Robin Room and The Sociological Unconscious
October 5, 1997
Robin Room seems to feel that he has made an Einsteinian discovery in connecting my work on controlled drinking therapy to my views that Draconian legal/taxation controls to discourage alcohol and other substance use are the wrong social policy to pursue (Peele, 1987a), and in finding that both points of view stem from my idea that society must establish value frameworks and that individuals be punished when they act antisocially (as opposed to when they pursue their private pleasures). In other words, society's province is to protect itself and the individuals in it. It rightly sets the rules to accomplish this and punishes those who violate them. Where it has no role is in telling people what to put in their bodies, based on always incorrect assumptions (because no drug, including alcohol, has the inexorable negative effects attributed to it by the societies which disapprove of each such substance's use).
This is all laid out in my classic paper, "A moral vision of addiction: How people's values determine whether they become and remain addicts" (Peele, 1987b), in which I label values the ignored variable in addiction theory and practice. I adduce the following evidence to show this is the case: (1) the great variability in practice and experience with a variety of drugs, such as alcohol, depending on what cultures teach and enforce in the way of drug-related behavior; (2) that alcoholic and other drug-related misbehavior is generally associated with individuals' pre-existing antisocial value and behavior patterns; (3) when individuals change addictive patterns, they generally do so in terms of larger value structures in which this behavior is imbedded, key elements of which conflict with the addictive behavior.
Indeed, quite a bit of the evidence for this point of view, in the case of alcohol, comes from work performed by Room while at the Berkeley Alcohol Research Group. This includes, for starters, the product of a conference on the topic of Alcohol and Disinhibition (Room & Collins, 1983), which found this link was highly attenuated and essentially mediated by cultural meanings and permissions associated with imbibing alcohol. Furthermore, Cahalan and Room (1974) showed that cultural groups differ dramatically in their problem drinking, and that groups which drink with few problems (e.g., Italians and Jews) embrace drinking as a cultural tradition and disdain abstinence. The opposite pattern (i.e., enforced abstinence, frequent acting out with alcohol) characterizes conservative Protestant sects (mainly Southern Baptists). At the same time, better-educated individuals are more likely to drink, but to drink without problems, than the less well-educated, who frequently abstain but have elevated problem drinking rates nonetheless (Hilton, 1987). Cahalan and Room further showed that problem drinking was centered in groups of young males who had other antisocial proclivities (not that these were inbred, but were rather reinforced by their social group).
As to the ability of society to mandate these attitudes, and to remedy alcoholic misbehavior with formal treatment regimens, let me quote Room from a conference in which we both participated in San Diego in 1988 entitled, "Evaluating Recovery Outcomes":
In comparing Scotland and the United States, on the one hand, with developing countries like Mexico and Zambia, on the other hand, in the World Health Organization Community Response Study, we were struck with how much more responsibility Mexicans and Zambians gave to family and friends in dealing with alcohol problems, and how ready Americans and Scots were to cede responsibility for these human problems to official agencies or to professionals. . . . Studying the period since 1950 in seven industrialized countries (including California), a period in which alcohol consumption grew, we were struck by the concomitant growth of treatment provision in all these countries. The provision of treatment, we felt, became a societal alibi for the dismantling of long-standing structures of control of drinking behavior, both formal and informal. (Room, 1988, p. 43)
What has consistently stymied Room, given his strong endorsement of the Ledermann hypothesis that reducing alcohol consumption dramatically alleviates the most severe end of the drinking problem spectrum, has been the increase in self-reported alcohol dependence symptoms found in ARG surveys in the US during a period of declining consumption beginning in 1980, one which was furthermore accompanied by radical expansion of the treatment enterprise (Room, 1989cf. Hilton & Clark, 1991; Room & Greenfield, 1993). Room, who cannot really comprehend that beliefs directly influence alcoholic behavior and experience (as shown by his recent ramblings that biological scientists have discovered a true link between alcohol and aggression), interprets this as a perplexing metaphenomenon whereby the 12-Step movement has convinced many more people to testify that they have lost control of their drinking, whereas Room divines that they really have not.
