THE ST. LUKE'S JOURNAL OF THEOLOGY
Vol. 20: No.2, 124-138, March, 1977
SOME THEOLOGICAL QUESTIONS ARISING
FOR MALE ALCOHOLICS IN RECOVERY
by Robert M. Claytor, Jr.
This article concerns itself with the small percentage of alcoholics who are in the process of recovery. If we take the National Council on Alcoholism's conservative estimate of nine million alcoholics in this country and A.A.'s figures of approximately 450,000 in its ranks, we arrive at a "guesstimated" figure of a five per cent probable recovery rate for alcoholics.
This article is not about intervention in drinking problems. It is not a "how-to" treatise on motivation. Here we concern ourselves with those who are aware of their problem, "own" it, desire to stop drinking, and are in treatment.
The writer has dual purposes in mind with this paper vis-a-vis the parish priest and his ministry. These purposes are to show that:
a. The competent and sensitive parish priest conversant with a dynamic understanding of Alcoholics Anonymous can have an extremely valuable part in the recovery of an alcoholic. This role involves both theological interpretation and specific pastoral functions.
b. The dynamics of the recovery process provide a view of metanoia at a very practical and functional level. To facilitate this understanding necessitates some amplification of how the Twelve Step recovery process of Alcoholics Anonymous works.
Most of the effective alcohol recovery programs are strongly rooted in and related to A.A. This article assumes that recovery - not cure - from alcoholism is essentially a two-year process involving continued support, therapy, and "aftercare."
Most of the research data for this article was gained while the writer was working in two clinical settings with alcoholics described as follows:
A. U.S. Naval Alcoholic Rehabilitation Center, Norfolk, Virginia.
From January of 1972 until September of 1973 the writer functioned as a chaplain, meeting weekly for an hour-and-a-half with the patients of the U.S. Naval Alcoholic Rehabilitation Center at Norfolk, Virginia. This combination of group therapy and theological input was called "The Chaplain's Hour." More than half of the time was spent in dialogue and interaction with the patients. Patients were all active duty Navy or Marine Corps personel, including all ranks, officers as well as enlisted. Over ninety per cent were male. Patients had either volunteered for treatment or had been assigned for treatment against their will as a result of maladaptive behavior related to alcohol. This treatment center had a capacity for seventy-five patients. Since its opening it had operated at full capacity and had a waiting list. Treatment lasted for eight weeks post-detoxification.
While in the treatment program these patients attended a minimum of five and a maximum of seven A.A. meetings per week in the community. They attended at least five additional A.A. meetings per week as part of the treatment program in the center. All patients were required to become totally familiar with the literature of A.A. and to complete the Fourth Step written inventory before leaving the center.
B. Western State Hospital, Staunton, Virginia
From January of 1974 until September of 1976, the writer functioned as a chaplain, meeting weekly for an hour and a half with the patients on the alcoholism unit at Western State Hospital. Group therapy plus theological input was the style of relating to these patients. These patients had either admitted themselves to the hospital because of a self-diagnosis of alcoholism or alcohol-related problems, or they had been committed by the courts for the same reasons. The socio-economic strata from which the patients come is typical of state hospital clientele. This means the patient population includes the "skid-row" alcoholic, the recidivist who has been through most of the other treatment programs, and a surprising number who come from middle-class families. All levels of education and professional development seem to be represented.
We cite 1974 as a typical year. The treatment program lasts for three weeks post-detoxification. In 1974, 363 male alcoholics went through this program. The ages of the male alcoholics ranged from 16 to 75, with a median age of 49.5 and a mean age of 47.38. The Western State Hospital treatment prayer program has been significantly influenced by Alcoholics Anonymous. All patients attend two meetings of A.A. per week in town and two meetings per week on the hospital grounds. The meetings are conducted by local A.A. groups. All patients are required to become familiar with the literature of A.A. and to complete a Forth Step written inventory before leaving the hospital.
