EARLY ALCOHOLISM TREATMENT:
The Emmanuel Movement and Richard Peabody
Katherine McCarthy, Ph.D.
Journal of Studies on Alcohol, Vol.45, No.1, 1984*
Alcoholics and those who treat them have been of necessity present oriented. The day-to-day effort of maintaining or promoting abstinence in living people leaves little attention for reflection on the history of treatment. This history can, however, offer much needed perspective on the problems and limitations of treatments; it permits us to learn from both the success and failure of earlier work and philosophies.
This article will outline the history of what is usually called the "Peabody Method" of recovery from alcoholism. Its best known practitioner, Richard Peabody, began treating alcoholics individually in the early 1920s; his followers continued until the l950s. As with the later Alcoholics Anonymous program, its roots were in Protestant religious thought rather than in medicine. Its later practitioners imitated the psychiatric model of professional practice, but their ideas stemmed from pre-Freudian, characteristically American Progressive thought.
Peabody’s book The Common Sense of Drinking, first published in Boston in 1931 was widely read and influenced several medical and lay practitioners. The basic strategy did not originate with Peabody, however, he refined and "professionalized" ideas that he had learned in the Emmanuel Movement from Dr. Elwood Worcester and Courtenay Baylor.
The Emmanuel Movement began in Boston in 1906 in the Emmanuel (Episcopal) Church. The movement’s founder, Dr. Elwood Worcester, practiced a method of healing for assorted forms of "nervousness" including alcoholism and other addictions. Worcester and his assistant, Dr. Samuel McComb, operated a free clinic supported by the church for about 23 years. The movement was widely reported in the press, and Worcester and McComb became well known for their success with alcoholics as well as other types of patients.
In 1913, Courtenay Baylor began to work for the Emmanuel church as a specialist in alcoholism; he was probably the first paid alcoholism therapist in this country. Originally an insurance agent he had come to Worcester in 1911 for help with his drinking problem. After a period of sobriety he retired from the business world to become a paid "friendly visitor" in the church’s Social Services Department. He remained at the Church until Worcester’s retirement in 1929, after which the two practiced together at the Craigie Foundation of Boston. Worcester died in 1940. In 1945, by now an old man, Baylor resumed his old job at the Emmanuel Church. By all accounts he died sober. Baylor described his treatment technique in the book Remaking a Man (1919) as did Anderson: in his book titled "The Other Side of the Bottle" (1950).
Baylor’s most famous patient was Richard Peabody, son of a well known Boston family, who came to the Emmanuel church for help with his alcoholism in about 1922. Peabody survived his World War I service unscathed, but after several years of heavy drinking found that his life was falling apart. He had lost his share of the family fortune in shipping at a time when everyone else was becoming rich from the war. In 1921 his wife (later known as Caresse Crosby) obtained a divorce; she had become so afraid of him that she would not stay alone with him and had appealed to her uncle, J.P. Morgan for financial and moral support. Peabody suffered from acute depression and was hospitalized more than once.
Despite his family’s wealth and prestige. Peabody was not prepared for a career and supporting a family. He had graduated from Groton preparatory school (where his uncle, Rev. Endicott Peabody, was headmaster) but never finished Harvard. When he married in 1915, his wife’s family was already worried about his drinking. Peabody quickly escaped from family life by signing up for military service at the Mexican border. Soon after, he left again for the war in France, having barely seen his two children. Military life was apparently a preoccupation with the men in his family; Mrs. Crosby described his parents’ home as having a "family atmosphere of eau de cologne and tiptoe discipline….The household ticked on a training schedule." Major and Mrs. Peabody lived a "militaristic" existence, "a strange, muted life, uneventful and unjoyful;" everything was highly polished with "implements of war laid out like precious objets d’art." According to Mrs. Crosby, Mrs. Peabody spent most of her life in nightclothes. Peabody was an only child "who had never been allowed to play or cry, for both these exercises disturbed his parents," quite a different picture from the "overindulged, pampered childhood" that Peabody later insisted was the primary cause of alcoholism.
Peabody attended the Emmanuel Church’s clinic and weekly health classes in the winter of 1921-1922 and by 1924 was listed in one of its publications as a volunteer assistant in the Social Service Department (Emmanuel Church, Department of Community Services, 1924). Sometime during the l920s he established his own office on Newbury Street in Boston. During this period he "effected some remarkable cures" and became known to some as "Dr. Peabody"; patients came to him from considerable distances. It is likely that Baylor referred patients to him from the church, since there were probably more applicants than Baylor himself could handle. A few years earlier Baylor had observed in a Church report that alcoholics were coming for treatment from as far as Santa Barbara, Denver, Mobile, Washington and Philadelphia, "while New York is a suburb from which we have many commuters." By 1933, Peabody was practicing in New York at 24 Gramercy Park.
In the 1930s Peabody was publishing articles in both the medical and lay literature on his method: The New England Journal of Medicine (1930), Mental Hygiene (1930), The American Mercury (1931) and American Magazine (1931). His book, The Common Sense of Drinking (1931) was republished in 1935 as an Atlantic Monthly Press book. By the late 1930s, several physicians interested in the new "scientific approach" to alcoholism were using his technique, including Norman Jolliffe at Bellevue Hospital in New York, Merrill Moore at Boston City Hospital and Edward Strecker at the Institute of Pennsylvania Hospital in Philadelphia. In 1944, the Yale Center of Alcohol Studies opened the first free clinic exclusively for the treatment of alcoholism; the Yale plan Clinics in New Haven and Hartford offered individual and group treatment under the direction of a Peabody therapist, Raymond G. McCarthy.
Before his death in 1936, Peabody had trained several, of his sober patients to become lay therapists like himself, including Samuel Crocker, James Bellamy, Francis T. Chambers Jr., William W. Wister and Wilson Mckay. Wister’s experience of treatment with Peabody is described in detail in a book by Bishop titled The Glass Crutch, with an epilogue by Wister himself. Strecker and Chambers also published a book detailing their version of the method.
Peabody and his coworkers apparently did not share Baylor’s personal success at remaining sober. A common opinion is that Peabody died intoxicated, although the evidence is not conclusive. Samuel Crocker, who had once shared an office with Peabody, told Faye R. that he was intoxicated at the time of his death. The personal copy of Peabody’s book belonging to Bill Wilson (one of the founders of A.A.) now in the A.A. Archives, contains the following inscription; "Dr. Peabody was as far as is known the first authority to state, "once an alcoholic, always an alcoholic," and he proved it by returning to drinking and by dying of alcoholism - proving to us that the condition is uncurable." This copy was originally owned by Rosa Burwell of Philadelphia. Some early A.A. members share the opinion that Peabody died intoxicated. The published sources contradict each other. Wister quoted Peabody’s second wife to the effect that he died of pneumonia. The editors of Scribner’s magazine, which published an article of his posthumously, claimed that he died of a heart attack. Mrs. Crosby did not say.