As to controlled drinking, that hot potato that Room alternately avoids entirely or puts down, the best evidence that alcoholism is not a constant or progressive pattern is provided by consistent findings at ARG that alcohol problems are extremely variable over time, so that those drinking with problems at point one are unlikely to be drinking with problems (or to manifest the same problems) at point two (Clark, 1976; Clark & Cahalan, 1976; Roizen, Cahalan, & Shanks, 1978). Indeed, as I pointed out in my rejoinder to Room's comment on my 1987 Keller Award-winning paper (Peele, 1987c), the traits which Cahalan and Room (1974) found showed the least continuity over time were the physiological traits associated with alcohol dependence.
Why is it that Room spends most of his time disclaiming ideas his empirical research has uncovered? This is because he (and Ron Roizen) misconstrue waffling as scientific objectivity. In their absurdist vision, scientists don't have inclinations about how the world really works. The most casual familiarity with the history of science (and the world views of Newton, Darwin, and Einstein, among many others) indicates that great science is instead powered by strong world views. As sociologists, Room and Roizen fear the accusation that they are simply decorating their personal opinions with scientific bunting (one can only imagine how many times at Berkeley Room and Roizen were asked their opinions about the radical sociologist Herbert Marcuse).
Room, by taking all sides of all issues, feels he escapes this sociological onus. But what he mainly succeeds in doing is obfuscating the issues and disguising the strong and consistent results on drinking and drinking problems that sociology (and his own work) has reliably uncovered. Room is proudest of writing articles which confound his readers by denying everything he has previously announced he stood for. Thus, after decades of emphasizing the relativity of alcohol problems (e.g., the drinking problem most consistently uncovered for males is wives who complain that they drink too much, the remedy for which could as easily be to have their spouses accept higher levels of drinking as for them to cut back), what tumult was created when Room (1984) announced that anthropologists were too relativistic in ignoring drinking problems in the developing world!
What gives the final lie to this delusion that scientists cannot function properly when they have strong ideas about how the world works is that, of course, Room has his own only too obvious world view. He grinds his axes in message after message to various lists, protected only from the realization of his peculiar slant on things by obfuscation and obtusenesshis expressed views defy summary, while Room employs all the tricks of a political debater in (unsuccessfully) attempting to mask his biases. Room has a true secret to hidehe is the most prosaic of alcohol theorists, a man who believes alcohol is inherently addictive and dangerous.
Cahalan D., & Room, R. (1974). Problem Drinking Among American Men. New Brunswick, NJ: Rutgers Center of Alcohol Studies.
Clark, W. B. (1976). Loss of control, heavy drinking and drinking problems in a longitudinal study. Journal of Studies on Alcohol, 37:1256-1290.
Clark, W. B., & Cahalan, D. (1976). Changes in problem drinking over a four-year span. Addictive Behaviors, 1:251-260.
Hilton, M.E. (1987). Demographic characteristics and the frequency of heavy drinking as predictors of self-reported drinking problems. British Journal of Addiction, 82:913-925.
Hilton, M.E., & Clark, W.B. (1991). Changes in American drinking patterns and problems, 1967-1984. In D.J. Pittman and H.R. White (Eds.), Society, Culture, and Drinking Patterns Reexamined (pp. 157-172). New Brunswick, NJ: Center of Alcohol Studies.
Peele, S. (1987a). The limitations of control-of-supply models for explaining and preventing alcoholism and drug addiction. Journal of Studies on Alcohol, 48:61-77.
Peele, S. (1987b). A moral vision of addiction: How people's values determine whether they become and remain addicts. Journal of Drug Issues, 17:187-215.
Peele, S. (1987c). What does addiction have to do with level of consumption? A response to R. Room. Journal of Studies on Alcohol, 48:84-89.
Roizen, R., Cahalan, D., & Shanks, R. (1978). "Spontaneous remission" among untreated problem drinkers. In D.B. Kandel (Ed.), Longitudinal Research on Drug Use (pp. 197-221). Washington, DC: Hemisphere.
Room, R. (1984). Alcohol and ethnograhpy: A case of problem deflation? Current Anthropology, 25:169-191.
Room, R. (1988). Summary. Evaluating Treatment Outcomes (pp. 43-45). San Diego, CA: UCSD Extension.
Room, R. (1989). Cultural changes in drinking and trends in alcohol problem indicators. Alcologia, 1:83-89.
Room, R., & Collins, G. (Eds.). (1983). Alcohol and Disinhibition: Nature and Meaning of the Link. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism.
Room, R., & Greenfield, T. (1993). Alcoholics Anonymous, other 12 step movements and psychotherapy in the U.S. population, 1990. Addiction, 88:555-562.