The Natural History of Alcoholism Revisited - Book Reviews

Book Reviews

Vaillant’s academic peers saw The Natural History of Alcoholism as “objective, scholarly, and factual,” “wise” and “comprehensive”, an “outstanding and highly recommended text”, and “one of the few and by far the most thorough and scientific.” James Royce wrote that Vaillant "cites innumerable studies and examines opposing viewpoints on every issue," but that this objectivity made the book harder to read for the general reader since the conclusions were difficult to extract.

There were varying opinions on the book’s readability. According to David N. Saunders “The book is hard to follow because so much research material is included.” The New York Times advised that the casual reader should skip over most of the technical discussion, whereas The National Review noted only an “occasional thicket of psycho-statistical jargon.”

Royce wrote that Vaillant failed to summarize new (in 1983) research findings on alcohol’s interaction with the brain, and that Vaillant had not quoted some notable researchers who have argued for the disease model of alcoholism. Saunders held that more discussion of the treatment issues was needed and noted that many of the measurements made before Vaillant took over the studies were very crude.

Perhaps the sharpest critic of Vaillant’s work was controlled drinking proponent Stanton Peele. In a 1983 review in The New York Times, Peele wrote that "The results of this research do not provide ready support for the disease theory of alcoholism. ... finds strong evidence in the inner city group for sociocultural causality in alcoholism." In his book Diseasing of America Peele claimed that "Vaillant emphatically endorses the disease model... He sees alcoholism as a primary disease... However, Vaillant's claims are not supported by his own data." Other reviewers held the opposite, that Vaillant did not see alcoholism as a disease. Addiction researcher James E. Royce wrote that "Vaillant avoids a simplistic medical model of alcoholism, pointing up instead its complexity as a socio-psycho-biological illness." David N. Saunders of the School of Social Work, Virginia Commonwealth University, wrote that Vaillant "maintains that alcoholism is both a disease and a behaviour disorder." In his summary at the end of the book, Vaillant in fact wrote that "Alcoholism can simultaneously reflect both a conditioned habit and a disease; and the disease of alcoholism can be as well defined by a sociological model as by a medical model."