Looking around her living room that spring morning former First Lady Betty Ford, like most hard-drinking junkies, didn’t quite get it.
“My makeup wasn’t smeared, I wasn’t disheveled, I behaved politely, and I never finished off a bottle, so how could I be an alcoholic?” she recalled years later. “And I wasn’t on heroin or cocaine. The medicines I took — the sleeping pills, the pain pills, the relaxer pills, the pills to counteract the side effects of other pills — had been prescribed by doctors, so how could I be a drug addict?” One medical professional in the room that day remembers that Ford “looked small, almost like a doll, lost in the [sofa] cushions, and as her husband made his opening remarks, you could see the confusion on her face.”
Ford was still in her bathrobe as, one by one, her husband and children told her the truth. Former President Gerald R. Ford lamented the slurring of her speech. Son Mike and his wife Gayle raised the possibility that she wouldn’t live long enough to ever know the children they intended to have. Son Steve recounted the day he and his girlfriend prepared an elaborate dinner for her, only to have her ignore their efforts as she watched TV and slid into an alcoholic haze. Son Jack said he “was always kind of peeking around the corner into the family room to see what kind of shape mother was in.” Daughter Susan, who had rallied the family to confront its matriarch, broke down as she explained how she had always admired her mother’s grace as a Martha Graham-trained dancer and couldn’t stand to see her “falling and clumsy.”
The Ford family intervention didn’t take long that morning of April 1, 1978, but it began a series of events that profoundly changed Betty Ford’s life and much more. She agreed to undergo a week of medically supervised detoxification — during which she was weaned from alcohol, Librium, and what she later described as “gourmet medications” — at her brand-new Rancho Mirage home. Then, the day after her 60th birthday, Ford was driven two hours to the Navy hospital in Long Beach to learn the 12 Steps of Alcoholics Anonymous. Suddenly the term “public drunkenness” took on a whole new meaning.
After settling into a standard room with three roommates, Ford released a statement that, without apology, described her intention to overcome her “insidious” addictions.
By making hers a public rather than a private struggle, straight-talking Betty Ford transformed the image of a drug-abusing alcoholic from a nameless, faceless loser into a noble and likable survivor. She helped diminish the stigma long associated with addiction and treatment, especially for women.
The grim surprise party that started her down that road also spawned a recovery movement that Ford never could have imagined, a national conversation in which troubled souls seemed willing, even eager, to make a cathartic public confession or act of contrition. In the decades that followed, it became hard to turn on a television talk show without hearing survivors’ tales about overcoming everything from incest, gender confusion, compulsive eating disorder, and bulimia to sexual addiction, co-dependence, rape, even alien abduction and satanic possession.
To understand why Betty Ford’s intervention had such impact, it’s important to understand her unexpected role in what’s known as the “modern alcoholism movement,” which began in 1935 when two men — a New York stockbroker (Bill W.) and an Akron, Ohio, surgeon (Dr. Bob S.) — pioneered a method of dealing quietly and anonymously with addiction by creating Alcoholics Anonymous and preaching the 12-step gospel that has changed countless apostles. Back then and into the 1960s, no one knew quite what to do with drunks and junkies. Some steered them into mutual-aid societies such as A.A., or simply watched them medicate themselves to death. Others dispatched their substance abusers to sanitariums for rounds of detox. Still others subjected substance abusers to experimental behavior-modification treatments, including hypnosis, electroshock therapy, and methadone treatment.
In 1970, the federal Hughes Act officially recognized drug and alcohol addiction as a disease, setting the stage for what eventually became a multibillion-dollar-a-year industry of specialty treatment centers, court-ordered compliance, and sophisticated marketing. Even so, there remained a social stigma.
Betty Ford in 1978 didn’t fit neatly into any of the public’s stereotypes of a drunk or a drug addict. She was a very clean, very polite, very successful substance abuser — someone admired rather than reviled.
