Stories We Tell Ourselves And Believe About Ourselves: I've Been Studying This Book, It Is Extremely Important

In his fine study of alcohol and its destructive consequences, Firewater:  How Alcohol Is Killing My People (And Yours),  Harold R. Johnson, informed by his long experience of first hand observation of all levels of alcohol use as a young man growing up in modest circumstances up to and including as a defense lawyer and a prosecutor, he holds that the stories people tell themselves about themselves, the stories about themselves that they take in from other people, from tradition, from the media, etc. plays a crucial role  in drinking.  Being a member of the Cree People, he goes into a lot of that through the lens of the "drunken Indian" stereotype, mentioning, among other things, the role that the Canadian Supreme Court played in making alcoholism among First Nations worse using a conception of individual liberty without consultation of those most effected by their rulings.  That example should make anyone piously intoning the rote phrases of libertarianism and liberalish libertarianism stop and think about what really matters, in the end, the ends of following their preferred lines.*

Much of Harold R. Johnson's book revolves around the fact that how people imagine themselves has a dominant role in how they behave, what they choose to do how they believe they are compelled to behave.  If your story is that you are someone who never drinks alcohol,  you won't drink.  If your story is that you're a rowdy, rough and tough boozer,  you'll act out the role you create for yourself.  If you are told and believe that your alcoholism is a result of colonization and racial oppression (the first of four models of drinking presented in the book) , you will believe your power to stop drinking isn't sufficient to overcome forces out of your control - that's related to the "victim" story, the second one in the book.   Both of those models of why people who drink, drink are, obviously, stories that are both disempowering, preventing people from feeling they were capable of changing their lives to save their lives.  Both of them give drinkers one of their most cherished possessions, sometimes the last thing the hardest core drinkers will have, an excuse to keep drinking.  

I'm going to go through the third model he presents, the scientific one, the medical one in depth, his third model of how people see and think of alcohol abuse.

We've tried to understand and treat the problems of alcohol by telling stories of victimhood (Victim Model) and of historical trauma (Grief and Trauma Model).  There is also the standard Medical Model, which treats alcoholism as a disease.  The treatment is to quit drinking and with the use of support groups, a twelve-step program, surrendering oneself to something higher, and sheer willpower, and slowly, with time, the cravings should diminish and eventually stop. 

The idea of treating alcoholism as a disease is a  little misleading.  Even though it kills a lot of people, it is not the same as smallpox, for instance.  We have referred to alcoholism as a disease so that we could get our heads around the problem without blaming the alcoholic.   Before we considered it a disease we thought it was a moral problem or a willpower problem.   Calling it a disease helped us to search for solutions without putting all the blame on the person, who was obviously unable to change on his or her own. 

The problem with calling alcoholism a disease is that it takes control away from the alcoholic.  If it is a disease like muscular dystrophy or measles or tuberculosis, then the person cannot do anything about it;  that's just the way it is, a matter of chance or bad luck.  We have been telling the alcoholic that the solution is that they have to quit drinking completely and never drink again as long as they live, and if they have trouble doing that, they should seek out a higher power to help them, and if they follow the twelve steps recommended by Alcoholics Anonymous and it still doesn't work, then they are not being honest enough. 

We might be better off calling alcoholism an "injury."   Addictions and poor health from over consumption are similar to repetitive strain, like carpal tunnel syndrome, where we use a particular muscle too much in a poor way and injure ourselves as a result.  Excessive drinking in binges over a long period of time causes damage to our brains and other organs like the liver.  No matter how serious the damage that's done, we still cannot call it a disease.  Because here's the thing:  like a sprained muscle it starts to get better as soon as we quit using it.  Leprosy doesn't work that way and neither does cancer. 

The difference between calling addiction a disease and calling it an injury is how the person who has it deals with it.  If the person says,  "I have a disease.  It's God's will.  There is nothing I can do about it," then their power is taken away from them.  If the person says instead,  "I drank so much, so often, that I injured myself"  then they are in a position to do something about it.  It is something they control.  

