THE DOCTOR’S OPINION W - Alcoholics Anonymous

1 THE DOCTOR S OPINIONWe ofAlcoholics Anonymous believe that thereader will be interested in the medical esti -mate of the plan of recovery described in this testimony must surely come from medicalmen who have had experience with the sufferings ofour members and have witnessed our return to well-known doctor, chief physician at a nationallyprominent hospital specializing in alcoholic and drugaddiction, gave Alcoholics Anonymous this letter:To Whom It May Concern:I have specialized in the treatment of alcoholismfor many late 1934I attended a patient who, though he hadbeen a competent businessman of good earning ca -pacity, was an alcoholic of a type I had come to regardas the course of his third treatment he acquired cer -tain ideas concerning a possible means of recovery. Aspart of his rehabilitation he commenced to present hisconceptions to other Alcoholics , impressing upon themthat they must do likewise with still others.

2 This has become the basis of a rapidly growing fellowship ofthese men and their families. This man and over onehundred others appear to have personally know scores of cases who were of thetype with whom other methods had failed facts appear to be of extreme medical impor -tance; because of the extraordinary possibilities of 11/20/13 3:43 PM Page xxvgrowth inherent in this group they may mark a newepoch in the annals of alcoholism. These men maywell have a remedy for thousands of such may rely absolutely on anything they say about truly yours,William D. Silkworth, physician who, at our request, gave us this let -ter, has been kind enough to enlarge upon his views inanother statement which follows. In this statement heconfirms what we who have suffered alcoholic torturemust believe that the body of the alcoholic is quite asabnormal as his mind.

3 It did not satisfy us to be toldthat we could not control our drinking just because wewere maladjusted to life, that we were in full flightfrom reality, or were outright mental defectives. Thesethings were true to some extent, in fact, to a consider-able extent with some of us. But we are sure that ourbodies were sickened as well. In our belief, any pic -ture of the alcoholic which leaves out this physical factor is doctor s theory that we have an allergy to al -cohol interests us. As laymen, our OPINION as to itssoundness may, of course, mean little. But as ex -problem drinkers, we can say that his explanationmakes good sense. It explains many things for whichwe cannot otherwise we work out our solution on the spiritual aswell as an altruistic plane, we favor hospitalization forthe alcoholic who is very jittery or befogged.

4 Moreoften than not, it is imperative that a man s brain becleared before he is approached, as he has then a bet-xxviTHE DOCTOR S 11/20/13 3:43 PM Page xxviter chance of understanding and accepting what wehave to doctor writes:The subject presented in this book seems to me to be ofparamount importance to those afflicted with alcoholic say this after many years experience as MedicalDirector of one of the oldest hospitals in the country treat-ing alcoholic and drug was, therefore, a sense of real satisfaction when Iwas asked to contribute a few words on a subject which iscovered in such masterly detail in these doctors have realized for a long time that some formof moral psychology was of urgent importance to Alcoholics ,but its application presented difficulties beyond our concep-tion. What with our ultra-modern standards, our scientificapproach to everything, we are perhaps not well equippedto apply the powers of good that lie outside our years ago one of the leading contributors to this bookcame under our care in this hospital and while herehe acquired some ideas which he put into practical applica -tion at , he requested the privilege of being allowed to tellhis story to other patients here and with some misgiving,we consented.

5 The cases we have followed through havebeen most interesting; in fact, many of them are unselfishness of these men as we have come to knowthem, the entire absence of profit motive, and their com -munity spirit, is indeed inspiring to one who has laboredlong and wearily in this alcoholic field. They believe in themselves, and still more in the Power which pulls chronicalcoholics back from the gates of course an alcoholic ought to be freed from his physicalTHE DOCTOR S 11/20/13 3:43 PM Page xxviicraving for liquor, and this often requires a definite hospitalprocedure, before psychological measures can be of maxi-mum believe, and so suggested a few years ago, that theaction of alcohol on these chronic Alcoholics is a manifesta-tion of an allergy; that the phenomenon of craving is limitedto this class and never occurs in the average temperatedrinker.

6 These allergic types can never safely use alcoholin any form at all; and once having formed the habit andfound they cannot break it, once having lost their self-confidence, their reliance upon things human, their prob-lems pile up on them and become astonishingly difficultto emotional appeal seldom suffices. The messagewhich can interest and hold these alcoholic people musthave depth and weight. In nearly all cases, their idealsmust be grounded in a power greater than themselves, ifthey are to re-create their any feel that as psychiatrists directing a hospital for Alcoholics we appear somewhat sentimental, let them standwith us a while on the firing line, see the tragedies, the despairing wives, the little children; let the solving of theseproblems become a part of their daily work, and even oftheir sleeping moments, and the most cynical will not wonder that we have accepted and encouraged this move-ment.

7 We feel, after many years of experience, that wehave found nothing which has contributed more to the rehabilitation of these men than the altruistic movementnow growing up among and women drink essentially because they like theeffect 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 alco-holic life seems the only normal one. They are restless, irritable and discontented, unless they can again experiencexxviiiTHE DOCTOR S 11/20/13 3:43 PM Page xxviiithe sense of ease and comfort which comes at once by tak-ing a few drinks drinks which they see others taking withimpunity. 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, emerg-ing remorseful, with a firm resolution not to drink is repeated over and over, and unless this person canexperience an entire psychic change there is very little hopeof his the other hand and strange as this may seem to thosewho do not understand once a psychic change has occurred,the very same person who seemed doomed, who had somany problems he despaired of ever solving them, suddenlyfinds himself easily able to control his desire for alcohol,the only effort necessary being that required to follow afew simple have cried out to me in sincere and despairing ap-peal: Doctor, I cannot go on like this!

8 I have everythingto live for! I must stop, but I cannot! You must help me! Faced with this problem, if a doctor is honest with him-self, he must sometimes feel his own inadequacy. Althoughhe gives all that is in him, it often is not enough. One feelsthat something more than human power is needed to pro-duce the essential psychic change. Though the aggregateof recoveries resulting from psychiatric effort is consider-able, we physicians must admit we have made little impression upon the problem as a whole. Many types donot respond to the ordinary psychological do not hold with those who believe that alcoholism isentirely a problem of mental control. I have had manymen who had, for example, worked a period of months onsome problem or business deal which was to be settled ona certain date, favorably to them.

9 They took a drink a dayor so prior to the date, and then the phenomenon of cravingat once became paramount to all other interests so that theTHE DOCTOR S 11/20/13 3:43 PM Page xxiximportant appointment was not met. These men were notdrinking to escape; they were drinking to overcome a crav-ing beyond their mental are many situations which arise out of the phenom -enon of craving which cause men to make the supreme sacrifice rather than continue to classification of Alcoholics seems most difficult, andin much detail is outside the scope of this book. There are,of course, the psychopaths who are emotionally are all familiar with this type. They are always goingon the wagon for keeps. They are over-remorseful andmake many resolutions, but never a is the type of man who is unwilling to admit thathe cannot take a drink.

10 He plans various ways of changes his brand or his environment. There is the typewho always believes that after being entirely free from alcohol for a period of time he can take a drink withoutdanger. There is the manic-depressive type, who is, per-haps, the least understood by his friends, and about whoma whole chapter could be there are types entirely normal in every respect except in the effect alcohol has upon them. They are oftenable, intelligent, friendly these, and many others, have one symptom in com-mon: they cannot start drinking without developing thephenomenon of craving. This phenomenon, as we havesuggested, may be the manifestation of an allergy whichdifferentiates these people, and sets them apart as a distinctentity. It has never been, by any treatment with which weare familiar, permanently eradicated.