A major study tackles basic questions about problem drinking
Everybody knows an alcoholic, and everybody thinks he knows why the person drinks. Weak character. No self-control. Had a miserable childhood. Has a terrible marriage. Cannot face reality. Hates work. Is paranoid. The denials and rationalizations, the self-pity and selfimportance, the guilt and anguish are all parts of a predetermined type, the "alcoholic personality." Right?
Wrong. The alcoholic personality is the result of alcoholism, not the cause. This is the most startling and original conclusion of a new landmark study, The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery (Harvard University Press; $25), on the affliction that hits one American family in three. The author, Dr. George Vaillant, 48, a Harvard psychiatrist, is one of the most respected researchers in adult development. Vaillant tackles other key questions that specialists in the disorder have been debating for years: Can an alcoholic return to social drinking? Is there a genetic cause for the affliction? Why are some ethnic groups more likely to become alcoholics? How effective are hospital treatment centers?
It is a mark of Vaillant's achievement that his book, instead of sparking more controversy on a disputed subject, is being hailed by leaders in the field as a major breakthrough. Dr. William Mayer, acting head of the Federal Government's National Institute on Alcohol Abuse and Alcoholism, considers Vaillant's work to be "an unmatched contribution and a reasoned approach to solving the massive health and social problems relating to the excessive use of alcohol." Last week the American Medical Society on Alcoholism gave Dr. Vaillant its annual award "in commemoration of outstanding contribution and unstinting dedication" in the field of alcoholism research.
The key to Vaillant's work is that it is the first long-term study of alcoholism as it develops in individual lives. The usual approach is to examine alcoholics to see how their sickness evolved, a technique that is always blurred by the distortions of the victim's memory. Vaillant was able to begin at the beginning. For the past 16 years he has been the director of a unique research study that since 1940 has been following the lives of 200 Harvard graduates and 400 innercity, working-class men from Boston and Cambridge. In 1977 Vaillant published the first results of this research: Adaptation to Life, a study of factors in the Harvard group that led to success after college. In his new work, which focuses on 136 men who became alcoholics, Vaillant also draws on his experience as a director of the respected Cambridge Hospital Alcohol Program. Vaillant and his fellow researchers watched 26 from the Harvard group and 110 from the blue-collar group travel their individual paths to alcoholism and, equally important for the study, observed men with similar lives who did not develop problems.