Addiction Intervention
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ToughLove.pdf
TOUGH LOVE: A Brief Cultural History of the Addiction Intervention
Claire D. Clark Emory University
Popular media depictions of intervention and associated confrontational therapies often implicitly reference—and sometimes explicitly present— dated and discred- ited therapeutic practices. Furthermore, rather than reenacting these practices, contemporary televised interventions revive them. Drawing on a range of literature in family history, psychology, and media studies that covers the course of the last 3 decades, this paper argues that competing discourses about the nuclear family enabled this revival. Historians such as Stephanie Coontz, Elaine Tyler May, and Natasha Zaretsky have demonstrated that the ideal nuclear family in the post-WWII United States was defined by strictly gendered roles for parents and appropriate levels of parental engagement with children. These qualities were supposedly strongly associated with middle-class decorum and material comfort. By the 1970s, this familial ideal was subjected to a variety of criticisms, most notably from mental health practitioners who studied— or attempted to remedy—the problematic family dynamics that arose from, for example, anxious mothers or absent fathers. After psychological professionals began to question the logic of treating maladjusted individuals for the sake of preserving the nuclear family, a therapeutic process for doing exactly that was popularized: the addiction intervention. The delayed prevalence of therapeutic interventions arises from a tension between the psycho- logical establishment that increasingly viewed the nuclear family as the primary site and source of social and psychological ills, and the producers of popular media, who relied on the redemptive myth of the nuclear family as a source of drama.
Keywords: popular culture, addiction, intervention, confrontational therapy, nuclear family
Senator Walter Mondale: I recall somebody said— maybe it was you—the cocktail hour had replaced the family hour. Dr. Urie Bronfenbrenner: The children’s hour. Senator Mondale: The children’s hour. Is there any way to chart that? How do you know? Dr. Bronfenbrenner: It is very hard to chart that partly because of the very existence of the neglect of concern for children and families. Nobody has even been look- ing. We do not know what the problems are. That is how deeply they are buried from public consciousness or even scientific consciousness. (American families: Trends and pressures: Hearing before the Subcommit- tee on Children and Youth of the Committee on Labor and Public Welfare, 1973)
During the heyday of the idyllic postwar nu- clear family, public visions of domestic prob- lems were rare. According to historian Natasha Zaretsky (2007), 1973 marked a moment in which concerns previously contained within the home had officially spilled out into the family therapy session, the streets, and the U.S. Senate. After an anomalous period of postwar prosper- ity and (according to Bronfenbrenner’s testi- mony) the unhealthy repression and denial of the dangers of its indulgences, middle-class dysfunction was going public. It has not gone back.
Alongside these 1973 senate hearings, PBS debuted the documentary miniseries An Ameri- can Family, a vérité-style exposé that caused controversy by jointly disproving Norman Rockwell and Leo Tolstoy: Beneath every iden- tically happy American family, the series sug- gested, is a similar mess of “laughs, tears,” and
This article was published Online First November 7, 2011. Claire D. Clark, Department of Behavioral Sciences and
Culture, Science & History, Rollins School of Public Health and Graduate Institute of Liberal Arts, Emory University.
Correspondence concerning this article should be ad- dressed to Claire D. Clark, Graduate Institute of Liberal Arts, 537 Kilgo Circle, S415-Callaway Center, Atlanta, GA 30322. E-mail: [email protected]
History of Psychology © 2011 American Psychological Association 2012, Vol. 15, No. 3, 233–246 1093-4510/11/$12.00 DOI: 10.1037/a0025649
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“mistakes.”1 The show chronicled an upper- middle-class nuclear family (the aptly named “Louds”) in Santa Barbara, California, through- out the parents’ separation, and concluded with their eventual divorce. With the entrance of the Louds, the documented life of the “real” Amer- ican family became the subject of public enter- tainment as well as professional inquiry. While the American public has vacillated between the desire to view depictions of happy and unhappy families, the psychological profession has ex- perimented with various approaches to treating the problems that arise in real ones. What is the relationship between popular and professional visions of the development of the postwar American family?
Family historians who concentrated on the “inward turn” and “domestic containment” that accompanied White class mobility in the 1950s noted TV’s role in promoting consumerism along with idealized insularity.2 Betty Freidan (1963) famously observed that this consumer- ism also included psychiatric services, espe- cially for discontented mothers and wives. In contrast, media historians have documented how scientific researchers and professional ex- perts (including psychologists) used a variety of media to “educate” the public over the course of the twentieth century. These historians analyzed how technological development, economic in- frastructure, and government regulation have influenced the content and form of psycholo- gists’ messages.3 So far, stories that have combined these two narratives have usually concluded that as society became more media- saturated, the information conveyed by media became more spectacular, and that, in general, this phenomenon had a negative effect on both individual psychology and family life.
How did this argument work? Partly by sug- gesting that the cocktail hour and the TV set worked in concert, dulling the senses and pro- moting interfamilial distraction rather than con- nection. In his testimony, Brofenbrenner noted a study that recorded audio in middle-class homes and found that children heard their fa- thers’ voices less than 40 times a week. In the 1950s and 1960s, family therapists increasingly stepped in to address disequilibrium in families rendered dysfunctional by, for example, avoidant-dismissive mothers or absent dads. For both left- and right-leaning historians, these “helping” professionals only exacerbated the
problem by continuing to encourage a psycho- logical outlook that was both self-centered and overly reliant on the external validation pro- moted by hyperconsumerism—what Christo- pher Lasch (1979) later described as a “culture of narcissism.”4 Screen-cultures scholar Lynn Spigel (1988, 1992) describes how the physical presence of the TV in the postwar American household supported this psychological out- look. Promoted as a “window on the world,” the TV allowed families to look “out” at places and products that represented the good life, and en- couraged viewers to imagine similar families across the nation who might be sharing the experience of TV-watching in their own living rooms. At the same time, the window metaphor also implied that the TV might be a way for other people to see into the once-private space of the family home.
In the 1950s, the people who wanted to get into the family home via TV were not, on the whole, interested in cold war spy tactics or even Bronfenbrenner-style observational micro- phones. They sought to impart knowledge, not to observe domestic behavior. TV historian Anna McCarthy (2010) shifts the scholarly at- tention away from the “proverbial living room to the boardrooms of the Waldorf Astoria,” where elite businessmen and professionals imagined the TV set as a legitimate way to
1 The TIME magazine cover story, from which these quotes were drawn, was titled “Show business: A sample of one?” (1973). The invocation of the language of social science in reference to reality-based television, as well as the relationship between this genre and sociology and an- thropology, is explored in Simon (2005). The changing definition of reality television in general is explored in the collection in which Simon’s article is featured: G. Edgerton and B. Rose (Eds.), 2005, Thinking outside the box: A contemporary television genre reader, Lexington, KY: Uni- versity of Kentucky Press.