As someone who has supported AA as, not a panacea but as something that has saved the lives of many people, I am sure that lots of people will take what Harold Johnson says here as a total repudiation of that.  I don't get that at all, Harold Johnson points out in part of the book which I'll discuss later that AA works for a percentage of those who try to stop drinking, as I recall elsewhere he said that it has a success rate of about 8%, which could be contrasted with the "scientific treatment" model of 2 to 6%.   Which points mainly to the fact that addiction is an extremely hard thing to fix or "cure" or "heal" or whatever way you choose to look at it.  For those it works for, AA works. For those it doesn't work for, who knows why?  Different AA groups are radically different, they are so different I think it makes no sense to consider AA as one thing.  I don't know if there have been studies to see what kind of variation in success different meetings might have and what is different about meetings that have better and worse rates of success.  That would be useful to know.  I don't know of any AA members who blame their alcoholism on God or any groups that would encourage that, though I've known enough alcoholics and addicts to know that many of them will grasp on to any assembly of words as an excuse to not stop drinking.  

As long as we're taking a critical look at the medical model of alcoholism - not to mention more casual, non-habitual alcohol use which kills people and leads to misery,  I think we need to ask if even obvious alcoholism can be assumed to spring from similar origins and tendencies and motives or be susceptible to one or a narrow range of ways to fix it.  I would guess there are alcoholics who become alcoholics because they like alcohol and its effects without there being any deep traumatic personal pain that leads to drinking, though there are certainly alcoholics like that, too.  I would bet that there are dozens if not hundreds of types of alcoholism and that what would work to treat alcoholism and alcohol abuse would be as variable in its success rate. 

And that's not to get to the harmful to deadly results that casual drinking and occasional drunkenness can cause.  Which, Harold Johnson includes in his treatment of the problem.

The biggest shortcoming with the Medical Model of approaching alcohol as a disease is not how it treats of fails to treat alcohol dependency.  The problem with alcohol is that people who are not addicted to it, people like the person who ran over my brother, simply drink too much at times and then make poor decisions.  Bassed upon the number of people I see in court who are charged with offenses committed while drinking, I estimate that among that population of drinkers, only about 15 to 20 per cent are at the stage where they have drunk too much, too often, and, in doing so, have rewired their brains to the point that they are compulsively and obsessively addicted to alcohol.  The Medical Model doesn't account for the 80 to 85 per cent of people experiencing problems with alcohol.   This model, therefore, the one that tells a story of alcohol and disease, fails to help our greater community with problems of alcohol.  The person who ran over Garry was not addicted to alcohol.  He or she did dink excessively that one night, but that was one night too many.  

That is such an important and so often overlooked point about drinking, you can get drunk or even slightly intoxicated with it and have an accident, in a car, in a house, with machinery, near the water, while tending young children, etc. and it can have live changing and life ending effects.  The emphasis on alcoholism when thinking about the problem of drinking masks that significant effect that alcohol, presented so positively in the media going back to the first depiction of the first jolly drunk (or merry drunk or hale goodfellow or cheerful tippler) falsifies.  In reading and re-reading Harold Johnson's book, in following up on his footnotes and citations, I thought about how drinking is presented in stories and can't think of many if any truly positive depictions of total abstainers.  I can't remember any models of happily sober people, of people who never drink and would always refuse drink as a role model.  Oddly, the only thing close to that I remember seeing on any TV show was the cartoon figure Mountie Paul Gross played in Due South and, while you might want to be able to depend on such a fictitious character come to life, he wasn't really presented as a role model anyone would want to copy.  It would have been a mighty hard thing to be Benton Fraser, though from what I've experienced an seen, going through life not being addicted to alcohol or other substances is a lot more pleasant and easy for everyone, especially the sober person.  The depiction of habitually sober people has been as falsely negative as the depiction of drunks has been falsely positive.  

I will go on with this.  One point that Harold Johnson which is important is that, contrary to the stereotype,  Native Americans, First Nations People, Indians have about the highest percentage of complete abstainers, of sobriety as measured.   


* I think it's clear that something called "freedom" "liberty" and even "equality under the law" divorced from the real life results of those will end up enslaving people, harming people, killing people.   If you can't see that from the free speech, free press granted he liquor industry, the corporate media, you might be able to understand that when you consider the gun industry and its lawyers' and hired hack writers' and yakkers' articulation of "freedom," "liberty" and "equality under the law."   It is one of the stupidest things in the "enlightenment" articulation of rights includes lots of things, lying, thieving, reckless behavior, being dangerously drunk, etc. as rights when there is no rational case to be made for including such negative choices in any enumeration of rights. 

Update:  Well, you know who agrees with me about Benton Fraser being a cartoon figure?  Paul Gross.  It took me all of five seconds to find this.

"I think it works through false nostalgia," says Gross, stretching out in a trailer that features a bust of Elvis and an austere diet of biscuits and Canadian spring water. "I mean, we know that nobody like Benton Fraser ever really existed."