Women Are Not Powerless

By Hallie Hart Hodenfield 07/30/14

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 paperback this 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?

I don’t think AA should have the lock on the market, so to speak, but I do think it has use and validity. Part of what is so useful about AA is that it involves peers helping other peers, as opposed to being a downward-looking solution. AA was the first to really de-stigmatize alcoholism in terms if it being a moral issue, and so I think it can be really helpful to women, or anyone, to think “Oh, I’m not bad.” You mentioned loneliness as a big trigger for alcoholism in your book, and I do think AA addresses this in a way that talking to a doctor cannot. But I also agree with you about the drawbacks for women, or any oppressed minority, of having to yet again say “I surrender! I’m powerless!” That’s something that’s not talked about enough and I really appreciate that you did address it.

I was at a meeting in San Francisco, and there were so many gay, and lesbian, and transgender, bi, people of color, and I thought – I’m a middle class white woman with a college education, and these people are not, so the idea that they’re having to say over and over and over again that they’re powerless, and to examine their flaws – I think a lot of us are pretty aware of our flaws in the first place, and if it’s helpful for people, if they really did terrible things while under the influence, or things that they’re ashamed of, then go for it, but I know a lot of women who were really ground down by that experience – it made them feel worse. I have suffered from depression in the past, and I know that when you feel like crap, you are already repeating that in your head about what a rotten person you are. That’s the news crawl of your brain already, you don’t need to be led to have to do that, because that’s all you’re hearing. And while it was a milestone for those men at that period of time, to acknowledge, “Hey, we don’t have control over this,” it’s a different society today, and that’s one thing I wanted to point out.

I think the other side of that coin is that Alcoholics Anonymous is about ceding control over one’s drinking, and the subtitle of your book is about regaining control. Many people do not feel they have any control over their alcohol use, and have tried to control it, for years, and so saying, “This is something I cannot actually control,” is not necessarily a giving up of ego, but actually a way to empower oneself, and get help.

I understand that, but at the same time, I heard many times in AA, in the meetings that I went to and certainly from many of the people that I spoke to, that “You’re arrogant. You’re being arrogant again. There’s your ego again.” You know, one woman, she said, “Oh, I’m so happy, I’m so proud of myself, and the group just brought her down, because she was allowed to be proud of her sobriety chip, but she’s not allowed to be proud of a promotion that she’d gotten? I have to respectfully challenge the idea that your ego is that negative of a thing. 

Where would you go if you had a problem?

I would go to a female doctor who’s trained in the most modern aspects to understand and help me tailor a program that would be best for myself. I would also learn how I could control my anxiety, which as an older woman, I’ve learned to do. I would try SMART Recovery, I would try Charlotte Kasl’s sixteen step program. To me, of all things, it kind of makes the most sense. They’re not about powerlessness, they’re about using your own intuition. It’s about finding your own internal strengths, and willpower. It’s the opposite message. It’s cognitive behavioral therapy for yourself. And cognitive behavioral therapy has been shown to be the most effective modality for depression, for anxiety, for so many things. You can argue that AA does employ some because you’re going to meetings, you’re stepping away from your triggers, you’re reminding yourself.

But another thing that perplexed me when I did go was that if you haven’t had a drink in 32 years, and you go to meetings four times a week, and you still remember the last time you were drunk, and you want that, if it works for you, then great, please don’t think I’m making judgments, but why is that necessary? Why is it necessary to repeat for 32 years that same story? To me it feels like negative self-reinforcement. The other groups do seem much more positive and open to new language, open to using medication in addition to the program as it is set, and I know in AA, technically the people are not supposed to warn against using medication, but that is something else I’ve heard a great deal of as well, that you weren’t going to be sober if you take antidepressants, you weren’t going to be sober if you went to the dentist and you needed Novocaine. I heard those stories many times. One woman at a meeting was extremely anxious because she had to get a root canal and what was she going to do, and her sponsor told her “Don’t let them give you anything for the pain.” And she was so worked up with anxiety about getting the root canal, and not having anything for the pain, that she had a slip.

My perception of the women that you interviewed and wrote about is that they are predominantly middle-aged middle class white women who “drink too much,” who aren’t what I would term full-blown alcoholics: most of them haven’t lost anything, most of them are just waking up with headaches.

Overwhelmingly the women who are getting into trouble with their drinking are white, and many of the women who had lost something didn’t end up in the book because they were still struggling, and my editor wanted to show people hopeful ways out. 

The research shows that the women who are getting into trouble the most are white college educated women. Latinas are keeping right up with white women, because they’re coming here, especially if they’re fairly new, they have all of the pressures of their own cultural expectations, and they’re trying to make money, and they’re trying to succeed in a culture that has very different messages. Alcohol companies are definitely targeting Latinas. If you go to Washington Heights, it’s appalling, you see ads for alcohol pops that are passion fruit flavored, or coconut flavored. It’s like “Hey chicas!” And black women suffer from alcohol dependence as well, but not in the same numbers that white women do, and the epidemiologists believe that that’s for religious reasons, that there are so many women who have strong religious identities, and their religions prohibit alcohol. So, it may look narrow, and I tried to explain why it is narrow, because white middle class women are closest to the power center, and they’re drinking like those men, and they’re having those problems because their bodies aren’t able to handle the alcohol.

What changes would you like to see?

I want people to know that there are many different tools, and there are many different options. That’s the goal of the book, that if you find yourself getting into trouble, it doesn’t mean that this is necessarily a lifelong diagnosis. It might be, but there are many different ways to get better. You can moderate. There’s research showing that that works. Other people say, if you suggest that people have controlled drinking and they limit the number of drinks they have a week, well that means you’re an alcoholic. Then all of France, and all of Spain and all of Italy are. They keep a tally, in their heads, of what they drink – does that mean that everyone in those nations is a functional alcoholic? I don’t think so. I want people to realize that you can stop yourself, you can step back, that you’re not going to necessarily have to get on that one trajectory of the Jellinek’s curve, that just because you can see yourself on that curve doesn’t mean you’re going to end up there. Some people get better after they hit bottom, but you can intervene early just as you would with asthma, or with high cholesterol, with more effective treatments. We need to have a culture that approaches moderation in a different way. And I think even our guidelines, the U.S. guidelines for safe drinking, they’re certainly lower than everywhere else in the industrialized world, and moderate alcohol use is associated with higher longevity in many different studies. So why do we have the one drink? For a lot of women that’s when their drinking becomes secretive, because they drink more than one drink, they know that the U.S. government says that’s bad, or their doctor says that’s bad, or that means they have a problem, so that’s when it starts to go underground.

So according to that, these women don’t actually have a problem; it’s a problem with language more than a problem with drinking.

I do think we have a problem with language. And part of it is the word “alcoholic.” And that is something that is kind of old-fashioned, it’s kind of like “nervous breakdown.” And it’s also an identity that I think a lot of people are afraid of. That admission might be really helpful for some, but isn’t it possible that people just be recovered? “I used to have a bad habit, and I changed my ways.” I think that’s a much more empowering way of thinking.

Hallie Hart Hodenfield is a regular contributor to The Fix. She last wrote about Colin Broderick and Mika Brzezinski.

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Hallie Hart Hodenfield is a writer and freelance journalist, living in New York. She is also a clinical social work professional experienced in mental health counseling with children, adolescents, and families, particularly related to issues of trauma. Her experience extends to global social work and practice with immigrants and refugees.  writer and freelance journalist. You can find Hallie on Linkedin.