Harold A. Mulford, Jr. — In Memoriam

Editor’s Note:  Points welcomes Paul Roman’s warmhearted reflections and commentary on fellow sociologist Harold Mulford’s life and work.  Mulford was a pioneer in the application of sociological thought and methods to alcoholism and alcohol as public problems.  As Paul’s commentary amply suggests, Hal was also a passionate and respected scholar.   

This memorial for Harold A. Mulford, Jr. will neither begin nor end with the standard statement about how much we have lost with Hal’s passing on June 28, 2012 just short of “four score and ten” at age 89.  Tapping a perhaps less common tradition, let us celebrate some of the unique gifts that alcohol social science gained by his travels with us.

Hal Mulford’s life has both storybook qualities but as a scholar, features that are absolutely unique.  Born on an Iowa farm and growing into a strapping handsome man, Hal was a hero in the Good War, with a medal-producing record of laying down the enemy with major artillery during D-Day and then fighting on through the Pacific Theater to nearly the end of the War.  After marriage and the beginning of his family, and a GI Bill bachelor’s degree from Morningside College in 1947, his eventual education at the University of Iowa led him to a doctorate in sociology in 1955.  Here he was substantially influenced by Manfred Kuhn, founder of what is known as “The Iowa School of Symbolic Interaction” wherein the somewhat elusive tenets of this perspective are put to hard-nosed empirical test.  Hal’s work continually reflected this perspective; my attempted summary of the core of his life’s work would center on his efforts to construct the symbolic and interactional world of the deviant drinker and alcoholic through scale construction.

Following a brief stint as an apparently overloaded sociology instructor at Northwest Missouri State College, Hal received a surprise invitation to return to his Alma Mater, where he ended up spending the remainder of his career.  His appointment started and remained in the Medical School’s Department of Psychiatry where he quickly earned a full professorship.  Others often joked about his “garret” in the State Psychopathic Hospital, describing both a sort of ivory tower and the splendid isolation of having a full time tenured assignment as a research professor.

As a scholastic infant at the time, brought to national sociology meetings while in grad school by my mentor Harry Trice, I remember delight in meeting Hal, a wonderfully social person, a center of the group, but always ready to draw in another member and very attentive to learning who you were and what you wanted to do.  This memory takes away much regret for Hal’s parting, for in his final days he was limited to the setting of a nursing home.  His hearing had deteriorated to the point that he could no longer have a phone conversation.  It is hard not only to imagine him as inactive but not being able to converse at will with his wide range of friends and his loving family.

Amy and Hal, 1948

He and I were once at a conference together in Durham, North Carolina and due to missing the hotel van, got caught on the wrong side of an interstate highway from where the evening cocktail party and dinner were to held.  Highly motivated, as was I, Hal led the way across four lanes of heavy traffic, over some fences and barriers, and into the room with the open bar well before it closed.  From my perspective as a one-time mentee and long-time long-distance friend, he had an incredibly rich and full life.  All the memories I’ve located have focused on his warmth and kindness first, and then the persistence with which he approached hard work.

What must be preserved with Hal’s passing is his unique and unswerving position that alcohol dependence could be most effectively and efficiently resolved at the community level.  He rejected the need for an expensive specialized treatment industry and never gave up this belief.  His alternative model was centered on guiding and supporting people who were ready to recover.  This was accomplished through the availability of a clearly designated agent in the community whose role was centered on the guidance process.  This could include AA, but in my search of his work, Hal never expressed unbridled enthusiasm but simply respect for the Fellowship, recognizing that it played an important role in his community-based scheme but did not work for everyone.  But instead of just talking about it or evaluating it, Hal actually took over operation of one of the treatment programs he designed, at Oakdale, IA, for a period of five years.

His core notion was dreadfully simple, and required no special technologies:  the course of nature has demonstrated, over and over and over, that people who are motivated to change their drinking behavior will do so.  Various types of brute force will not alter this process.  He also articulated, independently from others’ parallel observations, a recovery process that typically if not always began during the individual’s drinking career.  Two ways of looking at this are the “seed of doubt” that develops via some combination of cognitions or, more sociologically, the “spoiling of drinking identity” where a social event that might be minimally visible embeds the notion that one’s drinking behavior is distinctively deviant.

Projecting backward, I am guessing that if Hal’s vision would have been fulfilled, we would something not very much different from the Recovery Movement that has apparently gained a lot of strength in some locales, but which would neither need nor have a linkage with (or homage to) a treatment industry, which would not exist.  By contrast of course, the Recovery Movement seems both foundationally connected and implicitly “beholden” to the treatment industry, longing to some degree to become an institutionalized adjunct to it, replete with some degree of funding.  I will indeed wish Hal were at my side should such observations lead to a debate!

