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Anonymous in it's Third Decade
to the New York City Medical Society on Alcoholism
By Bill W., April 28, 1958
years ago, I read a paper before the Medical Society of
the State of New York at its annual gathering. For us
of Alcoholics Anonymous, that was a history-making event;
it marked the first time that any of Americas great
medical associations had taken favorable notice of our
Fellowship. The physicians of that day did far more than
take notice of us; they received us with open arms and
allowed our account of AA to be published in their Journal.
Reprints of that 1944 paper have since been scattered
in tens of thousands of copies throughout the world, convincing
physicians everywhere of AAs worth. What this perceptive
and generous act has since meant to countless alcoholics
and their families, only God Himself knows.
appreciative that the members of the New York Medical
Society on Alcoholism have in the same generous spirit
invited me to be here tonight, it is with a sense of timeless
gratitude that I bring you greetings from those 250,000
recovered alcoholics who now comprise cur membership in
some 7,000 groups, here and abroad.
the better way to understand AAs methods and results
is to have a look at its beginnings, at that time when
medicine and religion entered into their benign partnership
with us. This partnership is now the foundation of such
success as we have since had.
nobody invented Alcoholics Anonymous. AA is a synthesis
of principles and attitudes which came to us from medicine
and from religion. We alcoholics have simply streamlined
those forces, adapting them to our special use in a society
where they can work effectively. Our contribution was
but the missing link in a chain of recovery which is now
so significant, and of such promise for the future.
people know that the first taproot of AA hit paydirt some
thirty years ago in a physicians office. Dr. Carl
Jung, that great pioneer in psychiatry, was talking to
an alcoholic patient. This, in effect, is what happened
patient, a prominent American businessman, had gone the
typical alcoholic route. He bad exhausted the possibilities
of medicine and psychiatry in the United States and had
then come to Dr. Jung as to a court of last resort. Carl
Jung had treated him for a year and the patient, whom
we shall call Mr. R., felt confident that the hidden springs
underneath his compulsion to drink had been discovered
and removed. Nevertheless, he found himself intoxicated
within a short time after leaving Dr. Jungs care.
he was back, in a state of black despair. He asked Dr.
Jung what the score was, and he got it. In substances,
Dr. Jung said, "For some time after you came here,
I continued to believe that you might be one of those
rare cases who could make a recovery. But, I must now
frankly admit that I have never seen a single case recover
through the psychiatric art where the neurosis is so severe
as yours. Medicine has done all that it can for you, and
thats where you stand.
R.s depression deepened. He asked: "is there
no exception; is this really the end of the line for me?"
replied the doctor, "There are some exceptions, a
very few. Here and there, once in a while, alcoholics
have had what are called vital spiritual experiences.
They appear to be in the nature of huge emotional displacements
and rearrangements. Ideas, emotions and attitudes which
were once the guiding forces of these men are suddenly
cast to one side, and a completely new set of conceptions
and motives begin to dominate them. In fact, I have been
trying to produce some such emotional rearrangement within
you. With many types of neurotics, the methods which I
employ are successful, but I have never been successful
with an alcoholic of your description."
protested the patient, "Im a religious man,
and I still have faith." To this Dr. Jung replied,
"Ordinary religious faith isnt enough. What
Im talking about is a transforming experience, a
conversion experience, if you like. I can only recommend
that you place yourself in the religious atmosphere of
your own choice, that you recognize your personal hopelessness,
and that you cast yourself upon whatever God you think
there is. The lightening of the transforming experience
may then strike you. This you must try- it is your only
way out." So spoke a great and tumble physician.
the AA-to- be, this was a ten-strike. Science had pronounced
Mr. R. virtually hopeless. Dr. Jung s words had
struck him at great depth, producing an immense deflation
of his ego. Deflation at depth is today a cornerstone
principle of AA. There in Dr. Jungs office it was
first employed in our behalf.
patient, Mr. R., chose the Oxford Groups of that day as
his religious association and atmosphere. Terribly chastened
and almost hopeless, he began to be active with them.
