Stein H F
Department of Family Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Recent Dev Alcohol. 1993;11:153-64.
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.
酒精被视为美国文化的一个核心象征。与酒精、其他“物质”以及它们广泛流传的民俗文化相关的语言，被证明是酒精成瘾及治疗的官方“疾病”模型的基础。文中讨论了赋予疾病模型合理性和实验有效性的文化心理学。与其他社会中的“附身”理论类似，在美国的酒精成瘾现象中，“非我”被视为超越了正常的、社会化的“我”，即使不会引发慢性病，也会导致醉酒状态。这种人格解体产生了一个悖论：一个因疾病过程而被认为失去控制的人却需要进行自我控制。有人认为，疾病模型在无意中助长了其支持者旨在治疗的那些问题。作者认为，关于酒精、酒精成瘾和酗酒者的传统理论，为远比酒精使用复杂得多的情况提供了一个标准化、同质化、刻板的描述。文中还提出了替代当前这种隐喻的观点。
