Beer, Booze and Behavior:
The Devil Made Me Do It

© 1995 Robert J. Chapman, PhD

Abstract
If a common denominator exits when considering alcohol and its role in our culture, it is the impact that drinking can have on behavior. This essay will review the literature with regards to the more frequently cited explanations for the connection between alcohol and drunken comportment. Suggestions will be made via case study as to the clinical significance of this information when working with the alcohol abusing or dependent client.

ALCOHOL AND BEHAVIOR
Demon Rum

Awareness of the association between the consumption of alcohol and the onset of socially unacceptable behavior has historically resulted in the American belief that alcoholic drink, in and of itself, was responsible for the aberrant behavior frequently displayed by the intoxicated consumer (Critchlow, 1986). This in mind, it then stood to reason that if alcohol was the cause of criminal or otherwise deviant behavior, then to remove alcohol from the public's possession would be to reduce the incidence of criminal activity and social deviancy (Critchlow, 1986; MacAndrews & Edgerton, 1969). As a result, a legislative approach to a reduction in aberrant behavior was adopted. Prohibition, as the 18th amendment to the U. S. Constitution came to be known, essentially made alcohol an illegal substance and relegated its producers, distributors, purveyors, and consumers to the status of criminal (Kinney & Leaton, 1991).

While the historical precursors of the 18th amendment that ushered in prohibition and reasons associated with its repeal are beyond the scope of this essay, suffice it to say that legislation was not sufficient to eliminate alcohol from the American social diet. Of particular interest when considering this chapter of American history, are the twin facts that all consumers of alcohol are not predestined to display deviant or criminal behavior when imbibing and, for those who do, drunken comportment is not realized on every drinking occasion (MacAndrews & Edgerton, 1969). Additionally, in spite of legislation to the contrary, alcohol continued to be produced effectively, distributed systematically, sold profitably, and consumed faithfully throughout the years of U.S. Prohibition (Kinney & Leaton, 1991).

If the removal of alcohol from the public's possession could not be ensured through legislation and law enforcement, and if consumers could not be found to universally display socially unacceptable behavior on each drinking occasion, the argument that alcohol, in and of itself, was bad (i.e. evil and corrupting) and that `Demon Rum' was the embodiment of moral turpitude was seen as questionable at best.

We need only consider the number of consumers who make use of alcohol without behaving outside social bounds or note alcohol's inability to ensure errant behavior on each drinking occasion (even for those who have displayed such behavior in the past) to realize that an inanimate object is incapable of possessing moral characteristics. It would appear that alcohol is neither necessary nor sufficient to cause socially unacceptable or otherwise objectionable behavior.

Even so, the apparent association between alcohol and its consumer's aberrant behavior still remains (Goodale, T.G., 1986 McCarty, D. & Kaye, M., 1984).

Alcohol as Pharmacological Agent

Continuing to search for possible explanations of alcohol's ostensible ability to influence its host and portend socially objectionable behavior, the pharmacological effects of ethanol became suspect. Tarter and Sugarman (1976) demonstrated that ethanol, in and of itself, has profound physiological and psychological effects on its consumer. This can be more graphically expressed in a poem, anonymously written by a Native American, that speaks to these effects;

