Vol. 10 No. 10 (October 2000) p. 558-561.

DISEASES OF THE WILL: ALCOHOL AND THE DILEMMAS OF FREEDOM by Mariana Valverde. (Cambridge Studies in Law and Society) Cambridge: Cambridge University Press, 1998. 251 pp. Cloth $59.95. ISBN 0-521-62300-6. Paper $19.95. ISBN 0-521- 64469-0.

Reviewed by Ann-Marie Szymanski, Department of Political Science, University of Oklahoma.

How does the will work? Answering (or re-asking) this question has been central to both the moral and scientific aspects of Western modernity. Liberal political philosophy and the MENS REA of legal doctrine rest upon an irreducible belief in the freedom of the will: of the self-acting soul, bridging mind and body, whose autonomy creates the possibilities of possessive individualism and personal responsibility. In contrast, the rise of the natural and social sciences has undermined the will's autonomy in any number of ways - be it by establishing its somatic basis, subsuming it within a FAIT SOCIAL, or unbundling it into psychic constituents. By exposing the will's ideological and empirical determinations, the sciences challenge the premise of liberalism, and the coherence of law itself.

Within this hoary dilemma of the Enlightenment, experiences of addiction - part physical, part spiritual, yet reducible to neither - continue to fascinate. Given that the will does work, how are such "diseases of the will" to be comprehended? The ontological ambivalence of the will, and the hybrid quality of its defects, resist any stable explanation, even on liberalism's most rigorous terms. For example, as Gary Becker's recent notion of "rational" addiction implies, morality and science are seemingly reconciled within the play of incomes and prices about the individual's stable consumption function; yet even this move merely re-enacts, with exquisite paradox, this Enlightenment dilemma by assuming the very transcendental subject which addiction (not to mention economic science) otherwise mock.

To explore this dilemma, Mariana Valverde brings to her genealogy of alcohol control a Foucauldian historicism that maps these control efforts against alcohol's shifting "rationalities of governance." Her argument must be understood against the backdrop of what might be called the Foucauldian version of modernization theory. In this standard narrative, the unfolding of modernity has entailed a wholesale shift away from older, pastoral and act- based (especially punitive) modes of governance and towards the disciplinary normalization of identities constituted through the social construction of deviant others (the insane, the homosexual, etc.). In turn, knowledge-based disciplinary strategies to construct and control deviance have given way to "neoliberal" techniques of risk management that act not directly upon the individual, but upon the opportunities and constraints that shape behavior in the mass as a field of stochastic possibility.

Applied to alcohol, this narrative would describe how the moralism of 19th century temperance efforts and the criminalization of drunkenness were

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supplanted by medical understandings of alcohol use that sought a somatic basis for addiction in the etiology of alcoholism. With the failure of prohibition and the accompanying growth, by the mid 20th century, of a hedonistic consumption culture, the governance of alcohol through constituting and treating the alcoholic personality fell into abeyance. Rather than a disease of the will, alcohol abuse was reconceptualized as a concern for social prophylaxis. Towards this end, instead of confronting (and curing) the alcoholic identity, regulatory policies aimed to minimize the harm caused by alcohol - through regulating the time and place of its consumption, its advertisement and taxation; through campaigns against drinking while driving, while pregnant, etc.

If, according to this standard narrative, alcohol governance is no longer conceived as defining and curing addiction, then to that extent the underlying problematic of the will's determinedness would seem to be transcended. As with Becker's notion of "rational addiction," contemporary governance works through human freedom rather than against it. Given, as an historical matter, the ubiquity and relative legitimacy of alcohol when compared with other addictive substances, alcohol becomes a particularly apposite site for deconstructing the binary oppositions of freedom and determinism that have governed the modern project. For indeed, in Valverde's words, "the genealogy of alcoholism.takes us far beyond the sphere of medical history: it begins to offer elements toward what we might call the genealogy of the free will" (p. 67).