Wister’s authorized biography reports that he became drunk in 1941 after seven years of sobriety, and although he became sober again, he did not resume therapeutic work. Faye R., who knew Baylor, Crocker and McKay also resumed drinking. Faye R. was at different times a patient of Baylor, Crocker and McKay. She has been abstinent in A.A. for 40 years. Her summary of the Peabody therapists is: "They had many wonderful ideas but they just didn’t have the magic of A.A."
Marty Mann described the Peabody Method as being primarily for the well-educated or the well-to-do, a description that also characterized patients of Freudian analysis of the time. William Wister’s family, was as well known in Philadelphia as Peabody’s was in Boston; Francis Chambers belonged to Philadelphia’s most exclusive men’s clubs. Faye R. reported that Baylor, Crocker and McKay were also from well-do-do Boston families.
Few but the well-to-do could afford Peabody’s fees. Wister was broke and in debt when he appeared on Peabody’s doorstep in 1934, so the therapist offered to reduce his fixed fee of $20 per hour to $10. Peabody told Faye R. that his fee was $10 per session for seven visits per week; she went to Crocker instead, then newly established in practice, for $5 per session. According to Faye R., Baylor scorned such exorbitant rates even when he was himself in difficult financial straits.
It appears that the considerable majority of patients of the Peabody practitioners were men, although Baylor and Peabody occasionally referred to "men and women" as potential patients. Peabody’s method, however, was clearly geared to the needs and interests of men, and Baylor’s was much less so, as will be described below. The age distribution of Peabody’s .patients is not known. Peabody once remarked to Faye R., then had known of to do so. Peabody himself was probably only a year or two older than that when he stopped drinking. Probably the great majority of the alcoholic patients of those practitioners were white, since their race was not mentioned. Worcester did point with pride to the success of his church’s self-help tuberculosis program with blacks, but did not refer to them among the clinic patients.
Peabody made important philosophical changes in and added some psychiatric terminology to the treatment method although it had as its original model quite a different conception of the relationships among body, mind and spirit than those used by Peabody’s contemporaries. Worcester and McComb based their claims as healers on their qualifications as clergymen; coincidentally, both had doctorates in psychology. The later practitioners, however, had serious problems of establishing professional identification; Peabody and his followers therefore made serious compromises in their work in the hope - ultimately unfulfilled -that they could be accepted as mini-psychiatrists. The Emmanuel Church clergy began their work at a time when almost no one had heard of Freud, a time when the whole notion of psychotherapy and "functional" nervous disorders was still very new and open to various eclectic treatments. Worcester and McComb were severely criticized by both. physicians and fellow clergy for daring to invade medical territory, but in 1906 the medical profession had neither the organization nor the public acceptance to force them out of the field. By the 1930s, however, this. had changed considerably. In 1940 Wister was actually threatened with arrest for practicing medicine without a license. In trying so hard to imitate the prestigious intellectual ideas of the l930s, Peabody and his followers essentially gutted their method of the vital substance that had made Worcester and Baylor so successful in earlier decades.
In 1935 a new rival to Peabody was quietly being born in Akron, Ohio. By 1942, A.A. had grown enough in size and popular reputation to be a viable alternative to the Peabody Method in some urban areas. As with the patients of the earlier method, A.A. was initially composed primarily of the well-to-do and well educated. Because it was free and nonprofessional, however, it quickly spread to a much wider group. Additionally, A.A. in its basic concepts of healing and suffering, was much more similar to the Emmanuel Movement than to the professional therapists. Organizationally, it was quite different from both, but Elwood Worcester would certainly have recognized its basic beliefs as very harmonious with his own. Faye R. reported that, near the end of his career, Baylor attended an A.A. meeting and loved it: he enthusiastically recommended it to her. Bill Wilson and his wife Lois (later to become the founder of ‘Al-Anon) both read The Common Sense of Drinking in the early days of his sobriety and were very interested in it. However, only a few phrases and helpful hints from it were incorporated into the A.A. program. The Emmanuel Church like thousands of other American churches -now houses a large A.A. meeting: it meets on Wednesdays in the old parish house, the same place where Worcester and McComb gave Wednesday night classes for up to a thousand "nervous sufferers."
THE EMMANUEL APPROACH
Worcester and McComb were not alcoholics. Their therapeutic method was originally designed to treat the condition then called "neurasthenia," a term covering an assortment of neurotic symptoms, psychosomatic problems, phobias, extreme worry, anxiety, addiction and other problems then considered non-organic. In a follow up study of clinic patients during part of 1906-1907, Cabot reported that only 12% were alcoholics. In the Emmanuel Church 1909 Yearbook, McComb described a cured patient -a young, well educated, "refined" woman who had been irritable, self-conscious, preoccupied with morbid thoughts and uninterested in life; "It is mainly, through not exclusively for sufferers of which this young woman is the type that our health conference has been inaugurated." The considerable majority of the nonalcoholic patients were women. Worcester and McComb reported three rules for accepting alcoholic patients: (1) They must come voluntarily from their own desire to stop drinking, not solely because of pressure from others. (2) They must be willing to accept the goal of total abstinence, for "the attempt to convert a drunkard into a moderate drinker…..cannot be done once in a thousand times."
(3) They must be dry during the first interview and pledge to be abstinent for one week. The brief pledge apparently had some value: "In the course of many years experience very few patients have broken this promise."
Worcester believed that all diseases had physical, mental and spiritual components - some problems might’ be primarily physical, such as a broken leg, but the patient’s attitudes could still promote or retard healing. Many problems were more obviously’ related to a person’s mental state. A case of deafness, for example, might be purely organic and should be treated first by a physician, but some cases were also of psychological origin and could be relieved by psychotherapy. Many of Worcester’s patients had primarily moral problems or habits that required a new way of life: addictions, anxiety, or excessive fear or worry. The realms of the body, mind and spirit interacted in a delicate balance in each person; an improvement in one’ area might lead to improvements in another. Severe pain from an intractable physical ailment could be relieved by changes in attitude; the physical craving for alcohol or morphine could be eliminated by a more spiritual way of life. All nervous sufferers could be helped by redirecting their attention away from themselves to a life of service to others. Exercise, proper’ breathing and natural sleep would ultimately promote a proper spiritual balance.
The concept of the unity of body, mind and spirit that Baylor inherited from Worcester was probably unique in American thinking of the time. Worcester acquired his ideas from the German psychologist, Gustav Fechner, with whom he had studied at the University of Leipzig. Fechner was renowned for his early work in experimental psychology, but his lifelong philosophical interest was in developing a true Geistwissenschaft, or a science that would include both the material and the spiritual worlds. He believed that the relationships between these two realms could be understood through mathematical formulas that would explain both without reducing either to the terms of the other. ‘Worcester explicated Fechner’s ideas and claimed that he was unable to disentangle Fechner’s ideas from his own commented: "The modern temperament finds the union of the mystical and the scientific difficult to understand. Yet Fechner’s mystical grasp upon the unity of life and the world lives on, and in each generation finds a welcome from a few."
