WE OF Alcoholics Anonymous
believe that the reader will be interested in the medical estimate
of the plan of recovery described in this book. Convincing
testimony must surely come from medical men who have had
experience with the sufferings of our members and have witnessed
our return to health. A well known doctor, chief physician at a
nationally prominent hospital specializing in alcoholic and drug
addiction, gave Alcoholics Anonymous this letter:
To Whom It May Concern:
I have specialized in the
treatment of alcoholism for many years.
In late 1934 I attended a
patient who, though he had been a competent business man of good
earning capacity, was an alcoholic of a type I had come to
regard as hopeless.
In the course of his third
treatment he acquired certain ideas concerning a possible means
of recovery. As part of his rehabilitation he commenced to
present his conceptions to other alcoholics, impressing upon
them that they must do likewise with still others. This has
become the basis of a rapidly growing fellowship of these men
and their families. This man and over one hundred others appear
to have recovered.
I personally know scores of
cases who were of the type with whom other methods had failed
completely.
These facts appear to be of
extreme medical importance; because of the extraordinary
possibilities of rapid growth inherent in this group they may
mark a new epoch in the annals of alcoholism. These men may well
have a remedy for thousands of such situations.
You may rely absolutely on
anything they say about themselves.
Very truly yours,
(Signed) - - - - - M.D.
The physician who, at our request,
gave us this letter, has been kind enough to enlarge upon his
views in another statement which follows. In this statement he
confirms what we who have suffered alcoholic torture must
believe-that the body of the alcoholic is quite as abnormal as his
mind. It did not satisfy us to be told that we could not control
our drinking just because we were maladjusted to life, that we
were in full flight from reality, or were outright mental
defectives. These things were true to some extent, in fact, to a
considerable extent with some of us. But we are sure that our
bodies were sickened as well. In our belief, any picture of the
alcoholic which leaves out this physical factor is incomplete.
The doctor's theory that we have
an allergy to alcohol interests us. As laymen, our opinion as to
its soundness may, of course, mean little. But as ex-problem
drinkers, we can say that his explanation makes good sense. It
explains many things for which we cannot otherwise account.
Though we work out our solution
on the spiritual as well as an altruistic plane, we favor
hospitalization for the alcoholic who is very jittery or befogged.
More often than not, it is imperative that a man's brain be
cleared before he is approached, as he has then a better chance of
understanding and accepting what we have to offer.
The doctor writes:
The subject presented in this
book seems to me to be of paramount importance to those afflicted
with alcoholic addiction.
I say this after many years'
experience as Medical Director of one of the oldest hospitals in
the country treating alcoholic and drug addiction.
There was, therefore, a sense of
real satisfaction when I was asked to contribute a few words on a
subject which is covered in such masterly detail in these pages.
We doctors have realized for a
long time that some form of moral psychology was of urgent
importance to alcoholics, but its application presented
difficulties beyond our conception. What with our ultra-modern
standards, our scientific approach to everything, we are perhaps
not well equipped to apply the powers of good that lie outside our
synthetic knowledge.
Many years ago one of the leading
contributors to this book came under our care in this hospital and
while here he acquired some ideas which he put into practical
application at once.
Later, he requested the privilege
of being allowed to tell his story to other patients here and with
some misgiving, we consented. The cases we have followed through
have been most interesting; in fact, many of them are amazing. The
unselfishness of these men as we have come to know them, the
entire absence of profit motive, and their community spirit, is
indeed inspiring to one who has labored long and wearily in this
alcoholic field. They believe in themselves, and still more in the
Power which pulls chronic alcoholics back from the gates of death.
Of course an alcoholic ought to
be freed from his physical craving for liquor, and this often
requires a definite hospital procedure, before psychological
measures can be of maximum benefit.
We believe, and so suggested a
few years ago, that the action of alcohol on these chronic
alcoholics is a manifestation of an allergy; that the phenomenon
of craving is limited to this class and never occurs in the
average temperate drinker. These allergic types can never safely
use alcohol in any form at all; and once having formed the habit
and found they cannot break it, once having lost their
self-confidence, their reliance upon things human, their problems
pile up on them and become astonishingly difficult to solve.
Frothy emotional appeal seldom
suffices. The message which can interest and hold these alcoholic
people must have depth and weight. In nearly all cases, their
ideals must be grounded in a power greater than themselves, if
they are to re-create their lives.
If any feel that as psychiatrists
directing a hospital for alcoholics we appear somewhat
sentimental, let them stand with us a while on the firing line,
see the tragedies, the despairing wives, the little children; let
the solving of these problems become a part of their daily work,
and even of their sleeping moments, and the most cyni cal will not
wonder that we have accepted and encouraged this movement. We
feel, after many years of experience, that we have found nothing
which has contributed more to the rehabilitation of these men than
the altruistic movement now growing up among them.
