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The
Society of Alcoholics Anonymous
American
Journal of Psychiatry, Vol. 106, 1949
By Bill W.
Alcoholics
Anonymous is grateful for this invitation to appear before
The American Psychiatric Association. It is a most happy
circumstance. Being laymen we have naught but a story
to tell, hence the quite personal and unscientific character
of this narrative. Whatever their deeper implications
the attitudes and events leading to the formation of Alcoholics
Anonymous are easy to portray.
Two
alcoholics talk across a kitchen table. One is drinking,
the other is not. Severe chronics, the threat of commitment
hangs over both. The time is November 1934. The active
drinker became, years later, the writer of this paper.
My sober visitor was an old friend and schoolmate, long
catalogued by physicians and family as hopeless. I enjoyed
the same rating and well knew it.
My
friend had arrived to tell me how he had been released
from alcohol. In truth, the quality of his sobriety seemed
"different." Having made contact with the Oxford
Group, a nondenominational, evangelical movement, my friend
had been specially impressed by an alcoholic he had met,
a former patient of C. G. Jung. Unsuccessfully treating
this individual for a year, Dr. Jung had finally advised
him to try religious conversion as his last chance. While
disagreeing with many tenets of the Oxford Group, my former
schoolmate did, however, ascribe his new sobriety to certain
ideas that this alcoholic and other Oxford people had
given him. The particular practices my friend had selected
for himself were simple:
1.
He admitted he was powerless to solve his own problem.
2. He got honest with himself as never before; made an
examination of conscience.
3. He made a rigorous confession of his personal defects.
4. He surveyed his distorted relations with people, visiting
them to make restitution.
5.
He resolved to devote himself to helping others in need,
without the usual demand for personal prestige or material
gain.
6.
By meditation he sought Gods direction for his life
and help to practice these principles at all times.
This
sounded pretty naive to me. Nevertheless my friend stuck
to the plain tale of what had happened - no evangelizing.
He related how practicing these precepts, his drinking had
unaccountably stopped. Fear and isolation left and he had
received considerable peace of mind. With no hard disciplines
nor any great resolves, these attributes began to appear
the moment he conformed. His release was a byproduct. Though
sober but months, he felt he had a basic answer. Wisely
avoiding any argument, he then took leave. The spark that
was to become Alcoholics Anonymous had been struck.
What
then did happen at the kitchen table? Perhaps this speculation
were better left to medicine and religion. I confess I do
not know. Possibly conversion will never be fully understood.
Looking
outward from such an experience, I can only say with fidelity
what seemed to happen. Yet something did happen that instantly
changed the current of my life. I havent had a drink
for over fourteen years. All else will be mere personal
opinionor just fancy.
My
friends story had generated mixed emotions; I was
drawn and revolted by turns. My solitary drinking went on,
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 medicos. Third, that
those age-old precepts, when transmitted by him, had struck
me with great power. Fourth, that I could not, and would
not, go along with any God concept. No conversion nonsense
for me. Thus did I ponder. 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 shall not break away.
One
morning after my gin a realization welled up. "Who
are you," I asked, "to choose how you are going
to get well? Beggars are not choosers. Suppose 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 didnt stop them,
and you thought conversion could, your pride would fly away.
You would soon stand in public squares crying "Amen"
among 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 or not?"
Of
course I did try. In December, 1934, I appeared at Towns
Hospital, New York. My old friend, Dr. W.D. Silkworth, shook
his head. Soon free of sedation and alcohol, I felt horribly
depressed. My alcoholic friend turned up. Though glad to
see him, I shrank a little. I feared evangelism. Nothing
of the sort happened. After small talk, I again asked him
about the Oxford Groups. Quietly, sanely enough, he told
me, and then departed.
Lying
there in conflict, I dropped into a black depression. Momentarily
my prideful obstinacy was crushed. I cried out, "Now
Im ready to do anything - anything to receive what
my good friend has." Expecting naught, I made this
frantic appeal: "If there be a God, will he show himself!"
The result was instant, electric, beyond description. The
place lit up, blinding white. I knew only ecstasy and seemed
on a mountain. A great wind blew, enveloping and permeating
me. It was not of air, but of Spirit. Blazing, came the
tremendous thought, "You are a free man!" Then
ecstasy subsided. Still on the bed I was now in another
world of consciousness which was suffused by a Presence.
