Condensed from The American Journal of Psychiatry
by Harry M. Tiebout, M.D.
Alcoholics Anonymous is the name applied to a group of ex- alcoholics who, through a therapeutic program which includes a definite religious element, have successfully combated alcoholism.
The group stems from the efforts of one man, William Wilson, who in 1934 found an answer to his drinking problem in a personal religious experience. Since then, many alcoholics have become sober by using this approach.
Alcoholics Anonymous claims a recovery rate of 75 percent of those who really try their methods. This figure, coupled with their mushroom growth, commands respect and demands explanation.
Characteristic of the so-called typical alcoholic is that he is completely self-centered, dominated by feelings of omnipotence, intent on maintaining at all costs his feelings of self- importance and self-satisfaction.
Among problem drinkers these qualities have been described as “defiant individuality” and “grandiosity.” Inwardly the alcoholic books no control from man or God.
He, the alcoholic, is and must be master of his destiny.
It is easy to see how the person possessing the more or less constant presence of these character traits, has difficulty in accepting God and religion. Religion demands that the individual acknowledge the presence of a God and so challenges the very nature of the alcoholic.
But if the alcoholic can truly accept the presence of a Power greater than himself, he modifies at least temporarily and possibly permanently his deepest inner structure and when he does so without resentment or struggle, then he is no longer typically alcoholic.
Wilson states that the success of the group with any alcoholic depends upon the degree to which the individual undergoes a conversion. His own experience was of the sweeping, cataclysmic type which lifted him out of a slough of despond and transported him to heights of ecstatic joy and happiness where he stayed for some hours. This state was then succeeded by a feeling of peace, serenity and the profound conviction that he was freed from the bondage of liquor.
He states that roughly 10 percent enter Alcoholics Anonymous on the strength of such an experience. The remaining 90 percent who stay dry achieve the same result by developing slowly and much more gradually the spiritual side of their nature through following the various steps in the program already outlined.
What then is a spiritual awakening? Here the personal experience of Mr. Wilson is again informative. A man of energy, drive and great ability, in his thirties, he found himself completely bogged down by drink. For at least five years he fought without success the downhill process that was going on in him.
He was desperate, depressed, with all the fight knocked out of him. He was willing to try anything because he knew that the alternative facing him was a state hospital and a life of permanent insanity.
Suddenly in this agony of spirit, he cried aloud, “If there is a God, let Him show himself now.” And with this plea his religious experience started. He points out, and I think rightfully, that it was not until he became utterly humble that he could and did turn to God for the help that was there.
In other words, in the light of Mr. Wilson’s own experience, a religious or spiritual awakening is the act of giving up one’s reliance on one’s omnipotence. The defiant individuality no longer defies but accepts help, guidance and control from the outside. And as the individual relinquishes his negative, aggressive feelings toward himself and toward life, he finds himself overwhelmed by strongly positive ones such as love, friendliness, peacefulness and pervading contentment, which state is the exact antithesis of the former restlessness and irritability. And the significant fact is that with this new mental state the individual is no longer “driven to drink.
Further insight into the phenomenon of spiritual change came from a patient whose case I now wish to cite. He is a man in his early forties. From a family of wealth and the youngest of several children, he was the pampered darling of a neurotic, hypochondriacal mother.
Drinking began in late adolescence. Almost at once he learned to rely on liquor to help him meet social situations, and as the years rolled on, this reliance became more pronounced.
He proved to be an exceedingly responsive patient, readily acknowledging his alcoholic tendency, and quickly becoming interested in Alcoholics Anonymous. After about a month, he was convinced that he had the problem in hand. Within a short time, however, nipping set in and four months later he returned after some weeks of steady drinking.
Again he showed himself responsive to interviews, but it now became apparent that there was a real battle ahead. The traits already described reared themselves as insuperable barriers to therapy.
During the weeks that we were discussing these obstacles the patient began to nip on the sly and finally went off on a full-fledged spree. As is usual with all alcoholics, as he sobered up he was filled with remorse, guilt and a tremendous sense of humility.
The defiant personality was licked by the very excesses of its own behavior and, in that mood, he was utterly sure he would never take another drop. On the third day of his recuperation, however, he informed me during an interview that I had better do something about it, and when I asked him what ” it” referred to, he replied, “My old feeling is coming back over me; I just feel myself closing in from you and all that has just happened.”
The indifference to his problem, the aggressive sureness, the utter lack of any real sense of humility and guilt, all the character traits which he had come to identify with the frame of mind that led to drinking were returning and crowding out the feelings, the thoughts, almost the sensations which filled him as he came out of his drinking bout. He knew that if these returning feelings again took hold of him sooner or later he would go on another alcoholic spree. He realized that somehow he must cling to the attitudes at the end of the bout.
The next day he began his interview with the statement, “Doc, I’ve got it.” He then went on to report his experience of the previous night. This experience I label for want of a better term, “a psychological awakening.” What happened was a sudden flash of understanding about himself as a person. This occurred around eleven o’clock, and he lay in bed, wide awake until four o’clock in the morning fitting his new insights and understanding to his knowledge of himself.
It is not easy to reconstruct the events of that five hour period, yet those events constitute a major experience in the life of that patient which gave him a basic appreciation of himself as an alcoholic. Moreover, for the first time, he could see himself as he had always been, and in addition he could sense the sort of person he must become if he were to remain sober. Without being aware of it at the time, he had switched from a completely egocentric, subjective point of view to an objective, mature understanding of himself and life.
In retrospect, it is apparent that the patient became aware of his basic egocentricity. For the first time he was able to penetrate behind the facade of his rationalizations and defense reactions and to see that always hitherto he had put himself first.
He was literally unaware that other souls existed except insofar as they affected him. That they, too, might have separate existences, similar yet different from his, just never had taken on the aspect of reality.
Now he no longer felt himself the omnipotent being who viewed the world only in relation to himself. Instead, he could see himself in relation to the world and could realize that he was but a small fraction of a universe peopled by many other individuals. He could share life with others. He had no further need to dominate and to fight to maintain that domination. He could relax and take things easy.
His new orientation can best be described in the patient’s own words. As he put it, “Why, Doc, do you know I’ve been a fraud all my life, and I never knew it. I used to think I was interested in people, but that wasn’t really so. I wasn’t interested in my mother as a person who was sick. I didn’t realize that she as a person might be suffering; I only thought what will happen to me when she is gone. People used to point me out as a dutiful son and an example, and I believed it. But there wasn’t anything to it. I was just anxious to keep her near, because she made me feel better. She never criticized me and always made me feel that whatever I did, I was O.K.”
New insights illuminated his previous relationships with people. With respect to this point, he remarked, “Do you know, I’m beginning to feel closer to people. I can think of them sometimes. And I feel easier with them, too. Maybe that’s because I don’t think they’re fighting me, since I don’t feel I’m fighting them. I now think maybe they can really like me.”
In conclusion, it is my belief that Alcoholics Anonymous relies upon an emotional force, religion, to achieve an emotional result. It overthrows a negative, hostile, act of emotions and supplants them with a positive set in which the individual no longer need maintain his defiant individuality, but can live in peace and in harmony with the world.
(Source: Science Digest, May 1944)