behaviour. Hearing experiences of drunkenness that they w e l l recognize being presented and explained i n terms of alcoholism, AA "prospects" may be more l i k e l y to i n t e r p r e t t h e i r own d r i n k i n g i n s i m i l a r terms and to consider the p o s s i b i l i t y that the shared experiences of problem d r i n k i n g stem from a shared c o n d i t i o n of alcoholism. At such a p o i n t , they w i l l probably accept a copy of Alcoholics Anonymous to read and / or agree to attend an AA meeting. The f i r s t AA meeting newcomers g e n e r a l l y attend i s an open meeting, which i s the predominant meeting format i n AA. (Closed meetings, which are only attended by AA members, often focus on s p e c i f i c i s s u e s , such as working a p a r t i c u l a r Step of the program.) Although there i s s u b t l e v a r i a t i o n from group to group on the o r g a n i z a t i o n and content of open meetings, most elements are included as part of a more or l e s s standard p r a c t i c e . A meeting w i l l u s u a l l y begin with a 67 reading of the f i r s t few pages of Chapter 5 of Alcoholics Anonymous, "How I t Works," i n which the Twelve Steps are presented and w i l l f o l l o w with a b r i e f d i s c u s s i o n of t e c h n i c a l or o r g a n i z a t i o n a l matters and then an i n v i t a t i o n f o r newcomers - whether they consider themselves a l c o h o l i c s or not - to introduce themselves by t h e i r f i r s t names. The vast m a j o r i t y of meeting time, however, i s dedicated to opening the f l o o r t o any i n d i v i d u a l s who wish t o speak about t h e i r experiences with a l c o h o l and / or alcoholism. I t i s l a r g e l y through hearing the r h e t o r i c a l p r a c t i c e s of these speakers that prospective members l e a r n to define themselves with the permanent, u n i t a r y disease of a l c o h o l i s m ( A l a s u u t a r i 1992; O ' R e i l l y 1997). Speakers at open AA meetings almost u n i v e r s a l l y f o l l o w a s t r u c t u r e d p a t t e r n , r e f e r r e d to as " t e l l i n g one's s t o r y , " that i s r e a d i l y apparent to even the casual observer and that adheres to a normative a u t o b i o g r a p h i c a l format i n which i n d i v i d u a l s ' l i v e s are organized i n t o periods d i s t i n g u i s h e d from one another by the speaker's changing r e l a t i o n s h i p with a l c o h o l . Thus, by example, i n d i v i d u a l s l e a r n to formulate t h e i r l i v e s as a s e r i e s of events that are brought about by the mani f e s t a t i o n s of a l c o h o l i s m (whether those events might have been experienced as such at the time or not). 68 Presented i n a s o r t of three-act play, AA members' s t o r i e s p o s i t i o n a l c o h o l as an e s s e n t i a l o r g a n i z i n g element i n t h e i r past, present, and future l i f e events. In Act I, the speaker r e l a t e s the "bad o l d days," p o r t r a y i n g l i f e as an a l c o h o l i c mired by d r i n k i n g - r e l a t e d problems; t h i s often i n c l u d e accounts of " l i v i n g i n d e n i a l " - of r e f u s i n g to acknowledge one's d r i n k i n g problem. In Act I I the a l c o h o l i c , a f t e r " h i t t i n g bottom," poised on the verge of d e s t r u c t i o n , reaches a t u r n i n g point that p r e c i p i t a t e s h i s or her entrance i n t o AA. F i n a l l y , i n Act I I I , the speaker t e l l s of h i s or her " r e t u r n to grace" and of how i t was achieved through complete abstinence from a l c o h o l and through working the Twelve Steps of A l c o h o l i c s Anonymous. In one of the s t o r i e s featured i n Alcoholics Anonymous c h a r a c t e r i z e d by a t y p i c a l n a r r a t i v e denouement, a promising young man begins d r i n k i n g u n p r o b l e m a t i c a l l y a f t e r h i s pregnant wife i s p r e s c r i b e d a d a i l y glass of beer. Soon afterwards, as Act I opens, h i s d r i n k i n g has become excessive, h i s l i f e wrought with d i f f i c u l t i e s : [...] I had no f r i e n d s . I didn't care to go v i s i t i n g unless the p a r t i e s we might v i s i t had p l e n t y of l i q u o r on hand and I could get drunk. Indeed, I was always 69 w e l l on my way before I would undertake to go v i s i t i n g at a l l . A f t e r holding good p o s i t i o n s , making b e t t e r than an average income f o r over ten years, I was i n debt, had no clothes to speak of, no money, no f r i e n d s , and no one any longer t o l e r a t i n g me but my w i f e . My son had a b s o l u t e l y no use f o r me. Even some of the saloon-keepers, where I had spent so much time and money, requested that I stay away from t h e i r places. F i n a l l y , an o l d business acquaintance of mine, whom I hadn't seen f o r s e v e r a l years o f f e r e d me a job. I was on that job f o r a month and drunk most of the time (AA 1976: 301) . Here, the s t o r y of a c t i v e a l c o h o l i s m i s t o l d . The t u r m o i l he experienced because of h i s f a i l u r e to meet personal, s o c i a l , and economic expectations i s a s c r i b e d to a preoccupation with a l c o h o l . His f i r s t concern, above s o c i a l i z i n g with f r i e n d s , parenting h i s c h i l d , or f i n a n c i a l l y supporting himself and h i s f a m i l y , i s to get drunk. A l c o h o l t a i n t s a l l aspects of h i s existence - and those around him - as he e x h i b i t s the immature, s e l f i s h q u a l i t i e s common to i n d i v i d u a l s of a l c o h o l i c s . 70 In Act I I , the man describes how he was brought i n t o contact with AA: Just at t h i s time my wife heard of a doctor i n another c i t y who had been very s u c c e s s f u l with drunks. She o f f e r e d me the a l t e r n a t i v e of going to see him or her l e a v i n g me f o r good and a l l . Well ... I had a job, and I r e a l l y wanted desperately to stop d r i n k i n g , but couldn't, so I r e a d i l y agreed to v i s i t the doctor she recommended. That was the t u r n i n g point of my l i f e . My wife accompanied me on my v i s i t and the doctor r e a l l y t o l d me some things that i n my s t a t e of j i t t e r s n e a r l y knocked me out of my c h a i r . He t a l k e d about himself, but I was sure i t was about me. He mentioned l i e s and deceptions i n the course of h i s s t o r y i n the presence of the one person i n the world I wouldn't want to know such t h i n g s . How d i d he know a l l t h i s ? I had never seen him before, and at the time hoped I would never see him again. However, he explained to me that he had been j u s t such a rummy as I, only f o r a much longer p e r i o d of time. He advised me to enter the p a r t i c u l a r h o s p i t a l with which he was connected and I r e a d i l y agreed. In 71 a l l honesty though, I was s k e p t i c a l , but I wanted so d e f i n i t e l y to q u i t d r i n k i n g that I would have welcomed any s o r t of p h y s i c a l t o r t u r e or pain to accomplish the r e s u l t . [-.] A f t e r being i n the h o s p i t a l f o r s e v e r a l days, a plan of l i v i n g [AA's twelve step program], was o u t l i n e d to me (AA 1976: 301-302). On the verge of d e s t r u c t i o n , the a l c o h o l i c here i s confronted with a Faustian d e c i s i o n : to s a c r i f i c e h i s soul f o r a dr i n k , to chose a path to mental, p h y s i c a l , and economic r u i n ; or to chose, f o r h i s wife, h i s c h i l d r e n , and h i s own s a l v a t i o n , to q u i t d r i n k i n g . However, the decision to seek a s s i s t a n c e f o r a d r i n k i n g problem i s not the f a t e f u l , l i f e - d e f i n i n g moment; many i n d i v i d u a l s with d r i n k i n g problems decide to q u i t d r i n k i n g only t o begin again s h o r t l y afterwards. The p i v o t a l i n s t a n t i s the moment of r e c o g n i t i o n when he hears " h i s s t o r y " being t o l d by another i n d i v i d u a l ( i n t-h i s case, by h i s own doctor) ; that i s when he r e a l i z e s that the st o r y of the a l c o h o l i c i s i n f a c t h i s own st o r y . He does not simply i d e n t i f y with the character of the s t o r y of the a l c o h o l i c , he i d e n t i f i e s himself as the character, as the a l c o h o l i c . This moment of 72 r e c o g n i t i o n i s a l s o a moment of r e - c o g n i t i o n : as he develops se l f - c o n s c i o u s n e s s , or consciousness of h i s a l c o h o l i c s e l f , he begins to t h i n k h i s d r i n k i n g , h i s l i f e , and h i s experiences anew - as those of an alcoholic. The f i n a l act, Act ( I I I ) , s h i f t s to the present tense to depict the b l e s s i n g s that the recovering a l c o h o l i c now enjoys as a r e s u l t of working the AA program: I t i s impossible to put on paper a l l the b e n e f i t s I have derived ... p h y s i c a l , mental, domestic, s p i r i t u a l , and monetary. This i s no i d l e t a l k . I t i s the t r u t h . From a p h y s i c a l standpoint, I gained s i x t e e n pounds i n the f i r s t two months I was o f f l i q u o r . I eat three good meals a day now, and r e a l l y enjoy them. I sleep l i k e a baby, and never give a thought to such a t h i n g as insomnia. I f e e l as I d i d when I was f i f t e e n years younger. Mentally... I know where I was l a s t night, the night before, and the nights before t h a t . A l s o , I have no fear of anything. I have s e l f confidence and assurance [•••] • From a domestic standpoint, we r e a l l y have a home now. My wife i s glad to see me come i n . My youngster has adopted me [...] . 73 S p i r i t u a l l y ... I found a Friend who never l e t s me down and i s ever eager to help. I can a c t u a l l y take my problems to Him and He gives comfort, peace, and happiness. From a monetary standpoint ... i n the past few years, I have reduced my r e c k l e s s debts to almost nothing, and have had money to get along on comfortably. I s t i l l have my job, and j u s t p r i o r to the w r i t i n g of t h i s n a r r a t i v e , I received an advancement (AA 1976: 303). As a r e s u l t of h i s re-conception as an a l c o h o l i c , h i s r e b i r t h as Homo Alcoholus, and h i s entry i n t o AA, the na r r a t o r has experienced a new beginning, a new l i f e of complete s a t i s f a c t i o n that was only achieved by embracing (rather than denying) h i s alcoholism. His fortunes, as a recovering a l c o h o l i c , are s c a r c e l y short of miraculous, and too numerous to l i s t ; he i s a blessed s o u l . With the c o n s t r u c t i o n of h i s l i f e s t o r y according to the AA recovery format, AA members i n e x t r i c a b l y l i n k a l c o h o l i s m to conceptions of t h e i r selves so that even when they' are freed from d r i n k i n g problems, i t remains the c e n t r a l o r g a n i z i n g element of t h e i r e x i s t e n c e . In the passage above, the na r r a t o r ' s l i f e i s thought of i n terms 74 of, and understood to be determined by, h i s r e l a t i o n s h i p to a l c o h o l : d r i n k i n g , he was underweight and could not sleep p r o p e r l y ; sober, he i s w e l l nourished and w e l l rested. A l c o h o l caused him memory problems and i r r a t i o n a l f e a r s ; a b s t i n e n t , he i s mentally sound and s e l f - a s s u r e d . As a drunk, domestic t e n s i o n almost destroyed h i s f a m i l y ; as a recovering a l c o h o l i c , he i s surrounded by love and respect. Formerly, he had no s p i r i t u a l i t y to speak of; now, as a member of AA, he has discovered a Higher Power and found s p i r i t u a l peace. And whereas he used to have d i f f i c u l t y h o l d i n g onto jobs and p r o v i d i n g f o r himself and h i s f a m i l y , a l c o h o l - f r e e he i s a model employee, earning promotions and a good income. For him, as f o r many AA members, al c o h o l i s m becomes a master s t a t u s , c o l o u r i n g a l l other i d e n t i t i e s i n a s i m i l a r hue (e.g., an a l c o h o l i c husband, an a l c o h o l i c employee, an a l c o h o l i c parent). Thus, the well-known, standard i n t r o d u c t i o n used i n AA meetings, "My name i s — and I'm an a l c o h o l i c " i s not j u s t a banal i n t r o d u c t i o n that members u t t e r at the beginnings of meetings (although i t i s that as well) ; i t i s a l s o a d e c l a r a t i o n of s e l f and a pr e s e n t a t i o n of information that i s e s s e n t i a l f o r ' a true understanding of most aspects of the i n d i v i d u a l s ' l i v e s . 