The expected rebuttal to Hal’s anti-establishment position (deeply admired by Stan Peele, among others) is that without formal treatment, alcoholics will die in great numbers, making Mulford’s vision simply negligence through nihilism.  But Hal was not taken by such passionate positions.  My projection is that Hal’s perspective, not flatly articulated in any source that I could find, was centered on cost effectiveness, and it demanded recognition of the massive amount of failure and cost associated with formal treatment.  While he never had the opportunity to conduct a formal clinical trial (and in addition to actually directing a program) he conducted several “comparative effectiveness” studies on this community treatment approach in the Iowa communities where it was successfully implemented for an unknown period of time, with the cost figures always coming out hands-down in favor of his approach.

I have found this stream of Hal’s scholarly work of the greatest fascination, although it might well have been his most frustrating and is certainly his least published.  Fortunately for all of us, two unpublished works by Hal are available at Bill White’s website (www.williamwhitepapers.com) under the titles “Alcoholism in Wonderland: A Memoir” and “Alcohol Abuse and Citizen Action: The Community Counselor/Consultant Approach.”

Turning to his mainstream science, a bibliographic calculation might well show Hal among the top 10 lifetime contributors to what is now the Journal of Studies on Alcohol and Drugs, formerly the Journal of Studies on Alcohol, and before that the Quarterly Journal of Studies on Alcohol.  Hal’s multiple contributions set the stage for empirical definitions of patterns of drinking, preoccupation with drinking, and trouble with drinking.  I used his measures as part of my dissertation research, and at one point had them memorized, with two wry items sticking in particular, “Do you nurse your drinks or just toss them off?” and “I sneak drinks when no one is looking.”  Unfortunately, since I was interviewing mostly female clerical employees in the middle of New York City, I didn’t find many, if any, problem drinkers.

Hal’s main sets of publications were centered on creating social epidemiological measures and then applying them, both in Iowa and nationally.  His later publications comprised a fairly complicated debate regarding the effects of changes in alcohol availability in Iowa, conducted between he and his colleague Jerry Fitzgerald, and Hal Holder, the leading prevention guru at the time.

For a very tiny group of us, too small to make up an association or have a blog, Hal Mulford’s movement onward is very near to the closing of a generation of post-war sociologists who provided a foundation of sorts for alcohol sociology that may or may not survive.  The last three of these veterans (and most were also WWII veterans) who are still amongst us are Joe Gusfield at UC San Diego, George Maddox at Duke and Bob Straus, at the University of Kentucky, with Bob being the one who sat at the foot of the master, Selden Bacon.  Others in this group who have moved on included Dave Pittman, Harry Trice, Milton Maxwell, Earl Rubington, Ed Lemert, Keith Lovald, and Charles Snyder.  While I’ve surely left someone out, this group had its home in the Committee on Drinking Behavior of the Society for the Study of Social Problems, at the time a sort of renegade organizational spin-off from the aloof and “scientific” American Sociological Association.  SSSP members wanted to muck around in the real world of pain and trouble, but not too much.  The time of reference is mainly the 1960s, and while there was some temporal overlap, there was to my knowledge little if any interaction across the group and the emerging social science center at Berkeley.  Characterizing the content of this “SSSP” version of alcohol sociology is a task for another day, but one well worth considering.

SSSP was a little world that Hal enjoyed, and its unabashed ideology offered a good fit with his orientations.  I remember clearly the national meeting I attended in the early 1970s when Hal was noticeably absent.  The talk was, “He can’t get away….he’s running a treatment center!”  The group really didn’t know what to do with that fact……Hal was definitely “off, doing his thing” and taking a far deeper dip in the pond of social reality than the rest of us cared to think about.

He proved his first point about the efficacy and efficiency of the simple and inexpensive treatment delivery system that he had developed, and then when no one paid attention to his findings, he proved his second point, made later in his career at a conference in 1988:

Taking advantage of, and deliberately reinforcing, the public illusion that medical science can diagnose and effectively treat alcoholism, entrepreneurs have built a large and growing alcoholism treatment industry that is rapidly developing into a black hole, sucking in alcoholics, problem drinkers, potential problem drinkers, children of alcoholics, grandchildren of alcoholics, impaired employees, and so on apparently without end.”  (H. A. Mulford, “The extent and patterning of job-related drinking problems,” in Paul M. Roman, ed., Alcohol Problem Intervention in the Workplace:  Employee Assistance Programs and Strategic Alternatives. Westport, CT: Greenwood Press, 1990, 125-140.)