Again, for the theoretically minded ATHG subscribers. ------- Forwarded Message Follows ------- Date: Fri, 21 May 1999 17:18:31 +0200 Reply-to: Kettil Bruun Society <[log in to unmask]> From: Robin Room <[log in to unmask]> Subject: Re: all knowledge in field disproven To: [log in to unmask] Ron -- no, I'm not arguing all labelling is bad, I'm arguing that a generation or more of sociologists have been skeptical of it -- skeptical, that is, of the processes described as labelling -- at time when sociology was spending considerable energy pointing out the effects ("secondary deviance") the labelling itself can have. We discussed long ago, as I remember, how curiously small a connection there was between alcohol sociology and the formal American sociological labelling literature -- a couple of pieces by Tric and Roman are the main citations specifically focussed on it, I think. But I still would argue that a disvaluing of labelling is in the background of Bruun et al., 1975 (the purple book) and is e plicitly expressed in Maekelae et al., Alcohol, Society, and the State, 1981. I think it's an underlying factor, too, in the ambiguity about the alcoholism concept in such sociological discussions as Seeley, 1962. I got Valverde's book, Diseases of the Will: Alcohol and the Dilemmas of Freedom (Cambridge University Press, 1998) out of hock today -- Swedish customs punished me for ordering it by internet f om Barnes and Noble by making me pay customs at a far-away post-office. Valverde makes an ambitious effort to tie it all together -- the history of inebriety, AA and "the power of powerlessness", t e postwar history of alcohol studies, alcohol control systems and ideology, legal concepts about intoxication as an excuse, controlled or moderate drinking -- with a focus on the cultural nexus betw en drinking and willpower. Sociologists, psychological moderationists, judicial theorists, and psychiatrists are all subjected to the somewhat harsh light of this critical gaze. I look forward to eading it. I think it will be viewed as a landmark, whether we regard us "insiders" regard it as so or not. Just as the "sociology" section in the bookstores has more or less dissolved into other things, what I think of as critical sociological perspectives today operate under other labels. Valverde s a criminologist. A wonderfu dissertation in this same Foucauldian area of ideologies of self-control by an Australian, Helen Keane, now being turned into a book, came under the heading "cultural studies". Robin -----Original Message----- From: Ron Roizen <[log in to unmask]> To: [log in to unmask] <[log in to unmask]> Date: den 21 maj 1999 18:19 Subject: Re: all knowledge in field disproven >APPLETON and VALVERDE? My God, Robin, these are pretty damn marginal folk >on whom to >vouchsafe the general vigor and salutary condition of "on the side" >sociology since Gusfield! I haven't >even gotten Valverde's recent book yet and Appleton did one paper and then>seems to have disappeared from the scene. > >Moreover, the great sociological critics of psychiatric labeling--starting >with the great Lemert's book, Social Pathology (1950?)--eschewed dissing >the alcoholism label, probably because they regarded it as an exercise in >status rescue pushed forward largely by the labelees themselves and NOT the >exercise of arrogance by a powerful foe (institutional psychiatrists) as in >other mental illness labels. You've written persuasively on the >status-rescue aspects of the disease-concept movement yourself. Are we now >to infer that all labeling is bad, period, because it fails some sort of >small "d" democracy test? > >Ron > >---------- >> From: Robin Room <[log in to unmask]> >> To: [log in to unmask] >> Subject: Re: all knowledge in field disproven >> Date: Friday, May 21, 1999 7:03 AM >> >> Laura -- >> The context for my answer was Stanton's attribution of the cooptation >of sociology to involvement in large-scale epidemiology. >> I certainly agree that sociology's role has been pretty equivocal -- >in part, of course, reflecting that sociologists are not of one mind about >the disease concept. And you're right that there was an effort at a >truce, stage-managed by Griffith Edwards, between psychiatric and >sociological perspectives in a WHO meeting in 1976, recorded in G. Edwards >et al., Alcohol-Related Disabilities, Offset Publication No. 32, Geneva: >WHO, 1977. (And yes, I am implicated in this document.) The formulation >of the truce was that there are many alcohol-related disabilities >(=problems; WHO was on a big disability kick at the time), and that the >alcohol dependence syndrome