<論文>アルコール問題の概念化に関する一考察 : 疾病概念を中心に

Abstract

In various discourses on medicine, psychotherapy or self-help group activities, issues related to alcoholism such as dependence and addiction have attracted much interest. It is often said that these problems are "hidden" or "denied", in the sense that everyone tends to avoid confronting with the problems. In this paper, I would like to give a close examination into the ways in which some of the main assumptions related to alcoholism are conceptualized, with a purpose of showing why such negation has to take place under the present paradigm of alcoholism. Firstly, E.M. Jellinek's work on alcoholism will be examined. For Jellinek, alcoholism is nothing but a disease. He argues in a scientific way that the human body suffers "loss of control" as an effect of a long-term habit of drinking. But his study also implies that the "loss of control" is limited to very few cases. This leads us to the examination of the relation of the indivisual will to the control of drinking. In the next chapter, I will turn to the historical process through which the notion of "diseases of the will" was born. It was an expression widely used in Temperance thoughts in the United States. By tracing the ways in which alcohol problems caught the Reformists' attention, I will show that they became personalized and moralized at the same time. In other words, the appearance of the notion of "disease of the will" marked a critical moment in which the idea of socially coping with the problem was lost. As M. Valverde (1998) also points out, many scientific challenges to the classically religious concept of "freedom of the will" did not effect the change of the policy of individualization. Indeed, some of the primary concepts concerning alcoholism (such as the "will", the "disease" as well as the "dysfunctions of the will") are no longer moralistic but somatic ones, but at the same time, individualization is so persistent in the field of alcoholism that the sufferer is still under the strong pressure of resolving the problem by exercising his or her own will. This, I would argue, is one of the main reasons why alcohol problems remains "hidden" or "denied" under the existent paradigm of alcoholism. This study is expected to make an important contribution to the development of social theory, especially in the fields of medicalization, power/knowledge realtion as well as the individualization of risk management in late modernity.