I Am Alcohol and Great Are My Powers I was born between the Earth and Spirit worlds, between life and death, between substance and decay. I was once a part of the essence of life, sleeping in the pulp of corn, grain, and fruit. My existence there was harmless- I slept waiting for the death and decay of the plant life, when I would awaken for a fleeting instant to mark the final decomposition of life. Animals who have eaten of the decaying fruit know the circle of my powers. At first sensation is my power to bring pleasure and warm feelings to the host I invade. My warmth and cheer have caused pain and death for countless thousands. For my circle of power begins with pleasure but runs toward pain with each drink of my essence. The powers are progressively stronger, so that each step entices the host to consume more and more. When gripped within my powers, the host becomes confused- he thinks that pursuing my powers will give him power, but it makes him powerless. He confuses increasing pain with increasing pleasure. He sees my illusion as reality. He sees my power of death as the essence of his life. If the drinker chases my circle of power to a full rotation, only the thought of his death will bring pleasure to his mind, for death is one of two ways for release from my power, and completes the circle. The only other way is to turn in mid-circle to face the pull of my charms, and fight them step by step to the beginning of the circle. This battle has been fought by many, but won by few. Those few know of my strength and ferocity- they have broken the spell of a terrible foe, but have not defeated me. For the memory of my pleasure giving will lurk within their hearts, waiting but to be seized upon in a moment of lonely despair or impulse. Those who resist my attractiveness after having broken from my spell are holy men. They have done battle with the evil spirits in the earth world, and their reward in the spirit world is great. Those who partake of my juices but resist the pull of the circle tempt my powers, but they may be successful if they are aware of my terrible might and illusory nature. But if they seek life through me, they will come to know death.

Kinney & Leaton (1991) suggest specific physical and emotional changes for the consumer resulting from the pharmacological effects of an increasing blood alcohol level (BAL). As the amount of alcohol consumed per hour increases (when controlled for gender, weight, and physical tolerance to ethanol), there is a predictable change in the consumer's behavior. Physical indications of an increasing blood alcohol content (i.e. speech, motor coordination, respiration) are readily noted by even the most naive of consumers with the emotional (i.e. mood, affect) evidence of intoxication equally noted (McAuliffe & McAuliffe, 1975).

Ethyl alcohol is a central nervous system depressant drug (Health & Human Services, 1990). This appears to support the argument that the behavioral displays of intoxicated individuals may be due to the impaired higher brain functions of consumers with a resulting loss of personal inhibitions (Muehlberger, 1956). These higher brain functions are also the site of one's awareness of cultural norms and taboos, learned by the individual and responsible for the successful navigation of culturally sensitive areas of attitudes, values, and beliefs (Pedersen, 1988). To this end, while specific behaviors exhibited when intoxicated may vary from culture to culture, the prevalence of socially unacceptable behavior displayed when inebriated remains constant (MacAndrew & Edgerton, 1969).

Christiansen, Goldman, & Inn (1982) were interested in the possible connection between the expectations of drinkers and the pharmacological effects of ethanol. They found that while drinker expectations of alcohol are a priori, "... (the) pharmacological experience with alcohol crystallizes existing expectancies" (p. 336). This finding appears to support that of Russell and Mehrabian (1975) who suggest that a recognition of alcohol's ability to modify emotion is a significant factor in a drinker's decision to imbibe and, when tempered with drinking experience, can influence the number of alcoholic drinks consumed.

Personal Expectations of Drinking

If alcohol as a substance can not be seen as the definitive source of intoxicated behavior, as it is inconsistent in its influence on individuals across drinking occasions, and its pharmacological effects are likewise incongruous across drinking experiences for a specific consumer, can the consumer's expectations of its effect on a given occasion in some way shed light on the apparent association between alcohol consumption and drunken comportment?

Rohsenow (1983), in considering the role of expectancy in explaining alcohol related behaviors, suggests that "(t)he mere belief [emphasis that of this author] that alcohol has been administered is sufficient to result in loss of control and craving in alcoholics and changes in social anxiety, aggression, sexual arousal, and mirth in social drinkers, independent of actual consumption" (p.752).

Marlatt, Demming, & Reid (1973) have reported that the relationship between drinker expectations and binge drinking is significant. They purport that previous consumption of a specific quantity of alcohol with a resulting constellation of expected behaviors following imbibing, can define a successful (i.e. positive) past drinking experience and increase the likelihood that consumers will pursue these expectations, often resulting in an extension of the time spent drinking.

