From The New England Journal of Medicine
Alcohol has always had a special role in the United States. From 1620, when the Puritans were forced to land on Plymouth Rock because the Mayflower had almost run out of beer, until 1933, when Prohibition was repealed in an unprecedented move, the use of alcohol has been the baton by which the self-righteous have conducted antipleasure movements in America. In her well-researched, well-written book, Lori Rotskoff shows how the drinking of alcohol assumed another role: "workers forged a sense of class identity during their leisure hours . . . passed in the familiar surroundings of the neighborhood saloon." The saloon became a locale where men could get together and free themselves from the "constraints and demands of wives or mothers." Research shows that abusive drinkers were overlooked by the treatment community in the 1930s and 1940s, in part because hospitals and other facilities for people who drank to excess were shut down during Prohibition. This dearth of treatment options led to the creation of Alcoholics Anonymous (AA), in 1935. AA's evolution soon spawned Al-Anon, whose members included the wives of alcoholics; these groups functioned as support groups. Rotskoff uses stories, advertising, scientific studies, and movies to show how the relationship between men and women in the marital state is infused, informed, and interwoven with scientific, moral, and social beliefs about the use of alcohol. In fact, definitions of alcoholism have fluctuated with the times and the social context. Gradually, the use of alcohol became acceptable for recreational and social reasons, first for white, middle-class men, later for white, middle-class women, and eventually for other classes of society. Fortunately, alcohol problems develop in only a very small percentage of drinkers -- 5 to 7 percent, according to government surveys. Love on the Rocks explores how different perceptions of problem drinking have evolved; the author cleverly incorporates the effects these changes in perception have had on wives in an "alcoholic marriage," while examining the evolution of healthy and unhealthy drinking within the social contexts of the Great Depression, World War II, and the Cold War era. Rotskoff recounts examples that portray the enormous shift in the definitions of alcohol problems, which run the gamut from "sin" to "sickness." She also shows that this change in perception has spawned our present-day obsession with labeling all excessive behavior as sickness or disease. Rotskoff concludes that opponents of alcohol "shore up their own power and authority, by regulating the consumption of intoxicating beverages alternatively through moral suasion and legal coercion" and makes the important point that relinquishing legal control over the use of alcohol in America began the movement "to legislate private morality." Most important, in this landmark book, Rotskoff shows how activists have taken "the therapeutic vision of self-control [which] extended beyond the avoidance of threatening substances; it also entailed adherence to a complex, gendered system of emotion management." As we have seen and experienced, she points out, "By the 1980s a diverse network of self-help groups, professional therapists, book publishers, entrepreneurs, and television producers had given rise to a vast recovery movement that applied a therapeutic model of addiction to almost every kind of excessive behavior, including gambling, sex, and shopping." Reading this interesting book about the role of alcohol in America and its evolution in our society since the end of Prohibition makes this longtime student of alcohol-related issues realize why it is so difficult for people today to believe and trust themselves in an era of experts. Morris Chafetz, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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A lively account of the culture of drink--and the gendered tensions it encoded--across the twentieth century. Wide-ranging, engaging, and informative.
(Elizabeth Lunbeck, author of "The Psychiatric Persuasion: Knowledge, Gender, and Power in Modern America")
"Lori Rotskoff, who writes wonderfully well, has filled a blank in the (gendered) social history of American drinking and sobriety from Prohibition through the fifties: a subtle, engaging, and now indispensable study. (John W. Crowley, author of "The White Logic: Alcoholism and Gender in Modernist American Fiction")"