This post was originally published on December 3, 2014.
HuffPo recently posted a nifty cartoon depicting the absurdity of what it might look like if people treated the physically ill the same way they treat the mentally ill. The piece is a little slice of genius and the artist, Robot Hugs, deserves accolades for illustrating such a complex issue in a simple, yet effective way. But a big part of what we are up against when trying to get society at large to understand mental illness is propelling the idea that they may ever be able to understand it. I am all in favor of uncovering base rate double standards—and I hope this cartoon helps some see the issue in a different light—but I think the movement would be better served if we lobbied for mental illness as something diagnosed by trained professionals but only truly understood by the people who have it.
I was recently at a 12-step meeting where the speaker, boasting 22 years of sobriety, stood at the podium and confidently “informed” nearly 100 alcoholics that despite what they may have heard, alcoholism is not a disease. She then did what many of her ilk do—held up a copy of The Big Book of Alcoholics Anonymous and declared, “There is no place in this book that says alcoholism is a disease.”
This, of course, is not true. The Big Book refers to alcoholism as a spiritual disease, as well as a physical and mental illness, on page 64 of the basic text. It also supports the disease concept in 19 places spread throughout 11 of the personal stories in the fourth edition (which are published and included as a part of the Big Book as a whole). But the conviction in which this speaker delivered her opinion of what alcoholism is or isn’t—as someone who had been asked to act as a representative of the program and share her experience, strength and hope—felt toxic. Not only do these kind of internal contradictions alienate and send mixed messages to newly sober alcoholics—as well as create fodder for those already struggling with their ego of their own perceived intelligence and valued self-will—but it weakens our unity and therefore effectiveness as a group.
What I can’t understand is why labeling alcoholism a disease is so upsetting for certain people. Doesn’t it make things easier by letting us off the hook for all of our otherwise unexplained behavior? Much like the schizophrenic who won’t take his meds because he doesn’t want to be labeled crazy, I see the alcoholic who is hell bent on controlling his alcoholism as someone who is just a little sicker than the rest of us. Twenty-two years of sobriety proves nothing more than that the person has learned how to not pick up a drink; it doesn’t mean that person is any saner or wiser then the day he or she walked in to their first meeting.
Personally, seeing alcoholism as a disease has been one of the key factors in my sobriety. Finally understanding why I was struggling with life so much years after my craving for alcohol disappeared set me free from the torture of self-hatred and shame. It doesn’t help that the current Diagnostic and Statistical Manual of Mental Disorders, the DSM-V, categorizes alcoholism a disorder, not a disease. The difference? Medically it’s that disease has a known cause and a disorder doesn’t. Socially it’s that people—including, apparently, some alcoholics—still think it’s a matter of self-will and discipline and that is where the stigma lies.
If we really want to change how the world views mental illness, we need to hire the campaign manager who handled the N-word. Not only is it no longer socially acceptable for anyone to use the N-word (black people being semi-exempt), it’s not acceptable to even question why it’s not acceptable. People are deeply offended by it—the end. You don’t say it, you don’t think it, and you don’t let anyone else say it either. It’s become possibly one of the most universal taboos of the Western world and it’s been less than 40 years. I hope to one day get to a point that when someone says they struggle with a mental illness, that statement is respected, not questioned, and supported. Until then, thank God for therapy.
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