Southwick, Steele, Marlatt, & Lindell (1981) in a now classic study demonstrated "...that alcohol expectancies are systematically related to drinking experience and to phase of intoxication (p. 719)." As the frequency of use and quantity of consumption per outing for each drinker studied increased, personal expectations for those drinkers of greater stimulation, perceived dominance, and pleasurable disinhibition during moderate intoxication also increased.

Personal expectations of drinking appear to be more reliable in predicting alcohol use than individual attitude when considering intentions when consuming alcohol (Stacy, Widaman, & Marlatt, 1990). While the recollections of previous experiences with alcohol may include both positive and negative experiences, positive expectancies more frequently result as positive experiences with alcohol in the past are more readily retrieved from the drinker's memory. Ainslie, (1975) reported that the impulsive use of alcohol could be explained by a drinker's recollection of past immediate positive experiences with the drug. Such recall can be explained via the immediacy assumption (Stacy, Widman, & Marlatt, 1990 referring to Stacy, Krank, & Marlatt, 1989) which states that the initial euphoric stage of alcohol consumption, with its associated positive experiences for the consumer, predates any later negative consequences that may be associated with the drinking experience.

In strict behavioral terms, the immediate and positive rewards of the initial drinking experience increase its potency as a reinforcer over the delayed (or frequently absent) negative consequences of consumption. As a result, expectations of drinking recalled from memory by the consumer will often be positive with the expected positive influence on the drinkers decision to consume.

By way of example, a graduation tradition for Greater Philadelphia Area High Schools is to follow commencement exercises with a week long visit to the New Jersey seashore. This sojourn is euphemistically referred to as `Senior Week' and for many, is often a week long binge with alcohol, the primary drug of choice. This graduation celebration and experiential precursor to collegiate life is in great part influenced by the celebrating student's expectations of Senior Week and the `traditional' role played by alcohol coupled with previous High School drinking experiences.

Similarly, Lang, Goeckner, Adesso, & Marlatt (1975) demonstrated a relationship between drinker expectations and displayed aggression. More colloquially put, how often may it be over-heard on college campuses, "I can drink beer all night and just get silly, but watch out if I get into the hard stuff (i.e. distilled spirits), I can count on a fight". In essence, with the intoxicating drug the same in beer as in the `hard stuff' (i.e. ethanol), the pharmacological effect of the drug consumed may not be as significant in predicting behavioral outcome as is the consumer's expectations when intoxicated by a particular type of alcohol.

To explain drunken comportment via consumer expectations of alcohol impairment is a possible explanation for the varied behavioral responses displayed by drinkers. In essence, drinkers who await the onset of promiscuity following their imbibing and/or that of their date may explain a significant number of acquaintance/date rapes that occur on American college campuses each year.

However, while it does appear that personal expectation predicated upon past drinking experience can account for a personal decision to consume alcohol, it does not necessarily explain the variety of intoxicated behaviors which a specific drinker may well display on different drinking occasions. Maisto, Connors, & Sachs (1981) suggest that problems exist with explaining drunken comportment via an expectancy model. They question whether it is the physiological effects of the alcohol consumed, mitigating effects such as environment, or both which elicits the drinker's expectations. It is such a point that leads Steele and Southwick (1985) to question whether there are systemic effects of alcohol which influence human behavior and if so, how do they occur.

Alcohol and disinhibition

A more traditional explanation of the seeming association between alcohol and drunken excess is alcohol's ability to remove inhibitions (i.e. disinhibition) from its consumer thereby freeing the drinker to engage in a wider range of behaviors (Pernanen, 1976). Due to the intoxicating effect of alcohol, as the consumer's BAL increases by ingesting alcohol faster than the body can metabolize it (see Kinney & Leaton, 1991), traditional social and cultural cues that influence individual behavior become less significant. As the portions of the brain responsible for identifying and cataloging social mores are anesthetized by the increasing concentration of ethanol in the blood, the host is less conscious of the social determinants of appropriate behavior with a resulting increase in overt displays uncommon to the consumer when sober. In short, "(t)he effects of alcohol then are due to its release of the lower brain centers from the higher brain controls" (Critchlow, 1986 p. 753 referring to Chafetz & Demone, 1962). In essence, disinhibition theory suggests that all behavior changes observed during intoxication are physiologically influenced.

