Deflation at Depth — The Cornerstone Carl Jung Handed Bill Through Ebby – Bill W.

Contents, one, Alcoholics Anonymous, Beginnings and Growth, presented to the New York City Medical Society on Alcoholism, April 28, 1958. Two, Basic Concepts of Alcoholics Anonymous, presented to the State of New York Section on Neurology and Psychiatry, Annual Meeting, May 1944. Three, The Society of Alcoholics Anonymous, presented to the American Psychiatric Association, 105th Annual Meeting, Montreal, Quebec, May 1949. Beginnings and Growth, by Bill W., presented to the New York City Medical Society on Alcoholism, April 28, 1958. Fourteen years ago, I read a paper before the... Medical Society of the State of New York at its annual gathering. For us of Alcoholics Anonymous, that was a history-making event. It marked the first time that any of America's great medical associations had taken favorable notice of our fellowship. The physicians of that day did far more than take notice of us. They received us with open arms and allowed our account of AA to be published in their journal. Reprints of that 1944 paper... have since been scattered in tens of thousands of copies throughout the world. Convincing physicians everywhere of AA's worth. What this perceptive and generous act has since meant to countless alcoholics and their families, only God Himself knows. Keenly appreciative that the members of the New York City Medical Society on Alcoholism have, in the same generous spirit, invited me to be here tonight. It is with a sense of timeless gratitude that I bring you greetings... from those 250,000 recovered alcoholics who now comprise our membership in some 7,000 groups, here and abroad. As of 1986, membership exceeds one million and more than 67,000 groups are recorded. Perhaps the better way to understand AA's methods and results is to have a look at its beginnings. At that time, when medicine and religion entered into their benign partnership with us. This partnership is now the foundation of such success as we have since had. Certainly nobody invented Alcoholics Anonymous. AA is a synthesis of principles and attitudes which came to us from medicine and from religion. We alcoholics have simply streamlined those forces, adapting them to our special use in a society where they can work effectively. Our contribution was but the missing link in a chain of recovery which is now so significant and of such promise for the future. Few people know that the first taproot of AA hit pay dirt some 30 years ago in a physician's office. Dr. Carl Jung, that great pioneer in psychiatry, was talking to an alcoholic patient. This, in effect, is what happened. The patient, a prominent American businessman, had gone the typical alcoholic route. He had exhausted the possibilities of medicine and psychiatry in the United States and had then come to Dr. Jung as to a court of last resort. Carl Jung had treated him for a year. And the patient, whom we shall call Mr. R, felt confident that the hidden springs underneath his compulsion to drink had been discovered and removed. Nevertheless, he found himself intoxicated within a short time after leaving Dr. Jung's care. Now he was back in a state of black despair. He asked Dr. Jung what the score was, and he got it. In substance, Dr. Jung said, For some time after you came here, I continued to believe that you might be one of those rare cases who could make a recovery. But I must now frankly tell you that I have never seen a single case recover through the psychiatric arts where the neurosis is so severe as yours. Medicine has done all it can do for you, and that's where you stand. Mr. R's depression deepened. He asked, Is there no exception? Is this really the end of the line for me? Well, replied the doctor, there are some exceptions, a very few. Here and there, once in a while, alcoholics have had what are called vital spiritual experiences. They appear to be in the nature of huge emotional displacements and rearrangements. Ideas, emotions, and attitudes, which were once the guiding forces of these men, are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate them. In fact, I have been trying to produce some such emotional rearrangement within you. With many types of neurotics, the methods which I employ are successful. However, I have never been successful with an alcoholic of your description. But, protested the patient, I'm a religious man, and I still have faith. To this, Dr. Jung replied, Ordinary religious faith isn't enough. What I'm talking about is a transforming experience. A conversion experience, if you like. I can only recommend that you place yourself in the religious atmosphere of your own choice. That you recognize your personal hopelessness, and that you cast yourself upon whatever god you think there is. The lightening of the transforming experience of conversion may then strike you. This you must try. It is your only way out. So spoke a great and humble physician. For the AA to be, this was a pin strike. Science had pronounced Mr. R virtually hopeless. Dr. Jung's words had struck him at great depth, producing an immense deflation of his ego. Deflation at depth is today a cornerstone principle of AA. There, in Dr. Jung's office, it was first employed in our behalf. The patient, Mr. R, chose the Oxford group of that day as his religious association and atmosphere. Terribly chastened and almost hopeless, he began to be active with it. To his intense joy and astonishment, the obsession to drink presently left him. Returning to America, Mr. R came upon an old school friend of mine, a chronic alcoholic. This friend, whom we shall call Ebby, was about to be committed to a state mental hospital. At this juncture, another vital ingredient was added to the AA's synthesis. Mr. R, the alcoholic, began talking to Ebby, also an alcoholic and a kindred sufferer. This made for identification at depth, a second cardinal AA principle. Over the bridge of identification, Mr. R passed Dr. Jung's verdict of how hopeless, medically and psychiatrically, most alcoholics were. He then introduced Ebby to the Oxford group, where my friend promptly sobered up. My friend Ebby well knew of my plight. I had gone the familiar course. In the summer of 1934, my doctor, William V. Silkworth, had given me up and had pronounced me hopeless. He had been obliged to tell me that I was the victim of a neurotic compulsion to drink that no amount of willpower, education or treatment could check. He added that I was also the victim of a bodily derangement that might be in the nature of an allergy. A physical malfunction that virtually guaranteed brain damage, insanity or death. Here again, the god of science, which was then my only god, had well depleted me. I was ready for the message that was soon to come from my alcoholic friend, Ebby. He came to my house one day in November in 1934 and sat across the kitchen table from me while I drank. No thanks. He didn't want any liquor, he said. Much surprised, I asked what had got into him. Looking straight at me, he said he had got religion. This was a real crusher and a front of my scientific training. As politely as possible, I asked what brand of religion he had. Then he told me of his conversations with Mr. R. And how hopeless alcoholism really was, according to Dr. Carl Jung. Added to Dr. Silkworth's verdict, this was the worst possible news. I was hard hit. Next, Ebby enumerated the principles he had learned from the Oxford group. Though he thought these good people sometimes too aggressive, he certainly couldn't find any fault with most of the basic teachings. After all, these teachings had sobered him up. In substance, here they are as my friend applied them to himself in 1934. 