One with the Universe, a great peace stole over me and I
thought, "So this is the God of the preachers; this
is the Great Reality." But reason returned, my modern
education took over. Obviously I had gone crazy. I became
terribly frightened.
Dr.
Silkworth came in to hear my trembling account of the phenomenon.
He assured me I was not mad; that I had perhaps undergone
an experience which might solve my problems. Skeptical man
of science he then was; this was most kind and astute. If
he had said "hallucination" I might now be dead.
To him I shall be eternally grateful.
Good
fortune pursued me. Somebody brought a book entitled "Varieties
of Religious Experience" and I devoured it. Written
by James, the psychologist, it suggests that conversion
can have objective reality. Conversion does not alter motivation,
and does semi-automatically enable a person to be and do
the formerly impossible. Significant it was, that marked
conversion experiences come mostly to individuals who know
complete defeat in a controlling area. The book certainly
showed variety. But bright or dim, cataclysmic or gradual,
theological or intellectual in bearing, such conversions
did have common denominators, they did change utterly defeated
people. And so declared William James. The shoe fitted.
I have tried to wear it ever since. For drunks, the obvious
answer was deflation at depth and more of it. That seemed
plain as a pikestaff. I had been trained as an engineer,
so the views of this authoritative psychologist meant everything
to me.
Armored
now by utter conviction and fortified by my characteristic
power drive, I took off to cure alcoholics wholesale. It
was twin jet propulsion; difficulties meant nothing. The
vast conceit of my project never occurred to me. I pressed
my assault for six months; my home was filled with alcoholics.
Harangues with scores produced not the slightest result.
None of them got it. Disappointingly, 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
endless backslides later on. For I had found that working
with alcoholics had a huge bearing on my own sobriety. But
why wouldnt any of my new prospects sober up?
Slowly
the bugs came to light. Like a religious crank, I was obsessed
with the idea that everybody must have a "spiritual
experience" just like mine. Id forgotten that
there were many varieties. So my brother alcoholics just
stared incredulously or kidded me about my "hot flash."
This had spoiled the potent identification so easy to get
with them. I had turned evangelist. Clearly the deal had
to be streamlined. What came to me in six minutes might
require six months in others. It was to be learned that
words are things, that one must be prudent. It was also
certain that something ailed the deflationary technique.
It definitely lacked wallop. Reasoning that the alcoholics
s "hex," or compulsion, must issue from some deep
level, it followed that ego deflation must also go deep
or else there couldnt be any fundamental release.
Apparently religious practice would not touch the alcoholic
until his underlying situation was made ready. Fortunately
all the tools were right at hand. You doctors supplied them.
The
emphasis was straightway shifted from "sin" to
"sickness" - the "fatal malady," alcoholism.
We quoted doctors that alcoholism was more lethal than cancer;
that it consisted of an obsession of the mind coupled to
increasing body sensitivity. These were our Twin Ogres of
Madness and Death. We leaned heavily on Dr. Jungs
statement how hopeless the condition could be and then poured
that devastating dose into every drunk within range. To
modern man science is omnipotent; it is a god. Hence if
science would pass a death sentence on the drunk, and we
placed that verdict on our alcoholic transmission belt,
it might shatter him completely. Perhaps he would then turn
to the God of the theologian, there being no place else
to go. Whatever the truth in this device, it certainly had
practical merit. Immediately our whole atmosphere changed.
Things began to look up
Bankrupt
at the time, I stumbled into a business venture. It took
me to Akron, Ohio, where the deal quickly collapsed leaving
me dispirited. Alone, I panicked in fear of getting drunk.
This was something new for I realized that I hadnt
thought of drinking since the December 1934 experience.
I could now see my peril clearly and thus brush off the
usual rationalizations. With relief, I perceived that my
new spiritual conditioning really meant something now that
the heat was on. But that didnt stop the compulsive
up rush of drinking desire. I needed to talk to another
alcoholic, and quickly.
