|
AA Alcoholics Anonymous
Dr. Silkworth - Doctor's Opinion
Forward to first Edition, Alcoholics Anonymous: WE, OF Alcoholics Anonymous, are more than one
hundred men and women who have recovered from
a seemingly hopeless state of mind and body. To show
other alcoholics precisely how we have recovered is the
main purpose of this book. For them, we hope these
pages will prove so convincing that no further authentication
will be necessary. We think this account of our
experiences will help everyone to better understand the
alcoholic. Many do not comprehend that the alcoholic is
a very sick person. And besides, we are sure that our
way of living has its advantages for all. THE DOCTOR’S OPINION - ALCOHOLICS ANONYMOUS
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
hopeless.
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.
You may rely absolutely on anything they say about
themselves.
Very truly yours,
William D. Silkworth, M.D. 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
—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 doctor’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.
More often than not, it is imperative that a man’s brain be
cleared before he is approached, as he has then a better chance
of understanding and accepting what we have to offer.
The doctor writes:
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
at once.
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
craving for liquor, and this often requires a definite hospital
procedure, before psychological measures can be of
maximum benefit.
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.
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
the sense of ease and comfort which comes at once by
taking a few drinks—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 hand—and strange as this may seem to
those who do not understand—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:
"Doctor, I cannot go on like this! I have everything to live
for! I must stop, but I cannot! You must help me!"
Faced with this problem, if a doctor is honest with
himself, he must sometimes feel his own inadequacy. Although
he gives all that is in him, it often is not enough.
One feels that something more than human power is
needed to produce the essential psychic change. Though
the aggregate of recoveries resulting from psychiatric
effort is considerable, we physicians must admit we have
made little impression upon the problem as a whole.
Many types do not respond to the ordinary psychological
approach.
I do not hold with those who believe that alcoholism is
entirely a problem of mental control. I have had many
men who had, for example, worked a period of months on
some problem or business deal which was to be settled on a
certain date, favorably to them. They took a drink a day or
so prior to the date, and then the phenomenon of craving
at once became paramount to all other interests so that the
important appointment was not met. These men were
not drinking to escape; they were drinking to overcome
a craving beyond their mental control.
There are many situations which arise out of the phenomenon
of craving which cause men to make the supreme
sacrifice rather than continue to fight.
The classification of alcoholics seems most difficult,
and in much detail is outside the scope of this book. There
are, of course, the psychopaths who are emotionally unstable.
We are all familiar with this type. They are always
"going on the wagon for keeps." They are over-remorseful
and make many resolutions, but never a decision.
There is the type of man who is unwilling to admit that he
cannot take a drink. He plans various ways of drinking. He
changes his brand or his environment. There is the type
who always believes that after being entirely free from alcohol
for a period of time he can take a drink without
danger. There is the manic-depressive type, who is, perhaps,
the least understood by his friends, and about whom a
whole chapter could be written.
Then there are types entirely normal in every respect
except in the effect alcohol has upon them. They are often
able, intelligent, friendly people.
All these, and many others, have one symptom in common:
they cannot start drinking without developing the
phenomenon of craving. This phenomenon, as we have
suggested, may be the manifestation of an allergy which
differentiates these people, and sets them apart as a distinct
entity. It has never been, by any treatment with which we
are familiar, permanently eradicated. The only relief we
have to suggest is entire abstinence.
This immediately precipitates us into a seething caldron
of debate. Much has been written pro and con, but among
physicians, the general opinion seems to be that most
chronic alcoholics are doomed.
What is the solution? Perhaps I can best answer this
by relating one of my experiences.
About one year prior to this experience a man was
brought in to be treated for chronic alcoholism. He had
but partially recovered from a gastric hemorrhage and
seemed to be a case of pathological mental deterioration.
He had lost everything worthwhile in life and was
only living, one might say, to drink. He frankly admitted
and believed that for him there was no hope. Following
the elimination of alcohol, there was found to be no
permanent brain injury. He accepted the plan outlined in
this book. One year later he called to see me, and I
experienced a very strange sensation. I knew the man by
name, and partly recognized his features, but there all
resemblance ended. From a trembling, despairing, nervous
wreck, had emerged a man brimming over with selfreliance
and contentment. I talked with him for some
time, but was not able to bring myself to feel that I had
known him before. To me he was a stranger, and so he left
me. A long time has passed with no return to alcohol.
When I need a mental uplift, I often think of another
case brought in by a physician prominent in New York.
The patient had made his own diagnosis, and deciding his
situation hopeless, had hidden in a deserted barn determined
to die. He was rescued by a searching party, and, in
desperate condition, brought to me. Following his physical
rehabilitation, he had a talk with me in which he
frankly stated he thought the treatment a waste of effort,
unless I could assure him, which no one ever had,
that in the future he would have the “will power” to
resist the impulse to drink.
His alcoholic problem was so complex, and his depression
so great, that we felt his only hope would be through
what we then called "moral psychology," and we doubted
if even that would have any effect.
However, he did become "sold" on the ideas contained
in this book. He has not had a drink for a great many
years. I see him now and then and he is as fine a specimen
of manhood as one could wish to meet.
I earnestly advise every alcoholic to read this book
through, and though perhaps he came to scoff, he may
remain to pray.
William D. Silkworth, M.D.
From: Doctor's Opinion, Alcoholics Anonymous, Big Book
© Alcoholics Anonymous
NOTE: "It worked then. It works now.
It works real good if you work it!"
-- Dallas B.
|
