THE LIVED EXPERIENCE OF FEMALE ALCOHOL DEPENDENCE

201 Pages·2010·0.83 MB·English

THE LIVED EXPERIENCE OF FEMALE ALCOHOL DEPENDENCE:
A HERMENEUTIC PHENOMENOLOGICAL APPROACH

by

RIANA RABIE

submitted in accordance with the requirements
for the degree of

MASTER OF ARTS

in the subject

PSYCHOLOGY

at the

UNIVERSITY OF SOUTH AFRICA

SUPERVISOR: PROF K W GRIEVE

NOVEMBER 2009
ACKNOWLEDGEMENTS
I would like to thank those who have contributed to this study both directly and indirectly. I
value all these contributions. I want to thank God for guiding me through this enriching
period in my life, for providing me with inner strength and insight to continue until the end. I
also want to thank my parents for their continued support, friendship and encouragement to
always do my best. You always believed in me and without your support and unconditional
love, completion of this project would not have materialised. I want to thank Dr Bonn for her
dedication to my study and her continued support and assistance, not just as a lecturer but also
as a friend. To Kate, I want to thank you for persevering with me. There were times I could
not anticipate going beyond my interpretations, but your „so what?‟ replies to my findings
finally paid off. You made me realise that with a bit more patience, it is possible to take my
interpretations to another level. Bernard, you are a true friend. You believed in me achieving
my goal from the first day we met. Your support over the past four years played a significant
part in completing this dissertation, more than you can ever imagine. Thank you Melinda for
helping me realise that nothing can stand in my way of realising a dream, I will forever be
grateful to you. In addition, completing this project would not have been possible without the
support from my other friends, especially Antoinette, for believing in me and always
understanding the implications of undertaking writing a dissertation. I also want to thank Elim
Clinic and Magaliesoord for allowing me to conduct the interviews. I am sure that arranging
interviews may have been inconvenient, but you always made me feel welcome and allowed
me to complete the interviews in the time allowed. Lastly, I want to thank the staff at the
Psychology Department of the University of South Africa. Christa, thank you for your
constant willingness to assist with any query I might have had.
1. ABSTRACT
The hermeneutic phenomenological study interprets the lived experience of female alcohol
dependence. Literature reveals that past research into alcohol dependence has generally used
male subjects that formed the standard for theories, and treatment, of alcohol dependence.
Researchers realised that alcohol dependent women differ significantly from their male
counterparts, leading to an increase in exploratory studies of female alcohol dependence.
However, these studies only provided a description of the disorder. How female alcohol
dependents experience their disorder and how it makes sense to them has been largely
ignored. The philosophy of Martin Heidegger provided the framework for collection, analysis
and interpretation of data. Analysis revealed four life-worlds: „The Disheartened One‟, „The
Ambivalent Player, „The Contemplator‟ and „The Covert Chauvinist‟. A lived experience
typology of female alcohol dependence was proposed, namely „The Condemned‟, „The
Utopian‟ and „The Realist‟. Implications of the findings on treatment and recommendations
for future research are discussed.

