Alcoholism – What’s It All About?

By bob k

“If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, you are probably alcoholic.”

This is one of the descriptions of alcoholism from the book “Alcoholics Anonymous,” referred to affectionately by AA members as the “Big Book.” Notably absent is any requirement for daily indulgence, morning drinking, hard liquor, unemployment, rubbing alcohol consumption, or any of the other characteristics stereotypically associated with alcoholism.

AA’s founders Bill Wilson, and Dr. Robert H. Smith were undeniably alcoholic. Problematic drinking had devastating consequences on their lives, in a multiplicity of ways. Wilson, a one-time successful stock analyst, by his mid-thirties was unemployable, surviving on his wife’s wages as a store clerk, and the generosity of his relatives. Brother-in-law Leonard Strong, a physician, financed four “rehabs” for Wilson at Towns Hospital, a New York facility specializing in the treatment of affluent alcoholics. Wilson was slipping into alcoholic insanity, while, forty pounds underweight, he was simultaneously dying of malnutrition.

Bob Smith was an Akron MD, a surgeon, with a practice that was plummeting as precipitously as his reputation. For over two years, his long-suffering wife, Anne, had  been dragging him to the altar of Christian salvation, but no miracle had been forthcoming.

Wilson’s first trip to Towns was followed by a period of sobriety. “It relieved me somewhat to learn that in alcoholics the will is amazingly weakened when it comes to combating liquor, though if often remains strong in other respects. My incredible behavior in the face of a desperate desire to stop was explained. Understanding myself now, I fared forth in high hope. For three or four months the goose hung high.”

Of course, Wilson drank again, as have millions of other alcoholics, men and women, young and old, rich and poor. Spouses, children, parents and employers are both frustrated and bewildered. The drinking (or drugging) has ceased for some significant period of time, “normality” seemingly has been restored, but the drinker returns to drink, or the drugger returns to drugs. Everyone is mystified, sometimes the alcoholic/addict himself.

At Towns Hospital, Bill Wilson met a psychiatrist, William Silkworth, who had dedicated his life in a sadly unproductive effort to rehabilitate drunks. Many left his care sober, with a new understanding of the malady, and with hope restored. Almost all drank again, most within a relatively short period of time. Success, defined by long-term sobriety, amounted to only about two percent of his cases.

Asked to contribute a “DOCTOR’S OPINION” to AA’s Big Book, first published 75 years ago, the  medical man wrote:

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.

Physiologically different

This returns us to the root problem of alcoholics, the lack of “control over the amount.” Silkworth called this as “the phenomenon of craving… a craving beyond their mental control.” Alcoholics talk about “having a couple,” but are almost totally lacking in the ability to drink moderately. Silkworth was convinced that alcoholics were physically different from the non-alcoholic majority of the population.

One hundred years earlier, an insightful Abraham Lincoln had remarked, “In my judgment such of us who have never fallen victims have been spared more by the absence of appetite than from any mental or moral superiority over those who have. Indeed, I believe if we take habitual drunkards as a class, their heads and their hearts will bear an advantageous comparison with those of any other class.”

The drunkard’s excess of appetite is not a mere moral weakness, but an actual physiological anomaly.

A mental obsession

Unfortunately, the sober alcoholic does NOT return to a state of normalcy, although outward appearances may fail to demonstrate a brewing discontent. Sobriety is a difficult thing to deal with for the untreated alcoholic, and produces, almost inevitably, an existential angst that at some point, pushes to the side all of his well-considered reasons for not drinking.

AA’s second step refers to being restored to sanity. Is the alcoholic insane?

Inasmuch as his thinking regarding drinking is concerned, AA thinks “yes.”

Again AA’s book tells us,

…the main problem of the alcoholic centers in his mind, rather than in his body. If you ask him why he started on that last bender, the chances are he will offer you any one of a hundred alibis. Sometimes these excuses have a certain plausibility, but none of them really makes sense in the light of the havoc an alcoholic’s drinking bout creates… If you draw this fallacious reasoning to the attention of an alcoholic, he will laugh it off, or become irritated and refuse to talk.

Once in a while he may tell the truth. And the truth, strange to say, is usually that he has no more idea why he took that first drink than you have. Some drinkers have excuses with which they are satisfied part of the time. But in their hearts they really do not know why they do it. Once this malady has a real hold, they are a baffled lot. There is the obsession that somehow, someday, they will beat the game. But they often suspect they are down for the count.

AA founder Bill Wilson had his last drink in December, 1934, just prior to his fourth detox at Towns Hospital, and about six weeks before his fortieth birthday. Through an association with a religious organization, the Oxford Group, Wilson’s new ideas of personal powerlessness, were augmented. Turning to God for help, clearing one’s conscience through confession and restitution to others for harm done, were seen as actions which could produce, in the alcoholic, a critical deflation of his childlike self-centeredness.

The most vital of Wilson’s discoveries was that healing comes in helping others.

Men helping themselves by helping others

Early in the twentieth century, two Episcopal ministers with doctorates in Psychology began an outreach to the disadvantaged of Boston. Among these, not surprisingly, were many alcoholics. In 1909, church member Ernest Jacoby, a prominent industrialist sponsored gatherings in the church’s basement, specifically for alcoholics. From a humble beginning of a mere six members, this fellowship of alcoholics grew rapidly, with the “Jacoby Club” separating from the “mother” group, the “Emmanuel Movement,” in 1913.

