|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
To Whom It May Concern:
I have specialized in the treatment
of alcoholism for many years.
In late 1934 I attended a patient
who, though he had been a competent business man 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
These facts appear to be of
extreme medical importance; because of the extraordinary possibilities
of rapid 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 themselves.
Very truly yours,
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.
(Signed) - - - - - M.D.
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.
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 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:
The subject presented in this
book seems to me to be of paramount importance to those afflicted
with alcoholic addiction.
I say this after many years'
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
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.
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 cyni cal 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 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
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
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 worth while 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
self-reliance 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 City. 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.