KEYWORDS: alcoholism; alcohol dependence; female; hermeneutics; interpretation; life-
world; lived experience; Martin Heidegger; phenomenology; qualitative; typology; women.
CONTENTS
1. Chapter 1: Introduction
1.1. Alcohol: the enduring enigma 1
1.2. Background and rationale of this study 2
1.3. Aim of this study 3
1.4. Overview of chapters 4
2. Chapter 2: Theoretical background
2.1. Introduction 6
2.2. Effects of alcohol consumption 6
2.3. Alcohol abuse and alcohol dependence 7
2.4. Alcohol dependence and denial 11
2.5. Jellinek‟s typology of alcohol dependence 11
2.6. Aetiology of alcohol dependence 14
2.6.1. The disease theory 14
2.6.2. Psychodynamic theories 16
2.6.3. Personality theories 18
2.6.4. Cognitive theories 21
2.6.5. Behavioural theories 22
2.6.6. Family systems theory 26
2.6.7. Transactional analysis theory 26
2.6.8. The role of genetics 27
2.6.9. Socio-cultural explanations 28
2.6.10. The biopsychosocial theory 30
2.7. Conclusion 31
3. Chapter 3: Literature Review
3.1. Introduction 33
3.2. Psychological causes of alcohol dependence 33
3.2.1. Childhood abuse 34
3.2.2. Mental health 35
3.2.3. Personality 35
3.2.4. The role of the family 36
3.2.5. Social learning and cognition 37
3.2.6. Conclusion 39
3.3. The role of genetics in the development of alcohol dependence 39
3.4. Socio-cultural influences 40
3.5. Physiological consequences of alcohol dependence 41
3.6. Female alcohol dependents: The invisible population 43
3.6.1. Increase in female alcohol dependence 44
3.6.2. Social stigma and discrimination 46
3.6.3. Drinking in isolation 47
3.6.4. Female alcohol dependence treatment 47
3.7. Conclusion 50
4. Chapter 4: Research design and methodology
4.1. Introduction 52
4.2. Research design 53
4.3. Philosophical background 54
4.3.1. Phenomenology 54
4.3.2. Descriptive phenomenology 55
4.3.3. Interpretive phenomenology (hermeneutics) 56
a. Martin Heidegger‟s hermeneutics 58
4.3.4. Conclusion 61
4.4. Data collection and analysis 61
4.4.1. Thematising 62
4.4.2. Design of the study 62
4.4.3. Interviewing 63
4.4.4. Transcribing 67
4.4.5. Analysing 68
a. General orientation 68
b. Steps to follow 69
c. Facets of a hermeneutic analysis 70
4.4.6. Verifying 71
4.4.7. Reporting 72
4.5. Strengths and limitations 73
4.6. Ethics 73
4.7. Conclusion 74
5. Chapter 5: General findings
5.1. Introduction 75
5.2. Overview of the research process 75
5.3. Theory and existing literature 77
5.3.1. DSM-IV-TR criteria 77
5.3.2. Jellinek‟s typology of alcohol dependence 79
5.3.3. Nature of drinking behaviour 80
5.3.4. Disease theory and heredity 85
5.3.5. Laymen‟s theories 87
5.3.6. Behavioural theories 87
5.3.7. Family systems theory 90
5.3.8. Transaction analysis theory 92
5.3.9. Psychodynamic theories 94
5.3.10. Personality theories 96
5.3.11. Cognitive theories 100
5.3.12. Socio-cultural findings 103
5.3.13. Biopsychosocial theory 104
5.4. Conclusion 105
6. Chapter 6: The lived experience of female alcohol dependence
6.1. Introduction 106
6.2. The lived experience of female alcohol dependence 106
6.2.1. The Disheartened One: Inner turmoil vs. Inner peace 108
a. Inner turmoil 108
b. Inner peace 122
6.2.2. The Ambivalent Player: Loner vs. Team player 128
a. Loner 129
b. Team player 136
6.2.3. The Contemplator: Lies and manipulation vs. Honesty 141
a. Lies and manipulation 141
b. Honesty 146
6.2.4. The Covert Chauvinist: Womanhood causes my problems vs. I appreciate
being a woman 149
a. Womanhood causes my problems 149
b. I appreciate being a woman 153
6.3. Conclusion 154
7. Chapter 7: Discussion and recommendations
7.1. Introduction 156
7.2. The lived experience of female alcohol dependence 156
7.2.1. The Disheartened One 157
7.2.2. The Ambivalent Player 159
7.2.3. The Contemplator 160
7.2.4. The Covert Chauvinist 161
7.2.5. Conclusion 162
7.3. My own reflections 163
7.4. Lived experience typology of female alcohol dependence 165
7.4.1. The Condemned 166
7.4.2. The Utopian 166
7.4.3. The Realist 167
7.5. Female versus male alcohol dependence 168
7.6. Limitations of the present study 168
7.7. Recommendations 168
7.8. Conclusion 170
References
Appendix A
Appendix B