A Real Disease
I once had a doctor examine my colon for signs of cancer.Thankfully, he found no cancer, but he did discover that I had diverticulosis, which is a condition where tiny pockets, called diverticula, develop along the wall of the large intestine.If something is lodged in one of these pockets, it is possible for an infection and inflammation to occur.Diverticulitis can be very painful, and in some cases it can require the surgical removal of part of the intestine.About one third of people over the age of 50 have diverticulosis, but most people have no symptoms of diverticular disease and only find out they have it when they have a colonoscopy.There is no cure for this disease, but doctors believe a high fiber diet is beneficial and may prevent more diverticula from forming as well as lessen the chance of an attack of diverticulitis.
Notice how the description of this disease is totally different from the discussions regarding alcoholism.Go to any medical website for information on diverticulosis and the discussion focuses on biology rather than behavior, but in the discussions of alcoholism, the focus is on behavior and not biology.The same is true for all other so-called diseases of behavior, like gambling, shopping, sexual activity, and so forth.
Someone might respond by saying that I am being asked to manage diverticular disease with a high fiber diet just as the alcoholic is asked to manage his alcoholism disease by total abstinence, the Twelve Steps theory, and AA meetings.This, however, is a good example of comparing apples with oranges.Diverticula disease is biological and can be observed by a physician.I did not choose this disease and the disease itself is not a behavior, but consuming large quantities of alcohol over a long period of time is a behavior.In my case, the doctor did not try to find some out-of-control behavior in my life and identify it as diverticulosis.He did not say, “You have an allergy to low fiber foods that cause you to lose control of your behavior.You must never eat low fiber foods again because this disease makes these foods irresistible.”Instead, he focused on biology, and showed me the pictures of my disease.In this way, the fallacy of the alcohol disease issue can now be clearly defined: a behavior is not a disease.
It is argued that gambling is also a disease, but a doctor cannot examine a person’s body and discover any evidence that it is a disease.There is no blood test or physical observation that suggests one cannot control gambling.A physical exam might show the results of gambling.For example, if a person gambles away all of his money, he may be malnourished because he cannot buy food, but this condition could just as easily be the result of some other kind of behavior.The doctor may say: “You must now manage your gambling disease by not gambling, attending Gamblers Anonymous (GA) for the rest of your life, and accepting the Twelve Steps theory.”But how does the doctor know whether the disease is gambling or shopping since both can cause one to become impoverished?Likewise, uncontrolled sexual activity may cause one to develop a sexually transmitted disease (STD), but an STD is a true disease while sexual activity is a behavior.Although the distinction between behavior and disease appears obvious, it is usually dismissed in the discussion of alcohol abuse.George Vaillant (1983), for example, argues that the defining characteristic of alcoholism is when “an individual has lost capacity consistently to control how much and how often he drinks…” (17).Drinking large amounts of alcohol can affect human biology and this can be observed by a physician, but drinking alcohol is a behavior while cirrhosis of the liver is a disease.
J B Myers