Shortly
I was introduced to Dr. Robert S., a surgeon. He was an
alcoholic in a bad way. This time there was no preachment
from me. I told him my experience and what I thought I knew
about alcoholism. Needing him as much as he did me, there
was a genuine mutuality for the first time and, as we now
say in A.A., he soon "clicked" never to drink
again. That was June 1935. We began to spend long hours
on drunks at a local hospital. One of them is sober yet,
no relapse. Though nameless, the first A.A. Group had actually
started. Dr. S. has since hospitalized some 4,000 cases
at Akron. The bulk have recovered. All this too without
a cent of monetary return to him. Thus he became co-founder
of Alcoholics Anonymous. As I left Akron in September 1935
three alcoholics were staying sober. Arrived at New York,
I set to work and another A.A. group took shape. But nothing
was very sure; we still flew blind.
It
was soon necessary to retire from the Oxford Group. The
good people there had disapproved us. For our purpose, the
Oxford Group atmosphere wasnt entirely right. Their
demands for absolute moral rectitude encouraged guilt and
rebellion. Either will get alcoholics drunk, and did. As
nonalcoholic evangelists, they couldnt understand
that. Good friends these, we owed them much. From them we
had learned what, and what not, to do.
Then
commenced a 3 year season of trial and error eventuating
in our textbook, "Alcoholics Anonymous," published
in 1939. That book, now backbone of our A.A. society, opens
with a typical story of drinking and recovery. Next comes
a chapter of hope, entitled "There Is A Solution."
In A.A. vernacular two chapters describe alcoholism and
the alcoholic, their object being of course to first identify
and then deflate. A chapter is devoted to softening up the
agnostic. This leads to the "Twelve Steps" of
present-day Alcoholics Anonymous. The heart of our therapy,
and a practical way of life, these "Steps" are
little but an amplified and streamlined version of the principles
enumerated by my friend of the kitchen table.
The
balance of the text is mostly devoted to practical application
of these "Twelve Steps," and to reducing the inner
resistances of the reader. Working with other alcoholics
is very heavily emphasized. Chapters are devoted to wives,
family relations, and employers. The final chapter pictures
the new society and begs the recovered alcoholic to form
a group himself. This ideology is then shored up by 30 case
histories, or rather stories, written by A.A. members. These
complete the identification and stir hope. The 400 pages
of "Alcoholics Anonymous contain no theory;
they narrate experience only.
When
the book appeared in April 1939, we had about 100 members.
One third of these had impressive sobriety records. The
movement had spread to Cleveland and drifted toward Chicago
and Detroit. In the East it inclined to Philadelphia and
Washington. There was an extraordinary event at Cleveland.
The Plain Dealer published strong pieces about us backed
by editorials. A barrage of telephone calls descended on
20 A.A. members, mostly new people. A.A. book in hand, they
took on all comers. New members worked with the still newer.
Two years later, Cleveland had garnered by this chain reaction
hundreds of new members. The batting average was excellent.
It was our first evidence that we might digest huge numbers
rapidly.
Then
came great national publicity. The Saturday Evening Post
piece (March 1941) shot thousands of frantic inquiries into
our tiny New York office. This gave us lists of alcoholics
in hundreds of cities. Business men traveling out of established
A.A. centers used these names to start new groups. By sending
literature and writing often, A.A. groups sprung up by mail.
With no personal contact whatever, this was astounding.
Clergy and medical men began to give their approval. I wish
to say that Dr. Harry Tiebout, chairman of our discussion
today, was the first psychiatrist ever to observe and befriend
us. Alcoholics Anonymous mushroomed. The pioneering had
ended. We were on the U.S. map.
As
of 1949 our quantity results are these. The 14-year-old
society of Alcoholics Anonymous has 80,000 members in about
3,000 groups. We have entered into 30 foreign countries
and U.S. possessions; translations are going forward. By
occupation we are an accurate cross section of America.
By religious affiliation we are about 40% Catholic; nominal
and active Protestants, also many former agnostics, and
a sprinkling of Jews comprise the remainder. Ten to 15%
are women. Some Negroes are recovering without undue difficulty.
Top medical and religious endorsements are almost universal.
A.A. membership is pyramiding, chain style, at the rate
of about 30% a year. During 1949, we expect 20,000 permanent
recoveries, at least. Half of these will be medium or mild
cases (average age about 36) a fairly recent development.
