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The Facts About Alcoholism
interview with Dr. Selden D. Bacon,
Foremost Authority on Alcoholism
What teachings to youth?
How shall employers deal with problem?
center of Alcohol Studies at Yale University has just completed
several surveys on the problem of alcoholism--as it affects
industry, education, highway safety, government as well
as family life:
makes an alcoholic? Is it drinking to excess or is it something
else? What are the symptoms--and how can anyone tell whether
she is in danger of becoming an alcoholic? What are the
States and cities doing about the problem, especially as
it affects traffic accidents? How is industry, troubled
sometimes by heavy absenteeism, handling the alcoholic?
get the answers to these and other related questions, the
editors of U.S. News & World Report interviewed in their
conference room for two hours Dr. Selden D. Bacon, Director
of the Center of Alcohol Studies, Yale University.
far back as 1930, interest in the study of alcohol began
at Yale in the Laboratory of Applied Physiology with the
issuance of scientific papers and the collection of information
amassed in previous years. Biochemists, researchers in sociology,
economists and psychologists began to make surveys and to
seek scientific answers to the many questions people were
asking about the use and effects of alcohol.
1943 the pressure of public interest led to the establishment
of a summer school of studies at Yale which has been operating
ever since. It is usually attended by representatives of
the distilling and brewing industries, five or six professional
temperance people, a dozen physicians, and about the same
number of nurses, 25 to 30 ministers, 30 to 40 social workers
and probation officers, 30 to 40 who are engaged in education,
a few judges, and a few
members of “Alcoholics Anonymous” who are
engaged in teaching or in industrial personnel work.
than 1,600 have graduated from the school and a large proportion
is making use of this training in State and local, voluntary
and governmental agencies dealing with problems of alcohol
and alcoholism. At least 75 have become executive directors
of such groups.
the co-operation of the Connecticut Prison Association,
an outpatient clinic just for alcoholics was begun in 1944,
and a year later the first State Commission on Alcoholism
was established by Connecticut and Dr. Bacon has been its
chairman ever since. In 1940 the Quarterly Journal of Studies
on Alcohol was started. The Center also published a series
of 15-page pamphlets that have been in unusual demand for
such technical material.
Yale Center now has six major divisions and is primarily
interested in popular education on the subject of alcohol
and research in certain areas of social and health problems,
such as drunken driving, the problem drinker in industry
and related subjects.
interview with Dr. Bacon follows:
Is yours the only center of scientific studies on alcohol
in this country, Dr. Bacon?
It is the only one. We think it would be
healthier thing if there were two in the country. We had
hoped that one would start down in Texas. Dr. Jellineck
left us to go there and start such a center, but it finally
broke up. He has since become the head of the World Health
Organization Committee on Alcoholism.
What is the alcohol problem?
There are several types of problems. There are scientific
problems, there are group problems, and there are individual
problems. But it is pretty impossible to separate them.
Take, for example, the particular problem of alcoholism:
If anybody wants to say it is a mental problem, I’d
day they are absolutely correct; if anybody wants to say
it’s a legal problem, they are absolutely correct--or
an economic problem or a medical problem or a social problem.
Most people are not alcoholic, are they?
We would say that there are approximately 60 to 70 million
drinkers out of a population of 110 million people of 15
years of age and over. We would suggest that there are just
short of 4 million out of that 60 to 70 million who are
patently losing, or have lost, their control, and their
lives are beginning to show, or have already shown, damage
in one or more aspects.
Then the difference between the heavy drinker and the alcoholic
is that the alcoholic has lost control?
Yes, but there is no real line between them, no clear-cut
But only 1 person out of 16 who drinks is an alcoholic,
is that right?
Is that proportion rising?
The best-known estimate is that developed by Dr. Jellineck
which shows that between 1940 and 1948 there seemed to be
a rather regular increase, and that in ‘49 and ’50
it reached, so to speak, a plateau, and may show some indication
of going down. However, remember this, that it takes from
6 or 7 to 20 years for alcoholism to develop, so if you
are trying to think of a rise between 1940 and 1947 don’t
think of what happened between 1940 and 1947 alone, although
what happened then might have speeded it up.
It could go back to the depression years?
Does your research show that alcohol is injurious to the
Alcohol oxidizes when it gets into the human system. It
oxidizes at the rate of an ounce in two or three hours.
For 100-proof whisky, which is 50 per cent alcohol, that
means that 8 ounces of whisky would be all gone from the
system in less than 12 hours, most of it breathed away,
some lost through sweat or urine. This proportion would
vary with an individual’s weight and also with the
amount of food he had in ‘his stomach. Then the alcohol
is gone. Even in the most pronounced binges, you lose it
all in 48 hours. Chemical tests show that.
What does it do to the body? Why cirrhosis of the liver
and so on?
The actual answer to cirrhosis is not known, but I think
the most prevalent theory is this: The liver under certain
circumstances will tend to develop what is called “fatty
tissue.” In other words, you get fat mounting up there,
which cuts down the function of the liver. Now there is
an agent--probably this is over simplified--that counteracts
this tendency, so that the fatty tissue doesn’t last
and finally take over the whole organ.
of us have stronger counteragents and some of us have weaker
counteragents. Those who have weaker counteragents are very
likely to develop cirrhosis of the liver--and they may never
have had a drop of alcohol in their lives! Or they could
be persons who take a drink once or twice a year, at wedding
ceremonies or something, and they get cirrhosis.
have very strong counteragents and they can drink the alleged
fantastic amounts that they say they do--a quart and a half
every day of their lives, and so on.
when you take a person who may be just below average in
his counteragent effect, alcohol does--this is one theory--so
reduce the effect of this weaker counterpart that this fatty
tissue begins to form a little more and a little more, especially
in the case of people who drink a great deal and continuously.
may take 10 years before it begins to show up. Then you
begin to get hobnail liver and the like so that just by
palpation (touching the body from the outside) you can feel
these hard spots where this fatty tissue has developed.
What do you mean by “a great deal”?
You have to consider the person’s weight and so on,
but let’s say he is drinking pretty regularly a pint
of whisky every day. It will vary with the liver, of course.
Even with the weakest liver in the world, you are not going
to get cirrhosis automatically.
What about the heart?
I am no expert on that, but I will leave some suggestions
on it. Your question is out of my field and this answer
certainly should not be regarded as authoritative from a
medical viewpoint. But there is an action on the arteries
from alcohol which will make it easier for blood to flow.
So that if you begin to get a condition similar to, let’s
say, arteriosclerosis a certain amount of alcohol--and I
don’t recommend alcohol as the best way of doing this--may
grant one a certain amount of relief from the hardening-artery
situation, and there will be a little less effort on the
part of the heart to pump and keep the blood going.
Is that why patients with a heart condition are given alcohol?
I don’t think so. I don’t think many physicians
know much about alcohol as such, anyway. Why should they?
They don’t get any training on it. It isn’t
mentioned in medical schools, except for the alcoholic diseases
which are found in probably less than 25 per cent of the
alcoholics in some countries and I think a smaller proportion
in this country.
tremens, alcoholic hallucinosis, chronic avitaminosis, chronic
gastritis, other things--and these are recognizable conditions,
illnesses that would be discovered and labeled by any competent
physician--which follow upon years of excessive drinking--are
called the diseases of alcoholism. If you find delirium
tremens in 18, 19 or 20-year-olds, I think you have good
grounds for suspecting a psychotic condition set off or
merely aggravated by alcohol.
From the ordinary use of alcohol, what would you say is
the effect on the heart? Is it helpful or harmful?
I wouldn’t say that it was particularly one or the
other until you get into conditions relating to certain
ages, as, say, 50 beyond, in which it may serve a useful
Doesn’t it cause an immediate palpitation of the heart?
Doesn’t a drink cause the heart to beat faster?
I can’t answer that question. By the way, you can
see almost any bad reaction you want to see after the injection
of alcohol following certain situations, but whether that
is caused by alcohol or not—
Physiology books in school used to warn against the use
of alcohol, and one of the ways they did it was to tell
you that it caused immediate stimulus and as soon as the
stimulus had worn off you would have a certain fatigue and
a certain reaction. Therefore, alcohol, in stimulating the
heart, was harmful. That was in the textbooks in the old
days. Is the modern theory any different?
We made a survey in 1940 of all the textbooks being used.
I think what was done was to pick out 10 common fallacies--such
as alcohol is a stimulant, alcohol causes certain diseases,
alcohol does something to the brain tissue, drinking causes
shortening of life, and so forth--all beliefs that have
been disproved by objective and empiric evidence that could
be repeated in any laboratory--and checked the tests against
This was a survey you conducted on those fallacies?
Well, first, we know the fallacies. We had worked on them
in our own laboratory. Then we went out and, as far as we
could, -studied every text that was used in a school system,
whether parochial or State, all the manuals put out by the
State bureaus on alcoholic education, all the temperance
stuff and checked to see how widespread these fallacies
were. And about 98 per cent of the books had these fallacies.
What does alcohol supply? What is it that people seek?
There is one very good answer: Alcohol--and I don’t
care in what form you get it as long as it’s ethyl
alcohol--is what is called a “sedative.” I am
merely repeating their statements of the pharmacologists,
the physiologists and the biochemists. Under the sedatives
they would subclassify it as a “depressant.”
This means that it tends to produce sleep finally. But it
does so in a very special way--namely, that you can take
just a little bit and it will have a slight depressant action.
No matter how little you take, it will hit certain central
the outward behavior of the person may seem just the opposite
of being “depressed”; what happens is that certain
controls are reduced; it is more like releasing a brake;
it is not a stimulant, not stepping on an accelerator.
you drink a little more and it hits the central nervous
structure more; a little more, it hits still more; and finally
you will go to sleep. If somebody should then inject more
while your are asleep finally the heart would “forget,”
if you like, and you would drop dead. You already will have
been dropped, however, before that takes place.
lucky, shall we say, that it is very difficult to drink
yourself to death. You could do it, but it takes quite a
few minutes for the alcohol to get into operation. Drinking
at any ordinary speed would result in one’s passing
out before a fatal amount was consumed. But if you drank
a quart or a quart and a half just as fast as you could,
possibly injecting it into your system, you might kill yourself.
Alcohol is a poison?
On the basis that any substance you take can kill you, yes.
But this is also true of mashed potatoes.
Well, why do people drink? If it is a sedative, why would
people go through all this just to go to sleep?
In the early stages, alcohol has this reaction: You relax,
you operate more slowly, or you operate with less efficiency
and exactitude and discrimination. This takes place first
in those areas in which “learning” is recent
or difficult or painful. Now as to this learning, if we
had an experiment here and sat here and went around learning
the names of the States or 15 varieties of flowers, that
might be interesting and prove the point. If you were tested
on this learning you might get a score of 95. After one
or two small drinks, however, you would only score perhaps
85. If geography or the study of flowers had always been
painful or difficult for you, your sober score might be
88, but after one or two small drinks it might drop to 65.
for human beings, this sort of learning is not too important.
that is important for us in the sense that it affects our
daily lives and carries heavy emotional impact would concern
such things as, perhaps, one’s perception of one’s
self. “Am I a pretty reasonable sort of guy? Do most
people think I’m a stinker? Am I weak? Am I stupid?
Am I sexually rather impotent, so that no woman would ever
be interested in me?” --or, if a woman--“Would
any man ever look at me,” and “I can never be
a mother.” This sort of learning is very painful.
It may take over 15 to 20 years to learn, and it is horrible
to live with. Or there is the matter of not being able to
assert one’s self, to stand up in competition with
know of people who are frightened in these ways. They may
have the capacity, the ability, and so forth, to live adequately
and happily--but they can’t exercise it.
So they take to alcohol to forget all this?
Well, this is what happens--this is the sort of learning
that is first realized: Here’s a fellow who is very
shy in a group. He has a couple of drinks and loses some
of that very painful learning (shyness or exhibitionism
are learned modes of behavior) temporarily, so that now
he can talk a little more freely. He suddenly forgets that
he is incompetent or frightened.
His inhibitions are gone?
They are not gone--they are temporarily reduced.
Would you consider, then, to that extent that alcohol can
serve a useful purpose?
Well, you selected the word “useful.” I didn’t.
Let’s take an example: This man on my left may be
my boss. I think he is an awful stuffed shirt and I want
to punch his face in and tell him he’s an old jackass.
However, I have learned to control such impulses. But now
I have a few drinks and say, “You’re an old
jackass.” Well, that probably didn’t turn out
But couldn’t it be the opposite? Couldn’t it
relax the fellow who is too shy to stand up and address
a group and help him to forget about his shyness?
Well, here is a classic example: There was the man in Germany
in 1888 or so who moved to a new town. He was quite a shot,
and they have a rifle club there and they go out to see
Herr von What’s-his-name and ask him if he can shoot.