A Description of General Alcoholic Phenomenology
Alcoholism is difficult to define adequately with any real precision. The Diagnostic and Statistical Manual of the American Psychiatric Association defines alcohol addiction as follows:
"This condition should be diagnosed when there is direct or strong evidence that the patient is dependent on alcohol. If available, the best direct evidence of such dependence is the appearance of withdrawal symptoms. The inability of the patient to go one day without drinking is presumptive evidence. When heavy drinking continues for three months or more it is reasonable to presume addiction to alcohol has been established."
For purposes of this paper, the more commonly used clinical and operational description obtains: An alcoholic is a person with obsessional thinking about drinking who has lost control over the amount of alcohol he consumes once he begins to ingest it. However, this loss of control is seldom within his conscious awareness and is usually mistakenly attributed to moral weakness by the alcoholic. Since this debility is progressive, he will have begun to develop an increasing number of problems.
Most of the non-A.A. world tries to determine alcoholism by the number and gravity of the life problems that drinking engenders. Marital conflict or divorce, loss of job, hospitalization for alcoholism, financial problems, and avoidance of friends are typical. This is unfortunate because the perennial question of the alcoholic to himself is, "Is this one bad enough to make me an alcoholic ?" The human capacity to rationalize that which is frightening almost inevitably produces a negative answer. Until the alcoholic self-diagnoses himself, little progress will ensue.
To exacerbate the problem further, there are three strong reasons the alcoholic cannot accept his alcoholism. These reasons are: 1) palimpsests (blackout) or amnesic states; 2) the psychoanalytically described phenomenon of repression (this is escalated because of the fact that there is, in his recent life, so much more material, in terms of behavior, to repress); and 3) euphoric recall is probably the most devastating blind-spot of all. This is the phenomonon of remembering drinking episodes euphorically or in only a pleasant way. This means that the ability of the alcoholic to make the necessary self-diagnosis is extremely difficult for most and for many, apparently, impossible. The objective data he needs to reach this conclusion are almost totally outside of his awareness, and they will stay out of his awareness as long as his defense system works. The conclusion that he is an alcoholic is terrifying. He usually knows total abstinence to be the price of recovery. His highly developed defense system keeps him out of touch with reality. If the behavior which most disturbs the spouse, family, employer, associates, and the parish priest were presented to the subject by means of a video tape machine, the alcoholic himself would be the most surprised of all. Unfortunately, hardly anyone in the life of the alcoholic will be aware of this phenomenon. They will mistake his "blindness" and intrapsychic repression as obstreperousness, stubbornness, or meanness.
The mood swings of a drinking alcoholic range from expansive feelings of grandiosity and omnipotence, while inebriated, to feelings of despondency, despair and humiliation while in the "hangover" or withdrawal state. The moods of shame, guilt, impending doom, and the constant fear of detection seem well-nigh universal among drinking alcoholics. The alcoholic is out of touch with the reality of his own life history at this point. He is constantly swearing off only to return to drink within hours, but this return is generally rationalized as a desired choice rather than as the enslavement to a compulsion.
While personality generalizations are somewhat suspect, this writer perceives alcoholics as a class as bright, sensitive, frequently charming, "nice" people. They seem almost universally passive-dependent and/or passive-agressive. While drinking they lead a double life, referred to by the "Big Book" as analogous to the story of Dr. Jekyl and Mr. Hyde.
As the illness of alcoholism progresses, the male alcoholic will reach the stage of sexual impotence, incontinence, delusions, hallucinations, delerium tremens, and possible convulsions upon withdrawal. The final "symptom" is death!
The family of the alcoholic, if he still has one, is generally characterized by a great deal of scapegoating. Everyone learns at convenient times to blame all ills on the alcoholic as the alcoholic becomes expert at blaming everyone but himself. This is understandable, since the guilt for his behavior has become almost too heavy to bear.
A Crisis of Faith
While the genesis of A.A. is deeply rooted in the Judaeo-Christian faith, this does not seem widely appreciated within the "folklore" of A.A. The notion that A.A. is divinely inspired is widely held among A.A. members. Yet, most of them are not aware that two priests, one nun, one psychiatrist and two other physicians helped conceive the process in conjunction with the co-founders. This writer cannot urge strongly enough that the parish priest read A.A. Comes of Age. This is a kind of "church history" of A.A. with the GSO "imprimatur." The priest should also read Chapters 2-11 of the "Big Book."