1. Ebby admitted that he was powerless to manage his own life. 2. He became honest with himself as never before, made an examination of conscience. 3. He made a rigorous confession of his personal defects, and thus quit living alone with his problems. 4. He surveyed his distorted relations with other people, visiting them to make what amends he could. 5. He resolved to devote himself to helping others in need, without the usual demand for personal prestige or material gain. 6. By meditation, he sought God's direction for his life, and the help to practice these principles of conduct at all times. This sounded pretty naive to me. Nevertheless, my friend stuck to the plain tale of what had happened. He related how practicing these simple precepts, his drinking had accountably stopped. Fear and isolation had left, and he had received a considerable peace of mind. With no hard disciplines, nor any great resolves, these changes began to appear the moment he conformed. His release from alcohol seemed to be a byproduct. Though sober but months, he felt sure he had a basic answer. Wisely avoiding arguments, he then took his leave. The spark that was to become Alcoholics Anonymous had been struck. One alcoholic had been talking to another, making a deep identification with me, and bringing the principles of recovery within my reach. At first, my friend's story generated mixed emotions. I was drawn and revolted by turns. My solitary drinking went on for some weeks, but I could not forget his visit. Several themes coursed in my mind. First, that his evident state of release was strangely and immensely convincing. Second, that he had been pronounced hopeless by competent doctors. Third, that these age-old precepts, when transmitted by him, struck me with great power. Fourth, that I could not and would not go along with any God concept. That there would be no conversion nonsense from me. Often trying to divert my thoughts, I found it no use. By chords of understanding, suffering, and simple verity, another alcoholic had bound me to him. I could not break away. One morning after my gin, this realization welled up. Who are you, I asked, to choose how you are going to get well? Beggars are not choosers. Supposing medicine said carcinoma was your trouble. You would not turn to Pond's extract. In abject haste, you would beg a doctor to kill those hellish cancer cells. If he could have stopped him, and you thought religious conversion might, your pride would fly away. If need be, you would stand in a public square, crying amen along with other victims. What difference, then, I reflected, between you and the cancer victim? His sick body crumbles. Likewise, your personality crumbles. Your obsession consigns you to madness or the undertaker. Are you going to try your friend's formula, or not? Of course, I did try. In December 1934, I appeared at Pound's Hospital, New York. My old friend, Dr. William Silkworth, shook his head. Soon free of sedation and alcohol, I felt horribly depressed. My friend, Ebby, turned up. Though glad to see him, I shrank a little. I feared evangelism, but nothing of the sort happened. After some small talk, I again asked him for his neat little formula for recovery. Quietly and sanely, without the slightest pressure, he told me. Then he left. Lying there in conflict, I dropped into the blackest depression I had ever known. Momentarily, my prideful obstinacy was crushed. I cried out, Now I am ready to do anything. Anything to receive what my friend, Ebby, has. Though I certainly didn't really expect anything, I did make this frantic appeal. If there be a God, will he show himself? The result was instant, electric, beyond description. The place seemed to light up, blinding white. I knew only ecstasy and seemed on a mountain. A great wind blew, enveloping and penetrating me. To me, it was not a bear, but a spirit. Waving, there came the tremendous thought. You are a free man. Then the ecstasy subsided. Still on the bed, I now found myself in a new world of consciousness, which was subdued by a presence. One with the universe, a great peace stole over me. I thought, So this is the God of the preachers. This is the great reality. But soon my so-called reason returned. My modern education took over. I thought I must be crazy, and I became terribly frightened. Dr. Silkworth, a medical saint if there ever was one, came in to hear my trembling account of this phenomenon. After questioning me carefully, he assured me that I was not mad, that I had perhaps undergone a psychic experience which might solve my problem. Skeptical man of science, though he then was, this was most kind and astute. If he had said, Hallucination, I might now be dead. To him I shall ever be eternally grateful. Good fortune pursued me. Ebby brought me a book entitled, Varieties of Religious Experience, and I devoured it. Written by William James, a psychologist, it suggests that the conversion experience can have objective reality. Conversion does alter the reality. It does alter motivation, and does semi-automatically enable a person to be and to do the formerly impossible. Significant it was that marked conversion experiences came mostly to individuals who knew complete defeat in a controlling area of life. The book certainly showed variety, but whether these experiences were bright or dim, cataclysmic or gradual, theological or intellectual in bearing, such conversions did have a common denominator. They did change utterly defeated people. So declared William James, the father of modern psychology. The shoe fit, and I have tried to wear it ever since. For drunks, the obvious answer was depletion at depth and more of it. That seemed as plain as a pike staff. I had been trained as an engineer, so the views of this authoritative psychologist meant everything to me. This eminent scientist of the mind had confirmed everything that Dr. Jung had said, and had extensively documented all he claimed. Thus, William James firmed up the foundation on which I and many another have stood all these years. I haven't had a drink of alcohol since 1934. Armored now by utter conviction, and fortified by my characteristic power drive, I took off to cure alcoholics wholesale. It was twin-jet propulsion. Difficulties meant nothing. The vast conceit of my project never occurred to me. I pressed the assault for six months, and my home was filled with alcoholics. Harangues with scores produced not the slightest results. Disappointingly, Ebby, my friend of the kitchen table, who was sicker than I realized, took little interest in these other alcoholics. This fact may have caused his backslide later on. So he did make his eventual recovery. But I had found that working with alcoholics had a huge bearing on my own sobriety. Nevertheless, none of my prospects were getting sober. Why was this? Slowly, the defects of my approach came to light. Something like a religious crank, I was obsessed with the idea that everybody must have a spiritual experience, just like mine. I forgot that James had said there were many varieties of the transforming experience. My brother alcoholics just stared incredulously or joshed me about my hot flesh. Of course, this spoiled the potent identification that