When a Man Loves a Woman was one of the most tender romances of the early 90s and remains one of the most empathic, sensitive and yearning films that Hollywood has ever produced about addiction. Written by Ronald Bass and Al Franken, it centres on a San Francisco couple, Alice Green and Michael Green, played by Meg Ryan and Andy Garcia, whose marriage is challenged when Alice turns out to be a serious alcoholic. While Ellen Burstyn and Philip Seymour Hoffman make appearances, their cameos are very slight, leaving most of the two-hour plus run time focused squarely on the couple. Both leads are outstanding, but Ryan delivers one of her very best performances (which crystallises in the final monologue) and also a pivotal performance in the evolution of her career over the 90s. She hadn’t quite settled into her trademark scatty mode at this point, and yet the enormous challenge of the film, which required her to act drunk or semi-drunk for most of the screenplay, also feels like the origin of the nonplussed style that would become her signature.

From one perspective, When a Man Loves a Woman forms part of a broader convergence of mainstream Hollywood and Lifetime melodrama in the early 90s. As in a Lifetime film, there are moments here that are quite raw, especially the scene when Alice’s alcoholism manifests itself for the first time. Her daughter, Jess, played by Tina Majorina, bears the brunt of it, first when Alice strikes her (“I hit her so hard”) and then when she finds that her mother has collapsed through the glass wall of the shower, and is lying prone on the bathroom floor surrounded by blood and broken shards, which leads her to call Michael with the most traumatic news imaginable to a young child: “Mommy died.” Of course, Alice is not dead, but her alcoholism is confronting in a different way, and sees her whisked off to a sanatorium in the second act, where this Lifetime approach segues into the lexicon of an older strand of Hollywood films about addiction: “How was rehab?” “It was nifty…I threw up like a good girl.”

Nevertheless, this rehab sequence is a mere interlude, and never displaces us too much from the focus on San Francisco, which is one of the strong points of the film. For the circuitous and vertiginous sightlines of the City by the Bay work perfectly for a protagonist who is perpetually tipsy, to the point where the undulations of the city often seem to signal a major alcoholic bout before Alice has reached it, or become fully aware of it. One of her recurring alcoholic symptoms seems to be crawling out to the curb of her hilly street, and failing to navigate the transition from the level floor of the house to the dropoff of the slope, as if her addiction had allowed her to commune with the topography beneath the city’s infrastructure.

When a Man Loves a Woman thus forms part of a broader trend of 90s films that saw San Francisco as a metaphor for downward mobility, and the decline of the nuclear family, from Pacific Heights to Mrs. Doubtfire, an anxiety that here constellates around the cautionary tale of another alcoholic that circulated around Alice’s neighbourhood until it became the stuff of urban legend. This woman, Alice recalls, came from money, had a loving family, and lectured at Stanford, but still ended up sleeping under a bridge in Golden Gate Park when the drink overtook her. By the third act, the city has proliferated into two alternative futures, one in which Alice retains her middle-class status, and one in which she loses it, suffusing us in a dreamy temporality that conjures up Vertigo, especially once Michel starts to trace, track and trail her, partly to make sure she is safe, but also in an attempt to discern an echo of the woman he once knew. This trajectory culminates with a direct nod to Hitchcock’s film, in which Michael watches Alice as she gazes across San Francisco Bay, directly beneath the Golden Gate Bridge, seeing in the waters a mirage of the liquid that has caused her such grief.

Inflected through Alice’s addiction, this cityscape often approaches the sinister overtones of the 90s erotic thriller – and certainly When a Man Loves a Woman has the same sensuous strangeness, the same awry excess of libido, that defined the erotic thriller at its peak. We see this arcane extravagance early on, in the midst of one of Alice’s benders, when she responds to a busted car alarm by running outside and pelting eggs at the offending vehicle, before Michael joins her in a desperate attempt to lean into and inhabit her offbeat jouissance. Over time, this energy shifts to the beats and tics of their relationship, which depends on public displays of affection, moments of knowing sexual communion, that revel in the thrill of being insiders with one another, performing their intimacy while all the world is present. However, this energy becomes more desperate as the film proceeds, as if their libido has taken a fatal hit, until it emerges that their marriage’s eroticism is bound up with Alice’s alcoholism. Unable to get completely intoxicated on each other any more, the whole pleasure-principle of their marriage turns awry, unleashing a swathe of unresolved appetites.