Both unofficially and officially A.A. is very busy protesting how non-theological and non-religious it is. Of course, "religious" and "theological" are used here in the popular sense, not in that of the trained theologian. The "preamble" of A.A. says, "...A.A. is not allied with any sect, denomination, politics, organization or institution. ..does not wish to engage in any controversy..." God is referred to as "God as we understand Him," a Higher Power," or a "Power greater than ourselves."
As the beginnings of a crisis of faith begin to emerge for the recovering alcoholic, he is told that he must find a "God of his own understanding" if he is going to recover, yet he is not told specifically how or where to look outside of A.A. He is told that if he works the Twelve Steps he will have a spiritual awakening "as a result of these steps."
Notice the number of references to God in the Twelve Steps; (The comments in parentheses by the writer.)
1. "We admitted we were powerless over alcohol - that our lives had become unmanageable." (Already a subtle attack upon his own "infantile omnipotence.")
2. "Came to believe that a Power greater than ourselves could restore us to sanity."
3. "Made a decision to turn our will and our lives over to the care of God as we understood Him." (Notice the more prevenient nature of God's action in Step 2 before any conscious decision making in Step 3. Also, note that the statement of the steps is essentially the older members sharing their "experience, strength and hope" with the newer members. Note how the message is cast in the past tense of the behavior of the older members, meaning, "this is what we did and found that it worked for us," rather than, "here is what you must do." This seems an extremely commonsense manifestation of grace.)
4. "Made a searching and fearless moral inventory of ourselves."
5. "Admitted to God, to ourselves, and to another human being the exact nature of our wrongs."
6. "Were entirely ready to have God remove all these defects of character."
7. "Humbly asked Him to remove our shortcomings." (Notice the almost incredible amount of trust placed in the healing and redeeming power of God.)
8. "Made a list of all persons we had harmed, and became willing to make amends to them all."
9. "Made direct amends to such people wherever possible, except when to do so would injure them or others."
10. "Continued to take personal inventory and when we were wrong promptly admitted it."
11. "Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out." (Not only is trust in God required, but now a life of prayerful relationship with Him is assumed.)
12. "Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs." (A very often neglected key to the whole spiritual process of A.A. is that the spiritual awakening is "as the result of these steps.")
So, A.A., not "allied with any sect or denomination," makes reference to God or a direct euphemism for God in six out of the Twelve Steps. Further, in a summary paragraph following the Twelve Steps, the "Big Book" says:
"Our description of the alcoholic, the chapter to the agnostic, and our personal adventures before and after make clear three pertinent ideas:
(a) That we were alcoholic and could not manage our own lives.
(b) That probably no human power could have relieved our alcoholism.
(c) That God could and would if he were sought.
It is not hard to understand that the recovering alcoholic begins a quest for God, and often a whole new look at organized churches. This quest is often seen by the recovering alcoholic as a matter of life and death. For to continue to drink is to die. The only help held out to him is reliance upon A.A. He is convinced he must take A.A. seriously. A.A. is clearly insisting to him that he find God, so if he is to take A.A. seriously, he must take the quest for God very seriously.
A.A. hammers home two basic concepts: 1) It is the first drink that gets you drunk, and 2) the life of continued drinking can issue in either the "wet brain" or death or both. No hell-fire-and-brimstone preacher ever was more effective in leading someone to turn for help out of his "hell." It was Martin Luther who said that man must experience damnation before he can experience salvation. Alcoholics can understand this truth at an extremely basic and practical level, although they may not be able to articulate it. The alcoholic comes to realize that up to this point, he has seen alcohol only as a solution for most of his life problems. Now he realizes how it has become the center of his life and the center of the source of meaning of his life. Nearly all of the pleasant as well as the unpleasant associations in his life are alcohol-related. We might call it "alco-logia." All thinking and reasoning is, figuratively speaking, soaked in alcohol. Not only is alcohol greater than he is, he comes to see that it is his "god." At the same time, this "god" is destroying him. It is worship of the "god" alcohol, that is chronically killing him. To the extent that will-to-live remains, he is now willing to be aware of what is happening to him.
