of Alcoholics Anonymous believe that the reader
will be interested in the medical estimate of
the plan of recovery described in this book. Convincing
testimony must surely come from medical men who
have had experience with the sufferings of our
members and have witnessed our return to health.
A well known doctor, chief physician at a nationally
prominent hospital specializing in alcoholic and
drug addiction, gave Alcoholics Anonymous this
have specialized in the treatment of alcoholism
for many years.
four years ago I attended a patient who, though
he had been a competent business man of good
earning capacity, was an alcoholic of a type
I had come to regard as hopeless.
the course of his third treatment he acquired
certain ideas concerning a possible means
of recovery. As part of his rehabilitation
he commenced to present his conceptions to
other alcoholics, impressing upon them that
they must do likewise with still others. This
has become the basis of a rapidly growing
fellowship of these men and their families.
This man and over one hundred others appear
to have recovered.
personally know thirty of these cases who
were of the type with whom other methods had
facts appear to be of extreme medical importance;
because of the extraordinary possibilities
of rapid growth inherent in this group they
mark a new epoch in the annals of alcoholism.
These men may well have a remedy for thousands
of such situations.
may rely absolutely on anything they say about
- Very truly yours,
(Signed)- - - - - M.D.
physician who, at our request, gave us this letter,
has been kind enough to enlarge upon his views
in another statement which follows. In this statement
he confirms what anyone who has suffered alcoholic
torture must believe - that the body of the alcoholic
is quite as abnormal as his mind. It does not
satisfy us to be told that we cannot control our
drinking just because we were maladjusted to life,
that we were in full flight from reality, or were
outright mental defectives. These things were
true to some extent, in fact, to a considerable
extent with some of us. But we are sure that our
bodies were sickened as well. In our belief, any
picture of the alcoholic which leaves out this
physical factor is incomplete.
doctor's theory that we have a kind of allergy
to alcohol interests us. As laymen, our opinion
as to its soundness may, of course, mean little.
But as ex-alcoholics, we can say that his explanation
makes good sense. It explains many things for
which we cannot otherwise account.
we work out our solution on the spiritual plane,
we favor hospitalization for the alcoholic who
is very jittery or befogged. More often than not,
it is imperative that a man's brain be cleared
before he is approached, as he has then a better
chance of understanding and accepting what we
have to offer.
subject presented in this book seems to me to
be of paramount importance to those afflicted
with alcoholic addiction.
say this after many years' experience as Medical
Director of one of the oldest hospitals in the
country treating alcoholic and drug addiction.
was, therefore, a sense of real satisfaction when
I was asked to contribute a few words on a subject
which is covered in such masterly detail in these
doctors have realized for a long time that some
form of moral psychology was of urgent importance
to alcoholics, but its application presented difficulties
beyond our conception. What with our ultra-modern
standards, our scientific approach to everything,
we are perhaps not well equipped to apply the
powers of good that lie outside our synthetic
four years ago one of the leading contributors
to this book came under our care in this hospital
and while here he acquired some ideas which he
put into practical application at once.
he requested the privilege of being allowed to
tell his story to other patients here and perhaps
with some misgiving, we consented. The cases we
have followed through have been most interesting;
in fact, many of them are amazing. The unselfishness
of these men as we have come to know them, the
entire absence of profit motive, and their community
spirit, is indeed inspiring to one who has labored
long and wearily in this alcoholic field. They
believe in themselves, and still more in the Power
which pulls chronic alcoholics back from the gates
course an alcoholic ought to be freed from his
physical craving for liquor, and this often requires
a definite hospital procedure, before psychological
measures can be of maximum benefit.
believe, and so suggested a few years ago, that
the action of alcohol on these chronic alcoholics
is a manifestation of an allergy; that the phenomenon
of craving is limited to this class and never
occurs in the average temperate drinker. These
allergic types can never safely use alcohol in
any form at all; and once having formed the habit
and found they cannot break it, once having lost
their self-confidence, their reliance upon things
human, their problems pile up on them and become
astonishingly difficult to solve.
emotional appeal seldom suffices. The message
which can interest and hold these alcoholic people
must have depth and weight. In nearly all cases,
their ideals must be grounded in a power greater
than themselves, if they are to re-create their
any feel that as psychiatrists directing a hospital
for alcoholics we appear somewhat sentimental,
let them stand with us a while on the firing line,
see the tragedies, the despairing wives, the little
children; let the solving of these problems become
a part of their daily work, and even of their
sleeping moments, and the most cynical will not
wonder that we have accepted and encouraged this
movement. We feel, after many years of experience,
that we have found nothing which has contributed
more to the rehabilitation of these men than the
community movement now growing up among them.
