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 Alcoholics
Anonymous-Saturday Evening Post, March 1, 1941 |
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Laymen and Alcoholics
by Genevieve Parkhurst
As
he came out from under the opiate the man in the hospital
bed opened his eyes to black darkness. Somewhere in the
room, as if from a distance, his wife was asking quiet questions.
Then the doctor was answering her. “I must be frank,”
he was saying. “I’ve never known a patient who
had reached this phase of this type of alcoholism to recover.
Even if your husband were to stop drinking, and that is
not likely after twenty-five years of it, he is bound to
have recurrent spells of blindness and an increase of the
trouble with his legs. Disintegration is setting in. About
six months are all I can give him to live.”
While
he was lying there, waiting for the doctor’s prophecy
to come true, a stranger came to see him. The stranger was
a man who had once been in the same condition. And a stranger
had come to see him, just as he had come, to tell of the
unknown men who, under the name of Alcoholics Anonymous,
were helping to cure other alcoholics just as they had been
helped.
The
patient was impressed with what his visitor told him about
the new treatment. When the alcohol was gone from his system
and he was able to hobble about on crutches he attended
a meeting of the group. Encouraged to do so by his doctor,
he consulted with its leaders. In three months he was out
of the hospital. In six months he was well enough to be
back at his desk. Now, after four years in which he has
not had a drink, he is in excellent health. And the disease
has left none of its marks on him.
This
man’s story is no longer an unusual one. Within the
past few years many such hopeless cases and many less serious
ones that were once listed as doubtful have been healed.
The healers have not all been members of Alcoholics Anonymous,
but they have all been laymen. And their success in this
difficult field has impelled the physicians who once considered
them as “dangerous meddlers in a dangerous province”
not only to sanction their practice but to invite them to
share the burden of curing alcoholism.
At
the annual meeting, held last fall, by the Research Council
on Problems of Alcohol, a group of physicians and social
scientists who for the past three years have been making
an intensive study of the nature of the disease which makes
drunkards of so many men and women, Dr. Merrill Moore, Associate
in Psychiatry, Harvard Medical School, startled the conference
of which he was chairman with the remark that “Physicians
in general are admitting that the lay healers are doing
remarkable work.” Asked at the end of the conference
to expand his comment, he said, “We know that if we
are going to make any real advance we must tap every source
of knowledge and healing there is … Not only lay therapists,
but lawyers, clergymen, and social workers are successfully
helping and treating the alcoholic. . . This means treating
someone who is emotionally sick or hurt or down or sometimes
weak. Certainly physicians have no comer on it. There is
no magic to it. And no royal road.”
Again
at the Council’s three-day symposium held in Philadelphia
last December, under the auspices of the Association for
the advancement of Science, the achievements of lay healers
were touched upon. Some of the healers read papers, and
at the informal luncheon and dinner conversations they were
listened to and even deferred to by the medical scientists.
To
learn the consensus of opinion I questioned forty of the
leading medical authorities who attended the symposium either
as participants or audience. Thirty-four of them admitted
that, in face of the evidence, the lay therapists were getting
the best results. Some of them went so far as to say that
the laymen were curing cases which the physicians had pronounced
incurable.
The six who held back were not complete dissidents. Their
difference was a difference in their school of thought.
Unlike their colleagues who believe that alcoholism is caused
by some deep mental and emotional disturbance of which drinking
is only a symptom, and that its care must therefore be mental,
they contend that its cause lies in some fundamental chemical
derangement and that its cure must therefore be chemical.
“We
grant you,” said one of them, “that a drunkard
may be cured of the drinking habit, but that does not mean
he is cured of alcoholism. For the fact remains that alcohol
is a poison to him. And if at any time he takes to drinking
again, no matter how moderately he may begin, he will again
end up as a drunkard. The alcoholic may be said to be completely
healed only when he can drink without disaster. Some day
some bright young chemist will emerge from his laboratory
with some chemical which will do away with the allergy which
makes the systems of some people intolerant to alcohol.
Then the cure for alcoholism will have been found.
“In
the meantime,” he concluded, “I’ll gladly
give credit to the laymen who are doing so much to arrest
the disease by curing the drunkards of drinking.”
I
am not of course presuming to decide which of the two schools
is right. Since it is the excessive drinking which causes
all the havoc in alcoholism, what really matters is the
apparent agreement on both sides that drunkenness can be
healed and that the lay therapists are breaking all past
records in the number of their healings.
