The Doctor's Opinion seems appropriate here. I will highlight a few parts that are calling out to me right now.
THE DOCTOR’S OPINION
We of Alcoholics Anonymous believe that the reader will be
interested in the medical estimate of the plan of recovery described
in this book. Convincing testimony must surely come from medical
men who have had experience with the sufferings of our members
and have witnessed our return to health. A well known doctor, chief
physician at a nationally prominent hospital specializing in
alcoholic and drug addiction, gave Alcoholics Anonymous this
letter:
To Whom It May Concern:
I have specialized in the treatment of alcoholism for many years.
About 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.
In the course of his third treatment he acquired certain ideas
concerning a possible means of recovery. As part of his
rehabilitation he commenced to present his conceptions to other
alcoholics, impressing upon them that they must do likewise
with still others. This has become the basis of a rapidly growing
fellowship of these men and their families. This man and over
one hundred others appear to have recovered.
I personally know thirty of these cases who were of the type
with whom other methods had failed completely.
These facts appear to be of extreme medical importance; because
of the extraordinary possibilities of rapid growth inherent in this
group they may mark a new epoch in the annals of alcoholism.
These men may well have a remedy for thousands of such situations.
You may rely absolutely on anything they say about themselves.
Very truly yours,
(Signed) - - - - - M.D.
The physician who, at our request, gave us this letter, has been
kind enough to enlarge upon his views in another statement which
follows. In this statement he confirms what we who have suffered
alcoholic torture must believe that the body of the alcoholic is
quite as abnormal as his mind. It did not satisfy us to be told that
we could not control our drinking just because we were maladjusted
to life, that we were in full flight from reality, or were outright
mental defectives. These things were true to some extent, in fact,
to a considerable extent with some of us. But we are sure that our
bodies were sickened as well. In our belief, any picture of the
alcoholic which leaves out this physical factor is incomplete.
2
The doctor’s theory that we have an allergy to alcohol interests
us. As laymen, our opinion as to its soundness may, of course, mean
little. But as ex-problem drinkers, we can say that his explanation
makes good sense. It explains many things for which we cannot
otherwise account.
Though we work out our solution on the spiritual as well as an
altruistic plane, we favor hospitalization for
the alcoholic who is very jittery or befogged. More often than
not, it is imperative that a man’s brain be cleared before he is
approached, as he has then a better chance of understanding and
accepting what we have to offer.
The doctor writes:
The subject presented in this book seems to me to be of paramount
importance to those afflicted with alcoholic addiction.
I say this after many years’ experience as Medical Director of
one of the oldest hospitals in the country treating alcoholic and drug
addiction.
There was, therefore, a sense of real satisfaction when I was asked
to contribute a few words on a subject which is covered in such
masterly detail in these pages.
We doctors have realized for a long time that some form of moral
psychology was of urgent importance to alcoholics, but its
application presented difficulties beyond our conception. What with
our ultra-modern standards, our scientific approach to everything,
we are perhaps not well equipped to apply the powers of good that
lie outside our synthetic knowledge.
About 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.
Later, he requested the privilege of being allowed to tell his story
to other patients here and with some misgiving, we consented. The
cases we have followed through have been most interesting; in fact,
many of them are amazing. The unselfishness of these men as we
have come to know them, the entire absence of profit motive, and
their community spirit, is indeed inspiring to one who has labored
long and wearily in this alcoholic field. They believe in themselves,
and still more in the Power which pulls chronic alcoholics back
from the gates of death.
Of course an alcoholic ought to be freed from his physical
craving for liquor, and this often requires a definite hospital
procedure, before psychological measures can be of maximum
benefit.
We believe, and so suggested a few years ago, that the action
3
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 selfconfidence, their reliance upon things human, their
problems pile up on them and become astonishingly difficult to
solve. Frothy emotional appeal seldom suffices. The message which
can interest and hold these alcoholic people must have depth and
weight. In nearly all cases, their ideals must be grounded in a power
greater than themselves, if they are to recreate their lives.
If any feel that as psychiatrists directing a hospital for alcoholics
we appear somewhat sentimental, let them stand with us a while
on the firing line, see the tragedies, the despairing wives, the little
children; let the solving of these problems become a part of their
daily work, and even of their sleeping moments, and the most
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 altruistic movement now growing up among
them.
Men 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 recovery.
On the other hand—and strange as this may seem to those who
do not understand—once a psychic change has occurred, the very
same person who seemed doomed, who had so many problems he
despaired of ever solving them, suddenly finds himself easily able
to control his desire for alcohol, the only effort necessary being
that required to follow a few simple rules.
Men have cried out to me in sincere and despairing appeal:
”Doctor, I cannot go on like this! I have everything to live for! I
must stop, but I cannot! You must help me!“
4
Faced with this problem, if a doctor is honest with himself, he
must sometimes feel his own inadequacy. Although he gives all that is
in him, it often is not enough. One feels that something more than
human power is needed to produce the essential psychic change.
Though the aggregate of recoveries resulting from psychiatric effort
is considerable, we physicians must admit we have made little
impression upon the problem as a whole. Many types do not respond
to the ordinary psychological approach.
I do not hold with those who believe that alcoholism is entirely
a problem of mental control. I have had many men who had, for
example, worked a period of months on some problem or business
deal which was to be settled on a certain date, favorably to them.
They took a drink a day or so prior to the date, and then the
phenomenon of craving at once became paramount to all other
interests so that the important appointment was not met. These men
were not drinking to escape; they were drinking to overcome a
craving beyond their mental control.
There are many situations which arise out of the phenomenon
of craving which cause men to make the supreme sacrifice rather
than continue to fight.
The classification of alcoholics seems most difficult, and in much
detail is outside the scope of this book. There are, of course, the
psychopaths who are emotionally unstable. We are 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 is the type of man who is unwilling to admit that he cannot
take a drink. He plans various ways of drinking. He changes his
brand or his environment. There is the type who always believes
that after being entirely free from alcohol for a period of time he
can take a drink without danger. There is the manic-depressive
type, who is, perhaps, the least understood by his friends, and about
whom a whole chapter could be written.
Then there are types entirely normal in every respect except in
the effect alcohol has upon them. They are often able, intelligent,
friendly people.
All these, and many others, have one symptom in common: they
cannot start drinking without developing the phenomenon of
craving. This phenomenon, as we have suggested, may be the
manifestation of an allergy which differentiates these people, and
sets them apart as a distinct entity. It has never been, by any
treatment with which we are familiar, permanently eradicated. The
only relief we have to suggest is entire abstinence.
5
This immediately precipitates us into a seething caldron of debate.
Much has been written pro and con, but among physicians, the general
opinion seems to be that most chronic alcoholics are doomed.
What is the solutions Perhaps I can best answer this by relating
an experience of two years ago.
About 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 hemorrhage 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 to alcohol.
When 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.
His 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.
However, he did become ”old“ 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 to meet.
I earnestly advise every alcoholic to read this book
through, and though perhaps he came to scoff, he may
remain to pray.