To his intense joy and astonishment, the obsession to
drink presently left him.
to America, Mr. R. came upon an old school friend of mine,
a chronic alcoholic. This friend - whom we shall call
Ebby- was about to be committed to a state mental hospital.
At this juncture another vital ingredient was added to
the AA synthesis. Mr. R., the alcoholic, began talking
to Ebby, also an alcoholic and a kindred sufferer. This
made for identification at depth, a second cardinal AA
principle. Over this bridge of identification, Mr. K.
passed Dr. Jungs verdict of how hopeless, medically
and psychiatrically, most alcoholics were. He then introduced
Ebby to the Oxford Groups where my friend promptly sobered
friend Ebby knew well of my plight. I had gone the familiar
course. In the summer of 1934 my doctor, William D. Silkworth,
had given me up and had pronounced me hopeless. He had
been obliged to tell me that I was the victim of a neurotic
compulsion to drink that no amount of will power, education
or treatment could check. He added that I was also the
victim of a bodily derangement which might be in the nature
of an allergy - a physical malfunction that virtually
guaranteed brain damage, insanity or death. Here again
the God of Science-which was then my only god - had well
deflated me. I was ready for the message that was soon
to come from my alcoholic friend Ebby.
came to my house one day in November, 1934, and sat across
the kitchen table from me while I drank. No thanks, he
didnt want any liquor, he said. Much surprised,
I asked what had got into him. Looking straight at me,
he said he had "got religion." This was a real
crusher, an affront to my scientific training. As politely
as possible, I asked what brand of religion he had.
he told me of his conversations with Mr. K, and how hopeless
alcoholism really was, according to Dr. Carl Jung. Added
to Dr. Silkworths verdict, this was the worst possible
news. I was hard hit. Next Ebby enumerated the principles
he had learned from the Oxford Groups. Though he thought
these good people sometimes too aggressive, he certainly
couldnt find any fault with most of their basic
teachings. After all, these teachings had sobered him
substance, here they are, as my friend applied them to
himself in 1934:
Ebby admitted that he was powerless to manage his own
2. He became honest with himself as never before and made
an "examination of conscience."
3. He made a rigorous confession of his personal defects
and thus quit living alone with his problems.
4. He surveyed his distorted relations with other people,
visiting them to make what amends he could.
5. He resolved to devote himself to helping others in
need, without the usual demand for personal prestige or
6. By meditation he had sought Gods direction for
his life and the help to practice these principles of
conduct at all times.
sounded pretty naive to me. Nevertheless, my friend stuck
to the plain tale of what had happened. He related how,
practicing these simple precepts, his drinking had unaccountably
stopped. Fear and isolation had left, and he had received
a considerable peace of mind. With no hard disciplines nor
any great resolves, these changes began to appear the moment
he conformed. His release from alcohol seemed to be a by-product.
Though sober but months, he felt sure he had a basic answer.
Wisely avoiding arguments, he then took his leave. The spark
that was to become Alcoholics Anonymous had been struck.
One alcoholic had been talking to another, making a deep
identification with me and bringing the principles of recovery
within my reach.
first, my friends story generated mixed emotions,
I was drawn and revolted by turns. My solitary drinking
went on for some weeks, but I could not forget his visit.