He says, “Sure,” and goes boom, boom, boom,
and gets 20 bull’s eyes out of 20 shots. So they ask
him if he would like to join the team when they go over
and play Von Sedlitzville. All right. So they make him anchor
man down there, but old Boom-boom-boom gets 12 on the bull’s
eye, 6 on the outside, and so forth. “Oh, well. He
was upset, he was new.” So they try him again, and
again he’s a failure. But in the interim he is out
on the range practicing and hitting 20 out of 20. One day
somebody by mistake or something happened upon this: “Just
before the meet we will give him a couple of drinks.”
He goes up and, instead of hitting only 12 out of 20, he
Score Can Rise, But Ability Fall
what has happened is this: The alcohol has reduced his acuity,
his reaction time, his discrimination, so that he could
not get 20 out of 20, but it has also reduced his inhibition,
his fear, or whatever it was that was bothering him in competitive
situations, so that he doesn’t drop way down to 12.
Alcohol actually seems to improve his ability, but it has
also actually brought his abilities down. Is it useful?
problem here is not the answer. It is the question. Americans
always want black-and-white, or yes-and-no, answers to questions
concerning good and bad, or true and false. Most questions,
unfortunately, cannot realistically be answered in such
simplicity. Alcohol is not either useful or nonuseful. It
is clearly both, depending on the person, situation, amount
and many other variables.
Makes An Alcoholic
What is your answer to the question as to what makes an
alcoholic? Most people don’t know what the word means.
Most people don’t understand why, since they can take
a drink every day in their homes and never get drunk, all
of a sudden somebody comes along and takes one drink and
he’s under the table. Why is that?
I can’t accept the example of one drink and under
the table. An alcoholic might pass out after taking one
drink while you watched him. He would have had 20 drinks
previously without your knowledge. Sometimes people who
are utterly inexperienced will act, following a drink, in
ways they think to be “tight” or “high.”
Adolescents experimenting with alcohol may show behavioral
responses utterly inexplicable from the action of the small
amounts they have consumed. However, it’s hard to
believe that even they would fall under a table with one
What about the difference between the person who takes a
drink every day and is not an alcoholic and the person who
drinks a little now and then and is an alcoholic?
We would say that there are probably two important criteria
to distinguish the alcoholic from what might be termed the
“heavy drinker.” One of them is this: the lack
of control exhibited by the individual over, first, when
or if he will drink. That is, “Will I drink this afternoon,
or not?” Of course, he is going to drink sometime.
Second is the loss of control over the extent to which he
will drink. That is, sometimes he has decided he will sit
down for two and suddenly finds he is having his sixth drink.
And when I say, “decided,” I mean that this
can even be announced. It is not only internal, which can
be discovered by an objectively trained observer, but he
may even say, “I’ve got this meeting coming
up,” or “My kid’s having a birthday party
and I’m not going to take a drink.” Then to
his own amazement, shock and horror, he finds himself having
other is that he plans to have three drinks but--not every
time, but with increasing frequency--he takes 30 or 40 and
is drinking to oblivion. He’s out of control. That
is one aspect.
other we would say--and this must happen eventually--is
that this excessive drinking, through drunken behavior,
begins to create problems of itself--remorse, anger toward
others, guilt, feelings of inferiority, helplessness, and
so forth, within the individual, and manifest signs appear
of trouble in his relations with his social environment,
that is with friends, family, on the job and the like.
man is having his “status quo” as an individual
regularly damaged because of this drinking. Now, it is those
two things—chronic and increasing damage directly
related to drinking, and the lack of control over drinking--which
mark the alcoholic from the “heavy drinker.”
Do you think that a person who is a chronic drinker inevitably
becomes an alcoholic?
No, that isn’t so. There are millions of regular
drinkers who aren’t and won’t become alcoholics.
Well, then, what is it that encourages the chronic drinker
into the alcoholic stage?
But the alcoholic doesn’t have to be a chronic
drinker. Of course, if I could give you the answer just
like ABC, we wouldn’t have to be here, because it
would be something we would know how to fix. We have some
ideas about it, however.
say that we have a number of people who meet these two criteria--they
are out of control, which has gone on over some period of
time, and some socially or emotionally significant aspect
of their lives has been damaged thereby. I think we will
find that there are quite a few different types.
Problem for Some is Psychotic
type I would call “adjunctive” alcoholism. That
is not a technical term; I just use it. Here is a man who
from the point of view of the depth of his condition, the
difficulty of treating it, and its impact on his whole life
is more importantly affected by something other than his
drinking problem. He is what the psychiatrists call psychotic
or protopsychotic, if there is such a term. And he has found,
or thinks he has found, that getting drunk relieves the
horrible feelings of psychosis. His psychotic symptoms are
not extreme, so the manifestations don’t strike you
or the man on the street or the cop on the corner, except
in rare instances.
he gets drunk 30, 40, 50 times a year, and the "drunkenness"
behavior is noticeable. This, if you like, is a facade,
the appearance of the condition. He may well be called a
“damned drunk” or “inebriate,” or
whatever the term happens to be. He is haled into court,
the social worker will see him, the minister will see him,
his wife will scream, his boss will fire him, and so forth,
and he will be called an alcoholic. And maybe he is developing
alcoholism, but his major problem is something else. We
find this with certain types of psychotics.
Are there quite a few of that type?
I would say that, although our figures are not too good,
there are quite a few. I would say that a number of epileptics
can be found here, because alcohol apparently reduces the
strength of the trigger mechanism that sets off the epileptic
who have brief epileptic seizures like that--3-second attacks,
so that all you notice is that sometimes the person doesn’t
seem to be paying attention to you--may gain some relief
from using alcohol. The man may not understand it, but he
drinks and he feels better. And he had better look out.
Because the day one starts using alcohol as a medicine for
a chronic condition, he is using a sedative for-privately
Then aren’t you finding that mental-hygiene problems
are closely related to alcoholism?
So that some people who have mental or emotional aberrations
of one kind or another become alcoholics?
Yes, they might try to find relief in this
However, I would say that the larger number of people who
are neurotic--and I mean here psychiatrically determined
neurosis--although they have the opportunity to drink, do
not become alcoholic. While excessive drinking may have
relieved some emotional pain, it was not acceptable to them
for a variety of reasons. Maybe their own neurotic pattern
was functional enough for them to meet their troubles. Maybe
they were brought up to believe that getting drunk is a
horrible evil, far worse than their neurotic pain.
Let me say that the likelihood of a woman who is neurotic
becoming regularly and often rather drunk, perhaps even
developing into an alcoholic, is much less likely than in
the case of a man, because the social pressures on drunkenness
are much heavier against a woman than a man in our society.
As a result, it is a less likely sort of adjustment to problems
for women in our society.
Let’s take it in reverse. Aren’t the people
who are trying to cure alcoholism aware today
of the fact that they have to cure the mental problems as
This calls for a lot of comment. First, Let me say none
of us accepts the word “cure.” That
is one of these words I would like to eliminate because
we say that no alcoholic is ever cured--it is merely an
Does that mean that alcoholism is a disease?
Only to this point--that to our knowledge it cannot be helped
to the extent that the person can relearn how to become
a social, temperate, moderate drinker.
He must give it up completely?
Absolutely, forever, in any form, in any amount. We have
cases of people who had stopped for 15 years and who thought
it was safe, or some naive doctor told them a beer isn’t
drinking, and so they go on again—
And it takes very little quantity--
It’s the alcohol. The quantity doesn’t matter,
no. If they are unaware that they are taking alcohol, if
they don’t even know about it, or in some circumstances
if the ingestion is interpreted in so ritualized a fashion
that it has nothing whatsoever to do with “drinking”
as that is interpreted by the individual, then there might--and
I emphasize the “might”--be no effect. I still
wouldn’t be surprised if it did start him off again.
the Catholic priest who is a recovered alcoholic. At Mass,
as I understand it, nobody gets any wine at all except the
priest; sometimes he may have to take quite a little because
it all has to be used. I have heard, and I would believe
that in the case of certain priests who were recovered alcoholics,
that this ingestion of alcohol--because chemically that
is what it is--did not cause the man to revert to alcoholism.
Certainly a sincere priest wold not interpret this act as
“drinking.” However, it would seem a great risk
Well, do you think that if we make progress with mental
hygiene in America we will tend to reduce alcoholism?
We will reduce that proportion that I was speaking of. I
started off with the worst, the psychotics and pronounced
What are some of the others?
There is a certain proportion that are feeble-minded. We
would say that the proportion of alcoholism in the feeble-minded
is much higher than it is in the general population. But,
altogether, it’s a small number. The feeble-minded,
the psychotic and the epileptic are three categories in
what I termed adjunctive alcoholics. The person who begins
to act like an alcoholic at 17, 18 or 19 presents at least
a strong suspicion of a major neurotic or approaching psychotic
situation, perhaps schizophrenia.
alcoholism will take anywhere from 7 to 15 years to develop
from the early -symptoms to the final full-blown appearance
But with major neurotic conditions the development may take
less than a year.
Are these the only groups who are likely to turn from social
drinking to excessive drinking?
On, no. This is just one small segment. I would say that
we have some people that are called “neurotic.”
Now, what I mean by “neurotic” is approximately
this: His peer group--we will say “his” and
not “her” because we run 5 l/2 males to one
female--thought at the time, say during the teens, that
the individual was clearly peculiar.
are “screwballs,” or whatever the popular word
is among their group, and they are known as that by the
others. They’re frightened, they’re shy, they
don’t get along well in interpersonal relationships,
they don’t know how to fight, they don’t know
how to date, they don’t know how to dance, they don’t
know how to dress, and so forth. They may study excessively,
they may be highly overcompensating athletes who are terrified
of other people, they may be “mother’s boys.”
And the others recognize it, and it is noticeably interfering
with their day-to-day life. This person at 16, 17 or 18
may discover alcohol. He may not even know that he has discovered
it. He may go to his first party and have some drinks and
simply know that, “Gee, when I go to the Joneses on
Saturdays I have a wonderful time!”
after several experiences he can’t help making the
correct discrimination because he went to Green’s
house and it was Thursday and there were drinks and he had
a wonderful time, and the next Saturday he went to the Joneses,
had no drinks and he felt awful. This person, then, begins
to find that with drinks he can act more like a human being,
that he his accepted by others, and there is this tremendous
relief--“My God, I can be a human being after all!”
group of alcoholics with this background, I would say, is
more sizable than the psychotics. But I would not say that
they are all the alcoholics by any means. Anybody who tries
to explain alcoholism entirely in terms of basic or character
neurosis faces an impasse.
If we should make more progress in
hygiene will we make more progress in the field of alcoholism?
As mental hygiene is able to do something about the prevention
of psychosis, for this percentage, yes. As it is able to
do something for the prevention of neurosis, or social or
emotional deviation, obviously for a bigger percentage,
then, take this even large group of alcoholics who don’t
give evidence of early neurosis. You only discover them
when they are 40. You go back through their life histories
and you can’t find in the school record any evidence
that they were peculiar--they were just like everybody else.
everybody--and this is pertinent to the mental-hygiene question--everybody
has personality difficulties. We all of us have stronger
and weaker spots in emotional and social adjustment by definition.
Some of us are quite well adjusted in relationships with
the opposite sex on a series of levels, whether it refers
to actual sexual intercourse or whether it refers merely
to talking to secretaries. Some of us are average and some
of us are a little more or a little less well adjusted.
Some of us in the matter of competition and assertion and
dominance are stronger or weaker. All of us have certain
weak spots. We are not robots.
say that I am weak when it comes to asserting myself with
people in a higher status or
with older men. Maybe it has something to do with early
experiences with my father or my older brother. Anyway,
it is a common thing. It is found in personnel problems
all the time. You promote a good man and he collapses. Why?
He cannot give orders on a higher level.
boy is, let us say, now 23, 24, 25, and he has all the ambitions
that most young American men have, and he feels a little
more at ease, a little more relaxed, and loses a little
of this restraint after a few drinks. Well, he says to himself,
so do a lot of other people. So what!
about age 25, 26, 27, this particular problem becomes even
more significant to him. The boy is no longer in the school
or college situation and can’t fall into one of those
nicely defined categories where this is the faculty, these
are my elders, these only lower classmen, and begins to
realize that he is a competitive person, too.
too, can get up there and can even disagree with those people.
In fact, the situation demands that he compete. This makes
him somewhat ill at ease, but over the week end when he
has a cocktail, some highballs, or whatever it may be, he
loses some of his fears and anxieties on this score, and
this loss becomes highly important.
would seem to be a point, as we recapture the life experience
of the alcoholic, where there suddenly is an increase in
the intake. Let’s say that in his group they usually
have, say, three cocktails two nights a week and on
Saturday nights. This man’s intake jumps up 50
Drinking Gets Serious
Is this suddenly?
It would seem so. At least the man remembers it, and so
do some of his friends. Then he begins to show all sorts
of symptoms, but I will skip all of them and go right into
the possible mental-hygiene aspect of it. He begins to increase
the time of drinking and may have a couple in the afternoon.
He may even shift jobs so that he may get into a position
where this sort of thing is more possible. He may shift
friends so that he associates frequently with those among
whom heavier drinking is socially acceptable.
we will find that he is making certain decisions and is
meeting certain people particularly at the times when he
can have a few drinks--not that he is going out and hanging
on to lampposts. He may tie one on now and then if the people
in his group tie one on. But he is regularly drinking more.
