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– Understanding and Counseling the Alcoholic
J. Clinebell, Jr. (1956)
Emmanuel Movement is of salient importance to anyone who
would help alcoholics. Though it is no longer in existence
as a movement, it is anything but a mere ecclesiastical
museum piece. Its goals, working philosophy, understanding
of man, conception of alcoholism, and even some of its methods
are worth emulating today. Here was perhaps the earliest
experiment in a church-sponsored psychoreligious clinic.
Here was the first pioneering attempt to treat alcoholism
with a combination of individual and group therapy, the
first attempt to combine the resources of depth psychology
and religion in a systematic therapeutic endeavor. During
its course the movement attracted many alcoholics and became
well known for its success in treating them.
movement came into being on a stormy evening in November,
1906, at the Emmanuel Episcopal Church in Boston, when the
first "classes" for those with functional illnesses
was held. The guiding genius of the movement was a brilliant
Episcopal clergyman named Elwood Worcester. His associate
throughout most of its course was the Rev. Samuel McComb.
Both men had had extensive graduate study in psychology
and philosophy. Worcester had a Ph.D. from Leipzig where
he studied under Wilheim Wundt, founder of the first psychological
laboratory, and physicist-psychologist-philosopher Gustav
a long time before 1906, Worcester had had a growing conviction
that the church had an important mission to the sick, and
that the physician and clergyman should work together in
the treatment of functional ills. As a preliminary step
he consulted several leading neurologists to ascertain whether
such a project as he had in mind, undertaken with proper
safeguards, would have their approval and cooperation. A
favorable response was received, and the plan was launched.
Emmanuel program of therapy consisted of three elements:
group therapy administered through its classes, individual
therapy administered by the ministers and staff at the daily
clinic, and a system of social work and personal attention
carried on by "friendly visitors." The growth
of the movement was phenomenal. Three years after its inception,
a California disciple could write:
work, begun as a parish movement, has grown so that the
local demands have overtaxed a large corps of workers while
importunate calls from many cities in this and other lands
for knowledge of the work, and pitiful calls for help from
sick ones everywhere have to be put aside... .Meanwhile,
in two years the work has been taken up by ministers of
many faiths who see in the new movement a return to the
faith and practice of the Apostolic Church. These. . .are
finding new power in their work.
disciple also described the manner in which plans were being
put into operation for training ministers who wanted to
use the Emmanuel technique in their parishes, and for setting
up the movement in large centers. By 1909 the movement had
spread abroad and was represented in Great Britain by a
committee under the title "Church and Medical Union."
The Emmanuel clinic in Boston was deluged by patients. During
one six-month period nearly five thousand applications were
received by mail alone. Of these only 125 could be accepted.
Hundreds of clergymen and many physicians were visiting
Boston to study the methods. Influential physicians like
Richard C. Cabot gave their support to the movement.
first definite book on the movement was Religion and Medicine,
The Moral Control of Nervous Disorders, which appeared in
1908. Demand for this book was so great that it went through
nine printings in the year of publication. For twenty-three
years Worcester continued as rector at Emmanuel. The movement
continued to flourish there and in other parts of the country.
The need for help was so great that often a line of patients
cued outside the church. In 1929 Worcester resigned from
his parish in order to give full time to the movement. A
considerable sum of money had been received to carry on
the work, so the movement was incorporated as the Craigie
Foundation. In addition to the patients which he saw at
his home, Worcester accepted many invitations to conduct
week long clinics and lecture series in prominent eastern
churches. In 1931 Worcester and McComb produced Body, Mind
and Spirit, a book which showed clearly the development
of their thought following the earlier books of the movement.