was so necessary to establish with them. I had turned evangelist. Clearly, the approach had to be only. What had come to me in six minutes might require six months with others. I had learned that words were things that one had to be proved. At this juncture, the spring of 1935, Dr. Silkworth pointed out to me that I had forgotten all about depletion at depth. I had simply turned preacher. Said he, why don't you pour the grim medical facts into these people before you do anything else? Have you forgotten what William James said about ego depletion at depth? Give them the medical business and give it to them hard. Skip that account of your hot flesh. Recite your symptoms extensively so as to get an identification at depth. When you do this, your prospects may become willing to adopt the single moral precepts you have been trying to teach. Here was the most vital contribution to the synthesis. Once again, it had been made by a physician. The emphasis was straightaway shifted from sin to sickness, the fatal malady, alcoholism. We quoted several doctors to the effect that alcoholism was often more lethal than cancer, that it consisted of an obsession of the mind coupled to increasing body sensitivity. These were our twin ogres, madness and death. We leaned heavily on Dr. Jung's statement of how hopeless the condition could be and then poured that devastating dose into every drunk within range. To modern man, science is omnipotent, virtually a god. Hence, if science passed a death sentence on the drunk and we placed that fearful verdict on our alcoholic transmission belt, one victim talking to another, it might shatter the listener completely. Then the alcoholic might turn to the god of the theologian, there being no other place to go. Whatever truth there was in this device, it certainly had practical merit. Immediately, our whole atmosphere changed. Things began to look up. A few months later, I was introduced to Dr. Robert S., an Akron surgeon. He was an alcoholic in a bad way. This time, there was no preachment from me. I told him of my experience and of what I knew about alcoholism. Because we understood and needed each other, there was genuine mutuality between the two of us. Dr. Robert S. was an alcoholic in a bad way. This time, there was no preachment from me. I told him of my experience and of what I knew about mutuality for the first time. This marked the end of my preaching attitude. This idea of mutual need added the final ingredient to the synthesis of medicine, religion, and the alcoholic experience which is now Alcoholics Anonymous. Dr. Bob, a very grim case, sobered almost immediately and never took a drink to the time of his death in 1950. He and I soon commenced to work on numbers of alcoholics that we found at the Akron City Hospital. Almost immediately, there was a recovery and then another. The first successful AA group had been formed. Returning to New York in the fall of 1935, this time, with all the ingredients of recovery, another group soon took shape in this city. Nevertheless, progress of the Akron and New York group was painfully slow for the next few years. Hundreds of cases were tried and the number of cases increased and the number of cases decreased and the numbers of cases were tried but only a few responded. Near the close of 1937, however, 40 were sober and we began to be far more sure of ourselves. We saw that we had a formula which might carry from one alcoholic to the next, eventually produce, change style, a very large number of recoveries. So came the question, how can our good news be spread to the millions and throughout the world? One basic answer seemed to be in a literature detailing our methods. Another need was for widespread publicity which would bring great numbers of cases to us. By the spring of 1939, our society had produced a book which was called Alcoholics Anonymous. In this volume, our methods were carefully described. For the sake of greater clarity and thoroughness, the word of mouth program which my friend Ebby had given to me was enlarged into what we now call AA's 12 suggested steps for recovery. This was the backbone of our book. To substantiate AA methods, our book included 28 case histories. We hoped that these stories might fully identify us with readers at a distance, and they certainly have. Our fellowship adopted the name of our book, Alcoholics Anonymous, as its own. The advent of that volume marked a historical turning point. In the 20 years since, this basic text has gained a circulation of nearly 400,000 copies. In 1986, this tradition passed 6 million. Countless alcoholics have sobered with no other aid than reading this volume and practicing its principles. Our next need was publicity, and it was forthcoming. Houghton Osler, the noted editor and writer, printed a piece in Liberty Magazine about us in 1939. The following year, John D. Rockefeller Jr. gave AA a dinner, which was widely publicized. The next year, this story alone brought us thousands of new people. As we gained size, we also gained in effectiveness. The recovery rate went way up. Of all those who really tried AA, a large percent made it at once. Others finally made it, and still others, if they stayed with us, were definitely improved. Our high recovery rate in the original edition of Alcoholics Anonymous. In fact, 75% of those finally achieved sobriety. Only 25% died or went mad. Most of those still alive have now been sober for an average of 20 years. In our early days and since, we have found that great numbers of alcoholics approach us and then turn away. We have happily learned that the majority of them later return, provided they are not too psychopathic or too brain damaged. Once they have learned from the lips of other alcoholics that they are beset by an often fatal malady, their further drinking only turns up the screw. Eventually, they are forced back into AA. It is therefore a lot higher than we at first thought it could be. Another development of recent years has been a source of much comfort. In our early times, we could only deal with last gas cases. Nothing could be done until alcohol had nearly wrecked its victim. But nowadays, we don't always have to wait while sufferers plumb these depths. In consequence, half of today's membership in AA is composed of far milder cases. Very often, the family, the job, and the victim's health are relatively unimpaired. Even potential cases are today approaching us. People who have suffered only a little. Here and abroad, too, our society is making much headway in crossing every barrier of race, yet we must humbly reflect that Alcoholics Anonymous has so far made only a scratch upon the total problem of alcoholism. Here in the United States, we have helped to silver up scarcely 5% of the total alcoholic population of 4,500,000. The reasons are these. We can't deal with alcoholics who are too psychopathic or brain damaged. Many alcoholics don't like our methods and may look for an easier or different way. Millions still claim to the rationalization that their troubles are wholly due to their personal circumstances and are therefore somebody else's fault. To get the alcoholic or the potential alcoholic to admit that he is the victim of an often fatal and progressive malady is usually a very difficult task for all of us, whether physicians, clergymen, families or friends. However, there is much reason to hope. One of the greatest reasons for hope lies in what new physicians are already