75 A l c o h o l i s m not only has a tendency to overr i d e other c h a r a c t e r i s t i c s w i t h i n i n d i v i d u a l s , i n t e g r a t i n g m u l t i p l e aspects of selfhood i n t o more or l e s s u n i f i e d a l c o h o l i c i d e n t i t i e s ; i t al s o overrides d i f f e r e n c e s between i n d i v i d u a l s . For many AA members, al c o h o l i s m i s such a c e n t r a l o r g a n i z i n g aspect of t h e i r existence that they can i d e n t i f y with other a l c o h o l i c s regardless of d i f f e r e n c e s i n race, gender, age, or c l a s s . One AA member's d e c l a r a t i o n that "I'm enough of an a l c o h o l i c that I, that there's j u s t got to be some common ground between me and anybody e l s e who's an a l c o h o l i c somewhere" (O ' R e i l l y 1997: 144), a t t e s t s to the a f f i n i t y between a l c o h o l i c s as i n h e r e n t l y s i m i l a r i n d i v i d u a l s who face s i m i l a r problems and s i t u a t i o n s , share common i d e a l s and goals, and recognize themselves i n each other. Thus, p a r a l l e l i n g and r e s u l t i n g from discourses on a d d i c t i o n and al c o h o l i s m that o r i g i n a t e d i n the mid-nineteenth century and developed through the d i s c u r s i v e i n t e r a c t i o n s of s c i e n t i s t s , medical experts, t h e r a p i s t s , and problem d r i n k e r s , a new c l a s s i f a c t o r y s p e c i f i c a t i o n , a new "s p e c i e s , " emerged. I n d i v i d u a l s whose overindulgence i n dr i n k had p r e v i o u s l y been considered i n terms of episodes and temporary lapses i n moral character, have become 76 alcoholics, whose natures are e s s e n t i a l l y ' s i m i l a r to one another and e s s e n t i a l l y d i f f e r e n t from normal d r i n k e r s (at l e a s t i n the most fundamental r e s p e c t s ) . As a r e s u l t of the "disco v e r y " of t h i s d i f f e r e n c e , and of the s o l i d i f i c a t i o n and d i f f u s i o n of the disease conception of a l c o h o l a d d i c t i o n i n which i n d i v i d u a l s ' mysterious b i o l o g y or physiology e x p l a i n s t h e i r compulsions to dr i n k (experts have so f a r not been able to s p e c i f y the reasons f o r the divergence of the a l c o h o l i c from the normal d r i n k e r ) , the i d e n t i f i c a t i o n of addic t s - both the i d e n t i f i c a t i o n of a species of divergent i n d i v i d u a l s and the subsequent s e l f - i d e n t i f i c a t i o n of i n d i v i d u a l s as that species - emerged. This discovery, too, ne c e s s i t a t e d the development a whole apparatus of governance to detect, c o n t r o l , and regulate a l c o h o l i c s , of which AA's program formed an i n t e g r a l p a r t . 77 CHAPTER III: THE GOVERNANCE OF ALCOHOLISM IN AA AA'S TWELVE STEPS: THE CONSTITUTION OF SUBJECTIVITY Since i t s beginnings i n the l a t e 1930s, A l c o h o l i c s Anonymous has declared i t s e l f to have no other purpose than to a s s i s t i n d i v i d u a l s i n recovering from alcoholism. Whereas temperance a c t i v i s t s sought to e l i m i n a t e the production, s a l e , and consumption of a l c o h o l i n order to prevent the r u i n of American s o c i e t y , d i s c u s s i o n of a l c o h o l by AA members never i n any o f f i c i a l context i n c l u d e s a condemnation of d r i n k i n g behaviour on a general, s o c i e t y -wide b a s i s . I t i s only the d r i n k i n g behaviour of a l c o h o l i c s that AA endeavours to regul a t e , since the d r i n k i n g of "normal" i n d i v i d u a l s does not need s p e c i a l management or c o n t r o l (indeed, f o r AA the l a t t e r i s the i d e n t i f y i n g c h a r a c t e r i s t i c of normal d r i n k i n g ) . A l c o h o l i c s Anonymous then, has l i m i t e d i t s a c t i v i t i e s to the development and teaching of a pragmatic, i n d i v i d u a l i s t i c approach to de a l i n g with problems r e l a t e d to a l c o h o l . Given that a l c o h o l i s m i s constructed i n AA discourse as a c o n d i t i o n which i s both medical and s p i r i t u a l / moral, i t should perhaps not be s u r p r i s i n g that AA's i s a hy b r i d program, c o n t a i n i n g d i v e r s e elements of treatment. The 78 standard medical p r e s c r i p t i o n f o r alc o h o l i s m i s , simply put, not to dr i n k . A l c o h o l i c Anonymous l i t e r a t u r e f r e q u e n t l y repeats t h i s information, and almost as f r e q u e n t l y c i t e s one or another statement of the American Medical A s s o c i a t i o n i n con f i r m a t i o n . However, f o r most i n d i v i d u a l s who i d e n t i f y as a l c o h o l i c s , and e s p e c i a l l y f o r AA members, "not d r i n k i n g " a l c o h o l i s not i n f a c t a simple matter of choice. Although a r e a l d e s i r e to stop d r i n k i n g i s an absolute n e c e s s i t y , true s o b r i e t y i n AA requires an e n t i r e plan f o r l i v i n g a l c o h o l - f r e e , a framework of e t h i c a l self-governance f o r f o r t i f y i n g a l c o h o l i c s against temptation and habi t on a perpetual b a s i s . AA's concept of s p i r i t u a l i t y has generated considerable debate among AA members, as w e l l as among academics, who seek to c l a s s i f y AA as - or d i s t i n g u i s h i t from - a r e l i g i o u s o r g a n i s a t i o n . S e t t i n g s p e c i f i c t h e o l o g i c a l questions aside, t h i s study i n v e s t i g a t e s the s p i r i t u a l elements of AA i n s o f a r as they are pursued as a resource f o r recovering from alcoholism. S p i r i t u a l i t y i s sought by AA members, of course; but i t i s sought with, a u t i l i t a r i a n purpose, as a means of c r e a t i n g a s t a t e of peace and s e r e n i t y i n which the a l c o h o l i c can lead not only an a l c o h o l - f r e e l i f e , but a l i f e of complete f u l f i l m e n t and 79 happiness. Indeed, the s p i r i t u a l elements of AA's program can be u s e f u l l y conceptualised as part of a quest f o r what might be c a l l e d an e t h i c a l existence. Members of AA, l i k e c i t i z e n s i n C l a s s i c a l a n t i q u i t y who p r a c t i s e d the " a r t s of ex i s t e n c e " (cf. Foucault 1985), pursue i n t e n t i o n a l , purposive a c t i o n s that adhere to c e r t a i n r u l e s of conduct i n hopes of transforming themselves i n such a way that they are brought c l o s e r to an i d e a l mode of being. The Twelve Steps of AA, and the e n t i r e volume Alcoholics Anonymous (as w e l l as the many other p u b l i c a t i o n s of A l c o h o l i c s Anonymous) were composed as p r a c t i c a l t e x t s i n the 1930s so that the experiences and achievements of e a r l y AA members could be put to use by other i n d i v i d u a l s . Along with a number of other o f f i c i a l t e x t s , i t puts f o r t h g u i d e l i n e s , suggests c e r t a i n courses of a c t i o n , and exp l a i n s techniques and p r a c t i c e s that a l c o h o l i c i n d i v i d u a l s may s e l e c t or d i s c a r d as they attempt to transform themselves and t h e i r everyday conduct. Thus, beginning an a n a l y s i s of AA's recovery program i n terms of techniques of the s e l f , of methods of self-improvement and s e l f - t r a n s f o r m a t i o n , allows us to ft. capture elements of c o n t i n u i t y i n the management and r e g u l a t i o n of d e s i r e from the C l a s s i c a l and e a r l y C h r i s t i a n eras through to contemporary times. 80 But while t h i s transformation i s undertaken by AA members on an e t h i c a l b a s i s , as a p u r s u i t of an existence i n which t h e i r own a c t i v i t i e s and behaviours become c o n s i s t e n t with personal values and p r i n c i p l e s of l i v i n g w e l l , the program a l s o engenders s i g n i f i c a n t d i s c i p l i n a r y d i s p o s i t i v e s , most notable of which are the normalizing / deviance-reducing logos of AA and the s o c i a l / i n s t i t u t i o n a l pressures brought to bear on problem d r i n k e r s . The a l c o h o l i c subject who has achieved s o b r i e t y i n AA becomes more d i s c i p l i n e d , more s e l f -c o n t r o l l e d , of course, but als o more d o c i l e , more employable, and more f u n c t i o n a l . We can see evidence of at l e a s t an i m p l i c i t awareness of t h i s dual process i n A l c o h o l i c s Anonymous' own d e s c r i p t i o n of i t s Twelve Steps as "a group of p r i n c i p l e s , s p i r i t u a l i n nature, which i f p r a c t i s e d as a way of l i f e , can expel the obsession to dr i n k and enable the s u f f e r e r to become hap p i l y and u s e f u l l y whole" (AA 1953: 15) . Working the AA program, i n d i v i d u a l s becomes not only happy - content with themselves, with t h e i r l i v e s , with t h e i r existence - but al s o useful, more able to serve a s o c i a l purpose, to co n t r i b u t e to the w e l l being of themselves, t h e i r f a m i l i e s , t h e i r employers and t h e i r s o c i e t y . 81 The centrepiece of AA's program of recovery i s the Twelve Steps of A l c o h o l i c s Anonymous. These steps are included i n Alcoholics Anonymous and many other AA p u b l i c a t i o n s , d i s p l a y e d on posters and w a l l hangings i n community centres, churches, and rented h a l l s , and even p r i n t e d on t - s h i r t s : 1. We admitted we were powerless over a l c o h o l - that our l i v e s had become unmanageable. 2. Came to b e l i e v e that a Power greater than ourselves could r e s t o r e us to s a n i t y . 3. Made a d e c i s i o n to turn our w i l l and our l i v e s over to the care of God as we understood Him. 4. Made a searching and f e a r l e s s moral inventory of ourselves. 5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 6. Were e n t i r e l y ready to have God remove a l l these defects of character. 7. Humbly asked Him to remove our shortcomings. 8. Made a l i s t of a l l the persons we had harmed, and became w i l l i n g to make amends to them a l l . •9. Made d i r e c t amends to such people wherever p o s s i b l e , except when to do so would i n j u r e them or others. 10. Continued to take personal inventory and when we were wrong promptly admitted i t . 11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only f o r knowledge of His w i l l f o r us and the power to car r y that out. 82 12. Having had a s p i r i t u a l awakening as the r e s u l t of these steps, we t r i e d to ca r r y t h i s message to a l c o h o l i c s , and to p r a c t i c e these p r i n c i p l e s i n a l l our a f f a i r s . These steps, l i k e most AA t e x t s , are presented i n the c o l l e c t i v e "we" of A l c o h o l i c s Anonymous and e x p l i c i t l y embody the experiences of "hundreds of thousands" of a l c o h o l i c s who have stopped d r i n k i n g . Though the requirements of the Twelve Steps may i n i t i a l l y seem i n t i m i d a t i n g , the AA authors assure the reader that the program can be followed by a l l but a few i n d i v i d u a l s , those who are " c o n s t i t u t i o n a l l y incapable of being honest with themselves" and are "incapable of grasping and developing a manner of l i v i n g which requires rigorous honesty" (AA 1976: 58). Even those who can derive b e n e f i t from AA, however, should not expect a recovery free from obstacles and temporary setbacks; acknowledging that "No one among us has been able to maintain anything l i k e p e r f e c t adherence to these p r i n c i p l e s , " the AA members cla i m " s p i r i t u a l progress ra t h e r than s p i r i t u a l p e r f e c t i o n " (AA 1976: 60). Thus, "working the program" i n AA i n v o l v e s more than simply remaining sober; indeed, a b s t a i n i n g from a l c o h o l i s only a s t a r t i n g p o i n t . Members of AA " f e e l a man i s 83 unthinking when he says s o b r i e t y i s enough" (AA 1976: 82), since s o b r i e t y i s understood to be a f l e e t i n g c o n d i t i o n , a temporary r e p r i e v e from one's alcoholism. Although a l c o h o l i c s might not d r i n k on one day, they may the next -and l i k e l y w i l l , i f they have not e s t a b l i s h e d a system of t o t a l s e l f - c a r e that c o n s t a n t l y monitors for- f e e l i n g s , thoughts, a t t i t u d e s or sta t e s of being that might lead them back to dr i n k . Accordingly, the Twelve Steps of AA are designed to produce i n a l c o h o l i c s a " t o t a l psychic change" and to e s t a b l i s h new s p i r i t u a l and e t h i c a l e x istences. Working the Twelve Steps, AA members work toward t h e i r own s a l v a t i o n , b u i l d i n g up v i r t u e through regimes of s e l f -governance and d e l i v e r i n g themselves from the " h e l l on ea r t h " of a c t i v e a l c o h o l i s m to the (worldly) paradise of recovery. In a very r e a l sense, then, AA members are i m p l i c a t e d i n a system of p a s t o r a l power which assumes as i t s u l t i m a t e object not the problem d r i n k e r s ' consumption of a l c o h o l , but the soul of the a l c o h o l i c . This system, which, as we w i l l see, r e l i e s on and deploys d i s c i p l i n a r y technologies, techniques of the s e l f , and at times even brute f o r c e , w i l l now be examined i n some depth, as we analyze the Twelve Steps of AA according to t h e i r thematic and p r a c t i c a l 84 o r g a n i z a t i o n : Steps One through Three i n v o l v e c r e a t i n g a s p i r i t u a l f o u n d a t i o n f o r t h e program o f work, e s p e c i a l l y t h r o u g h the development o f a r e l a t i o n s h i p w i t h a " h i g h e r power;" Steps Four t h r o u g h Seven c o n c e r n the a l c o h o l i c ' s r e l a t i o n s h i p w i t h him- or h e r s e l f , t he p u r s u i t of s e l f -knowledge and s e l f - c a r e t h r o u g h p r a c t i c e s d i r e c t e d a t the a l c o h o l i c ' s s o u l ; Steps E i g h t and Nine e n t a i l w o r k i n g on t h e a l c o h o l i c ' s r e l a t i o n s h i p s w i t h o t h e r i n d i v i d u a l s t h r o u g h t e c h n i q u e s o f e x p i a t i o n ; and Steps Ten thr o u g h Twelve s y s t e m a t i z e Twelve-Step work i n t o a p e r p e t u a l regime of d a i l y a c t i v i t y . The f i r s t o f t h e Twelve Steps {We admitted we were powerless over alcohol - that our lives had become unmanageable) s t a t e s and a f f i r m s members' i n a b i l i t y t o c a r e f o r t h e m s e l v e s . A c t i v e a l c o h o l i c s a r e p o w e r l e s s t o c o n t r o l t h e i r own l i v e s , t o c a r r y on day-to-day l i v i n g as normal i n d i v i d u a l s do, and t h i s impotency i s t r a c e d t o t h e do m i n a t i o n of t h e i r t h o u g h t s and a c t i v i t i e s by a l c o h o l . A l c o h o l i s p e r s o n i f i e d or r e i f i e d here (and elsewhere i n AA) , a t t r i b u t e d w i t h c h a r a c t e r i s t i c s t h a t make i t a f o r m i d a b l e opponent: "Remember t