Perhaps he is meeting problems with his wife or his kids
that have made him very uneasy. He can’t stand the
kids at supper time, and he is afraid his wife expects him
to do things he can’t do, but if he has two cocktails
every night he no longer notices their criticisms, their
requests for his attention. He may be abrupt and even a
little sarcastic with them, and doesn’t know that
he is doing it.
is a very slow, gradual process. We call it the “pampering
effect” of alcohol. There was a weak spot in his personality
armament and, instead of trying something new and learning
through variation, no, he protects himself more and more
by alcohol. The needs for the personality go on and new
needs come up, especially in the weakest areas, and this
fellow is not learning, he is not growing, he is not changing,
but more and more is covering it up.
if the situation develops whereby he is put under some special
pressure, he may--and it is three o’clock in the afternoon--say,
“If only I had a couple of drinks!” And he’s
right--because he has those couple of drinks and it doesn’t
bother him so much. Then occasionally begins to get drunk.
Now, when he gets drunk, he has not only the remorse that
any might have who experience a -hang-over, but also has
this awful remorse about the situation which he didn’t
resolve and about what he did while drunk, plus the fact,
“I’ve done it before and before and before,
and I can’t stop it!" He experiences a monumental
psychological effect from the hang-over.
vicious-circle process can now be seen. As the individual
more and more depends on alcohol to meet certain situations--and
for a while he is successful, for it does work--he is, through
lack of exercise, so to speak, reducing his basic equipment
to meet other people and particular types of situations
effectively. As this happens, he needs a little more. As
he begins to take a little more, he begins to make “drunkenness”
mistakes. In other words, he could be overly aggressive
and doesn’t even know it; you can be critical of him,
and he doesn’t even notice.
soon the liabilities of drinking -overtake the assets. Furthermore,
occasionally he oversteps and really gets drunk and does
things that create new, major difficulties, so he has to
get over this additional problem. To cover up this new problem
created by the excessive use of alcohol, he uses more alcohol,
and so the nice little vicious circle becomes a bigger vicious
may be that a definition of psychological addiction”
would be the use of alcohol to overcome the effects of alcohol,
whereas when you are merely using alcohol to overcome situational
problems or neurotic problems, this is not the case. Then
you are drinking to overcome shyness or inferiority feelings,
which are not created by alcohol.
Now, where does mental hygiene fit in?
We would say two things. First, let’s note this fact.
Over the past 50 years, which is at longest the reign of
modern psychiatry—and perhaps you would prefer 25
years--psychiatrists have been peculiarly unsuccessful with
alcoholics. The psychiatrists know this and dislike the
alcoholics; the alcoholics know this and dislike the psychiatrists.
And so the hope of doing anything, one with the other is,
of course, very low. Psychiatrists are not alone in that,
however--it covers everybody else, too.
But why have the psychiatrists, if this is a mental-hygiene
problem, not done better?
One answer to that would be that the psychiatrist, quite
correctly, sees that this person has personality difficulties
and in some instances they see a long-lasting character
neurosis, one that’s been in the developmental stages
for years, perhaps since the age of 4 or 5. So the psychiatrist
says that, unless we get rid of this thing at the bottom,
we are just playing games with the thing at the top.
the alcoholic comes into the office and the psychiatrist
starts needling back into this, perhaps, adolescent problem,
and then back to the 7 or 3-year-old period. The alcoholic
looks at the psychiatrist and wonders, “Which one
of us is screwy?” Here he is; his wife is going to
toss him out on his ear, he can’t hold food on his
stomach, his glasses are smashed, he has lost his papers,
he is going to lose his job. He has this horrible feeling
of fear, of additional worry about this alcohol business,
and here this weird character is asking him what dreams
he had about his great-grandmother when he was 4 years old.
That’s an exaggeration, of course--
Yes it is, but it is significant of a very important thing:
The psychiatrist, very correctly, proceeds on the premise
that there were underlying difficulties much more significant
than the actual effect of the alcohol. And so they begin
to talk about alcohol as a symptom, but I would suggest
to you that, as the alcoholic ‘has gone through alcoholic
experiences for many years, he is no longer merely a neurotic
type B or a neurotic type C. He may once have fitted such
a label, but now he has added alcohol-dependency and has
fused the two into something new. He has problems, demanding
problems, problems that have gone so deeply into his insides
that this alcohol will trigger him off even 15 to 20 years
later, even if he never takes a drink in the interim. The
alcohol dependence is terribly important in itself. It is
a new thing. It is what we call “alcoholism.”
So you do have your original problem in personality and
Yes--and perhaps you can tie this original to poor neighborhoods,
unresolved Oedipus complexes, lack of affection, and so
forth, yes. But, unless there is also understanding of the
impact of excessive and chronic alcohol ingestion and what
it can do to an emerging, growing personality, therapy won’t
get very far.
the first place, you will have a lot of alcoholics who won’t
have what you would call a neurosis, and yet they are just
as bad as the other fellows in the end. When you get the
one who has this real neurotic problem you probably can’t
reach him by the usual psychiatric technique because, as
the psychiatrist would put it, he is an objectionable, un-co-operative
person--and that is right.
Is there any inherent tendency to become an alcoholic? You
hear of people referred to as a natural for alcoholism—
Let’s put it this way: Acquired characteristics are
not inherited--that is, you cannot inherit a taste for alcohol.
You do not inherit drinking. Alcoholism? There is an inherited
structure which is closely related to one’s potentiality
to develop an effective personality. So, since weaker personalities
are prone to maladjustments of all sorts, including alcoholism,
say that alcoholism is found to a higher degree among the
feeble-minded than the rest of the population. Certain of
the feeble-minded probably have a structured, organic deficiency
which can be inherited. However, they inherit feeble-mindedness,
I want to clear up this heredity question a little bit.
Do I understand you to say that, while there is no acquired
taste, if a parent has a personality defect, and that defect
is reproduced in the child--
It couldn’t be personality--it would have to be an
Well, does that cause the child to take to drink?
The organic defect does not cause the individual to drink.
The organic defect has an effect on their ability to intellectually
or in reaction time or in emotional spasms or in certain
diseases, say, tuberculosis.
If that is reproduced in the child, then the child will
be susceptible to the same thing?
It will be susceptible to personality disorders, sometimes
alcoholism, sometimes delinquency or neuroses. Now, I should
add one more thing--that alcoholism runs in families.
What is the reason that it runs in families?
Because the father or the mother who is an alcoholic finds
it almost impossible to give love and affection and attention
and responsibility to anybody, especially to a child, who
may well make him feel guilty and the like. This is, of
course, particularly true of the mother. The situation in
which the alcoholic’s children live, the way they
are brought up, just everything, tends to make them upset
people. Sometimes they will become extreme, wild “drys,”
ascetics; sometimes they will become extreme drunks. Sometimes
they may be moderate drinkers. But they experience hardships
of an emotional nature during infancy, childhood and adolescence
if the parent is an alcoholic.
might add something else here. Alcoholism cuts across all
social groups, all educational groups, all occupational
groups. It is limited to certain age groups, yes, largely
because it is a slowly (10-15 years) developing condition;
it is most common between 35 and 55. It differs by sex,
yes--5 or 6 men to 1 woman.
in ethnic, cultural background--we find that the Mediterranean
people--the Italians and the Greeks, for example--will tend
to have ‘low rates. The Jews, almost all of whom use
alcoholic beverages, have an extraordinarily low rate, a
fact which has been recognized for over three centuries.
so-called native white American group will have quite a
high rate, as will the Irish, Scandinavian, English, and
noticeable thing is the difference between the sexes. In
this country the ratio is about 5 l/2 or 6 to 1; in England
for many years, 1890 to 1940, it was running about 2 men
to 1 woman; in Scandinavia at the same time it was about
27 men to 1 woman. But it is interesting to note that, after
three generations in this country, the Scandinavian rate
began to descend to about 11 or 12 to 1, the English to
come up to about 4 to 1. Those Jews who have more and more
become secularized, gotten away not only from the Orthodox
but also from the Conservative or the Reformed—especially
if their parents have also--their rate has begun to go up.
other words, the Americanization process is gradually working
in this sphere as well as others.
What are the prealcoholic symptoms?
Well, there’s an increase in intake--we
the man who is drinking just like the other people in his
group. The quantity doesn’t matter--it may be six
sherries a week, or two highballs a night. This man starts
increasing his intake, and he begins to show some of these
behaviors--and remember it is the repetition of these behaviors
and their patterning with the others, not just their occasional
first thing it suggests is an increase in gross, drunken
behavior--that is, when he has a little too much, instead
of acting the way he used to act when he had a little too
much, he begins to be more out of control in his immediate
all know that inhibitions go down with drinks--one forgets
the immediate worries, the immediate fears. For instance,
you’re all being very polite here, but if we were
at a cocktail party, I couldn’t get all this attention.
I’d have to talk a little louder; my jokes aren’t
really very funny, but after two or three drinks they really
begin to seem to me to have that particular flavor that
would make Noel Coward jealous, and even you may forget
a bit and laugh at some of my jokes.
this is still within the range of social acceptance of that
group. This man, however, begins to go beyond that. He starts
to be a big shot--spends a lot of money, sets them up for
the boys in the back room; he get noisy; certain words which
are limited perhaps to times when I hit myself with a hammer
begin to come out more and more in general conversation.
In a variety of ways this man’s behavior more and
more often becomes obvious, irritatingly obvious, to the
other members of the group when he is drinking.
in a Blackout
thing of considerable significance is the appearance, often
very early in the game, of what is called “the blackout”
or “pulling a blank”--this is sort of temporary
amnesia. The man is drinking along about 7, 7:30 or 8. Now
the blackout begins, but, if you’re the man you don’t
know it--You’re still around, you’re having
drinks, you’re talking--you may get in a car, and
drive 50 miles, you may take a room at a hotel, but memory
has stopped completely and one cannot recall anything that
has taken place since 8:30.
can imagine the terrific impact this will have on women
in our society, because there is immediately the thought:
“I may have had a sexual experience--or other people
will think I have, which is just as bad.” It is terrifying—less
terrifying for a man.
get situations where a man has a blackout which lasts 36
to 48 hours--he ends up in another city, he doesn’t
know where he is. He learns to have a newspaper sent up
to his room to discover the date and what town he’s
in. I now of one man who when he came out of the blackout
remembered that he was to have signed a $400,000 contract
the previous day at 10 a.m. Quickly making himself presentable,
he rushed in to the corporation president with whom he was
to have closed the deal, made some lame apologies, and hoped
the whole thing wasn’t off. The corporation president
looked at him rather strangely and then stated: “Mr.
C., you were here yesterday at 10 a.m. and we signed the
agreement.” Not all blackouts have this type of surprise
for the end of the story.
there is the gulping and sneaking—this is an indication
that it is not social drinking any more--the fellow has
to do more than the social pattern will allow. He needs
to get this personality jolt or lift through acquiring a
significant and rapid concentration of alcohol in his system--just
a little bit doesn’t get him started. He begins to
know that at the Jones house he will only get a couple of
martinis, so before he goes to the Joneses’ he usually
has a couple of quick ones--he’s the fellow who has
to help the hostess, and incidentally get a few slugs on
the side. He is learning that he must have more.
these are early symptoms.
Can they be corrected? Can he stop?
Could you give him some rules, Dr Bacon?
To know that next he goes into alcoholism--that that is
the next step--the first great crucial point, the loss of
control. He meant to have two drinks, he winds up drunk.
We find that he begins to need special rationalizations
to explain his drinking, because people begin to notice
he is drinking more. And these rationalizations cover the
waterfront--everything you have ever heard of.
At this time he may show a few instances of drinking alone.
Drinking alone can be all right under a doctor’s prescription,
or some people use it to go to sleep, or there may be a
religious ritual. But I’m not talking about any of
those. He begins to drink alone and. likes it. He doesn’t
need all these other people pressing in on him, he may become
a “loner.” This is quite usual with women alcoholics
for whom social conventions don’t allow as many socially
acceptable opportunities for drinking. Not all alcoholics
along in here--it may wait until the later stages--some
dear, dear friend or even a physician may advise him during
a hang-over--and he gets more hang-overs than others and
they hurt him far more than they do other people--that a
“quick one” at the beginning of the day will
help. Many, many times it becomes humanly impossible for
him to think of getting up and going to work and so on without
begin to find some asocial behavior. I am not talking about
anything marked. But we do find a little trouble on the
job, a little trouble at home, a little trouble here and
there, automobile trouble, or what not. It’s more
than he had been having in the past. It is reported on--quietly.
But most of his friends tend to hush up comments about it.
Trying to be helpful perhaps, many people try to cover up
for him. Of course, he tries to do so also. Naturally, the
day of reckoning gets worse as it is postponed. And about
this time he may say, “I’ve got to do something
about this.” So he tries to change the pattern--a
little shift from rye to gin, or he will stop drinking before
5 in the afternoon, or he will only drink at home, never
in a commercial place.
Does that help?