Of
alcoholics who stay with us and really try, 50% get sober
at once and stay that way, 25% do so after some relapses
and the remainder usually show improvement. But many problem
drinkers do quit A.A. after a brief contact, maybe three
or four out of five. Some are too psychopathic or damaged.
But the majority have powerful rationalizations yet to be
broken down. Exactly this does happen providing they get
what A.A. calls a "good exposure," on first contact.
Alcohol then builds such a hot fire that they are finally
driven back to us, often years later. They tell us that
they had to return; it was A.A, or else. They had learned
about alcoholism from alcoholics; they were hit harder than
they had known. Such cases leave us the agreeable impression
that half our original exposures will eventually return,
most of them to recover. So we just indoctrinate the newcomer.
We never evangelize; Barleycorn will look after that. The
clergy declare we have capitalized the Devil. These claims
are considerable but we think them conservative. The ultimate
recovery rate will certainly be larger than once supposed.
Such
is a glimpse of our origin, central therapeutic idea, and
quantity result. The qualitative result is assuredly too
large a subject for this paper.
Alcoholics
Anonymous is not a religious organization; there is no dogma.
The one theological proposition is a "Power greater
than ones self." Even this concept is forced
on no one. The newcomer merely immerses himself in our society
and tries the program as best he can. Left alone, he will
surely report the gradual onset of a transforming experience,
call it what he may. Observers once thought A.A. could appeal
only to the religiously susceptible. Yet our membership
includes a former member of the American Atheist Society
and about 20,000 others almost as tough. The dying can become
remarkably open minded. Of course we speak little of conversion
nowadays because so many people really dread being God-bitten.
But conversion, as broadly described by James, does seem
to be our basic process; all other devices are but the foundation.
When one alcoholic works with another, he but consolidates
and sustains that essential experience.
The
forces of anarchy, democracy, and dictatorship play impressive
roles in the structure and containment of our society; Barleycorn
the Tyrant Dictator is quite impersonal. But Hitler never
did have a Gestapo half so effective. When the anarchy of
the alcoholic faces his tyrant, that alcoholic must become
a social animal or perish. Perforce, our society has settled
for the purest kind of democracy. Naturally, the explosive
potential of our rather neurotic fellowship is enormous.
As elsewhere, it gathers closely around those eternal provocateurs:
power, money and sex. Throughout A.A. these subterranean
volcanos erupt at least a thousand times daily; explosions
we now view with some humor, considerable magnanimity, and
little fear at all. We think them valuable object lessons
for development. Our deep kinship, the urgency of our mission,
the need to abate our neurosis for contented survival; all
these , together with love for God and man, have contained
us in surprising unity. There seems safety in numbers. Enough
sand bags muffle any amount of dynamite. We think we are
a pretty secure, happy family. Drop by any A.A. meeting
for a look.
But,
there isnt the slightest evidence that violent neurosis,
drunkenness, or lunacy is to be the destiny of Alcoholics
Anonymous. Such dark forecasts have not materialized.
Many
an alcoholic is now sent to A.A. by his own psychiatrist.
Relieved of his drinking, he returns to the doctor a far
easier subject. Practically every alcoholics wife
has become, to a degree, his possessive mother. Most alcoholic
women, if they still have a husband, live with a baffled
father. This sometimes spells trouble aplenty. We A.A.s
certainly ought to know! So, gentlemen, here is a big problem
right up your alley.
Now
to conclude: We of A.A. try to be aware that we may never
touch but a segment of the total alcohol problem. We try
to remember that our growing success may prove a heady wine;
that our own resources will always be limited. So then,
will you men and women of medicine be our partners; physicians
wielding well your invisible scalpels; workers all, in our
common cause? We like to think Alcoholics Anonymous a middle
ground between medicine and religion, the missing catalyst
of a new synthesis. This to the end that the millions who
still suffer may presently issue from their darkness into
the light of day!
I
am sure that none, attending this great Hall of Medicine
will feel it untoward if I leave the last word to our silent
partner, Religion:
God
grant us the serenity to accept the things we cannot change,
courage to change the things we can, and wisdom to know
the difference.
*
Read at the 105th Annual Meeting of the American Psychiatric
Association, Montreal, Quebec, May 23-27, 1949
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