Introduction
This essay is focused with how power has instigated stigmatisation and the labelling of alcohol use and how unhelpful this is to understanding alcohol behaviour. The boundaries, where social norms and authoritarian rule extol social order from have been contradictory where alcohol is economically prolific and labelling of problem drinking, socially deviant (Bancroft, 2009: 33-35). Alcohol is best understood from an holistic sociocultural model that Heath (1987b: 13) states is a method of analysing behaviour and instigating constructive intervention from a joint biomedical and cultural perspective. However, the control of alcohol and deeply embedded behaviour constructed historically can produce victimisation and psychologically internalised emotions which are self-policed to the detriment of the individual (Foucault, 1979: 215-216) which this essay traces as a social life of alcohol.
The first section describes alcohol drinking behaviour of British lower-class society as labelled ‘deviant’ and how economic progress and the use of its power regulated and transformed them into scapegoats. It gives a broad history of how this created class divides, blurring the understanding of alcohol’s meaning for consumers, and culminates in how labelling theory (Becker, 1991) explains how alcohol drinking ‘deviant’s’ become the propagators of their own subjugation.
The essay goes on to explain that the historic deviant labelling of problematic drinking has been integrated into alcohol recovery organisation Alcoholics Anonymous (AA). Alongside historical societal changes in the scientific recognition of human behaviour it has subliminally enhanced the label culture of drunkenness by shifting the power of external labelling to self labelling (Heather and Robertson, 1997: 103). AA confine the ‘alcoholic’ to a disease status which developed the self-determining drinker to self-victimised medical patient (McDonald, 1994: 3). An alternative is suggested by popular author, Alan Carr (2003) which resembles the sociocultural model of alcohol behaviour analysis.
The last section brings the historical perspective of stigmatisation and labelling and the self-regulatory mode of power construction together through the lens of Foucault’s (1979) Panopticism and Goffman’s (1990) theory of stigma. Pregnant women in the US were labelled and criminalised for alcohol consumption, creating a self-regulatory psychological internalisation that Foucault (1979) analogises with Bentham’s panopticon prison and criminals, and which is entrenched in the medical profession.
Drunkenness – a brief history of the drunken scapegoat
In England after the 1580s there was a wealth divide, and consequently a class divide. This was encouraged by the sale of tobacco and alcohol to the poor who used intoxicants to escape the rigours of daily life. A commercial boom led to the disparity of manners and civility aligned with different types of alcohol being consumed (Withington, 2011: 634). As England entered the seventeenth century these practices continued, reinforced by behavioural rules associated with Britain’s social organisation and power structures (Mintz, 1986: 154).
Divides were encouraged by the temperance movement represented by Protestantism delineating women in particular for being drunk, but also generally the lower classes, and abstinence as a moral pathway to respectability (Warner, 1997: 105-106). As alcohol became more popular through trade, wealthy merchants and elites increased their social status with power in politics and a new learning and culture emerged leaving behind an uneducated and ‘uncultured’ lower class with the label of excessive drinkers (Withington, 2011: 639-650). Paradoxically it was the wealthy who were driven as much by intoxication and regulation linked to decorum but with ‘a tendency to blame the poor rather than the rich for uncivil consumption’ (Ibid,: 657).
Wealthy elites continued to construct excessive drinking as part of their culture and identities into the eighteenth century (Withington, 2011: 635) and drinking for lower classes was fully established as different and part of British Imperialism’s commanding and ‘reshuffling of nature’ (Courtwright, 2001: 11). What was ‘natural’ manifested in the workplace in the nineteenth century with the master manufacturer of the industrial revolution’s obsession with disciplining. Drunkenness was antithesis to their aims (Thompson, 1963: 393-394). Separating of alcohol behaviours gave rise to a higher power of morality that temperance and evangelical movements considered deviant behaviour (McDonald, 1994: 3). Heather and Robertson state (1997: 99) the deviant label is well known as being a method of control to eradicate unwelcome behaviours by powerful sections of society. This instigated the labelling of drunkenness, implanting doubt as a notion of its normality and the concept of normality as different and of higher and more respectable quality (Goffman, 1990: 149) and became a technique of control.
As science progressed alongside the industrial revolution, drunkenness was transformed and criminalised by authorities (Heather and Robertson, 1997: 11-12). A new middle class was forming, and its aspirations of wealth aligned with industriousness, thrift and respectability disassociated itself from working class associations with drunkenness and irresponsibility (Ibid,: 12). Segregation by class was aided by the moral deviance labelling of alcohol whilst maintaining the economic benefits of alcohol sales (Courtwright, 2001: 190). A cycle of economic power and a moral code established a work ethic helped by labelling drunkenness which in turn contributed to the self-regulation of the working class (Fromm 1960: 80 in Thompson, 1963: 394). The workers were socially constructed to enslave themselves in the workplace, as abstinent.