Now
when I use the terms “alcoholic” and “drinker”
I am not referring to the casual convivialist nor to the
extreme cases in which the patients’ minds have lost
all touch with reality. They are the physicians’ private
enigma. I mean the man or woman whose abilities, health,
and social graces have been dissipated by constant drinking
and who is not able to stop it without help from the outside.
And
when in this instance I speak of the layman I do not include
the charlatans who make false claims for their patent nostrums.
I am thinking only of those therapists whose accomplishments
are acknowledged by the physicians and who work along with
them in their diagnoses, consulting them as the individual
cases may warrant.
Specifically,
these fall into three groups: the trained psychologists
with whom treating alcoholism is a profession; religious
healers; and former alcoholics with whom healing is an avocation.
The
professional psychologists are not many. They are exclusive,
accepting only a few patients at a time. And they are expensive.
As I have already gone into their methods of work in a previous
number of this magazine I shall now say only that they are
skilled, painstaking, and highly successful, and it is a
pity that there are not more of them and at a price which
the middle class could more easily afford. The religious
healers are doing some excellent salvage work, particularly
among the poor. To go into their technic would involve a
discussion of articles of faith for which I am not prepared.
So I shall confine myself to the third group, the men who
have been alcoholics themselves and who, having been cured,
are now spreading out like a network and with an efficacy
that is convincing to the most conservative medical men.
That
they are meeting with success should not, however, be either
astounding or extraordinary. For the truth is that while
all along the doctors--and I am only echoing them when I
say so--have been trying to find out what alcohol does to
the alcoholic, nobody has tried to find out what it does
for him. But these men know the whole bitter story. They
know the drive of drink, its satisfactions and elations.
They know the sting of its broken resolutions, as they are
drawn back to it again and again. They know its jubilations
and deep despairs. They know the things, so infinitesimal
to the balanced temperament, which set the drinker on edge
and send him into his cups as a way of escape. They know
his whims and his disinclinations. How he thinks, how he
feels, how he rationalizes are well-worn pages to them.
This is not to say that every alcoholic who has been straightened
out is qualified to heal others. But among them there are
many whose highly sensitive and intelligent natures, added
to a capacity for making friends, fit them peculiarly for
this highly specialized curative art. As a further aid there
is that strong bond between drinkers which makes it easy
for the man who has been down and is up again to reach those
who are still down or groping.
II
In
order to keep their record straight, before going into their
processes, it must be noted that their therapeutic definitions
and principles coincide with those of the medical specialists.
They recognize alcoholism as a “fugal” disease,
meaning that it is made up of several strains, each one
of which is involved in the others. There is the first cause
which is usually some circumstance or event in early environment
which sets up an “imbalance” in the personality,
making it difficult or even impossible for those who are
thus afflicted to face the realities of life. Or it may
be some inherent tendency, such as a highly strung nervous
system, which is aggravated by some such circumstance as
I have mentioned. As a second or remote cause, there are
the problems which arise in every life and which the unbalanced
temperament is not able to cope with. Third, there is the
drinking, which is the means of escape and a symptom of
the disease at the same time.
If
the disease is to be cured every one of its elements must
be taken into consideration. The first cause must be detected
and explained away. The patient must be taught how to face
his problems as they come to him. And he must be given new
interests to take the place of his former interest in drinking.
Two
further points should be borne in mind. To be healed of
alcoholism the drinker must have the desire to stop drinking
and he must be willing to face a future in which he will
never again be able to take a drink. For in the annals of
medical science there is no record of a man’s having
been healed of alcoholism unless he had taken the cure of
his own volition. Nor is there any record of a reformed
drunkard who was ever able to drink moderately without going
the whole way down hill again.
With
the perspective clear, let us look into the process of this
new lay therapy through the story of one of it practitioners.
Mr. Ex, as we shall know him, began to drink when he was
a student at college during the prohibition era. By the
time he was thirty-five he had been arrested for drunken
and disorderly conduct in a chain of ports around the world.
More to please his parents than himself he had taken the
“cure” in five expensive alcoholic retreats,
only to drink more on coming out of them than he had before
going in. Outstanding psychiatrists had told his father
that his type of alcoholism was rarely curable.
Then
something he does not speak of happened to make him want
to stop drinking. With all that he had learned about drinking
and the drinker in his fifteen years’ carousal he
was able to stop by himself. During the months when he was
striving for equilibrium he found peace through helping
one of his former companions at the bar. Five years have
passed during which he has devoted his leisure to this curative
work, and he has a number of difficult cases to his credit.