Several themes coursed in my mind: first, that his evident
state of release was strangely and immensely convincing;
second, that he had been pronounced hopeless by competent
doctors; third, that these age-old precepts, when transmitted
by him, struck me with great power; fourth, that I could
not, and would not, go along with any God concept, that
there would be no conversion nonsense for me. Often trying
to divert my thoughts, I found it no use. By cords of understanding,
suffering and simple verity, another alcoholic had bound
me to him. I could not break away.
morning after my gin, this realization welled up. "Who
are you," I asked, "to choose how you are going
to get well? Beggars are not choosers. Supposing medicine
said carcinoma was your trouble. You would not turn to Ponds
extract. In abject haste you would beg a doctor to kill
those hellish cancer cells. If he couldnt stop them,
and you thought religious conversion might, your pride would
fly away. If need be, you would stand in a public square,
crying Amen along with other victims. What difference
then," I reflected, "between you and the cancer
victim? His sick body crumbles. Likewise, your personality
crumbles, your obsession consigns you to madness or the
undertaker. Are you going to try your friends formula -
course, I did try. In December, 1934, I appeared at Towns
Hospital, New York. My old friend, Dr. William Silkworth,
shook his head. Soon free of sedation and alcohol, I felt
horribly depressed. My friend Ebby turned up. Though glad
to see him, I shrank a little. I feared evangelism, but
nothing of the sort happened. After some small talk, I again
asked him for his neat little formula for recovery. Quietly
and sanely, without the slightest pressure, he told me.
Then he left.
there in conflict, I dropped into the blackest depression
I had ever known. Momentarily my prideful depression was
crushed. I cried out, "Now I am ready to do anything
- anything to receive what my friend Ebby has." Though
I certainly didnt expect anything, I did make this
frantic appeal, "If there be a God, will He show Himself!"
The result was instant, electric, beyond description. The
place seemed to light up, blinding white. I knew only ecstasy
and seemed on a mountain. A great wind blew, enveloping
and penetrating me. To me, it was not of air, but of Spirit.
Blazing, there came the tremendous thought, "You are
a free man." Then the ecstasy subsided. Still on the
bed, I now found myself in a new world of consciousness
which was suffused by a Presence. One with the universe,
a great peace stole over me. I thought, "So this is
the God of the preachers, this is the Great Reality."
But soon my so-called reason returned, my modern education
took over. I thought I must be crazy, and I became terribly
Silkworth, a medical saint if ever there was one, came in
to hear my trembling account of this phenomenon. After questioning
me carefully, he assured me that I was not mad, that I had
perhaps undergone a psychic experience which might solve
my problem. Skeptical man of science though he then was,
this was most kind and astute. If he had said, "hallucination,"
I might now be dead. To him I shall ever be eternally grateful.
fortune pursued me. Ebby brought me a book entitled "Varieties
of Religious Experiences" and I devoured it. Written
by William James, the psychologist, it suggests that the
conversion experience can have objective reality. Conversion
does alter motivation, and it does semi-automatically enable
a person to be and to do the formerly impossible. Significant
it was that marked conversion experience came mostly to
individuals who knew complete defeat in a controlling area
of life. The book certainly showed variety. But whether
these experiences were bright or dim, cataclysmic or gradual,
theological or intellectual in bearing, such conversions
did have a common denominator - they did change utterly
defeated people. So declared William James, the father of
modern psychology. The shoe fitted, and I have tried to
wear it ever since.
drunks, the obvious answer was deflation at depth, and more
of it. That seemed as plain as a pikestaff. I had been trained
as an engineer, so the views of this authoritative psychologist
meant everything to me. This eminent scientist of the mind
had confirmed everything that Dr. Jung had said, and had
extensively documented all he claimed. Thus William James
firmed up the foundation on which I and many another have
stood all these years. I havent had a drink of alcohol
now by utter conviction, and fortified by my characteristic
power drive, I took of f to cure alcoholics wholesale. It
was twin-jet propulsion; difficulties meant nothing. The
vast conceit of my project never occurred to me. I pressed
the assault for six months, and my home was filled with
alcoholics. Harangues with scores produced not the slightest
results. (Disappointingly, Ebby, my friend of the kitchen
table, who was sicker than I realized, took little interest
in these other alcoholics. This fact may have caused his
backslide later on, though he did make his eventual recovery.)
But I had found that working with alcoholics had a huge
bearing on my own sobriety. Nevertheless, none of my prospects
were getting sober. Why was this?
the defects of my approach came to light. Something like
a religious crank, I was obsessed with the idea that everybody
must have a "spiritual experience" just like mine.