doing and may still do. Perhaps some of you may be asking, how can we help still more effectively? Here, we AAs can offer nothing authoritative, but we do feel we can do more than we can do. A few years ago, a drunk was mostly a nuisance. The physician and the hospital could get him over rough hangovers. A little comfort might be afforded the family, but little else could be done. Now the situation is different. Nearly every city in Hamlet in the country has an AA that is so often stepped in. He is the one usually called upon when real trouble starts to loom. After getting the victim sobered up and the family quieted down, he can frankly tell the alcoholic what ails him. He can do the same thing for his patients that Carl Jung did for Mr. R. and that Dr. Silkworth did for me. He can get well by himself, but he needs lots of help. Since a great deal is today known about the emotional and metabolic deficiencies of the alcoholic, family physicians can document their presentation in a far more convincing manner than could our early pioneer doctors. It is very gratifying to know that today the subject of alcoholism is being discussed. The facts about alcoholism are easy to obtain. Organizations like the National Council on Alcoholism, the Yale School of Alcoholic Studies, and since 1962 the Rutgers School of Alcohol Studies, plus innumerable state rehabilitation and clinical efforts are ready sources of helpful knowledge. So on, let's take a look at our fellowship. Or if he balks at AA, he may be directed to a clinic, a psychiatrist, or an understanding pastor. At this stage, the main thing is that he recognizes illness and then he starts to do something about it. If the family physician does something about it, it will bring results. These simple procedures do not rob the family physician of much time, nor will they necessarily be hard on the patient's pocketbook. A concerted effort of this is the very special thanks of AA to them. Now we come to the specialist, usually the psychiatrist. I'm glad to say that psychiatrists in great numbers are referring alcoholics to AA, even psychiatrists who more or less specialize on alcoholics. Their understanding of alcoholics is extremely important. In 1849, for example, the American Psychiatric Association allowed me to read a paper on AA before a section of its annual meeting. As these doctors specialize in emotional disorders, and alcoholism is certainly one of them, this act of theirs has always seemed to me a wonderful achievement. I have never been sufficiently appreciative of all of this. It used to be the fashion among some of us in AA to decry psychiatry, even medical aid of any description, save that barely needed for sobering up. We pointed ourselves to AA for the first time in the history of the American Psychiatric Association. We also realized that the discoveries of the psychiatrist and the biochemist have vast implications for us alcoholics. Indeed, these discoveries are today far more than what we have ever seen. We have been able to make good discoveries without any AA at all. It should here be noted that some of the recovery methods employed outside AA are quite in the system. We often release the big neurotic overhang from which many of us suffer after AA has sobered us. We know the psychiatrists have sent us innumerable alcoholics who would never otherwise approach AA, and many clinics have done likewise. We have to make a pledge to the whole medical fraternity that AA will always stand ready to cooperate, that AA will never trespass upon medicine, that our members who feel the call will increasingly help in those great enterprises of medicine, and that we will continue to support AA in the future. We will continue to support AA in the future. We will continue to support AA in the future. We will continue to support AA in the future. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Next round of enen questions are will I have to answer the last question? Hello, everybody. My name today co-founder of Alcoholics Anonymous continuing on page 18. Prior to the second part is an excerpt from the pamphlet The Illness Called Alcoholism published by the American Medical Association Committee on Alcoholism and Drug Dependence Council on Mental Health Department of Health Education reprinted with permission. Is alcoholism really an illness? The American Medical Association and the World Health Organization as well as many other professional groups regard alcoholism as a disease. The judiciary and lawmakers also are recognizing it as a disease. Some authorities continue to see alcoholism only as an expression of underlying emotional problems. Others see it starting as a symptom which precedes an illness and requires treatment in itself. The Committee on Alcoholism and Drug Dependence of the American Medical Association defines alcoholism as an illness in which there is preoccupation with alcohol and loss of control over its consumption as a type of drug dependence that can harm a person's health and interfere with his ability to work and get along with other people. The alcoholic usually drinks heavily and gets drunk often. Quantity and frequency, however, are only one sign. Although some alcoholics actually drink less than some social drinkers, this does not change their basic condition nor make it less serious. The key factor is loss of control and craving for the drug alcohol. Physical disabilities and difficulties of adjusting to life may contribute to the development of the illness as well as results of it. Drinking by oneself or drinking early in the morning may be signs of alcoholism, but they are not always present. Similarly, living on Skid Row, and Marvin.com for more information. Thanks for watching and stay tuned for more. being irresponsible and other behavior commonly regarded as fundamental to alcoholism are neither limited to the disorder nor necessarily part of it in fact the class of alcoholics made up a financially successful professional person may well be one of the largest and certainly one of the most seriously neglected groups in this country following her excerpt from an address on basic concepts of alcoholics anonymous by bill w presented to the medical society of the state of new york section of neurology and psychiatry annual meeting new york new york may 1944. alcoholics anonymous has but one purpose one objective only to help other alcoholics to recover from their illness nothing is that of the alcoholic approaching us say they desire on his part to get well. He subscribes to no membership requirements, no fees or dues, nor is a belief in any particular point of view, medical or religious, demanded of him. As a group, we take no position on any controversial questions. Emphatically, we are not evangelists or reformers. Being alcoholics who have recovered, we aim to help only those who want to get well. We do this because we have found that working with other alcoholics plays such a vital part in keeping us all sober. You may inquire, just how does AA work? I cannot fully answer that question. Many AA techniques have been adopted after a 10-year process of trial and error, which has led to some interesting results. But, as laymen, we doubt our own ability to explain them. We can only tell you what we do and what seems from our own experience. From our point of view, who happens to us? At the very outset, we would like it made ever so clear that AA is a synthetic concept. A synthetic gadget, as it were, drawing upon the resources of medicine, psychiatry, religion, and our own experience of drinking and recovery. You will search in vain for a single new fundamental. We have merely streamlined old and proved principles of psychiatry and religion into something new. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature of AA. We have not yet been able to understand the nature And then we have created a society of its own kind where he can enthusiastically put the very principles to work on himself and other sufferers. Then, too, we have tried hard to capitalize on our one great natural advantage. That advantage is, of course, our personal experience as drinkers who have recovered. How often do doctors and clergymen throw up their hands when, after exhaustive treatment or exhortation, the alcoholic still insists, you don't understand me, you never did any serious drinking yourself, so how can you? Neither can you show me many who have recovered. Now, when one alcoholic who has got well talks to another who hasn't, such objections seldom arise, for the new man sees in a few minutes that he is talking to a kindred spirit, one who understands. And he is. Neither can the recovered AA member be deceived, for he knows every trick, every rationalization of the drinking game, so the usual barriers go down with a crash. Mutual confidence, that indispensable of all therapy, follows as surely as day does night. And if this absolutely necessary rapport is not forthcoming at once, it is almost certain to develop when the new man has met other AAs. Someone will, as we say, click with him. As soon as that happens, we have a good chance of selling our prospect those very essentials which you doctors have so long advocated. And the problem-breaker finds our society a congenial place to work them out for himself and his fellow alcoholic. For the first time in years, he thinks himself understood and he feels useful. Uniquely useful, indeed, as he takes his own turn promoting the recovery of the alcoholic. No matter what the outer world still says of him, he now knows that he can get well. For he stands in the midst of scores of cases worse than his own, who have attained the goal. And there are other cases precisely like his own, a pressure of testimony which usually overwhelms him. If he doesn't succumb at once, he will almost surely do so later, when barleycorn bills are still hot afire. The only type of medicine he will ever use on the caso is the bereavement pill. The only thing he can do is stay in that cell. And if he doesn't, he will have to retire. Those are the kind of people this is all about. And here is that. else within their means, having exhausted their pet rationalizations, they came back and took their medicine. That is why we never need evangelized alcoholics. If still in their right minds, they come back once they have been well exposed to AA. Now, to recapitulate, Alcoholics Anonymous has made two major contributions to the program of psychiatry and religion. One, our ability as ex-drinkers to secure the confidence of the new man, to build a transmission line into him. Two, the provision of an understanding society of ex-drinkers, in which the newcomer can successfully apply the principles of medicine and religion to himself and others. So far as we AA's are concerned, these principles, now used by us every day, seem to be in surprising green. Let's compare briefly what, in a general way, medicine and religion are. Medicine and religion tell the alcoholic. Medicine says, one, the alcoholic needs a personality change. Religion says, one, the alcoholic needs a change of heart, a spiritual awakening. Two, medicine says, the patient ought to be analyzed and should make a full and honest mental catharsis. Religion says, the alcoholic should make examination of the conscience and a confession, or a moral inventory and a frank discussion. Three, medicine says, serious personality defects must be eliminated through accurate self-knowledge and realistic readjustment to life. Religion says, character defects, sins, can be eliminated by acquiring more honesty, humility, unselfishness, tolerance, generosity, love, etc. Four, medicine says, the alcoholic neurotic retreats from life, is a picture of anxiety and abnormal self-concern. He withdraws from the herd. Religion says, the alcoholic's basic trouble is self-centeredness. Filled with fear and self-seeking, he has forgotten the brotherhood of man. Five, medicine says, the alcoholic must find a new compelling interest in life, must get back into the herd. To find an interesting occupation, should join clubs, social activities, political parties, or discover hobbies to take the place of alcohol. Religion says, the alcoholic should learn the expulsive power of a new affection. Love a serving man, a serving God. He must lose his life to find it. He should join the church and there find self-forgetfulness in service. For faith without work is dead. The far, religion and medicine are seen in hardy accord, but in one respect they do differ. When the doctor has shown the alcoholic his underlying difficulties and has prescribed a program of readjustment, he said to him, now that you understand what is required for recovery, you should no longer depend on me. You must depend upon yourself. You go do it. Clearly then, the object of the doctor, is to make the patient feel better and more comfortable. self-sufficient, and largely if not wholly dependent upon himself. Religion does not attempt this. It says that faith in self is not enough, even for a non-alcoholic. The clergyman says that we shall have to find and depend upon a higher power, God. He advises prayer and frankly recommends an attitude of unwavering reliance upon him who presides over all. By this means, we discover a strength much beyond our own resources. So the main difference seems to add up to this. Medicine says, know yourself, be strong, and you will be able to face life. Religion says, know thyself, ask God for power, and you become truly great. In Alcoholics Anonymous, the new man may try either method. He sometimes eliminates the spiritual angle from the 12 suggested steps to recovery. And wholly relies upon honesty, tolerance, and working with others. But it is curious and interesting to note that faith always comes to those who try this simple approach with an open mind. And in the meantime, they stay sober. If, however, the spiritual content of the 12 steps is actively denied, they can seldom remain dry. That is our AA experience everywhere. We stress the spiritual simply because thousands of us have found we can't do without it. Foiled down, these steps mean simply A. Admission of alcoholism, C. Personality analysis and catharsis, C. Adjustment of personal relations, D. Dependence upon some higher power, E. Working with other alcoholics. Most strongly, we point out that adherence to these principles is not a condition of AA membership. Any alcoholic who admits he has a problem is an AA member regardless of how much he disagrees with the program. Faced upon our experience, the whole program is a suggestion only. The alcoholic, objecting at first to the spiritual factor, is urged to keep an open mind, meanwhile, treating his own AA group as a power greater than himself. Under these conditions, the newcomer commences to undergo an unhygienic therapy. Under these conditions, the newcomer commences to undergo an unhygienic therapy. Under these conditions, the