Gross (1977: 121) described the difficulties confronting the alcohol dependence model:

The foundation is set for the progression of the alcohol dependence syndrome by virtue of its biologically intensifying itself. One would think that, once caught up in the process, the individual could not be extricated. However, and for reasons poorly understood, the reality is otherwise. Many, perhaps most, do free themselves.

Here an originator of the alcohol dependence syndrome, which emphasizes the self-perpetuating nature of the biological effects of alcoholism, is bewildered when it fails to explain the majority of the outcomes of alcoholism. Most nonexperts would explain the predominance of alcoholic remission by resorting to concepts like "sowing one's oats" and "growing up." Fortunately, this folk wisdom persists in some remote areas of addiction theory, like Mulford's (1984:38) natural process model:

Time is moving the developing alcoholic out of the status of the "young man sowing wild oats." He is now expected to be a responsible husband, father, employee, and useful community member. It is no longer excused as "boys will be boys."

The medicalization and biologization of ordinary human development is a dangerous misunderstanding of the nature of human behavior. For example, Merrell Dow Pharmaceuticals has been placing full-page ads in major magazines indicating the basis of smoking is a "physical dependence on nicotine.... Because these effects can defeat even a strong willpower, your chances of quitting successfully are greater with a program that provides an alternative source of nicotine to help alleviate tobacco withdrawal," that is, chemical detoxification under medical supervision. Schachter (1982), for one, found smokers who tried to quit on their own were two to three times more successful than those who sought professional help. In a review of the methods Schachter's subjects used to quit, Gerin (1982) reported:

The techniques of the 38 heavy smokers who quit smoking for nearly seven years were less varied. Roughly two-thirds reported their only technique was deciding to stop. "I took the cigarettes out of my pocket," one said, "threw them away, and that was it."

How well would we expect the same smokers to do under a medically supervised withdrawal maintenance program extending over months in which the doctor and nicotine-weaning drug were seen as the agents of control?

It is not enough to say merely that self-cure in addiction has been discredited by professionals. Self-curers are now being penalized. When many baseball players revealed during a federal trial that they had used cocaine but had quit (reasons given were "I was getting older and had too much to lose" and that one player felt "cocaine played some part" in his slipping performance), baseball commissioner Peter Ueberroth ordered severe fines and other penalties. Yet players who admit they are "chemically dependent" and who submit to treatment are not penalized according to the policies of professional baseball and other sports. In this scheme, those who claim to be addicted or whose drug use becomes uncontrolled are better off than those who control their substance use or who quit on their own.

How Do So Many Quit Addictions Without Our Help?

When we consider the elaborate and expensive treatments that have been created to eliminate addiction, we may marvel at the naive techniques self-curers employ. In the Schachter (1982) study

it seems that these people lost weight when they made up their minds to do so, and managed to drop substantial poundage by eating smaller portions and less fattening food. People made comments like: "I just cut down, just stopped eating so much." To keep the weight off, they stuck to their regimens of eating less (Gerin, 1982:32).

Recall that these subjects had lost an average of 34.7 pounds and maintained this weight loss for an average of 11.2 years. Again, Schachter found those who did not undergo formal weight-loss programs stood a better chance of achieving remission, although weight loss was just as common for the superobese (thirty percent or more overweight) as it was for less overweight subjects.

In considering the banality and at the same time the idiosyncratic or personalized nature of people's methods for losing weight, it might seem that the best techniques are the ones people devise for themselves in line with their own life circumstances. Thus, every time a well-known personality loses weight, magazines rush to report the star's reduction secrets to others, although the methods may have worked primarily because they were developed by the person who relied on them in the first place. Similarly, founders of weight-reducing movements like Richard Simmons and Jean Nidetch point to themselves as examples of why everyone should follow their methods, when in fact they might as well instruct people to find the methods that make the most sense for them.

Possibly, larger processes of change may be the same for people whether or not they enter therapy (Waldorf, 1983) or whatever the area of addictive behavior they seek to modify. On the other hand, in a study of comparisons between treated and untreated smokers who quit, those who were treated relied more on behavioral-type methods for avoiding a return to smoking, while self-curers used more cognitive coping techniques (Shiffman, 1985). Those who were treated appeared to be rehearsing learned strategies, while self-curers seemed to look to themselves for a method - usually involving thinking about themselves and their situations - that worked. It could well be that different types of people resort to treatment or do it on their own. Wille (1983) found those who relied on treatment to quit narcotic addiction feared that they could not manage withdrawal by themselves.

Several accounts of the self-descriptions of alcoholics (Ludwig, 1985; Tuchfeld, 1981) and heroin addicts (Waldorf, 1981; Wille, 1983) who quit on their own have emphasized powerful and at the same time subtle existential shifts in attitudes about themselves and their addictions. That is, while the episode that prompted a change in their lives could be undramatic (unlike the hitting-bottom phenomenon usually described at AA), some such unexceptional event often triggered a powerful psychological reaction in the addict. These reactions were connected with other areas of their lives that addicts valued - for example, alcoholics who quit or cut back frequently mentioned the effect their drinking had on their families (Tuchfeld, 1981). The former addicts usually made changes in their work lives and personal associations that supported their new drug-free or non- addict identities, just as such life shifts often added to their urge to quit.