h a t we d e a l w i t h a l c o h o l — , " i n d i v i d u a l s a r e warned, "cunning, b a f f l i n g , p o w e r f u l ! " (AA 1976: 58-59). A l c o h o l i c s a r e Davids a g a i n s t a G o l i a t h , t he 85 odds are stacked against them, and alone - without any t o o l s or weapons and r e l y i n g only on themselves - they are doomed to defeat: "Our human resources, as marshaled by the w i l l , were not s u f f i c i e n t ; they f a i l e d u t t e r l y " (AA 1976: 45). Since a l c o h o l i c s are morally and s p i r i t u a l l y i n c a p a c i t a t e d , they l a c k the courage, strength, and v i r t u e necessary to vanquish a l c o h o l ; they are destined - by the weakness of t h e i r s o u l s , the regions subjugated by s e l f i s h n e s s , h a b i t , temptation, and v i c e - to be subjugated by a l c o h o l . Step Two {Came to believe that a Power greater than ourselves could restore us to sanity) reveals that the g u i l e and cunning of a l c o h o l i s not the only source of a l c o h o l i c s ' h e l p l e s s n e s s ; powerlessness i s e s t a b l i s h e d not only by ex t e r n a l i m p o s i t i o n (the enslavement of a l c o h o l i c s by alcohol) but als o by inherent p r e d i s p o s i t i o n . I f nature provides most men and women with a c o n s t i t u t i o n designed to withstand the demands of everyday l i f e - which include "normal" e a t i n g and d r i n k i n g h a b i t s - the a l c o h o l i c has not been provided f o r as w e l l as most people. Within the a l c o h o l i c body, an a l l e r g y to a l c o h o l - or whatever mechanisms of p h y s i o l o g i c a l a d d i c t i o n - react to a l c o h o l as a poison r a t h e r than as " j u s t a d r i n k . " When a l c o h o l i c s consume l i q u o r , " [ t ] h e blood stream and body c e l l s are f i r s t 86 a f f e c t e d , then the b r a i n " (AA 1951: 26), and i f d r i n k i n g proceeds unabated, p h y s i o l o g i c a l and mental breakdown f o l l o w . Following the precept that they cannot r e l y on t h e i r own meagre resources i n the f i g h t against a l c o h o l and the " i n s a n i t y " of alcoholism, AA members deduce that t h e i r only chance t o overcome powerlessness i s to f i n d a source of strength outside of themselves. Acknowledging that a l c o h o l and the l e s s e r p a rts of t h e i r souls and bodies c o n s t i t u t e a power greater than themselves, a l c o h o l i c s i d e n t i f y the need to acquire a power that, s i m i l a r l y , i s greater than themselves and a l c o h o l . Having recognized that such an ex t e r n a l power i s t h e i r only chance of l i b e r a t i o n from alcoholism, of r e s t o r i n g t h e i r l i v e s , bodies, and minds to normalcy, i n Step Three {Made a decision to turn our will and our lives over to the care of God as we understood Him) AA members commit themselves to d i s c o v e r i n g a higher power and to n e g o t i a t i n g a s p i r i t u a l a l l i a n c e i n which they entrust themselves to the guardianship of t h i s "God." C o l l e c t i v e l y , then, the f i r s t three of the Twelve Steps l a y the groundwork f o r the s p i r i t u a l e d i f i c a t i o n that the AA members are induced to undertake; however, t h i s groundwork i s l a i d c a u t i o u s l y , with a circumspection 87 i n d i c a t i n g an awareness of p o s s i b l e r e s i s t a n c e to the r e l i g i o u s overtones of the program. Step One formulates the problem a l c o h o l i c s face - powerlessness over a l c o h o l -without making any reference to s p i r i t u a l i t y , and frames the issue as a p r a c t i c a l matter, i n terms of manageability. In Step Two the c o n d i t i o n of alc o h o l i s m i s f u r t h e r elaborated, as the powerlessness of alc o h o l i s m i s a d d i t i o n a l l y framed as an issue of mental h e a l t h . Although again not e x p l i c i t l y i n d i c a t e d , the s p i r i t u a l nature of the AA i s foreshadowed: c a p i t a l i z a t i o n i m p l i c i t l y a t t r i b u t e s the r e s t o r a t i v e "Power" wit h an agency and being that n o n - s p i r i t u a l , e x t e r n a l powers such as medication or psychotherapy would l a c k . F i n a l l y , i n Step Three, the s p i r i t u a l aspects of AA are f u l l y revealed: the "Power" of Step Two i s s p e c i f i e d as "God," a d i v i n e e n t i t y who w i l l l i b e r a t e from enslavement to al c o h o l i s m only those who earn t h e i r s a l v a t i o n through the d u t i f u l execution of I t s w i l l . The prudence with which s p i r i t u a l i t y i s introduced i n these foundational Steps r e f l e c t s the acute awareness i n AA that references to God and the r e l i g i o u s connotations they possess might deter some a l c o h o l i c s from c o n s i d e r i n g the program as a treatment option. AA members (as authors of o f f i c i a l l i t e r a t u r e and as i n d i v i d u a l recovering a l c o h o l i c s ) 88 repeatedly assure i n d i v i d u a l s who are agnostic or a t h e i s t that "God" i s synonymous with "Higher Power," both of which may or may not be conceived of as the C h r i s t i a n d e i t y . In the meetings I observed the term "Higher Power" rather than "God" was used by the vast m a j o r i t y of speakers, and i n the t e l l i n g of t h e i r l i f e s t o r i e s many members made e x p l i c i t mention of the i n i t i a l apprehension they experienced i n response to AA's s p i r i t u a l i t y . Frequently, they o f f e r e d t h e i r own s e l e c t i o n s of higher powers (which ranged from f r i e n d s and deceased fa m i l y members to Nature and Star Trek's Captain Picard) as proof and example of the p o s s i b i l i t y of working AA's program without r e l i g i o u s c o n v i c t i o n or conversion. And indeed, despite the importance of i t s s p i r i t u a l elements, AA i s a d i s t i n c t l y h y b r i d program, a recovery technology that was developed and continues to f u n c t i o n on the b a s i s of a complex epistemic formation that contains a m u l t i p l i c i t y of d i s c u r s i v e elements that come i n t o play at various moments and contexts. Recovery from a l c o h o l i s m r e q u i r e s " s l o w l y but s u r e l y l a y i n g the groundwork f o r a cl o s e personal contact with God" (AA 1951: 53), but a l s o the concurrent support of p h y s i c a l , mental, domestic, and economic foundations. These various elements provide 89 s t a b i l i t y f o r the others and, i n tu r n , r e q u i r e the others f o r t h e i r own support. Recovery i n AA, then, n e c e s s i t a t e s a h o l i s t i c approach to l i v i n g well, a healthy balance among d i f f e r e n t components of members' selves so that pressures from any one source cannot threaten the i n t e g r i t y of the systems that u l t i m a t e l y prevent them from r e t u r n i n g to dri n k . Steps Four through Seven c o n s i s t of a s e r i e s of techniques that are used to i d e n t i f y and r e p a i r personal flaws that might d e s t a b i l i z e a recovering a l c o h o l i c ' s s p i r i t u a l . b a l a n c e . These processes of r e f l e c t i o n and change occur w i t h i n a c o n f e s s i o n a l c o n f i g u r a t i o n that was transposed to AA d i r e c t l y from the Protestant o r g a n i z a t i o n s that AA founders were a f f i l i a t e d with (AA 1976: x v i ) ; hence, t h e i r o r i g i n s can be traced through the genealogy of confession that Foucault p a r t i a l l y describes i n the f i r s t volume of The History of Sexuality (1985) . As such, they continue the general incitement by s o c i a l , moral, and p r o f e s s i o n a l a u t h o r i t i e s to speak about d e s i r e w i t h i n i n d i v i d u a l s , to a r t i c u l a t e i t s dimensions, to understand i t s e f f e c t s , to accumulate knowledge about i t s f u n c t i o n i n g on the human s o u l , and to deploy that knowledge i n e f f o r t s of management and r e g u l a t i o n . 90 I t i s true that there are d i f f e r e n c e s between the confessions described by Foucault on the one hand, which i n v o l v e h i e r a r c h i c a l observation, s u b j e c t i o n to a u t h o r i t y , and compulsion and, on the other, the more e g a l i t a r i a n c o n f e s s i o n a l techniques of A l c o h o l i c s Anonymous. Most notably, i n s t e a d of being sought out by p r o f e s s i o n a l experts or s p e c i a l i s t s , AA c o n f e s s i o n a l s are presented to oneself, one's higher power, and other l a y i n d i v i d u a l s . However, such d i f f e r e n c e s should not preclude a comprehensive a p p l i c a t i o n of the a n a l y t i c s of governmentality to AA's c o n f e s s i o n a l p r a c t i c e s . Conceding that the gaze of AA observes and judges, but i n s i s t i n g that "what i s observed, judged and transformed i s one's own s p i r i t u a l progress, not the body of medicine or the mind of the psy s c i e n c e s " (1998: 124), Valverde concludes that AA i s f i r s t and foremost an e t h i c a l program. She thus refuses to apply the "paradigm of c o n f e s s i o n " to AA's p r a c t i c e s , presumably because of a s t r i c t a s s o c i a t i o n of c o n f e s s i o n a l p r a c t i c e s with d i s c i p l i n a r y s t r a t e g i e s . However, t h i s conceptual r i g i d i t y - a r e f u s a l to recognize or acknowledge that techniques of governance may engender elements of d i s c i p l i n e and s e l f - r u l e c o n c u r r e n t l y - r e s u l t s i n an a n a l y t i c a l one-sidedness; hence she o f f e r s a more or l e s s u n q u a l i f i e d e t h i c a l 91 c h a r a c t e r i z a t i o n of AA. I would l i k e to suggest that the observation, judgement, and c o r r e c t i o n t h a t occurs w i t h i n AA i s much l e s s neat than Valverde allows; i t in v o l v e s e t h i c a l governance, c e r t a i n l y , but e t h i c a l governance combined with elements of d i s c i p l i n a r y governance - i n c l u d i n g the confession. AA members' own comments i d e n t i f y important ways i n which d i s c i p l i n e features i n AA p r a c t i c e s . The assurance, "You're not a bad person, you are a s i c k person t r y i n g to get b e t t e r . I have a disease c a l l e d a l c o h o l i s m and I can't d r i n k . My medicine i s A.A. and the poison i s a l c o h o l . I come here f o r my medicine. I get a l i t t l e b i t b e t t e r every day" (Denzin 1987: 173), f o l l o w i n g one AA member's expression of g u i l t and remorse about i n d i s c r e t i o n s committed while drunk, undeniably suggests a c o n f e s s i o n a l process. One member of AA (perhaps i n conjunction with others) r e c e i v e s the testimony and admission of g u i l t of another, and, employing a medical gaze, renders a judgement. S i m i l a r l y , another AA member's comment that " [ t ] e l l i n g a bunch of people, um, about some of the i n s a n i t y and... the events that happened as a r e s u l t , or i n connection with my d r i n k i n g , there was r e a l l y , um, something very f r e e i n g about i t . I t ' s n i c e to be able to t a l k about something you're not 92 too sure of and suddenly a bunch of people laugh about it... t hat i s l i k e one of the greatest h e a l i n g powers I've ever had" ( O ' R e i l l y 1997: 136) i n d i c a t e s some of the c o n f e s s i o n a l and d i s c i p l i n a r y aspects of 7AA. Again, an expert discourse i s summoned - t h i s time, i n a p s y c h o l o g i c a l diagnosis of mental i n f i r m i t y - to evaluate the confession and to provide a v e r d i c t that " f r e e s " the i n d i v i d u a l ' s conscience. Insofar as they frame experiences of al c o h o l i s m i n terms of psychology or physiology, both of the examples c i t e d above i n d i c a t e the presence of expert a u t h o r i t i e s of the human sciences i n the consciousness of AA members, i f not i n t h e i r p h y s i c a l presence. More c o n c r e t e l y , accounts of i n t e r a c t i o n s between a l c o h o l i c i n d i v i d u a l s and others a s s o c i a t e d w i t h AA - those who c o l l e c t i v e l y make up AA i t s e l f and c o n s t i t u t e an a u t h o r i t y on al c o h o l i s m beyond any one i n d i v i d u a l - v e r i f y the existence of an expert, d i s c i p l i n a r y presence i n AA. Just as the a u t h o r i t i e s of the human sciences have synthesized t h e i r knowledge by observing and a n a l y z i n g numerous case s t u d i e s , the d i s c u r s i v e and epistemic e f f e c t s of m i l l i o n s of AA confessions have developed and s o l i d i f i e d a weighty a u t h o r i t y on alc o h o l i s m and i t s treatment. Just as the human sciences s t r a t e g i c a l l y and p o l i t i c a l l y deploy t h e i r expert knowledges, i t i s 93 p r e c i s e l y AA's e x p e r t i s e , i t s c l a i m to have been i n s t r u c t e d by experience, that allows i t to e s t a b l i s h i t s e l f as a d i s c i p l i n a r y a u t h o r i t y that can e x t r a c t confessions even from those who o f f e r r e s i s t a n c e . Members sense that the gaze which emanates from other recovering a l c o h o l i c s i s , beyond i n d i v i d u a l gazes, the gen e r a l i z e d gaze of AA i t s e l f . With f e a r , excitement, i n d i f f e r e n c e , or r e s i g n a t i o n , they t u r n towards i t , e x p l a i n i n g themselves, accounting f o r t h e i r a c t i o n s , seeking t h e i r t r u t h s , and r e c e i v i n g explanations, accounts, and t r u t h s of themselves i n t u r n ; they are diagnosed, f o r g i v e n , l i b e r a t e d , and i n s t r u c t e d . Step Four {Made a searching and fearless moral inventory of ourselves) o f f e r s a l c o h o l i c s a