Worcester and McComb were best known for their use of suggestion and autosuggestion. They employed hypnosis with a small number of alcoholics to keep them sober long enough to receive treatment, but in most cases they merely put the patient in a state of relaxation. With the patient seated in a comfortable chair in a dim and quiet room, the therapist would give directions for systematically relaxing each limb and slowing down racing thoughts. Baylor would ask the patient to imagine that he was sailing in a small boat toward an island, at first quickly, then more slowly until the person ended up lying comfortably on a sunny shore.
Worcester believed that a person’s subconscious mind was more amenable to outside influence while he was in this relaxed condition. He could then suggest to an alcoholic, for example, that the desire to drink would soon pass, that he would soon sleep better and that he could begin to make progress in his life. Worcester believed that in this way powerful healing forces of the subconscious mind( a term that he intentionally retained after Freud’s "unconscious" became popular) could be brought into play to support a person’s conscious desire to recover. Worcester saw the subconscious mind as an essentially positive force: it was the source of enormous strength, creativity, inherited memory and communication with the spiritual realm. It was, in short, the spirit of the soul. Consistent with his view of the unity of the soul and body, he saw the subconscious as the regulator of elementary physical processes, including the heartbeat, circulation, respiration and time keeping; thus positive suggestions directed to it could affect physical health.
For Worcester, the, redirection of attention was a very basic element of therapy. Nervous sufferers and alcoholics became morbidly preoccupied with their destructive habits and sufferings; the therapeutic effort was to redirect that attention toward higher goals - the development of a spiritual life and service to others. Misdirected attention, produced often by physical pain or bad habits, caused much avoidable’ suffering; "A large part of the sorrow, ‘failure, sickness and discouragement of’ life comes from this one source, the anticipation of evil. If we could disregard all pain and misfortune but the actual, we should deliver ourselves from about eight—tenths of the sorrow of this life." (This is the same principle as A.A.’s injunction "don’t project" - or assume a future possibility to be present fact.)
Attention could be redirected at first by a therapist through suggestion while the patient was in the relaxed stated but the patient must be taught to practice autosuggestion until new mental habits were learned. The latter technique made the healing power of the subconscious available in daily life; it consisted of "holding a given thought in’ the mental focus, to the exclusion of all other thoughts." The patient learned autosuggestion and other techniques (proper breathing, hints on obtaining restful sleep, etc.) not only in individual treatment sessions but in the Wednesday night classes in which the clergy and others lectured on such topics as habit, anger, worry and fear.
The theological basis of Worcester’s belief in redirected attention rested on the Biblical "resist not evil" which he interpreted to mean that constructive psychological change could be promoted more effectively by building up a person’s strengths than by directly attacking the problem or bad habit itself. For example, Baylor reported successfully treating a woman with a phobia about open spaces by engaging her in a deep conversation about her work while walking with her, for the first time in many years, through Boston Public Gardens. He had already done the ground work, however, with many sessions of relaxation and suggestion and by gradually weaning her away from sleeping medications.
The Emmanuel clinic used prayer as an essential vehicle for acquiring the power of attention, just as some holistic healing strategies today often employ meditation for related purposes. Worcester’s theory went well beyond that of simple meditation, however; for him, the therapeutic dynamic was that "surrender implied in sincere prayer is always followed by the consciousness of peace and inner freedom." The mechanism here, as with attention, is paradoxical: "Only by surrender to the All Holy and All Powerful are, the potentialities of the self realized." What follows is a process of conversion; "Whereas the sinful tendency about which (the patient) was in the main concerned is robbed of its attractive quality and the thought of it finds no entrance to his imagination." New sources of energy from the subconscious are thereby tapped. These paradoxes had long been familiar to religious thinkers, but they were not described in the psychiatric literature until the 1940s with Tiebout’s analyses of the therapeutic mechanisms of A.A.
Worcester also saw the benefit of group support and the service that afflicted could render each other, an idea that A.A. developed to a much greater extent years later. The Emmanuel Movement prescribed not only individual therapy, lectures and reading, but provided social hours after the weekly classes at which the patients were expected to talk to each other their growth and progress. Following the principle of redirected attention, however they were not supposed to dwell on their ailments. The Church also ran a well staffed Social Service Department that provided "friendly visitors" to call on patients and provide moral support, assist in finding jobs and occasional financial help. Some staff members, such as Baylor, were paid former patients: others were volunteers.
The "guiding principle" of the Social Service Department, according to the Emmanuel Church 1909 Yearbook, was to turn the thoughts of each sufferer from himself to others. In all troubles of mental origin, one of the most successful curative agencies has been to get one person to help another suffering from exactly from his own trouble. How can we ask another to make efforts which we will not make ourselves? In this way moral strength is passed on from one to another."
An important off-shoot of this arrangement was ‘the Church sponsored club for alcoholics. Founded in 1910 by’ a nonalcoholic parishioner, Ernest Jacoby, the club held meetings in the church basement on Saturdays and its space was used for socializing on most other nights. Nonalcoholic’s also attended and the club’s relationship to alcoholism was disguised’ in Church reports, but the evidence is that its purpose was to help newly abstinent patients reinforce each other’s abstinence. Its motto was "A club for men to help themselves by helping others." There were no membership fees. The only requirement for membership was "an expressed desire to lead an honorable life and a willingness to aid other men less fortunate." Worcester’ added one other requirement; "They should not come to the Church drunk." A follow-up committee sought out those who failed to appear for meetings. A system resembling A.A. sponsorship was created, called "special brothers," in which each member was expected to look out for another. Saturday night meetings included food, entertainment and lectures on topics of current interest. "The broadest religious tolerance was observed, and many faiths were represented." In the 1910 Church report, 20 persons were listed by name as officers and members of the club. No women’s names were included.
By 1912, the club announced that it had "already accomplished results beyond our farthest hopes." The club had grown, and most of its original members were still attending. It was arranging for a better system of record keeping and was soliciting contributions for a new clubhouse; one was reported from a little girl who gave a benefit fair. The club moved out of the’ Church in about 1914; nothing is known of it after that time except for Greene’s report that it maintained good relations with the Emmanuel Church, which continued to send it new members.
The ideas of self-help and mutual support as alcoholism treatment were not original to the Emmanuel Movement. The best known historical antecedent was the Washingtonian Movement of the 1840s, a large group of abstinent alcoholics and nonalcoholic temperance advocates who achieved brief but spectacular success at "reforming" drunkards. Some recent authors have noted that other temperance groups in the following decades also employed the group-support principle. According to Levine, "In the latter half of the 19th century the Sons of Temperance, the Good Templars, and a host of smaller fraternal groups, functioned in much the same manner that A.A. does today. They provided addicts who joined their organizations with encouragement, friendship and a social life free from alcohol. They went to inebriates in time of need, and in some cases offered financial support as well." It is difficult to determine at this distance whether the founders of the Jacoby Club were familiar with the earlier organizational forms. The major difference in the Emmanuel Church work was that it rejected temperance preaching as a means to attract or help alcoholics.