For all practical purposes the Emmanuel Movement as such
came to a close with Worcester’s death in 1940.
is noteworthy that three outstanding lay therapists for
alcoholics in this country, Courtenay Baylor (who carried
on the work at the Emmanuel Church for a time after Worcester’s
death), Richard Peabody, and Samuel Crocker, were products
of the movement. A lay therapist is a nonmedical practitioner
who specializes in helping alcoholics professionally. For
a description of the method of treatment used by Courtenay
Baylor, see Dwight Anderson’s "The Place of the
Lay Therapist in the Treatment of Alcoholics," Q.J.S.A.,
Method of Treating Alcoholics
Emmanuel classes were held once a week. In this group experience,
alcoholics were lumped together with patients suffering
from other functional illnesses treated by the clinic. A
disciple of the movement, Lyman P. Powell, who had tried
the technique in his own church, describes the procedure:
Wednesday evening from October until May you will find,
if you drop in at Emmanuel Church, one of the most beautiful
church interiors in the land filled with worshipers.. .A
restful prelude on the organ allures the soul to worship.
Without the aid of any choir several familiar hymns are
sung by everyone who can sing and many who cannot. A bible
lesson is read. The Apostles’ Creed is said in unison.
Requests for prayer in special cases are gathered up into
one prayerful effort made without the help of any book.
One Wednesday evening Dr. Worcester gives the address, another
Dr. McComb, still another some expert in neurology or psychology.
The theme is usually one of practical significance, like
hurry, worry, fear, or grief, and the healing Christ is
made real in consequence to many an unhappy heart.
subjects discussed at the classes included: habit, anger,
suggestion, insomnia, nervousness, what the will can do,
and what prayer can do. The class was always followed by
a social hour in the parish house. Reporting on the results
of these group experiences, Powell says: "Though the
mass effect of the service is prophylactic, it is not uncommon
for insomnia, neuralgia and kindred ills to disappear in
the self-forgetfulness of such evenings."
heart of the Emmanuel therapy was the clinic. Before a patient
was accepted for treatment, he was required to have a careful
diagnostic examination by a physician and in some cases,
a psychiatrist. If psychosis or organic pathology was disclosed,
the individual was not accepted. If the disease appeared
to be simply functional, the applicant was registered for
treatment and directed to the rector’s study. In the
case of alcoholics, it was felt by Worcester that they should
be seen every day, especially in the early phases of their
treatment. The new, nonalcoholic habits which the "psychotherapy"
was implanting were to be treated as tender shoots until
they took firm root. The patient was felt to need the daily
support of the therapist until these new habits were firmly
rooted, after which the therapist met the patient once or
twice a week. Just how long the average alcoholic treatment
took is not clear from the literature. No cases of alcoholism
were listed among the quick cures - i.e., those effected
in one or two sessions. A treatment period of at least several
months seemed to have been involved in most of the cases
treatment itself included "full self—revelation"
in which the patient poured out all the facts - physical,
mental, social, moral, and spiritual — which might
have any bearing on the sickness. This catharsis was felt
to have a curative effect in itself often serving to "unlock
the hidden wholesomeness" of the patient’s inner
life. The second phase of the treatment consisted of "prayer
and godly counsel." This apparently was aimed chiefly
at teaching the patient the techniques of prayer and helping
him strengthen his spiritual life, rather than praying for
the individual. The third phase was the use of relaxation
and "therapeutic suggestion," the latter administered
in some cases while the patient was under mild or deep hypnosis.
It is noteworthy that although Worcester began by using
hypnosis in many different types of difficulties, he eventually
limited it to use with some alcoholics. Apparently he felt
that the alcoholic needed the more powerful effect of hypnotic
patient is next invited to be seated in a reclining chair,
taught to relax all his muscles, calmed by soothing words,
and in a state of physical relaxation and mental quiet the
unwholesome thoughts and untoward symptoms are dislodged
from his consciousness, and in their place are sown the
seeds of more health-giving thoughts and better habits."
the course of the movement there occurred a highly significant
transition in the thought and methodology used. The change
consisted of the gradual incorporation of psychoanalytic
techniques, as Worcester began to learn of the dynamic psychology
of Freud. This was accompanied by diminishing dependence
on suggestion, the therapeutic device in vogue in the early
days of the movement due to the influence of Worcester’s
European training with the physiological psychologists.