and women drink essentially because they like
the effect produced by alcohol. The sensation
is so elusive that, while they admit it is injurious,
they cannot after a time differentiate the true
from the false. To them, their alcoholic life
seems the only normal one. They are restless,
irritable and discontented, unless they can again
experience the sense of ease and comfort which
comes at once by taking a few drinks - drinks
which they see others taking with impunity. After
they have succumbed to the desire again, as so
many do, and the phenomenon of craving develops,
they pass through the well-known stages of a spree,
emerging remorseful, with a firm resolution not
to drink again. This is repeated over and over,
and unless this person can experience an entire
psychic change there is very little hope of his
the other hand - and strange as this may seem
to those who do not understand - once a psychic
change has occurred, the very same person who
seemed doomed, who had so many problems he despaired
of ever solving them, suddenly finds himself easily
able to control his desire for alcohol, the only
effort necessary being that required to follow
a few simple rules.
have cried out to me in sincere and despairing
appeal: "Doctor, I cannot go on like this! I have
everything to live for! I must stop, but I cannot!
You must help me!"
with this problem, if a doctor is honest with
himself, he must sometimes feel his own inadequacy.
Although he gives all that is in him, it often
is not enough. One feels that something more than
human power is needed to produce the essential
psychic change. Though the aggregate of recoveries
resulting from psychiatric effort is perhaps considerable,
we physicians must admit we have made little impression
upon the problem as a whole. Many types do not
respond to the ordinary psychological approach.
do not hold with those who believe that alcoholism
is entirely a mental condition. I have had many
men who had, for example, worked a period of months
on some problem or business deal which was to
be settled on a certain date, favorably to them.
They took a drink a day or so prior to the date,
and then the phenomenon of craving at once became
paramount to all other interests so that the important
appointment was not met. These men were not drinking
to escape; they were drinking to overcome a craving
beyond their mental control.
are many situations which arise out of the phenomenon
of craving which cause men to make the supreme
sacrifice rather than continue to fight.
classification of alcoholics seems most difficult,
and in much detail is outside the scope of this
book. There are, of course, the constitutional
psychopaths who are emotionally unstable. We are
all familiar with this type. They are always "going
on the wagon for keeps." They are over-remorseful
and make many resolutions, but never a decision.
there are those who are never properly adjusted
to life, who are the so-called neurotics. The
prognosis of this type is unfavorable.
is the type of man who is unwilling to admit that
he cannot take a drink. He plans various ways
of drinking. He changes his brand or his environment.
There is the type who always believes that after
being entirely free from alcohol for a period
of time he can take a drink without danger. There
is the manic-depressive type, who is, perhaps,
the least understood by his friends, and about
whom a whole chapter could be written.
there are types entirely normal in every respect
except in the effect alcohol has upon them. They
are often able, intelligent, friendly people.
these, and many others, have one symptom in common:
they cannot start drinking without developing
the phenomenon of craving. This phenomenon, as
we have suggested, may be the manifestation of
an allergy which differentiates these people,
sets them apart as a distinct entity. It has never
been, by any treatment with which we are familiar,
permanently eradicated. The only relief we have
to suggest is entire abstinence.
immediately precipitates us into a seething caldron
of debate. Much has been written pro and con,
but among physicians, the general opinion seems
to be that most chronic alcoholics are doomed.
is the solution? Perhaps I can best answer this
by relating an experience of two years ago.
one year prior to this experience a man was brought
in to be treated for chronic alcoholism. He had
but partially recovered from a gastric hemorrage
and seemed to be a case of pathological mental
deterioration. He had lost everything worth while
in life and was only living, one might say, to
drink. He frankly admitted and believed that for
him there was no hope. Following the elimination
of alcohol, there was found to be no permanent
brain injury. He accepted the plan outlined in
this book. One year later he called to see me,
and I experienced a very strange sensation. I
knew the man by name, and partly recognized his
features, but there all resemblance ended. From
a trembling, despairing, nervous wreck, had emerged
a man brimming over with self-reliance and contentment.
I talked with him for some time, but was not able
to bring myself to feel that I had known him before.
To me he was a stranger, and so he left me. More
than three years have now passed with no return
I need a mental uplift, I often think of another
case brought in by a physician prominent in New
York City. The patient had made his own diagnosis,
and deciding his situation hopeless, had hidden
in a deserted barn determined to die. He was rescued
by a searching party, and, in desperate condition,
brought to me. Following his physical rehabilitation,
he had a talk with me in which he frankly stated
he thought the treatment a waste of effort, unless
I could assure him, which no one ever had, that
in the future he would have the "will power" to
resist the impulse to drink.
alcoholic problem was so complex, and his depression
so great, that we felt his only hope would be
through what we then called "moral psychology",
and we doubted if even that would have any effect.
he did become "sold" on the ideas contained in
this book. He has not had a drink for more than
three years. I see him now and then and he is
as fine a specimen of manhood as one could wish
earnestly advise every alcoholic to read this
book through,and though perhaps he came to scoff,
he may remain to pray.