While, as noted earlier, disinhibition may be either a positive or negative experience for the consumer, it is the resulting increase in a drinker's socially objectionable behavior following consumption that has fostered the view of disinhibition as an explanation for the observed association between alcohol and aberrant behavior.

As if to augment this explanation of alcohol's physiological effects on behavior, Critchlow (1983, 1985) has suggested that Kelley's (1971, 1972) theory of attribution offers further explanation of how alcohol is associated with errant behavior.

Upon investigation, Critchlow (1985) found that subjects asked to review short stories depicting acts that may or may not have been associated with alcohol, by individuals who were reported to be either intoxicated or sober and either social or alcoholic drinkers, were evaluated differently with regards to the actor's degree of responsibility for the act and extent of consequence that followed. As all subjects reviewed the same short stories, the only variables which accounted for the difference in subject responses were the degree of actor intoxication and status as social/alcoholic drinker. Based upon her findings, Critchlow concluded that alcohol was a mitigating circumstance in interpreting individual behavior and did influence the degree of culpability attributed to the perpetrator. MacAndrew & Edgerton in their 1969 treatise on the socio-cultural foundations of drunken comportment have suggested that alcohol is used universally as a socially acceptable approach to realizing `time out' from the cultural values and demands of the society in which the consumer lives.

Yet, earlier attempts to explain the interaction between alcohol and expectancy (Schachter, 1964, 1971) have been brought into question by Maisto, Connors, & Sachs (1981). They suggest that to apply Schachter's interactionist theory, i.e. emotion is the result of physiological arousal and cognitive interpretation, to alcohol experiments is not appropriate.

In Schachter's original study with Singer (1962), this association was reported after the subjects ingested a substance believed to have nonspecific or obscure effects. When considering the consumption of alcohol, it can not be assumed that some (if any) subjects would be inexperienced with alcohol and its effects. To this end, it would be impossible to determine if the reported results were due to the physiological effects of the alcohol, the expectations of the subject, or both.

Alcohol myopia

Thus far, alcohol as a beverage, its pharmacological effects, the expectations of its consumers, and its ability to lessen a drinkers inhibitions, have been considered as possible explanations for the apparent association between alcohol consumption and drunken comportment. Each, while plausible in its consideration of the association, fails to clarify the specific reason why the behaviors of alcohol consumers vary- both across drinkers and drinking occasions for the same drinker.

In pursuing this issue empirically, Steele and Southwick (1985) conducted a meta-analysis of 35 published studies designed to consider the question of alcohol and social behavior. These reviews of alcohol's effect on social or socially significant behavior were considered with reported results rated and validated by independent judges in order to determine the extent to which high or low inheritor conflict influenced individual drinking behavior.

Steele & Southwick (1985) argued that a cognitive explanation for alcohol's impact on social or socially significant behavior could explain the onset of drunken comportment. They reasoned that alcohol's capacity to impair a drinker's awareness of the degree of conflict existing between behaviorally instigating and inhibiting cues results in greater attention being given to the instigating cues with a corresponding increase in the drinker's display of socially unacceptable or excess behavior. Additionally, to the extent that the conflict between instigating and inhibiting cues is low, the level of alcohol intoxication was shown to be insignificant with regards to predicting drunken comportment.

It is this presence of conflict between instigating and inhibiting cues and alcohol's ability to impair the cognitive process of evaluating both that gives rise to the variance in behaviors noted in individuals with similar BAL or the same individual who, on separate occasions with similar BALs, may behave differently. Alcohol myopia, as Steel and Joseph (1990) have come to refer to this effect, suggests that the conflict between instigating and inhibiting cues increases with alcohol consumed and was found to be unaffected by the expectations of the individual consumer. Additionally, the Steele & Southwick (1985) meta-analysis found that with few exceptions, these results were generalized in each study reviewed.