is one of them. >> All in all, I think the "on the side" critical perspective has not >suffered much from any cooptation. Gusfield and after him Conrad and >Schneider and after them Appleton and Valverde have done quite OK in >mainline sociology; I don't think anyone would see any of them as coopted. >For those of us working in the grants economy, "on the side" critical >pieces have not directly earned us our living (although mine probably >helped me get my job in Sweden), but I don't think our participation in the >grants economy coopted us away from them (whereas I would see that as >having happened to some in the drugs literature). But maybe I'm too far >inside to see out on this. >> What you call the "public health paradigm" is something else again >from the disease concept -- in fact, the models have often been viewed as >antithetical. In this, yes, sociologists did play an important role. >Christoffer Tigerstedt has a paper at the Montreal KBS reexamining Kettil >Bruun's role -- ask someone who is going there for it; they have the >password to print it off the website. A couple of British psychiatrists -- >notably Edwards -- were important in this history, but you would have to >search a long way to find any American psychiatric influence on the "public >health paradigm" in the alcohol field. >> One thing that occurred to me reading Caroline Sutton's dissertation >on the Swedish alcohol discourse, and which is there in Tigerstedt's paper, >too: the sociologicalness of the paradigm lies in its emphasis on measures >that apply to aggregates rather than individuals. At the heart of the >sociological connection, then, is an animus against labelling, whether >therapeutic or punitive. Keep in mind the Scandinavian context in which >the paradigm developed: a history of extensive individual control and >labelling -- the "buyer surveillance" system in Finland; >individually-assigned ration-amounts in Sweden, according to the >ration-holder's worthiness; local committees of neighbors (temperance >boards) keeping watch over your drinking behaviour in Finland, Norway and >Sweden. What is now called the public health model offered a rationale >which justified sweeping all this away: that rates of alcohol problems in a >population could be kept in check instead by measures like taxes and >opening hours which did not sitoo keen on disease concepts, I acknowledge.) > Faced with this value choice, sociologists have often leaned the other >way. Robin >> >> -----Original Message----- >> From: Laura Schmidt <[log in to unmask]> >> To: [log in to unmask] <[log in to unmask]> >> Date: den 21 maj 1999 05:24 >> Subject: Re: all knowledge in field disproven >> >> >> Robin, maybe you are being a little too generous to the sociologists in >> addiction research. The heavy influence of the medical-epidemiologic >paradigm >> on the way that sociologists do work in this field can't be ignored. >What has >> suffered is the distinctively "on the side" critical perspective that >> characterizes some sociology. What has done better under this influence >is >> micro-sociology and survey methods. The same is true of the sociology of >> deviance and medicine. Just take a look at the ASA's health journal, the >> Journal of Health and Social Behavior. What you see is primarily >social-psych >> and psych-epi studies with long theory sections. >> But at the same time, I really can't agree to a simplistic >explanation of >> this as a case of sociologists being coopted. Or if so, then >sociologists >> played an active role in their cooptation. Sociologists, after all, had >a lot to do >> with getting us where we are today: to an addiction field oriented around >the >> public health paradigm -- that strange blend of sociology, >medical-epidemiology and >> health moralism. The interesting questions for "on the side" sociology >today >> are where did this paradigm come from and what does it do for us? >Certainly >> one thing that it does for us is to allow social scientists and >psychiatrists >> to peacefully coexist in the same field. In other words, it allowed for >an >> uneasy resolution of the debates over the disease concept in the 60s and >70s. >> During the 1970s (particularly in discussions at the WHO around framing >the >> ICD criteria), social scientists and psychiatrists came into agreement >that there >> were actually two phenomena that should be studied and intervened on: >> "dependence" and "alcohol-related problems." Since then, there's been >room at >> the table for everybody. And for better or worse, we can call ourselves >a >> truly "interdisciplinary" field. >> >> Laura Schmidt >> Alcohol Research Group, Berkeley >> >> At 05:17 PM 5/20/99 +0200, you wrote: >> > >> > Stanton -- no implication about you, don't be touchy. I was just >interested >> > where you stand on this. >> > Whether it's red wine or ethanol has rather different implications. I >> > actually think it's ethanol, and the red winemakers (and their allies >in the >> > research and professional literature) have put one over on the great >> public. >> > There is no single claim on alcohol and health, good or bad, that has >had a >> > great a measurable effect on people's consumption choices as the red >wine >> > theory. >> > If it's really red wine/resveratrol, then grape juice or raisins or >> > whatever would do just as well as the red wine, usually for cheaper, >and >> > without the "side-effects", as the medication literature would say. >> > >> > The "we're both sociologists" referred to Laura -- it would never have >> > occurred to me to accuse you of sociologism. >> > When the directorate of NIAAA was disowning any controlled-drinking >> > implications of the RAND followup, they tended not make much of the >fact >> that >> > if your criterion was abstinence for the whole 4.5 years of follow-up, >the >> > success rate would be 7.5%. It has been a long time since the treatment >> > evaluation literature tried to hew to the abstinence standard as its >> > criterion for success -- the results look too gloomy. It is surprising, >> > actually, that more people don't notice the discrepancy between the >outcome >> > criteria and the official treatment goals. >> > On sociologists being tamed by "the advent of large-scale >> > epidemiological research": I would say the history here has been at >worst >> > mixed and often better than that. Conrad and Schneider, in the first >> edition >> > of From Badness to Sickness (not sure about the 2nd), had a curious >footnote >> > where they made much the same charge about the Berkeley group I used to >be >> > part of -- since we were funded by the feds, it puzzled them that some >of us >> > nevertheless wrote critically about the disease concept, and they kind >of >> > predicted that we would eventually be coopted. But the Schmidt and Room >> > paper, I would contend, is evidence that this hasn't yet happened >(Laura is >> > at ARG) -- the findings of the study are pretty subversive of a simple >> > US-centred disease concept. >> > My take on it would be that in my professional lifetime sociologists >> have >> > been privileged in alcohol studies (unlike drugs or tobacco research) >to be >> > allowed to nip the hands that feed us, without suffering much reprisal. >I >> > know psychologists have the scars to prove that this hasn't always been >true >> > for them. Perhaps sociologists matter less, since most of us can't >actually >> > corrupt clients. Maybe we fare better because we tend to be critical of >ALL >> > governing images, rather than propose a competing one, as psychologists >tend >> > to do. >> > This doesn't mean that all of us spend all our time nipping the hands. >> > Ron Roizen, I know, has been perplexed at and critical of my >> > ability/tendency/willingness to both do work within a paradigm and also >> stand >> > outside it critically. (If you would put it differently, Ron, it's up >to you >> > to jump in.) >> > I agree that large-scale epidemiological research threatens to weaken >> the >> > position of sociologists, but it is because others have been moving in >on >> and >> > perhaps taking over the territory, not so much that the sociologists >have >> > been coopted. The psychiatric epidemiological tradition, in particular, >has >> > a hard time taking a critical stance to what it is studying, since its >> > paradigm is that the psychiatrists get to define what it is that is >being >> > measured, and the epidemiologist's job is just to apply this >definition. >> > Please don't get me wrong, I am certainly not inclined to be >> > congratulatory about alcohol sociology. We have a long way to go. Robin >> > >> > -----Original Message----- >> > From: Stanton Peele <<mailto:[log in to unmask]>[log in to unmask]> >> > To: <mailto:[log in to unmask]>[log in to unmask] >> > <<mailto:[log in to unmask]>[log in to unmask]> >> > Date: den 20 maj 1999 16:53 >> > Subject: Re: all knowledge in field disproven >> > Robin: >> > >> > Are you implying something about me -- where have I said in any mail or >> > elsewhere that the beneficial effects of alcohol are limited to wine? I >> > didn't say it in the mail you reponded to. And, who aside from you, has >> > mentioned the idea that resveratrol accounts for alcohol mortality >> findings? >> > I am bewildered by your insinuatons here. Are you striking out blindly? > >> > >> > I think you short shrift your positions (or the reality) in each of >your >> (and >> > my) points -- your expressed regret about the benefits of alcohol in >your >> > former exchange, the impact of the variability of physical dependence >> > symptoms in terms of your assumptions and those made in the field, and >the >> > overall impact of MATCH (they didn't require 15 commentaries in >Addiction to >> > agree that all therapy is =) -- for example, no one has yet addressed >the >> > reliance on reduced drinking as the sine qua non of the overall success >of >> > treatment claimed for MATCH (by Gordis, among others), and the >consternation >> > this would sow in NIAAA were it to be acknowledged. >> > >> > Since this list is not specifically clinically oriented, the lack of >> > discussion of this finding seems to me to indicate how strongly in lock >step >> > the field has become -- it is no longer necesary for the directorship >of the >> > NIAAA to shoot down the Rand researchers (whose study it funded) over >> > controlled drinking findings, and for battle lines to be drawn and >fought >> > over it. Whereas you are inclined to congratulate sociology for its >> critical >> > role (Robin, when you say "we're both sociologists" did you mean >Schmidt or >> > me along with you? -- I'm a psychologist), the advent of large scale >> > epidemiological research has largely reversed that role. The "best" >> > sociologists are now funded to support the same growing ball of string >that >> > not only clinical researchers, but biological, are accreting. Everyone >toes >> > the same lines now. >> > (Robin: find something in this last paragraph that you will agree has >some >> > semblance or appearance or note of truth, and cop to it and discuss it >-- >> > just as an intellectual exercise, just to give some credence to the >idea >> that >> > sociologists are able to step back from the globe and discuss their >role in >> > it.) >> > >> > Stanton >> > >> > Robin Room wrote: >> >> >> >> Oh, Stanton.... If only the pastures were so green for sociologists, >> who >> >> are never so happy as when disproving conventional wisdom. 1. >Actually, >> >> Nancy Day and I somewhat beat the rush on the general-mortality >findings, >> >> though our study was not published in a journal and thus does not >usually >> >> get noticed (see pp. 79-92 in Alcohol and Health: New Knowledge, 2nd >> special >> >> report to Congress, final edition, June 1974). We were using better >> >> measures of drinking than the usual epidemiological study, since we >were >> >> analyzing mortality in longitudinal drinking surveys. But of course >the >> true >> >> godfather of this line of findings is Raymond Pearl in 1926. It's a >little >> >> hard to argue, after you read Pearl, that this is a new finding. Nor >> do I >> >> agree that it "strikes at the foundation of modern public health >analysis >> >> and policy", since you apparently can get most of the heart-protective >> >> effect from alcohol with a drink every second day. (Incidentally, >Stanton, >> >> shouldn't you be leading a campaign to say it's not the red wine or >> >> resveratrol, stupid, it's the ethanol? Or where do you stand on >> this?) To >> >> the best of my memory, the "unfortunately" was ironic. A couple of bad >> >> experences in grad. school should have taught me that irony is usually >a >> >> mistake -- it only works within a shared frame of reference. 2. I >don't >> >> think you should blame the rest of the cadre for this minor point in >> Schmidt >> >> and Room. In what you have picked on, we may have been reaching a >> little in >> >> our write-up, setting up a paper tiger we could then crush (or >whatever Mao >> >> did with paper tigers). We're both sociologists, after all. As for >> >> Project Match, the finding that nearly all treatment modalities make >about >> >> the same amount of difference has been there in the literature for >quite a >> >> while (although it profoundly threatens the claims of CBT and other >> >> "evidence-based" clinical traditions). The sociologist's best hope for >a >> >> disciplinary future, in fact, is that disproofs of cherished positions >> often >> >> make very little difference in practice, so after a while we get to do >the >> >> disproving all over again. Robin >> > > ----- To join the KBS-LIST, send the command SUBSCRIBE KBS-LIST YOURFIRSTNAME YOURLASTNAME To signoff the list, send the command SIGNOFF KBS-LIST to [log in to unmask] If you experience difficulties signing on or off, write to [log in to unmask]