Although Worcester was himself a supporter of the idea of temperance, he had an approach to the problem of the moral status of alcoholism different’ from that of his temperance predecessors or scientific successors. Worcester had no doubt that alcoholism was both a disease and a moral problem. Addiction involved habit, for him clearly a moral category, yet he unhesitatingly ranked alcoholism along with tuberculosis, cancer and syphilis as the four major diseases of his time. To Worcester, the question of will was irrelevant to alcoholism and neurasthenia; both were diseases of the whole person in body, mind and spirit, not merely problems of the faculty of will. According to Levine, "In 19th and 20th century versions, addiction is seen as a sort of disease of the will, an inability to prevent oneself from drinking." For temperance advocates, this meant that moral exhortation addressed to the will would be sufficient to keep a person from drinking. Other historians have described the remedy for alcoholism espoused by the late nineteenth-century Reform Clubs and the Woman’s Christian Temperance Union as "gospel temperance" -a moral suasionist attempt to spark a spiritual rebirth in alcoholics and to get them to keep a pledge of total abstinence. The task as the Union Signal put it, was analogous to "Peter preaching to the gentiles." This same view characterized the mission approach of the Salvation Army and other turn-of-the-century mission efforts.
By comparison, Worcester’s approach ‘was more modern in totally rejecting moral suasion, as a healing strategy. Worcester believed that sermons were for normal people: "Something more than exhortation, argument, or persuasion is’ necessary.... They may provoke opposition on the patient’s part or they may even be dangerous." Something more was needed because more than one aspect of the personality was involved; like A.A., Worcester felt that the individual’s entire life was affected and that an appeal solely to the strengthening of the will would thus be inadequate. He saw evil as a more basic, pervasive condition in’ the individual’s life than did most of his contemporaries, such as the mind—cure practitioners and those with various scientific approaches, including the most recent. For Worcester, recovery must come from surrender to both an external force (as in conversion) and to the, healing capacities within the subconscious.
According to Clinebell, one secret of the Emmanuel Movement’s success lay in this effort to reduce an alcoholic’s guilt rather than to increase it as did the other strategies of the time: "Emmanuel therapy apparently was frequently able to convey this experience. When guilt is reduced, the energies previously employed in the guilt and self-punishment process, are freed and made available for therapeutic Ends. The alcoholic’s inferiority is reduced... by (his) becoming aware of his ‘higher and diviner self’ which is his real self." Like others of the Progressive Era, Worcester had great faith that the human race was improving and that an enlightened science could help reduce human suffering. He did not believe that his method was, antagonistic to medicine or that it was a "mind-cure"; on the contrary, he believed his method to be more scientific than that of contemporary physicians who could understand only the body, without any theoretical comprehension of the importance of mind and soul. He believed that clergy and physicians working’ together could accomplish far more than either alone. Worcester and McComb firmly believed in the essential goodness of human nature, even of the unconscious mind; for them the ideal life was a balance of natural inner forces, not a constant struggle with instincts and impulses. For Worcester, feeling in itself was never a problem; even painful emotions such as fear had their useful functions. Kurtz (Not-God, A History of Alcoholics Anonymous) noted that Bill Wilson also had a basic acceptance of human instincts, which for him only became a problem when alcohol, permitted them to "run riot."
In defense of the reality of his patients’ nervous sufferings, Worcester ‘once stated that he would rather break both thighs than undergo the pain that some of them experienced. Worcester and McComb never hesitated to speak of fear, faith, hope and the spirit; Peabody would not even mention the word "suffering." His book was, of course, an offer of hope and help to alcoholics, but Peabody could not bring himself to name the feelings.
Worcester was writing primarily for and working for women, although he never publicly acknowledged this. In 1908, he earned the equivalent of a year’s salary writing five enormously successful articles — including one oh alcoholism in women-for the Ladies Home Journal. Peabody was writing self-consciously for men. His examples of schools, clubs and recreational activities were exclusively those of upper-class men. He worried about the "manly complex" that might drive a man back to drink; he urged his readers to remember that "it is the manly thing to do to give up drinking because the weakling cannot do it." His ambivalence about stereotypically female feelings and expressiveness runs through his work and accounts for many of the ways in which his methods diverged from those of Worcester and Baylor.
Courtenay Baylor must have been a, remarkable man. Constance Worcester and Faye R. spoke of him with great personal affection, even many years later. Peabody dedicated his book to him; Anderson described him: "He had a ‘soothing7 beautiful voice that lulled you but at the same time gave ‘you confidence. It was a voice you could, trust."
On Baylor’s effectiveness, he commented: "If I had been one of those skeptics, who say it is not the therapy but .the therapist that gets results, he would have been a shining example; for he was one of the most illuminating and persuasive personalities I have ever met. However, the results of his work for four decades of practice and the success of the people whom he had trained give solid proof that in this case the value lay in the therapy as well as the man." Baylor did not confine his work to alcoholism; his book (Remaking a Man) was intended to help various types of nervous sufferers, including the shell-shock victims with whom he began working in 1917.
Baylor did not see alcoholics as being fundamentally different from other people. Every person who drinks, however moderately, "has a ‘true alcoholic neurosis’ to the extent that he drinks," since he makes up excuses for drinking and will not stop without a struggle. Like Worcester, he was willing to blame alcohol for alcoholism rather than finding the fault in the individual’s early history. He believed that all neurosis took the form of alternating periods of rationalization and excuses. Therefore, the treatment for alcoholism was not significantly different from the treatment for other forms of nervous suffering.
Baylor fully accepted the Emmanuel Church’s model of social service and mutual helpfulness for his own work; he did not foster professional distance between himself and his patients. According to Constance Worcester, he did not discuss the fact that he was an alcoholic with outsiders, but, unlike Peabody, he was direct about this with his patients. He required mutual confidentiality as a condition of his work: "Before we get through, I shall have to reveal as much about myself as you do about yourself." He insisted that the patient take increasing responsibility for the work. At the beginning of treatment the patient was informed that: "You will act in a double capacity: you are to be patient and physician at the same time." The patient and instructor "are to study out together certain fundamental psychological laws, the knowledge of which will enable them to get to the bottom of that trouble." Baylor’s goal with a patient was "to so help him to help himself that his reconstruction will be permanent." Faye R. reported that his methods were much less formal than those of Crocker and McKay.
According to Baylor, all neuroses, including alcoholism, resulted from mental and physical "tenseness." He believed that "the taking of the tabooed drink was ‘the physical expression of a certain temporary but recurrent mental condition which appeared to be a combination of wrong impulses and a wholly false, though plausible, philosophy. The cause of this mental state was a condition of the brain "akin to physical tension" during which it "never senses things as they really are." For example, the person believes that his troubles are entirely the fault of other people or circumstances, and does not realize the extent to which his own depression, fear or irritability color his perceptions and may actually change the attitude of others toward him. This leads to more practical problems and to greater tenseness, which will be expressed in further drinking or neurotic behavior: "literally a circle of wrong impulses and false philosophy — each a cause and a result of the other."
The solution, therefore, was first to promote physical and mental relaxation, and then to examine in a calm frame of mind those "false, though plausible" attitudes. Ultimately, the patient should learn permanent relaxation by practicing the techniques that he has learned. Anderson described this state as "a combination of ‘suppleness, vitality, strength and force -a certain definite intentional, elasticity." Baylor called it peace of mind and stated: "Peace of mind will do wonders."