Because his "god" has backfired on him, because it now damns him instead of delivering him, because it fails him, for these reasons and these alone most alcoholics will consider another "god" as an alternative. Pious altruism is to no avail. Discussion of his wife and family, of stopping drinking for their sakes, is worse than worthless. To the extent that he can hear these reasons at all, he usually will feel more guilt, more pain, and will even reason, "Well, I might as well drink myself to death. I'm no good to them or anyone else anyway."
His crisis crystallizes. Alcohol is a power much greater than he is, whether drunk or sober. He cannot "lick it." What A.A. has told him makes sense. Only super-human aid holds out any promise. Alcohol is bigger than life itself. It is going to take something else bigger than life to be bigger than alcohol for him. What else is there but God? Metaphysical arguments about the existence, or non-existence, of God have long since paled into insignificance.
Questions About the Existence of God
There is commonly much skepticism on the part of recovering alcoholics. They tell you quite frankly that they have been preached at so much, and in the South, where this author lives and gathers his data, much of traditional Protestantism is still associated with prohibition. The alcoholic who grew up in the prohibitionist environment has to feel guilty not only for drunkenness, but also his having drunk at all. It is not uncommon for the recovering alcoholic to label himself agnostic or atheist. The problem is so significant that Chapter 4 of the "Big Book" is entitled "We Agnostics."
Ironically, both the Federal Government and the State of Virginia utilize this chaplain to "teach the spiritual side of the program" in compulsory alcohol treatment programs, the first amendment to the United States Constitution notwithstanding.
Attitudes of the individual A.A. members vary everywhere from the faith of the dedicated Christians to the self-proclaimed atheist. The attitudes of the A.A. members vary along the whole spectrum with one exception. None of them is casual about the matter. Tillich would describe them as being "concerned ultimately." So does this writer.
Arguments are futile. To the believer who has recovered, to try to argue with him against the existence of God is like trying to convince a man who was just rescued from drowning that the life guard who pulled him out of the water probably does not exist. The older A.A. member who calls himself a non-believer is usually pretty well entrenched and in a small minority within the fellowship of A.A.
It is not at all uncommon to hear one say, "I used to think I did not believe in God. Then I came to understand that the truth of the matter was that I just did not think God believed in me. It was you people (in A.A.) who have made me see through your lives that God does, after all, believe in me."
There are very practical ways in which this comes about. A newer member is trying out the 11th step, "Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out." An older member shares his experience, "Well, at first I tried it by saying, 'O God, if you're there and if you can here me, please let me get through the day without a drink.'" So, it is "working!" No one in A.A. is about to suggest that this might just be auto-suggestion. Next, he begins to thank this God for getting him through the day. This God becomes functional in his life. Before he realizes it, he has "come to believe."
What does pass for atheism in the recovering alcoholic is more of a psychological reaction to pain than any sort of carefully reasoned theological position. When Sigmund Freud reasoned against the existence of God by saying that God was merely a projection of our own father image onto the heavens, he was in error in the sense of purely reasoned metaphysics. However, the significance of his truth here is that the way most of us think about God is highly influenced by the way we think about our own parents and parental figures. Those who have perceived their parents mostly in terms of fear of being caught, of fear of condemnation and rejection, may have to deal with this psychodynamically by denying that their heavenly "father" (obviously, to them, only mean, vicious and rejecting) does not, in fact exist. Denial of the existence of God may be a covert and unconscious expression of hostility toward God emanating from deeply buried anxiety.
The Issue of Conversion Experience and Related Theological Questions.
Anyone who has seriously tried to break himself of a bad habit knows experientially something of the difficulty of the task. For instance, if the habit has to do with tobacco, time must be restructured. We cannot sit around idly "not smoking" and expect success. We may have to re-socialize away from those who perpetually smoke. We will need to break thought associations which are linked with smoking, such as "finishing a meal reminds me of tobacco." Finally, if there is to be any contentment in life after the breaking of the habit, there will have to be some change of attitudes vis-a-vis smoking and tobacco.
