By Carl Erik Fisher
The Washington Post January 29, 2022
Hundreds of elegant passengers poured off the Queen Mary, the enormous luxury liner, and down to the docks of 1935 New York City. Among the jostling crowds, Marty Mann’s mother and sister craned their necks, eager to catch a glimpse of Marty. They wondered: How had their brilliant debutantes changed after six years in Europe, hobnobbing with the likes of Virginia Woolf and others in the famous Bloomsbury Group?
The stream of passengers thinned out. Where was she? Finally some crew members emerged at the top of the gangway, hauling a stretcher with a woman sprawled across it. It was Marty, unconscious, reeking of alcohol.
What her family didn’t know was that Mann had needed to borrow money to book passage home. She had once been a successful advertising executive and glittering socialite, but her drinking had long been out of control. She had already attempted suicide twice. She had meant to sober up on the trip home so she could disembark with a clear head and finally get her life together, but by the time land came into sight, Mann was passed out at the Queen Mary’s sumptuous art deco bar.
Her mother immediately found a place for her to be hospitalized, and for the next several years, Mann’s life would be consumed by one question: What, exactly, was wrong with her?
Mann bounced from psychiatrist to psychiatrist, seeing more than a half-dozen doctors, but most psychoanalysts of the time didn’t consider addiction a proper subject for psychiatric treatment, and no one would take on her case. Soon she was homeless, living from couch to couch, blackout to blackout, drink to drink, with no relief in sight.
Imagine the terror of suffering from alcoholism in the 1930s — having the sense that something was wrong, but not quite understanding what. The profusion of theories, explanations and cures, none of which seemed to work. The confusion and despair. This was a dark time for patients with addiction, the pessimistic attitudes captured well in the original 1937 version of the film “A Star Is Born”: Norman Maine’s alcoholism is a death sentence, one that compels him to walk into the Pacific Ocean to relieve the burden on his wife.
Eventually, and only through the influence of well‐connected friends, Mann managed to be admitted to Bellevue Hospital’s neurological ward, then gain admission as a charity case to Blythewood, an upscale mental-health facility on a 50‐acre estate in Connecticut. Mann threw herself into psychotherapy, meeting with her psychiatrist Harry Tiebout an hour each day, but even then she struggled. She was given weekend passes to visit the city, each time confidently ready to test her resolve not to drink. She’d have a string of successful visits, but before long she would return drunk, ashamed and most of all baffled. After months of treatment, a defeated Tiebout told her that if something didn’t change, he’d have to discharge her.
Then, one day in early 1939, Tiebout excitedly called Mann to his house and showed her a prepublication draft of a new book written by a small group of alcoholics who had founded their own new program: Alcoholics Anonymous. Flipping through the pages, Mann felt hopeful. She was skeptical about the religious language in the book, but the prospect of relief that the group promised — through a method entirely outside the medical profession — seemed worth investigating. Tiebout put her in a train to New York City once more. This time, Mann was cautiously optimistic, wondering what she might find at her first “meeting.”
AA was a tiny scrappy informal fellowship in those early days Of course it would soon become the most significant and enduring
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|AA was a tiny, scrappy, informal fellowship in those early days. Of course, it would soon become the most significant and enduring social movement in the history of addiction, one that has defined our national understanding of substance problems — arguably exerting an even greater influence than the medical profession.Less widely appreciated is the role of Margaret “Marty” Mann in this history. Mann was a brilliant strategist and a public-relations genius who played a crucial role in mid-century alcoholism advocacy. Today she is largely forgotten, even to many of the most ardent AA devotees, despite the fact that she might have been more important to the rise of AA’s popularity than founder Bill Wilson himself.As many critics have noted, AA was created by and for those in power — namely White, Protestant, middle‐aged, professional men — and it wasn’t easy for women in AA in those early days. Around that time, the prevailing stereotypes of female alcoholics were legion: sexually promiscuous, neglectful mothers, sicker than men and harder to cure. Many men in AA referred alcoholic women to their wives rather than trying to help the women themselves, worried that the presence of women in meetings would be too tempting. To this day, men outnumber women in AA by nearly 2 to 1.Arriving in Manhattan on that chilly April evening in 1939, Mann rode a clattering subway down to Wilson’s home in Brooklyn Heights. Initially nervous, she hid upstairs until Wilson’s wife, Lois, coaxed her down to join the group in the living room. She immediately felt an unmistakable rightness to it all: “I could finish their sentences! They could finish my sentences! We talked each other’s language! It was not a room of strangers. These were my people.”Mann was outwardly different from other AA members. She was a lesbian, and her partner, Priscilla Peck, later joined AA — they were among the first women to be long‐term members, and certainly among the first LGBTQ people. Nevertheless, she found enormous strength in the mutual identity of an alcoholic.Mann threw herself into the nascent fellowship, which grew slowly. Later in 1939, Bill and Lois Wilson, Mann, and a few others drove to Cleveland to help establish a new meeting. In front of the crowd, Mann quipped, “Wouldn’t it be wonderful if some day we could travel across the country and find an AA meeting in every town?” It was a joke, and the hundred or so people collapsed in laughter. For Mann, though, it was only a half-joke. In their own circle, people were relapsing, even dying. Surely there was more they could do.In sobriety, Mann was a dynamo. Brimming with energy, brilliant and polished, she captivated audiences at AA meetings. She became known in her social circles as the go‐to person for advice and counsel. AA was growing: The group opened a spacious office near Grand Central Station and was answering a rising volume of correspondence from across the country and, soon, the world.Yet Mann hungered for