Baylor believed that his failures resulted from his inability to gain a patient’s attention; some remnant of spiritual capacity must be present in order for him to break the "vicious circle of neurasthenia" - or the patients endless brooding attention to his troubles. "I fail to get this attention either because the patient has an innate lack of desire to change his life and ideas and no spiritual element out of which to build such a desire, or because he has an actual mental defect, or because his illness is so deep-seated and his spiritual side so buried that the stimulus dynamic enough to reach and arouse him or the time and personal attention necessary to get through to him have been lacking."
Baylor’s strategy was to supply the person with a "new point of attention, a’ new philosophy of life, and a new courage with which to face life." The complex interaction of ‘body, mind and spirit can be seen here: "attention" was for Worcester and Baylor both a spiritual and a mental concept, with both cause and effect in the physical realm. To attend to good rather than to resist evil, and also to develop a new sense that life is worthwhile would not only promote spiritual growth but actually keep some patients alive.
One way to redirect a patient’s attention was to provide a new time focus. The new interest and new point of view should be "so big and so different that they occupy the present moment fully and make all of life seem worthwhile." One strategy that he used for adjusting the ,patient’s time sense to a normal pace was to speed up or slow down his own thinking during a therapeutic session to match that of the patient; he would then take the lead in adjusting the speed of the patient’s thoughts to a more normal level.
Baylor made no direct reference to the "subconscious" but it is clear that he regarded it as a vital spiritual force in redirecting a patient’s attention. Interviews with patients were "one hundred per cent suggestion, direct or indirect." There is nothing "weird" or "uncanny" about this, he explained; it is as natural as the fact that a salesman’s cheerfulness has a positive effect on a customer. (Those who believe that the theory of suggestion is dead might take another look at modern advertising.) The reeducational work itself, however, is logical and rational; it proceeds through discussion of the patient’s past to "analysis and explanation and definite instruction." Baylor described the results to be anticipated by the patient as the awakening of a new part of the mind or spirit: "Because you have recognized a new function, or another sense perhaps, you will have a hope that you can handle life instead of having life handle you." Success with the method would lead to new confidence, efficiency and happiness; but happiness,he believed, could not be directly sought.
Applying Worcester’s principle of "resist not evil," Baylor did not address phobias directly but worked to eliminate the background reasons for fears in general; otherwise the phobia might recur in altered form. Relaxation would make an alcoholic able to cope with "tense" periods of his life before they actually leads him to a drink. (The actual practice of A.A. meetings resembles this "resist not evil" principle, without using that language; the bulk. of a recovering alcoholic’s effort is to establish a foundation of "sober thinking" rather to confront the alcohol itself directly. A.A. teaches its members to avoid the recurring periods of "alcoholic thinking" or "dry drunks" that resemble Baylor’s "tenseness."
After a few years of’ experience, Baylor began to realize that a longer course of treatment was necessary for alcoholics than what Worcester had provided. Worcester had seen most alcoholics several times a week for a few weeks or months. A newspaper ("Preacher-Healer tells of his cures") reported the case of a woman addicted to alcohol, chloral and morphine who had been "cured" by Worcester in seven visits. There was a form of follow-up, however; she was thereafter required to write him a letter whenever she felt like taking a drink or a drug. Baylor did not mention follow-up to treatment, although Faye R. reported that he and the Peabody therapists were always willingly available by telephone.
In the Annual Report of the "Men’s Department" Emmanuel Church 1916 Yearbook), Baylor announced: "We have come to feel that it is unwise to attempt to accomplish the work in a few interviews, and an agreement is made with those who come that they will abide by our instructions for a year, This means that they see us frequently at first. Periods between visits are then lengthened, a course of rea4ing is taken up and various exercises are carried through." A typical interview lasted a half-hour. He described the long-term difficulties as follows:
"Getting the man to stop drinking is only the first step in a very long march. All the negative traits induced by alcohol must be eliminated and the positive traits put in their places. Irritability, self-pity, fear, worry, criticism of friends, bitter hatred of enemies, lack of concentration, lack, of initiative and action, all these must be worked out of the character. The entire mental process must be changed, a new sense must be grown, one that can recognize the soul; when this is accomplished we have the man himself cured from alcoholism."
According to some sources, Baylor was "more worldly" than ‘Worcester and paid more attention to practical problems, including the effects of alcohol on the family. Worcester had enlisted the cooperation of the family in. accepting the goal of sobriety for both the patient and themselves. Baylor went much further in discussing the specific problems that family members developed as a result of living with an alcoholic in the practical, mental and spiritual areas. Much of Baylor’s time was spent working with relatives; he recognized the difficulty that they experienced in accepting an alcoholic who had changed greatly by becoming sober. He compared the difficulty of this task to a "delicate surgical operation." He also worked directly with employers to try to change negative attitudes. Faye R. reported that he later developed a considerable practice in divorce counseling. His Social Services Department of ten provided material assistance to families of alcoholics, whether or not the alcoholic was in treatment.
Baylor did not consider himself a scientist. He felt that his work was "more than a science; it is also an art." In the introduction to Remaking a Man, he apologized for the lack of technical terminology. Peabody, however, took quite a different tack. In the introduction to his book he explained that he had simplified his "somewhat technical vocabulary" so that the average layman can read it without reference to a dictionary." Neither man had a college degree. Each brought vital experience to the problem of alcoholism, but they chose to use it in quite different ways.
Baylor had none of Peabody’s professional pretensions, yet his claim to competence was broader: he believed that he could understand and influence not only the mind, but the body and spirit as well. The originators of the Emmanuel Method did not consider their work to be subordinate to that of medical professionals; the Rector of Emmanuel Church initially hired physicians to do routine diagnostic work, then took over the task of healing when they had failed.
We know somewhat more about Worcester and Baylor’s therapeutic success. In 1908, Dr. Richard C. Cabot of the Harvard Medical School published a report on the outcome of 178 cases of all types, including alcoholism, seen by Worcester and McComb in a six-month period of 1907. Of 22 alcoholics, 11 were listed as "much improved" or "slightly improved"; seven had unknown outcomes. These rather vague terms do not reflect the fact that Worcester, during the early months of this period, was using a technique that he later reported to Peabody was a total failure - trying to teach his patients to "drink like gentlemen." Exactly when his approach changed is not clear.
Clinebell concluded: "It’ seems possible that the Emmanuel Movement enjoyed a relatively high degree of success in providing at least temporary sobriety," based on, Worcester’s long-term reputation and his own statements. Baylor reported in 1919 that, of about 100 cases that he had seen personally in the previously seven years, about two-thirds had been successful. His annual reports from 1913 to 1916 also refer to significant numbers of "successful cases" each year. We do not know how long the patients of either Worcester or Baylor were able to maintain their abstinence, but Worcester referred to several who had "stood like rocks in their place for years."