way to s y s t e m a t i c a l l y expose the harmful character t r a i t s that are e i t h e r caused by or are the cause of t h e i r alcoholism, the "mental poisons" that have the power to induce confused t h i n k i n g and, undetected, can r e s u l t i n a l c o h o l i c relapses. Through moral inventory, AA members are encouraged to take a b u s i n e s s - l i k e approach to i d e n t i f y i n g , p e r s o n a l i t y flaws by c r e a t i n g a l i s t i n which they enumerate as many character imperfections as p o s s i b l e . Proper execution of t h i s moral accounting requires the recovering a l c o h o l i c to focus an e t h i c a l gaze upon him- or h e r s e l f , searching f o r , observing, 94 and judging the moral flaws that may be h i d i n g i n h i s or her so u l . Since self-knowledge i s e s s e n t i a l f o r s u c c e s s f u l recovery, the AA member must hot leave any p s y c h o l o g i c a l , s p i r i t u a l , or moral stone unturned - no matter how p a i n f u l or d i s t a s t e f u l the d i s c o v e r i e s turn out to be. . Working r e l e n t l e s s l y and u n m e r c i f u l l y , a thorough s e l f - a p p r a i s a l w i l l uncover "many complexities that r e q u i r e study and med i t a t i o n " (AA 1951: 59). In working Step Five (Admitted to God, to ourselves, and to another human being the exact nature of our wrongs) AA more c o n c r e t e l y begin t h e i r c o n f e s s i o n a l work: a f t e r adding to t h e i r l i s t of general flaws a b i o g r a p h i c a l account of t h e i r d r i n k i n g careers that includes the ways i n which they wronged themselves and the i n d i v i d u a l s around them through t h e i r drunken thoughts and a c t i o n s , they divulge t h i s i n f o r m a t i o n to themselves, t h e i r higher powers, and another i n d i v i d u a l . This process i s described i n Alcoholics Anonymous: We [AA members] pocket our pr i d e and go to i t , i l l u m i n a t i n g every t w i s t of character, every dark cranny of the past. Once we have taken t h i s step, w i t h h o l d i n g nothing, we are d e l i g h t e d . We can look the 95 world i n the eye. We can be alone at p e r f e c t peace and ease (AA 1976: 75). Just as p a t i e n t s are sometimes required to forgo t h e i r modesty i n order to be tr e a t e d by a p h y s i c i a n , recovering a l c o h o l i c s must, no matter how shameful, bare the e n t i r e t y of themselves to the p u r i f y i n g l i g h t of AA. Only once t h i s step has been m e t i c u l o u s l y completed - when i n d i v i d u a l s have made every e f f o r t to confess t h e i r a l c o h o l i c s i n i n a l l i t s m a n i f e s t a t i o n s - can AA members hope to begin to exor c i s e t h e i r s p i r i t u a l demons. Thereafter, a moral c a t h a r s i s occurs; as recovering a l c o h o l i c s come to accept t h e i r s i n s and have t h e i r s i n s accepted by others, to f o r g i v e themselves and receive forgiveness, s e l f - r e s p e c t i s rest o r e d . Moreover, with the a b i l i t y to look at themselves without shame or g u i l t , they discover once again t h e i r real s e l v e s , the selves t h a t , while remaining a l c o h o l i c i n terms of physiology, are becoming "normal" i n terms of psychology, s p i r i t u a l i t y , and m o r a l i t y . Having obtained self-knowledge - a'n understanding of t h e i r a l c o h o l i c souls that was achieved through s e l f -i n t e r r o g a t i o n and di s c u s s i o n s with other i n d i v i d u a l s - AA members begin to work towards self-improvement. In Step Six (Were entirely ready to have God remove all these defects of 96 character) and Step Seven {Humbly asked Him to remove our shortcomings), AA members c a l l upon t h e i r higher powers to r i d them of t h e i r imperfections with the conscious goal of e s t a b l i s h i n g a new e t h i c a l existence. However, a l c o h o l i c s themselves are not free from r e s p o n s i b i l i t y i n t h i s process: i n d i v i d u a l s must be prepared to f u l l y subject t h e i r w i l l s to t h e i r higher powers and to a c t i v e l y pursue change i n thought, a c t i o n , b e l i e f , and outlook. The focus of a l c o h o l i c s ' r e l a t i o n s to themselves that was maintained i n the work of Steps Four through Seven s h i f t s to working on s o c i a l r e l a t i o n s i n Step Eight (Made a l i s t of all the persons we had harmed, and became willing to make amends to them all) and Step Nine (Made direct amends to such people wherever possible, except when to do so would injure them or others). This work i s undertaken as processes of moral accounting and confession as w e l l : a l c o h o l i c s are required - again, with a methodical, record-keeping technique that documents s i n - to ' create an inventory of outstanding s o c i a l debts that l i s t s the a c c i d e n t a l mistakes and i n t e n t i o n a l wrongs they committed to others (even i f those others might not be aware of these i n j u r i e s ) and to confess t h e i r g u i l t . However, beyond t a k i n g inventory and d i s c l o s i n g the r e s u l t s to others, 9 7 a l c o h o l i c s are required to s e t t l e up t h e i r s o c i a l accounts by "making- amends." Working these Steps, recovering a l c o h o l i c s request forgiveness from the i n d i v i d u a l s they have wronged and assume l i a b i l i t y f o r the debts they i n c u r r e d . Generally, AA members approach each i n j u r e d i n d i v i d u a l , confess to him or her the exact nature of t h e i r misdeeds, and e x p l a i n that while t h e i r a c t i o n s stemmed from t h e i r a l c o h o l i c i l l n e s s , they are not attempting to avoid r e s p o n s i b i l i t y f o r t h e i r behaviour; that i n f a c t , they d e s i r e the opportunity to e s t a b l i s h r e p a r a t i o n a l terms f o r the damages they wrought so that they may c l e a r t h e i r consciences and r e s t o r e t r u s t and g o o d w i l l t o t h e i r r e l a t i o n s h i p s . With c l o s e acquaintances, s i n c e r e apologies may be a l l that i s r e q u i r e d ' f o r such e x p i a t i o n ; however, s a c r i f i c e s s i g n i f i c a n t l y l a r g e r than p r i d e may be required. I f a l c o h o l i c s have outstanding f i n a n c i a l debts, they are advised by AA to approach t h e i r c r e d i t o r s , e x p l a i n t h e i r s i t u a t i o n , and o f f e r to make payments as f r e q u e n t l y as p o s s i b l e (without compromising the w e l l being of themselves or t h e i r f a m i l i e s ) . I f they have been dishonest at work, s t e a l i n g , avoiding d u t i e s , or d r i n k i n g on the job, they are urged to come clean to t h e i r employers. And i f a l c o h o l i c s have committed any c r i m i n a l 98 offences during t h e i r d r i n k i n g careers, AA wisdom i s that i t i s best to confess to the proper a u t h o r i t i e s . While i n d i v i d u a l s working the AA program may h e s i t a t e to undertake such admissions i n fear of consequences that might range from m i l d embarrassment to imprisonment, AA i n s i s t s to i t s members on the n e c e s s i t y of proceeding: "We [ a l c o h o l i c s ] may lose our p o s i t i o n or r e p u t a t i o n or face j a i l , but we are w i l l i n g . We have to be. We must not shrink at anything" (AA 1976: 79). Since recovery i s a l i f e - o r - d e a t h issue f o r a l c o h o l i c s , losses i n s t a t u s , wealth, and even l i b e r t y are a l l reasonable p r i c e s to pay fo r the s t a b i l i t y of s o c i a l l i f e and peace of mind that w i l l help safeguard an a l c o h o l i c ' s s o b r i e t y . Thus, by e s t a b l i s h i n g a v i t a l imperative of e x p i a t i o n , AA e x t r a c t s f i g u r a t i v e and p a s t o r a l confessions, and even formal ones that may r e s u l t i n c r i m i n a l c o n v i c t i o n or other forms of d i s c i p l i n e . Having completed Steps One through Nine, i t i s assumed that AA members w i l l now have n e u t r a l i z e d many of the v u l n e r a b i l i t i e s that had i n the past caused them to d r i n k or prevented them from stopping d r i n k i n g : they have given up the s e l f - c e n t r e d notion that they could q u i t d r i n k i n g by themselves and placed f a i t h i n the as s i s t a n c e of a high 99 power; sought out through i n t r o s p e c t i o n and s e l f - a n a l y s i s a l l of t h e i r imperfections and worked toward removing them; and confessed and received forgiveness f o r past s i n s , making r e s t i t u t i o n s whenever p o s s i b l e . In doing so, they have forged a s p i r i t u a l and moral freedom, and foundation f o r l i f e f r e e (or with a minimal amount) of s t r e s s . Indeed, i f they have t r u l y worked the program to the best of t h e i r a b i l i t i e s , they have l i k e l y achieved a complete reordering of t h e i r souls so that now, i n most respects, they resemble "normal" i n d i v i d u a l s . However, although AA members may have made si n c e r e e f f o r t s to combat t h e i r a l c o h o l i c defects - and may have made s i g n i f i c a n t progress - both s p i r i t u a l and c o n s t i t u t i o n a l p e r f e c t i o n w i l l forever elude them. Recovery from a l c o h o l i s m i s never completed. Because the dangers of " s l i p p i n g " or " f a l l i n g o f f the water wagon" are ever present, s o b r i e t y - and s u r v i v a l - can never be taken f o r granted by recovering a l c o h o l i c s . AA members are r e c u r r e n t l y warned that " [ i ] t i s easy to l e t up on the s p i r i t u a l program of a c t i o n and r e s t upon our l a u r e l s . We [ a l c o h o l i c s ] are headed f o r t r o u b l e i f we do, f o r a l c o h o l i s a subtle foe. We are not cured of al c o h o l i s m . What we r e a l l y have i s a d a i l y r e p r i e v e " (AA 1976: 85). Even among a l c o h o l i c s who have.been recovering 100 f o r lengthy periods of time, r i s k l u r k s p e r p e t u a l l y . Indeed, p e r i l s may grow greater with extended s o b r i e t y , as i n d i v i d u a l s may begin to " f o r g e t " they are a l c o h o l i c : they may become overconfident about t h e i r a b i l i t i e s to consume a l c o h o l u n p r o b l e m a t i c a l l y , f o r g e t t i n g that "one dr i n k can h u r t , " or they may gr a d u a l l y become l e s s v i g i l a n t i n t h e i r e t h i c a l work. I t i s p r e c i s e l y to combat such dangerous complacency that AA members use the term " r e c o v e r i n g " r a t h e r than "recovered" a l c o h o l i c s : to emphasize the permanency and precariousness of the a l c o h o l i c c o n d i t i o n and the n e c e s s i t y of constant, programmatic e f f o r t s to maintain the e x i s t e n t i a l balance that s o b r i e t y r e q u i r e s . Steps Ten through Twelve, r e f e r r e d to by AA members as the "maintenance steps," provide a means of undertaking recovery work i n p e r p e t u i t y . These Steps are approached not with the o b j e c t i v e of f i n i t e and successive completion, as were the previous Steps, but instead with the i n t e n t i o n of extending the work of s o b r i e t y i n d e f i n i t e l y . Step Ten {Continued to take personal inventory and when we were wrong promptly admitted it) c a l l s f o r i n d i v i d u a l s to engage i n techniques of s e l f - r e f l e c t i o n , confession, and e x p i a t i o n s i m i l a r to those learned i n previous steps. In a d v i s i n g how 101 to "work" Step Ten, AA describes the " d a i l y personal inventory": When we [AA members] r e t i r e at night, we c o n s t r u c t i v e l y review our day. Were we r e s e n t f u l , s e l f i s h , dishonest or a f r a i d ? Do we owe an apology? Have we kept something to ourselves that should be discussed with another person at once? Were we kind and l o v i n g toward a l l ? What could we have done b e t t e r ? (AA 1976: 86) Thus, i n d i v i d u a l s are required on a d a i l y b a s i s to appraise t h e i r thoughts, a t t i t u d e s , and behaviours of the past 24 hours and to search f o r i n d i c a t i o n s of s p i r i t u a l or moral t r o u b l e . I f any are i d e n t i f i e d , these must be promptly d e a l t with before they develop i n t o problems that might threaten a l c o h o l i c s ' s o b r i e t y . And even i f no obvious signs of danger can be discovered, a recovering a l c o h o l i c w i l l be able to ensure s p i r i t u a l progress by i d e n t i f y i n g o p p o r t u n i t i e s f o r p o s i t i v e self-improvement. Step Eleven (Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out) focuses on maintaining a good r e l a t i o n s h i p between recovering a l c o h o l i c s and t h e i r higher powers. AA members are encouraged to begin each day with a 102 prayer, i n which they acknowledge t h e i r higher power as t h e i r saviour from al c o h o l i s m and ask to be granted (mental, p h y s i c a l , s p i r i t u a l ) strength to car r y out the Power's w i l l . A d d i t i o n a l l y , to ensure greater focus and e f f i c i e n c y , they are advised to take s e v e r a l short breaks during t h e i r days to r e l a x and meditate (AA 1951; AA 1976) . By keeping i n constant contact with themselves and t h e i r higher powers, AA members reduce the r i s k of f a l l i n g from the s p i r i t u a l path of AA. Step Twelve, the l a s t of the maintenance steps and the f i n a l step i n the AA program, c o n s i s t s of two components. The f i r s t (Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics] c a l l s upon AA members to make e f f o r t s to a s s i s t i n d i v i d u a l s who are experiencing d r i n k i n g problems by informing them of AA's