THE DOCTORâ€™S OPINION in the book -- Alcoholics Anonymous
Note: Page numbers are in Roman Numeral and refer to 3rd Edition of the book, check your page number if you are using a different edition of the Big Book. The wording is the same -- the page numbers may be different.
THE DOCTORâ€™S OPINION
WE OF Alcoholics Anonymous believe that the
reader will be interested in the medical estimate of
the plan of recovery described in this book. Convincing
testimony must surely come from medical men who have
had experience with the sufferings of our members and
have witnessed our return to health. A well-known doctor,
chief physician at a nationally prominent hospital
specializing in alcoholic and drug addiction, gave Alcoholics
Anonymous this letter:
To Whom It May Concern:
I have specialized in the treatment of alcoholism for
In late 1934 I attended a patient who, though he had
been a competent businessman of good earning capacity,
was an alcoholic of a type I had come to regard as
In the course of his third treatment he acquired certain
ideas concerning a possible means of recovery. As part
of his rehabilitation he commenced to present his conceptions
to other alcoholics, impressing upon them that
they must do likewise with still others. This has become
the basis of a rapidly growing fellowship of these men
and their families. This man and over one hundred others
appear to have recovered.
I personally know scores of cases who were of the type
with whom other methods had failed completely.
These facts appear to be of extreme medical importance;
because of the extraordinary possibilities of rapid
xxiv THE DOCTOR'S OPINION
growth inherent in this group they may mark a new
epoch in the annals of alcoholism. These men may well
have a remedy for thousands of such situations.
You may rely absolutely on anything they say about
Very truly yours,
William D. Silkworth, M.D.
THE DOCTORâ€™S OPINION
The physician who, at our request, gave us this letter,
has been kind enough to enlarge upon his views in another
statement which follows. In this statement he confirms
what we who have suffered alcoholic torture must believe
â€”that the body of the alcoholic is quite as abnormal
as his mind. It did not satisfy us to be told that we could
not control our drinking just because we were maladjusted
to life, that we were in full flight from reality, or were
outright mental defectives. These things were true to some
extent, in fact, to a considerable extent with some of us.
But we are sure that our bodies were sickened as well. In
our belief, any picture of the alcoholic which leaves out
this physical factor is incomplete.
The doctorâ€™s theory that we have an allergy to alcohol
interests us. As laymen, our opinion as to its soundness
may, of course, mean little. But as ex-problem drinkers,
we can say that his explanation makes good sense. It
explains many things for which we cannot otherwise account.
Though we work out our solution on the spiritual as
well as an altruistic plane, we favor hospitalization
for the alcoholic who is very jittery or befogged. More
often than not, it is imperative that a manâ€™s brain be
cleared before he is approached, as he has then a bet-
xxv -- THE DOCTORâ€™S OPINION
ter chance of understanding and accepting what we have
The doctor writes:
The subject presented in this book seems to me to be of
paramount importance to those afflicted with alcoholic
I say this after many yearsâ€™ experience as Medical Director
of one of the oldest hospitals in the country treating
alcoholic and drug addiction.
There was, therefore, a sense of real satisfaction when
I was asked to contribute a few words on a subject which
is covered in such masterly detail in these pages.
We doctors have realized for a long time that some
form of moral psychology was of urgent importance to
alcoholics, but its application presented difficulties beyond
our conception. What with our ultra-modern standards,
our scientific approach to everything, we are perhaps
not well equipped to apply the powers of good that
lie outside our synthetic knowledge.
Many years ago one of the leading contributors to this
book came under our care in this hospital and while here
he acquired some ideas which he put into practical application
Later, he requested the privilege of being allowed to tell
his story to other patients here and with some misgiving,
we consented. The cases we have followed through have
been most interesting; in fact, many of them are amazing.
The unselfishness of these men as we have come to
know them, the entire absence of profit motive, and
their community spirit, is indeed inspiring to one who
has labored long and wearily in this alcoholic field. They
believe in themselves, and still more in the Power which
pulls chronic alcoholics back from the gates of death.
Of course an alcoholic ought to be freed from his physical
xxvi -- THE DOCTORâ€™S OPINION
craving for liquor, and this often requires a definite hospital
procedure, before psychological measures can be of
We believe, and so suggested a few years ago, that the
action of alcohol on these chronic alcoholics is a manifestation
of an allergy; that the phenomenon of craving
is limited to this class and never occurs in the average
temperate drinker. These allergic types can never safely
use alcohol in any form at all; and once having formed
the habit and found they cannot break it, once having
lost their self-confidence, their reliance upon things human,
their problems pile up on them and become astonishingly
difficult to solve.
Frothy emotional appeal seldom suffices. The message
which can interest and hold these alcoholic people
must have depth and weight. In nearly all cases, their
ideals must be grounded in a power greater than themselves,
if they are to re-create their lives.
If any feel that as psychiatrists directing a hospital for
alcoholics we appear somewhat sentimental, let them stand
with us a while on the firing line, see the tragedies, the
despairing wives, the little children; let the solving of these
problems become a part of their daily work, and even of
their sleeping moments, and the most cynical will not
wonder that we have accepted and encouraged this movement. We feel,
after many years of experience, that we
have found nothing which has contributed more to the
rehabilitation of these men than the altruistic movement
now growing up among them.
Men and women drink essentially because they like the
effect produced by alcohol. The sensation is so elusive that,
while they admit it is injurious, they cannot after a time
differentiate the true from the false. To them, their alcoholic
life seems the only normal one. They are restless,
irritable and discontented, unless they can again experience
xxvii -- THE DOCTORâ€™S OPINION
the sense of ease and comfort which comes at once by
taking a few drinksâ€”drinks which they see others taking
with impunity. After they have succumbed to the desire
again, as so many do, and the phenomenon of craving
develops, they pass through the well-known stages of a
spree, emerging remorseful, with a firm resolution not to
drink again. This is repeated over and over, and unless
this person can experience an entire psychic change there
is very little hope of his recovery.
On the other handâ€”and strange as this may seem to
those who do not understandâ€”once a psychic change has
occurred, the very same person who seemed doomed, who
had so many problems he despaired of ever solving them,
suddenly finds himself easily able to control his desire for
alcohol, the only effort necessary being that required to
follow a few simple rules.
Men have cried out to me in sincere and despairing appeal:
â€œDoctor, I cannot go on like this! I have everything to live
for! I must stop, but I cannot! You must help me!â€
Last edited by Dallas
on Thu May 07, 2009 2:28 am, edited 2 times in total.