No. It isn’t drinking patterns that are his trouble;
it is the excessive ingestion of alcohol. And he can fit
that into any pattern of drinking. Being an alcoholic, he
will. Pretty soon--and it will be the end of what we call
“the early stages”--he may go to get help from
a minister, friend or someone outside the family, or he
may even go to a sanitarium or a doctor or a hospital. He
tries them all out.
we come to the beginning of the last stage, which is the
“binge.” We have our own way of talking about
a “binge.” A person can be completely "blotto"
for 48 hours or for a week and we might not call it a binge
if this fellow, let’s say, is drunk over the week
end, but on Monday morning he gets to the job. He may be
on a two-week vacation and he is "blotto" for
three or four days, but perhaps he has not completely disrupted
social expectancy and social habit of his group. But this
bird, who has started his week-end drinking about Friday
at 2 p.m. and slowly slides off only about Monday noon and
doesn’t get around to the office till Tuesday--this
four days is much more significant than six days on a vacation.
The man begins to go on binges which clearly disrupt and
insult the society.
this point, the alcoholic may start getting secretive about
his drinking. By now he will have surely learned the morning
drink business, and he learns to keep a supply for the morning.
He starts hiding his supply and he may develop all the tricky,
tricky habits of the confirmed alcoholic and waste extraordinary
ingenuity on protecting his secret supply. I call it wasted--sometimes
the mental exercise equals Thomas Alva Edison at his best.
might say that one of the most tragic things in the world
is to see an alcoholic who has a half bottle left for the
morning which he puts away where the little woman isn’t
going to find it--only to discover in the morning that he
had been in a blackout when he did the hiding.
a frantic, maddening search will follow!
finally begin to see a social breakdown which is really
manifest. His friends, if they are still in that category,
find it harder and harder to cover up. Now he loses the
second or third job, and even though he got in to the office
first and resigned, too many people know he was fired. Trouble
with the wife and kids begins to come out in the open, and
so on. Social difficulties mount rapidly. He begins perhaps
to show some physical symptoms, tremors; more and more often
he’s in a physically run-down condition, which was
perhaps present earlier in an acute fashion but over in
two days--now it becomes chronic. And his rationalizations
to himself--no longer can he find explanations in the culture
that will satisfy even him, to say nothing of others. He
is beginning to give up. His fears and his guilt and his
remorse, instead of being pinpointed to what he did last
night, or to his attitude toward his wife over 6 years,
or 16 years, now become generalized without definition.
is undefined fear, undefined remorse that he can’t
even explain--he has this black depression. It is called
the blues sometimes--the real blues because you can’t
identify it. That’s the difference between the real
blues and a sentimental blues--you can always say it’s
because Mama went away—but with the real blues you
can’t identify what it is that is so painful, so threatening.
That’s what’s so horrifying. And at this point
the fellow may give up socially on the grand scale, may
slip down into Skid Row. Now the “DT’s”
may appear, and so on.
What can you do to help--in the early stages particularly?
I would like to answer that in the first instance by pointing
out that the behaviors called “early symptoms”
are not by themselves symptoms. They have been ridiculed
by some newspaper commentators, and if they are considered
as separate instances, such ridicule may be O.K. It is when
they are patterned and repetitive and increasing that they
are early symptoms. For instance, among your friends may
be some who have had a blackout. Does that mean they’re
alcoholics? No. It may have to do with the improper utilization
of alcohol by the body. Your friend may have gotten drunk
several times, he may have sneaked drinks once in a while,
he may have said at parties a couple of times, “Let’s
have one for the road,” or he may stop at your house
to have a nightcap, or he may stop at a tavern on the way
to a party.
by themselves, these need not be symptoms. It is only when
these things get into a pattern and become repetitive, that
they make sense as early symptoms of alcoholism. Naturally,
drunkenness may occur many times without any of these things
being present at all.
What can be done about it?
For the people in the later stages you need almost a re-forming
of life--particularly in social adjustments--and, for some
people, also in the emotional sphere. Drinking will have
to be given up permanently. Some may need physiological
care beyond remedies for temporary acute ills. Originally,
some 10 years and more back, it was the late-stage alcoholics
who came looking for help, and so rather drastic steps were
as “Alcoholics Anonymous” and our clinics
began to be more widely known, some of the frightened people
in the middle and earlier stages came in. In fact, today
they are the largest groups we see.
What are you going to do for them?
First, we began to find they are different types. Some of
them were way back in the first stages, some of them needed
a little knowledge and a little guidance from a neutral
and a respectable source; when they could see where they
were and could be given a little support. If they could
have some of the situational factors--such as the wife,
who has been doing the wrong thing even with the best motives,
triggering the guy into his alcoholism—when they could
receive just a little help, they could help themselves quite
you could relieve those pressures and give this man just
a little support, a little hope, a little help, then he
didn’t have such a hard time.
Could the people in the middle stages, who had lost control,
So far as we know, they can’t stop permanently without
help. Now, there is going to be a case here and a case there
where they can. Ordinarily we don’t know in such cases
whether they really were alcoholics before they stopped--just
that they said so or their doctor, or Aunt Mathilda or the
judge said that they were alcoholics. Then you may find
out that this judge or mother-in-law thinks anybody who
has two beers a week is an alcoholic.
In that group he isn’t out of control, then?
That very control is the crucial point in getting into alcoholism.
Can he stop at that point’ and later on be
a moderate drinker?
So far as we know he cannot become a controlled drinker.
There may be some people who manifest some of these behaviors
for a variety of reasons and later on drop the variant behavior
without dropping the drinking. However, to date there is
no well-recorded case that has been followed over as little
as seven months, of a person who had--by consent of two
or three outside observers going over the record--been an
alcoholic, no matter what the stage, who was later on, say
for a period of roughly a year, found to have been a controlled
What about before he loses control and sees some symptoms,
what does he do in that period?
He can keep control.
How does he do it?
As a matter of advice, I would say to him: “Buster,
you’d be awfully smart to play it safe. The safe way
is for you to have a look around at your life, find out
what you’re getting amusement from, where your job
is, where your friends are, and see in what areas drinking
seems to press itself, socially, upon you, and start manipulating
those situations a little. Maybe you can control it.”
is a typical way to find out--I’ve ever proven this,
but it sounds reasonable and was suggested to me by a member
of “Alcoholics Anonymous,” or “AA’s,”
as they are called. To find out if one is an alcoholic or
not, you get the is-he-or-isn’t-he person to tell
you what he thinks sort of average, social, moderate drinking
is. Let’s say he decides a highball every night and
two cocktails three times a week. You say, “O.K.,
that’s what it is. Now, every night for one month
you’re to have one highball--never more, never less.
And Thursday, Friday and Saturday you have two cocktails--never
more, never less.” If he can keep that up for 30 days,
the chances are he is not an alcoholic.
is, of course, a rule-of-thumb thing, and I can see where
some wiseacre alcoholic would do it and get away with it.
I’ve known alcoholics to go through the aversion treatment--and
a horribly painful course it is--they go right through the
treatment, kidding the doctor the whole way through. Going
out in between sessions and drinking and drinking till they
can take it without becoming sick to their stomach, and
then going back for the next treatment, because they are
showing off. They’re showing that the doctor is a
damn fool. They’re showing Aunt Martha, and they are
showing themselves how clever they are, and so on. Of course,
they’re fooling no one but themselves, but with a
motivation like that I suppose, some alcoholic could pass
this 30-day test. It would be a terrific strain on him.
For ‘Early’ Cases
You can’t reach any of these people unless they want
to be helped, can you?
As far as therapy is concerned, I think this is a potential
excuse for failure that is very dangerous for progress in
this field. Even “AA’s” use this excuse.
For example, they try t o help Joe over here. A couple of
weeks go by, and then, flop, Joe’s drunk again. Well,
they try again and he flops again--and the answer is “Joe
don’t want to throw any blame in one direction alone.
Let’s say that a psychiatrist works with an alcoholic,
or a clinic that really knows something about alcoholics--they
work with Charlie. And he flops, not once, but again and
again. What’s the professional explanation? “He’s
are both ways of saying, “I don’t know,”
and “I’m not to be blamed.” The answer
that he isn’t ready yet isn’t an answer--it’s
merely a restatement of a problem.
certain times, at certain places, with certain people, under
certain situations, this man is more ready or less ready--and
the need of the therapist, “AA”’ psychiatrist,
or other, is to be able to recognize and manipulate these
more favorable situations. There are certain ways of dealing
with certain alcoholics so that the readiness can be brought
further forward. And this is what I was coming to when you
asked me about stopping the condition.
the Yale Clinic and the “AA’s” were getting
the real McCoy. In the late ’30s and early ’40s
you hit the “AA’s” with a wham. The candidate
did not have shoes that matched, had been in 12 jails, 6
workhouses, reform schools, State hospitals, sanitariums,
had lost his wife, etc.--the works. “Alcoholics Anonymous”
started about 1934. About 1938 or 1939 two things happened--they
got some people who hadn’t gotten that far--they still
had a necktie, a job, a wife. And the answer was: “Go
on, go back out, you’re not an alcoholic--you don’t
know what drinking is--scram.”
some of the others said: “No, that attitude is bad
as far as “AA” is concerned. Maybe you’re
right--maybe this guy isn’t a real alcoholic, but
he should have a chance. We cannot determine who is and
ain’t. We have got to help.” So they tried it.
the same thing happened when a woman showed up. This was
a man’s organization and the idea of women brought
in the idea of pink ladies, that sort of drinking, and brought
in fears that, having women around, even if they had been
real lushes, would ruin the whole fellowship. But they said,
“We’ve got to try it.” And just as in
the case of the men who hadn’t hit real rock bottom
as drunks, it worked in an amazing proportion of the cases.
was noticed that these people with a milder, shorter history
(a) probably had just had a binge, and (b) that they probably
had just had a nasty shock--mother died, for which they
blamed themselves indirectly, or they had been kicked off
their job, or they had been divorced, or they had had their
first jail experience. It was a shock to them. And so, they
talked about that shock as a bottom, and called it a “high
lo and behold, by 1950 the high bottoms in “AA”
almost certainly outnumbered the low bottoms.
the clinics we’ve had the same thing. In the early
days we got the real ones, the men who had touched low,
low bottom. Then we got more and more who were in the middle
stages and then some in the earlier stages.
something else. When people began to come to “AA”
who were 25, 26, 29 years of age, they came in all right,
but some couldn’t stand it--they liked the “AAs,”
they liked the philosophy, they liked the program, they
know they had been helped, but they couldn’t stand
going in two nights a week to listen to these old timers
yack-yack-yack about “what I did at Armentiers”
or about their 25 years of wild drinking, or something of
of ‘Junior AA’s’
was far from their own experience. So you begin to have
a development in the larger cities of so-called “Junior
AA’s.” A different sort of re-socialization
or modified socialization was needed. The “AA”
are very flexible and very empiric, and they found that
for many of the youngsters this worked. They picked up a
lot more screwballs in this group--that is, youngsters who
were deeply neurotic, perhaps psychopathic, who were also
drinking excessively, and who got a terrific bang out of“AA”’
and went along beautifully for six weeks.
over, and going wild.
So they have had some difficulty with such groups, but there
is no question that they have helped a great many of them.
The significant thing is the change from late-stage alcoholics
to middle and early-stage alcoholics, from helping alcoholics
averaging 45 years of age to those averaging 36 or 38 years
What have you found in the clinics?
We have found the same thing in the clinics. Because of
the availability of help, because of the anonymity, because
of the lowering of the stigma around alcoholism people are
willing to come in and ask for help. This is a hard thing
for the alcoholic to do, partly because in the back of his
mind is just what was in your psychology textbook—the
horrible implications of this disease and the moralizing
that accompanied it. But now there are places where they
don’t believe in these horrors and don’t preach
at you. In fact, in “AA” there may be many who
think drinking is just dandy, but that they're sick and
they can’t take it--it’s like diabetes, “I
can’t take sugar,” or “I’ve got
an allergy to sweets so I can’t take them.”
This is making the condition respectable and the possibility
of seeking help less painful. So they come in.
Do you find that young people are interested in the work
of the “AA” and the clinics?
Yes. The high-school and young college people who had suddenly
gotten very interested in “AA” speakers or those
from clinical centers. We note at the Yale Center that our
people get an almost fascinated response from these youngsters.
The students even ask to have them come, and no one has
to take attendance. Their reaction would appear strikingly
different from that shown to classical temperance lectures.
some of these students need what I would call intellectual
knowledge and guidance. They’re not personality-problem
kids, they’re not alcoholics, but they’ve been
receiving this nonsense--that is the way they look at it--about
alcohol. For instance, they’ve been told: ‘The
first drink--it’s the first drink that’s the
dangerous one--you’re one drink away from a drunk.