This had dual effects. The deviant as purported in labelling theory, is outcast and distinguished from normal society by actions for whatever reason they occur. In this case drunkenness. The label also becomes an identity of the individual who behaves as society intends the label to produce, becoming a self-fulfilling prophecy (Heather and Robertson, 1997: 103). The act of deviancy and therefore its labelling is an act of enterprise on behalf of the legislators (Becker, 1991: 162-163) and creates the deviant but the compliance to not be too. This contradictory and hypocritical mode of judgment where all classes’ behaviour included drunkenness, but one decries the other, is constructed by those who claim not to be deviant (Becker, 1991: 8-9). The outcome of these events points to a deliberate use of alcohol as a vehicle to marginalise people for nefarious reasons. As time progressed and more types of human behaviour was explained scientifically, the moral deviance label transformed to medicalised disease.
Disease Theory – AA and the shifting of power
The birth of the disease theory of alcohol began to replace the model of deviance in the eighteenth century and the rise of science replaced moral codes of behaviour propagated by the church and civil authorities with medical theories that explained human behaviour external to individual free will (Heather and Robertson, 1997: 18-19). The deviant drinker who chose to drink, albeit immoral, did not need an explanation. They were autonomous and behaviour could be problematic but not a social problem. This changed and the diseased drinker was usurped by the knowledge of science and power conferred to the professional who subsequently labelled them in medical terms as addict or mentally ill (Ibid,: 19). Drinking became individualised and in the 1850s labelled with the title ‘alcoholic’ which resulted in its connection to psychosis and related to some of the ‘major categories of psychiatric thought’ (Ibid,: 27).
The compulsive drinker or the recovering diseased patient manifested in one of the most successful and famous methods to address problem drinking in the twentieth century; Alcoholics Anonymous (AA). AA do not stigmatise or judge drinking alcohol but remove power from the individual and supplant it in an external source of higher status which has its roots ideologically in protestant evangelicalism and in the real physical terms of a present supporting group (Antze, 1987: 172-174). However, as objective stigmatisation was eradicated, internal judgment was not and ‘we had to concede to our innermost selves that we are alcoholics’, that ‘no real alcoholic ever recovers control’ and ‘the delusion that we are like other people […] has to be smashed’ (AA_World_Services, 1939: 30). AA’s idea of control lies in the notion of the lack of it and is where, in contrast to AA, Alan Carr (2003: 26-28), a popular addiction control author, de-stigmatises the alcoholic. He claims that control, and therefore the lack of self-control was never present, negating the loss of it. The disease therefore has no form to connect to unlike infectious diseases.
This separation from mainstream society by medicine is a reminder of the plague and its resultant leprosy where an existent mode of control in seventeenth century European urban society intensified its segregation policy as a means of governing and monitoring carried out by inhabitants themselves for their own good (Foucault, 1979: 198). Carr (2003: 18-28) eliminates the realm of order where Foucault’s (1979: 198) leper was confined and exiled and state authorities trained in confining, reminiscent of the alcoholic who is reformed to order with external intervening power. He transfers alcohol consumer perspectives to the terms of their lives and environment (Carr, 2003: 18-28). Carr and AA take similar approaches apart from their labelling process which is absent and prevalent respectively. However, AA do not victimise, but I argue contribute to the medicalised approach that some authorities use to which they are committed to ‘an irreversible disease’ (Antze, 1987: 172).
Pregnant mothers – The Panopticon of self-regulatory power
No culture is free of ideology, and institutions of which medicine is one, create culture (McDonald, 1994: 12) as they progress. Their growth is engineered by power, inextricably linked to discipline, where it seeps into every structure of social authority to maximise ‘the docility and utility of all the elements of society’ (Foucault, 1979: 218). Foucault examines the culture of discipline in Panopticism which has become public discourse in western industrialised countries around the subject of the morality of drinking alcohol during pregnancy and health of the unborn fetus (Bell et al., 2009: 156). Bell et al. draw attention to the ‘punitive and value laden language’ (Ibid,) that surrounds the topic and growing research in the US which points to the negative impacts on health opposed to a sociocultural view which includes environmental and cultural issues. The underlying moral message commits mothers who drink alcohol while pregnant to emotionally loaded labels such as ‘killers’ and ‘abusers’ (Ibid,: 157). These labels avoid stringent analysis rendering mothers victims of stigmatisation and discipline by power laden medical institutions and media organisations which miss environmental causes of drinking whilst pregnant. They are stigmatised and legislated against as criminals (Bell et al., 2009: 160).