I forgot that James had said that there were many varieties
of the transforming experience. My brother alcoholics just
stared incredulously or joshed me about my "hot flash."
Of course this spoiled the potent identification that it
was so necessary to establish with them. I had turned evangelist.
Clearly the approach had to be altered. What had come to
me in six minutes might require six months with others.
I had to learn that words were things, that one had to be
this juncture - the spring of 1935 Dr. Silkworth
pointed out to me that I had forgotten all about deflation
at depth. I had simply turned preacher. Said he, "Why
dont you pour the grim medical facts into these people
before you do anything else? Have you forgotten what William
James said about ego deflation at depth? Give them the medical
business, and give it to them hard. Skip that account of
your hot flash. Recite your symptoms extensively,
so as to get an identification at depth. When you do this,
your prospects may become willing to adopt the simple moral
precepts you have been trying to teach." Here was a
most vital contribution to the synthesis. Once again it
had been made by a physician.
emphasis was straightway shifted from "sin" to
sickness - the fatal malady - alcoholism. We quoted several
doctors to the effect that alcoholism was often more lethal
than cancer; that it consisted of an obsession of the mind
coupled to an increasing body sensitivity. These were our
twin ogres -: Madness and Death. We leaned heavily on Dr.
Jungs statement of how hopeless the condition could
be, and then poured that devastating dose into every drunk
within range. To modern man, science is omnipotent - virtually
a god. Hence if science passed a death sentence on the drunk,
and we placed that fearful verdict on our alcoholic transmission
belt, one victim talking to another, it might shatter the
listener completely. Then the alcoholic might turn to the
God of the theologian, there being no other place to go.
Whatever truth there was in this device, it certainly had
practical merit. Immediately our whole atmosphere changed.
Things began to look up.
few months later, I was introduced to Dr. Robert S., an
Akron surgeon. He was an alcoholic in a bad way. This time
there was no preachment from me. I told him of my experience
and what I knew about alcoholism. Because we understood
and needed each other, there was genuine mutuality for the
first time. This marked the end of my preaching attitude.
This idea of mutual need added the final ingredient to the
synthesis of medicine, religion and the alcoholics
experience which is now Alcoholics Anonymous.
Bob," a very grim case, sobered almost immediately
and never took a drink to the time of his death in 1950.
He and I soon commenced to work on numbers of alcoholics
that we found at the City Hospital. Almost immediately there
was a recovery, and then another. The first successful A.A.
group had been formed. Returning to New York in the fall
of 1935, this time with all the ingredients of recovery,
another group soon took shape in this city.
progress of the Akron and New York Groups was painfully
slow for the next few years. Hundreds of cases were tried,
but only a few responded. Near the close of 1937, however,
forty were sober and we began to be far more sure of ourselves.
We saw that we had a formula which might carried
from one alcoholic to the next - eventually produce, chain
style, a very large number of recoveries. So came the question:
"How can our good news be spread to the millions of
alcoholics in America and throughout the world?" One
basic answer seemed to be in a literature, detailing our
methods. Another need was for widespread publicity which
would bring great numbers of cases to us.
the spring of 1939, our Society had produced a book which
was called "Alcoholics Anonymous." In this volume,
our methods were carefully described. For the sake of greater
clarity and thoroughness, the word-of-mouth program which
my friend Ebby had given to me was enlarged into what we
now call AAs "Twelve Suggested Steps for Recovery."
This was the backbone of our book To substantiate
AA methods, our book included twenty-eight case histories.
We hoped that these stories might fully identify us with
readers at a distance, and they certainly have. As we had
withdrawn from the Oxford Groups, our Fellowship adopted
the name of our book, "Alcoholics Anonymous,"
as its own. The advent of that volume marked a historical
turningpoint. In the twenty years since, this basic
text has gained a circulation of nearly 400,000 copies.
