What We Get Wrong About Women & Alcoholism

When you picture a woman who's an alcoholic, you might visualize someone who's down on their luck, who reeks of alcohol, and who can't handle themselves after having one drink too many, à la Emily Blunt's character in The Girl On The Train.
But, the reality is often different. According to the National Institute on Alcohol Abuse and Alcoholism, for women, "at-risk" or "heavy" drinking involves more than three alcoholic drinks on any day, or more than seven drinks per week — which, to some of us, may not seem like that much. If you've exceeded that number throughout your life, you're not the only one. A study from last year found that Americans, particularly women, are consuming more and more alcohol throughout the years.
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Yet, we have vastly different expectations for men and women when it comes to alcoholism. In her book, The Recovering: Intoxication and Its Aftermath, writer Leslie Jamison delves into the stories we tell about addiction, using her own history as well as the stories of artists throughout history who've struggled with alcoholism.
Here, Jamison talks to Refinery29 about how we perceive addiction as it relates to men and women of different racial and class backgrounds — and the effects those impressions have on how we help people recover.
How do you think gender plays a role in how we perceive people with addictions?
"There’s a really well-worn groove in the cultural imagination for the 'male genius drunk' who was a little bit of a rogue, and maybe dysfunctional or destructive, but there was something charming about this dysfunction, and that self-destruction was related to his genius and the art he made.
"Female drunks are more likely to be seen as melodramatic, histrionic, self-indulgent, and all sorts of perceptions seem to be attached to women that I think has to do with the different expectations around caregiving that we bring to women. If you’re expected to be a caregiver, it’s easier to see getting drunk or using substances as a failure of that caregiving task."
What do you think a stereotypical alcoholic in America looks like to people?
"I think people probably have a few different models in mind. On one extreme, there’s a Skid Row, down-and-out, completely at the end of his rope, wino stereotype. But, I also think people have the model of the alcoholic housewife who’s sneaking drinks from a bottle tucked in the back of the pantry. There’s also the alcoholic businessman who gets flushed on planes and hotel bars.
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"But, I think there’s more space in the cultural imagination than there used to be for the high-functioning alcoholic who might not necessarily seem to be completely falling apart from the outside, but for whom alcoholism is a corrosive force nonetheless."

Certain kinds of drinking seem more acceptable when you’re in college or in your mid-20s.

Leslie Jamison
Do you think those stereotypes differ based on race and class?
"I certainly think that’s one manifestation of systemic racism in America, that minority communities are disproportionately associated with addictions. And, addiction tends to get narrated in terms of vice, crime, and betrayal of the social contract when we’re talking about people of color versus white people, who, I don’t want to completely generalize, but are more likely to be afforded the privilege of having their addiction seen in terms of suffering, illness, psychic complexity, interior anguish."
Would you say that drinking a lot is more socially acceptable amongst college-age women or women in their 20s? Why or why not?
"I certainly think that certain kinds of drinking seem more acceptable when you’re in college or in your mid-20s, and then maybe that same amount of drinking would seem more out of place among a group of 35-year-olds, or around young children.
"People just age out of certain drinking patterns, and over the years, just looking at my own life and other people’s lives, I was really struck by the same amount of drinking, measuring it by volume, it might play out two different ways in two different lives.
"Someone can be a heavy drinker who just likes to get drunk, but it hasn’t yet created that feeling of total need or dependency. You might have those friends who are heavy drinkers, but it’s very easy for them to go for a night without drinking and they wouldn’t know the difference — it’s just that when they do drink, they like to get drunk. But, it’s different than someone who, every time they go for a day without drinking, it’s a really big deal psychologically, and it feels like deprivation every time they’re not allowed to get that relief of a drink at the end of the day. That’s certainly what it felt like for me, and I was aware that with the amount I drank, maybe someone else could drink that amount and they wouldn’t become attached to the same negative emotional consequences and feelings of obsession."
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A lot has been made of the fact that you accomplished so much while going through alcoholism. What do you think it means to be a high-functioning alcoholic?
"There’s a lot of impulse to be like, Well, it’s not a real addiction if it doesn’t take your job away, or it doesn’t take your kid away. But, there’s a shared experience of deep obsession and deep dependence and that can take different paths, and it’s sort of like for people maybe who haven’t struggled with [addiction], the external signifiers can seem really important.
"For me, the impulse to achieve and the impulse to get drunk are completely linked together. They happen to coexist. The same parts of me that wanted to get every single gold star or that wanted to prove I was good enough to myself, my family, my partner, institutions, that ceaseless desire to be good enough, came in part from a fear that I wasn’t good enough, and that fear in turn had the power to produce so much anxiety. And, those anxieties produced the desire to get drunk, and I spent so much of my life trying to have everything together and being in control that it also produces a deep desire to surrender control and let things fall apart a little. When you’ve been holding onto the reins so tightly, sometimes at the end of the day, you want to let go, and drinking allows you to do that."
Do you think being a high-functioning alcoholic affects how you get help?
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"I think being high-functioning, having a certain amount of privilege, has everything to do with what perception gets attached to you. But, one of the things I really like about Alcoholics Anonymous and 12-step recovery is that it’s pretty democratically accessible, so you can have lost a lot and show up, you can have lost a little and show up, you can be wealthy and show up, you can be not wealthy and show up. The fact that it’s a free program and there is a tremendous diversity in the program — age diversity, racial diversity, class diversity, vocational diversity — means that I think many people feel included, rather than it serving a specific subset of society. And, that’s not to say it works for everyone or appeals to everyone, but it’s one of the few spaces I’ve seen organic non-hierarchical recovery."
What would you want to change about the way we view women and alcoholism?
"I guess I would love for women who are struggling with addiction, whether it’s alcohol or some other substance, to be viewed with compassion, no matter their race or class, no matter what their substance of choice is, and hopefully to remove that element of judgment that can come in, either because of the constructions of women as self-pitying or prone to drama, or the construction that women are supposed to be caregivers, so there’s a moral failure implicit in any woman who’s surrendering to the self-indulgence of getting drunk. [I want] to lift that ethical accusation out of the perception of female alcoholics."
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The Recovering: Intoxication and Its Aftermath is available online and in bookstores now.
If you are struggling with substance abuse, please call the SAMHSA National Helpline at 1-800-662-4357 for free and confidential information.
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