2 See Elaine Tyler May (2008) for a discussion of “do- mestic containment” and Stephanie Coontz (2000) for a discussion of how television promoted an unrealistic, in- ward-looking, and nostalgic vision of the nuclear family.
3 For a discussion of the co-optation of scientific exper- tise by the “superstitious” and sensationalistic twentieth- century mass media, see Burnham (1987). For a discussion of the details of the production of scientific programming on radio and television, see LaFollette (2008).
4 On this point, Lasch agrees with Coontz and May, though they are more concerned about the substitution of consumerism for political action than its role weakening individual psyches and wills (or the effect this weakening has on the “haven” of the nuclear family).
234 CLARK
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educate, inspire, and shape democratic citizens (p. 9). Whether sponsoring debates about deseg- regation or demonstrations of “better living through chemistry,” TV, in its early years, could be used by elites for the good of the hypothetical public. Some of these goods were unabashedly psychological; demonstrations of group therapy techniques, for example, were broadcast as part of the “public service” program The Johns Hopkins Science Review. While dramatizations of the psy- choanalytic “talking cure” had been a prominent feature of Hollywood films such as The Snake Pit (1948), the initial appearance of psychological techniques on TV was distinguished from these cinematic depictions by their didactic format, the prominence given to actual scientific or psycho- logical professionals, and the intimate positioning of the screen inside the homes of the intended audiences who were supposedly dutifully recep- tive of the programs’ messages.
Whether spectators were actually so dutiful is debatable, but changes in government regula- tion and ownership of the airwaves brought about the end of the “American viewing pub- lic,” which splintered into demographic “mar- kets.” The “technocratic elites” of the postwar period lost their monopoly (McCarthy, 2010, p. 7). As a result, station programming became saturated with sitcoms (1970s), syndication brought talk shows (1980s–1990s), and cable networks introduced “reality” programming (1990s–present). Although it has been credited as the first “reality show,” An American Family (1973) aired at a time when this process of deregulation was underway, but well before the less restrictive cable TV labor market began to influence production. While produced and dis- tributed under different conditions than the talk shows and reality programs that would follow it, the documentary series was received, both then and now, as a prescient indicator of later cultural and familial shifts.5 As Natasha Za- retsky (2007) noted, beginning in the 1970s, “fears about the fate of the family shaped de- bates about American national decline, and fears about the nation’s future were mediated through the family” (p. 17). While Zaretsky (2007) examines challenges to the trope of the ideal nuclear family, I focus more clearly on the conditions in which this “mediation” took place and the roles played by the cooptation (or dra- matization) of psychological practice in this process. Changes in the production and distri-
bution of popular representations of psycholog- ical practices has meant that credentialed prac- titioners have less control about the ways in which their methods are portrayed. Yet these portrayals have presumably affected the profes- sional landscape; for example, public interven- tions are often accompanied by exhortations to seek private psychological assistance via help lines, self-help books, or residential rehabilita- tion facilities. Surprisingly, a series of discussions of these addiction interventions suggest that, rather than contributing to the ideas challenging to the nuclear family, TV’s distorted adoption of psychological practices has worked to recuperate the familial ideal of midcentury. The nuclear fam- ily ideal was defined by Elaine Tyler May (2008) as the unrealistic belief that “family life in the postwar era would be secure and liberated from hardships past”; that “affluence, consumer goods, satisfying sex and children would strengthen fam- ilies, allowing them to steer clear of potential disruptions”; and that “adhering to traditional gen- der roles and prizing material stability” was the best path to the good life (p. 14).
The addiction intervention is a staged en- counter that brings to the surface the tensions that were both dulled and exacerbated by the proverbial “cocktail hour.” Perhaps because confrontational therapeutic techniques have largely fallen out of favor in professional psy- chological practice, scholars have been reluc- tant to recognize the persistent prevalence of depictions of the intervention as an appropriate, if overly dramatic, therapeutic strategy. Taking an approach that might be broadly termed “cul- tural studies,” this paper combines cultural his- tory’s concern with the discursive tension be- tween the public and private spheres with a “history of ideas” approach that traces the ap- pearance of a concept (the addiction interven- tion) through a series of historical moments (Lovejoy, 1936). Rather than offering an ex- haustive account of every representation of the therapeutic “intervention”— or even every in- tervention technique—this paper identifies and analyzes key “moments” in which variations of
5 Print and television advertisements for Cinema Verite, HBO’s April 2011 docudrama based on the series, dubbed it “the first reality show” and opened with a series of intertitles contextualizing the appearance of Louds within a series of significant historical events, including the Vietnam War.
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the psychological practice have been reenacted in popular and televisual culture.6
Focusing on confrontational therapies and the addiction intervention, this paper details three instances in which the popular media’s adoption of these techniques served to recuperate the status of the fragmented nuclear family (both specific and archetypal) in which the confron- tations took place. I begin with Betty Ford’s addiction intervention, which, 10 years after the professional technique was generated, first brought the concept of the intervention into popular consciousness. I continue with an anal- ysis of daytime talk shows of the 1990s, reading these as a throwback to confrontational encoun- ter therapies of the 1970s. I argue that, origi- nally, these therapies provided a way to refor- mulate new visions of family or to cope with the widespread loss of long-term committed rela- tionships; when the confrontational therapeutic tactics later reemerged in popular culture, how- ever, they were instead used to police, rather than challenge, the normalized nuclear family.
In these cases, the distinctions between the private space of the nuclear family home and the public sphere of popular media discourse are complicated in significant ways. Throughout my discussion, I demonstrate that popular me- dia has used the rhetoric of space to dramatize the dysfunctional power dynamics of the “pri- vate” families being represented and that this visibility signaled the vulnerability of the ideal nuclear family in general.7 This discussion of space culminates in my final example, which examines intervention-based reality shows, such as A&E’s Intervention and TLC’s Ad- dicted. Scenes in which families screen record- ings of the bad behavior of the addict in crisis literalize and affirm the trope of welcome, even curative, surveillance introduced in the prior popular iterations of the therapeutic confronta- tion. I reach the conclusion that, over the past 30 years, the ideal of the nuclear family was ex- ploited as popular culture reversed the course of psychology’s challenges to it.