His
technic is simple. He employs no formidable terminology,
as his experience has been that the ominous vocabulary of
some practitioners is confusing and repellant to the sick
and jittery mind. Since no two cases are alike, his approach
comes by intuition, and the discipline and text emerge out
of each case as it moves along.
According
to Mr. Ex, ninety-five out of every hundred drunkards have
the deep desire to stop drinking. Only a few will admit
it. They think it is a confession of weakness; or they are
afraid of becoming unpopular in their social group; or they
cannot face the knowledge that liquor has got the best of
them. And any direct suggestion from their family that they
see the doctor or take a cure drives them farther into their
cups.
Therefore
Mr. Ex’s approach is the more subtle one of man to
man. He goes out where drinkers congregate. The man he is
looking for may be someone he knows or whose family has
asked him to step in and take hold. He never talks shop
until he is sure he is on firm ground. A glass of tomato
juice may evoke a question or the lift of an eyebrow, to
which his answer implies that he has had more than his share
of gin. A comparison of symptoms and an exchange of reminiscences
may follow. By degrees the drinker may be led to unload
his troubles and the friendship is established.
From
there it is a short step to his admission that he wants
to stop his drinking--a cue for Mr. Ex to ask him why he
doesn’t stop. He may say that it will make a sap out
of him. The response to that is that only a strong man can
give it up. Or he may say that he is thinking of going to
an institution--then when he comes out he can take a few
drinks without wanting to get drunk.
“At
this point,” Mr. Ex says, “I tell him what happened
to me not once, but five different times
when I thought I had been cured and could take a drink.
What I am doing all this time is leading him to a mood where
I can ask him to play ball with me. Just how I do so depends
of course on the personality I am trying to reach.”
The
most difficult alcoholics to approach are those who take
alcohol as a narcotic to avoid the pains and the realities
of living. Most often they have to go through some devastating
experience before they are ready to give it up. However
it comes, it is only when the patient expresses a real desire
to be cured that the cure begins.
Somewhere at the outset when a diplomatic moment presents
itself he is persuaded to see the doctor for a general going-over.
Regular meals and exercise for those who can take it are
prescribed. And work. If the patient still has his job so
much the better. If not something absorbing is found to
keep his mind employed at some spot away from himself and
his former rendezvous.
Some
alcoholics cannot stand the strain of giving up liquor all
at once; they can be led to taper off. When they find they
are able to go any length of time without a drink their
morale shoots upward. Curiously enough, the first few weeks
of abstinence are not always the hardest. For the old urgency
has a way of turning up at the end of the second or third
month, trying to beat them down again. Mr. Ex's prescription
for such hours is immediate action--a brisk walk, a bus
ride, the movies, or even a telephone call--any interlude
that will bring about a change of thought. As such temptations
are resisted they recur less frequently until finally they
are gone never to return. A good exercise in resistance
is to walk past bars until one is able to ignore one’s
own favorite bar in the same way. A patient who can do this
half a dozen times is ready to enter a bar or
go where drinking is without taking a drink. When he has
gone successfully through this ordeal he is well fortified
for complete recovery.
Mr.
Ex is devoting the gratuities he receives for his treatments
to a fund with which he is establishing an Alcoholic Consultation
Bureau in the city where he lives. It is to be a county
center where those with drinking problems of their own or
those who have a drinker in the family may go for treatment
or advice, safe in the knowledge that their confidence and
identity will be respected. If it proves effective he hopes
that it will become a model for other communities to follow.
III
At
the time the previous article on this subject was published
I received hundreds of letters from Harper readers in many
parts of the country. They came from men and women in many
walks who laid bare their most intimate personal sorrows
as they asked me to advise them about some member of the
family who was drinking to excess. There was little I could
tell them. Psychiatric treatments were beyond what most
of them could afford or there were no psychiatrists in their
localities. In some instances psychiatry had been tried
and had failed. The few reliable private institutions I
knew of were too remote or too costly. Most of the public
hospitals, if there were any in the communities, had no
alcoholic ward. The public mental hospitals, generally speaking,
were insane asylums from which the discharged alcoholic
patients where known to be worse off than when they had
entered.
It
is to such people as these, people who do not know where
to turn for help that Alcoholics Anonymous, the group of
men I mentioned in the first part of this article, are hoping
to have something to say.
