Recent developments in alcoholism:substance and symbol.

Alcohol is discussed as a core symbol of American culture. The language associated with alcohol, other "substances," and their widely shared folklore are shown to underlie the official "disease" model of alcoholism and treatment. The cultural psychology that gives the disease model its plausibility and experimental validity is discussed. Similar to "possession" theories in other societies, in American alcoholism the "not-me" is seen as overtaking the normal, social "me," inducing states of drunkenness if not chronic disease. This depersonalizing creates a paradox: requiring control from one held to be out of control by virtue of the disease process. It is argued that the disease model inadvertently helps perpetuate the very problems its proponents aim to treat. The author argues that conventional theories of alcohol, alcoholism, and alcoholics provide a standardizing, homogenizing, stereotypic story of far more complex accounts of alcohol use. Alternatives to the current metaphor are suggested.