Vernon Johnson, Betty Ford, and the Double Bind in the Nuclear Family
On Saturday afternoon, April 1, 1978, former First Lady Betty Ford was pacing across her home in Rancho Mirage, California, contem- plating phoning her son and daughter-in-law in
Pittsburgh, when suddenly they appeared at her front doorstep. What seemed, at first, to be a pleasant surprise, then, moments later, a humor- less April Fool’s Day joke, became an entirely solemn “intervention.” Additional family mem- bers assembled, along with a Navy doctor, and seated themselves in a semicircle in front of Ford. One by one, her husband, sons, daughter, and daughter-in-law recounted Ford’s failures as both mother and public figure, and connected these lapses to her dependency on alcohol and prescription pain medication: She slurred her words at the ballet; she was unavailable to baby- sit her grandchildren; she refused to come to the dinner table when called, preferring instead to finish her cocktail by the TV. The accumulation of sins, delivered with accusatory compassion by those closest to her, caused Ford to “collapse into tears,” admit that she needed help for chemical dependency, and accept the aid of- fered by naval doctor Joe Pursch, head of the Alcohol and Drug Rehabilitation Service at Long Beach.
Later, after emerging from the facility at Long Beach that would come to bear her name, Ford would justify and contextualize the event using the rationale of a particular branch of the addiction treatment industry. Her description became both popular archetype and the how-to manual for the addiction intervention, a con- frontational therapeutic technique first pro- moted by Episcopalian minister Vernon John-
6 The dramatic mode of the intervention has expanded from Vernon Johnson’s (1990) model, which concentrated on alcohol and drug users in nuclear families to include confrontations by family, friends, coworkers, and others about “strange” addictions, inappropriate clothing choices, real estate listings, and school lunches.
7 Academic debates on the rhetoric of space are wide- ranging and multidisciplinary; indeed, they encompass en- tire fields (architecture and cartography, for example). For our purpose here, a crude summary of literature in critical theory views space as a construction, a concept that links more concrete “places” (such as “living rooms” or “subway stations”) by the process of categorical “spatialization.” These representational linkages might come in predictable forms, such as maps, but they can also be conveyed through language, staging, or classical Hollywood editing. Who is granted access to particular spaces, and how they move through them, can be indicative of other categorical power dynamics (between people of varying races, genders, or abilities, for example). This paper follows Jürgen Haber- mas’s (1962) well-known distinction between public and private “spheres,” and builds upon subsequent studies of their gendered associations and dimensions.
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son almost a decade earlier. In her autobiogra- phy, Ford (1978) wrote, “The thinking used to be that a chemically addicted person—whether on pills or alcohol— had to hit bottom, decide he wanted to get well, before he could begin to recover; but now it’s been demonstrated that a sick person’s family, along with others signifi- cant and important to the patient, can intervene to help him despite himself” (p. 281).
Although Ford’s name was already associ- ated with one public health cause— cancer awareness—following her hospitalization at Long Beach, “Betty Ford” became synonymous with addiction rehabilitation facilities. Ford’s intervention did not occur on TV, but it was recounted in her autobiography and later dra- matized in a made-for-TV movie. Therefore, as a public event, it provided a model for later portrayals of the addiction intervention. Fur- thermore, the narrative’s conclusion in Ford’s successful residential treatment, and her subse- quent support of treatment centers, implicated the psychological profession and suggested le- gitimacy for the intervention’s rhetoric. The addiction intervention, and popular representa- tions of confrontational therapies more gener- ally, are as much about saving the ideal of the nuclear family as they are about “helping the addict despite himself.” Indeed, feminist scholar and cultural theorist Helen Keane (2002) has argued, “In spite of the concern with the authentic inner self and its destruction by addiction, this intervention [was] largely about Mrs. Ford’s failure to keep up appearances and meet her maternal and wifely duties. According to this irrational but omnipresent fear of surveil- lance, Ford’s lapses at both the public ballet and in the privacy of her living room were equally damning. The Ford family seemed to be accus- ing her not so much of being an addict, but of letting her addiction show and interfere with the smooth running of their lives” (p. 83). The smooth running of their lives takes place, mean- ingfully, within the home, which becomes both the subject of inquiry and the setting in which the drama of confrontation unfolds. The scene of Ford’s domestic intervention references TV, both explicitly and implicitly. Ford’s recollec- tion that the semicircle formed by her concerned family members during her intervention re- mains “burned in her brain” resonates with Spi- gel’s (1992) discussion of the postwar “family circle,” featured in popular photography as a
family of TV viewers “grouped around the set in semicircle patterns” (p. 16). TV watching was thus framed as a “family activity” and the “cement” that would solidify families previ- ously separated by the war. As Keane (2002) explains, these familial, gendered expectations create the drama that the staged addiction inter- vention resolves.
Keane (2002) concentrates on the interven- tion as it appears in a kind of classical form and deconstructs the paradox outlined in the script presented in Johnson’s (1990) “complete guide for families,” entitled Everything You Need to Know About Chemical Dependence. Keane (2002) notes that, according to Johnson’s script, placing the addict in the center of the semicircle encourages scrutiny that assumes wrongdoing. The subject of the intervention is not allowed to “to have her own equally true stories to tell about the betrayals, disappointments and bad behavior” (p. 81). But Keane’s observation that the intervention removes the complicated fac- tors of “contradictory and conflicting versions of reality operating simultaneously, interwoven with webs of power, resentment and love”—and that these factors are present in “even the most functional of families”— has a historical prece- dent in psychological trends in family systems therapies that emerged after World War II.
Deborah Weinstein has argued that, during the 1950s and 1960s, the concept of culture had traveled beyond the disciplinary boundaries of anthropology and sociology. The “culture con- cept” played “an integral role in the processes by which family therapists simultaneously de- fined the object of their research and treat- ment—the family—and built their new field” (Weinstein, 2004, p. 23). Seminal family ther- apists such as Nathan Ackerman, Murray Bo- wen, and Don Jackson employed the concept in a variety of contradictory ways that, Weinstein claims, demonstrates tensions between “views of family therapy as a conservative force for maintaining the nuclear family or a progressive force for overcoming social inequality.”
A comprehensive overview of the field of family therapy is neither practical nor relevant here, but despite their contradictory philoso- phies, family therapists of the 1960s generated several significant concepts about family sys- tems that were largely ignored by Johnson and omitted from popular portrayals of the Johnson- style intervention. Murray Bowen (1978), for
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example, advanced the category of the “desig- nated patient.” In Bowen’s formulation, a “des- ignated patient”—unlike the addict in the typi- cal intervention—should be viewed as the symptom, rather than the sole source, of the family’s problems. Mental health practitioners, later associated with what was called the antip- sychiatry movement, made similar contribu- tions to a growing body of research that viewed the family system itself as a source of sickness and potential site of therapeutic intervention. Prominent among this literature was the theory of the “double bind,” advanced by, among oth- ers, R. D. Laing. This theory of the double bind argued that repeated, inescapable exposure to messages that contradicted each other at differ- ent levels of communication (for instance, a parent criticizing a child for not expressing love then withdrawing physically when the child did express affection) might produce serious psy- chiatric problems, most notably schizophrenia.