Countless alcoholics have sobered with no other aid than
reading this volume and practicing its principles.
next need was publicity, and it was forthcoming. Fulton
Oursler, the noted editor and writer, printed a piece in
"Liberty" magazine about us in 1939. The following
year, John D. Rockefeller, Jr., gave AA a dinner which was
widely publicized. The next year, 1941, there was a feature
article in the "Saturday Evening Post." This story
alone brought us thousands of new people. As we gained size,
we also gained in effectiveness. The recovery rate went
away up. Of all those who really tried AA, 50 per cent made
it at once, 25 per cent finally made it; and the rest, if
they stayed with us, were definitely improved. That percentage
has since held, even with those who first wrote their stories
in the original edition of "Alcoholics Anonymous."
In fact, 75 per cent of these finally achieved sobriety.
Only 25 per cent died or went mad. Most of those still alive
have now been sober for an average of twenty years.
our early days, and since, we have found that great numbers
of alcoholics approach us and then turn away - maybe three
out of five, today. But we have happily learned that the
majority of them later return, provided they are not too
psychopathic or too braindamaged. Once they have learned
from the lips of other alcoholics that they are beset by
an often fatal malady, their further drinking only turns
up the screw. Eventually they are forced back into PA, they
must do or die. Sometimes this happens years after the first
exposure. The ultimate recovery rate in PA is therefore
a lot higher than we at first thought it could be.
development of recent years has been a source of much comfort.
In our early time, we could only deal with last-gasp cases.
Nothing could be done until alcohol nearly wrecked its victim.
But nowadays we dont always have to wait while sufferers
plumb these depths. We can now help alcoholics to see where
they are headed - before they "hit bottom." In
consequence, half of today s membership in A.A. is
composed of milder cases. Very often, the family, the job,
and the victims health are relatively unimpaired.
Even potential cases are today approaching us, people who
have suffered only a little. Here and abroad, too, our Society
is making much headway in crossing every barrier of race,
creed and circumstance.
we must humbly reflect that Alcoholics Anonymous has so
far made only a scratch upon the total problem of alcoholism.
Here in the United States, we have helped to sober up scarcely
five per cent of the total alcoholic population of 4,500,000.
reasons are these; We cant deal with alcoholics who
are too psychopathic or brain-damaged; many alcoholics dont
like our methods and they look for an easier or different
way; millions still cling to the rationalization that their
troubles are wholly due to their personal circumstances
and are therefore somebody elses fault. To get the
alcoholic or the potential alcoholic to admit that he is
the victim of an often fatal and progressive malady is usually
a very difficult matter. This is the big problem that still
faces all of us, whether physicians, clergymen, families
or friends. However, there is much reason to hope. One of
the greatest reasons for hope lies in what you physicians
are already doing - and may still do. Perhaps some of you
may be asking, "How can we help still more effectively?"
we A.A.s can offer nothing authoritative, but we do feel
that we can make some helpful suggestions. Consider the
family physician. Only a few years ago, a drunk was mostly
a nuisance. The physician and the hospital could get him
over rough hangovers. A little comfort might be afforded
the family, but little else could be done.
the situation is different. Nearly every city and hamlet
in this country has an A.A. group. Yet all too often, the
alcoholic will not try A.A. This is just where the family
physician can so often step in. He is the one usually called
upon when real trouble starts to loon. After getting the
victim sobered up and the family quieted down, he can frankly
tell the alcoholic what ails him. He can do the same thing
for his patients that Carl Jung did for "Mr. R."
and that Dr. Silkworth did for me. This is to make it clear
to the reluctant drunk that he has contacted a progressive
and often fatal malady, that he cant get well by himself,
that he needs lots of help. Since a great deal is known
today about the emotional and metabolic deficiencies of
the alcoholic, family physicians can document their presentation
in a far more convincing manner than could our early pioneer
is very gratifying to know that today the subject of alcoholism
is being taught in many of our medical schools. In any case,
the facts about alcoholism are easy to obtain. Organizations
like the National Council on Alcoholism, the Yale School
of Alcoholic Studies, plus innumerable state rehabilitation
and clinical efforts, are ready sources of helpful knowledge.