Worcester stoutly defended the method of psychoanalysis.
In 1932 he wrote: "I cannot agree with Stekel who advises
that analysis be attempted in alcoholic cases only after
other means have failed. I have found it helpful to begin
my treatment with an analysis of childhood and youth."
Worcester used standard psychoanalytic techniques such as
dream analysis and the probing of early memories as a part
of his therapy.
others who have attempted to use such techniques with alcoholics,
Worcester had encountered the problem of breaking the addictive
cycle long enough to allow the therapy to have some effect.
He developed his own unique solution which he felt was responsible
for his success in keeping the patient sober while therapy
got a foothold. The solution consisted of two parts: (a)
making the analysis relatively brief; (b) combining analysis
with his earlier method, therapeutic suggestion.
insight gained through analysis of alcoholics, Worcester
arrived at a profound understanding of alcoholism: "The
analysis, as a rule, brings to light certain experiences,
conflicts, a sense of inferiority, maladjustment to life,
and psychic tension, which are frequently the predisposing
causes of excessive drinking. Without these few men becoming
habitual drunkards. In reality drunkenness is a result of
failure to integrate personality in a majority of cases.
Patients, however darkly, appear to divine this of themselves,
and I have heard some fifty men make this remark independently:
"I see now that drinking was only a detail. The real
trouble with me was that my whole life and my thoughts were
wrong. This is why I drank."
went on to say:
"It is this consciousness of crippling dissociation
of powers, of inhibition and repression which predisposes
men to drink. In alcoholism in its early stages they find
release of their faculties, the dissociation of their fears
and inhibitions, as so many have said, "A short cut
to the ideal."
aim of Emmanuel therapy was the reconstruction of the inner
self so that the alcoholic could remain abstinent -Worcester
had no illusions about alcoholics becoming social drinkers.
There was a conviction that this reconstruction of personality
must utilize the resources inherent in the person. Psychoanalysis
was an important technique for releasing these resources.
Worcester came to regard analysis as essential, he also
observed that "few drunkards have been cured by analysis
alone." He recognized that their are two levels to
the alcoholics problem - the underlying psychic conflicts
and what he called the "habit itself," the effect
on the nervous system of continued inebriety and the craving
resulting therefrom. Analysis, he had found, had little
effect on the latter, whereas suggestion often "supplied
immediate help and permanent immunity from the return of
the habit." His working hypothesis was that analysis
relieved the psychic problems, "reducing the problem
presented by the drunkard largely to a physical habit."
Suggestion effected a strengthening of the will and a distaste
for liquor so that the physical habit could be controlled.
Worcester gives a sample of how he administered therapeutic
suggestion to alcoholics: "Most alcoholics are highly
suggestible and I have found a few who failed to respond
to the technique intended to induce mental repose and abstraction
and physical relaxation. When the patient had obtained this
condition, I should address him in low monotones and offer
him repeated suggestions, positive and negative, somewhat
as follows: "You have determined to break this habit,
and you have already gone days without a drink. The desire
is fading out of your mind, the habit is losing its power
over you. You need not be afraid that you will suffer at
all. In a short time liquor in any form will have no attraction
for you. It will be associated in your mind with weakness
and sorrow and sickness and failure. These thoughts are
very disagreeable to you and you turn away from them. You
wish to be free, you desire to lead a useful, happy life.
Liquor is your enemy, but you are overpowering it and in
a short time it will have no power over you at all."
Then as a person accustomed to depend on alcohol for sleep,
when deprived of it, are apt to suffer from insomnia, I
should add suggestions as to sleep and rest."
addition to the suggestions given by the therapist, the
patients were taught autosuggestion so that their treatment
could continue between sessions.
third phase of the Emmanuel program consisted of the "friendly
visitors," whose purpose was "to give the environment
of the patients care similar to that provided for their
bodies by the physicians, and for their minds by the clergymen."
often patients... .need more than anything else a friend
to show personal sympathy and interest, to encourage them,
and to make sure they are following the prescribed directions.