program. "Carrying the message" to other i n d i v i d u a l s i s understood by most AA members to be an e s s e n t i a l part of s o b r i e t y , since i t i s b e l i e v e d that "nothing w i l l so much insure immunity from d r i n k i n g as i n t e n s i v e work with other a l c o h o l i c s " (AA 1976: 89). In part , t h i s propagative work func t i o n s as a means of r e g u l a t i n g or d i s c i p l i n i n g the larg e amounts of free time and energy that AA members formerly spent on d r i n k i n g and d r i n k i n g - r e l a t e d a c t i v i t i e s : working 103 c h a r i t a b l y with others, recovering a l c o h o l i c s remain u s e f u l l y a c t i v e and focused on p u r s u i t s other than d r i n k i n g . More importantly, i n s a c r i f i c i n g time, energy, and money to help others, i n d i v i d u a l s f i r m l y e s t a b l i s h t h e i r AA co n v i c t i o n s p u b l i c l y and p e r s o n a l l y : r e a f f i r m i n g with a c t i o n s t h e i r own commitment to the AA program and reconfirming (through the s a l v a t i o n of newcomers) the be n e f i t and importance of maintaining a v i g i l a n t , a c t i v e s o b r i e t y . I t i s i n the second component of Step Twelve (to practice these principles in all our affairs) that i t becomes c l e a r that AA's program t r u l y o f f e r s , beyond a means a b s t a i n i n g from a l c o h o l , a "design f o r l i v i n g " (AA 1976: 2) fo r i t s members. C a l l e d upon to i n t e g r a t e AA's philosophy -i t s system of values, b e l i e f s , and ideas about the best way fo r a l c o h o l i c s to l i v e - i n t o a l l aspects of l i f e , i n d i v i d u a l s working Step Twelve c o n s t i t u t e t h e i r every thought and a c t i o n as objects of an a l c o h o l i c (recovery) p r a c t i c e . And continuously pursuing t h i s goal, continuously working and re-working t h e i r existence, AA members r e c o n s t i t u t e themselves as e t h i c a l a l c o h o l i c s u b j e c t s . As such, recovering a l c o h o l i c s obtain and maintain the balance and s t a b i l i t y that allows them not only to stay on the water 104 wagon, but to r i d e i t along "the high road to a new freedom" (AA 1976: x x i ) . THE FULFILMENT(S) OF RECOVERY The "new freedom" AA o f f e r s to a l c o h o l i c s i s a freedom from d r i n k of course, but a l s o , more importantly, a freedom from the multitude of (moral, p s y c h o l o g i c a l , p h y s i c a l ) d i s o r d e r s that otherwise renders a l c o h o l i c s ' l i v e s unbearable. As we have already seen, Act I I I of t e l l i n g one's s t o r y p r i m a r i l y c o n s i s t s of • an account of the p o s i t i v e changes that have been brought about by one's involvement with AA. Although i t v a r i e s with each s t o r y , the l i s t of b e n e f i t s accrued from working AA's program g e n e r a l l y i n c l u d e , i n one form or another, improvements i n i n d i v i d u a l s ' h e a l t h , t h e i r f a m i l y dynamics, t h e i r mental a c u i t y and p s y c h o l o g i c a l s t a b i l i t y , t h e i r s o c i a l r e l a t i o n s h i p s , as w e l l as t h e i r employment status and m a t e r i a l w e l l - b e i n g . The end of the Act, as a concl u s i o n to i n d i v i d u a l s ' s t o r i e s , u s u a l l y i n v o l v e s speakers thanking AA f o r these changes, f o r t h e i r recovery, and f o r being given back the l i v e s they possessed before t h e i r a l c o h o l i s m had become apparent. Recovery i n AA, then, i s l a r g e l y experienced by AA members as a r e t u r n to a former s t a t e of being, a r e t u r n to 105 the "normal" a b i l i t i e s , a p t i t u d e s , c o n d i t i o n s , and p o s i t i o n s experienced p r i o r to developing d r i n k i n g problems. However, there i s something more than t h i s as w e l l : since AA's s p i r i t u a l program allows recovering a l c o h o l i c s to master not j u s t t h e i r consumption of a l c o h o l but t h e i r souls as w e l l , i t promises a p o s i t i v e freedom, c h a r a c t e r i z e d by a la c k of misery and despair and al s o new horizons of choice and p o s s i b i l i t y . Thus, whereas "normal" ( i . e . , non-a l c o h o l i c ) i n d i v i d u a l s who have not had to go through the t r i a l s of a l c o h o l i s m and have not experienced the " m i r a c l e " of recovery may tend to take l i f e f o r granted, recovering a l c o h o l i c s o f t e n embrace the "second chance" they have been provided with a s p i r i t of s e l f - a c t u a l i z a t i o n . A f t e r a c h i e v i n g s o b r i e t y , many AA members describe developing a "new inner comfort, and the w i l l i n g n e s s and strength to do something about the t r a i t s [they] couldn't l i v e w i t h " (AA 1976: 229) . To the extent that i t allows i t s members to e l i m i n a t e problematic d r i n k i n g and the p h y s i c a l / p s y c h o l o g i c a l / s o c i a l / moral c h a r a c t e r i s t i c s of the a c t i v e a l c o h o l i c , and to the extent that i t allows them to replace these a b n o r m a l i t i e s with r e g u l a r i t y , constancy, and a sense of wel l - b e i n g , A l c o h o l i c s Anonymous provides i t s members with a 106 system of self-governance with which recovering a l c o h o l i c s can meet t h e i r own e t h i c a l standards of conduct and can f u l f i l t h e i r own personal expectations. However, despite AA's primary focus on the soul of the a l c o h o l i c and on s e l f -f u l f i l m e n t , the process of personal recovery a l s o i n v o l v e s p a r a l l e l operations of s o c i a l and economic recovery. These l a t t e r processes are f r e q u e n t l y i m p l i e d i n member's observations about t h e i r own r e c o v e r i e s , as i n the f o l l o w i n g example: Everyday, I f e e l a l i t t l e b i t more u s e f u l , more happy and more f r e e . L i f e , i n c l u d i n g some ups and downs, i s a l o t of fun. I am a part of A.A., which i s a way of l i f e . I f I had not become an a c t i v e a l c o h o l i c and j o i n e d A.A., I might never have found my own i d e n t i t y or become a part of anything (AA 1976: 417) . Here, a recovering a l c o h o l i c , who harnesses her mental and p h y s i c a l c a p a b i l i t i e s through working the AA program on a perpetual, d a i l y b a s i s , now has the power to r e s i s t being overwhelmed by offending d e s i r e s that would otherwise i n t e r f e r e with her a b i l i t y to incorporate h e r s e l f i n t o normal l i f e . As she achieves e t h i c a l or s p i r i t u a l progress and work towards personal f u l f i l l m e n t , she a l s o becomes p r o g r e s s i v e l y more able to serve a purpose; and even though 107 l i f e may provide challenges and hardships, i t i s w i l l i n g l y -and h a p p i l y - p a r t i c i p a t e d i n . Thus, she suggests that the e t h i c a l governance she engages i n produces d e s i r a b l e outcomes f o r h e r s e l f and the world w i t h i n which she e x i s t s . The wider s o c i a l and i n t e r p e r s o n a l b e n e f i t s of AA members' self-governance have not gone unnoted by AA. I t i s commonly observed that " f o r every man [ s i c ] who d r i n k s others are i n v o l v e d " (AA 1976: 104), others who s u f f e r as a r e s u l t of a l c o h o l i s m even though they are not themselves a l c o h o l i c . L i k e a l l i n d i v i d u a l s , a l c o h o l i c s have moral o b l i g a t i o n s to f u l f i l the r o l e s and expectations placed upon them from spouses, c h i l d r e n , parents, f r i e n d s , co-workers, acquaintances, and so f o r t h ; however, since a c t i v e a l c o h o l i c s o f t e n withdraw from human contact, these o b l i g a t i o n s f r e q u e n t l y go unmet. In AA, a process of s o c i a l recovery occurs, i n which i n d i v i d u a l s who tend to be "lone wolves" (AA 1976: 2) during t h e i r a c t i v e a l c o h o l i s m become, once again, s o c i a l animals: i n s t e a d of remaining separated from the r e s t of the world by f e e l i n g s of estrangement, resentment, and shame, they turn outward with the joy of recovery and eagerness to begin l i f e anew. Domesticated, they are returned to t h e i r f a m i l i e s and f r i e n d s , d u t i f u l , c o n s c i e n t i o u s , a t t e n t i v e , c a r i n g , and trustworthy, with a 108 d e s i r e to r e b u i l d the t r u s t and love that was damaged by neglect and / or abuse during former d r i n k i n g days. Included i n the recovery operations of AA, too, are more general, s o c i e t a l r e c o v e r i e s : r e c o v e r i e s of the p u b l i c and p r i v a t e costs a t t r i b u t e d ( in discourses on al c o h o l i s m w i t h i n AA and dominant currents of s o c i a l thought) to the c r e a t i o n and / or aggravation of a range of " s o c i a l i l l s " by a l c o h o l (and, p a r t i c u l a r l y , a l c o h o l i c ) consumption. For example, AA's c o n t r i b u t i o n to the reduction of problem d r i n k i n g i m p l i e s a m i t i g a t i o n of socio-economic t r o u b l e s such as unemployment, corporate waste, crime, and the abuse of s o c i a l welfare programs. Furthermore, by f o s t e r i n g an increased e f f i c a c y and r e s p o n s i b i l i t y i n i n d i v i d u a l s who, as a c t i v e a l c o h o l i c s , had been unable to " p u l l t h e i r own weight," AA e n t a i l s a b i o p o l i t i c a l reclamation of the motivations, s k i l l s , and c a p a c i t i e s of i t s members. And again, AA has not been r e t i c e n t i n i n t i m a t i n g these b e n e f i t s to agents of s o c i a l and p o l i t i c a l management. Most s i g n i f i c a n t l y i n i t s promotional e f f o r t s , A l c o h o l i c s Anonymous has portrayed i t s e l f as a technology of human resource management to the a d m i n i s t r a t i v e c l a s s e s of the p r i v a t e s e c t o r . In a chapter of Alcoholics Anonymous, "To Employers," an AA member who "was at one time a s s i s t a n t 109 manager of a c o r p o r a t i o n department employing s i x t y - s i x hundred men" speaks d i r e c t l y to "business men [ s i c ] everywhere," o f f e r i n g them advice that "ought to prove e x c e p t i o n a l l y u s e f u l " (AA 1976: 136) . He spea'ks with a dual a u t h o r i t y : as an a l c o h o l i c and as a forme.r executive, he can r e v e a l the t r u t h about the problem of a l c o h o l i s m and a l c o h o l i c employees i n the workplace. He knows about managerial concerns, business o b j e c t i v e s , how a l c o h o l i c s i n the workplace can i n t e r f e r e with these, but he a l s o knows the a l c o h o l i c mind, and knows what treatment w i l l work best to f u n c t i o n a l l y r e s t o r e problem d r i n k e r s . Thus, he i s able to present a complete account of the "business" of managing alcoholism. The former executive begins by d e p i c t i n g h i s own experiences as a manager before he developed the symptoms -and understandings - of alcoholism. He describes three d i f f e r e n t cases i n which employees under h i s charge committed s u i c i d e , two a f t e r being f i r e d by him f o r drunkenness. Although none of these men appeared to have blamed him f o r t h e i r f a t e s , t h e i r t r a g i c deaths were avoidable ones, and he accepts at l e a s t p a r t i a l r e s p o n s i b i l i t y f o r them: "Here were three e x c e p t i o n a l men l o s t to t h i s world because I d i d not understand al c o h o l i s m 110 as I do now" (AA 1976: 137). I m p l i c i t l y , then, the author's executive audience, some of whose employees are l i k e l y a l c o h o l i c s , might be responsible (morally i f not l e g a l l y ) for. the f a t a l i t i e s of those under t h e i r s u p e r v i s i o n . Furthermore, they may be responsible f o r the l o s s of ex c e p t i o n a l employees, and thus may be causing unnecessary expense f o r themselves or t h e i r companies. Death, of course, i s only the most extreme example of the corporate waste produced by the inadequate management of alcoholism. Other, more common - and u l t i m a t e l y more c o s t l y - cases i n c l u d e i n d i v i d u a l s who take s i c k leave because of hangovers or d r i n k i n g - r e l a t e d i l l n e s s , accidents and decreased p r o d u c t i v i t y r e s u l t i n g from d r i n k i n g on the job, and the l o s s of t r a i n e d or s k i l l e d employees who q u i t or have to be f i r e d from t h e i r p o s i t i o n s because of t h e i r d r i n k i n g problems. The author himself admits to having cost h i s business community "unknown thousands of d o l l a r s " and warns that although a d m i n i s t r a t o r s might be unaware of i t , " [ t ] h i s kind of waste goes on unabated" (AA 1976: 137). Indeed, s w i t c h i n g to the f i r s t - p e r s o n p l u r a l that i s common to most of the Alcoholics Anonymous t e x t , summoning the ex p e r t i s e of m i l l i o n s of f i r s t - h a n d experts on al c o h o l i s m -i t i s asserted t h a t : "the business f a b r i c i s shot through 111 with a s i t u a t i o n which might be helped by b e t t e r understanding [of a l c o h o l i s m and a l c o h o l i c s ] a l l around" (AA 1976: 137) . Here, there i s an imperative to shed the ignorance that prevents companies from managing alcoholism: the "business f a b r i c " i s r i d d l e d almost to the point of c r i s i s with holes caused by problem d r i n k e r s and drains on p r o f i t a b i l i t y . Given the average employer's l a c k of understanding about the c o n d i t i o n , the human resource expert of AA understands and f o r g i v e s the most prevalent approach to d e a l i n g with alcoholism, namely