HOW PHYSICIANS HAVE CONTRIBUTED TO
THE PRINCIPLES OF ALCOHOLICS ANONYMOUS
By William Loving, MD, ABAM, and Ulysses McLester, CADAC
Formed by a small group of alcoholics in the 1930s, Alcoholics Anonymous is devoted to the rehabilitation of alcoholics. This amazing fellowship has grown into a multinational network of thousands of chapters of AA. The organization has flourished even though it has never had a centralized president or leader, nor has it had a centralized treasurer or budget. It has grown because its concepts are sound and the need for such a group is great.
What most physicians don't realize about Alcoholics Anonymous is the fact that their profession has made major contributions to the establishment of the group. In fact, without their input there would essentially be no Alcoholics Anonymous today.
The first major contribution made to the development of Alcoholics Anonymous was by a physician-William Silkworth, M.D. Dr. Silkworth, as the director of Townes Hospital in New York City in the early 1930's, found that alcoholics seemed to undergo an allergic type reaction when consuming alcohol. They would have an abnormal reaction to the consumption of alcohol and also develop a craving for it. Most alcoholics realize they don't consume alcohol like other people; this "allergy" which is an abnormal reaction to food or substance, is exactly why they cannot drink like their normal peers. This observation still astounds the average drinker.
Dr. Silkworth elaborated on this concept of the allergic reaction to alcohol by saying that the alcoholic cannot safely use alcohol in any form at all. Consider the statement "cannot safely use alcohol in any form at all." Many people, both professional and non-professional, often tell the alcoholic he cannot drink, and the alcoholic will simply turn to them and say "bring your money and let's check that out." The alcoholic knows he can drink but what he doesn't realize is that he cannot safely drink without developing a craving and getting out of control with alcohol. The first vital piece of information given by the medical world then, was that the alcoholic had a type of "allergy" to alcohol and in fact, the alcoholic had a different chemical or physiological reaction to this substance than the normal person.
Dr. Silkworth's second contribution to the development of the AA principles was that not only did the alcoholic have a disease of the body, but also an "obsession of the mind." An obsession of the mind is an idea or thought that overrides all other valid information. Once the alcoholic began to think about drinking, even though he knew he could not safely drink, he would drink. Once he started drinking, he would re-activate the craving and become out of control with alcohol. Dr. Silkworth didn't know the cure for this allergy and this cycle through the obsession of the mind. But from observations of the many alcoholics he had treated, he knew that a small percentage of these people could abstain from alcohol if they made a very profound change in their personality, or underwent an entire "psychic change," as he put it.
A further contribution regarding alcohol and alcoholism came from Carl Jung, M.D. He knew that the alcoholic must have a spiritual change to overcome the obsession of the mind. Such a statement was a very radical departure for a psychiatrist of his reputation to make. Dr. Jung based his observations on his work with an alcoholic man by the name of Roland H. He had been analyzed by Dr. Jung for a year, hoping to find the basic cause of his alcohol problem. After a year of treatment, learning all he could possibly learn about the workings of the human mind, Roland knew it would be impossible for him to drink again, but he did drink again. Baffled by this action of his, he returned to Dr. Jung to ask if there was any hope for him. Dr. Jung told him no, that he would probably die of alcoholism. If he wanted to live, it would be necessary to place himself under lock and key. At Roland's insistence, Dr. Jung did let him know that there was a possible solution, and that would be a spiritual experience. Dr. Jung described this spiritual experience as one which involved a huge emotional upheaval and replacement of ideas, emotions and attitudes. He had observed this previously in a few alcoholics he had treated, and knew of a few cases where patients had pulled themselves "up from the gutter," and had returned to become leaders in their social sphere. He noted that these people had changed their ideas, faced their emotions, and adjusted their attitudes in a very profound way. Once this had taken place, a type of religious or spiritual conversion was seen in these people. It was usually found and observed in the confines of the church, even though the church did not usually want to become involved with the conversion experience of the alcoholic. This spiritual change was somewhat analogous to Dr. Silkworth's "psychic change." Dr. Jung noted that "alcohol" in Latin is "spiritus," and "the same word is used for the highest religious experience as well as for the most depraving poison." His prescription for this problem then was "spiritus contra spiritum."
The two major contributions from the medical world were: 1) the alcoholic basically has an allergic response to alcohol, and 2) to recover from it, the patient must undergo a profound psychic or spiritual experience.
Based on these two vital pieces of information, the Twelve Steps of Alcoholics Anonymous were written. The first step dealt with the information given by Dr. Silkworth which stated the alcoholic is powerless over alcohol, and his life becomes unmanageable because of the allergy of the body and the obsession of the mind. The allergy and obsession acting together create a person who is powerless over alcohol. "I have a body that says I can't drink and a mind that says I want to drink." When these two premises conflict, the mind always wins, and the person drinks again. The solution is Step Two of the Alcoholics Anonymous program, i.e., "come to believe that a power greater than ourselves would restore us to sanity." Once a person will admit to himself that he alone cannot do anything about this powerlessness and that a power far greater than himself is necessary to help him, there is some hope. The third step of Alcoholics Anonymous deals with a crossroads…"which do I choose…which decision do I make…to continue the old way or to begin a new way?"
The remainder of Steps Four through Twelve are simply to help a person attain this spiritual or psychic experience. By virtue of this experience, the alcoholic begins to change his ideas, emotions and attitudes. Once this happens, he has an entire psychic change or spiritual experience sufficient to overcome drinking. It is very important that the medical world claims its contributions because without them, the alcoholic never would have known what this problem really involved or how to obtain the solution.
FOOTNOTES
1. Alcoholics Anonymous Big Book.
2. "Pass It On" and the Bill W. / Carl Jung letters.
3. Not God.
Written by William M. Loving, M.D. and Ulysses McLester, CADAC.
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