So armed, the family physician can - as we say in A.A. "soften"
up the drunk so that he will be willing to take a look at
our Fellowship. Or if he balks at A.A., he may be directed
to a clinic, a psychiatrist, or to an understanding pastor.
At this stage, the main thing is that he recognize his illness
and that he start to do something about it.
the family physicians job is carefully done, the results
are almost immediate. If the first attempt doesnt
work, the chances are better than even that persistent and
successive approaches will bring results. These simple procedures
do not rob the family physician of much time, nor will they
be necessarily hard on the patients pocketbook. A
concerted effort of this sort by family physicians everywhere
could not fail to achieve immense results. In fact, the
effect of the family physicians work of this sort
has already been great. And for this, I would like to set
on our record the very special thanks of AA to them.
we come to the specialist, usually the psychiatrist. Im
glad to say that psychiatrists in great numbers are referring
alcoholics to A.A., even psychiatrists who more or less
specialize on alcoholics. Their understanding of alcoholics
is now great. Their patience and their tolerance of us,
and of AA, has been monumental.
1949, for example, the American Psychiatric Association
allowed me to read a paper on AA before a section of its
Annual Meeting. As these doctors specialize in emotional
disorders - and alcoholism is certainly one of them -this
act of theirs has always seemed to me a wonderful example
of fine humility and generosity. The reprints of even that
one paper have had a vast effect, world-wide. Im sure
that we A.A.s have never been sufficiently appreciative
of all of this. It used to be the fashion among some of
us in A.A. to decry psychiatry, even medical aid of any
description, save that barely needed for sobering up. We
pointed to the failures of psychiatry and of religion. We
were apt to thump our chests and exclaim, "Look at
us. We can do it, but they cant." It is therefore
with great relief that I can report this to be a vanishing
attitude. Thoughtful AA members everywhere realize that
psychiatrists and physicians helped to bring our Society
into being in the first place and have held up our hands
also realize that the discoveries of the psychiatrists and
the biochemists have vast implications for us alcoholics.
Indeed, these discoveries are today far more than implications.
Your President and other pioneers in and outside your Society
have been achieving notable results for a long time, many
of their patients having made good recoveries without any
A.A. at all. It should here be noted that some of the recovery
methods employed outside A.A. are quite in contradiction
to AA principles and practice. Nevertheless, we of AA ought
to applaud the fact that certain of these efforts are meeting
with increasing success.
know, too, that psychiatry can often release the big neurotic
overhang from which many of us suffer after A.A. has sobered
us. We know that psychiatrists have sent us innumerable
alcoholics who would have never otherwise approached AA,
and many clinics have done likewise. We clearly see that
by pooling our resources we can do together what could never
be accomplished in separation; or in short-sighted criticism
and in competition.
I would like to make a pledge to the whole medical fraternity
that AA will always stand ready to cooperate, that A.A.
will never trespass upon medicine, that our members who
feel the call will increasingly help in those great enterprises
of education, rehabilitation and research which are now
going forward with such promise.
menacing is the growing spectacle of alcoholism that nothing
short of the total resources of society can hope to vanquish
or much lessen the strength of our very dangerous adversary,
John Barleycorn. The subtlety and power of the alcoholics
malady is revealed on every page of mankinds history
- and never so starkly and so destructive as in this century.
our combined understanding and knowledge have been fully
massed and applied, we of AA know that we shall find our
friends of medicine in the very front rank - just where
so many of you are already standing today.
such an array of benign and cooperative action is in full
readiness, it can, and will surely be, a great tomorrow
for that vast host of men who suffer from alcoholism, and
from all its dark and baleful consequences.
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