Victims of alcohol especially need this assistance to prevent
relapse after the conclusions of treatment before they have
acquired full self—reliance."
and McComb reported that the system was very successful.
They pointed out that alcoholics profited from becoming
friendly visitors to other alcoholics who were beginning
their treatment and that they made very effective visitors.
One thinks immediately of the A.A. system of sponsorship
and the principle of Twelfth Step work in this connection.
patients... .need occupation to keep them from being self-centered.
Clerical work has been found useful, but the best results
have come from sending them as friendly visitors to others
less fortunate. Not only does this have a good effect on
the visitor, but new converts are proverbially enthusiastic,
and the alcoholic who finds himself released from his bondage
is a most valuable assistant in encouraging and keeping
up to the mark patients who have just begun."
friendly visitor system was administered by a committee
which included several trained social workers. Through this
system the alcoholic was aided in finding employment and,
if necessary, given a financial loan for a limited time
while he adjusted his life. The friendly visitors often
helped the patient readjust in the area of his family life.
the Emmanuel Movement stands in contrast to the approaches
studied previously. All of Worcester’s writings reflect
the conception that all life is permeated by the divine
spirit, a belief which had its roots in the panpsychism
of his teacher, Fechner. In discussing "Mabn’s
Life in God," Worcester wrote:
secret of all spiritual religion is the union of the human
soul with the divine soul, the belief that man’s spirit
and God’s spirit are in their essence one. Without
this belief man’s relations with God become formal
and external. The world, robbed of the haunting presence
of the indwelling deity, becomes irreligious and profane."
he held that the spirits of God and man are in their essence
one, Worcester did not think of man as depraved or lost
in sin. Man’s spirit is a part of God; his realization
and healing consist not in surrender to an external Power,
but in the redirecting, releasing, and reeducating of the
inherent powers—the hidden wholesomeness—of
the spirit within. This positive conception of man contrasts
vividly with mission and Salvation Army doctrines of the
impotent, sinful man who can be saved only by surrender
to an external Power. Rather than seeing man’s beatitude
in the abnegation of self, Worcester felt that the purpose
of therapy was to help the person "find freedom and
to discover a better way of life for himself." Prayer
was considered an important means of releasing the divine
energies within the soul trapped by one’s neurosis.
felt that many religious workers in the field of healing
had made the mistake of supposing that God can cure in only
one way. God cures by many means. An act of healing, whatever
the means used, is religious, since the divine spirit permeates
all of life. The healing of bodies and spirits by medicine,
rest, kindness, and self—understanding is just as
much an act of God as healing which depends on prayer and
suggestion. Further, healing of the mind and spirit is not
some sort of divine magic but is the divine spirit working
through the orderly forces of nature. This general orientation
provided the basis for a thoroughly cooperative relationship
between the various healing disciplines involved in Emmanuel
his view of man Worcester (in contrast to previous approaches)
held to a thoroughly unrepressive attitude toward man’s
desires and feelings. He recognized that the tendency, especially
among Christian thinkers of the past, has been to deny these
factors in human life. Concerning the conflict between reason
and conscience on the one hand, and emotion and desires
on the other, he writes:
first step toward a possible solution of this fundamental
problem of human life... .is to recognize the legitimacy
of both these elements of our being. In our disposition
to do this lies whatever superiority we possess over former
generations and our chief hope for the future."
handling of the problem reflects Worcester’s psychoanalytic
problem of responsibility, a key problem whenever religion
and psychology meet, was handled in a realistic manner by
this approach. Worcester could not have fallen into freewill
moralism concerning alcoholism. For one thing, from the
beginning of the movement, he recognized alcoholism as an
illness. Further his training in psychology had acquainted
him with the role played by the subconscious mind in all
behavior, including alcoholism. In 1908, long before the
idea had become generally accepted, Worcester wrote:
believe that there is a subconscious element in the mind
and that this element enters into every mental process.
