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alcoholics suffer from "Alcoholic Behavior" or
are they simply victims of human nature?
the late William D. Silkworth, M.D.
© The A.A.
Grapevine, Inc., January 1947
mystery of slips is not as deep as it may appear. While
it does seem odd that an alcoholic who has restored himself
to a dignified place among his fellow men, and continued
dry for years, should suddenly throw all his happiness overboard
and find himself in mortal peril of drowning in liquor -
often the reason is very simple.
are inclined to say, "There is something peculiar about
alcoholics. They may seem to be well, yet at any moment
they may turn back to their old ways. You can never be sure.
"This is largely twaddle. The alcoholic is a sick person.
Under the technique of Alcoholics Anonymous he gets well,
that is to say his disease is arrested. There is nothing
unpredictable about him any more than there is anything
weird about a person who has arrested diabetes.
get it clear, once and for all, that alcoholics are human
beings just like other human beings - then we can safeguard
ourselves intelligently against most of the slips. Both
in professional and lay circles there is a tendency to label
everything that an alcoholic may do as "alcoholic behavior."
The truth is it is simply human nature. It is very wrong
to consider many of the personality traits observed in liquor
addicts as peculiar to the alcoholic. Emotional and mental
quirks are classified as symptoms of alcoholism merely because
alcoholics have them, yet these same quirks can be found
among non-alcoholics also. Actually they are symptoms of
mankind; ORDINARY PEOPLE. Of course, the alcoholic himself
tends to think of himself as different, someone special,
with unique tendencies and reactions. Many psychiatrists,
doctors, and therapists carry the same idea to extremes
in their analyses and treatment of alcoholics. Sometimes
they make a complicated mystery of a condition which is
found in all human beings, whether they drink whiskey or
be sure, alcoholism, like every other disease, does manifest
itself in some unique ways. It does have a number of baffling
peculiarities which differ from all other diseases. At the
same time, many of the symptoms and much of the behavior
of alcoholism are closely paralleled and even duplicated
in other diseases.
alcoholic "slip," as it is known in Alcoholics
Anonymous, furnishes a perfect example of how human nature
can be mistaken for alcoholic behavior.
"slip is a relapse! It is a relapse that occurs after
the alcoholic has stopped drinking and started on the AA
program of recovery. "Slips" usually occur in
the early stages of the alcoholic's AA indoctrination, before
he has had time to learn enough of the AA technique and
AA philosophy to give him solid footing. But "slips"
may also occur after the alcoholic has been a member of
AA for many months, or even after several years, and it
is in this kind, above all, that one finds a marked similarity
between the alcoholic's behavior and "normal"
victims of other diseases.
one is startled by the fact that relapses are not uncommon
among arrested tubercular patients. But there is a startling
fact - the cause is often the same as the cause which leads
to "slips" for the alcoholic. It happens this
way: When a tubercular patient recovers sufficiently to
be released from the sanitarium, the doctor gives him careful
directions for the way he is to live when he gets home.
He must be in bed every night by, say, eight o'clock. He
must drink plenty of milk. He must refrain from smoking.
He must obey other stringent rules. For the first several
months, perhaps for several years, the patient follows directions.
But as his strength increases and he feels fully recovered,
he becomes slack. There may come the night when he decides
he can stay up until ten o'clock. When he does this, nothing
untoward happens. The next day he still feels good. He does
it again. Soon he is disregarding the directions given him
when he left the sanitarium. Eventually he has a relapse.
same tragedy can be found in cardiac cases. After the heart
attack, the patient is put on a strict rest schedule. Frightened,
he naturally follows directions obediently for a long time.
He, too, goes to bed early, avoids exercise such as walking
up stairs, quits smoking, and leads a Spartan life. Eventually,
though, there comes a day after he had been feeling good
for months, or several years, and has recovered from his
fright. If the elevator is out of repair one day, he walks
up three flights of stairs. Or he decides to go to a party
- or do just a little smoking, or take a cocktail or two.
If no serious after-affects follow the first departure from
the rigorous schedule prescribed, he may try it again until
he suffers a relapse.
both cardiac and tubercular cases, the acts which led to
the relapse were preceded by wrong thinking. The patient
in each case rationalized himself out of a sense of his
own perilous reality. He deliberately turned away from his
own knowledge of the fact he had been the victim of a serious
disease. He grew over-confident. He decided he didn't have
to follow directions.
that is precisely what happens with the alcoholic - the
arrested alcoholic, or the alcoholic in AA who has had a
"slip." Obviously he decides again to take a drink
some time before he actually takes it. He starts thinking
wrong before he actually embarks on the course leading to
is no more reason to charge the "slip" to alcoholic
behavior than there is to lay a tubercular relapse to tubercular
behavior or a second heart attack to cardiac behavior.
alcoholic "slip" is not a symptom of a psychotic
condition. There is nothing "screwy" about it
at all. The patient didn't follow directions. And that's
human nature! It's life! It's happening all the time, not
merely among alcoholics, but among all kinds of people.
The preventive is plain. The patient must have full knowledge
of his condition, keep in mind the facts of his case and
the nature of his disease, and follow orders.
the alcoholic, AA offers some directions. A vital factor,
or ingredient, of the preventive, especially for the alcoholic,
is sustained emotion. The alcoholic who learns some of the
technique or the mechanics of AA but misses the philosophy
or the spirit, may get tired of following directions - not
because he is alcoholic but because he is human. Rules and
regulations irk almost anyone, because they are restraining,
prohibitive, negative. The philosophy of AA however, is
positive and provides ample sustained emotion - a sustained
desire to follow directions voluntarily.
any event, the psychology of the alcoholic is not as different
as some people try to make it. The alcoholic has problems
peculiar to him perhaps, in that he has been put on the
defensive and consequently has developed nervous frustrations.
But in many instances there is no more reason to be talking
about the "alcoholic mind" than there is to try
to describe something called the "cardiac mind,"
or the "TB mind." I think we will help the alcoholic
more if we can first recognize that he is primarily a human
being - afflicted with human nature.
© The A.A.
Grapevine, Inc., January 1947
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