It strikes me that the question of whether
alcoholism was or was not referred to as a
"disease" during the early AA period is a
lot more complicated than you are implying.
- - - -
See for example one of the best modern
sociological studies of Alcoholics Anonymous:
Annette R. Smith, Ph.D., "The Social World of
Alcoholics Anonymous: How It Works," with an
introduction by Linda Farris Kurtz, DPA,
Hindsfoot Foundation Series on Treatment and
Recovery (New York: iUniverse, 2007), pp. 74-75.
Annette Smith notes that:
The word "disease" appears only three times
in the A.A. Big Book. It is mentioned first on
page 64 in discussing alcoholism, then again
at the beginning of the second part of the
book in the story of Bill Dotson, the Akron
lawyer who was Alcoholics Anonymous Number
Three. When Bill Wilson and Dr. Bob visited
Dotson in the hospital, they told him he had
"a disease," and when he explained his
conversion to his wife, he told her he felt
that God had cured him "of this terrible
disease." (AAWS, 1976:187-188, 191)
However, in spite of its avoidance of the
specific word "disease," alcoholism is referred
to over and over again throughout the book
as a "sickness," a "malady," and an "ailment,"
and alcoholics are characterized as persons who
are "sick" or "ill." In the Personal Stories
section of the third edition of the Big Book,
one of the subtitles is "How Forty-Three
Alcoholics Recovered From Their Malady." [NOTE 44]
Kurtz (2002:5) states that despite the fact
that "A.A. does not promote the disease concept
of alcoholism," most members refer to their
alcoholism as a disease. However, this can be
regarded more as a metaphor than as a literal
description in the sense in which the word
disease is usually employed in technical medical
terminology (Kurtz, 1979:199-202). Use of this
metaphor removes the stigma generally attached
to alcoholism in society, allowing A.A.
participants to see themselves as "sick"
rather than "bad" (Conrad and Schneider,
1980), and to assume the "sick role" (Parsons,
1952), so that recovery becomes possible. As
will be shown in this chapter, dealing with
and finally accepting this concept is crucial
in enabling newcomers to move through the four
progressive stages of becoming integrated into
A.A.'s social world.
NOTE 44. Sick, sick person, or sickness on
pages 18, 64, 67, 90, 92, 100, 101, 106, 107,
108, 115, 139, 140, 141, 147, 149, 153, 157,
Ill or illness on pages 7, 18, 20, 30, 44, 92,
107, 108, 115, 118, 122, 139, 140, and 142.
The words ail or ailment are used on pages 135,
Malady appears on pages 23, 64, 92, 138, 139,
and 165. (AAWS, 1976)
AAWS. 1976. Alcoholics Anonymous. 3rd ed.
New York: Alcoholics Anonymous World Services.
Orig. pub. 1939.
Kurtz, Ernest. 1979. Not-God: A History of
Alcoholics Anonymous. Center City, Minn:
Kurtz, Ernest. 2002. "Alcoholics Anonymous
and the Disease Concept of Alcoholism."
Alcoholism Treatment Quarterly 20 (Nos. 3/4):
Conrad, Peter and Joseph W. Schneider. 1980.
Deviance and Medicalization: From Badness to
Sickness. St. Louis: C.V. Mosby.
Parsons, Talcott and Renee Fox. 1952. "Illness,
Therapy and the Modern Urban American Family."
The Journal of Social Issues 8(4):31-34.
- - - -
It is impossible, I believe, to discuss the
issue of�why alcoholism was regarded as a
disease in early AA without a detailed and
careful study of�Sally Brown and David R.
Brown, A Biography of Mrs. Marty Mann.
We can start with p. xiii, a citation of
"Imagine Such a Disease" by the President of
the American Medical Society.
And then go on to p. 10, where the Brown's
describe the basic credo which Marty publicized
all over the United States:
"Alcoholism is a disease and the alcoholic
is a sick person.
