Loss of control and craving

In the sociopolitical context of the disease theory, some kind of notion of loss of control over drinking behaviour is essential for the attempt to absolve the alcoholic from legal and moral responsibility for his actions, since it implies, by definition, that his deviant drinking behaviour is no longer within the realm of personal choice. Etiological theories classifiable under the last heading were reviewed by MacLeod. Up to the early 1960s the evidence on which formulations of loss of control and craving had been based were the clinical observations of psychiatrists and other professional helpers and the historical reports of their experiences given by recovered alcoholics themselves. The main point is that no systematic observations of alcoholics’ drinking behaviour had been made under controlled conditions and subject to elementary objective criteria for the collection of scientific data. The design of all the experiments we shall be reviewing was based on the principles of operant methodology as set out by Skinner.