This
organization, which now has a membership of over two thousand
and centers in fifty localities that embrace all of our
States except a few in the Middle West between the Rocky
Mountains and the Mississippi River, had its beginning in
the healing of one man, a Wall Street broker whom we shall
speak of as Mr. Jones. After a drinking career of fifteen
years in which he had built his ration of gin up to two
quarts a day, he was pronounced a hopeless alcoholic. Some
time before this verdict a friend who had been cured of
dipsomania with the help of a religious group had told of
his experience with such simple precision that Mr. Jones
had been challenged by it. Thinking now of what the doctors
had said, his mind reverted to his friend, and he sought
the same aid. “In a week,” says Mr. Jones, “I
had taken my last drink. In a month my
appetite for liquor was completely gone.”
Shortly
after this a business trip took him to Akron, Ohio, where
he remained to help a former crony who had lost his job
and was without the prospect of another, as the title of
“confirmed drunkard” had been conferred upon
him by the townspeople. This friend healed one of his own
friends. Mr. Jones did likewise. By the time he was ready
to return to New York he and his patients had made plans
for a full-time avocation of healing alcoholism and for
starting a healing movement across the country.
Mr.
Jones realized that, while drinkers may have their similarities,
no two of them are ever alike in nature. If he were to reach
out toward all those who needed help he saw that he would
have to broaden his therapy, which up to this time had been
wholly religious. Back in New York, he and his wife took
five non-paying alcoholics into their home for study and
experimentation. In healing them he was able to formulate
a set of elastic principles capable of spanning a wide area
of cases.
In
1936--two years after it had been started--the movement
had spread with such rapidity that money was needed for
office purposes. Two or three of the members felt -that
if they could take the time to collaborate on a book about
their experiences they would be able to raise the necessary
amount. Someone told Mr. John D. Rockefeller of the recoveries
they had effected. After he had looked into their activities
he made it possible for them to take the time to write the
book. When it was ready to be published a group of Mr. Rockefeller’s
associates consented to form a Board of Trustees to handle
the royalties as they accrued.
Last
year, with the work speeding forward, Mr. Rockefeller felt
that what it now needed was “not money but standing.”
At a dinner given by him to two hundred of the country’s
most prominent men he invited Mr. Jones to speak. What he
had to say was verified and approved by medical scientists
and clergymen through such spokesmen as Dr. Foster Kennedy
and the Reverend Harry Emerson Fosdick. The honorarium of
three thousand dollars raised that evening, together with
royalties from the book, maintain a small office in downtown
New York. Mr. Jones’s salary is thirty dollars a week.
“I have a strong feeling,” he explains, “that
if I were to commercialize my services within the group
by accepting money I should impair my effectiveness.”
Among
the members of Alcoholics Anonymous are lawyers, doctors,
clerks, chauffeurs, stenographers, and housewives, and they
are of all ages between the early twenties and the late
sixties. Out of two thousand current cases, ninety-five
per cent of whom are employed, one thousand have not tasted
liquor since they attended their first meeting. For some
this means three months. For others, six years. Five hundred
have -slipped a bit now and then, but they are out of the
quicksands. The other five hundred are not yet quite sure
that they want to be cured, or they are suffering from the
more doubtful forms of the disease; but they are being helped.
It
has been said that the technic has the mark of Buchmanism.
It probably has, and of other religious groups and healing
methods. For it is a synthesis of everything that has proved
useful in the whole field of alcoholic diagnosis and treatment.
A movement that has for its purpose a crusade of mutual
assistance in which one drinker becomes therapist for another,
it is open to anyone who drinks too much and cannot stop
of himself. Two exactions only are demanded of him. He must
be sincere in his wish to be healed. He must have the desire
to help his fellow drinkers. Anonymity is maintained because
of the extreme sensitiveness of the alcoholic to prejudice
or ridicule. And it prevents giving offense to relatives
or to doctors and spiritual advisers, all of whom have their
redemptive parts to play.
The
actual phases of the treatment are not fundamentally different
from other mental therapies. But the instruments are not
the same and the terminology is non-existent. The “mental
catharsis” of the psychologists becomes here the simple
business of talking out loud to an audience made up of those
who are taking the cure themselves. These open meetings
are practical forums in which the members exchange points
of view and offer suggestions under the leadership of the
more experienced therapists such as Mr. Jones. Once a week
the families of the patients are invited to special meetings
where the care of convalescents is the main topic of conversation.
Another
important step is the mental inventory in which the patient
lists his virtues and his faults as an aid to self-appraisal.