more. There were still legions of people, she thought, who had never heard of their lifesaving program.World War II was raging, and Mann was working in her new job, producing radio programs on American history. One featured Dorothea Dix, the 19th‐century crusader who led a national campaign against the inhumane treatment of the mentally ill, and Mann was profoundly moved. What if there was a similar battle to be waged on behalf of alcoholics?Soon afterward, she woke in the middle of the night with an epiphany, ran to her typewriter and typed out a detailed plan for a national campaign that would convince the public that alcoholism was not a moral but a medical condition.Her plan was to reach not just scientists and medical professionals but the whole of society. Her project was medicalization: She wanted to make alcoholism into a disease like any other, one that would be recognized and treated as such.Mann attributed this notion of disease to AA, but the main AA text she was reading used the term “disease” only once, and generally in AA, the physical is always tempered with, if not wholly subordinated to, the spiritual. Mann, on the other hand, insisted that alcoholism was a clear, known and singular scientific entity.She was more innovator than inventor. Interest in thinking about alcoholism as a disease was already on the rise. In 1941, the U.S. Public Health Service had issued an important publication framing alcoholism as a public health problem rather than immoral behavior. A group of alcohol scientists had also established a group called the Research Council on Problems of Alcohol, which was attempting to promote a therapeutic approach to alcohol problems. At Yale University, some researchers involved with the research council had already begun conducting studies, engaging in state‐level advocacy, and generally promoting a new scientific vision of alcoholism.Mann connected with these Yale researchers — most fatefully, a brilliant and iconoclastic Hungarian American man named E.M. “Bunky” Jellinek who recognized Mann’s gifts She was a stunningly talented speaker Her social capital was unmatched including a|
|Bunky Jellinek, who recognized Mann s gifts. She was a stunningly talented speaker. Her social capital was unmatched, including a firm footing in the growing fellowship of AA. As an attractive, upper‐class woman willing to identify herself as an alcoholic in recovery, she shattered the dominant stereotype of the alcoholic as a skid row bum.Mann moved in with the Jellinek family in New Haven and spent the summer studying alcoholism. A few months after that, she was ready.In October 1944, Mann held a news conference in New York to announce a new national organization to combat alcoholism. In her dignified, finishing‐school accent, like Katharine Hepburn with just a hint of a homey Midwest twang, she captivated the 45 newspapers in attendance, especially after she revealed herself as an alcoholic, one who had “been free for five years.”Mann announced that her organization, which in time became known as the National Council on Alcoholism (NCA), would embark on a campaign to convince the public that, first and foremost, “alcoholism is a disease.”News items about the news conference appeared for two weeks afterward. Time magazine published a feature story on Mann that month. In less than a year, she made no fewer than 49 speaking appearances across the country, and her visibility only rose from there — in later years, she routinely booked more than 200 public talks a year. Everywhere she went, she established and developed local “alcoholism information centers” that launched public education campaigns framing alcoholism as a disease.There was a churning positive feedback loop between grass roots organizing and high‐level connections. It was the birth of what scholars have come to call the “modern alcoholism movement,” a vigorous yet loosely organized coalition of advocates for mutual help and therapeutic approaches. AA grew from slightly more than 10,000 members in 1944 to just shy of 100,000 members in 1950.Mann’s advocacy was soon felt in the medical domain. She helped establish the medical organization that eventually became today’s American Society of Addiction Medicine, the nation’s largest professional organization of its kind. Slowly but surely, these efforts helped inspire therapeutic approaches to addiction, as community hospitals began establishing specialized alcoholism treatment units. In 1956, the American Medical Association adopted a resolution recognizing “alcoholism as a medical problem.” A year later, the American Hospital Association passed its own resolution urging general hospitals to develop programs for treating alcoholics.Mann leaned on her connections with politicians, such as President Lyndon B. Johnson, once a member of the Texas NCA. In 1966, he announced a new program in a special health message to Congress, declaring that alcoholism was “a disease which will yield eventually to scientific research and adequate treatment.”Two years later, Mann and the NCA rejoiced when Harold Hughes, an AA member and an openly recovering alcoholic, was elected to the Senate, where he proceeded to work for federal legislation on alcoholism and arranged for Mann to testify before Congress.In 1970, Congress passed a comprehensive alcoholism act, known as the Hughes Act. President Richard Nixon almost let the bill die in a pocket veto, but at the last minute Mann’s wealthy Republican allies put some backdoor political pressure on the president, who finally signed the bill into law on the last day of 1970. It was the first significant federal legislation on alcoholism. Not only did it create the National Institute on Alcohol Abuse and Alcoholism, but it laid the groundwork for today’s system of addiction treatment.Soon after the Hughes Act was passed, Mann gave a speech declaring an end to “America’s 150‐year war” of alcohol versus alcoholism. Since the first days of our nation, she explained, the moralistic forces of temperance, the “drys,” had railed against the evils of alcohol. The supposed evil of demon rum had attached itself to alcoholics; this was “the origin of stigma, that smothering blanket which so effectively prevented alcoholics or their families from recognizing, admitting, or seeking help for their illness.”But then her NCA had brought together two important countervailing forces: scientists (in the form of the Yale researchers) and alcoholics (in the form of AA), and through their combined powers, the alcoholism movement won the day over the forces of superstition and stigma.This article is adapted from “The Urge: Our History of Addiction,” by Carl Erik Fisher, published by Penguin Press.|