A little beer here and there, and this horrible social drinking
will lead to death, disgrace, disease. The liver will turn
purple, the brain shrink, and so on.”
students, to be sure, know this is not true. I say that
they know this for the following reason--some 60-odd million
people, most of them parents, use alcoholic beverages. These
beverages are in the icebox or they’re in the cupboard
or they’re at the party, and the youngsters know that
their dad drinks, and so on. They also know that he isn’t
drunk and he isn’t crazy and he isn’t going
to be. Furthermore, I don’t think kids care much about
warnings which refer to the senile part of the population--those
who are past 32 or 33. Alcoholics are usually portrayed
as being even older than this.
certain proportion of teenagers, let’s say 20 per
cent, do not consider these classic temperance talks to
be nonsense. In their families, their neighborhood and their
church and so on they have always heard these beliefs and
assertions, and the message fits into their life; it may
reinforce their belief. Of course, 99 per cent of this particular
group weren’t going to drink anyway.
the others--and this is a very regrettable point--may react
so negatively to the unrealistic part of the classical temperance
talk that they reject all notions of any danger in drinking
and even become intolerant of abstainers. I would go to
the extent of saying that, though it may be -unconscious
on the part of these very sincere well-meaning “drys,”
they are doing something which is unmoral. I criticize the
“drys” and not the “wets” on this
point, because the “drys” have a program and
the “wets” don’t have anything--they just
have “shhhh” when anyone mentions that there
are real problems.
the “drys,” by over exaggeration, by saying
things that are utter nonsense, unfortunately get across
the idea to the nonabstainers, who happen to be the majority,
that everything they say is unrealistic. There happen to
be some very real dangers attached to drinking and anybody
who doesn’t think so is affected by certain biases
of an antidry philosophy.
very little factual information about alcohol is given to
the younger people. They would really like to know something
about alcohol, but what they want to know, and what the
“drys” are anxious to tell them are two different
things. The younger people would like to know the difference
between drinks. They would like to know: “What does
this drinking do as far as athletics are concerned? Is it
necessary to take drinks on a date? And how many drinks
should you take, and what, and where and under what situations?
How is it going to hurt me?”
to Tell Youth
What do they want to know?
I think what a good many of them have in the back of their
minds--the girls won’t ask the question but they want
to know--is what happens from a certain number of drinks,
does one get sexually excited? Is drinking on dates necessary,
is it wrong, and so on? But what they hear
about from the classic temperance speakers are the general
things, crime, divorce, bad housing, the fall of Pearl Harbor,
murder--they see pictures of deaths on the highway where
the kids are drunk.
the people who give these talks and make these pictures
often know so little about drinking and alcohol that they
make ridiculous mistakes--the youngsters know better than
the “drys” do; sometimes they show a person
taking three drinks and then acting like a maniac. There
must be, in a group of one hundred 16 and 17-year-olds,
30 persons who have had three drinks several times. They
know that nothing like that took place at all. And another
30 who have had only one drink or so look at the three-drink
fellows and begin to think “Well, I guess I can take
three drinks too.” Kids don’t like the morally
superior person looking down at them saying, “Don’t,
What should you tell them?
I think they want to know something. Probably most interesting
to them would be knowledge of the psychological effects
of drinking. I think they should be given the physiological
facts of alcohol. I think they should be told something
about the customs of drinking. There are some groups in
which the drinking of alcohol starts at about the time of
weaning. There are some groups in which drinking is a normal,
expected and in some ways a socially significant aspect
of life--you’ve got to be able to know the difference
between certain types of wines, how many cocktails to serve,
this group the person who says that he doesn’t drink--especially
if he says he doesn’t drink and indicates that you
shouldn’t either—is going to be such a deviant
in that group that he is going to build social problems
for himself, just as the drinker in the abstaining group
is going to do.
try to repress this person is to suggest certain social
disabilities of all sorts. However, there are obviously
points at which certain types of ingestion of alcohol go
beyond any customs for an individual and are frightfully
dangerous for that individual, to say nothing of this future,
family, job, etc., which is only theoretical.
drinking may be bad for some. Other things being equal,
I see no advantages to drinking by teenagers that couldn’t
be gained in other ways. However, what I personally think
and what millions of teen-agers do may be two different
things. Telling them nothing, telling them nonsense, or
talking down to them with nothing but negative commands—these
are all ineffective and rather escapist types of education,
especially since the students want education on the matter.
What do the students say about the “AA” speakers?
The student loves the “AA” presentation because
that is the “Horatio Alger” story amid blood
and amid tears, and so forth, and you come out of the slime
as Sir Galahad and rise to the top--and that goes big in
this country. And the “AA’s” laugh at
the negative authorities who are pressing on the kids. They
are real, experienced “he-man” drinkers, and
at the same time they seem to have achieved a morality.
And this the teenagers like, too. And when they have this
message with its emotional, sincere feeling--and often the
“AA” speakers are a little exhibitionistic anyway
and so they are often magnificent speakers--the students
love it. For that matter so do a lot of adults.
I don’t think that fundamentally knowledge about alcoholism
is a major need in an educational program. Of course, it
is important to learn that, if one has an alcoholism problem
there is hope--but I think the students should learn something
about alcohol and about drinking, just as they should learn
something about oxygen and carbon tetrachloride or the form
of government in Idaho, or something else.
addition, drinking is something that hits across more aspects
of life than carbon tetrachloride or government in Idaho--it
affects marriage, birth and death--it can be involved in
almost all social phenomena except the activities demanding
immediate, high-tension discrimination and responsible action.
Drinking, for example, is not related to tight-wire walking
or piloting an airplane, at least not on American lines.
the students are going to have to make a decision about
drinking--as to their own behavior, also with their wife,
their neighborhood, their kids, their religion, their government,
and so on. And in 90 per cent of our educational institutions
they learn nothing except what 8 out of 10 of them recognize
Habits of Students
this connection, I’d like to mention our recently
completed study of the drinking habits and attitudes of
about 16,000 college students the country over--private,
parochial, and State colleges, co-ed and man or woman only
colleges, big and little, and so on. Here we report on who
drinks, what they drink, when, where, with whom, when they
started, what they think about drinking and about abstainers
and about sex activity and drinking, what problems they
may have experienced, what their parents, their church,
the college authorities, their friends and others say and
do, and so on. It is the first objective study of drinking
habits ever made in this country, and it may well help to
build a better foundation for teachers and teaching materials.
We certainly hope so.
Could you tell us something about it?
Most assuredly, but it is covered comprehensively in a book,
entitled “Drinking in College,” by Professor
Robert Strauss and myself, just out.
What about the alcohol problem particularly in industry
There is the same feeling there as in other parts of the
society. They want to cover it up and hide it and so on.
It has a stigma. But there is getting to be a gradual perception
by an increasing number of companies that “Yes, there
is a problem and why don’t we do something about it?”
Of course, it doesn’t show in their records, it’s
always hidden, but the problem is there. And there are now
techniques of dealing with it.
Is it a growing problem?
I don’t think we can say that it is a growing problem,
but we can say this--that the age range is 30 to 50. Industry
and business and agriculture employ 60 million, of whom
a large proportion must be in that age group, and so they
have a great number of them. But most of them are back in
the early stages. They don’t have any drunks. Oh,
they have them now and then, but they are fired. They don’t
have the psychotics, the “Skid Row” bums, and
so forth. They may have had them when they were 23, but
they got rid of them. What they do have is the slowly developing,
carefully hidden condition, usually hitting a man as he
gets to be about
40 and is just reaching his peak productivity in the company,
a peak he never achieves.
How does absenteeism stand with these people?
We have a few clinics started in some industries, and their
records show that the alcoholic’s absenteeism rate
runs a little better than twice that of the average of the
Would you call that high or low?
Twice as high as the rest of the whole plant. For instance,
if the absenteeism runs 4 per cent for the whole plant,
it will run 8 or 9 per cent among the alcoholics in that
plant, among the early problem drinkers or incipient alcoholics
in that plant.
for business and industry, therapy is easier with this group
than with any other. Success expectancy is fantastically
high, partly explained because the motivation for recovery
among these men is tremendous. In one plant, the absenteeism
rate after a year and a half with the first 100 alcoholics
who went through--and they had success with 100 out of 120--was
cut to about 2.3. The average absenteeism rate of the plant
was 4.8, and for three years before they came in for help
it was running for these 100 alcoholics at about 10.
How do they help them? What does an industrial establishment
The first thing to do, briefly, is to get top management
to recognize that there is a problem and not to be scared
of it and to be looking into what can be done about the
problem. The second thing is to decide to give responsibility
to a department, probably industrial health or personnel,
to do something. Next, the thing to do is to appoint a man
to get special training in addition to his already acquired
training. We have four or five-day training sessions just
for this purpose.
What are they trained to do?
These people go back and do two things. First, they offer
counseling, often making referrals to already existing resources
in or outside the plant. They must go out in the community
and find out what resources there are in the plant--the
plant probably already has resources to take care of this,
but it has never been done.
they start helping a few people. The first ones they get
are often going to come from the disciplinary board and
are going to be the worst cases and have to be sold the
idea. When they find that this has helped six or seven fellows--and
you know two of them and you know three of them and so on--the
word goes out and management says, “Now, look. Our
policy is not coddling--this is not a home for drunks--but
when we think alcoholism is involved, we are going to treat
it as any other problem. We are going to try to help this
person and give him every possible chance. If he won’t
live up to it, then--out. We will change our retirement,
our disability, our pension policy--we are going to keep
an open, flexible mind on this.”
man in charge will try to change negative attitudes in the
medical and other departments. Something can be done, and
this is shown most clearly through the successful cases.
Then the man will try to get to some of the foremen or the
floor supervisors, because they are the men who know just
who the problem drinkers are. If they will co-operate, cases
will be gotten sooner, the therapy success rate will rise,
a lot of cases will never get to the disciplinary committee,
and so on.
the supervisors and foremen have to be shown that something
can be done, that this will be more effective than hiding
the cases, that it is not a snooping, “dry”
movement, that it is not a
sentimental, coddling program, that it will not result in
firing the man nor in interfering with production, and so
problem drinker is almost never at the plant when drunk’
by the way. He’s there in a rather
late hang-over, beautifully masked, doing nothing or sometimes
making mistakes, a horrible public-relations liability.
His friends cover up, and nobody says anything.
So we suggest certain ways of talking with the supervisors,
maybe giving them one or two pages of statements, showing
them a 10 or 12-minute movie, giving them some idea of the
problem and the program. Maybe half of them will catch on
and will start sending a couple of people in--anonymously,
quietly, and not even connected with the records.
Where does a company find out all the things necessary to
institute a program like this?
We at the Yale Center run special 3 and 5-day courses just
for industrial people.
Can this be found anywhere else in the United States?
No, but certain plants are doing their own work.
Then you are the center of information on this whole subject.
Can anyone get literature from you?
Should we do away with alcohol? Can we do away with it?
“If we should” is a question that has to be
answered from the point of view of a particular ethical
system. One ethical system will say, “Yes,”
another will say, “No.”
Do you have a personal opinion on that?
I don’t have any great opinion on that because I think
your second question makes the first one--for our society
in this century, particularly--academic.
You mean it is impossible to get rid of it?
I would say at this time we don’t know of any technique
by which you can get rid of it.
Looking at the thing in its broadest possible angle, we’ve
developed in America two points of view about the liquor
problem. One is frequently expressed under the word “prohibition,”
and the other one under the heading “moderation.”
In your studies, do you feel that we would solve this liquor
problem by complete prohibition, the extinction of the manufacture
Let’s put it this way: If there were no alcohol, there
would be no problems related to alcohol--period. There is
no question about that. If you could eliminate alcohol,
there couldn’t be such a thing as an alcohol problem.
Do you mean that you would really remove all the problems
related to alcohol, or do you mean the problems that people
think they solve by alcohol?
I mean that you would eliminate any function that alcohol
plays in crime, poverty, disease, death, disgrace, alcoholism,
and so forth--by definition.
But you wouldn’t remove those problems, would you?
Oh, no. In some of them I would say that the use of alcohol
plays a larger role than in others. For instance, I would
say that you would eliminate the biggest crime of all--drunkenness.
That is the single biggest crime in the United States except
for traffic violations.
think that among the others you would unquestionably eliminate
a certain amount of disorderly conduct, and you would eliminate
a considerable amount of petty assault. For example, you
and I get mad at each other, and we were probably going
to get mad at one another, alcohol or not alcohol, but with
a few drinks in us, or in either one of us, it is more likely
that we are going to get into physical violence, because
the inhibition or control of aggression is reduced. Instead
of just swearing at you, I throw something at you--perhaps
I won’t throw with any great accuracy, perhaps you
won’t duck with usual speed or accuracy. But the emotion
and behavior that went into a fight, let us say, could have
been dissolved through more socially acceptable avenues
than those opened up by alcohol.
What would you say the effect of successful elimination
of alcohol would be on traffic accidents?
Granted than no substitute came in--like bootleg liquor--I
would say that all sorts of accidents would be cut down.
For instance, you would eliminate the effect of fatigue
as it lowers acuity and discrimination. You would reduce
the expression of aggression in driving. Alcohol, so to
speak, allows extended fatigue and aggression in driving
and these are major factors in auto accidents.
Are there statistics that show that traffic accidents are
primarily due to alcohol?
I would not say “primarily.”