These Boston drunkards found that there was a strength in banding together with others of their ilk, and a great many gained, and maintained, sobriety. The group had weekly meetings, a mentoring program, relaxation techniques, and social events with food, drink and music. The Washingtonian Society had done something very similar in the 1840’s.

The Emmanuel philosophy was characterized by unflagging optimism, and an attempt to infuse positive thinking.

Reverends Worcester and McComb, the Emmanuel founders, were less dogmatic than the preponderance of their colleagues, and they encouraged the afflicted to call upon a “higher Spirit” for assistance. Although the Emmanuels had adopted a “soft-sell,” they were staunchly Christian. A loosening of the religious component of the approach followed the leave-taking of the alcoholics, to form their own distinct fellowship. Lack of success in the original conversion mission was counterbalanced by the efficacy of the rehabilitation enterprise.

The effectiveness of “passing it on” as a means of sustaining sobriety was realized by Worcester and McComb who lobbied for a simple plan of after-care. “Save thyself, save others. Having gained the farther shore, bring others over.”

Even more evocative of an AA that was still thirty years into the future, was the Jacoby Club’s formally adopted slogan, “A Club for Men to Help Themselves by Helping Others.”

AA’s core principle

“Bill’s Story” in the Big Book addresses this vital element:

My wife and I abandoned ourselves with enthusiasm to the idea of helping other alcoholics to a solution of their problems. It was fortunate, for my old business associates remained skeptical for a year and a half, during which I found little work. I was not too well at the time, and was plagued by waves of self-pity and resentment. This sometimes nearly drove me back to drink, but I soon found that when all other measure failed, work with another alcoholic would save the day.

AA is often called a “self-help” group, but more accurately it would be seen as a spiritual fellowship dealing in mutual aid.

In May of 1935, Wilson was five months sober and feeling shaky while out of town on a business trip to Akron, Ohio. A temptation to drink was powerful, and palpable. Seeking out another alcoholic to help, that in doing so, he might help himself, he was led to Dr. Bob Smith, who after a stumble achieved permanent sobriety in June of 1935. Smith also had had periods of sobriety earlier in his life. Months and months.

Contrary to the view of many in the public, and some in our media, these abstinences are not proof of the lack of alcoholism. Returns to drinking after such dry intervals are common, as the problem drinker is propelled toward “the sense of ease and comfort which comes at once by taking a few drinks.” Alcoholics drink too much when they drink – drunken stupors are common, and when they stop, they don’t “stay stopped,” even after professing a “come to Jesus moment.”

The medical community sometimes views alcoholics quite simply as people who continue to drink AFTER drinking has caused life problems.

Not just a river in Egypt

”Denial” is well understood in the modern world as it applies to alcoholism. “I just have a couple.” “I only drink on the weekends.” “I am never drunk at work.” “I don’t drink everyday.” “I don’t NEED it – I can take it or leave it.”

“I am not a perfect human being.”

A great many AA members have been regarding Mayor Ford as “one of us,” for quite some time. Many of us didn’t drink every day, and many retained prominent positions or boasted of stellar employment histories. But – “If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, you are probably alcoholic.”

Or, you have a “come to Jesus moment” that wears off in a couple of months.

Public misperceptions

Alcoholics Anonymous experienced explosive growth in the 1940’s and 1950’s, largely because of its success in enabling drunkards to maintain sobriety on a long-term basis. Ongoing abstinence is sustained in large part through the “purposefulness” of helping others, and a continuing communion with one’s fellows.

For centuries there have been, from time to time, spectacular “church cures” of the alcoholically afflicted. Sadly, a substantial percentage were not sustained, as the new fellow congregationalists of the redeemed failed to provide a feeling of “fitting in.” A square sober peg in a round dry hole.

To some degree, very old stereotypes of what it is to be an alcoholic persist in the public consciousness, and in the media. Until very recently, Mayor Ford was frequently spoken of on talk radio as a binge drinker, and not, as an alcoholic – the two descriptions seen, it seems, as mutually exclusive. Although it now appears to have been untrue, many Ford defenders have been heard making the claim that the mayor was never drunk at work, but only while “relaxing,” and “on his own time.” AA members understand that among alcoholics, there are a broad array of drinking patterns and behaviors. While some fall to the unfathomable depths, others rise to significant social positions in spite of their vice. These “functioning alcoholics,” understandably, are often seen to stubbornly adhere to their denial. Of course, the great writers, generals, princes, and Prime Ministers are not rendered less alcoholic by their worldly achievements.

The second looming misperception is about treatment. Brother Doug’s recent emotion-clogged speech wished for the mayor “a speedy recovery,” the naïve words of one who “doesn’t get it.” A rehab of 30, 60, or 90 days might be the beginning of something wonderful, although quite frankly, the math is dismal, but it doesn’t “fix” anyone.

I do look forward to the wealth of clichés forthcoming when the Ford campaign resumes.

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bob k. is an active Southern Ontario AA member, sober since 1991. He is working to complete a book of essays on the various people who influenced AA history.

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