of threatening employees and u l t i m a t e l y t e r m i n a t i n g them. However, i t i s not the best approach from a f i s c a l p e r s p e c t i v e , and demonstrates a " l a c k of knowledge as to what part the employer might p r o f i t a b l y take i n s a l v a g i n g t h e i r s i c k employees" (AA 1976: 139). Employers are thus enjoindered to consider t h e i r a l c o h o l i c workers as commodities - commodities that have been somewhat damaged or reduced i n value, but are s t i l l worth a recovery e f f o r t . Such a salvaging process i s then o u t l i n e d by the author i n s e v e r a l stages, the f i r s t being: State that you know about h i s d r i n k i n g , and that i t must stop. You might say you appreciate h i s a b i l i t i e s , would l i k e to keep him, but cannot i f he continues to 112 d r i n k . A f i r m a t t i t u d e at t h i s p o i n t has helped many of us. Next he can be assured that you do not intend to l e c t u r e , moralize, or condemn; that i f t h i s was done formerly, i t was because of misunderstanding. I f p o s s i b l e express a lack of hard f e e l i n g s toward him. At t h i s p o i n t , i t might be w e l l to e x p l a i n alcoholism, the i l l n e s s . Say that you b e l i e v e he i s a gravely i l l person, with t h i s q u a l i f i c a t i o n - being perhaps f a t a l l y i l l , does he want to get well? You ask, because many a l c o h o l i c s , being warped and drugged, do not want to q u i t . But does he? W i l l he take every necessary step, submit to anything to get w e l l , to stop d r i n k i n g forever? [...] We b e l i e v e a man should be thoroughly probed on these p o i n t s (AA 1976: 141-142). From the outset, the employer must evaluate the chances of success of h i s endeavour - j u s t as he would with any business undertaking. He should act i n a b u s i n e s s - l i k e manner to the suspected a l c o h o l i c employee, p o l i t e and emotionally r e s t r a i n e d , but not to be deceived: he knows that the employee has a d r i n k i n g problem. He w i l l not 113 accept d e n i a l s or excuses, even i f the employee i s not t r u t h f u l t o him- or h e r s e l f . I f the i n d i v i d u a l admits to being an a l c o h o l i c (a s i c k person) and agrees - on the employers terms, which r e q u i r e absolute commitment - to attempt to get b e t t e r , then the employer w i l l help him or her preserve h i s or her job. A f t e r s a t i s f y i n g y o u r s e l f that your man wants to recover and that he w i l l go to any extreme to do so, you may suggest a d e f i n i t e course of a c t i o n . For most a l c o h o l i c s who are d r i n k i n g , or who are j u s t g e t t i n g over a spree, a c e r t a i n amount of p h y s i c a l treatment i s d e s i r a b l e , even imperative. The matter of p h y s i c a l treatment should, of course, be r e f e r r e d to your own doctor. Whatever the method, i t s object i s to thoroughly c l e a r mind and body of e f f e c t s of a l c o h o l . In competent hands, t h i s seldom takes long nor i s i t very expensive. [...] i t may be necessary to advance the cost of the treatment, but we b e l i e v e i t should be made p l a i n that any expense w i l l l a t e r be deducted from h i s pay (AA 1976: 142-143). A p r o p r i e t a r y r e l a t i o n s h i p between employer and employee i s suggested i n t h i s passage, most e x p l i c i t l y i n the use of the term "your man" to r e f e r to the employee. The possessive 114 pronoun i s not a mere c o l l o q u i a l i s m ; i t i s an assurance of the employer's st a t u s as possessor of h i s / her worker, with the a b i l i t y to s t i p u l a t e c o n d i t i o n s and r u l e s that the employee must meet ( i f s/he wishes to avoid d i s m i s s a l ) . This p r o p r i e t a r y status i s something the employer holds i n regards to a l l n o n - a l c o h o l i c employees who must . agree to r e l i n q u i s h a c e r t a i n amount of time or energy f o r a set p r i c e . But i t i s heightened with a l c o h o l i c employees who, by agreeing to "submit to anything," give up the e n t i r e t y of t h e i r freedom. This ownership metaphor i s f u r t h e r developed when the author, s t a t i n g what i s apparently obvious, w r i t e s that p h y s i c a l treatment of the employee w i l l "of course" be overseen by the employer's own p h y s i c i a n . Without need f o r d i s c u s s i o n , i t i s presumed that the employee w i l l not have a say i n the matter of h i s or her own treatment, s/he w i l l submit to the gaze of the employer's (medical) agent j u s t as s/he submitted to the employer's w i l l . In recovering the a l c o h o l i c as a v i a b l e employee, the doctor and executive form a managerial a l l i a n c e , a p a r t n e r s h i p i n resource management, c o n f e r r i n g with each other and determining a course of a c t i o n according t o the employer's best i n t e r e s t s . And, s i n c e i t i s u l t i m a t e l y being financed by the employee, 115 t h i s treatment remains a sound f i n a n c i a l d e c i s i o n on behalf of the businessperson. I t i s the stage a f t e r the p h y s i c a l recuperation of the employee that recuperation of the losses caused by a l c o h o l i s m i n the workplace depends upon. For t h i s stage to be s u c c e s s f u l , the employee who d r i n k s p r o b l e m a t i c a l l y must be f u l l y d e b r i e f e d , so that he knows what i s r e q u i r e d of him: "he should understand that he must undergo a change of heart. To get over d r i n k i n g w i l l r e q u i r e a transformation of thought and a t t i t u d e " (AA 1976: 143) . At t h i s p o i n t , p o t e n t i a l a l c o h o l i c s should be presented w i t h a copy of Alcoholics Anonymous by the attending doctor, and encouraged to read i t . Employees w i l l then have i n t h e i r possession a program t h a t , i f they decide to use i t , should solve t h e i r problems and allow them to keep t h e i r jobs. Beyond t h i s , a l l t hat i s l e f t f o r the" employer to do i s to be understanding and f o r g i v i n g while i n d i v i d u a l s work through t h e i r recovery; and e s p e c i a l l y , t o be reasonable and l e v e l -headed i f and when employees, working AA's program, approach them with confessions of i n d i s c r e t i o n s or offences. C e r t a i n l y , n e i t h e r the author nor AA purport that every employee with a d r i n k i n g problem can be "salvaged" with t h i s method; however, they do present t h e i r program as a sound 116 business s t r a t e g y , a t o o l with which to r e p a i r the "sometimes serious leak" of time, personnel, and e f f i c i e n c y that companies face as a r e s u l t of a l c o h o l i c workers. Becoming part of a managerial team, consultants who advise and recommend t h e i r own human resource management methods over other p o s s i b i l i t i e s , they assure the employer: "we t h i n k that i f you persevere, the percentage of success w i l l g r a t i f y you" (AA 1976: 144). And of those employees who do s u c c e s s f u l l y adopt the AA "way of l i f e , " i t can be expected that most w i l l prove model employees, f u l l of energy and a d e s i r e not t o disappoint t h e i r employer. They take advantage of the employer's generosity; on the contrary, the recovering a l c o h o l i c " w i l l work l i k e the d e v i l and thank you to h i s dying day" (AA 1976: 149). Thus, the development of an understanding of AA by business . executives, and the r e f e r r a l of employees with perceived d r i n k i n g problems to AA, i s a matter of good business f o r employers. The recovery s t r a t e g y i s a humane one and, more importantly, i t i s very c o s t - e f f e c t i v e : AA does not charge fees f o r i t s s e r v i c e s , the employee i s r e s p o n s i b l e f o r the expenses of h i s or her own treatment, and the p o s s i b l e b e n e f i t s to be gained - not only through avoiding l o s s caused by problem d r i n k e r s , but a l s o through 117 the increased enthusiasm, d e d i c a t i o n , and p r o d u c t i v i t y of recovering a l c o h o l i c s - are s u b s t a n t i a l . And to the extent that these gains are r e a l i z e d with recourse to t h r e a t , compulsion, and command, with the goal of productive a d m i n i s t r a t i o n and c o n t r o l , AA's program takes on an existence beyond that of merely a system of e t h i c a l governance; i t becomes a mechanism of (commercial) d i s c i p l i n e . The d i s c i p l i n e s of medicine and psychology have a l s o recognized the u t i l i t y of AA i n r e g u l a t i n g the socio-medical deviance of problem d r i n k e r s . Alcoholics Anonymous a f f i r m s t h a t "medical s o c i e t i e s and p h y s i c i a n s throughout the world have set t h e i r approval upon [ A l c o h o l i c s Anonymous]" (AA 1976: 571), and c i t e s prominent medical prof es'sionals who express support f o r AA and acknowledge, i n one way or another, the important r o l e AA plays i n the treatment of a l c o h o l i c s . These t e s t i m o n i a l s are uniformly b r i e f , and u s u a l l y do not s p e c i f y any exact b e n e f i t s of AA treatment except that i n AA, a l c o h o l i c s appear to be able to stop d r i n k i n g . In the medical preface to the volume, however, Dr. W. S i l k w o r t h provides some account of the changes he perceived i n p a t i e n t s who became AA members. 118 S i g n i f i c a n t l y , the changes S i l k w o r t h describes are f o r the most part improvements i n d i s c i p l i n e and s e l f - c o n t r o l r a t h e r than i n p h y s i o l o g i c a l h e a l t h . He endorses AA i n s o f a r as i t f o s t e r s "growth" of the i n d i v i d u a l , however, the term i s used with moral connotations, i m p l i c i t l y suggesting that a l c o h o l i c s l a c k moral, s p i r i t u a l , and p s y c h o l o g i c a l maturity or development. Improvement i n these areas, more than b i o l o g i c a l development, i s what impresses S i l k w o r t h most s t r o n g l y . He c i t e s s e v e r a l cases of i n d i v i d u a l s he has t r e a t e d i n h i s h o s p i t a l , who, having j o i n e d AA, ' were transformed i n t o (morally) "superior beings." For example, when one former p a t i e n t c a l l e d on him a f t e r having been i n AA f o r a year, he experienced a "very strange sensation:" I knew the man by name, and p a r t l y recognized h i s f e a t u r e s , but there a l l resemblance ended. From a trembling, d e s p a i r i n g , nervous wreck, had emerged a man brimming over with s e l f - r e l i a n c e and contentment. I t a l k e d to him f o r some time, but was not able to b r i n g myself to f e e l that I had known him before (AA 1976: x x i x ) . In t h i s case, the p a t i e n t , e x i s t i n g i n a p a t h e t i c , almost r e p u l s i v e , s t a t e , disappears, and i s not seen again u n t i l some time l a t e r , when he reappears, m i r a c u l o u s l y 119 transformed, unrecognizable: he has become, as have other former p a t i e n t s i n v o l v e d with AA, "as f i n e a specimen of manhood as one could wish to meet" (AA 1976: xxx) . Again, however, the fineness of the specimen r e l a t e s more to the mental and moral q u a l i t i e s possessed by the recovering a l c o h o l i c than i t s p h y s i c a l a t t r i b u t e s . The " u n s e l f i s h n e s s " of AA members, t h e i r "community s p i r i t , " and t h e i r s u p e r i o r mental s t a t e are what S i l k w o r t h f i n d s " i n s p i r i n g to one who has laboured long and w e a r i l y " i n the a l c o h o l i s m treatment f i e l d (AA 1976: xxv). Beyond mere acceptance or r e c o g n i t i o n , the governance technology of A l c o h o l i c s Anonymous has been deployed by h e a l t h p r a c t i t i o n e r s as a primary, element of treatment. Problem d r i n k e r s under c l i n i c a l care are r e g u l a r l y ' r e f e r r e d to AA, which i s p o s i t i o n e d e i t h e r as an adjunct form of treatment, or - as i s e s p e c i a l l y the case with c l i e n t s who might not be able to a f f o r d s p e c i a l i s t s e r v i c e s on an i n t e n s i v e , long-term b a s i s - as a surrogate therapy. The Twelve Steps of AA have f u r t h e r been i n s t a l l e d w i t h i n the c o r r e c t i o n a l formations of t h e r a p e u t i c a u t h o r i t y to the extent that they have been i n s t i t u t i o n a l l y transposed: adopted by, adapted to, and subsumed w i t h i n more t r a d i t i o n a l apparatuses of medical a d m i n i s t r a t i o n i n p r i s o n s , 120 d e t o x i f i c a t i o n centres, r e h a b i l i t a t i o n c l i n i c s , and so f o r t h . Within such c o n f i g u r a t i o n s , the voluntary and e t h i c a l components become l e s s apparent and, by degrees, undergo a s t r a t e g i c m o d i f i c a t i o n , a d i s c i p l i n a r y reprogramming to f u n c t i o n as or w i t h i n mechanisms of c l i n i c a l and i n s t i t u t i o n a l recuperation. As c i v i c a c t o r s , then, p h y s i c i a n s , p s y c h i a t r i s t s , employers, f a m i l y members, and so f o r t h have recognized i n A l c o h o l i c s Anonymous a p r a c t i c a l means of achieving a recovery of a l c o h o l i c s , a recuperation of a l c o h o l i c s and of t h e i r s o c i a l , b i o l o g i c a l , and productive p o t e n t i a l . Further, they have sought to i n s t a l l t h i s recovery technology w i t h i n domains of d i s c i p l i n a r y , but non-sovereign, power. However, agents of sovereignty - those actors and agencies that concern themselves with the r e g u l a t i o n of d r i n k i n g and drunkenness i n the i n t e r e s t s of p u b l i c welfare - have a l s o deployed AA, as a deviance- and crime-reducing technology of the l e g a l system. Indeed, through the i n t e r v e n t i o n s of p u b l i c r e p r e s e n t a t i v e s such as p o l i c e o f f i c e r s , s o c i a l workers, court judges, and p r i s o n a d m i n i s t r a t o r s , AA has become well-entrenched i n j u r i d i c a l regimes of enforcement, c o r r e c t i o n , and punishment. Through d i r e c t or i n d i r e c t means, problem d r i n k e r s - or at l e a s t 121 those problem d r i n k e r s who become, f o r one reason or another, t a r g e t s of the l e g a l system - are exposed to A l c o h o l i c s Anonymous on a regular b a s i s by j u d i c i a l and executive delegates of government. For example, i n d i v i d u a l s a r r e s t e d by p o l i c e o f f i c e r s on drunkenness charges may be (temporarily) placed i n d e t o x i f i c a t i o n centres or "drunk tanks;" and although the i n t e n t i o n of t h i s b r i e f i n c a r c e r a t i o n i s to purge the body of a l c o h o l , i t i s not uncommon f o r such f a c i l i t i e s to have connections with AA members who are seeking to help others. In many p r i s o n s , as w e l l , a d m i n i s t r a t o r s may place inmates i n contact with AA members on an i n d i v i d u a l b a s i s , and / or may make p r o v i s i o n s f o r the establishment of r e g u l a r AA meetings. A l c o h o l i c s Anonymous publishes a pamphlet s p e c i f i c a l l y f o r inmates ("It Sure Beats S i t t i n g i n a C e l l " [AA 1972]) and maintains a correspondence program that provides AA "pen p a l s " to imprisoned a l c o h o l i c s . As w e l l , r e l a t i o n s between AA members and p r i s o n e r s may continue beyond periods of i n c a r c e r a t i o n regardless of whether an i n d i v i d u a l wishes to l i v e the AA way of l i f e o r n o t , since c o n d i t i o n s of parole sometimes s t i p u l a t e attendance of meetings. 