Would you say that they are incidentally due to alcohol?
I would like it larger than that. Figures have been put
out fairly regularly by the National Safety Council from
which it would be fair to state that alcohol is involved
in 20 per cent of all fatal automobile accidents. I would
say that is a gross underestimate.
What can be done about this, or is anything being done?
This is one of the problems related to alcohol about which
a great deal could be done. A start in this direction can
be seen, although -this particular cloud is still little
bigger than a man’s hand.
have had two major problems blocking greater control and
growing prevention of this problem: lack of quick, easily
administered, reliable tests to establish how much alcohol
is in a person’s system at the time of the accident
and the general tendency to lump all alcohol problems together
as just one, simple problem. The first barrier had to be
overcome so that police, courts, legislators and lawyers
would have a means to allow concrete distinction between
the driver under the influence and the person who was not.
Walking a straight line, the odor of the breath, and disorganized
behavior after an accident are not good evidence of “being
under the influence.” Until a useful means was developed,
the courts and police were effectively blocked from efficient
now have means for gaining factual, undeniable evidence
of the amount of alcohol in the brain. The best of these
techniques—I might be a little biased on this--was
developed by Dr. Greenberg at our laboratory, and is being
increasingly used by courts and police. Its use will not
only end the “two beers, Judge” alibi, but will
also protect the innocent, such as the man with concussion
or the diabetic in insulin shock who is arrested for drunk
driving or anything else and is tossed in the police lockup--sometimes
to die--because he acts and looks like a drunk.
this problem from the other alcohol problem is, I believe,
on the way. It is not the “Skid Row” bum or
the late-stage alcoholic who is involved in these automobile
for Drunken Drivers
No one has ever reported just what the social and personality
characteristics of this category consist of. The public
is probably 99 per cent united against driving under the
influence. However, they are far from 99 per cent against
drinking. Once we can separate these two, so that the public
can attack the specific problem without getting involved
in the old “wet-dry” fight, then the way will
be much clearer to overcome this menace.
legislative changes are needed in, perhaps, 30 States. The
real need today is to give the facts to the driving public
so that they can realize in ordinary language just what
“under the influence” means and how one gets
to that point. The insurance companies could play a big
part in developing such information, as could driving schools,
automobile associations and, after the program was set up,
the police and courts. Without such education, mere use
of the new gadgets is not likely to be too effective.
What’s blocking use of the new devices?
Well, time is needed for the police and courts to try out
the new techniques and learn application problems. So far,
their experience has all been highly favorable. Then, lawyers
and doctors interested in these cases must learn that none
of their rights or privileges is being hurt. General education,
plus experience, is needed. I think that an enormous reduction
of this really unnecessary death, destruction and misery
could be achieved in as short a period as five years if
people got behind the police and courts, supported studies
and helped in dissemination of the facts. Further, I think
the motivation for this sort of progress is good. At that
moment it needs leadership. This one of the alcohol-related
problems is in large measure susceptible to successful attack
here and now.
What would you say is the greatest stimulus to the drinking
of alcohol? Is advertising a major factor?
We can show that advertising has had little or no effect
on large segments of the population and never has had.
For purposes of stimulation in extreme cases?
For any purposes. In extreme cases it has no effect whatsoever.
For those people who are susceptible to be affected, yes,
it may have some effect. And then if those people become
extreme uncontrolled drinkers, I cannot tell you what proportion
that ad played, for, once they have become extreme drinkers,
I don’t care if you have a sign on every window in
the city or if there isn’t a sign within a thousand
miles, they are going to go on being extreme drinkers--period.
Advertising isn’t going to change alcoholics one way
might affect them in that, if you keep saying a certain
brand name, the next time they go in and ask for a shot
they may ask for that brand. I doubt it will have much effect,
because after they have had a considerable amount of alcohol,
75 per cent of them will be short of cash.
Then you would say that the stimulus for drinking wold have
to be looked for somewhere else than the advertising of
How would you list the order of stimuli? For instance, are
social gatherings and social customs the primary thing today?
Well, I will start off with the word “custom’‘--but
then remember that I am one of these academic specialists,
so I will want to hedge on what I define as “custom.”
There are certain groups in which there has been a custom
of drinking for generations. Now, when the father and the
mother and the close friends of the father and mother--they
may be in the neighborhood or not--when they ordinarily
drink and their drinking is fitted into the daily routine
of their life (not the “whoopie-whoopie--aren’t-we-being-daring”
type of drinking), then their kids, other things being equal,
are going to use alcoholic beverages.
you go to the other extreme, where father and mother not
only do not drink but also have expressed strong, negative
feelings about drinking and, to make it stronger, these
are backed up by the church and the school and the social
clubs, then that person is not going to drink until, and
unless, he gets away from that social milieu. If he does
drink, he will be rebelling from or simply moving away from
his group. His drinking, by the way, when he starts is going
to be more experimental, less well modeled, characterized
by more mistakes, just because he has no background for
it. He is not fitted for a drinking society any more than
you or I are fitted for an Eskimo society.
Is he more intemperate in his drinking then?
Let’s take two extreme groups to make it simple: For
example, the Mormon group, which
is a very well-integrated group with a religious system
penetrating right through family, government, economics,
neighborhood, everything; and then orthodox Jewry, which
is also very strong with an all-penetrating religion so
that we don’t know quite whether to call it a religion
as such--it is a total way of life.
the Jewish group, more than 90 per cent will use alcoholic
beverages and will use them certainly more than 50 times
a year. They will probably use wines, distilled spirits,
beer. In the other group, the Mormon group, a very large
percentage (compared with all other such groups in the country)
will not touch the stuff.
would say that, of the drinkers in the Mormon group, which
will be a small number, you will find a high percentage
of problem drinkers and later on alcoholics. Amongst the
Jewish group, with almost all being drinkers, you will find
a very, very low percentage of problem drinkers and alcoholics.
you shouldn’t jump from this and say, “Well,
let’s start everybody drinking at the age of three!”
That doesn’t follow at all.
Do you think the segment of society in which the inhibition
is great due to religious and other environmental factors
produces a greater number of rebels, or is the number incidental
who go out and deviate late from their teachings?
Rather than the number of inhibitions, I would say that
whether these sanctions worked, were acceptable, were easily
adopted by the individual, was the more pertinent question.
For example, it is an inhibition that none of us here may
go around without clothes, but I don’t think it bothers
one person here. Maybe it would bother one out of a hundred.
Where inhibitions are not putting the person in a position
of conflict, where his life is satisfying enough so that
he wouldn’t call them inhibitions, then inhibitions
are not creating rebels.
most of us, inhibitions are strong, unconscious controls
against actions we think we might like to perform. Actually,
the term refers to all the controls we have adopted--whether
we approve or not, or even recognize them or not. But where
the inhibitions, the taboos, the restraints don’t
upset more than 5 or 6 per cent of the group, I don’t
believe it would follow that mere numbers of inhibitions
would create rebellion.
However, if you have a series of different groups in a society
(and this means there would be differences in the patterns
of learned controls in each) and where there is mobility
for individuals, as in the case of war when all the young
men may go out from home and meet others, then you may have
people suddenly finding out, “By golly, I am inhibited.”
They may become, though not necessarily, very bothered
lot of young men, 17 or 18 years old, may think: “Here
I am in a uniform, but I am not really a man. All these
others in the camp think I’m a damned sissy and maybe
And then he may take a drink?
He may feel that he has to show off, one way or another,
but he doesn’t know how. He may, like any young person
taking on a new pattern (whether it’s dancing or bowling
or getting a job), overshoot the mark or do things differently
from everyone else, and then may have superguilt.
the fellow who has come up in a society where drinking is
quite ordinary. When he starts drinking, he might overdo
and even get drunk. He will be punished one way or another.
However, this experience does not have a terrific impact
on him. He doesn’t feel that he has been singled out
by God to be cursed, that he is essentially evil. Another
fellow from the Mormon society, where drinking is held a
sin, if he experiments and gets drunk, he may well feel
super-guilty, he may feel that Satan is responsible. So
that it is not only that he drank too much, it is his reaction,
his interpretation of the event. It may mean he feels: “Now
I am through with my family, my religion, I can never go
back.” His response to the act is just as important
as the act itself.
I can understand why the "drys" don’t like
your work, but why is it that the “wets” don’t
We have been discussing here at length alcoholism, drunkenness.
When stories. On alcoholism, drunken driving, excess drinking
and the like appear in the papers, everybody in the
Afraid it is going to lead to prohibition” again?
Yes. It is implied that discussion of such subjects is nasty--there
probably isn’t any such problem; it has been vastly
exaggerated, in fact, alcohol binds the family together,
etc., etc. Then one of the companies about 6 or 7 years
ago, to the shock and horror of the rest of the industry,
came out and said some people should not drink. Wow! Well,
it turned out to be all right: they’re still in business.
Doing very well, I understand.
Have you any facts as to whether conditions in States where
they have full State control are any better than in the
States where they license retail distribution?
You get what might be called a “lip reading”
or “false correlation” on this. The difference
between the monopoly and the licensed States is not particularly
great. When you take the States in which local option is
very widespread--like North Carolina where of 100 counties
perhaps are dry--or take the two dry States, from our estimates
there is a lower degree of alcoholism and there are fewer
drinkers. However, we would call this a false correlation.
The reason you have prohibition is obviously because you
have social groups and categories who are “agin”
They wouldn’t be drinking even if it were there?
Right. And their numbers are significant enough so that
they get political action. But if you go into Kansas or
Mississippi or Oklahoma, you will find the “AA”
What about the tax situation? Do you find that the bootleg
liquor creates worse conditions?
It may result in there being worse liquor, but alcohol is
alcohol. It is a chemical, and goodness and badness doesn’t
enter into it. As for bootleg liquor, there is no question
that it is produced in the most unsanitary circumstances,
that it gets very little attention, you get it loaded with
who-knows-what. It has in some places a most mysterious
sacred character, however--"I know Old Joe up in the
hill over there and he makes the original white mule,”
and things like that’ and everybody around there starts
buying it and feeling, “Wow, that’s wonderful
stuff,” and if the market goes up, they start producing
it faster and they are under pressure of being caught, so
there has to be a rapid turnover. There are no ‘controls
by health authorities or otherwise.
the situation gets really tough, you may be getting half
water, one quarter ethyl alcohol and who-knows-what else.
It is an irresponsible group operating without controls,
without the law, in business for the sole purpose of making
dough and making it fast, with no necessity of figuring
out “Will my customers like me five years from now?”
big liquor people are under a tremendous pressure from that
alone. The bonded people have to start, say, in 1950 to
decide what they are going to make. By 1951 or ‘52
it is whisky, but then goes into a warehouse for five years
and then they can sell it. Imagine the pressure they are
under to maintain good relations with their customers. Their
capital is tied up in the customer’s response five
years in the future.
Do you think the bootleg situation is getting worse?
I really don’t know.
The argument in Congress is, of course, that the high taxes
will drive the country into bootlegging--
And, theoretically, I believe that it is a good argument.
Whether in practice it is true or not, I can’t say.
To my mind this is one of those little conflicts way off
in left field, just as in my mind the advertising issue
is way off in left field. They happen to be the two things
that the “wets” and “drys” are fighting
about--one about one, the other about the other.
would like to see a check on the bootlegging matter from
an unbiased source, through the revenue reports. But in
my memory, and this is most casual--for the revenue records
have figures on how much illegal stuff was seized, the size
of the place, the amount of the alcohol, the potential production
per day--it seems to me that for some places, like New England,
there is no striking change.
this is not a conclusive argument, because the size of the
agency and its finances for going out and making the arrests
has not gone up, so maybe they’re just operating to
full capacity and their records have reached a top. But
I am very suspicious of the liquor industry’s statistics,
just as I am very suspicious of the statistics of the “drys.”
What about clinics?
In 1944 we decided to start an outpatient clinic just for
alcoholics. We had had laboratory and library studies, but
no clinical studies of our own. With the co-operation of
the Connecticut Prison Association, we were able to set
up two such clinics, one in Hartford and one in New Haven.
These were to be research clinics, but in about five weeks
it was obvious that a different purpose was being served.
They weren’t research clinics--they were service clinics.
They were mobbed, mobbed by what we would -call “late-stage
Yes, willing to try anything new to escape the pain of the
alcoholic life. This began to be pretty successful from
the point of view of service. But from the point of view
of research--well, I can’t say they accomplished “nothing,”
but it was a very minimum. However, by the end of that year
people in the Connecticut Legislature approached us with
a bill, which we strongly opposed, setting up an alcoholism
program, which was to be operated in the form of a specialized
hospital for long-term care of committed alcoholics.
legislation was changed to allow a program emphasizing voluntary
outpatient clinics, and Connecticut’ in 1945, established
the first commission on alcoholism. Today it has six outpatient
clinics, an inpatient facility, an education program with
schools, and so on. Also, since then about 40 of the States
developed some type of alcoholism program--there was nothing
prior to this.
1946, some of the people who had been at the School, and
others interested in alcoholism, said to us: “Look.