For example, in Laing and Esterson’s Sanity, Madness, and the Family (1964), they argued that many families maintain lies so strongly that vulnerable children or individuals become un- able to accurately discern the reality of their situation or basic facts about the world around them. In this formulation, neither the family nor the vulnerable “patient” has unassailable access to the “truth”; only the therapist does. But in a near-nihilistic twist common to countercultural antipsychiatry, this expertise withholds the up- beat promises of familial homeostasis promoted by Bowen (and, later, Johnson). Although os- tensibly configuring the family as a legitimate object for treatment by mental health profes- sionals, theories like Laing’s also confirmed the bleak suspicion, reflected in rising rates of de- linquency and divorce, that nuclear families that were not working should call into question the rationale for preserving the family in general.
Although psychological ethics maintains the confidentiality of practitioner– client sessions, both conservative and progressive family ther- apies (as defined by Weinstein, 2004) chal- lenged the boundaries between the private space of the family household and the public sphere. Some “progressive” family therapists of the 1960s and 1970s believed that strong nuclear families and corresponding forms of social co- hesion could serve a protective function against deleterious cultural forces, such as the “culture of poverty.” To collect data to prove this point,
Albert Scheflen and his research team video recorded the interactions in the homes of fami- lies in the Bronx. He ultimately suspended re- cording, noting, in a 1971 publication, that “the data collected about minority and poverty peo- ples are not matched by comparable data about the middle class in America. So direct data such as we have been collecting are likely to be compared to idealized myths about middle class American households . . . to the unwitting or deliberate detriment of our subject” (Scheflen, 1971, p. 450).
While Scheflen’s conclusion resonates with contemporary social science research standards, the idealized myths about sitcom-styled middle- class American households were, with the in- crease in studies on middle-class dysfunction and the filming and release of An American Family in the early 1970s, beginning to be re- vised. Although PBS’s portrayal of the Louds was critically received as both an indictment of the mythical American family and the failure of an overly psychologized confessional culture to “fix” it, in general, radical critiques advanced by a subset of mental health practitioners were omitted from therapeutic spectacles staged for mass audiences. As we will see, the Laschian confessional “culture of narcissicism” (Lasch, 1979) is not so overly psychologized as to be all-inclusive. Christopher Lasch located the weak hedonism of American culture in the de- cline of family and the rising popularity of psychospiritual groups such as Werner Erhard’s Seminars Training (EST). But popular televi- sual culture did not give full and lasting expres- sion to utopian, radical, or fringe personal growth movements; instead, it repressed them.
Confrontational Therapy, Talk Shows, and the Forgotten Context of the Therapeutic
Encounter
Betty Ford’s well-publicized intervention brought a pastoral addiction counselor’s nar- rowly recognized technique into the mainstream and, in so doing, demonstrated that the ideal of nuclear family was both fixable and functional. We can extend this argument by suggesting that popularized confrontational therapies—such as the addiction intervention— do historical, as well as rhetorical, work. Confrontational en- counter therapies of the 1970s, as established by groups like Synanon and EST, were dated and
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largely discredited when their techniques de- buted, in a different guise, on daytime TV talk shows of the late 1980s and early 1990s. Rather than straightforwardly reintroducing past group psychological practices, these new televised in- terventions actually revived them. The revival was made possible, in part, by a kind of repack- aging, which adapted old therapeutic practices to new circumstances of media production and marketplaces. It was also made possible by the persistent anxiety about the social and cultural status of the nuclear family. Ultimately, the talk show format reimagined the intervention by suppressing the earlier visions of confronta- tional group therapy as countercultural alterna- tives to family therapy. These “encounter” or “attack” therapies were intended to facilitate recovery by enabling the formation of new (nonfamilial) relational bonds. This alternative legacy of these therapies was forgotten, while their controversial therapeutic techniques were revitalized as a form of entertainment.
Previous literature on TV talk shows presents them as being libratory (because of their low- culture status and carnivalesque associations), disciplinary (because the guests are always sub- ject to the logic of the show’s format and the host’s opinion), or religiously inspired (as a secular form of low-Protestant revival and con- version confessional).8 Rather than viewing the shows as politically libratory or disciplinary on the level of the individual (either guest or viewer), I argue that the spectacular, shifting power dynamic of the talk show confrontation highlights, and then attempts to resolve, the dramatic tension already inherent in the (often lower-class) nuclear family. Although media studies scholars connected talk shows to nineteenth-century Evangelical conver- sion rituals, a more accurate historical precedent might be the countercultural therapies that define what Thomas Wolfe (1976) called America’s “Third Great Awakening.” According to Wolfe, this pseudoreligious movement of the 1960s and 1970s was not inspired by an “ecumenical spirit” but by the interpersonal contempt and self- absorption that seeped across all class boundaries. Unlike Evangelical conversion, the confronta- tional therapies that characterize this movement are angrily irreverent (there was no “back-and- forth” in the conversion narratives—the church always stood for truth).
“Trash” talk shows (so termed by media stud- ies scholars, who include Jerry Springer, Ricki
Lake, Geraldo, and Sally Jesse Raphael in this category) used a standard program format to stage confrontations, usually among family members. In “Confrontation as Spectacle: the Argumentative Frame of the Ricki Lake Show,” Ian Hutchby describes how the talk show situ- ated the guests as taking oppositional stances. First, the host introduced the guest, who comes to the show with a “complaint” about the second guest. The second guest is then “revealed” in two senses: physically, by being brought on- stage before the studio audience and, more sym- bolically, in the sense that “their disagreeable actions, previously confined to the private sphere of the guest’s everyday lives, are now being brought to public attention” (Hutchby, 2001, p. 162). The problematic second guest is then made to address the accusations of the first guest and the judgments of the audience.
Like the Johnson intervention, this confron- tation encourages the problematic family mem- ber to admit and “own” her addiction while providing her relatives the space to vent their frustrations. As in the Betty Ford case, the spa- tial rhetoric of the confrontation reflects the status of family. The family members typically sit beside each other on a stage, in front of a studio audience. But in order for their conflict to be explicitly opened up to public scrutiny or interjection, “space,” Hutchby (2001, p. 167) writes, “must be provided within the rapid flow of the argument onstage.” The talk show host creates that space. Hosts like Lake “stand with the audience, actively working to pick up on points of contention in order to further the au- dience’s opportunities to take sides in the dis- pute being played out on stage” (p. 167). The show cuts back and forth between the guests on the stage and the host, who stands in the audi- ence. Occasionally, the camera pans across the semicircular studio audience, which is generally encouraged to shame the guests for lapses in bourgeois morality or hyperbolic deviations from nuclear family norms. This space for spec-
8 Perhaps the most well-regarded book on TV talk shows is Jane M. Shattuc’s (1997) The Talking Cure: TV Talk Shows and Women, which argues that the tropes and tech- niques employed by TV talk shows of the 1990s arise from consciousness-raising groups and identity politics of the 1960s. For examples of work that views talk shows as liberatory in the Bahktinian sense, see Manga (2003); as religiously inspired, see Lowney (1999).