The alcoholic can be helped and is worth
This is a public health problem and therefore
a public responsibility."
- - - -
Or let us note how the issue is discussed by
Bill Swegan, the principal spokesman for the
wing of early AA which stressed the psychological
side of AA rather than the spiritual side.
Sgt. Bill Swegan, On the Military Firing Line
in the Alcoholism Treatment Program, pp. 13-15
"Alcoholism is not a behavior problem,
but a very complex disease"
"In the past half century, more has been
accomplished to recognize, define, and
eliminate the stigma associated with alcoholism
than had been brought about in any previous era.
At the heart of this change has been the partial
removal of the old principle of defining
alcoholism by the behavior it produces, and
the progress that has been made in solving
many of the mysteries surrounding the disease.
It is an illness, and this is now recognized
by most health agencies, medical treatment
facilities, and therapists.
Some resistance to the disease concept still
remains however among law enforcement people,
who often still wish to regard it completely
as a behavior problem. And this is also usually
true among the members of the alcoholic's
family. We must not forget that parents,
brothers and sisters, spouses and children,
are the ones who are constantly exposed to
the negative consequences of the alcoholic
behavior. It is difficult indeed for families
to think of alcoholism as a disease, when they
are the ones who are most immediately subjected
to all of the financial and social pressures
caused by the alcoholic family member, and
they are the ones most likely to suffer
physically from the alcoholic's rages and
tantrums and automobile accidents ....
Because even the major components of behavior
differ widely from alcoholic to alcoholic, it
is easy for someone who is an alcoholic to
pretend to himself that he is not. I certainly
did that to myself when I was in my twenties:
convincing me that I was in fact an alcoholic
was a very difficult process, even though when
you read my story, this may seem preposterous.
How could I conceivably not have known, quite
early on, that I was an alcoholic? It was
because people would point at so-and-so, and
say that he was an alcoholic, and I seemed to
myself to be totally different from that person,
in numerous essential ways. Therefore --
I would try to convince myself -- if he is an
alcoholic, then I am not, because I am not
the same as him.
Since alcoholism produces guilt and destroys
the alcoholic's feelings of self-worth, this
produces even greater barriers to responding
in any kind of positive way. If I had to admit
that I had become an alcoholic, then I would
feel even guiltier than I already did back
when I was in my twenties (which was overwhelm-
ingly great), and my almost totally-demolished
sense of self-worth would have been even
further destroyed. So I fought any attempt
by others to try to convince me that I had
a problem with drinking.
We must continue working to educate people
about the true nature of alcoholism. It is
not a behavior problem, and the kind of guilt
I felt about my compulsive drinking was
inappropriate. I had to do something about
it, and I had to do it before I was totally
destroyed by it. But becoming ill is not a
matter for which one should feel guilt, nor
is contracting an illness something which
should shatter one's sense of self-worth. We
do not blame sick people in a civilized society,
but help them to get well again.
And if I myself fall prey to some treatable
disease, from which I could recover by taking
appropriate steps, the intelligent response
is not to feel that I have become worthless,
but to take those steps which I must take to
bring about my recovery."
- - - -
If you want to talk about what Jellinek
believed and said, you have to ask "Jellinek
when?" because he changed his position over
a period of time. But he is most often
remembered for his 1960 book which was
entitled�"The Disease Concept of Alcoholism."
And Jellinek also means his AA disciples,
like Searcy Whaley in Dallas, Texas, to whom
Bill W. sent Ebby to see if Searcy could get
- - - -
What I'm trying to say here is, that if you
want to discuss the question of whether or not
alcoholism is properly to be regarded as�a
"disease" or an "illness" or a "malady" (or
as something else entirely), this is perfectly
all right. And we can talk about our own
theories about what is "good AA" and what is
But once you start talking about "what the Big
Book says" and "what early AA people believed,"
you have to go back and actually read the early
documents, and accurately report what those
folks actually said on that subject.
Glenn C. (South Bend, Indiana)