Gender identity influences the way alcoholics deal with their condition

A qualitative study conducted by researchers from the School of Arts, Sciences and Humanities at the University of São Paulo (EACH-USP) suggests that gender identity influences the way alcoholics deal with their condition.

The investigation was coordinated by Professor Edemilson de Campos, with the support of Fapesp and the collaboration of Nádia Narchi, also a professor at EACH-USP. The results were reported in the journal Drug and Alcohol Review.

Campos says that he obtained permission to attend the strictly female meetings of a group of Alcoholics Anonymous (AA) in the city of São Paulo. And it was in these meetings, as well as in the interviews with the participants, that she collected the first-hand testimonies used in her study.

“AA groups that bring together only women are frequent in the United States. But not in Brazil. AA discourages this format, claiming that alcoholism is one and affects men and women equally. But the women I interviewed think differently and told me that felt intimidated in mixed meetings. Some even reported that they had been victims of harassment and sexist jokes during the meetings”, says the researcher.

He informs that there are 120 groups of Alcoholics Anonymous in the city of São Paulo. But only two of them promote strictly female meetings: one in the north of the city and another in the Santa Cecília neighborhood. “As the AA do not have a hierarchical structure, the groups enjoy a lot of autonomy, including rotating coordination. I requested permission to attend the women’s meetings of the two groups, but only the participants from the northern zone agreed”, he says.

Campos reports that this meeting brought together 15 women, who met every Saturday: some recent attendees, with only two months of AA; others with more than 30 years of participation. In general, they were women with a lower income and lower level of education, some of whom were married to participants in Alcoholics Anonymous.

It is important to clarify that Alcoholics Anonymous considers alcoholism to be a “chronic and incurable disease”, resulting from a physical predisposition combined with a mental obsession with alcohol use. And they believe that there is no individual willpower capable of overcoming this disease. The support network formed by the group itself is an indispensable support for living soberly with it. Alcoholics Anonymous defines itself as a “brotherhood of men and women” not linked to “any sect or religion, any political movement, any organization or institution”. The “fellowship” does not charge fees or fees, but is financially self-sufficient thanks to the voluntary contributions of its members.

“We had already studied groups with mixed meetings. What we did, with great respect, in this strictly female meeting, was an ethnographic type of research, collecting individual reports about relationships, family, work and other subjects of interest to the participants. of the soul’ was the way these women themselves characterized their condition, marked by a strong feeling of rejection and loneliness due to social stigma”, says Campos.

A notable aspect noted by the researcher was that, while in mixed meetings men focused their reports on work and other impersonal aspects of practical life, participants in the strictly female meeting spoke much more about their intimacy. “That’s why women-only meetings are very important. Because they offer a safe space for expression. These meetings had the power to restore a sense of dignity to participants,” he argues.

In general, socially conditioned thinking is quite condescending to the father who neglects his paternal obligations. But he is relentless with the mother who proceeds in a similar way. “The feeling that alcoholism may have prevented them from fulfilling what society expected of them was something that weighed heavily on these women”, says Campos.

Criteria

In its fourth and most widespread revision, the Diagnostic and Statistical Manual of Mental Disorders (DSM), of the American Psychiatric Association, characterizes as substance dependent the individual who has fulfilled three or more of the following six criteria: spent much of their time getting, using, or recovering from the substance’s effect; used the substance more often or in greater amounts than intended; needed larger amounts to get the same effect; failed to decrease or stop substance use; continued to use the substance even after becoming aware that it was causing or worsening physical or mental health problems; and stopped doing or reduced the time dedicated to social, work or leisure activities due to substance use.

In the case of alcohol and other drugs that cause chemical dependence (such as benzodiazepine tranquilizers, amphetamine stimulants, cocaine, crack or similar), in addition to the six criteria mentioned, a seventh was added, defined by the manifestation of withdrawal symptoms, which vary according to the the substance. In this case, the individual is considered dependent if he or she meets three of the seven criteria.

These criteria apply equally to men and women. But what Campos found in his study was that, in addition to this general classification, the experience of alcoholism and its treatment is strongly influenced by the social marker of gender. “Contrary to the prevailing idea in AA, we found that women do need to have a safe space to expose their ‘soul pain,'” he concludes.

Research carried out in 2017 by Fiocruz, on drug use by the Brazilian population, found that approximately 2.3 million people, between 12 and 65 years old, were addicted to alcohol in the 12 months prior to the survey. The incidence was 3.4 times higher among men (2.4% of the male population) than among women (0.7% of the female population). But scholars on the subject consider that this last percentage may have been underestimated, due to the strong social stigma in relation to female alcoholism. Afraid of what “others” might think, say or do, many addicted women may have hidden their condition.