newcomer commences to undergo a personality change at such a rate and of such dimensions that he cannot fully account for it on the basis of self-realization and self-discipline. Not only does his alcoholic obsession disappear, but he finds himself progressively free of fear, resentment, and inferiority. These changes seem to have come about almost automatically. Hence, he concludes that a power greater than himself must indeed have been at work. Having come to this point, he begins to form his own concept of God. He then develops confidence in that concept, which grows as he gets through in everyday life that his new faith actually works, really produces results. This is what most AAs are trying to say when they talk about a spiritual experience. They mean a certain quality of personality change, which, in their belief, could not have occurred without the help and presence of the creative spirit of the universe. With the average AA, many months may elapse before he is aware of faith in the spiritual sense. Yet I know scarcely an AA member of more than a year's standing who still thinks his transformation wholly a psychological phenomenon based entirely upon his own normal resources. Almost every one of our members will tell you that while he may not go along with a clergyman's life, he may not go along with a clergyman's life. He may not go along with a clergyman's concept of God. He has developed one of his own on which he can positively depend, one which works for him. We AAs are quite indifferent to what people may call the spiritual experience of ours. But to us, it looks very much like conversion, the very thing most alcoholics have sworn they never would have. In fact, I'm beginning to believe that we shall have to call it just that. For I know our good friend, Dr. Harry, Piedmont is sitting here in this room. As you may know, he is the psychiatrist who recently told his own professional society, the American Psychiatric Association, that what we AAs get is conversion, sure enough, and no bullying. And if the spirit of that great psychologist, William James, could be consulted, he'd doubtless refer us to his famous book, Varieties of Religious Experience, Where Personnel and Change Through Discipline. Through the educational variety of third-year experience or conversion is so ably explored. Whatever this mysterious process is, it certainly seems to work. And with us, who are on the way to the asylum or the undertaker, anything that works looks very, very good indeed. And I'm very happy to say that many other distinguished members of your profession have pronounced our 12 steps good medicine. Clergymen of all denominations say they are good religions. And, of course, we AAs like them because they do work. Most ardently, we hope that every physician here today will find themselves able to share this happy agreement. In the early years of AA, it seemed to us alcoholics that we wandered in a sort of no-man's land, which appeared to divide science and religion. But all that has changed since AA has now become a common meeting ground for both countries. And I'm very happy to share this with you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Yes, Alcoholics Anonymous is a cooperative venture. All cases requiring physical treatment are referred to your physician. We frequently work with the psychiatrist and often find that he can do and say things to a patient which we cannot. He, in turn, avails himself of the fact that as ex-alcoholics, we can sometimes walk in where he fears betrayed. Throughout the country, we are in daily touch with hospitals and sanatoriums, both public and private. The enthusiastic support given us by so many of the noted institutions is something for which we are deeply grateful. The opportunity to work with alcoholics means everything. For most of us, it means life itself. Without the chance to forget our own troubles by helping others out of theirs, we would certainly perish. That is the heart of AA. It is our life's life. We have learned that alcoholism is a complex melody. That abnormal drinking is but a symptom of personal maladjustment to life. That as a class, we alcoholics are apt to be sensitive, emotionally immature, grandiose in our demands upon ourselves and others. That we have usually gone broke on some dream ideal of perfection. That failing to realize the dream, we sensitive folks escape cold reality by taking to the bottle. That this habit of escape finally turns into an obsession, or as you gentlemen put it, a compulsion to drink. So subtly powerful that no disaster, however great, even near death or insanity, can in most cases seem to break it. But we are victims of the age-old alcoholic dilemma. Our obsession guarantees that we shall go on drinking, but our increasing physical sensitivity guarantees that we shall go insane or die if we do. When these facts, coming from the mouth of you gentlemen of science, are poured by an AA member into the person of another alcoholic, they strike deep. The effect is shattering. That inflated ego, those elaborate rationalizations by which our neurotic brain has been trying to erect self-sufficiency on a foundation of inferiority, begin to ooze out of him. Sometimes this depression is like the collapse of a toy balloon at the approach of a hot poker. But depression is just what we AAs are looking for. It is our universal experience that unless we can start depression, and so self-realization, we get nowhere at all. The more utterly we can smash the delusion that the alcoholic can get over alcoholism on his own, or that someday he may be able to drink, like a gentleman, the more successful we are bound to be. In fact, we aim to produce a crisis, to cause him to hit bottom, as AAs say. Of course, you will understand that this is all done by indirection. We never pronounce sentences, nor do we tell any alcoholic what he must do. We don't even tell him he is an alcoholic. Relating the seriousness of our own cases, we lead him to draw his conclusion. But once he has accepted the fact that he is an alcoholic, and the further fact that he is powerless to recover unaided, the battle is half won. As the AA's habit, he is hooked. He is caught, as if in a psychological vise. If the jaws of it do not grip him tightly enough at first, more drinking will almost invariably turn up the screw to the point where he will cry enough. Then, as we say, he is softened up. This, we do, as the AA says, is a state of complete dependence on whatever or whoever can stop his drinking. He is in exactly the same mental fix as a cancer patient who becomes dependent, abjectly dependent, if you will, on what you men of science do for cancer. Better still, he becomes sweetly reasonable, truly open-minded, as only the dying can be. Under these conditions, accepting the spiritual implications of the AA, the AA program, presents no difficulty even to the sophisticated. About half the AA members were once agnostics or atheists. This dispels the notion that we are effective only with the religiously susceptible. These are some of the basic factors which perhaps partly account for such success as we have had. I wish time permitted me to give you an intimate glimpse of our life together, of our meetings, of our social side, of those fast friendships unlike any we had known, before. Of our participation by thousands in the war effort and the armed services, where so many AAs are discovering they can face up to reality. No longer