Indeed, she left the White House in January 1977 as the most popular First Lady since Jackie Kennedy. She had entered the international spotlight in a buttoned-down era when the prototypical Republican wife was a lacquer-haired deaf-mute with the adoring eyes of an acolyte. (Can you describe Pat Nixon’s voice? Didn’t think so.) Born in Chicago and raised in Grand Rapids, Mich., Ford brought to Washington a Midwesterner’s tendency to honestly answer any question. This is not a custom in Washington, D.C., where one of Ford’s early exchanges with the White House press corps signaled an era of often refreshing honesty in the nation’s capitol.
“Why didn’t you tell us?” a reporter once scolded after learning that Mrs. Gerald Ford had once been Mrs. Bill Warren.
“You never asked,” she replied.
One of Ford’s first unofficial actions as First Lady was to publicly declare her intention to sleep not only in the same White House bedroom as her husband, but in the same bed, thereby raising the possibility, technically, that sex could occur.
She’d proudly declared her enthusiastic support for the Equal Rights Amendment for women — a position not shared by her husband or his party — and when her husband was vice president under Richard Nixon, she told Barbara Walters how pleased she was by the Supreme Court’s 1972 Roe vs. Wade decision legalizing abortion. President Ford’s press secretary issued a statement declaring that Gerald Ford “long [ago] ceased to be perturbed by his wife’s remarks.”
Ford also was aware of the positive public impact that her personal behavior could have. A month after moving into the White House, her doctors had found a malignant lump and were forced to remove her right breast. Ford immediately went public with the news and began a course of chemo-therapy in the public spotlight. Supportive mail poured in, and the American Cancer Society saw a spike in donations. “Even before I was able to get up, I lay in bed and watched television and saw on the news shows lines of women queued up to go in for breast examinations because of what had happened to me,” she later recalled. One of those women was Happy Rockefeller, wife of then-Vice President Nelson Rockefeller. Turns out she had a lump, too, and had a similar operation a month after Ford’s mastectomy. Her husband credited Ford’s frank public disclosure with saving his wife’s life.
After leaving the White House, Betty Ford hired ghostwriter Chris Chase and set to work on her autobiography, The Times of My Life. She and Jerry eventually retreated to Rancho Mirage, and by the spring of 1978, she was polishing the final chapters. Ford devoted early chapters to her unlikely rise to the pinnacle of power. In later chapters, she recounted the many moments when her candor had caught official Washington and much of the nation off-guard.
But nothing in Ford’s nearly finished manuscript hinted at the most startling truth of all, one that not only would require a rushed final chapter for that book — subtly titled “Long Beach” — but an entirely new autobiography less than a decade later that dealt entirely with her battle against addiction. She had completely ignored her slide into a haze of cocktails and pain pills — apparently the only Ford family member able to do so.
The intervention, back then, had not yet become one of the most controversial features of the recovery culture. The idea is based on the theory that the most effective way to compel someone with a problem to seek treatment is for the people closest to them, family and friends, to confront them with the truth about how the problem has affected their lives. Interventions represent a significant departure from the methods established by the founders of A.A., who favored a volunteer, rather than a confrontational, approach. This also was long before the horror stories of abuse in which well-intentioned parents essentially had their troubled children kidnapped and hauled off to tough-love treatment facilities.
Ford was no less skeptical that morning as her family gathered from around the country to confront her in a home still filled with moving boxes. But a week later, the former First Lady of the United States of America was taking meals in a basement cafeteria at the Navy base and sharing a room with three other women. One was an admiral’s wife with a taste for Valium; the other two were young, regular Navy. As word spread about Ford’s treatment, the media began to portray addiction as a disease with no discernible demographic: the great equalizer.
“After I came into the hospital, it was as though a dam had burst,” Ford later recalled. “Newspapers and magazines poured in, filled with articles about women and drugs and alcohol. Bags of mail followed, and flowers, and messages sent by well-wishers.”