In the early years of the Emmanuel Movement there was almost no interest within the medical profession in "‘spirit", or feeling as healing resources. The great majority of psychiatrists and neurologists were concerned exclusively With somatic explanations for mental and emotional problems; they believed that all such problems would ultimately be explained by reference to "lesions" of the nervous system. As Grob has noted, late-nineteenth--century and early-twentieth-century psychiatrists, "having rejected as subjective and unscientific such affective sentiments as humanity, love and compassion....found their own supposedly objective and scientific approach to be barren."
Part of the great, influence of Freud on American thinking was of course his recognition of the role of feelings in various types of illnesses, both psychosomatic and purely psychological ones. For Freud, feelings and their conflicts were usually problematic and the cause of endless human difficulties. For Worcester, however, the awakening of new spiritual feeling was essential to the cure of many troubles; positive feelings in themselves constituted a cure.. Freud, and his followers also cultivated a dry and austere language, quite the apposite of the sentimentality of the clergy. By the post-World War I years, the kind of language of feeling that Worcester and McComb had used seemed insufficiently "professional" for physicians; in fact, it was rarely used as a form of public statement outside the churches.
The differences in the two approaches to alcoholism were summed up by Freud himself in comments he made to a reporter when visiting this country in 1909. When asked his opinion of the fact that Worcester and others "claimed to have cured hundreds of cases of alcoholism and its consequences by hypnotism, Freud replied, "The suggestive .technique does not concern itself with the origin, extent, and significance of the symptoms of the disease, but simply applied a plaster-suggestion-which it expects to be strong enough to prevent the expression of the diseased idea. The analytical therapy on the contrary. . . concerns itself with the origin and progress of the symptoms of the disease." (Hale, Freud and the Americans: The Beginning of Psychoanalysis in the United’ States. 1971) According to Hale, "he implied that hypnotism also was a morally doubtful kind of trickery that resembled ‘the dances of pills of feather-decorated, painted medicine men.’ He criticized the clergy and others who practiced without medical degrees: "When I think that there are many physicians who have been studying methods of psychotherapy for decades and, who yet practice it only with the greatest caution, this undertaking of a few men without medical, or with a very superficial medical training, seems to me at the very least of questionable good." He implied that such people might affect the reputation of his own method: "I can easily understand that this combination of church and psychotherapy appeals to the public; for the public has always had a certain weakness for everything that savors of mysteries and the mysterious, and these it probably suspects behind psychotherapy, which, in reality has nothing, absolutely nothing, mysterious about it." Hale concluded: "Admitting that he knew little about the Emmanuel Movement, he promptly condemned it."
Granted that the question was somewhat inaccurate (Worcester rarely used hypnotism), Freud’s response still shows not only his ignorance of addiction but his lack of interest in the actual relief of suffering. Rieff (Freud: The Mind of the Moralist) noted: "Clearly no one so unsentimental as Freud can be accused of loving humanity, at least not in the ways encouraged by our religions and their political derivatives,....He was interested in problems, not patients, in the mechanisms of civilization not in programs of mental health.
As Hale described it, "Freud at once constructed a counter-image that became in turn an important psychoanalytic stereotype- psychoanalysis was austere and difficult, requiring extraordinary expertise but promising radical cure."
Such was the narrow model of professional practice available to Peabody as a therapist of the 1920s. He did not attempt to imitate the particular techniques of a psychiatrist, but he systematically eliminated from his terminology and concepts anything that hinted of the church and "feather-decorated, painted medicine men." The acknowledgments in his book include Baylor and six physicians, but he did not mention the Emmanuel Church. Like the psychoanalysts, Peabody kept an extreme professional distance from his patients; Wister reported that all he had ever learned about Peabody personally was that "Peabody had learned much in Boston from, two noted psychiatrists and that he had married twice." Wister also noted that he spoke objectively, as though he were discussing the proper treatment for a broken leg and that he never discussed the moral aspects of alcoholism."
Since Peabody had no credentials and chose not to use his own experience as the basis for his claim to be a teacher, he was in a difficult position to justify his fees. The nearly total lack of interest of the medical profession in working with alcoholics should have given him a wide field in which to work, but the only formal reason he could give patients for coming to him for treatment was that it might speed up recovery. He quoted a patient approvingly: "I went to Peabody on the same theory that I would have gone to an instructor of mathematics had I found it necessary to learn calculus. Probably I could learn calculus by myself out of books, but it would take me a great deal longer than if I went to a competent teacher."
Peabody promised in his book to avoid "moralizing"; his was strictly a "scientific approach." By 1931, moralizing about alcohol was certainly out of favor, within his social class at least. The excesses of some of the Prohibition advocates and the difficulties of enforcing Prohibition had embarrassed most advocates of such laws into silence. It was becoming fashionable now to blame the drinker, not the social institution of drinking, for alcoholism. Peabody wrote an article on "Why Prohibition Has Failed," in which he claimed, in effect, that drinking is a normal human activity (for men, at least) and should not be tampered with by mere moralizers.
Peabody went a step beyond the anti-Prohibition logic. It was one thing to claim that ordinary drinkers should not have to feel guilty for their indulgence, yet quite another to imply that alcoholics themselves have ho problem with guilt or shame about their addiction. Nowhere did Peabody recognize the fact that alcoholics do feel much guilt and remorse about the trouble that they have caused themselves and others. Peabody provided no mechanism by which forgiveness and acceptance could be attained, either in a religious sense or through a group of similarly afflicted individuals.
The men of the Jacoby Club bonded together "to lead a more honorable life," but Peabody did not use even such indirect references to guilt or self-esteem. Since neither morality nor feeling was an acceptable topic of discussion for Peabody, the only justification he could give for the effort to become sober was, in effect, "efficiency." A man must be impressed with the fact that he is, undergoing treatment for his own personal good and because he believes it to be the expedient thing to do."
The major practical drawback to excessive drinking cited specifically’ by Peabody was its "supreme stupidity." His explanation was designed to appeal to the patient’s respect for ‘his own masculinity: "Just as all normal boys are anxious not to be considered incompetent in athletics, so to be thought stupid is the last thing that a full-grown man with any pretense to normality wishes. Even in prisons drunkards are held in low repute by criminals because they are where they are as a result of inferior intelligence rather than a distorted moral point of view."
It seems curious now that Peabody did not attempt to resolve the moralizing problem by calling alcoholism a disease or an illness. The disease concept was certainly, available to him-the Emmanuel Movement had used it freely, and it had been current in some circles of temperance workers and physicians since the late nineteenth century. Diseases, however, are ordinarily understood to have some connection with the body and Peabody’s basic philosophical orientation seemed derived from the mind-cure movement, including Christian Science, which essentially denied the significance of the body and was interested only in the mind as a means for controlling an individual’s life. Many of Peabody’s therapeutic suggestions resemble a secularized version of the writings on mind-cure and self-help dating from the 1890s. His work was thus a strange amalgam of these ideas and the quite different philosophical and psychological ideas of Worcester and McComb.
