Thoughts on alcoholism
Growing up, my life was distorted in many ways by the alcohol problems of both of my parents. My father was the more spectacular case, but I cannot remember my mother ever voluntarily celebrating with an evening of sobriety. My father would go months at a time sober, then tumble off the wagon and go on a prolonged bender until forcibly dried up, while my mother would sit up, every single GODDAMNED night I can remember, after the rest of us went to bed, drinking beer, smoking cigarettes, and feeling very sorry for herself.
They weren't the only alcoholics I knew, either. Across the street, one of our near neighbors was a constant drunk; I seldom or never saw him sober. While he was normally pretty good-natured, he could and did sometimes flare up at his hapless wife, who supported the family by running a nursing home (she, herself, was a RN).
Thinking about them, I came to the conclusion that instead of "alcoholism," singular, we should speak in terms of "alcoholisms," in the plural. They were very, very different.
My father seemed to metabolize alcohol differently from how other people do; even after a horrible bender when he'd stagger in looking like the proceeds of a grave robbery, he said that he'd never had a hangover. I don't know if Mom got hung over or not---she had almost no head for alcohol, so after three cans of the crappy cheap beer she'd swill down, she was visibly very much the worse for wear. Unlike Dad, who'd just crawl off to be alone when he was drinking, Mom would sit up for hours, brooding over every one of her wrongs, and if (God forbid) I needed to use the toilet after bedtime, she'd summon me downstairs and make me sit while she filled my ears with her complaints about things that had happened years or even decades ago. As for our neighbor, I can't speak to him much---I generally had little to do with him.
If I were a young fellow wanting to make a name for myself in the mind sciences, and had chosen alcoholism as my subject to study, I'd start by throwing everything we think we know about alcoholism overboard, and starting from scratch.
Some people seem to drink as a way to self-medicate for depression or untreated mental illness. Others, like my father, seem to metabolize alcohol differently. Still others may have become physically addicted to alcohol. And others may not be "alcoholics" in the strict sense, but are called such because they've had spectacular bouts with drink, or have got into trouble on account of drinking.
An approach that would work for one of these categories would almost certainly not work well, if at all, on others. One thing I'd do would be to absolutely forbid the use of the word "willpower." Dealing with this sort of thing is hard enough without stigmatizing the people with this problem as moral failures. I'd have thought that sort of thing would have died with prohibition, but apparently, not.