Alcoholics Anonymous scholar Ernest Kurtz – author of “Not God: A History of Alcoholics Anonymous” and “The Spirituality of Imperfection: Storytelling and the Search for Meaning” – is at it again with his sometimes  unorthodox and perhaps controversial explorations of AA history, this time with an essay entitled “Alcoholics Anonymous and the Disease Concept of Alcoholism.”

To cut to the chase, the crux of his argument is that the disease concept we hear invoked so often – generally interchangeable with the word ‘alcoholism’ itself – was not bandied about or even accepted in AA until the 1940s or 50s when Mrs. Marty Mann advocated for its adoption by the AMA and the health care profession.

Kurtz digs up plenty of compelling evidence that Bill Wilson, the co-founder of AA, found the disease concept problematic, and flatly refused to introduce it into the AA vocabulary or literature.  Bill put it rather plainly: “We have never called alcoholism a disease,” and elaborates further on his reasoning here:

We have never called alcoholism a disease because, technically speaking, it is not a
disease entity. For example, there is no such thing as heart disease. Instead there are many
separate heart ailments, or combinations of them. It is something like that with
alcoholism. Therefore we did not wish to get in wrong with the medical profession by
pronouncing alcoholism a disease entity. Therefore we always called it an illness, or a
malady — a far safer term for us to use.

To me this makes perfect sense – the intrinsic claim that alcoholism is a medical disease that meets all the criteria of being organically based in cells or organs has never seemed accurate or helpful.  Better to get on with business and call alcoholism, as Kurtz claims it was conceptualized and named in the pre-Mann era, an “emotional maladjustment.”  You can throw in a number of other phrases that attempt to describe the core problem – “spiritual bankruptcy” (which I suppose could be seen more as a symptom or result rather than an original cause), “hopeless condition of mind and body”, etc. – but to call it a disease per se, according to Kurtz, was believed by Bill Wilson and other to be a stretch.

To me this is mainly semantics – to my mind, there is some complex of emotional “maladjustments” or immaturity or disturbance, a mental obsessiveness and a general tendency towards both selfishness and self-destruction – that we could personify or give agency to by calling it something or other.  Disease, I believe, is the wrong word.  Malady works, but it’s kindof stuffy.  I guess I’d go with illness for convenience’s sake, but maybe there’s another word that is eluding me at the moment.

Interestingly, when I brought this up to my sponsor, he wasn’t buying it, at all.  In fact, he told me that he thought I was looking for loopholes by worrying about and debating these essentially academic issues – that I was, in his words, looking for an excuse to drink.

I sure don’t feel like that what’s I’m doing, but the unconscious – err, the disease? – is cunning, baffling, powerful!

Anyone have any thoughts or feelings about this issue?