Worcester had begun his clinic work partly in response to the apparent healing successes of Christian Science. He viewed their theology and that of New Thought as shallow and materialistic, however, and little resemblance existed between his tripartite view of the person and the idea in mind-cure that pure thought can be used to eliminate disease and to produce increased efficiency and business success. Christian Science denied the reality of bodily suffering altogether and of course had no use for the medical profession. Mary Baker Eddy did not believe in the existence of the unconscious, and other mind-cure writers "far from teaching an open-door policy toward the subconscious. . . taught absolute denomination over it."
According to Meyer ( The Positive Thinkers. .Religion as Pop Psychology from Mary Baker Eddy to Oral Roberts ) the central tenet of mind—cure was that "God was Mind....The crucial aim in this characterization was that it should guarantee a self-enclosed and coherent existence....Mind was above all the realm in which people might feel that life came finally under control." Christian Science, and later mind-cure expressed no interest in human service (a fact commented on quite sarcastically by both Mark Twain and Elwood Worcester), which might account for Peabody’s lack of interest in it.
Peabody continued to use several important ideas he had learned from Baylor: surrender, relaxation, suggestion and catharsis. His development and reformulation of some of these -particularly surrender and, suggestion- was much more specific to and useful for an alcoholic’s particular situation than the formulations of Worcester and Baylor.
Peabody was very clear about the new priorities for a reordered life: "The first step to sobriety is surrender to the fact that the alcoholic cannot drink again without bringing disastrous results" and "this surrender is the absolute starting point. The conviction of its supreme importance is an absolute necessity. With surrender, halfway measures are of no avail." This was undoubtedly the source of Bill Wilson’ s better known phrase: "Half measures avail us nothing." Peabody noted that an "intellectual surrender by no means settles the question," but he did not discuss the emotional aspect of such surrender. He did detail some of the obstacles to it, included "distorted ‘pride" and the conviction that drinking is "smart" or "manly."
The patient, must also have a conviction that he needs help. Peabody sometimes made a prospective patient convince him of the fact that he was truly an alcoholic. He would not accept a patient unless "he can say that he would like to be shown how to reconstruct his mental. processes so that in due time he will no longer want to drink."
Peabody used the same relaxation technique employed by Worcester and Baylor, although he was somewhat defensive about it: "I appreciate that this relaxation-suggestion phase of the treatment may sound like hocus-pocus to those who have never tried it." He justified relaxation in part on the grounds of efficiency - on the grounds that a person could accomplish more work in a day with less effort if the exercise were done daily. They could also be used as mental training to avoid "displays of temper, baseless apprehensions, shyness, and other unpleasant moods, not by trying to support them, but by finding out why they exist and anticipating occasions which might create them." The regular practice of relaxation would prevent the "accumulation of emotional tension." He devoted only one page to the physical aspects of the treatment, including exercise.
Suggestion had wider uses, Peabody defined its most useful form for alcoholics as "driving home platitudes as if they were profundities over and over again." ( It is very likely not a coincidence that this is the basic organizational principle of A.A. meetings ) The therapist supplied these suggestions during relaxation sessions and the patient was to repeat them nightly at bedtime. Peabody also assigned readings and the daily copying out of simple statements that he supplied one at a time as the patient was ready.
Like his predecessors, Peabody appreciated the significance of catharsis, although none of the three used that term. They all provided an opportunity for a patient to discuss his drinking history and earlier life experiences. Peabody saw this as a more formal task of analysis (in a somewhat Freudian sense) than did the’ others; it was not merely an emotional purging for the patient, but an opportunity for the therapist to point out the causes of the individual’s drinking. Peabody’s ideas about the causes of alcoholism will be discussed further below.
Unlike Worcester and Baylor, Peabody did not regard the unconscious as necessarily helpful. It was the repository of excuses, denial and: other obstacles to permanent abstinence, as well as the ever dangerous emotions it was the mental scrap heap to which the desire to drink must ultimately be relegated. The unconscious also needed to be "taught," and the method of teaching it was through thought control. "The most important element in the work (is) the control and direction of the thoughts toward the ultimate logical goal." All negative thoughts must be stopped and positive ones substituted; "When at length the mind is diverted, the unconscious, which is supposed to retain all memories, must be left with a true picture of the whole situation and the individual’s intellectual attitude toward it."
The most distinctive aspect of Peabody’s method was his plan for time control. He described it: Before going to bed the patient should write down on a piece of paper the different hours of the following day, beginning with the time of arising. Then, so far as can be determined beforehand, he should fill in these hours with what he plans to do. Throughout the day notations should be made if exceptions have occurred in the original plans, and it should be indicated whether these exceptions have been due to legitimate or rationalized excuses.... Small as well as larger activities that are taken up should not be dropped until completed unless they are in a sense unknown quantities, entered upon for the purposes of investigation only. Several pages of instructions follow. Peabody emphasized that the spirit in which the time plan is followed was more important than accuracy. Its functions were to (1) give the, patient something concrete to do to change his condition, (2) provide the patient with "training in executing his own commands" and (3) prevent idleness. Regarding this last point he quoted Stekel: "Earthly happiness….. is primarily dependent upon our relationship to time." Following this regimen might well have helped the patient to develop a new sense of responsibility, since he had to be accountable to his therapist for his actions every day. Peabody, however, did not discuss responsibility.
Faye R. recalled that her therapists told her to break down the schedule into 30-minute units. Marty Mann reported that one Peabody patient whom she knew carried time cards with him in his shirt pocket so that he would never be far from his schedule.
In his discussions of time and impulse control, Peabody appeared less like the psychiatrist and more like the industrial engineer perfecting his efficiency and productivity. He is also the military officer planning in advance so that his troops would not mutiny while he slept. He compared the time exercises to "close order drill"; discipline, not character, was his security. "In battle it has been proved over and over again that large hordes of individually brave but untrained men can accomplish little when opposed by a smaller but disciplined military group -so with the alcoholic and his temptation. He cannot expect consistently to conquer his enemy in every drawing room and country—club porch if he has made no advance preparation."
Peabody apparently expected the self to remain deeply divided; balance of any sort must have seemed unattainable to him because he recommended that constant vigilance be exercised against endlessly threatening, feelings. Wister reported that Peabody had told him: "I want you to begin thinking of yourself as two selves. There’s your intellectual self and your emotional self. This intellectual self is a good self, the logical self. Its your best self...Now there’s the other self, the emotional self. It’s always there and it is right that it should always be there. But it is the side that wants to drink....But thought control will shrink it down so that it becomes much smaller than the good ‘self. You must reconcile both selves. But you must permit the intellectual side to dominate."
Peabody, the factory manager, again noted: "Every phase of this therapy is governed by a time element. You will eventually learn to master your emotions and you will sit, intellectually, in the driver’s seat. For a time, however, you will have to direct your mental processes by hand . Later they will operate automatically." (This statement is exactly the opposite of A.A.s recommendation: "Get out of the driver’s seat.") Nowhere did Peabody speak of patients acquiring new feelings, desires or interests Other than "hobbies"- his limited aim was that they be free of one destructive desire. Alcoholics must "train their minds so that they no longer wish to drink." Clearly, Peabody "resisted evil" as strongly as he could.