Men and women drink essentially
because they like the effect produced by alcohol. The sensation is
so elusive that, while they admit it is injurious, they cannot
after a time differentiate the true from the false. To them, their
alcoholic life seems the only normal one. They are restless,
irritable and discontented, unless they can again experience the
sense of ease and comfort which comes at once by taking a few
drinks-drinks which they see others taking with impunity. After
they have succumbed to the desire again, as so many do, and the
phenomenon of craving develops, they pass through the well-known
stages of a spree, emerging remorseful, with a firm resolution not
to drink again. This is repeated over and over, and unless this
person can experience an entire psychic change there is very
little hope of his recovery.
On the other hand-and strange as
this may seem to those who do not understand-once a psychic change
has occurred, the very same person who seemed doomed, who had so
many problems he despaired of ever solving them, suddenly finds
himself easily able to control his desire for alcohol, the only
effort necessary being that required to follow a few simple rules.
Men have cried out to me in
sincere and despairing appeal: "Doctor, I cannot go on like
this! I have everything to live for! I must stop, but I cannot!
You must help me!"
Faced with this problem, if a
doctor is honest with himself, he must sometimes feel his own
inadequacy. Although he gives all that is in him, it often is not
enough. One feels that something more than human power is needed
to produce the essential psychic change. Though the aggregate of
recoveries resulting from psychiatric effort is considerable, we
physicians must admit we have made little impression upon the
problem as a whole. Many types do not respond to the ordinary
psychological approach.
I do not hold with those who
believe that alcoholism is entirely a problem of mental control. I
have had many men who had, for example, worked a period of months
on some problem or business deal which was to be settled on a
certain date, favorably to them. They took a drink a day or so
prior to the date, and then the phenomenon of craving at once
became paramount to all other interests so that the important
appointment was not met. These men were not drinking to escape;
they were drinking to overcome a craving beyond their mental
control.
There are many situations which
arise out of the phenomenon of craving which cause men to make the
supreme sacrifice rather than continue to fight.
The classification of alcoholics
seems most difficult, and in much detail is outside the scope of
this book. There are, of course, the psychopaths who are
emotionally unstable. We are all familiar with this type. They are
always "going on the wagon for keeps." They are
over-remorseful and make many resolutions, but never a decision.
There is the type of man who is
unwilling to admit that he cannot take a drink. He plans various
ways of drinking. He changes his brand or his environment. There
is the type who always believes that after being entirely free
from alcohol for a period of time he can take a drink without
danger. There is the manic-depressive type, who is, perhaps, the
least understood by his friends, and about whom a whole chapter
could be written.
Then there are types entirely
normal in every respect except in the effect alcohol has upon
them. They are often able, intelligent, friendly people.
All these, and many others, have
one symptom in common: they cannot start drinking without
developing the phenomenon of craving. This phenomenon, as we have
suggested, may be the manifestation of an allergy which
differentiates these people, and sets them apart as a distinct
entity. It has never been, by any treatment with which we are
familiar, permanently eradicated. The only relief we have to
suggest is entire abstinence.
This immediately precipitates us
into a seething caldron of debate. Much has been written pro and
con, but among physicians, the general opinion seems to be that
most chronic alcoholics are doomed.
What is the solution? Perhaps I
can best answer this by relating one of my experiences.
About one year prior to this
experience a man was brought in to be treated for chronic
alcoholism. He had but partially recovered from a gastric
hemorrhage and seemed to be a case of pathological mental
deterioration. He had lost everything worth while in life and was
only living, one might say, to drink. He frankly admitted and
believed that for him there was no hope. Following the elimination
of alcohol, there was found to be no permanent brain injury. He
accepted the plan outlined in this book. One year later he called
to see me, and I experienced a very strange sensation. I knew the
man by name, and partly recognized his features, but there all
resemblance ended. From a trembling, despairing, nervous wreck,
had emerged a man brimming over with self-reliance and
contentment. I talked with him for some time, but was not able to
bring myself to feel that I had known him before. To me he was a
stranger, and so he left me. A long time has passed with no return
to alcohol.
When I need a mental uplift, I
often think of another case brought in by a physician prominent in
New York City. The patient had made his own diagnosis, and
deciding his situation hopeless, had hidden in a deserted barn
determined to die. He was rescued by a searching party, and, in
desperate condition, brought to me. Following his physical
rehabilitation, he had a talk with me in which he frankly stated
he thought the treatment a waste of effort, unless I could assure
him, which no one ever had, that in the future he would have the
"will power" to resist the impulse to drink.
His alcoholic problem was so
complex, and his depression so great, that we felt his only hope
would be through what we then called "moral psychology,"
and we doubted if even that would have any effect.
However, he did become
"sold" on the ideas contained in this book. He has not
had a drink for a great many years. I see him now and then and he
is as fine a specimen of manhood as one could wish to meet.
I earnestly advise every
alcoholic to read this book through, and though perhaps he came to
scoff, he may remain to pray.