It is from this evaluation that the pattern of adjustment,
the vital core of rehabilitation, is drawn. (It is what
the psychiatrists call “personality change.“)
For instance, if a member has mistreated his wife, neglected
his family, or been dishonest in his business dealings,
or quarreled with his neighbor, he must not only change
his ways, but he must try somehow to repair the damage he
has caused. Whatever his troubles, he is given ample opportunity
to talk about them; for it is through such disclosures that
the real cause of his malady reveals itself. Instead of
evading his problems, as he has in the past, he is taught
how to solve them. And if he strikes a snag he knows where
to go for help--and it will be to someone who has been through
the same experience and will therefore be able to give him
a sympathetic and helpful hearing.
As
the treatments progress he is directed toward some interest
absorbing enough to take his mind away from liquor. Sometimes
he may find his release in the recognition of a Supreme
Being, a Power outside of himself who is greater than himself.
There have been a number of cases in which this religious
awakening has broken the spell of the exaggerated egotism
which was one of the persistent causes of his illness. However,
no compulsion is put upon the patient. He makes his own
choice. About sixty per cent of the members of Alcoholics
Anonymous are deists. Many who have not been to church since
they were children have returned to their faiths. And there
are not a few atheists among them. For most of them the
great hobby that holds their enthusiasm is the help they
are giving to one another. “It is a great satisfaction,”
said one of them who was in the advanced stages of the disease
when he was enrolled, “to know that you are marking
the difference between life and death for someone.”
The
processes employed in the course of treatment are not allowed
to become stagnant. “We are always experimenting,”
Mr. Jones explained. “We try something and if it doesn’t
work we throw it out. What we are striving for is a progressive
and ever more flexible system of healing which will cover
more and more of the peculiar effects of alcoholism on the
many diverse human personalities.”
IV
The
layman’s burden I have indicated is not for the shoulders
of the therapist alone. The family of the alcoholic--parents,
sisters and brothers, sons and daughters, husbands and wives--may
very well be the deciding factor in the success or failure
of his cure, just as they are often the chief contributors
to the disturbance which causes the illness. Because of
this possibility some physicians will not treat certain
patients unless they are removed from their homes until
recovery is pretty well assured. And all healers make every
effort to gain the co-operation of relatives as a precaution
against relapse. When families fail it is not as a rule
because they are contrary or apathetic, but because they
do not know the rules.
For
their benefit I am setting down a list of things to be remembered
which I have gleaned from these specialists:
The
convalescent needs care and sympathy, not nagging and recrimination.
He must, until you are sure that his recovery is complete,
be handled with silken gloves. For he has been through a
devastating purgatory. Invalid though he is, he wants to
be treated like a man and not a child. Yet, paradoxically,
he must in some things be looked after as if he were a child.
Great care must be given to his diet. Some medical scientists
are now thinking that alcoholism may be due to lack of sufficient
vitamins in the drinker’s system. Tomato and orange
juice, carrots, beets, celery, wild rice, milk, eggs, good
red meat (if his blood pressure is normal), and some chocolate
and sweets (if he is not diabetic), are some of the foods
that will give him the needed vitamins. However it is always
best to consult a doctor on his diet necessities.
Happy
occupation for his leisure hours is a vital must on his
program. Study his tastes, if you do not already know them,
and use your ingenuity in finding things for him to do that
he will enjoy. Don’t try to force him to meet people
or do things that he dislikes.
It
is imperative not to discuss his illness with him or to
comment about his abstinence or attract attention to it,
unless of course he opens up the subject. Then talk round
and away from it. If you are in the habit of serving cocktails
be sure to have one for him on the tray as well as not one
glass but two or three glasses of tomato or orange juice.
Let him make his own decisions. That is a part of his readjustment.
He is not well until he can say “No” to himself
in the face of temptation. Don’t lock the liquor away
from him. Don’t pat him on the back and tell him how
proud you are of him and how you all appreciate what he
is going through and are feeling sorry for him. Don’t
set up pressures by holding him to strictly to household
routine. Maybe he was finishing up a round of golf. Next
time, remembering what happened last time, he may take one
drink to brace him for what he thinks is going to happen
to him when he gets home. That one drink will make him feel
just fine. So he may rationalize that just one more won’t
do him any harm. And he’s right back where he started.
Beyond
everything, never rake up past offenses. Alcohol draws a
curtain over the reasons and the memory of its victims,
driving them blindly into acts for which they are not responsible
and which they cannot remember when they are sober, as such
acts make no record on the conscious mind.
These
details are not trifles. The convalescent drinker is edgy
and highstrung. If he can be kept healthy in body and contented
in mind he has a far better chance of complete and permanent
recovery than in an environment where he is constantly on
the defensive.
(Source:
Harper’s Magazine, September 1941)
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