The
Doctor'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 many
years.
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.
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ALCOHOLICS ANONYMOUS
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,
(Signed) - - - - - 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 a laymen, our opinion as to its soundness may,
of course, mean little. But as exproblem 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
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THE DOCTOR'S OPINION
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 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
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
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ALCOHOLICS ANONYMOUS
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 connot 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-
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THE DOCTOR'S OPINION
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 affect 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
people 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 ev-
ALCOHOLICS ANONYMOUS
erything
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 familiar
with this type. They are always "going on the wagon for
keeps."
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THE DOCTOR'S OPINION
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 experiences.
About
one year prior to this experience a man was brought in
to be treated for chronic alcoholism. He had
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ALCOHOLICS
ANONYMOUS
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 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. 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
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THE
DOCTOR'S OPINION
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.
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