Now, we are talking not only about a habit, and a very bad habit, alcoholism, but also about a dependency and a physiological addiction with roots which go deep into the persona. Consider that the problems that go with breaking any other bad habit multiply, as it were, exponentially.
For the recovering alcoholic, time must be restructured. Re-socialization away from old "drinking buddies" is essential. Thought associations are devastating if not altered. The alcoholic associates all forms of pleasure-music, dancing, sports, holidays, sex, eating, etc., with drinking. He must learn to enjoy himself without booze and without thinking of booze.
A.A. refers to this phenomenon as a "spiritual awakening" and requires it as the sine qua non for any long-term sobriety. Now, what our patient is told is that he must experience what is tantamount to at least a kind of mini-conversion experience. Let the "Big Book" speak for itself as it quotes the words of the celebrated psychiatrist, Carl Gustaf Jung, in referring to the "spiritual awakening" the alcoholic must experience if he is to recover:
"They appear to be in the nature of huge emotional displacements and rearrangements. Ideas, emotions and attitudes which were once the guiding forces of the lives of these men (sic) are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate them."
Since these changes are absolutely essential and "as the result of these steps" and not always "suddenly cast to one side," the later literature provides modification of the time factor involved in this essential change.
"Among our rapidly growing membership of thousands of alcoholics such transformations (suddenly revolutionary changes), though frequent, are by no means the rule. Most of our experiences are what the psychologist William James calls the "educational variety" because they develop slowly over a period of time. Quite often friends of the newcomer are aware of the difference long before he is himself. He finally realizes that he has undergone a profound alteration in his reaction to life; that such a change could hardly have been brought about by himself alone. What often takes place in a few months could seldom have been accomplished by years of self-discipline."
The theological trained ear begins to hear the dynamics of metanoia and the rebirth experience. Anyone who hears the Nicodemus story with his own name as the nominative of direct address asks the same question as did Nicodemus, "but how is this possible?"
The literature of A.A. is adamant and without compromise:
"If you have decided you want what we have and are willing to go to any lengths to get it - then you are ready to take certain steps... At some of these we balked. We thought we could find an easier, softer way. But we could not . ..Some of us have tried to hold on to our old ideas, and the result was nil until we let go absolutely."
What is being asked of the alcoholic is change of his basic raison d'etre. His whole reason for being, a life wrapped around a bottled anesthesia which has given solace for so long is being whisked away, and a new, but unknown, substitute is offered. He will have to have new ways of reducing anxiety and new ways of relating closely and intimately to others. The psychological "vacations" from reality we all need will have to be found in new ways. A new sense of significance must come and from another source. New ways of finding euphoria and other ways of experiencing transcendence are essential if he is to be "alive" with any sort of "abundant" life. The patient is afraid - terrified is not too strong a word. He is also irritable, resistant and dubious. Promise is held out, and it is described. Here is a description of the promise:
"If we are painstaking about this phase (the discussion of the first nine steps) of our development, we will be amazed before we are halfway through. We are going to know a new freedom and a new happiness. We will not regret the past nor wish to shut the door on it. We will comprehend the word "serenity" and we will know peace. No matter how far down the scale we have gone, we will see how our experience can benefit others. That feeling of uselessness and self-pity will disappear. We will lose interest in selfish things and gain interest in our fellows. Self-seeking will slip away. Our whole attitude and outlook upon life will change. Fear of people and of economic insecurity will leave us. We will intuitively know how to handle situations which used to baffle us. We will suddenly realize that God is doing for us what we could not do for ourselves.
Are these extravagant promises? We think not. They are being fulfilled among us - sometimes slowly. They will always materialize if we work for them"
But this promise has not yet been experienced. He asks, "Will it ever happen to me and can life even be fulfilling and content again?" The experience of the older members of A.A., to which they never cease testifying, is that for many of them, the reality described above has happened.
So, the patient who wishes to be a "winner" has his task cut out for him. He cannot just wander around vaguely looking for some kind of "Damascus" road where something might happen to him. He has been told that these changes occur as the result of these steps.