You people are trying awfully hard, but you can’t
effectively get your information out to a wide public. The
scientific journal is just dandy, but who reads scientific
journals? And how many will read these lay pamphlets or
the popular book of the American Association for the Advancement
of Science, ‘Alcohol Explored’? We need community
organizations to educate the public about alcoholism Will
We created the National Committee for Education on Alcoholism.
Soon we found ourselves to be a popular health movement,
like mental hygiene or cancer associations. Once this got
started, we pulled out of it, since this sort of work is
not an appropriate function of a university research department.
is now called the National Committee on Alcoholism and is
an independent organization. The clinic movement was more
and more taken over by an increasing number of State commissions,
and they soon started a National States’ Conference
How many years have you been studying in this problem?
I got interested in it because I was a potential criminologist;
I’ve been with the Laboratory since 1942.
You’ve been exposed to all phases of this in 10 years
or so--has it made you a teetotaler?
We at the Yale Center are kind of rigid
answers to this question--maybe a little unnecessarily so--I
don’t know. However, we feel that either the facts,
researches and conclusions are right or are not--and are
effective or not on there own merits. And the fact of our
own drinking or nondrinking we feel, doesn’t make
any difference. Certainly no one on the staff is an extreme
teetotaler or an extreme drinker.
How extensive is the “AA” movement in America?
There is no organization to this group.
are no officers. There is no treasury. There are no minutes.
For each group there is a chairman, theoretically revolving
every month or two. But they find that as soon as you set
up a typically American hierarchy with “Mr. Big”
at the top, then some of the boys, as soon as they get up
there, fall over into the bottom again. This matter of being
the big man, big ideas, big expansion, responsibilities,
building this clique up and that clique down--that has been
found a nice way to get back to alcoholism, not a way of
recovery from it.
Do you have statistics on how extensive a group it is?
Their figure can be determined from their paid-up membership--I
think theoretically each local group is supposed to give
a dollar per person per year to the central agency for the
publication of the book, information, intergroup service
and the like. They pass the hat at meetings to pay for the
rent of the hall and for the coffee and cokes and stuff.
Some feel they must be drinking something, and sweets seem
to be necessary for some.
paid-up membership of groups amounts to about 130,000. Their
membership--I don’t know what a member is--is a man
a member the moment he walks in? Does he have to be in one
month, two months, three months? There is no definition.
I would say there may be in the neighborhood of 175,000---
Out of about 4 million alcoholics in the U.S.?
How many groups are there?
I would say that in this country there are, perhaps, 3,000.
Then is this same movement true of other countries?
They will show you groups in 40 or more other countries.
As a wild guess, I would say that in 20 of those 40 other
countries they are Americans who happen to be over there.
This business of clubs and voluntary associations--Elks,
Chamber of Commerce, or the like--is an American phenomenon.
It clicks pretty well in the British Isles and in Scandinavia,
Australia and New Zealand. But you get over into France--well,
I think there is one French member. Of course, there are
Americans in Paris who are permanent fixtures. But the French
and Italians simply don’t have such organizations.
There is no feel for it. It is a typically American thing.
Do the other countries have the alcoholism problem at all?
Role of ‘AA’
If the psychiatrist has been stymied treating the alcoholic,
what has “Alcoholics Anonymous” been able to
Now, I think the psychiatrist can play a significant role.
I think that “Alcoholics Anonymous” can--in
fact, anybody that knows them at all knows that they do--play
a most significant role.
Then why is it that “AA” can succeed and the
Take a certain alcoholic who is pretty well along in his
alcoholism. He shows certain acute physiological problems.
They will usually pass away in four or five days. He also
has psychological problems. By the time he’s gotten
into this whirlwind he is frightened, in a world of pain,
sometimes beginning to act in a very immature fashion, usually
very egocentric, interested only in himself as though a
wall had grown up to separate him from others. Let’s
say that there is a wall within all of us protecting our
ego, but there are doors and windows through which you go
out to people and people come in to you.
the alcoholic it seems those doors and windows are getting
smaller and smaller--he isn’t interested in other
people. And if an alcoholic begins to show interest in you
or your job or what you are doing, all I can say is “Look
out!” He’s going to touch you pretty shortly--for
a drink, for money, or something. He is not interested in
you. He is not interested in ideas and things or people.
He tends more and more--many of them--to become an isolated
drinker, often a lone drinker. He has terrific ambivalences
and many of them show as incompatible drive, like, “I
want to be Napoleon,” or “I want to be Casanova,”
or “I want absolute dominance,” and at the very
same moment, “I want to be like a little baby in its
mother’s arms, loved because I should be loved.”
are absolutely incompatible needs, and yet that incompatibility
can be resolved temporarily in alcohol because discrimination,
judgement, self-criticism fall down and the man gets to
live more and more in a world of his own, unhindered and
unfrightened by ordinary -people, ideas and situations.
addition to physiological and psychological troubles, there
are social problems also. The man gives up ways of doing
things and does less and less. He is less and less interested
in attitudes, ideas, beliefs, intellectual questions and
problems around the community and he becomes increasingly
afraid of close, emotionally meaningful, interpersonal groups,
such as a friendship group, a marital group, parental group,
and that sort of thing. And it is from such groups, of course,
that we get our major stimuli to do things, our major punishments
for doing wrong. From and inside such groups we get our
very reasons for living. With the decrease in activities,
in ideas and in primary group membership, the man becomes
desocialized, so to speak.
by the way, those social and psychological characteristics
are just the reverse sides of the same coin. The man who
feels he is going to be the greatest writer, who is going
to make the biggest sale, who is going to swear off liquor
for life, or who is excessively cynical or aggressive, is
just the man who can’t long remain a member of a primary
group. Membership in such groups punishes wild activity
or non-activity, punishes extreme idealism or cynicism.
you have these physical, social and psychological problems,
and the drinking problem itself that have to be met.
What does the psychiatrist do and what does “Alcoholics
The psychiatrist goes back to the psychological roots. He
may or may not give the man some immediate physiological
help which means rest, food, some sort of sedation so that
he can get over the hang-over. And it doesn’t work’
because he is only trying to hit one wheel out of a five-wheel
vehicle or a four-wheel vehicle--except in extraordinary
Anonymous” does a series of things. One of the psychological,
social, personality problems of the alcoholic in the later
stages is that he gives up hope--hope in himself, hope in
people, hope in the world, hope in God. It seems to him
it is impossible for him to get out of it unaided. He has
tried everything. He has tried a hospital, he has tried
three doctors, he has tried a sanatorium. He has been to
ministers, priests, judges, and they have all given such
“damned fool” advice as “Look, old boy,
why don’t you be a man; look what you’re doing
to your wife. Why don’t you control your drinking?”
man knows what he had done! He has cursed himself more vitriolically
than anyone else could. He had been cursing himself for
years. But the “AA”’ from the very first
contact, expresses to this man the feeling that he, too,
was there. Charlie cannot only match him story for story
but he has been in 10 jails that this new fellow
never even heard of. He has had everything this guy has
had and more, and here he is--his coat matches his pants,
he has shoes on, and all that. But, most significantly,
he seems to be happy. He seems to be amused about the whole
thing. There are some who aren’t, of course.
am building up an ideal picture. There may be a few “AA’s”
who are just like the old sawdust-trail boys. But the new
candidate for “AA” begins to see that he can
do it. Here’s a man who did it. “It can be done!”
In other words, the approach varies dramatically from the
Yes, the “AA” talks to the man. This approach
is often the opposite to the nondirective therapy of the
psychiatrist—the psychiatrist must keep his mouth
shut and the patient must let out. The “AA”
violates that principle. He just sits down and says, “Well,
let me tell you about me,” and may not let the other
get a word in edgewise.
it is convincing to some that there is hope--and this he
never got from a psychiatrist because the psychiatrist doesn’t
know about alcoholism as this “AA” knows it.
The recovered alcoholic may not know about Oedipus complexes
being resolved, but he does know about drunks and butterflies
tromping around in your stomach and all that. He has had
bigger butterflies and has conquered them and is happy about
“AA” doesn’t tell the potential new member
that he must go through a terrific regime, he must control
himself, he must fight the good fight, and so forth. No,
this “AA” has more fun out of life than the
candidate has ever had and even has dough in his pocket,
his wife likes him again, and so do his kids. The thought
that “Maybe I could do the same” can strike
the potential new member very realistically. Now that is
one aspect of it.
is that the psychiatrist is inevitably talking downhill.
He is on one side of the desk and the alcoholic is on the
other side. He is well dressed, professional, of tremendously
high status, and authoritative, and the alcoholic is very
often scared to death of authority and so forth.
Pals in ‘AA’
The “AA” is more like an equal?
Yes. He could be a recovered banker or a ditchdigger, though
ordinarily a banker will work with a banker and a ditchdigger
with a ditchdigger. There is hope; there is a certain amount
of happiness; there is this interplay. That personality
wall has been broken down a little. Remember, this alcoholic
had to let the “AA” talk to him. The “AA”
is not going down the street to find a drunk and help him.
He may try that a few times, but after he has been rejected
regularly he will quit that process and will go only when
asked and when he sees that there is really some hope of
doing something. He can help only when the man has, so to
speak; tentatively, partially temporarily surrendered a
little and said, “All right, I’m licked. Can
you help me?” That’s a horrible thing to have
to say for a frightened, egocentric alcoholic, and he may
only half say it.
“AA” gives him something to help him immediately,
right now--none of this claptrap about
“Can you come around next Tuesday at 4 p.m.?”
That is perfectly ridiculous.
time we get people trying to come into our clinic from New
Mexico, or somewhere far away--they all have long-distance
telephonitis--if we don’t want them, or can’t
take them or see that they are half potted anyway, we tell
them, “Now, you come around next Thursday at 3 p.m.”
They won’t show up.
alcoholic’s problem is for him tremendously immediate,
and his feeling of “I would accept help if I could
get it” is right here, now, 4 p.m. Tuesday afternoon.
By 6 p.m.--“the hell
the psychiatrist has to give them a future appointment.
He can’t just say, “I am here any time for you
boys.” Both his professional and personal life would
be smashed. But the “AA” is ordinarily there
at the time and he offers some immediate, practical support.
He knows some techniques of helping out a hang-over--at
least he thinks they work.
physiologist may look at such techniques and say, “This
does not change the oxidation rate of alcohol by 10 seconds.”
But this “AA” thinks that it does, and helps
this guy and thus gives him the kind of magic that makes
him feel better. He then gives him something to do--and
this is tremendously important, because here’s a man
who has been holding himself away from everybody and everything--“Come
on over to the meeting tonight!”
alcoholic is terrified, but he goes to the meeting and he
sees 15, 25, 50 fellows--and they all seem happy! They look
at him and say, “Come on in, boy!”
It’s a different treatment?
Why, he hasn’t had that sort of treatment--maybe ever.
Anyway, for a long time it has been: “Look at that
drunk! Get him out of my office! Out! Out! Out!” Nothing
but arrogance, holier-than-thou business--even by those
who have been trying to help and be sympathetic.
“AA” people seem happy. He may hear something
about the “God stuff,” but a lot of the boys
will tell him: “Don’t you worry now about the
‘God stuff.’ Some of us are having hot flashes
and messages from mountain tops. But some of us just don’t
seem to get it, so don’t let it worry you.”
The only thing is this: “Do you think you could keep
from taking one til 6 o’clock tomorrow?”
He has heard about six-week deals, swearing off for life,
and all that sort of thing. “Well, I don’t know--”
“Now, wait a minute. Here are some ways.” And
so they force chocolate bars or coffee or some pet remedy
down the man and give him something to do during the day.
They ask: “Where are you going to sleep tonight?”
hasn’t any place to sleep at all--or, worse, he has
a place to sleep--home. He has to go home to the little
woman and this is going to make him drink.
maybe they will find some place for him, just for that 24
hours, and he will come back the next day. The haze has
been partially lifted, and these people were friendly. Now
he has friends and he has hope--a very glimmer of a hope,
perhaps also a: “These fellows may have something.
I’ll get it in about six weeks and then
I will be able to drink like a gentleman again. ‘
other boys will know he may feel this because they went
through the same deal, and hey accept it. All right. So
they help him in very simple, material ways. They know a
fellow who knows a fellow and so he may be able to get a
job, a bed, somebody who will hold his wife and kids off
of him for a while, whatever it may be. And there is something
for him to do at night.
this man has sworn off before. He has been on the wagon
once or twice before, and what did he do? He couldn’t
go around with his usual friends. Should he go to the church
social a couple of nights a week? He wasn’t the kind
of fellow who would fit into that. He wasn’t interested
in what they talked about, what they did, or what they looked
like. Where else could he have gone--the club?
The Salvation Army?