Our daily life is influenced far more than the shrewdest
of us suspect by the subconscious activity which is at work,
exercising a selective power even in apparently accidental
choices. Hence the real cause of our acts are often hidden
was convinced that "it is the subconscious that rules
in the mental and moral region where habit has the seat
of its strength." Further, he believed that therapeutic
suggestion was able to unfluence and guide the subconscious
mind into paths of health. As the influence of Freud grew
in his thinking, the importance of subconscious factors
was further enhanced.
was another reason why Worcester avoided a moralistic conception
of alcoholism and human ills in general. As early as 1908
he had recognized that the first six years of a child’s
life are the most important and determinative of his life.
It was therefore relatively easy for him to accept the findings
of the psychoanalysts in this area. In his last book he
wrote: "The great psychological thinkers and workers,
Freud, Jung, Adler, and others, were quick to perceive the
significance of childhood as the chief determinant of life."
Evaluation of This Approach
effective was the Emmanuel therapy in breaking the addictive
cycle and providing initial sobriety? And how successful
was it in providing long-term sobriety? It is impossible
to answer these questions with certainty, since the movement
no longer exists and apparently there are no quantitative
records. For several reasons, however, it seems probable
that the Emmanuel movement enjoyed a relatively high degree
of success in providing at least temporary sobriety. We
know that the Emmanuel workers accepted for treatment only
those who wanted to stop drinking and who came on their
own volition. A.A. experience has shown that these mental
attitudes on the part of the alcoholic are essential prerequisites
for successful therapy. These Emmanuel requirements meant
that only patients who were "at bottom" and who
would accept responsibility in asking for help would be
treated. Second, we know that the Emmanuel therapists had
the advantage over "straight religious" approaches
of having medical assistance - a valuable aid in effecting
initial sobriety. Third, we know that suggestion administered
as in this therapy by a person with status, exercises a
powerful control over behavior. This is especially true
in the case of insecure and dependent people, such as alcoholics
frequently are. Fourth, we know from various reports that
suggestive therapy has produced impressive results with
alcoholics. Prior to the Emmanuel movement, Charcot treated
600 cases over a twenty—year period and reported 400
"cures." Tokarsky of Moscow reported that 80 percent
of the 700 alcoholics he had treated were cured, and Wiamsky
of Saratow claimed about the same percentage of cures out
of the 319 cases he treated. Unfortunately, no definition
of "cure" was given in these reports.
seems probable that many of those who gained temporary sobriety
through Emmanuel therapy stayed sober for an extended period.
The fact that Worcester and McComb over the years acquired
a reputation for success in treating alcoholics indicates
that many of their patients must have stayed abstinent.
In 1932 they were able to report: "It is well known
that we have obtained as good and as permanent results in
these fields as any other workers." If most of their
cures had been short—lived, they would not have enjoyed
cases are presented in Emmanuel literature which show that
sobriety extended over long periods. Worcester tells, for
instance, of treating a very difficult alcoholic with homicidal
tendencies who had been given up as hopeless by the doctors.
At the time of writing the man had enjoyed seven years of
sobriety. Worcester reported having little success in treating
"dypsomaniacs" - apparently the equivalent of
periodic alcoholics as contrasted with "ordinary alcoholics"
(steadies). In spite of this, he tells of successfully treating
a woman "dypsomanic," who had been judged hopeless
by two psychiatrists. Worcester writes:
I have kept in contact with this woman, I can say that she
was cured in the sense that for twenty—two years there
has been no return of the fatal cycle, not a drop of liquor
has passed her lips." That a good deal of success was
enjoyed by the movement, even in cases where relapses occurred,
is shown by Samuel McComb’s statement: "There
are other cases of alcoholism where a relapse has occurred,
but it has only been temporary; and fathers and sons have
been restored to their families with what a joy only those
who have felt the curse of intemperance can realize."