The theologically trained ear will pick itself up at the mention of "steps" and immediately suspect Gnosticism. Since I believe there is little, if any, of climbing ladders up to God in these steps, let us peruse them in some detail.
Step 4 is written "searching and fearless moral inventory" taken patiently and slowly so as to be "thorough." It is to list all of the offensive thought and behavior of the past which produces guilt and shame, as well as the positive attitudes of oneself. It is far more extensive and intensive than the preparation of the average penitent's first lifetime confession.
Step 5, "Admitted to God, to ourselves, and to another human being, the exact nature of our wrongs," it is a kind of cleaning out of the spiritual garbage can. It is admission of all of this to God, to oneself and to another human being. It involves all that anyone's lifetime confession does and much more. At this point the "Big Book" makes a very precise referral:
". ..Those of us belonging to a religious denomination which requires confession must, and, of course, will want to go to the properly appointed authority whose duty it is to receive it. Though we have no religious connection, we may still do well to talk with someone ordained by an established religion. We often find such a person quick to see and understand our problem. Of course, we sometimes encounter people who do not understand alcoholism."
The implications for an Episcopal priest should be obvious. Suffice it to say that it is hoped that this priest is, at the very least, conversant with the literature of the "Big Book" and the "12 and 12."
The priest can now expect some very specific questions to be inevitably articulated. "This God of understanding and forgiveness is very appealing, but is it all right with my church for me to believe this?" "My preacher told me that drunkards and whoremongers could never go to heaven, but would burn in hell. What do you think?" "Is there really a devil?" "Is there really a hell?" "I cannot believe every word of the Bible, so how can I believe any of it at all?" Usually, there are a number of specific questions about how did God make the sun stand still, create the world in seven days, etc. They are asking, "How can I understand God?"
Step 6, "Were entirely ready to have God remove all these defects of character," and Step 7, "Humbly asked Him to remove our shortcomings," involves a serious change of character, breaking of many old habits and the re-establishment of new habits. Step 7 and Step 8, "Made a list of all persons we had harmed, and became willing to make amends to them all," involve "amendment of life" in a radical sense. (This is taking "and intend to lead a new life", seriously.) This means searching out people and institutions whom one has harmed and violated and, in a most concrete way, attempting to make restitution wherever possible. It is only after all of this is done in a "painstaking" way that the promises listed above are held out. The recovering alcoholic has faced a number of spiritual crises, had many theological questions and struggled with them if he has any realistic hope of recovery.
But if guilt is to be reduced, self-acceptance recovered and relationships improved; if self-forgiveness, the forgiveness of others and the respect of others is to ensue, there is little hope through any other alternative.
Step 11 says, "Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out." Many alcoholics at this stage of recovery seek and need help from clergy. They need to know more about what prayer really is, how to pray and if their own style of informal prayer is valid. A.A. sees the 11th step as one of the three "maintenance" steps - as essential to maintain the new style of life.
The author hopes it is now evident that the competent and sensitive priest who is fairly sophisticated in the dynamics of alcoholism has a very important role to play in the recovery of alcoholics. He alone is qualified to perform this theological and pastoral function.
The theological areas to which he can speak concern the nature of God, sin and the life of prayer. A.A. has presented these issues to the recovering alcoholic as indispensable to recovery. Yet, A.A. has not provided all of the answers. A.A., by its very nature, cannot provide these answers.
Further, the taking of the 5th step, a combination of components and confession and counseling, is thought by the best A.A. authorities as indispensable to the "spiritual awakening" which is essential for longterm, contented sobriety. The "Big Book" specifically counsels that the alcoholic sees his priest for this purpose.
Finally, it is hoped that the 12 step process of "spiritual awakening" - a major attitudinal change - provides a valuable theological analogue. This major displacement and rearrangement of old ideas, attitudes and emotions by a whole new set of feelings, thoughts and attitudes provides an excellent lens through which to understand conversion to Jesus Christ. While the "spiritual awakening" should not be equated with Christian metanoia, it is as similar to it as anything known to this author. Further, the pastor who is aware of the dynamics of both, and understands both in relation to the other, may be able to be a more effective facilitator of Christian conversion. He can also have a richer theological understanding.