institutionalized, even within an AA group. We have found that God can be relied upon both in Alaska and India. The strength can come out of witness. That perhaps only those who have taken to the proof of reliance upon a higher power can fully understand the true meaning of the human spirit. Surely, you who are here this morning must realize how much we AAs are beholden to you. How much we have borrowed from you. How much we still depend upon you. For you have supplied us ammunition which we have used as your lay assistance. Gun pointers for your artillery. I have put out for inspection our version of the factors which bring about personality change, our methods of analysis, catharsis, and adjustment. I have tried to show you a little of our great new compelling interest in life. This society, where men and women understand each other, where the clamors of self are lost in our great common objective, where we can learn enough of patience, tolerance, honesty, humility, and service to subdue our former masters, insecurity, resentment, and unsatisfied dreams. Some, however, are sold out and have their last breath with this disdain of power. The first, then, is a wooly, lullabye. This is a behavioural pattern that is often misguided by the pseudonyms of power. Following are three comments by doctors. The first is by Foster Kennedy, M.D., a neurologist in New York City. We have heard a truly moving and eloquent address, moving in its form and in its facts. I have no doubt that a man who has cured himself of the lust for alcohol has a far greater power for curing alcoholism than has a doctor who has never been afflicted by the same curse of the lust for alcoholism. No matter how sympathetic and patient the doctor may be in the approach to his patient, the patient is sure either to feel or to imagine condensation for himself, or to get the notion that he is being hectored by one of the minor prophets. This organization of Alcoholics Anonymous calls on two of the greatest reservoirs of power known to man, religion, and that instinct for association with one's fellows, which Prater has called the Herd Instinct. Religious faith has been described by Matthew Arnold as a convinced belief in a power greater than ourselves that makes for righteousness, and the sense of helpfulness from this can be acquired through a kind of spiritual conversion which might well be called a variety of religious experience. The Sick Man The Sick Man's association with those who, having been sick, have become or are becoming well, is a therapeutic suggestion of cure, and an obliteration of his feeling of being in society a pariah, and his tapping of deep internal forces is shown by the great growth of this sturdy and beneficent movement. Furthermore, this movement furnishes an objective of high emotional driving power in making every cured drunkard a missionary to God. The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man The Sick Man appreciative conferences of this great therapeutic weapon. If we do not do so, we shall stand convicted of emotional sterility and of having lost the faith that moves mountains, without which medicine can do little. What do medical authorities think of AA? The next comment is by Carl Menninger, MD, of the Menninger Foundation. Also see a pamphlet, AA as a resource for the medical profession. Dr. Menninger's comment. In 1967, the American Medical Association stated that membership in AA was still the most effective means of treating alcoholism and quoted Dr. Ruth Hawk, an eminent authority on alcoholism and then medical director of the National Council on Alcoholism. With its thousands of groups and its 300,000 recovered alcoholics, now upwards of 1 million, AA has... undoubtedly reached more cases than all the rest of us together. For patients who can and will accept it, AA may be the only form of therapy needed. Dr. Manager continued, I have the utmost respect for the work AA is doing, for its spirit, for its essential philosophy of mutual helpfulness. I lose no opportunity to express my endorsement publicly and privately where it is of any concern. The final comment is by Marvin A. Block, MD, member of the American Medical Association's Committee on Alcoholism and Drug Dependence. Perhaps the most effective treatment in the rehabilitation of the alcoholic is a philosophy of living which is compatible with the individual and his family, and absorbing faith in himself which comes only after he has learned to understand himself, and a close association with others and their families. whose experiences parallel his own. The physician's cooperation with Alcoholics Anonymous is one way of obtaining these things for his patients. The third talk by Bill W. on the Society of Alcoholics Anonymous was a presentation to the American Psychiatric Association at its 105th annual meeting in Montreal, Quebec, May 1949. Following are excerpts from that address. Alcoholics Anonymous is grateful for this invitation to appear before the American Psychiatric Association. It is a most happy circumstance. Being laymen, we have naught but a story to tell, hence the quite personal and unscientific character of this narrative. Whatever their deeper implications, the attitudes and events leading to the formation of Alcoholics Anonymous are easy to predict. The speaker here describes his personal experience in achieving sobriety, his early, unsuccessful work with other alcoholics, and his eventual meeting in Akron, Ohio, in May 1935 with Dr. Bob S., who became the co-founder of Alcoholics Anonymous. When I left Akron in September 1935, three alcoholics were staying sober. Arrived in New York, I set to work, and another AA group took me to the hospital. I was in great shape, but nothing was very sure. We still flew blind. Then commenced the three-year season of trial and error, eventuating in our textbook, Alcoholics Anonymous, published in 1939. That book, now backbone of our AA society, opens with a typical story of drinking and recovery. Next comes a chapter of hope, entitled, There Is a Solution. In AA vernacular, two chapters describe alcoholism and the alcoholics, their object being, of course, to first identify and then be placed. A chapter is devoted to softening up the agnostic. This leads to the 12 steps of present-day Alcoholics Anonymous. The heart of our therapy and a practical way of life, these steps are little but an amplified and streamlined version of the principles enumerated by my friend of the kitchen. The balance of the text is mostly devoted to practical application of these 12 steps and to reducing inner resistances of the reader. Working with other alcoholics is very heavily emphasized. Chapters are devoted to wives, family relations, and employers. The final chapter pictures the new society and begs the recovered alcoholic to form a group himself. This ideology is a very important one. It is a very important one. It is a very important one. The story is then shored up by 30 case histories, or rather stories, written by AA members. These complete the identification and stir hope. The 400 pages of Alcoholics Anonymous contain no theory. They narrate experience only. When the book appeared in April 1939, we had about 100 members. One-third of these had impressive sobriety records. The movement, the movement had spread to Cleveland and drifted toward Chicago and Detroit. In the East, it inclined to Philadelphia and Washington. There was an extraordinary event at Cleveland. The