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#7 1997 Where Did Mrs. Marty Mann Learn Alcoholism Was A Disease and Why Should It Matter? by Ron Roizen
Mann presenting Bill W. with NCA's first Gold Key Award in 1959
Mann (1904-1980) was a superb speaker, who combined an air of complete frankness with an almost weary gratitude for her 1939 "discovery" that there existed something in the world called "alcoholism," that it was "an illness," and that she herself was "an alcoholic." It was this thingness about alcoholism--i.e., its solid tangibility as a concrete disease entity--that seemed to give Mann the rock upon which she built not only her own recovery but the message of the movement she championed. According to Mann's own account, the worsening course of her drinking in the mid-1930s as well as frightening occurrences of memory-erasing, post-drinking blackouts finally caused her to seek psychiatric help. The treatment experience that followed was remarkable in that it comprised almost two years of inpatient care.1 According to Mann's account, after being declined by several psychiatrists she became the noted Dr. Foster Kennedy's2 patient in his Neurology Ward in Bellevue Hospital for seven months. Next, and soon thereafter, she became Dr. Harry M. Tiebout's patient for a still longer, 16-month stay at Blythewood Sanitarium in Greenwich, Connecticut. It was at Blythewood in the Spring of 1939 that psychiatrist Tiebout handed Mann a manuscript copy of Alcoholics Anonymous--the volume that would before long become the celebrated "Big Book" of the AA movement. He invited her to read it. Mann thereafter credited her "discovery" of alcoholism's disease character to this text. Indeed, a consistent element in Mann's personal history talks was her contention that before reading the Big Book's MS she'd neither heard the term "alcoholism" nor been made aware of alcoholism's disease character. But can this contention have been literally accurate?
Moreover, a person with Mann's anxieties about drinking--and especially one as hungry for information about her problem as she says she was--might have encountered the term in more than a few places. For example, lay and professional representatives of the "Emmanuel Movement" and the "Peabody Method"--men such as Courteney Baylor, Francis T. Chambers, Jr., Dr. Samuel McComb, Richard R. Peabody, and Dr. Elwood Worcester--identified alcoholism as the target of their therapeutic efforts.3 Even Charles H. Durfee, Jr., an alcoholism therapist who preferred the term "problem drinker" for his patients, noted in a 1936 paper that presenting patients who manifested neither inadequate personalities nor evidence of clear psychopathology had usually been labeled "alcoholics."4 Contemporary magazines also used the term. For example, Genevieve Parkhurst, writing in the July, 1938 issue of Harper's, titled her article "Drinking and Alcoholism." Parkhurst's text, moreover, quoted "an eminent physician who has made alcoholism his special study" to the effect that the phenomenon was not a vice but a disease--thus prevoicing Mann's famous theme. Bellevue Hospital, where Mann was an inpatient, was well known as New York City's reception and respository center for "alcoholics." Internist Dr. Norman R. Jolliffe published a paper titled "The alcoholic admissions to Bellevue Hospital" in Science in 1936.5 "Alcoholism," the word, was by no means exotic or rare in 1930s America. Of course it's always possible that Mann regarded herself as "mentally ill" rather than "alcoholic," thus distancing herself from the currency of the term in medical and popular literature. Mann with E.M. Jellinek
The first edition of Alcoholics Anonymous contained only a single personal story by an alcoholic woman, titled "A Feminine Victory." By the time the BB's second edition was in preparation, however, this chapter's author had returned to drinking. Her chapter was replaced with another woman alcoholic's story, titled "Women Suffer Too." And this was Mann's story. Mann began her chapter with an account of a deeply disturbing blackout experience. She tells of suddenly finding herself wide awake in a livingroom "in the middle of an animated conversation" with a person whom she could not recall meeting. Terror struck Mann as she tried to recall and reconnoiter her situation. A drink might calm her anxiety, she thought, but instead she determined to leave the situation before she might "...let slip my abysmal ignorance of how I came to be here..." It was six o'clock in the evening. She recalled that she'd last checked her watch at one o'clock--when she was drinking martinis in a 42nd Street restaurant with a friend. In the intervening five hours, therefore, Mann had somehow ended-up in the Brooklyn basement apartment of a total stranger. It took two train changes and three-quarters of an hour, Mann related, to get back to Grand Central Station, where her adventure had started. And now comes the intriguing detail mentioned above--in a passage about the evening that followed:
His book, titled Asylum, was published in 1935 by Harcourt, Brace and Co. and sold very well. Mann's BB story suggests, of course, that she was familiar with Seabrook's book--even familiar enough with the treatment he received to have wished to enter the same establishment for her own troubled condition. As it happens, Seabrook's account readily employed the terms "alcoholic" and "alcoholism." Hence--and if she read the book--Mann had indeed been exposed to these terms well before encountering them in the Big Book MS. Seabrook's book also offered a remarkable argument for the legitimacy of his patienthood in a mental hospital as an alcoholic--in effect, a case for alcoholism's disease character. Seabrook's argument began with a description of his living circumstances as a patient:
There were only a few "drunks" in residence, Seabrook says, "...a scattering of a half dozen, maybe among three hundred patients" (p. 46). The facility's approach to residential grouping called for an intermixing of patients with different diagnoses--fourteen to a unit.