An interesting assumption in this explanation of drunken comportment is the ability of alcohol's intoxicating effects to instigate social responses determined by cues immediately experienced by the consumer while lessening that consumer's ability to attend to inhibiting cues and consider their significance in choosing behavioral responses to social situations when drinking.

In summary, alcohol myopia suggests that as intoxication by alcohol increases, the conflict between instigating and inhibiting cues affecting social behavior becomes more pronounced with a resulting propensity for the consumer to attend to and thus act on the instigating cue alone.

This explanation of drunken comportment addresses the discrepancies noted in the explanations of drunken excess reviewed above. It is this writer's belief that the theory of alcohol myopia satisfactorily addresses the question of drunken excess in behavior while explaining apparent discrepancies in the above interpretations regarding behavioral variance between drinkers and/or variance in behavioral outcome for a single drinker across separate drinking occasions.

But what has this to say regarding the prevalence of alcohol consumption in our society and the number of individuals referred to professional counselors for assessment of drinking problems?

Conclusion

The frequent problem encountered by many who provide treatment services to those diagnosed with alcohol abuse- i.e. DSM III-R 305.00- or alcohol dependence- i.e. DSM III-R 303.90- (APA, 1987) is denial. Often, this denial is steeped in the moralistic and judgmental view of alcoholism held by the client and learned via our societal view of alcoholism as indicative of moral turpitude and a lack of personal willpower and inner strength. A clinician's familiarity with the explanations of drunken comportment and resulting ability to explain both the criteria for the client's diagnosis as well as provide a rational accounting of the client's symptoms may well enable the professional counselor to assuage much of the client's resistance to accepting the diagnosis related to his/her drinking. To the extent that a client both understands `why' a particular diagnosis has been rendered and `why' the behavioral symptoms occurred, s/he is more likely to accept the clinical findings. While this understanding does not guarantee acceptance, it does allow the professional counselor to focus attention on the person with the diagnosis rather than appear to be interested in the diagnosis in-and-of itself. A case in point:

Matthew was a 19 year old college sophomore. His use of alcohol during his freshman year resulted in his having been `written-up' twice for violation of the university alcohol policy- once for underage drinking in the resident hall, a second time for returning to campus intoxicated and creating a disturbance in the resident hall. In his sophomore year, he was written-up a third time for intoxication and creating a disturbance and referred to the university counseling center for an alcohol assessment. Following a standard assessment involving a psychosocial evaluation, alcohol and other drug history, and review of Matt's current pattern of drinking, it was determined that a diagnosis of alcohol abuse- DSM III-R 305.00- was indicated. In relating this clinical finding to Matt, time was spent reviewing the extent to which the problems he acknowledged experiencing- low grade point average, danger of losing his campus housing because of repeated violations, reputation on campus as a `womanizer' to cite several- were all related to his use of alcohol. By explaining that the cited problems were understandable given the effect alcohol has on one's judgment and cognitive abilities- i.e. the theory of alcohol myopia as outlined above- Matt was able to accept that he was indeed abusing alcohol and recognize this as not so much a `weakness of will' as it was a realization that his pattern of drinking had reduced his ability to `act on' situations as opposed to `re-act' to them. An intervention strategy was outlined which included personal counseling intended to provide education about responsible decision making RE alcohol and the indications of a alcohol dependence. As a result, Matt was able to modify his alcohol intake by reducing the number of occasions per week during which he would drink and on those occasions, to alternate his favorite beer with a non-alcoholic beer thereby assuring a lower BAL on any given occasion. If the professional counselor does not assist the client in understanding `how' alcohol relates to personal behavior, the client is likely only `hear' the counselor passing judgment on him/her as a person. To understand the physiological and cognitive sources of intoxication will enable the professional counselor to explain a client's drunken comportment so as to bring him/her closer to accepting both the diagnosis and recommended course of treatment.

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