Goffman’s (1990: 90) stigmatisation theory claims judgment does not always produce undesirable traits though. Traits are only undesirable if they do not fit in with the norms of society. Those norms can change historically (Willis, 2002: 3) as well as public perceptions of them, leaving judgments from all perspectives subjective (Becker, 1991: 3). Therefore stigmatisation is an attribute of a person, and is a language of relationships where one person’s attribute is deeply discrediting but confirming of another’s usualness (Goffman, 1990: 13). The label has no substance itself, it is subject to what we impose upon it (Ibid,). However, public discourse does not always recognise this and political morality drives institutions and the media to marginalise certain groups of people. Ideological moral panic ensues (Cohen, 2002: xxxii), resulting in the quest to discipline and Bell et al. (2009: 158) found the research to be an ‘ideological project as much as an empirically driven one’ (Bell et al., 2009: 158).
Foucault’s (1979: 215-216) notion that discipline is distributed ideologically, between people, organisations and institutions in contrast to methods imposed upon them, links medicine’s moral crusade to label pregnant women to a process of marginalisation via moral panic. Foucault recognised architect Bentham’s panopticon prison, a penitentiary of continual self-regulatory subtle surveillance and human laboratory as a set of relations and functions applied to all institutions including the medical profession and the family (Foucault, 1979: 204-206). During the eighteenth century medical knowledge increased simultaneously alongside power, reinforcing one another in a circular process to a point where any objectification could be used as subjugation (Ibid,: 218). Social behaviour became medicalised where it wasn’t before (Becker, 1991: 6); birth and pregnancy became a medical concern.
The medical profession became absolute which is prevalent today in the US where women are scapegoated as a ‘central element of public health initiatives’ (Bell et al., 2009: 161) using labels of ‘selfishness’, ‘negligence’ and ‘irresponsibility’ to laden those who drink during pregnancy with guilt (Ibid,: 161-162). The panopticon as analogy but also as a function, designed ‘to induce in the inmate a state of conscious and permanent visibility that ensures the automatic functioning of power’ (Foucault, 1979; 210), marginalised, labelled and stigmatised women into self-regulating their own subjugation as medicalised subjects as well as being criminalised as ‘fetal abusers’ (Bell et al., 2009: 160). Environmental factors in studies were ignored and abstinence promoted but the signifiers of poor health of fetuses were poverty. Alcohol only caused harm when combined with malnourishment and women more likely to drink, were poor (Ibid,: 158).
Conclusion
The complexities of alcohol regulations can blur the boundaries of what alcohol related behaviour means and what the acceptable levels of behaviour around it are. Its symbolism and uses are varied from representations of power, ritual objectification and symbolic difference in Ghana (Akyeampong, 1996: 14-15) to the demarcation of leisure and work time denoting social responsibility and norms in the US (Heath, 1987a: 78). There are no universal set of understandings and therefore needs an acceptance of who, where, how and what type of alcohol is consumed to decipher how it works and what it means (Heath, 1987b). Therefore, the purpose of this essay is not to obscure the power structures that create certain behaviours and disavowal from incorporating them into a sociocultural analysis, but to ascertain that the historical context of power can obscure the meaning but also detract from the creation of meaning in the consumption of alcohol where marginalisation of people occurs.
The study therefore takes a critical view of stigmatisation and labelling through the theories of Goffman (1990) and Becker (1991) and how they are contributary to understanding how categorisation of humans are relevant to the definitions of society (Goffman, 1990: 150). The crusade of the labeler may be moral but subject to new and historical modes of knowledge or power (Becker, 1991: 150) as in AA. Judgment is self-regulating and they replace the conflict of volition and compulsion of the alcoholic with motivations identified and shifted to group support and higher power, be it ecclesiastical or self-constructed equivalents (Antze, 1987: 172-174), but to great success. A resulting question would be ‘what success is?’
Power structures can shape the outcomes of stigma and labelling judgments which Foucault (1979: 227-228) traces through influence of institutions which internalise the individual’s experience of life through self-policing in subjugation. Where AA may obscure their power structure for good moral reason other authorities can consciously criminalise (Bell et al., 2009: 160). Law that legislates against expectant mothers for drinking alcohol, endorsed by ideological medical documentation, who have already been marginalised through poverty (Bell et al., 2009) is missing the point in understanding consumer motivations, and a place where anthropological holistic study can bring the sociocultural model to bear (Heath, 1987b: 113).
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