in 1931, the Emmanuel leaders could report, "On the
whole our successes have been far more frequent than our
failures." This statement was made with the perspective
of twenty-five years of experience in the movement.
are many points at which the Emmanuel approach was superior
in theory and practice to the evangelistic approaches. While
recognizing the importance of group experience, the Emmanuel
approach also supplied individual psychotherapy. This combination
of individual and group therapy represents an obvious advance
over the mass evangelistic approaches. As the Emmanuel approach
came to incorporate psychoanalytic procedure in its therapy,
it dealt to some degree with the underlying causes of inebriety,
rather than simply relieving or changing symptoms. Worcester’s
observation that alcoholics respond best to relatively brief
therapy concurs with modern findings.
Emmamuel approach achieved an integration of the healing
resources of medicine, psychology, social work, and religion.
In the Salvation Army we saw a certain eclecticism in which
the resources of other professions were drawn on as supplements
to the basic religious approach. In contrast, the Emmanuel
workers saw medicine, psychology, and social work as integral
parts of a total "religious" approach to healing.
The medical and psychiatric screening of patients not only
protected the church clinic but also improved the possibility
of a favorable outcome.
goal of Emmanuel therapy - to promote the freedom and growth
of the individual by releasing inner resources, in contrast
to authority-centered approaches,- is in keeping with the
healthy needs of the alcoholic. We have seen that alcoholics
often have neurotic needs which encourage the formation
of immature dependency relationships. Their healthy needs
are for increased self—esteem and constructive autonomy.
In contrast to previously studied approaches, which encouraged
dependency and surrender to authority, Emmanuel thought
encouraged independence and growth in responsibility. Worcester
shunned the use of exhortation and persuasion as being "wholly
out of place in treatment." They may provoke opposition
on the patient’s part, or, they may even be dangerous,
because they impose the teacher’s personality and
philosophy on the patient instead of allowing him to find
freedom and to discover a better way of life for himself."
of depending on religious thrill and a sudden, dramatic
conversion, Emmanuel therapy relied on the gradual type
of religious change. It seems clear that Emmanuel’s
psychotherapy offered greater possibility of lasting change
than was true of the evangelistic approaches. The Emmanuel
workers recognized that evangelistic approaches have value
for some alcoholics; they also saw that many alcoholics
cannot be reached by those approaches. Powell, an Emmanuelite,
wrote: "While men like Gerry McAuley and the Salvation
Army leaders have done something, the emotional motive which
they use does not avail in every case."
Emmanuel approach recognized fully that the alcoholic needs
individual and group support during his recovery. The "friendly
visitor" system combined the principle of A.A. sponsorship
with the resources of a social caseworker. Undoubtedly this
friendly, individual attention and help were major factors
in the success of the approach.
approach was well equipped to help the alcoholic find real
self—acceptance and release from guilt. Its superiority
lay in its splendid conception of alcoholism and its understanding
of the psychodynamics’ of human behavior. Twenty—seven
years before A.A. began, this approach was regarding alcoholism
as a disease to be treated like other functional diseases.
In this early period there was a degree of moralism connected
with the conception of all functional illnesses. The influence
of psychoanalytic concepts gradually removed this moralism,
revealing the manner in which behavior is conditioned by
early experiences and by unconscious forces which are not
subject to the will.
therapy sought to reduce the alcoholics’ guilt rather
than to enhance it as in the previous approaches. It achieved
this by its disease conception of alcoholism and its positive
conception of man, allowing the therapist to establish a
nonjudgmental relationship with the patient. By means of
his acceptance of the patient, the therapist was able to
help the patient achieve self-acceptance. Self-acceptance,
it is well to remember, implies a sense of being accepted
by life. This the Emmanuel therapist was well equipped to
convey because of the positive, life-affirming philosophy
and theology of the movement. There is a sense of course,
in which the experience of "accepting oneself as being
accepted," to use Paul Tillich’s description
of salvation, results from any psychotherapy which is successful.
