culture and illness

[d-m-c at worldnet.att.net]

Alec, while it won't answer all your questions, you might want to check out
a critique of AA, Rudy's _Becoming Alcoholic_  Rudy uses in-depth
ethnographic interviews and participant observations in order to ask how
people learn to become or create an identity as an alcoholic. AA and the
twelve step model figure prominently in the process, as you probably know.
There is a tendency in these groups to insist that everyone is an
alcoholic, so even Rudy who clearly identified himself as a researcher was
constantly quizzed about his drinking habits and was told that the only way
he could participate was if he read a stack of literature on AA and
alcoholism.  Despite his objections that he didn't consider himself an
alcoholic, people nevertheless insisted that he was, but he was just in
denial.  The research was done nearly 20 years ago and I haven't read it in
a long time, but I think Wendy Kaminers stuff on women and self help
culture, especially co-dependency groups, makes a similar point:  when you
read the def. of who a co-dependent is, it would seem that *everyone* is.
I suspect that there is some clue here that points toward some answers.
I'm not entirely sure exactly what that answer is right now, though.
Still, from what I've seen of the way 12 step models work, they are clearly
symptomatic treatments--that is they treat the symptoms, rather than the
underlying problem  (errr sliding toward essentialism there, ey?) in the
same  way that cold medicine modifies the discomfort of the cold without
ever getting at the root cause of the cold.