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tacular moral appraisal is invited into the do- mestic sphere through the TV, which provides, according to Spigel (1988), both a “window on the world” and a way for people to keep their “distance from the world but at the same time imagine that their domestic spheres were con- nected to a wider social fabric” of viewers in other households (p. 14). Home audiences of TV talk shows were similarly incited to judg- ment or self-reflection, either by the host’s con- cluding messages, which directly addressed home viewers, or the crawling text at the bottom of the screen, featuring a phone number that offers help “to you or someone you love.” This tie-in with “helping” professionals recalled the authority previously associated with sponsored educational programs of the 1950s, but the dra- matic encounters between on-screen guests sug- gested that late-twentieth-century audiences needed considerably more incitement to con- sider such help.
Unlike the Johnson intervention, in which familial frustrations are tempered with love and bookended with the promise of recovery, talk show confrontations, like attack therapies, gen- erally encouraged participants to cross-exam- ine, question, and even ridicule each other about their personal behavior patterns. Rather than being presented as the impetus for entering re- covery treatment, this process itself was viewed as a form of therapy, designed to challenge the “designated patient’s” unworkable beliefs, atti- tudes, and defensive mechanisms, and facilitate subsequent behavior change.
In their genealogy of the evolution of encoun- ter groups, Broekaert, Vandevelde, Schuyten, Erauw, and Bracke (2004) argue that, in en- counter group practice, the focus has moved from mutual confrontation toward balanced and respectful dialogue. By analyzing transcripts of encounter groups held at a 20-year interval (in 1980, and again in 2000) they found that “to- ward” messages (comments leveraged at the designated patient) and “back” messages (re- sponses by the person being confronted) were considerably more balanced in the later session (Broekaert et al., 2004, p. 241). This rough chronology suggests that while the practice of “therapeutic” collective ridicule was falling out of favor in professional practice, it climbed to the height of its popularity in the mass culture phenomenon of daytime talk shows.
Although confrontations have always oc- curred within private households, confronta- tional therapies usually did not. Perhaps talk shows represented imagined private scenes, al- beit somewhat decoratively (Hutchby, 2001, noted that the Ricki Lake set, for example, was designed to resemble a living room). Yet the confrontation tactics employed on these shows were originally developed and popularized in relation to nontraditional households and alter- native conceptions of intimate relationships of choice. Synanon, the organization that devel- oped perhaps the earliest form of U.S. encounter therapy (called “the game”) began as a self- styled recovery mecca for heroin addicts and eventually grew to become an intentional com- mune that attracted a sizable population of non- addicts to its therapeutic lifestyle. In the context of the commune, the rationale went, encounter sessions kept the intentional extended family functional, friendly, and better adjusted than the average suburban family unit. Psychologist Abraham Maslow (1971) described Synanon as a “little Utopia” (p. 218) within a “mass of society [that] is still like a dead weight” (p. 223). According to Maslow, “The average American citizen does not have a friend in the world. Very few people have what a psycholo- gist would call real friendships. The marriages are mostly no good in the ideal sense as well” (p. 219). In contrast, Synanon was “a place out of the world where you can get real straightfor- wardness, real honesty and the . . . experience of a real group working together as a team” (p. 218). Cooperation and openness was made pos- sible by the confrontational “game” sessions that were a part of Synanon’s domestic life.
Werner Erhard’s seminars required consid- erably less commitment—they were intensive workshops that took place over day- or week- end-long retreats—and allowed participants to emerge from the confrontational sessions and return transformed to their workaday lives. During the day-long (and sometimes night-long) sessions, participants were forbid- den from eating, drinking, or using the bath- room, and were subjected to a barrage of insults intended to break down their psycho- logical defenses and “denial” about their abil- ity take control of their lives. In his ethnog- raphy of EST, Steven Tipton (1982) contends that the seminars ultimately helped partici- pants cope with the rootlessness of modern
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life, to embrace the “touch-and-go” nature of low- or limited-commitment romantic rela- tionships. Although EST borrowed from a number of psychological and religious tradi- tions—as well as the motivational language of business gurus like Dale Carnegie—it was not a legitimate psychological treatment mo- dality. By reconciling young professional in- dividuals with lives outside family units, these seminars also provided a functional al- ternative to therapies that aimed to heal the fractured modern family. Rather than compete with confrontational self-help modalities like EST, some professionals adopted their prac- tices, further blurring the distinction between legitimatized and dubious psychologies. Counselors Norman Paul and Betty Paul (1978) endorsed “the use of EST as adjunc- tive” to family therapy and video-assisted therapy, in which married couples view vid- eos of their therapy sessions as part of their analysis. EST and video therapy are “feed- back techniques” that work together to “con- front the patient with the reality of his own behavior, and experiences and events one has forgotten” (p. 61). Because the techniques are designed to help family members confront the patient’s presumed denial, the use of EST and video-assisted therapy in family counseling resembles the addiction intervention.
The mainstream media initially portrayed Synanon, EST, and other countercultural thera- pies as threats to the successful reproduction of the nuclear family system. Thomas Wolfe’s (1976) New York article, “The ‘me’ decade,” argued that group and couples therapies were inspired by the exhilarating rush that comes with “talking about Me” (p. 36), and were a vacuous trickling down of the privileged tradi- tions of a morally questionable upper class.9
The access to self-talk was democratized by the lower prices of alternative (i.e., not psychiatric psychoanalytic) therapies; unfortunately, in- creasing access to therapy resulted in social disintegration. Confrontations point out individ- uals’ flaws but destroyed the marriages rather than “fixing” them. Peter Marin (1975) ques- tioned the erosion of the idealized privileged bond between psychoanalyst and analysand. In “The New Narcissism,” Marin (1975) argued that group dynamics led to “the denial of history and a larger community” and favored “plati- tudes” over the recognition of real limits on
human action and possibility (p. 47). Further- more, he thought that the traditional therapeutic emphasis on gendered familial roles and respon- sibilities provided appropriate behavioral limits that helped individuals adapt to society.
In contrast, Edwin Shur (1976) argued, in The Awareness Trap, that countercultural group therapies were not entirely divorced from a sense of continuity with the past. His analysis of Eric Berne’s Games People Play (1964)10 sug- gests that rather than challenging the family, confrontational group therapy simply presents a new perspective on it. In games, individuals achieve satisfaction by placing themselves in “a strong psychological position while at the same time attempting to cast the partner-in-interac- tion into a wrong or weak one” (Shur, 1976, p. 109). Shur (1976) contends such interactions are an inevitable part of any form of social life and in this way “they come close to being Berne’s term for culture.” Culture becomes defined by the kinds of games people have played that are passed on from generation to generation; “child rearing con- sists mainly of teaching about right and wrong games” (p. 110). The intervention—an emblem- atic game11— does not liberate people to fulfill their own “unencumbered” potential but helps keep people in their assigned roles, playing by the inherited rules.