Two years after her intervention and public disclosure, on Oct. 9, 1981, Betty Ford helped break ground for an addiction treatment center at Eisenhower Medical Center in Rancho Mirage. She committed her fund- and consciousness-raising efforts to the cause and, reluctantly, lent her name and face to what has become the best-known facility of its kind in the world. The Betty Ford Center was dedicated one year later. One of the earliest to step forward for treatment was another of America’s most influential women, actress Elizabeth Taylor. Her decision to disclose her struggle had nearly as much impact as Ford’s in terms of destigmatizing alcohol and drug rehabilitation.
Taylor’s treatment also added a touch of glamour to the Betty Ford Center and to treatment in general, paving the way for other celebrity substance abusers to talk about their addictions and treatment. A curious snowballing began. At the time, insurance laws made rehab centers a potential profit center for hospitals, and facilities began cropping up fast.
The language began to soften. “Drunks” and “drug fiends” became “alcoholics” and “substance abusers.” The people around them became “enablers” and “co-dependents.” The culture began suspending harsh judgments and began looking to family histories and childhood traumas as a way to explain someone’s addiction. Ford’s treatment also was followed by what one addiction specialist calls a “new temperance movement.” Mothers Against Drunk Driving was founded in 1980, the same year First Lady Nancy Reagan’s “Just Say No!” slogan became the most memorable — and ridiculed — catchphrases of that decade. Warnings began to appear on beer, wine, and liquor labels, and anti-alcohol and drug programs became a staple of secondary and even elementary education.
More than 53,000 patients have sought help at Betty Ford Center since it opened. They have included homemakers, truck drivers, doctors, lawyers, athletes — some nearly as famous as Ford and Taylor: baseball legends Mickey Mantle and Darryl Strawberry, football player Todd Marinovich, country music singer Tanya Tucker. The list reads like a Who’s Who of the entertainment and sports worlds even though celebrities represent only a fraction of the center’s clients.
But after all the talk, after decades of often dramatic self-exposure, there remains a bottom line: A government report suggests that of the estimated 13 million to 16 million Americans who need treatment for alcohol or drug problems in any given year, only 3 million actually receive it. And something else is happening that Ford could not have foreseen that day in 1978. While recovery has changed lives for the better, and while Ford’s public struggle coaxed thousands of closeted addicts into the open and diminished the stigma of treatment, the lasting impact of all those public acts of contrition is hard to pin down. The snowball began to melt.
The Substance Abuse and Mental Health Services Administration, an arm of the federal Department of Health and Human Services, has designated September as National Alcohol and Drug Addiction Recovery Month partly because of a “restigmatization” of substance abuse and addiction in recent years. That same agency notes the impact of critics who have raised concerns about whether substance abuse is a medical or a behavioral problem. The backlash is obvious from a search of the Amazon.com online book catalog, which contains titles such as Peele’s Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control and I’m Dysfunctional, You’re Dysfunctional: The Recovery Movement and Other Self-Help Fashions by Wendy Kaminer.
Spending on substance abuse treatment between 1987 and 1997 shifted heavily from private to public, meaning that fewer alcoholics and drug addicts in this age of managed care can count on insurance companies and other private payers to cover the cost of treatment.
“Three trends are evident since 1990,” wrote William L. White, author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America. “The first is the restigmatization of severe and persistent alcohol and other drug problems. The images of First Ladies, next-door neighbors, and our own family members are being replaced with more demonized images that elicit fear and anger rather than compassion.” White said that trend, combined with the “demedicalization” of treatment and the “recriminalization” of addiction, now finds people like Betty Ford portrayed as “infectious agent[s] of evil” and recovery as an exception rather than a rule.
White has called for a “New Recovery Movement” in which “a vanguard of recovering people…step forward to offer themselves as living proof of the hope for sustained recovery from addiction” — a seemingly radical departure from the A.A. philosophy. During a speech to a New Jersey recovery group several years ago, White wistfully recalled Ford’s long-ago public confession as perhaps the best moment in the country’s history to be an alcoholic.
From the book Poplorica: A Popular History of the Fads, Mavericks, Inventions, and Lore that Shaped Modern America by Martin J. Smith and Patrick J. Kiger.
Published by arrangement with HarperCollins Publishers. All rights reserved.