Emmanuel therapy apparently was frequently able to convey
this experience. When guilt is reduced, the energies previously
employed in the guilt and self-punishment process are freed
and made available for therapeutic ends.
was achieved in Emmanuel therapy not by petitioning an authoritarian
Deity, but by modifying the unmerciful superego of the patient.
McComb wrote as follows concerning what he called the "New
England or Quaker conscience":
great need here is for a new conception of God. The mind
must be taught to rest in his fatherly love, in his tenderness
and grace. . . .By the constant presentation to the mind
of these ideas the conscience is gradually lightened of
its morbidity and the will is set free to act."
than concerning itself with specific "sins," the
Emmanuel approach focused attention on the underlying causes
of these symptoms - namely, the sick personality. This also
aided in reducing the alcoholic’s guilt load. In addition,
the psychoanalytic concept that alcoholic behavior is determined
in large measure by subconscious factors (beyond the realm
of willpower) had a tremendous guilt-reducing effect. The
positive conception of man and the recognition that his
drives and feelings are not inherently evil both contribute
to healthy self-acceptance on the part of the patient. Likewise
the conception of the healing process as resulting from
the release of inner resources (as contrasted with external
divine intervention) tends to enhance self—esteem
by enabling the patient to feel a sense of achievement in
his improved condition. It also serves to keep the responsibility
for healing with the patient. The alcoholic’s inferiority
is reduced not by identifying with a powerful authority-figure,
but by becoming aware of his "higher and diviner self"
which is his most real self.
Emmanuel workers recognized clearly that religious symbols
can be employed in ways that promote maturity and health.
They threw their influence behind the latter. As a result
we do not find the emphasis on fear and guilt which was
present in the previous approaches.
only minor changes, the mature Emmanuel concept of alcoholism
would be acceptable in the most enlightened circles today.
In one way it was superior even to the A.A. conception.
Because of its orientation in depth psychology, it recognized
that the selfishness and egocentricity of the alcoholic
are actually symptoms of deeper problems and conflicts.
This is in contrast to the A.A. position which does not
seem to recognize the symptomatic nature of selfishness.
(It should be added that many individual A.A.’s, particularly
those who have had psychotherapy, do recognize the nature
of selfishness.) Because of deeper understanding of personality,
the Emmanuel therapy was beamed more accurately at the roots
of alcoholism than is the A.A. therapy. Its use of psychoanalytic
techniques in its therapy provided it with the practical
means of getting at these underlying causes. Such techniques
are not present to any great degree in A.A. The Emmanuel
approach was superior to A.A. in that it made individual
as well as group therapy available to the alcoholic. Further,
because of its psychoanalytic grounding, it was less repressive
than A.A. in its attitude toward the self.
spite of its areas of theoretical superiority, it seems
probable that from a practical standpoint, Emmanuel was
less effective than A.A. Its therapy was less adequate than
A.A. in that it lacked an all-alcoholic support group. Further,
it did not capitalize fully on the recognition that helping
other alcoholics help the alcoholic patient to stay sober
himself. Nor did it capitalize on its recognition that one
alcoholic has a natural entree to another. Even though its
goal was nonauthoritarian, its therapy was dispensed by
an authority figure. It lacked the advantage of A.A.’s
self-help orientation, particularly the feeling on the part
of the A.A. member - "We’re licking this thing
ourselves" and "This is our fellowship."
Since the Emmanuel approach was dependent on professionals,
the number of alcoholics who could be helped was quite limited
as compared to A.A.
central weakness of the Emmanuel approach to alcoholism
would seem to be the use of suggestion. Although Worcester’s
therapeutic aim — increasing the freedom of the patient
- was psychologically sound, his method actually defeated
his aim. The thing that was not recognized was that suggestion
is an essentially authoritarian tool, that it substitutes
the authority of the "suggester" for the autonomy
of the individual, thus establishing an unconstructive dependence
on the therapist. The Emmanuel workers did not realize that
the "strengthening of the will" which they observed
in alcoholic patients was actually the result of the projection
of their authority on the patient. Carl R. Rogers includes
suggestion under "Methods in Disrepute" in his
discussion of counseling. He writes:
client is told in a variety of ways, "you’re
getting better," "You’re doing well,"
"you’re improving," all in the hope that
it will strengthen his motivation in these directions. Shaffer
has well pointed out that such suggestion is essentially
repressive. It denies the problem which exists, and it denies
the feeling which the individual has about the problem."