Wolfe (1976) similarly argues that once the self-indulgent entertainment of the therapeutic counterculture “went righteous,” by taking on a transcendent, religious fervor, it became possi- ble to view all human history in its light (p. 7). From this perspective, anthropology’s driving premise was not survival and procreation, but boredom, and all interpersonal dynamics throughout human history could be reduced to entertainment. More recently, new media has simply made it possible to record, analyze, and disseminate these group dynamics—and, most importantly, to profit from them.
Both the Synanon game sessions and EST encounters operated in quasi-public spaces, in
9 Wolfe (1976) includes fraternity hazing, aristocratic courting rituals, and psychoanalysis as among these privi- leged traditions.
10 Although he does not cite them, Berne’s “transactional analysis” games recall the Synanon “game” in their con- frontational style and structure.
11 See Berne’s (1964) discussion of the games alcoholics play, p. 71.
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the sense that the success of their staged con- frontations depended, in part, on the defensive- ness and shame they inspired in their central participants (Synanon members even recorded game sessions for later broadcast and analysis). By the late 1980s, the Synanon “family” had mostly dissolved, and the semipublic confron- tational psychological practices had gone both public and pop. Heightened domestic confron- tations were approximated on talk show stages. The confrontational encounter was redesigned. The encounter became a necessary method for preserving traditional family structures rather than a way to successfully escape them.
“Videotape Feedback,” Reality TV, and the Family’s Chronicle of the Addictive Process
The practice of secretly taping the “desig- nated patient” or addict, and screening his or her behavior as a part of the intervention, was an experimental therapeutic practice that largely fell out of favor by the end of the 1980s.12 It was revived on reality shows in the 2000s. In contrast to earlier talk show confrontations, in which an addict’s prior behavior is established by the host and recounted by mistreated family, friends, employers, or lovers, many reality shows document this behavior as it occurs. The footage is intended to provide irrefutable evi- dence of the addict’s condition, a method by which to, as Johnson (1990) wrote, “present real- ity to a person out of touch with it in a receivable way” (p. 325). The focus on the presentation of habitual, ostensibly destructive actions follows on the rising recognition of non-substance-based ad- dictions such as compulsive eating, gambling, or sex (also known as “behavioral,” “process,” or “soft” addictions). Contemporary psychologists make the case for the category of nonsubstance addictions on the basis of research on neuroplas- ticity and habitual behavior. In this paradigm, brain imaging, rather than prerecorded behavioral surveillance, provides evidence of addiction. In contrast to lab-based brain images, behavioral sur- veillance footage is amenable to reality shows because it locates evidence within the context of a familial confrontation and thus opens up an op- portunity for recovery that implicates and poten- tially redeems the family system.
In his comparison of the “real-life” televisual families the Osbournes (fathered by Ozzy) and the Louds, Derek Kompare (2009) argues that
codes of documentary filmmaking have ceded to “reality” via a concentration on what he calls “ignominious bodies” (p. 101). Ignominy “en- tails public shame or humiliation,” and its var- ious states include the “exhausted, enraged, de- pressed, careless, undressed, asleep, inebriated, and sick” (p. 107). Although the Osbournes’ self-conscious adoption of sitcom tropes cause Ozzy’s drug-ravaged body to be played for laughs, not tears, the camera’s exposure of vul- nerable and excessive bodily states is what makes it, according to Kompare (2009), worthy of the “reality” designation.
The various interventions featured on A&E and TLC serve up family tension as drama, not comedy. In fact, the status of the family as a whole, rather than the health and well-being of the designated patient, is most often at stake. Unlike brain images, which are employed to medically prove the individual is ill, video on the reality intervention is intended as proof that the individuals worthy of saving by virtue of their position within the family. The family, however dysfunctional, is therefore recuperated as a form of social organization with inherent value.
The promotional material for the shows and the staging of the interventions affirms the threatened and valued status of the nuclear fam- ily. Typical synopses of episodes on A&E’s Intervention web site (2010) highlight the ad- dict’s effect on the family and the potential for “tough love” to redeem it:
Once bright, likable, and athletic, Andrew has become a gaunt, menacing OxyContin addict. As a child, An- drew learned to manipulate his father, Dan, who now admits, “I can’t stand up to Andrew.” Can an interven- tion help Andrew—and make his father realize that if he doesn’t get tough with Andrew, the whole family will be destroyed? Sebastian, 21, and his brother Marcel, 20, were soccer celebrities in their town at a very young age. Cool and rebellious, Sebastian hung out with older teammates and started doing marijuana, cocaine and meth. Then Marcel got strung out on cocaine, Xanax and OxyCon- tin, and also sold drugs. Now their older brother is angry, their mother feels betrayed, and their father is ready to give up his wife, his oldest son, and his own life to save them. An intervention is the last hope for the entire family. [emphasis added]
12 For a case for “reviving” this “new old treatment” in the professional sphere, see Mihai et al. (2007).
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The narrative arc of each show is formulaic. The addict is introduced and his case history conveyed through a combination of direct- address confessionals by family and friends, intertitles, faded family photos (usually of hap- pier times), and candid footage of both addic- tive behaviors and family confrontations (usu- ally taking place within the home). The climax of each show, occurring in the last 5 to 10 minutes, is the “intervention.” Sometimes this confrontation serves as a catalyst to get the addict into treatment; in a few instances it con- vinces the addict to continue treatment follow- ing release from a hospital or detox facility.
Since the time of Betty Ford’s story, the family room evolved from home theater to mul- timedia production studio. Like the hotline cap- tions on daytime talk shows of the 1990s, inter- vention shows ask the home audience to get help for loved ones. On the web site or the cable channel, advertisements frequently promote idyllic, expensive addiction recovery centers. Whether staged in the home or in a recovery facility, the intervention’s set design is identi- cal: Chairs and couches are arranged in a semi- circular u-shape. Unlike Betty Ford, who faced her concerned family directly, in A&E’s series, the camera occupies the opening opposite the family; the designated patient sits in the semi- circle. The camera’s place in the intervention recalls Ron Simon’s (2005) observation that the reality phenomenon signals a “new audience investment in TV,” in which the traditional di- chotomy between “creating and watching TV . . . has been obliterated” (p. 200).