Plain Dealer published strong pieces about us, backed by editorials. A barrage of telephone calls descended on 20 AA members, mostly new people. AA book in hand, they took on all comers. New members worked with the still newer. Two years later, Cleveland had garnered by this chain reaction hundreds of new members. The batting average was excellent. It was our first evidence that we might digest huge numbers rapidly. Then came great national publicity. The Saturday Evening Post piece, in March 1941, shot thousands of frantic inquiries into our tiny New York office. This gave us lists of alcoholics in hundreds. Businessmen traveling out of established AA centers used these names to start new groups. By sending literature and writing often, AA groups sprung up by mail. With no personal contact whatever, this was astounding. Clergy and medical men began to give their approval. I wish to say that Dr. Harry Tybaugh, chairman of our discussion today, was the first psychiatrist ever to write a book. The first to observe and befriend us. Alcoholics Anonymous Mushroom, the pioneering had ended, we were on the US map. The speaker here summarized the size of the society in 1949. Approximately 80,000 members and 3,000 groups in 30 countries, and its general composition. Bill W. continued, of alcoholics who stay with us and really try, a large percent get sober at once. and stay that way. Others do so after some relapses, and still others show improvement. But many problem drinkers do quit AA after a brief content, maybe three or four out of five. Some are too psychopathic or damaged, but the majority have powerful rationalizations yet to be broken down. Exactly this does happen, providing that they get what AA calls a good exposure on first contact. Alcohol then builds such a hot fire that they are finally driven back to us, often years later. These tell us that they had to return. It was AA or else. They had learned about alcoholism from alcoholics. They were hit harder than they had known. Such cases leave us the agreeable impression that half our original exposures will eventually recur, most of them to recover. So we just indoctrinate the newcomer. We never evangelize. Barleycorn will look after that. The clergy declare we have capitalized the devil. These claims are considerable, but we think them conservative. The ultimate recovery rate will certainly be larger than once supposed. Such is a glimpse of our origin. A central therapeutic idea and quantity result. The qualitative result is assuredly too large a subject for this paper. Alcoholics Anonymous is not a religious organization. There is no dogma. The one theological proposition is a power greater than oneself. Even this concept is forced on no one. The newcomer merely immerses himself in our society and tries the program as best he can. Left alone, he will surely report the gradual onset of a transforming experience. Call it what he may. Observers once thought AA could appeal only to the religiously susceptible. Yet our membership includes a former member of the American Atheist Society and about 20,000 others almost as tough. The dying can become remarkably open-minded. Of course, we seek little of conversion nowadays. because so many people really dread being God-bitten. But conversion, as broadly described by James, does seem to be our basic process. All other devices are but the foundation. When one alcoholic works with another, he but consolidates and sustains that essential experience. The forces of anarchy, democracy, and dictatorship play impressive roles in the structure and containment of our society. Barley Corn, the tyrant dictator, is quite impersonal, but Hitler never did have a Gestapo half so effective. When the anarchy of the alcoholic faces his tyrant, that alcoholic must become a social animal or perish. For force, our society has settled for the purest kind of democracy. Naturally, the explosive potential of our rather neurotic fellowship is enormous. As elsewhere, it gathers closely around those eternal provocateurs, power, money, and sex. Throughout AA, these subterranean volcanoes erupt at least a thousand times daily. Explosions we now view with some humor, considerable magnanimity, and little fear at all. We think them valuable object lessons for development. Our deep kinship, the urgency of our mission, the need to abate our neurosis for contented survival, all these are the most important things we can do. All these, together with love for God and man, have contained us in surprising unity. There seems safety in numbers. Enough sandbags muffle any amount of dynamite. We think we are a pretty secure, happy family. Drop by any AA meeting for a look. Many an alcoholic is now sent to AA by his own psychiatrist. Relieved of his drinking, he returns to the doctor a far easier subject. Practically every alcoholic's wife has become to a degree his possessive mother. Most alcoholic women, if they still have a husband, live with a baffled father. This sometimes spells trouble aplenty. We AAs certainly ought to know. Now to conclude. We of AA try to be aware that we may never touch but a segment of the total alcohol problem. We try to remember that our drinking habits and our growing success may prove a heady whine. That our own resources will always be limited. So then, will you men and women of medicine be our partners? Physicians will be well, your invisible scalpels. Workers all in our common cause. We like to think Alcoholics Anonymous a middle ground between medicine and religion. The missing catalyst of a new synthesis. This to the end, that the millions who still suffer, may presently issue from their darkness into the light of day. I am sure that none attending this great hall of medicine will feel it untoward if I leave the last word to our silent partner, religion. God grant us the serenity to accept the things we cannot change, courage to change the things we can, and wisdom to know the difference. Following are the 12 traditions of Alcoholics Anonymous. 1. Our common welfare should come first. Personal recovery depends upon AA unity. 2. For our group purpose, there is but one ultimate authority. A loving God, as he may express himself in our group conscience. Our leaders are but trusted servants. They do not govern. 3. The only requirement for AA membership is a desire to stop, stop drinking. Each group should be autonomous, except in matters affecting other groups or AA as a whole. 5. Each group has but one primary purpose, to carry its message to the alcoholic who still suffers. 6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige beverted from our primary purpose. 7. Every AA group ought to be fully self-supporting, declining outside contributions. 8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers. 9. AA as such ought never be organized, but we may create service boards or committees directly responsible to those they serve. 10. Alcoholics Anonymous has no opinion on outside issues. Hence, the AA name ought never be drawn into public controversy. 11. Our public relations policy is based on attraction, rather than promotion. We need always maintain personal anonymity at the level of press, radio, and films. 12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities. This completes Three Talks to Medical Societies by Bill W., Alcoholics Anonymous, World Services, Incorporated. Narrated by David Weiler at the Braille Institute, Los Angeles, California, in the year 1988.