Wednesday, August 13, 2014
Women Are Not Powerless
Gabrielle Glaser tells The Fix that the rise of women's drinking in America isn't because they're alcoholics—and treating them that way, including by AA, could make it worse.
Simon and Schuster
Gabrielle Glaser opens Her Best-kept Secret: Why Women Drink—And How They Can Regain Control(published in paperbackthis month), with the words, “My name is Gabrielle, and I’m not an alcoholic.” This sentence neatly encapsulates the conclusions Glaser has come to about the rise of women’s drinking in America: these women are not alcoholics, in fact most people who call themselves alcoholics probably are not; Alcoholics Anonymous is predominantly unhelpful to women and in fact can worsen their problems; and the future lies in moderation, self-control, and a shift in the way we think about drinking.
Last summer Glaser sat down with me to talk about her book at the Algonquin Hotel, site of innumerable bouts of uncontrolled and immoderate drinking by epic wit Dorothy Parker, who (maybe) wrote about her own inability to curb her excesses: “I like to have a martini/ two at the very most/ After three I'm under the table/ after four I'm under my host.”
Perhaps Glaser has some alternative lessons to teach us about drinking that do not require us to forget what we would like to remember. Or remember what we would like to forget.
Why do you think drinking is on the rise among women in America?
The epidemiologists say it’s linked to college education. And there’s just so much anxiety that women have today. I think a lot of women are crawling out of their skin. I’m 49, but I didn’t recognize that I had that anxiety until I was in my early thirties, I didn’t even know what it was, I just thought that’s how I lived, and that experience of not being able to have enough air, I hear that all the time around me. There’s so much to worry about: we don’t turn off our machines, we’re always on our cell phones, the news is unrelentingly bad, there’s so much competition. I think that women feel that a lot more, it’s not that men don’t feel it, but a lot of it falls on to women.
What I’m hearing is that this anxiety, as well as the rise in drinking, are consequences of women catching up to men, and so there is an irony in that all this excessive drinking could be called a result of feminism.
Exactly, and that sounds like a really anti-feminist message, and I really worried about that a lot, and some people said, “You’re bringing us back to 1918.” No, I’m not bringing us back to 1918. I think it’s really important to understand that as much as we do, as much as we take on, as much as we are every bit as capable, this is one place in which we’re just not equal, and we can’t be. Even if there was a man who weighed the same, the physiological effects on a woman and a man are just not the same, that’s science. Also, more women are going into male fields, especially tech and banking – I had a source who was a young woman who worked at Google, and she said “That is the hardest-drinking place you can imagine.” What you saw on The Social Network, she said it happens every night. She said these kids are fabulously wealthy, they’re kids, they’re not grown-ups, and they drink like they’re in ancient Rome, and in order to be accepted, in order to become trusted as one of the guys, she said that for a long time she really felt like she had to keep up, including doing shots.
What do you think is a good way both to combat this rise in drinking among women and not couch it in a way that is anti-feminist?
I think a part of our awareness is actually that we are different, and we need to understand that as such. Women report feeling much more anxious than do men. It’s not that men aren’t anxious, but women are treated and diagnosed with anxiety disorders far more than men. If you are feeling that anxiety, and you’re drinking because of that anxiety, it’s important to find other ways to help relax yourself. I think to recognize your triggers and what you can do personally is a very empowering message: You can take control. You can do something to change. If you’re a stay-at-home mom and you’ve got two kids and they’re in six different activities, well, why the hell are they in six different activities. Cut back. Do they need Tae Kwon Do and hockey? That’s one thing you can do. You can learn to say no more. You can learn to say no to your boss more. That’s a feminist message. Rather than drinking you can say “Hey!” We need to learn to speak up for ourselves a little bit more.
You don’t like the term alcoholic.
No. It’s like being a little bit pregnant. You can have a little bit of an alcohol problem, but you can’t be a little bit of an alcoholic, and I think it’s much more important to say “Ok, here’s somebody on the spectrum, they’re a 3, and here’s somebody on the spectrum, they’re a 6.” It doesn’t mean they’re actually physically dependent on alcohol. That’s why I prefer to use the term alcohol dependent.
It seems that you think AA isn’t that effective, and you think it’s oppressive to women.
That’s what the research showed. AA is a group of people who have a similar narrative. First there’s the narrative of the founders, and then there’s the narrative of the people who are in the group. And if you match that narrative, and you see yourself in that narrative, and that’s helpful to you, that’s fantastic, and don’t read my book. But for the vast majority of people for whom AA doesn’t work, which is between 90 and 95% of the people who try it, then we need to be aware of other options. And there are so many other options that somehow don’t make it into public consciousness and popular culture.
And I think that’s because the narrative of AA is so dramatic. You can go and really feel like you’re a hopeless drunk, you go to meetings, your narrative turns around, you’re in recovery, you’re better, therefore it works. But what about the people outside that? Do I think it’s oppressive? Obviously if you’re in it, and you like it, then it’s not oppressive to you. Science has reported that many people find it oppressive. That’s what my reporting found. So, it’s not really what I think, but these are the data points.
But with alcoholism in general, but in AA in particular, it’s so hard to come by actual statistics that have any validity. I mean that 95% of non-efficacy, I don’t know how that’s actually possible to measure.
That’s from the Quarterly Journal of Alcohol Studies. Don McIntyre wrote that study, and then the Cochrane Review found that it was less effective than other modalities, and certainly the combined study that the government spent 30 million dollars on found it to be the least effective.
If these other programs are so effective, why aren’t they taking hold in the public consciousness? Can it really only be because of the narrative?
No, I think it’s because of the system we have in place. The overwhelming majority of the rehabs that we have in this country are 12-step based, and certainly the insurance companies reimburse for 12-step. They’re only now starting to reimburse for other modalities, and furthermore, medical students, when they are exposed to any sort of addiction treatment it’s AA or NA. So, it’s kind of a cul de sac of thinking in which they’re not exposed to these other things. A doctor I know gives talks on the use of Naltrexone [an opioid antagonist, that can block the effects of certain drugs, including alcohol]. And she said, at Columbia University, nobody had heard of it. And it’s been around for fifty years. Nobody’s making money off of that drug, it’s a generic drug, so pharmaceutical reps aren’t coming into doctors’ offices. They are coming in with the extremely expensive, difficult-to-reimburse, injectable form of Naltrexone, which of course bumps up the compliance level, but it’s $1,000 a month. What insurance company’s going to pay for that? So, all of that combines to crowd out the other options, and notice of the other options. What do you think?