To some extent, this evokes a certain anhedonia, a social malaise that transcends alcoholism and prevents When a Man Loves a Woman from ever quite approximating a traditional romance. The institution of the nuclear marriage and family continually reconfigures itself in one tensile formation after another as Alice and Michael dodge and weave around the desire that both sustains and eludes them, as we learn that one of the foundations of their relationship was his ability to put her back together (as she puts it) every time she became drunk. She starts to resent him, he starts to resent her for resenting him, they grow more distant, they grow closer, their family feels more precious, but also more fictional, as a late twist of sorts reveals that Michael is not even the biological father of their children, but a stepfather, and that the real father is entirely out of the picture. We realise, retrospectively, that the fantasy of the nuclear marriage and family has already been obliterated, much as Alice and Michael come to realise that instead of preserving this middle-class norm of respectability, they have to strive for a more provisional and open-ended mode of intimacy.

Director Luis Mandoki evokes this new intimacy in the very first scene of the film, which sees Michael and Alice run into each other in a San Francisco bar, as apparent strangers, while Alice is being chatted up by another stranger. Michael cuts in, and it soon emerges that he knows Alice, but the exact import of this scene is hard to fit with the narrative follows – when it occurs, why it occurs, what it says about their relationship, or how it contours Alice’s alcoholism, since it can’t be a coincidence that she is drinking alone when Michael comes upon her. Instead of making strict narrative sense, this scene operates more to capture a public-private threshold that by definition can’t fit into a Hollywood form of romantic narrative that fetishises the division of public and private life above all else. Just as it’s impossible to situate this scene with respect to the narrative that follows, so it’s impossible to figure out exactly how much of it is play-acting, and how much of it is sincere, since the couple never reference it, either as an event or as a ritual. Instead, the scene brims with the provisional and performative sense of self that occurs when public and private lives overlap – a selfhood that, in the midst of a crowd of sailors, on what appears to be Fleet Week in San Francisco, feels irredudibly queer. No surprise, then, that when Michael and Alice reunite after her time in rehab, Mandoki signals the change in their relationship by harkening back to Ryan’s role as adjunct to queer romance in Top Gun, as Michael, an pilot, comes across her clad in a bomber jacket, and the film briefly shifts into Tony Scott’s maximalist-emotive mode.

Over the film that follows, Alice and Michael realises that to deal with her addiction, and find a new outlet for their mutual intoxication, they have to embrace this same queasy position on the threshold of public space. Alice’s final gesture, in this respect, is the tell-all that ends the film, a reckoning of her sins in front of her AA meeting that reminded me of the conclusion of Notting Hill, which is equally fixated with this public-private threshold, but from the perspective of celebrity allure as it stood in the mid 90s. As in Notting Hill, this public moment is also radically private, since it turns out that Michael, like Hugh Grant’s character, is waiting and watching in the crowd. As with Notting Hill, too, the couple here never retreat to a conventional privacy, but remain poised at this nexus between their most personal lives and mass spectatorship, which Mandoki signals first by cutting between Alice’s speech and anonymous members of the crowd, and then crystallises into a final pan that pulls us back from Alice and Michael’s embrace until they’re embraced by the crowd milling around them.

The great generosity of When A Man Loves a Woman stems from this willingness to have the two leads meet each other halfway, in a reconfigured public-private sphere, rather than shoehorning them back into the public and private labours of a traditional Hollywood romance. That produces a remarkably sensitive treatment of alcoholism, equally compassionate to both parties, that captures the conundrum and opacity of addiction as a mental health crisis, a “cunning, baffling disease” that the film scrupulously refrains from ever really attempting to explain. Even Alice can’t quite articulate why her alcoholism peaked when it did, reflecting, in her final speech, that “when you don’t know, you just don’t know.” Likewise, she tells Michael, in the midst of their most impassioned argument, that “I think I could love you again, if for once you just said “I don’t know.” And it is that ability to not know together, to feel their way through a new kind of open-ended intimacy, that makes Mandoki’s film so ahead of its time, so resonant even thirty years later, and so sensitively and surprisingly attuned to the queer collectivity of early 90s San Francisco: “My wife is an alcoholic. Best person I ever met.”