by Ron Roizen

In RR #1, I began a consideration of an intriguing historical report prepared in connection with a 1993 NCADD conference. I'll refer this document as the Stepping Stones History or SSH report.¹

One of the report's most interesting features is that it offers an unusually candid organizational perspective on both NCADD's history and the history of the alcohol field. The report's author asked, in effect: What social and historical factors define NCADD's current survival matrix?

The report's answers--combined with its author's obviously rich knowledge of what Carolyn Wiener called "the alcohol problems social arena"--makes examining it a rare opportunity for a behind-the-scenes look at how an interest group like NCADD sees its world.

If anything struck me hardest in the report, it was the document's emphasis on the "problem" posed by anonymity in the Alcoholics Anonymous or recovery tradition. Anonymity, it turns out, translates into a kind of political invisibility from NCADD's perspective. It renders an otherwise useful grassroots constituency much less valuable.

Lowering this premium, the report suggested, would not only give people in the recovery community a louder political voice but would also make it easier for leadership to contact and organize them for political enterprises. The report's negative disposition toward anonymity was evidenced in other ways too-- including the interesting contention that anonymity actually perpetuates society's stigma on alcoholism, because a premium on anonymity gives the public the message that even the recovery movement sees alcoholism as indeed shameful and therefore requiring of anonymity's shield.

You don't need to be an Ernie Kurtz to detect that NCADD's critical perspective of anonymity also affords a telling indicator of just how far NCADD's sensibility for the 1990s has journeyed from the AA worldview.

After all, anonymity is hardly a throw-away item in the AA canon!

On the contrary, the principle is arguably the symbolic cornerstone of AA's philosophy of unselfishness. When Marty Mann, NCADD's revered co-founder, decided to break her personal anonymity in order to launch the organization back in the mid-1940s, her act was regarded with sufficient wariness that it spawned a considerable controversy within AA.

Now, a new NCADD, ideologically re-outfitted in a new historical context, regards the anonymity norm, per se, as an albatross.

The difference is striking.

The report is by no means insensitive to the NCADD departure from an older tradition of organizational aspirations and commitments.

In fact, the narrative appears to take special pains to explain, justify, and at times perhaps even excuse a little the NCADD's NPHA orientation to a more traditional, AA-oriented readership.

Perhaps the best face that can be put on the NCADD's NPHA agenda vis a vis its older, MAM constituency is that the two philosophical orientations are not fundamentally different. Almost as good is making the case that the NPHA agenda consitutes "the next step" in the MAM's original historical progression. But neither case is in fact an easy sell.

One point the report makes is that the NCADD needed to shift organizational goals because the older NCA's goals were by and large achieved. For example, most Americans will nowadays readily agree that alcoholism is an illness.

But the "already achieved" argument soon runs athwart the report's emphasis on the troubled status of alcoholism treatment institutions in the nation. Much that the MAM built, the report avers, is now threatened with dismantlement.

Just such a threat might have caused the NCADD to rededicate itself once again to to the older, MAM agenda. But the report's narrative never takes that direction as such.

Instead, however, the report elects to highlight some of the structural factors that drew NCADD into the embrace its new ideological orientation.

The list is telling.

The most important factor of all, says the report, was the passage of the "Hughes Act," creating the National Institute on Alcohol Abuse and Alcoholism (NIAAA). "In addition to the effects of government contracts," the report goes on, "NCADD, perhaps more than the rest of the field, was strongly influenced by the rise of the alcohol policy movement, and the Reagan era War on Drugs."

"NCA became the last national service organization in the field," the report's text confides, "to broaden its mission beyond alcoholism, when it added the 'and Drug Dependence' to its name in 1991."

Other factors impinged on the NCADD's organizational situation, too. For example, growth and fragmentation of the interest groups crowding the alcohol social arena weakened the organization's historic claim to centrality and marginalized its traditional alcoholism focus. New popular attentions to Fetal Alcohol Syndrome (FAS) and other alcohol-related problems, occasioned what the report describes as a "seemingly irrevocable division" with the beverge industry--once a partner in the older NCA's assault on alcoholism.

Another of the striking aspects of this fascinating report is the frankly political and economic plane of its narrative. There is of course nothing extraordinary or embarrassing about this sort of focus. All organizations must engage in "back-stage" activity (as sociologist Erving Goffman³ called it) to keep a roof over their heads, pay salaries, and make sure that disputes over parking privileges are settled fairly.

In contrast, "front-stage" activity is what organizations do when they put their programs on public display. Unlike the prosaic quality of back-stage activity, front-stage pursuits showcase the cherished values, the powerful popular paradigm, the pressing problem-claims, and the plan for action that an organization like the NCADD wishes to promote.

Not the least important lesson to be learned from the Stepping Stones History report is that the "front-stage" and the "back-stage" realms of NCADD's organizational life are by no means independent of each other. Backstage considerations have clearly helped shape front-stage agendas.

---

Footnotes:

¹ See RR #1, and footnote 1 therein, for a fuller description and citation of this report..

² For discussion of "regions and region behavior," see Chapter III of Erving Goffman's classic study, The Presentation of Self in Everyday Life (Garden City, NY: Doubleday Anchor Books, 1959).