LESBIANS' EXPERIENCES WITH ALCOHOL PROBLEMS: A CRITICAL ETHNOGRAPHIC STUDY OF PROBLEMATIZATION, HELPSEEKING AND RECOVERY PATTERNS (HELP-SEEKING).
Contributors: University of California, San Francisco.
Published: 1992
Number of pages: 341
Subjects: Health Sciences, Nursing.; Health Sciences, Mental Health.; Women's Studies.
Description: There is evidence that lesbians have greater incidence of alcohol problems, and are collectively moving away from alcohol use. Discrimination based on gender, sexual orientation, class and race complicate recovery for lesbians with alcohol problems. This critical ethnographic study addresses how lesbians identify alcohol problems, seek help and describe health care interactions related to alcohol problems. It also provides descriptions of lesbians' images of recovery and their personal and collective experiences in twelve-step mutual help groups such as Alcoholics Anonymous.

A racially and socioeconomically diverse group of 35 self-identified San Francisco area lesbians recovering from alcohol problems volunteered for participation in indepth interviews. The interview data was examined through narrative analysis, matrix analysis and ethnographic coding. The findings indicate that problematization is ongoing, and includes identification of problems other than alcohol. A conceptual model of the problematization process is developed that emphasizes relationships among alcohol problem construction, interaction, action, validation and reconstruction. Accounts are differentiated on the basis of whether alcohol problems are perceived to be circumscribed or pervasive in the women's lives.

Helpseeking and health care needs are identified, including safety and validation in health care and treatment contexts, and attention to multiple addictive problems, aftereffects of childhood trauma and adolescence as a critical transition for lesbians. Six dimensions of safety in health care interactions are described: client/provider conceptual compatibility, providers' preparedness to interact with lesbians, respect for boundaries, emotional climate, provider persuasiveness strategies and group dynamics. Images used by lesbian participants to describe their recovery experiences include, in order of their prominence, connecting, reclaiming self, empowerment, struggle with compulsivity, personal growth, vocational change, social transition, cycles/celebration, physical transition and conversion. Twelve-step mutual help groups are an important though controversial part of recovery for lesbians; three dialectical tensions are identified: assimilation/differentiation, authority/automony and false consciousness/politicization.

Conclusions and implications for practice and research are guided by the concept of marginalization. Experiences of those living at the periphery of society not only differentiate them from those at the center, but from other marginalized persons, making standardized health care approaches to lesbians and others who are multiply stigmatized inappropriate.
Notes: Source: Dissertation Abstracts International, Volume: 53-09, Section: B, page: 4590.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1992.

School code: 0034.