The treatment of addiction, like all areas of treatment, has had its changing fashions. In a recent syndicated column, Ellen Goodman (1990, p. A25) quoted the opening line of Kitty Dukakis' autobiography, “I'm Kitty Dukakis and I'm a drug addict and an alcoholic”. While admiring the fierce honesty of the book, Goodman lamented this self-description which collapses the complex personality she had once known and admired into a mere disease entity. Goodman says, “What troubles me … most … is what the culture of addiction treatment seems to demand of the troubled in this area. Your whole identity”. Now there is no reason to expect Ellen Goodman to understand the ego supportive and healing aspects of the disease concept, or to comprehend the full significance of an addict finally confronting his or her denials and evasions; but at the same time she is voicing a concern which illustrates a changing fashion in the treatment of addictive problems.