Although a few families resist the interven- tion, most episodes conclude that welcoming surveillance into the home has ultimately saved the family. In one episode, Lauren, a recent college graduate and physical education teacher who has become dependent on heroin, strongly resists what she perceives as the coercive and invasive tactics of the intervention. After being convinced to come out of her bedroom and into the familial semicircle in the living room, she exclaims, “This is an attack. This is going to be an attack. Let me go get a piece of paper be- cause I have some things I need to tell you.” But, as Helen Keane (2002) might have pre- dicted, the intervention did not give Lauren the opportunity to share her perspective—she leaves the circle, proclaiming, “This isn’t all about me. It isn’t all about me.” Later, when she
asks to speak with her family members without the presence of the camera crew, her request is denied. What follows is one of the most pro- tracted intervention sequences featured on the series. Lauren leaves and returns to the house- hold scene multiple times, trailed by a camera crew, in a psychodrama that lasts almost 15 min- utes before she agrees to go to treatment. When the show’s conclusion “follows up” with her 3 months later at her residential recovery center, she proudly displays a small bulletin board of family photographs in her room, stating, “My dad and me are working on our relationship and finally getting it to where it should be. My mom and I talk a little less, but that is good. It’s better that we just know that we’re there for each other and love each other.”
As an addendum to the happy restoration of her family’s relations, Lauren narrates footage illustrating her physical and emotional health. As she swims laps across the recovery center’s pool, Lauren’s voice-over retrospectively pro- claims, “My intervention was the best thing that ever happened to me.”
In practice, confrontational interventions are more likely to be, as addiction counselors and researchers William White and William Miller have written, “generally ineffective, potentially harmful, and professionally inappropriate” than wonderfully transformative (White & Miller, 2007, p. 30). Although A&E’s web site presents the video-assisted Johnson intervention as a le- gitimate treatment modality, most practitioners in recent years utilize “motivational interview- ing,” a technique that seeks to gauge the sub- stance abuser’s receptivity to behavior change, rather than force a point of crisis. But crisis, with its ability to dramatically implicate actual and imagined families, was popular TV. The recuperative mode of the addiction intervention enabled the traditional idea of the nuclear fam- ily, which was negotiated and challenged by family therapies of the 1950s and 1960s, to be reinvigorated. However, the televised confron- tation is ultimately deceptive, failing to appro- priately “educate” audiences about addiction, codependency, family dysfunction, or social scientific progress. While purporting to cele- brate normal family life, it actually exults the familial context as a site of individual well- being.
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Conclusion
By focusing on the inherent drama of the therapeutic encounter, rather than the psycho- logical theories that supposedly support it, sta- tions like A&E and The Learning Channel are not educating the public in the way corporate sponsors of the didactic early TV programs imagined. But the interventions featured there—supported, in part, by the addiction treat- ment services that provide advertising—almost certainly affect the field of psychology. Repre- sentations of psychological practice influence professional status and, potentially, popular opinion. In addition to the cable intervention “experts,” celebrity treatment providers, such as Dr. Phil McGraw and Dr. Drew Pinsky, essen- tially conduct their practices on TV.13 Discus- sions and newsletter columns in the media psy- chology division of the American Psychological Associations increasingly feature advice on how to build a personal “brand” for a psychol- ogy practice and how to convey psychological information to mass audiences via TV appear- ances or social networking platforms.14 At the same time, media psychology research about “trash” TV programming often pathologizes viewers rather than strategizing about how to reach them.15 While psychological practitioners might wish away discredited therapies and their low-culture depictions, these depictions suppos- edly show what psychologists “do,” or what the conditions for treatment might look like, possi- bly drawing in clientele through the use of such questionable tactics.
Had Lance Loud, the homosexual son fea- tured on PBS’s An American Family, been fol- lowed just a little longer, he might also have been the subject of an intervention.16 His later drug problems, partly created by the media scrutiny endured in his late teens and early twenties, would unlikely have been overcome by the same televisual devices. His family, how- ever, did experience a temporary resurrection: Death in an American Family, a special which aired in 2003, chronicled Lance Loud’s struggle with, and eventual death from, drug-related ill- nesses. The episode, promoted as “Lance’s final wish,” revolved around his sacrificial role. The filming temporarily reunited his divorced par- ents in the same house again and, ever so briefly, restored the family that had publicly fallen apart in the 1970s.
Despite the poignant conclusion to the Louds’ story, the long-term effect that publicly disseminated recorded interventions have on their participants is unknown. If the intervention works best as a kind of confession (albeit co- erced), what does it mean when the addict can no longer leave the scene behind? If the con- frontation provides ritualistic cleansing neces- sary for a journey of recovery, this function might be frustrated by the perpetual recurrence of the event on reruns or Internet sites. The real impact on families, who supposedly benefit from the public intervention, is also ambiguous. In recent years the distinction between anthro- pological, psychological, and purely sensational goals for recording family life has fallen out of focus. Whether particular families were broken apart by media inspection or saved by it, the perceived fragility of the ideal nuclear family has been exploited by the popularization of the addiction intervention.
13 Phil McGraw is most well known for his role as Oprah Winfrey’s psychologist and life coach. He employs his “tough love” approach to familial conflict in a syndicated talk show, The Dr. Phil Show (2002-present). Drew Pinsky is a board-certified doctor of internal medicine who directed the in-patient addiction treatment of minor celebrities in his on-camera reality show, Celebrity Rehab (2008-present).
14 See the Amplifer, the newsletter of Division 46: Media Psychology branch of the American Psychological Associ- ation for a range of discussions about increasing the visi- bility of professional psychologists in the mass media; the division’s “theme” for 2011 was “online connections with the public on a range of psychological issues.” For an explanation, see Wallin (2010).
15 See, for example, Reiss and Wiltz’s (2004) claim that people who watched reality television had an above-average trait motivation to feel “self-important . . . vindicated . . . and free of morality.” For a discussion of whether reality television viewers are voyeuristic, see Baruh (2010) and Nabi, Stitt, Halford, and Finnerty (2006).
16 Ironically, the public judgment of the Louds’s “exploi- tation” has since been quieted by a frenzy of tough-love consciousness-raising that promises to restore the troubled institution that both PBS and popular psychologists origi- nally critiqued.
References
A&E. (2010). Intervention episode guide. Retrieved from http://www.aetv.com/intervention/episode- guide/index.jsp
American families: Trends and pressures: Hearing before the Subcommittee on Children and Youth of the Committee on Labor and Public Welfare, 93d Cong. 136 (1973).
244 CLARK
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s co
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A m
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ol og
ic al
A ss
oc ia
tio n
or o
ne o
f i ts
a lli
ed p
ub lis
he rs
. T
hi s
ar tic
le is
in te
nd ed
s ol
el y
fo r t
he p
er so
na l u
se o
f t he
in di
vi du
al u
se r a
nd is
n ot
to b
e di
ss em
in at
ed b
ro ad
ly .
Baruh, L. (2010). Mediated voyeurism and the guilty pleasure of consuming reality television. Media Psychology, 13, 201–221.