Seabrook did not reveal this singular commonality straightaway. Instead, he narrated a series of cameo descriptions of his unit-mates--each time, and regardless of each case's symptomatology or diagnosis, coming to the conclusion that the patient could not control his behavior in some particular regard. This led, in turn, to Seabrook's discussion of his own alcoholism and how it also fit the cardinal criterion, applied previously to his unit-mates, of uncontrolled conduct.
Seabrook's passage contains remarkable echos of ideas that would not fully find expression in the new science of alcoholism until the publication of E.M. Jellinek's famous phased symptomatology in 1952.6 But what does it really matter whether Mann heard the term "alcoholism" and read a cogent argument for its disease character even before she commenced the long trail of neurologic and psychiatric treatment experience that at last brought her to AA's Big Book? Why should we care whether Mann's readiness to accept the alcoholism-as- an-entity and alcoholism-as-a-disease ideas had been, say, primed by reading Seabrook's well known book? Maybe Mann was too deeply befogged by her drinking when she read Seabrook's book to pay much attention to anything he wrote. Obviously, we need to take care not to place too much significance on the "Seabrook detail." It is at most, I believe, an intriguing hint. But as a hint, it hints at some important aspects of the sociology of social movements--aspects that merit more investigation. Social movements shape and guard the stories of their histories as treasured rhetorical capital. Such stories, moreover, often embody discernable proselytizing features. For instance, they may highlight a sharper break with past tradition than in fact was the case--by way of emphasizing the newness and originality of the new movement's cause. They may also frame their genesis ideas or inspirations in ways useful to current survival or growth preoccupations. The Seabrook detail, in turn, invites our attention to how such processes may have been at work in shaping Marty Mann's account of her personal rescue. It's a nontrivial question. After all, Mann's personal story went far
toward shaping
a larger movement.
1 Inconsistencies across Mann's accounts, however, cast doubt on what, precisely, her inpatient experience comprised and how long it lasted. 2 Mann frequently cited Dr. Tiebout by name in her talks, but she drew a veil of discretion across mention of the famous Dr. Kennedy by name, preferring to refer to him in vaguer terms such as "a well-known neurologist," etc. I know of only a single instance in the ten tapes I've heard in which she identifies Kennedy by name--and my guess is that this mention was in effect a slip of the tongue. I don't know why Mann would have treated the names of her two physicians so differently. 3 A wonderful book on pre-AA alcoholism treatment in the 1930s remains to be written. Meantime, see: Katherine McCarthy, "Early Alcoholism Treatment: The Emmanuel Movement and Richard Peabody" (Journal of Studies on Alcohol 45:59-74, 1984). 4 See Charles H. Durfee, Jr., "Understanding the Drinker" (Mental Hygiene 20:11-29, 1936, p. 13). 5 Vol. 83, p. 306 et seq.; see also Ron Roizen, "Women Alcoholics at Bellevue, 1918-1919" [Letters], Science (274:1450-1451, 1996). 6 E.M. Jellinek, "Phases of Alcohol Addiction" (Quarterly Journal of Studies on Alcohol 13:673-684, 1952). ©
1998 Ron Roizen
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