should be noted that suggestion was generally accepted as
a therapeutic device during the early period of the Emmanuel
movement. In fact, medical schools were teaching the technique
as a healing tool. As we have seen, the Emmanuel workers
put decreasing emphasis on suggestion as their knowledge
of psychoanalysis increased. Though their methodology became
relatively less repressive, it would seem probable that
the effectiveness of their psychoanalytic procedures must
have been vitiated in part by the continued use of suggestion.
was insightfully accurate in recognizing the two levels
of alcoholism and in his belief that something had to be
done to hold the addiction in check while psychotherapy
sought to deal with the underlying causes. Unfortunately,
the device he employed (suggestion) impeded the effectiveness
of the psychotherapy.
did this movement not survive? First, it was centered around
two strong and unusual personalities. There were few clergymen
with the kind of training and general qualifications possessed
by Worcester and McComb. Apparently the movement was not
successful in training younger men to carry on the tradition.
Second, the fundamental methodological weakness of the movement
may have contributed to its demise. The continued use of
a repressive device like suggestion over a long period of
time may have resulted in diminishing enthusiasm and decreasing
therapeutic return. Of course there is a sense in which
the movement continues in its influence on the clergymen
whose interest in psychotherapy and healing was stimulated
by their contacts with the movement, its literature, or
others who had felt its influence.
We Can Learn from the Emmanuel Approach
Emmanuel Movement was the first organized attempt to apply
the joint resources of psychology and religion to the problem
of alcoholism. Its degree of success suggests the
that lie in this direction. It was the first approach to
understand and seek to treat the underlying causes of alcoholism.
In spite of its methodological error, its general orientation
was positive and life-affirming, so much so that its critics
labeled it "hedonistic." The practical values
as well as the psychological validity of this outlook have
been discussed in our evaluation.
approach provides an impressive demonstration of the importance
in dealing with alcoholics of one’s conception of
alcoholism and the human situation in general. In its understanding
of the psychodynamics’ of alcoholism and its incorporation
of psychoanalytic insights and methods, this approach was
decades ahead of its time. In these regards, as in the handling
of the problem of guilt and responsibility, the Emmanuel
Movement has a great deal to teach many religious leaders
today. Among other things it provides an example of the
way in which a psychoanalytic orientation can mediate the
acceptance of God, thus enhancing self—acceptance.
As we have seen, it did this, not by encouraging surrender
to an external deity, but by resolving inner conflict, thus
releasing God-given resources within the personality. The
resolving of inner conflict was achieved through psychoanalytic
techniques which were based on a recognition of the dynamic
significance of the unconscious and by an actual accepting
relationship with one of God’s children, the therapist.
Emmanuel Movement pioneered in the field of church-sponsored
psychotherapeutic clinics. Its story should cause organized
religion to reflect on its general role in a society plagued
by widespread neurosis and inadequate facilities for treatment.
Startled by the overwhelming influx of patients, the Emmanuel
mere fact that disinterested clergymen and physicians were
willing to be consulted.. . .has brought persons to us in
such numbers that, although we have a good-sized staff,
it is impossible for us to see one person in five for a
single conversation. This one fact should cause the Church
to reflect. Why should there not be adequate assistance
for men and women who desire and need personal, moral and
this was written many years ago, the question is still relevant
and pressing in our day. A partial answer is emerging in
the pastoral counseling movement and the two hundred or
so church-related counseling services which have been established
in recent years.
in whole from the book Understanding and Counseling the
Alcoholic by Howard J. Clinebell, Jr. (1956)