Bassler, R., Litvak, A., (Producers) & Litvak, A. (Director). (1948). The snake pit (Motion picture). United States: 20th Century Fox.
Berne. E. (1964). Games people play. New York, NY: Grove Press.
Bowen, M. (1978). Family therapy in clinical prac- tice. New York, NY: Jason Aronson.
Broekaert, E., Vandevelde, S., Schuyten, G., Er- auw, K., & Bracke, R. (2004). Evolution of encounter group methods in therapeutic commu- nities for substance abusers. Addictive Behav- iors, 29, 231–244.
Burnham, J. (1987). How superstition won and sci- ence lost: Popularizing health and science in the United States. New Brunswick, NJ: Rutgers Uni- versity Press.
Coontz, S. (2000). The way we never were: American families and the nostalgia trap (2nd ed.). New York, NY: Basic.
Ford, B. (1978). Times of my life. New York, NY: Harper and Row.
Freedman, B. (Writer), & Pritchett, M. (Director). (2006). Lauren (television episode) in D. Partland & S. Mettler (Producers), Intervention. Sherman Oaks, CA: GRBTV.
Freidan, B. (1963). The feminine mystique. New York, NY: Norton.
Gilbert, C. (Producer), Raymond, S., & Raymond, A. (Directors). (1973). An American family. United States: Public Broadcasting System (PBS).
Habermas, J. (1962). The Structural transformation of the public sphere: An inquiry into a category of bourgeois society. Cambridge, MA: Polity.
Hutchby, Ian. (2001). Confrontation as a spectacle: The argumentative frame of the Ricki Lake show. In A. Tolson (Ed.), Television talk shows: Dis- course, performance, spectacle (pp. 155–171). Mahwah, NJ: Erlbaum.
Johnson, V. (1990). Everything you need to know about chemical dependence: Vernon Johnson’s complete guide for families. Center City, MN: Ha- zelden.
Keane, H. (2002). What’s wrong with addiction? New York, NY: New York University Press.
Kompare, D. (2009). Extraordinarily ordinary: The Osbournes as “An American Family.” In S. Mur- ray and L. Ouellette (Eds.), Reality TV: Remaking television culture (2nd ed., pp. 100 –119). New York, NY: NYU Press.
LaFollette, M. (2008). Science on the air: Popular- izers and personalities on radio and early televi- sion. Chicago, IL: University of Chicago Press.
Laing, R. D., & Esterson, A. (1964). Sanity, madness, and the family: Families of schizophrenics. New York, NY: Penguin Books.
Lasch, C. (1979). The culture of narcissism: Ameri- can life in an age of diminishing expectations. New York, NY: Norton.
Lovejoy, A. (1936). The great chain of being: A study in the history of an idea. Cambridge, MA: Harvard University Press.
Lowney, K. (1999). Baring our souls: TV talk shows and the religion of recovery. Hawthorne, NY: Al- dine de Gruyter.
Manga, J. (2003). Talking trash: The cultural politics of daytime talk shows. New York, NY: NYU Press.
Marin, P. (1975, October). The new narcissism. Harper’s, 251, 45–56.
Maslow, A. H. (1971). Synanon and eupsychia. In The farther reaches of human nature (pp. 216 – 226). New York, NY: Penguin.
May, E. T. (2008). Homeward bound: American fam- ilies in the cold war era (rev ed.). New York, NY: Basic Books.
McCarthy, A. (2010). The citizen machine: Govern- ing by television in 1950s America. New York, NY: New Press.
Mihai, A., Damsa, C., Allen, M., Baleydier, B., Lazignac, C., & Heinz, A. (2007). Viewing vid- eotape of themselves while experiencing delir- ium tremens could reduce the relapse rate in alcohol-dependent patients. Addiction, 102, 226 –231.
Nabi, R., Stitt, C., Halford, J., & Finnerty, K. (2006). Emotional and cognitive predictors of the enjoyment and reality-based and fictional television programming: An elaboration of the uses and gratifications perspective. Media Psy- chology, 8, 421– 447.
Paul, N., & Paul, B. (1978). The use of EST as an adjunctive therapy to family-focused treatment. The Journal of Marriage and Family Counsel- ing, 4, 51– 62.
Reiss, S., & Wiltz, J. (2004). Why people watch reality TV. Media Psychology, 6, 363–378.
Scheflen, A. E. (1971). Living space in an urban ghetto. Family Process, 10, 429 – 450.
Shattuc, J. (1997). The talking cure: TV talk shows and women. New York, NY: Routledge.
Show business: Sample of one? (1973, February 26). TIME. Retrieved from http://www.time.com/time/ magazine/article/0,9171,910572,00.html
Shur, E. (1976). The awareness trap: Self-absorption instead of social change. New York, NY: Quad- rangle.
Simon, R. (2005). The changing definition of reality television. In G. Edgerton and B. Rose (Eds.), Thinking outside the box: A contemporary televi- sion genre reader (pp. 179 –200). Lexington, KY: University of Kentucky Press.
Spigel, L. (1988). Installing the television set: Popu- lar discourses on television and domestic space, 1948 –1955. Camera Obscura, 6, 9 – 46.
245TOUGH LOVE: A BRIEF HISTORY OF THE ADDICTION INTERVENTION
T hi
s do
cu m
en t i
s co
py ri
gh te
d by
th e
A m
er ic
an P
sy ch
ol og
ic al
A ss
oc ia
tio n
or o
ne o
f i ts
a lli
ed p
ub lis
he rs
. T
hi s
ar tic
le is
in te
nd ed
s ol
el y
fo r t
he p
er so
na l u
se o
f t he
in di
vi du
al u
se r a
nd is
n ot
to b
e di
ss em
in at
ed b
ro ad
ly .
Spigel, L. (1992). Make room for TV: Television and the family ideal in postwar America. Chicago, IL: University of Chicago Press.
Tipton, S. (1982). Getting saved from the sixties. Berkeley, CA: University of California Press.
Wallin, P. (2010). Educating the public online about the value of psychology. Amplifier, 2. Retrieved from http://www.apa.org/divisions/div46/AmpSpring- Summer10_final_7.12.pdf
Weinstein, D. (2004). Culture at work: Family ther- apy and the culture concept in post-World War II America. Journal of the History of the Behavioral Sciences, 40, 23– 46.
White, W., & Miller, W. (2007). The use of confron- tation in addiction treatment: History, science and time for change. Counselor, 8, 12–30.
Wolfe, T. (1976, August 23). The “me” decade and the third great awakening. New York, 9, 26 – 40. Re- trieved from http://nymag.com/news/features/45938/
Zaretsky, N. (2007). No direction home: The American family and the fear of national decline, 1968 –1980. Chapel Hill, NC: University of North Carolina Press.
Received January 5, 2011 Revision received August 4, 2011
Accepted August 16, 2011 �
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246 CLARK
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