Points blog is back with a great interview with George Vaillant.
Here’s one of the questions and his response:
2. What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?
The value of the Grant study to the history of alcoholism is the number of urban myths that it exposes, and for this reason it received the biennial Jellinek prize for the best research in alcoholism in the world.
The first urban myth exposed is that depression causes alcoholism. Our prospective study shows beyond a doubt that alcoholism causes depression.
Second, alcoholics have unhappy childhoods due to their parents’ alcoholism; unhappy childhoods without a history of alcoholism do not lead to alcoholism. Therefore, the relationship between childhood and alcoholism appears to be genetic.
The third urban myth exposed is that AA is only for a few alcoholics and drugs are more useful. There are no two-year or longer studies of Naltrexone, Antabuse, or Acamprosate that have been shown to be effective, nor has long-term follow-up of cognitive behavioral therapy proved to be effective. On the other hand, when we followed, over 60 years, our sample of roughly 150 alcoholics, the men who made complete recovery—that’s an average of 19 years of abstinence—as contrasted to those men who remained chronically alcoholic until they died, the men who “recovered” went to 30 times more AA meetings than the men who remained chronically ill. Like outgrowing adolescence, it takes a long time to learn to put up with AA, but when you do, it works.
Obviously I haven’t read the book and little detail is given in the quote, but I think it would be difficult to prove that alcoholism causes depression exclusively and that the opposite is never the case, especially in those who develop depressive symptoms prior to the onset of drinking. Alcoholism might exacerbate depression (and vice versa) but it is a vast oversimplification to say that one exclusively causes the other.
The second ‘busted’ myth, and again only going on what is in the quote, is definitely an overreach. From the fact that “unhappy childhoods without a history of alcoholism do not lead to alcoholism” you could just as easily infer that alcoholism (or heavy drinking) is a learned behaviour or learned set of coping mechanisms. To claim that genetics alone is the culprit is a blatant flasehood and ignores the interplay between genetics, socialisation and acculturation and so on.
As for the final statement, not really busting an urban myth there. Two seperate wide scale national studies of treatment in the US and the UK have shown that therapy (of varying types), drugs, and AA are all as effective as each other. No one is clearly superior, therefore it makes sense that those who received more treatment (AA), if you consider all treatments equal, will have a better chance of long-term recovery.
And don’t get me started on Jellinek…
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