Yet, what Valverde discovers in her survey of the medico-legal discourses of alcohol governance is that these discourses DO NOT provide evidence of some diachronically-neat transition from one rationality of governance to another. Her main thesis is that the disciplinary governance of alcohol experienced an incomplete medicalization between the late 19th and mid 20th centuries. Moreover, even by the end of the present century policy towards alcohol has evinced (from the Foucauldian standpoint) an atavistic, even incoherent, mix of moral-punitive, disciplinary, and risk-management techniques. Framing her cases neatly with discussions of the consequences of two legal events - the passing of the British Inebriates Acts of 1879/1898 and the controversial Canadian DAVIAULT case of 1994 - Valverde argues that unresolved disputes about the definition and regulation of alcohol (ab)use reflect the ambivalent status of the will in medico-legal discourses. If alcohol abuse is a disease with a somatic basis, then its remedy invokes protocols beyond the control (and even knowledge) of the patient. Legal responsibility (and legal rights) may be correspondingly circumscribed. If abuse, however debilitating, reflects some pattern of conscious choice, then both responsibility and rights are enhanced. Yet, neither alternative fully comprehends the ontological hybidity of the will, At the intersection of mind and body, intention unfolds against the backdrop of its own self-limiting choices. As a consequence, attempts to govern (and govern through) alcohol inevitably invoke resistances to the prevailing rationality of governance.

Thus, in Valverde's cases, the construction of inebriety in Anglo- American medical discourses ultimately failed to differentiate it from nervous ailments like neurasthenia, or situate it within a "degeneration" paradigm. Expert

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disagreement over diagnostic protocols and social (particularly upper- class) resistance to the compulsory institutionalization mandated by the Inebriates Acts forestalled the medicalization of alcohol abuse. The development of alcohol science in the United States after Prohibition experienced a similar failure to fix a disciplinary identity for the alcoholic. If American alcohology had jettisoned the somatic and the field shook moralistic approaches of the Victorians, the discursive stability of the "alcoholic personality"'s own theoretical eclecticism and its fatal reliance on culturally specific norms of alcohol abuse. Moreover, competing approaches to alcohol use that stressed the epidemiology of risk and threatened to dispense with the very need for the construction of alcoholism as a somatic or personality disorder.

A recurring theme in the social resistance to medicalization attempts is the recrudescence of HABIT as a mode of implementing non-expert therapies for alcohol abuse. Valverde regards habit as an important site for deconstructing the binary opposition of freedom and determinism that underpins the disciplinary governance of alcohol. Drawing on the ideas of the American pragmatists as well as the practices of self-help therapies like Alcoholics Anonymous, Valverde suggests that self-governance through the building of habits resuscitates a neglected Greco-Roman tradition of ethical spirituality, a tradition that Valverde believes offers promising strategies of disciplinary resistance in the present day.

In its most recent form, alcohol governance through risk management does not so much supplant as supplement older discursive practices. In her examination of liquor licensing and regulation in a number of settings, Valverde concludes that modern governance of alcohol continues to subject it to older moral and disciplinary standards, albeit through the establishments of drink rather than upon drinkers themselves. Similarly, the discourse of "sensible" drinking invokes moral standards of self-control along with health and safety rationales. Ultimately, Valverde concludes, in the genealogy of alcohol "what we see is a piling up of rationalities of governance on top of one another, rather than a shift from one to another" (p. 177).

As Valverde's brief discussion of the DAVIAULT case suggests, the genealogical approach to alcohol promises pointed critiques of the conceptual coherence of alcohol abuse (as well as other compulsive practices) under the law. More empirically-minded historians of temperance will be dissatisfied by the crude abstractions of the Foucauldian periodization of governance. For example, the pragmatic management of drink through licensing, regulation, and even state provision (e.g., South Carolina's dispensary system) were contrapuntal themes to the refrains of 19th century prohibition movements long before the "neoliberal" paradigm of risk management. Similarly, fraternal organizations like the Sons of Temperance and the Good Templars actively practiced the homely arts of habit formation long before AA honed its Twelve Step method.

On the theoretical level, far more stimulating is Valverde's argument (however brief) for habit as a lens for understanding the ontological hybridity of the will. Yet even here, there remains something unsettling about the collateral effects of what might be called Valverde's "Foucauldian gaze." Having highlighted the historicity of governing rationalities, both

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lay and expert, concerning addition, Valverde finally aspires to a public sphere in which it is "possible to discuss one's feelings, hopes, and regrets without either rationalizing oneself in the name of the free will or psychologizing oneself in the name of some diagnosis.a public sphere that neither medicalizes our compulsions nor rationalizes our capacity for freedom" (p. 205). Yet if governance, in the Foucauldian sense, is inevitable, then Valverde's aspiration enacts a performative contradiction that is oddly reminiscent of alcohol's original characterization as a "disease of the will." A will to freedom, even with the knowledge that self-governance itself must be but another rationality of governance, might well represent the most exquisite compulsion of all.