It is difficult to imagine that efficiency, expediency and time management could provide sufficient inspiration to transform active alcoholism into a lifetime of sobriety. It was a far cry from Worcester’s promise of reawakened spiritual powers or Baylor’s hope for "recognition of the soul;" A life of mere efficiency and the systematic suppression of feelings, organized in hours or half-hours, certainly resembles Crosby’s description of the atmosphere in which Peabody grew up: a "strange muted life, uneventful and unjoyful". and a "tiptoe discipline (which) ticked on a train-like schedule." Such an arrangement might achieve freedom from alcohol, but it is much less clear what that freedom was for.
For Peabody, indulgence of feeling and lack of discipline were the causes, of alcoholism. He discounted heredity as causative, claiming instead that improper family circumstances lead to a "nervous condition," which "in turn induces alcoholism." He described his typical patient as a first or only son, suffering from a fear of maternal domination: he was "pampered and overprotected" as a child and drank to resolve his conflicts about achieving manhood. The patient "had unconsciously to choose between becoming a timid mother’s darling, completely surrendering his own personality, or putting up an exaggerated opposition. Of the two he unquestionably chose the wiser course." The typical mother ‘was "domineering and prudish" and the typical father was shy, with periods of despondency. Ultimately, the parents were responsible for the child’s alcoholism. "The resulting character, is the fault of the parents, though in the use of the word "fault" we do not wish to conjure up an ethical concept so much as one of ignorance and lack of self-control."
Later writers on this topic were not as delicate about the use of the "ethical concept." Much of Bishop’s fictionalized biography of Wister is an essay on his mother’s faults, on how she caused and encouraged his alcoholism. Strecker and Chambers were much more pointed in their insistence that mothers be blamed for the sins of their sons. Peabody did not single out mothers in particular. In a series of writings employing Peabody’s ideas, Strecker and Chambers’s denunciation of women and their insistence that men control women became increasingly shrill. In the book Their Mother’s Sons, the psychiatrist Strecker reached new depths in denouncing mothers for virtually every faulty male act of the World War II era, much like Philip Wylie’s better known Generation of Vipers. None of these writers informed us what the cause of alcoholism in women might be.
Although Peabody’s method was widely practiced for about two decades, little is known of its overall therapeutic success, and an accurate guess is impossible at this date. Marty Mann concluded that Peabody and his therapists "accomplished a heroic work during the 1930’s, when little else was being done for alcoholics" and that the method "was effective with a considerable number"’ of patients. It is known that a few remained abstinent and professionally active in the field of alcoholism. Others who failed at the Peabody method were known to have joined A.A. in its early years, but it is impossible to determine how many remained quietly sober without joining A.A. or professional groups. The fact that several of the Peabody method’s major practitioners - apparently including the founder - were not able to maintain their sobriety, however, does not bode well for other patients with whom contact was lost.
The major significance of Peabody’s work was probably not its long term therapeutic success but the hope that it gave, both to the researchers in the early scientific study.’ of alcoholism and to early A.A. members, that alcoholism was a treatable condition and a worthy topic for further research and investigation. In their review of the treatment literature, Bowman and Jellinek concluded, "In this country, Peabody has probably exerted more influence than anyone else on the psychotherapy of alcohol addiction," The writings of Peabody and of Strecker and Chambers reached a far wider audience than Baylor’s book ever had. By the 1930s, the Emmanuel Movement had almost been forgotten. Even if the physicians and other professionals of the late l930s and early 1940s had known of Worcester and Baylor’s work, they undoubtedly would have rejected it as too religious for their own use. A.A. methods could not be used directly by professional therapists, since these methods depended on a group of recovering alcoholics. The tone and style of Peabody’s writing was undoubtedly far more agreeable to professional practitioners by the end of Prohibition. The Peabody model was actively used in the Yale Plan Clinics, which employed both individual therapy and the class method of teaching similar to what Worcester had originally used. These class sessions were published verbatim in several issues of the Quarterly Journal of Studies on Alcohol and were very likely influential in the practice of other early clinics.
The difference between Worcester’s and Peabody’s work is in part accounted for by the spirit of the times when they developed their work. Elwood Worcester was 50 years old when World War I began; Richard Peabody was 20. Although Worcester incorporated some psychoanalytic concepts in his later work, he never altered his conviction that human nature was basically good and that the "subconscious" was a useful ally of consciousness. For Peabody, who had fought at Chateau-Thierry, those assumptions had become untenable. More congenial to his generation were the ideas of Freud, for whom the mind was an endless battleground of life and death instincts that could be kept in check only by the eternally vigilant forces of’ civilization. Peabody’s understanding of human life was thus more modern than Worcester’s. For the younger man, life was an endless struggle, not so much between conscious and unconscious forces, but between sober reason on the one hand and feeling (equated with intoxication) on the other. A tone of postwar despair and depression permeated his work. Writing in 1919, Baylor used relatively little of Worcester’s inspirational religious language, although he retained his basically spiritual view of the recovery process. Writing in 1930, Peabody had abandoned the spiritual language and concepts altogether.
Curiously, the postwar pessimism did not similarly affect Bill Wilson, who was Peabody’s close contemporary and who also fought in World War I. Wilson’s writings retained the language of another turn-of-the-century Protestant source, the Oxford Groups, through which he had initially stopped drinking. Many people, including new A.A. members and professionals, have reacted to his language in Alcoholics Anonymous, the primary A.A. sourcebook, as anachronistic and overly sentimental. It is essentially the same kind of style that was popular in Worcester’s time, with the same indomitable optimism and confidence in the efficacy of spiritual ideas. It contrasts sharply with today’s professional therapeutic language.
It is hard for us now to accept Worcester’s optimism about the human race or his conviction that our inner impulses are always beneficent ones. There are still no more than a few of us, as Murphy (Historical Introduction to ‘Modern Psychology) noted, who can understand his vision of the, unity of the mystical and material worlds; our culture has trained us for so long to keep them rigidly separated. Worcester also could not give us an explanation of suffering. Like A.A., he had only a theory of progress and improvement not a theory of evil.
It is probably unfortunate from the long-term point of view of treatment that the "scientific" interest in alcoholism that developed in the 1930s could find professionally acceptable only the rather limited approach of Peabody. The International Bibliography of Studies on Alcohol (Keller) does not even list the writings of Worcester and Baylor. Apparently, its definition of "science" was not broad enough even to include, the Emmanuel Movement, at least in the English speaking world. Perhaps, if we had adopted the broader concept of a Geistwissenschaft as Worcester — and perhaps also Freud - understood it, we would not be embroiled in such continuing problems with understanding the proper scope of the terms "science" and "disease."
Indirectly, one can conclude that the Emmanuel approach probably deserved its reputation for greater therapeutic success, since it used several of the major strategies that were later proved successful in related form by A.A. From the point of view of recovery, far more has’ been accomplished in the past 50 years by those who appreciated Worcester’s paradox - that the unmanageability of life may be turned around by relaxing, control, not by ever more frenzied efforts to regain it.