122 The most common use of AA by the j u r i d i c a l apparatus, however, i s f o r mandatory attendance of AA meetings to be in c l u d e d as p a r t of or i n l i e u of a sentence. In such cases, i n d i v i d u a l s who have been convicted - or wish to avoid c o n v i c t i o n - of offences that r e l a t e to drunkenness are ordered to p a r t i c i p a t e i n a set number of AA meetings ( i n d i v i d u a l s are commonly required to attend "90 meetings i n 90 days") and to have a court document signed by an AA organizer as proof of attendance. This a c t i v i t y i s most f r e q u e n t l y r e quired of i n d i v i d u a l s who have had m u l t i p l e a r r e s t s f o r d r i v i n g while i n t o x i c a t e d beyond l e g a l l i m i t s , and i s prevalent enough that i t has entered the vernacular of AA. And although "court c a r d i n g " generates a c e r t a i n amount of controversy among i t s members, many of whom oppose the attendance of meetings by i n d i v i d u a l s who do not, and do wish t o , i d e n t i f y as a l c o h o l i c s , AA g e n e r a l l y accepts and accommodates t h i s p r a c t i c e . I t i s i n i t s l e g a l a p p l i c a t i o n s that A l c o h o l i c s Anonymous i s most e a s i l y i d e n t i f i e d as" a technology of domination, that i s , when the program becomes an instrument i n v o l v e d i n governance on behalf of agents of the s t a t e . And indeed, i n t h i s c a p a c i t y , i n the execution of j u d i c i a l sentences, AA i t s e l f becomes an agent of the s t a t e 123 f u n c t i o n i n g not p u n i t i v e l y , but t h e r a p e u t i c a l l y , d i s c i p l i n a r i l y , as a means of t r e a t i n g , c o r r e c t i n g , and norma l i z i n g both c r i m i n a l (drinking) behaviour and deviant c o n d i t i o n s ( i . e . , a l c o h o l i s m ) . On behalf of the s t a t e , AA envelopes problem d r i n k e r s i n a re g u l a t o r y gaze, i t req u i r e s t h e i r confession ("Please sign my probationary record; I have been a r r e s t e d f o r drunk driving...") and i t imposes ( i n unison with sentencing j u d i c i a r i e s ) a d e f i n i t i o n of the problem. Court carders' own testimony confirms t h i s , as i n the i n s i s t e n c e of one i n d i v i d u a l that h i s mandatory attendance of AA meetings as a r e s u l t of dru n k - d r i v i n g c o n v i c t i o n s was u n f a i r , that the r e a l problem "was wit h the p o l i c e . I f they'd j u s t q u i t stopping me, everything would be f i n e " (Wilcox 1998: 32). AA i s included i n the indictment of h i s punishment because i t i s i m p l i c a t e d i n the same system of (unjust) r u l e as the p o l i c e , because i t ass e r t s the same judgement as the courts (that the individual i s the problem) and because i t enforces the w i l l of these l e g a l a u t h o r i t i e s . AA's m o t i v a t i o n f o r involvement i n the d i s c i p l i n i n g of c r i m i n a l l y offending d r i n k e r s i s not e a s i l y d i s c e r n i b l e since the o r g a n i z a t i o n has not (to my knowledge) o f f i c i a l l y commented on such matters. However, i t i s c l e a r that the 124 ( p a r t i a l ) subsumption of AA's " e t h i c a l " program w i t h i n a framework of j u r i d i c a l compulsion e n t a i l s an endorsement of the program by p u b l i c a u t h o r i t i e s - and u l t i m a t e l y augments the eminence of AA. Furthermore, through the performance of i t s d i s c i p l i n a r y operations, AA acquires the opportunity to e s t a b l i s h contact with a s i g n i f i c a n t number of "prospects" to which i t would not l i k e l y have access otherwise. And although many court carder's, f e a r i n g i n c a r c e r a t i o n or a d d i t i o n a l , p o s s i b l y felony, charges, c a r r y out the terms of t h e i r sentences without experiencing a s p i r i t u a l conversion or without i d e n t i f y i n g themselves as a l c o h o l i c , others, " a f t e r i n t e n s i v e exposure to the p r i n c i p l e s , a t t i t u d e s , and b e l i e f s expressed through the s p e c i a l i z e d language of A l c o h o l i c s Anonymous," g r a d u a l l y do come to accept the i d e n t i t y of a l c o h o l i s m and the AA way of l i f e (Wilcox 1998: 32) . Thus, A l c o h o l i c s Anonymous i s c a l l e d upon by 'a wide range of sources to b r i n g about a l c o h o l i c recovery: by ( s e l f - i d e n t i f y i n g ) a l c o h o l i c s themselves, and of course by the anonymous, composite e n t i t y of AA, but a l s o by r e l a t i v e s , romantic partners, f r i e n d s , employers, p h y s i c i a n s , p s y c h o l o g i s t s and p s y c h i a t r i s t s , s o c i a l workers, p o l i c e o f f i c e r s , i n s t i t u t i o n a l a d m i n i s t r a t o r s , and judges, 125 and by various other i n d i v i d u a l s who d i r e c t l y or i n d i r e c t l y concern themselves with a population of i n d i v i d u a l s whose consumption of a l c o h o l i s perceived to be problematic i n one way or another. In response to these di v e r s e c a l l s , and to the t r o u b l e s a t t r i b u t e d to problem d r i n k e r s , AA has e s t a b l i s h e d a program of recovering a l c o h o l i c s , and of a l c o h o l i c r e c o v e r i e s : a governmental system created and maintained by a l c o h o l i c s that endeavours to transform a c t i v e a l c o h o l i c s i n t o recovering a l c o h o l i c s , thereby salvaging i n d i v i d u a l s - and s o c i e t y - from the wreckage of drunkenness and r e s t o r i n g personal, s o c i a l , economic, and p o l i t i c a l values. The successes of these rec o v e r i e s - indeed, the success of AA - are of course impossible to confirm or deny i n any d e f i n i t i v e manner; however, as long as problem d r i n k e r s are i d e n t i f i e d as a l c o h o l i c s , as i n d i v i d u a l s whose inherent impulses to f u l f i l d e s i r e s f o r d r i n k prevent the f u l f i l m e n t of t h e i r p o t e n t i a l and whose natures re q u i r e s p e c i a l forms of a l c o h o l i c governance, the recovery l o g i c of AA w i l l l i k e l y provide s u f f i c i e n t j u s t i f i c a t i o n f o r the program's continued o p e r a t i o n ( s ) . 126 CHAPTER IV: CONCLUSION THE CULTURAL LOGIC OF AA This study has sought to explore some of the ways i n which a l c o h o l i c s u b j e c t i v i t y (and, by extension, the s u b j e c t i v i t y of the addict) i s produced and managed i n contemporary North American s o c i e t y . I t began i n Chapter I I by examining the h i s t o r y of AA and the genealogy of a l c o h o l i c s and alcoholism, noting d i s c u r s i v e s h i f t s i n the meanings of a d d i c t i o n and conceptions of d r i n k i n g problems as .well as t h e r a p e u t i c and i n s t i t u t i o n a l p r a c t i c e s . The d i s c u r s i v e and c o g n i t i v e production of the " t r u t h s " of a l c o h o l i s m was i n d i c a t e d as a simple matter of r i g i d l y h i e r a r c h i c a l power r e l a t i o n s , with s c i e n t i f i c experts studying and c l a s s i f y i n g i n d i v i d u a l s who remained more or l e s s passive r e c i p i e n t s of the knowledge of t h e i r " c o n d i t i o n . " Instead, i t found that a l c o h o l i s m and a l c o h o l i c s were produced with s i g n i f i c a n t exchange and linkage between the knowledges of p r o f e s s i o n a l experts and the l a y e x p e r t i s e of a d d i c t s about t h e i r own c o n d i t i o n s . Nevertheless, expert d i s c i p l i n e s did exert a s i g n i f i c a n t i n f l u e n c e on the conceptions of a d d i c t i o n . I t 127 was, a f t e r a l l , a p s y c h i a t r i s t who f i r s t proposed the disease model of alc o h o l i s m i n North America and recommended complete abstinence from a l c o h o l as the treatment of choice; and, more than a century l a t e r , the disease concept was re s u r r e c t e d not by addicts (who arguably d i d not yet e x i s t ) but by those experts of the human sciences who studied, c l a s s i f i e d , and catalogued the various forms of alcoholism. Those experts, too, were l a r g e l y responsible f o r the popular d i f f u s i o n of the disease concept of alcoholism, p u b l i c l y announcing t h a t a l c o h o l i c s deserved medical treatment rather than moral condemnation. Without doubt, AA and other groups of a l c o h o l i c s played an important part i n the a l c o h o l i s m movement; but a s i g n i f i c a n t part of t h e i r success must be a t t r i b u t e d to the f a c t that t h e i r ideas about the "disease" of a l c o h o l i s m bore a c e r t a i n imprimatur of s c i e n t i f i c l e g i t i m a c y . While t h i s study suggests that the d i s c u r s i v e and s o c i a l c o n s t r u c t i o n of modern conceptions of al c o h o l i s m by expert and l a y a u t h o r i t i e s has r e s u l t e d i n the " b i r t h " or " c r e a t i o n " of a population of a l c o h o l i c s , I do not mean to imply that the addict i s a mere f i c t i o n or that the compulsion that addicts f e e l to consume p a r t i c u l a r substances or to engage i n c e r t a i n a c t i v i t i e s are somehow 128 not " r e a l ; " or that c e r t a i n f e e l i n g s of compulsion towards substances or processes d i d not e x i s t before the widespread c i r c u l a t i o n of a discourse on a d d i c t i o n . Rather, f o l l o w i n g Ian Hacking's (1986) ideas on the "making up" of people, I would l i k e to suggest that the a l c o h o l i c i s a person who came i n t o being at the very time when the new modes of d e s c r i p t i o n and c l a s s i f i c a t i o n that "invented" a l c o h o l i s m arose. Thus, while impulses to d r i n k may have been experienced by i n d i v i d u a l s p r i o r to the development of contemporary discourses on a d d i c t i o n , with new modes of understandings such impulses were experienced with a d i s t i n c t character and f e l t to be l o c a t e d " w i t h i n " the addicted i n d i v i d u a l . Having looked at the conception(s) of Homo Alcoholus, I turned t o a c o n s i d e r a t i o n of how t h i s newly c o n s t i t u t e d i d e n t i t y formed the b a s i s f o r a regime of governance over the bodies and the souls of t h i s species. While there was a general consensus among experts that a l c o h o l i c s should completely a b s t a i n from d r i n k i n g , the a d m i n i s t r a t i o n of these p r o s c r i p t i o n s was not a simple matter. In some cases, of course, i n s t i t u t i o n a l i z a t i o n provided s u r v e i l l a n c e of i n d i v i d u a l s i n the c r i t i c a l stages of a l c o h o l i c disease. But f o r the most p a r t , such treatments were not v i a b l e , both 129 because of the economic expenses i n v o l v e d and because a l c o h o l i c s g e n e r a l l y r e s i s t e d such measures on a prolonged b a s i s . What seemed to be required was a form of therapy i n which a l c o h o l i c s could be c a l l e d upon (by themselves and / or by a wide range of s o c i a l and p o l i t i c a l agents) to e f f e c t an e t h i c a l governance, to e s t a b l i s h a system of s e l f -c o n t r o l . A l c o h o l i c s Anonymous emerged with such a treatment program i n the 1930s, and soon t h e r e a f t e r came to be regarded as an a t t r a c t i v e a l t e r n a t i v e to i n s t i t u t i o n a l i z a t i o n and other forms of d i r e c t medical i n t e r v e n t i o n . Chapter I I I began by examining some of the formations of a l c o h o l i s m and a l c o h o l i c s i n A l c o h o l i c s Anonymous: the d i s c u r s i v e formations of the program ( i . e . , the epistemic foundations upon which AA functions and depends); the c o g n i t i v e formation