For a few, perhaps, but this man probably regards Army shelters
as a place for drunken bums who are religiously a little
peculiar. He does not consider himself a bum, doesn’t
want organized charity, and is very scared of religious
appeals. Where can he go? He is all too apt to land in a
hotel room looking at the four walls and feeling greater
and greater need for a drink. And getting the drink, perhaps
after a great struggle, is a pretty sure thing for a drunk
because self-pity is going to get bigger and bigger and
bigger and the personality walls separating him from society
and its values will get higher and higher.
with “AA” he has a place where he can go, where
there is a bunch of fellows sitting around batting the breeze--some
of them are shooting craps, some are talking about the last
six hopefuls they picked up, and it may even look like a
barroom with cokes and coffee, with his kind of people standing
and sitting around. Some of this prayer stuff comes, but
that is a small price to pay--it only lasts three or four
minutes. He sees a lot of men who look just like him, and
he can go there seven nights a week. And if, when he’s
home, he suddenly gets that feeling, “I’ve got
to have a drink,” he has two or three phone numbers
and somebody will come over to him and use one of hundreds
of techniques. They talk, plead, curse them, slap them,
coddle them--some kind of help to get over that feeling
they have to have a drink.
soon this alcoholic begins to get some new ideas in addition
to immediate help, something to do and association with
this “AA” program suggests that there
are certain things that he has to do about himself mentally
and emotionally. They tell him to look at himself and to
take inventory. “What’s wrong with you, anyway?”
Power Greater than Self
12 steps of “AA,” by the way, only mention alcohol
or alcoholism twice. Once they say, “I admit that
alcohol has come to dominate my life,” or something
like that. “I admit” is the first. The last
step suggests, “I will go out and help other alcoholics.”
Other than that, the word “alcohol” does not
appear, and that last is pretty incidental as you can see.
“I’ve got to look at myself. I’ve got
to study myself. I’ve got to do it as honestly as
I can. I’ve got to try to find out what are the forces
that seem to be, impinging on me.”
many “AA’s” will say: “We think
that finally all these forces can be stated in terms of
a power greater than the self, which many of us call God.
Gall it what you will, but there is this power; it affects
you; and you have to learn how to manipulate it. The first
thing you have to do is to study yourself. Get some other
member to sit down with you, probably your sponsor, and
try to figure it out. How many people have you hurt, for
boy, here he can flatter himself with self-pity and guilt
and make himself out the biggest alcoholic of the bunch.
He can take a telephone book and check off almost every
name all the way through. “Do you think you can make
amends to these people without hurting anybody?” And
here is another chance for this self-pity, exhibitionism,
grandiosity. But it is a controlled, positively useful way
for the man to capitalize on certain personality weaknesses--of
course, not all alcoholics will have these particular problems.
steps concern getting into more effective contact with this
higher power, which some of them call God, and with furthering
self-understanding. Finally, the 12th step suggests that,
after having had a spiritual experience, or a basic change
in thinking and feeling, they will try to carry the new
principles into all aspects of their lives and, also, extend
them to help other alcoholics.
some of them, of course, jump from step 1 to 12 and they
are out there beating the drum to save other alcoholics
too soon, but that is understandable.
The first method of approach of the “AA’s”
then, is to be friendly on an equal footing?
Yes, to give realistic evidence that there is hope of recovery,
to help with, immediate problems, if possible, to present
the newcomer with a possible place to go, things to do,
and a program. Let’s note that “AA” doesn’t
preach, doesn’t ask for pledges, doesn’t blame,
doesn’t ask for conversion, doesn’t postpone,
doesn’t interview or take records, doesn’t offer
charity, or ask for dues. It does offer a sponsor, a man
to lean on during the first days or weeks. But pretty soon
“AA” requires a man to do more than receive
and lean--not that there are any written specifications.
new man has to make a self- analysis with another man. He
listens at meetings, is encouraged to speak with the others
at closed meetings. Then he is asked to speak at an open
meeting and to help another candidate. These things are
helping to break down the old self-protective walls. And
in the process he may get some very real awards. Now he
is not only leaning on his sponsor, but another fellow is
leaning on him. He is moving back slowly into emotionally
meaningful group membership and doing it without his alcohol
is also getting new ideas, not only from mixing with others
while sober, but from the self-analysis and from figuring
out how to help is new baby (candidate) and what to say
at the meeting. He may even read the “big” book
called “Alcoholics Anonymous.” He is gradually
refinding ways of doing things, ideas and primary group
membership. Also he is getting the benefits of sober living
in health, jobs, etc. He has change in his pocket, his wife
is beginning to think that she has a human being for a husband
again. Some people note, “Gee, George is sober; he
even seems to have fun doing things he never had fun doing
at Any Time
Can the alcoholic always find the "AA's"?
“AA” isn’t 24-hour a day therapy, but
it is always available. Then, when the man begins to get
the idea of living again and begins to like some other people
and is going out to help Joe and identifies himself with
Joe, then all of a sudden his whole psychological picture
has changed. As Dr. Harry M. Tiebout has pointed out, instead
o f just complying with “AA,” he accepts “AA.”
He may never have gotten down to the basic psychiatric problems;
however, I would say--just for an arbitrary figure--that
for 50 per cent of the alcoholics, deep psychotherapy is
probably contraindicated and might well trigger off more
troubles than there were during the alcoholism. He needs
to stop drinking. He needs support. He needs psychological
help. He often needs physiological help. He needs resocialization.
Of several alcoholics I have known, I asked one of them
what it was that got him -started after a long period of
years during which time he didn’t touch liquor, and
he told me that he had been employed as an assistant sales
manager and was making great progress. Then all of a sudden
one day he came in and they had changed his office, removed
his name from the door and put him at the end of the hall
and demoted him. He went right out and got drunk and attributed
it entirely to the disappointment. Is that a typical cause
for this return to alcoholism?
Tension, shock, or sudden changes for some of these people
is too much and they are less able to adjust or adapt themselves
to painful stimuli. However, I would want to ask a lot of
questions about the case you cite. Who stated that he had
“been making great progress”? What had he been
doing the previous weeks, which led to the demotion? Why
had he been acting that way? Was his demotion a great surprise
to others? Was it really a surprise to him? Was it a useful
excuse to get drunk? Did he get drunk because he was shocked,
or because this was his way of getting back at the boss?
Anything can serve as an excuse. It is worth noting that
a great many people have been demoted, and even though they
are regular drinkers they don’t go out and get drunk.
By itself a demotion cannot explain drunkenness.
Could any physiological deficiency cause it?
I don’t know just what that would be. There have been
some experiments with rats, by
the way, to discover whether physiological differences would
accompany differences in acquiring a taste for alcohol.
But a rat having no culture can’t be called neurotic.
They have no personality problems, although some of them
are more aggressive and others more pliable and all that.
Well, these tests were made to find out if any would show
a preference for alcohol over water. They put the rats on
a very limited, almost starvation diet to allow testability.
Some of the rats went for the alcohol and then seemed to
want to go on with it. Some persons drew the conclusion
from this experiment that some rats were physiologically
“set” to like alcohol. This was sufficiently
challenging to the physiologists in our laboratories, Greenberg
and Lester, to make them check such a conclusion.
happen to know that there are no vitamins in alcohol. Vitamins
don’t pass over the distillation process. But alcohol
is full of calories. These rats were on a starvation diet.
Greenberg and Lester said: “Let’s run that test
over again and give them a little bit more choice.”
So we gave them water, another liquid with calories in it,
but not alcohol, then just alcohol. Then the rats were put
through the same tests as in the earlier experiment.
original conclusion was shot to pieces. The rats were hungry!
They took the material loaded with calories. This time there
were two choices with calories. They took the non-alcoholic
type, perhaps because it didn’t have the sharp taste-effect
of alcohol. What was there in the alcohol itself in the
first experiment? It had calories and so the rats could
drink their meals. That is what many alcoholics are doing.
But why are they usually emaciated, then?
That is because of the life they lead, not alcohol, although
since alcohol is by itself a most unbalanced food for human
diet and since for some, during binges, nothing but alcohol
is ingested, they are undernourished. But this is not true
of all. In fact, I don’t think you’d know an
alcoholic when you saw one, unless (a) you’d known
him over a good period of time, or (b) he was on a binge.
We’ve all known some persons who seem to have a compulsion--if
they take one drink, they have to keep on, so that they
themselves have said, “Well, I’ve just go to
lay off the stuff altogether.” Now is that compulsion
There have been those who tried to figure out that this
uncontrolled drinking did have a physiological base. I would
say that they may some day discover such a base. But to
date they have not. Their evidence, we would say, is not
evidence. One or two may have gotten a lot of publicity--anything
which comes along in this field is publicized. When people
are very run down, as during a binge, they show a lot of
maladjustments, some physiological. Dr. X sees one thing
that seems to look awfully consistent, appears in all his
cases, for example, a certain type of glandular action.
Dr. X begins to compare the alcoholics who come into his
clinic with other people, and he finds that 99.4 per cent
have a tremendous glandular deficiency--or imbalance--for
example, an adrenalin deficiency. The alcoholics he sees
have an adrenalin deficiency, much more so than nonalcoholics.
I know some other things about adrenalin deficiencies--they
have a way of making people depressed, tired, unhappy and
weak. The major trouble with the obvious conclusion to this
finding is itself rather obvious: Does the alcoholic have
an adrenalin deficiency because he has been out on a binge,
or has he been out on a binge because of the adrenalin deficiency?
we go back and look at the population age 15 and separate
between the greater and lesser adrenal-structural people.
Then observe all those who drink for the next 40 years and
see if the alcoholics among them were all or chiefly from
the weak-adrenal group. Some people have alleged adrenal
disfunction to be the cause, and also alleged that correcting
this condition is the cure.
must admit we have to laugh a little at some of these reports,
because they state: “Yes, we fix the alcoholics up
and they go out of here sober and in good health, saying,
‘We’ll never have a drink again.“’
Well anybody who has ever known alcoholics is not peculiarly
impressed by that. Practically all alcoholics have sobered
up and sworn they would never drink again--done so many,
many times. We like to see them six months later. We like
to see them a year later. We like to see them four years
I don’t doubt that we may find a physiological difference
in function, in structure, in growth, which will be different
from many alcoholics compared to the nonalcoholic population.
But I would also make this forecast--that if we do, we will
also find that there will be a considerable proportion of
people who have this lower X factor who drink and who do
not become alcoholics, and that we will find a large number
of alcoholics who do not have this “X” factor.
In other words, it may be significant, but it will not be
a sufficient cause!
Is there some drug you can give people to stop their drinking?
One of our great problems has been to get increasing segments
of the public to discriminate a little more. They have a
tradition of 100 years in which a highly organized, very
sincere, emotionally powerful, beautifully effective organization
has told people again and again that alcohol, drinking,
drunkenness, the other problems related to drunkenness and
alcoholism are all the same thing. And we say: “This
is not so.”
ask: “Can you get a drug to stop drinking?”
Yes, you can--I don’t know whether the word “drug”
is quite correct. Take “disulfiram”--most popularly
known under the trade name of “Antabus”--I don’t
believe there is complete acceptance as to just what the
physiological process is, but, anyway, you take this pill
and any time within the next 24 hours if you take even a
small amount of alcohol you are going to approach death--the
eyes begin to bulge out, the face becomes horribly flushed,
the blood count goes down to zero, and so on, and you know
pretty soon you are going to stop kicking.
That’s a conditioned reflex, isn’t it?
No, it is a direct chemical effect which will occur the
first time. Whether there is in addition a conditioned response
following one or two experiences is a very moot point. But
let me assure you of this: If just by chance you forget
to take the pill and start drinking and then take a pill
or two, there will be a most unpleasant result. There is
a difference between drinking and alcoholism. “Antabus”
affects the drinking--not the alcoholism.
Oh, yes, but I thought the main idea was that these alcoholics
wanted to stop the drinking--
Yes, they may decide, “My life is being ruined
by drink’ so I will stop drinking.” That sort
of rational control is just what an impulsive drinker can’t
accomplish. That’s why he’s called “impulsive”
But does this mean that a person who gets started in alcoholism
There are certain so-called “prealcoholic symptoms.”
In that phase we know people can stop themselves. But once
this “control” factor is lost, they cannot stop
themselves without help.
They can use this drug, “Antabus,” can’t
Yes, but there is no question but that it can be a dangerous
thing. Let’s say you go to, the doctor and he gives
you a supply of 12 of the tablets,
and you go back six weeks later and get some more, and now
you have this little horde. There are two or three things
that may happen here. Knowing the alcoholic’s guilt,
remorse, and so forth, he forgets, on purpose -or not, to
take his “Antabus,” and he suddenly finds himself
in a bar and he has had two drinks, maybe three. He is very
upset, he’s got alcohol in him now. He rushes home
and says, “I’d better take three of the things.”
And he’s going to drop dead.
there is somebody else in the house, too--old Aunt Mathilda,
who has nice strong ideas about this. She might think: “What
a clever idea it would be if George were to stop drinking,
too. It is helping Harry.” So she is not by itself
a sufficient remedy for decides to give the pills secretly
to George. And a death can follow from that.
use of “disulfiram” is a little dangerous, but
under a doctor’s care it is not. However, it is not
by itself a sufficient remedy for alcoholism. It can help
toward a remedy by aiding the individual to stop drinking.
Without other changes in the individual, it can do little.
U.S. News & World Report, October 2, 1953)