Torken : tvångsvården av alkoholmissbrukare i Sverige 1940-1981

Sammanfattning: This dissertation investigates compulsory care of alcohol abusers in Sweden during the years 1940 to 1981. The purposes of the dissertation are twofold: in part to determine the concrete forms which care services for alcohol abusers took during the years focused on, in part to analyze what connections existed between the development of services and conceptions of the reasons for, consequences of and possible solutions to alcohol abuse. One point of departure is that the problem was defined with respect to the interests of influential social actors, and with respect to a very particular view of what a respectable life (free of social problems) was. Among the most influential actors involved in these social services, I argue for a focus not least on so-called “street-level bureaucrats”, with direct influence on the goals and methods of institutional care. The study is thus oriented towards mapping the development of problem definitions and formulation within the praxis of compulsory care in four institutionalized care establishments for alcohol abusers. This development is contrasted to broader trends of institutional and discursive development in the definition of alcohol abuse as a social problem.The legislation regulating compulsory care has constantly been founded upon assumptions of the social damage caused by alcohol abuse. At the level of concepts or discourse the consequences of causes for and solutions to alcohol abuse were initially defined in terms of individual morality, with definitions subsequently developing so as to depart from more medicalized terminology. Towards the end of the period the problem descriptions became focused on societal dysfunctions and reforms as the respective causes of and solutions to societally problematic alcohol abuse. At the level of treatment focused upon in the dissertation, societal explanations of alcohol problems departing from societal dysfunctions as causes thereof, and societal reforms as solutions, have never been fully integrated in care services praxis. This was not the case for the simple reason that these care activities, as such, were developed to deal with individuals rather than with society. Neither did a medicalized perspective come to dominate institutionalized care during the period studied – something which can be explained not least with the fact that the perspective’s expansion was not attended by development of medical treatment methods which were convincing with respect to results of use. On one hand, concretely practiced compulsory care thus long remained dominated by problem definitions departing from inmates’ gender-specific moral qualities. On the other hand, certain elements of a more resource-oriented and societal-reformist perspective can certainly be distinguished in the development of care services, albeit on the special terms associated with service implementation in the field.In conclusion, the historical development of care services for alcohol abusers shows that alcohol abuse need not necessarily, or primarily, be seen as a problem having to do with individuals’ relationship with alcohol. Other definitions of the problem have focused upon individuals’ relationship also to working life, the family, sexual morals, the gender order, or capitalist oppression. The problem has been seen as a workers’ and poverty problem, a problem of families and violence, a medical problem, or a symptom of societal problems. Causes have been sought in the character of individuals, the ways in which they have been raised or not raised, their spiritual life, their metabolism, their genetic material, their socioeconomic environment, gender and family situation. The proposed solutions have included everything from work, organized coffee breaks, medicines, psychotherapy and democracy to piece-rate wages, no wages, collective care, or solitary confinement. Alcohol itself has been a secondary factor in the problem definitions which have let themselves be attached – either via perceived links of cause or of effect – to more overarching social issues.