of AA a l c o h o l i c s (the production of a l c o h o l i c s u b j e c t i v i t y w i t h i n problem d r i n k e r s through the r e c o n s t i t u t i o n of h i s t o r i e s and experiences as those of Homo Alcoholus); and the t a c t i c a l formations of AA's regime of e t h i c a l governance (the deployment of techniques of s e l f -care and the st r a t e g y of r e - o r i e n t i n g the a l c o h o l i c ' s soul towards a path of s p i r i t u a l progress). I t i d e n t i f i e d how, founded upon a s p i r i t u a l b a s i s and o p e r a t i o n a l i z e d i n the 130 Twelve Steps of AA, these formations f o s t e r w i t h i n AA members a system of s e l f - r e g u l a t i o n that manages not the consumption of a l c o h o l , but the soul of the a l c o h o l i c , those parts of the body and consciousness from which disease manifests i t s e l f as an a p p e t i t e f o r a l c o h o l so powerful that i t causes a range of d i s o r d e r s which threaten to destroy the i n d i v i d u a l . While AA's program does not cure the disease of alcoholism, i t does, i f • p r o p e r l y maintained, allow the d e s i r e f o r a l c o h o l to be r e s i s t e d , weakened, and even e l i m i n a t e d , so that a l c o h o l i c s are freed from the misery and enslavement they formerly experienced. In a new s t a t e of freedom, AA members experience an inner peace and s a t i s f a c t i o n as they work towards c o n s t r u c t i n g f u l f i l l e d , rewarding l i v e s . F i n a l l y , although i n most accounts AA i s formulated and presented almost e x c l u s i v e l y as a system of e t h i c a l governance undertaken f o r purposes of s e l f - r e c o v e r y , I demonstrated that i t i s a l s o s i g n i f i c a n t l y i n v o l v e d i n the n o r m a l i z i n g and o p t i m i z i n g a c t i v i t i e s of d i s c i p l i n a r y power. In conjunction with s o c i a l , p r o f e s s i o n a l , i n s t i t u t i o n a l , and moral a u t h o r i t i e s , AA engages i n recovering a l c o h o l i c s not only as i n d i v i d u a l p e r s o n a l i t i e s , but as (anonymous!) human resources, as components whose c o n s t i t u t i v e functions 131 maintain the f a b r i c of s o c i e t y . In t h i s sense, I i d e n t i f i e d a twofold existence of AA: existence as a technology of the s e l f on the one hand, as a program of i n d i v i d u a l s p i r i t u a l / e t h i c a l recovery and a means of c a l l i n g upon i n d i v i d u a l s who experience t h e i r own d r i n k i n g behaviour as problematic to e s t a b l i s h i n t e r n a l forms of c o n t r o l ; and a l s o as a technology of d i s c i p l i n e , a program of s o c i a l / economic / p o l i t i c a l recovery imposed by systems of e x t e r n a l c o n t r o l onto i n d i v i d u a l s whose d r i n k i n g behaviour creates problems (or the perception of problems) f o r others. A l c o h o l i c s Anonymous, then, can be conceptualized as technology of governmentality, whose b i f u r c a t e d elements mutually produce and require one another as they i n s e r t d i s p o s i t i v e s of s o c i a l and b i o p o l i t i c a l management i n t o f i e l d s of p r o f e s s i o n a l , popular, i n s t i t u t i o n a l , and moral c u l t u r e , d i s p o s i t i v e s which are both a p p l i e d to and assumed by i n d i v i d u a l s . And i t i s as such that AA has developed and been deployed as a technology of l i b e r a l governance i n the West: a mechanism of power conditioned upon ad m i n i s t e r i n g and enhancing freedom rather than r e p r e s s i n g i t , and which fu n c t i o n s by d i s c o v e r i n g , understanding, and managing the hidden and mysterious aspects of human existence i n order to b r i n g about personal and s o c i a l w e l l - b e i n g . Thus, the 132 recovery l o g i c of AA reproduces a broader, c u l t u r a l l o g i c of recovery: of a s s o c i a t i n g s o c i a l problems with i n d i v i d u a l s who e x h i b i t behavioural deviance; of studying these i n d i v i d u a l s , e x t r a c t i n g confessions and imposing analyses; of developing systems of c l a s s i f i c a t i o n and d i f f e r e n c e that are imposed upon and adopted as s u b j e c t i v i t i e s ; of formulating m o d a l i t i e s of therapy, treatment, r e g u l a t i o n , c o n t r o l , and so f o r t h which are a p p l i e d to subjects by themselves and by others; and, by c o n t a i n i n g one's conduct and being w i t h i n realms of unproblematic normalcy; and thereby of r e s t o r i n g or augmenting the h e a l t h and l i b e r t y of the subject (from enslavement to the r u l e of "unnatural" c o n s t i t u t i o n s ) and s o c i e t y (from the ravages brought about by s o c i a l i l l s ) . The l o g i c of A l c o h o l i c s Anonymous i s indeed l a r g e l y a l o g i c of s e l f - r e c o v e r y i n which a l c o h o l i c s pursue t h e i r r e c o v e r i e s p r i m a r i l y as personal, s p i r i t u a l undertakings of the s e l f ; and even i f a l c o h o l i s m i s a c u l t u r a l f i x - t i o n , AA members fundamentally a b s t a i n from a l c o h o l not to avoid s o c i a l d i s a p p r o v a l or l e g a l repercussions, but r a t h e r to meet the s p i r i t u a l standards of AA, which are l a r g e l y adopted, too, as personal, e t h i c a l standards. But while these standards (e.g., honesty, r a t i o n a l i t y , s e l f - r e l i a n c e , 133 sense of purpose, motivation, duty, c h a r i t y , p r o d u c t i v i t y ) are presented as u n i v e r s a l standards of goodness and are not g e n e r a l l y i n t e r r o g a t e d by AA members, they are indeed c u l t u r a l standards as w e l l , engendering, supporting, and s u s t a i n i n g much of the same Protestant e t h i c that Max Weber (1958) i d e n t i f i e d as p r o v i d i n g the s p i r i t of c a p i t a l i s m . As recovering a l c o h o l i c s work i n AA towards meeting these standards, "they t r u l y begin to meet the i d e a l i z e d behaviour of American c u l t u r e . They endeavour to become more honest, more s o c i a b l e , more competent, more able to work f o r what they want, • more responsible f o r t h e i r a c t i o n s , and more' o p t i m i s t i c about the p o s s i b l e r e s u l t s " (Wilcox 1998: 59) . Insofar as AA members develop (and reproduce i n others) a d o c i l e , co-operative s p i r i t that b e t t e r s u i t s them to t h e i r dominant socio-economic system and recover "normal" forms of thought and conduct, then, AA al s o embodies a l o g i c of c u l t u r a l recovery, a process of s u t u r i n g and concealing wounds or f r a c t u r e s i n the hegemonic t o t a l i t y of the s o c i a l , economic, and c u l t u r a l systems of c a p i t a l i s m . U l t i m a t e l y , then, t h i s study has deduced the c u l t u r a l l o g i c of A l c o h o l i c s Anonymous; or, more p r e c i s e l y , i t has po s t u l a t e d AA as a nodal point w i t h i n a c i r c u l a r ( i . e . , reproductive) c u l t u r a l l o g i c of recovery: Created i n the 134 United States i n the 1930s by i n d i v i d u a l s who had been brought i n t o contact with d i s c i p l i n a r y a u t h o r i t i e s as a r e s u l t of t h e i r d r i n k i n g problems, AA i s founded upon and organized according to the same values, b e l i e f s , and methods that these problem d r i n k e r s had assumed from t h e i r own c u l t u r a l p o s i t i o n s and experiences. Through processes of d i s c u r s i v e and p r a c t i c a l f i x - t i o n , AA a r t i c u l a t e s behavioural deviance (problem drinking) to a c o n s t i t u t i o n a l c o n d i t i o n (alcoholism) and c l a s s i f i c a t i o n of s u b j e c t i v i t y ( a l c o h o l i c s ) . Through apparatuses of governmentality (alcoholism "treatment" i n AA and elsewhere) i t produces ( s o c i a l , medical, l e g a l ) conformity to the standards of thought and conduct that were dominant among these white, m i d d l e - c l a s s , C h r i s t i a n men - standards which continue, to a s i g n i f i c a n t degree, to p r e v a i l i n contemporary North America. And j u s t as AA r e f l e c t s dominant patterns of North American c u l t u r e i n i t s d i s c u r s i v e content and p r a c t i c a l techniques, i t c o n t r i b u t e s - to the extent that i t s conceptions of alc o h o l i s m have become ge o g r a p h i c a l l y , demographically, and s o c i a l l y d i f f u s e d throughout North America - to the c u l t u r a l reproduction of these p a t t e r n s . 135 CONCLUDING REMARKS I have focused my research p r i m a r i l y on the management and governance of alc o h o l i s m w i t h i n AA, rather than undertaking a broader, more comparative approach that might seek to r e l a t e some of the se v e r a l dozens of twelve-step a d d i c t i o n programs that e x i s t today. Instead of making ad-hoc comparisons and observations about a number of groups, my i n t e n t i o n has been to provide a more in-depth examination of the key o r g a n i z a t i o n that began - and continues to f u n c t i o n as the model f o r today's broad twelve-step recovery movement, and f o r a d d i c t i o n treatment i n general. Such an approach seemed d e s i r a b l e , even necessary, given the l a c k of c r i t i c a l s o c i o l o g i c a l analyses of contemporary conceptions of a l c o h o l i s m and a d d i c t i o n , the s u b j e c t i v i t i e s of a l c o h o l i c s and a d d i c t s , and of the governance of forms of what might be c a l l e d l i b i d i n a l or a p p e t i t i v e deviance. I b e l i e v e that the c u l t u r a l l o g i c of AA's recovery program i s analogous, to a greater or l e s s e r degree, to other contemporary forms of a d d i c t i o n treatment, and undertook to o u t l i n e some of the d i s c u r s i v e and r e g u l a t o r y developments i n v o l v e d with the p r o l i f e r a t i o n of a d d i c t i o n s u b j e c t i v i t i e s (and twelve-step programs) that have occurred i n the l a s t h a l f - c e n t u r y ; however, t h i s study u l t i m a t e l y 136 leaves the c r i t i c a l t h e o r i z a t i o n of a d d i c t i o n incomplete. Further s o c i o l o g i c a l a t t e n t i o n needs to be focused on the expansion of conceptions of a d d i c t i o n i n North American c u l t u r e and the regimes of governance that have emerged i n response to that expansion. In p a r t i c u l a r , a d d i t i o n a l study i s r e q u i r e d of the ways i n which various forms of a d d i c t i o n treatment that aim to manage a d d i c t i o n and to reduce the v i s i b i l i t y and prevalence of compulsive, problematic behaviours, have c o n t r i b u t e d to the emergence of u n i f y i n g , homogenizing notions of a d d i c t i o n and dependency that envelops a d i v e r s e number of substances and a c t i v i t i e s , and thus to the p r o l i f e r a t i o n and m u l t i p l i c a t i o n of " a d d i c t s . " . Furthermore, a complete s o c i o l o g i c a l account of the governance of a d d i c t i o n would n e c e s s i t a t e an i n v e s t i g a t i o n i n t o what might be c a l l e d the epidemiology of a d d i c t i o n , i n t o contemporary notions that u n c o n t r o l l e d d e s i r e s , d e s i r e s , impulses, cravings, and dependence can or should be t r e a t e d as s o c i a l contagions. This would r e q u i r e studying p u b l i c s a f e t y regimes that t r e a t compulsions and dependencies as t h r e a t s to h e a l t h and w e l l - b e i n g , of course; but a l s o how these t h r e a t s are formulated as c u l t u r a l i n f e c t i o n s that spread through s o c i a l contact and r e q u i r e p r e v e n t a t i v e r e g u l a t i o n (e.g., anti-drug campaigns that warn 137 parents to pay a t t e n t i o n to whom t h e i r c h i l d r e n a s s o c i a t e w i t h ; or p o l i t i c a l / s o c i a l work e f f o r t s to r i d subcultures of poverty of the plague of "welfare dependency"). I t would a l s o i n v e s t i g a t e the ways i n which perceptions of the r i s k s of "becoming" an addict (or, perhaps, of becoming an " a c t i v e " addict) seems to n e c e s s i t a t e preemptive regimes of monitoring and c o n t r o l at an i n d i v i d u a l l e v e l , even as those who consume and behave i n non-compulsive, unproblematic ways i n c r e a s i n g l y f e e l compelled to govern t h e i r own thoughts and conduct i n attempts to prevent the development or onset of a d d i c t i o n or dependency: "Did I d r i n k too much l a s t night? Am I spending too much time on the i n t e r n e t ? Could I stop i f I wanted to? Would I know i f I had a problem?" C e r t a i n l y , i n d i v i d u a l s who do not i d e n t i f y themselves as a d d i c t s are not e n l i s t e d i n the c o n t r o l of t h e i r own a c t i v i t i e s i n the exact same way that a l c o h o l i c s f i g h t the urge to d r i n k or compulsive gamblers r e s i s t the temptation to play poker. The s e l f - g o v e r n i n g addict engages i n techniques and p r a c t i c e s that depend on the uniqueness of t h e i r diseased i d e n t i t y which may not exactly be transposed to the non-addict - most notably, the p u r s u i t of complete abstinence. But what I would l i k e to suggest i s t h a t , due to widespread, popular discourse on a d d i c t i o n s , 138 dependencies, "problem behaviours," and so f o r t h , we are a l l s i t u a t e d i n similar regimes of governance, monitoring our thoughts, our a c t i o n s , our d e s i r e s , and our souls f o r signs of r i s k . 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New York: Oxford U n i v e r s i t y Press. 144 

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