William James, the 12 Steps, and Neuroplasticity

By Peter T.

When William Griffith Wilson died on January 24, 1971, he’d been sober 36 years.  By then AA’s co-founder, known to generations of grateful anonymous drunks as Bill W., was widely believed to be, even outside the fellowship, a man who understood sobering people up better than anyone else alive.

The rose-colored viewpoint of the famous article in the Saturday Evening Post, which effectively launched Alcoholics Anonymous worldwide, had not yet begun to fade, and the organization itself was widely touted as the most successful alcoholic treatment program of all time.

The news of Bill Wilson’s death, when anonymity no longer mattered, was published in the New York Times.

In 1935, not long after he got sober himself, Wilson searched out and counselled a boozy Akron, Ohio, MD named Robert Smith about how to quit drinking. Dr. Smith, reluctant at first, was willing to listen to another drunk, and when he eventually drank his last beer, on June 10, 1935, the event marked the birth of AA. Bill W. and “Dr. Bob” became co-founders.

Seven months earlier, religion had become a key element in Wilson’s sobriety. He’d had a dramatic spiritual awakening during yet another in a long series of attempts to get sober, this one in New York’s Town Hospital. When his alcoholic friend, Ebby Thacher, heard of his vision, he brought Bill a book by the great American psychologist, William James.

The book was The Varieties of Religious Experience, a collection of James’ much-heralded Gifford Lectures on Natural Religion, given by the celebrated psychologist at Edinburgh in 1901-1902. The day after his spiritual extravaganza, Bill started reading.

“By nightfall”, he wrote later, “this Harvard professor, long in his grave, had, without anyone knowing it, become a founder of Alcoholics Anonymous.” (My First Forty Years, Bill W., p. 151).

Bill’s friend Ebby had managed to get sober, at least temporarily, by attending meetings of the Oxford Group, a Christian movement which began at the British university of that name. Wilson himself, fresh from his own religious experience  and nothing loath, began going to Oxford Group meetings too.

AA and the Oxford Group parted company fairly early on, but many of the groups’ religious precepts linger on in the Twelve Steps, in the Big Book of “Alcoholics Anonymous”, in AA-approved literature, and in the very fibre of most AA meetings even eighty years later.

William James is, as Bill Wilson himself recognized, one of the original pillars of AA. And in a subtle but meaningful way, I believe he is also part of the reason why many agnostics, atheists and freethinkers, despite the program’s religious overtones, remain loyal and dedicated AA members today.

In 1890, William James is believed to have presented the first theory of neuroplasticity to the world in his two volume book, The Principles of Psychology. He didn’t call it neuroplasticity, but his meaning was clear. James was the first person to have pointed out that the human brain was malleable, and capable of reorganizing.

This theory has revolutionized neurological science, particularly in the 21st century. It means that we are no longer stuck with the brain we were born with, or with those long established mental and physical behaviours we sometimes refer to as “habits”. The brain is infinitely pliable and adaptable, and can change itself, even without prompting from its owner, if conditions dictate.

We have long understood that blind people rely more heavily on other senses, like hearing and touch, to compensate for their lack of sight. But the evidence suggests that this is not simply a learned response. The brain automatically rewires itself so that the sensory area usually responsible for handling sight information is pressed into service to handle sounds, for example.

In his fascinating book, “Musicophilia”, neurologist Oliver Sacks told of a study which found that 60 percent of blind musicians had “absolute”, or perfect pitch, as opposed to perhaps 10 percent among sighted musicians.

To do this, the brain opens up new “neural pathways” to its appropriate parts. The word pathways refers to the routes taken by data passing from neuron to neuron through electrical connections between them. “Neurons that fire together, wire together”’ is the way neuroscientists put it. Pathways effectively become cognitive wiring.

Other kinds of stimuli can promote the growth of new neural pathways that do more harm than good. For example, excess alcohol  changes the brain in ways that make it increasingly difficult for the alcoholic to stop drinking.

Long after the consumption of alcohol has ceased to be a pleasant experience, the alcoholic brain’s well-lubricated neural pathways continue to tell the inebriate that another drink will fix everything. That’s certainly the way it was in my case.

Despite the hangovers, the shakes, and the outrage of neglected and abused wives and husbands and friends, not to mention going broke and getting into trouble at work, our liquor-soaked neural pathways go on steering us to the untenable conclusion that life without alcohol would be pretty grim.

Norman Doidge, M.D., the Canadian neurologist whose book The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science burst on the scene in 2007, writes as follows:

“The usual view is that the addict goes back for more of his  fix because he likes the pleasure it gives and doesn’t like the pain of withdrawal. But addicts take drugs when there is no prospect of pleasure…”

When I think carefully about my own struggles with alcohol, I can see how the kind of neuroplasticity discussed above brought me to the edge of the abyss. But more important now, I can also see how it pulled me back from the brink.

Like many elderly people I have recently had problems getting enough sleep. I wound up in an overnight sleep lab last summer, where my sleep patterns were carefully analyzed. It became clear that I had a mild case of “positional” sleep apnea – it was worse on my back. A CPAP (Continuous Positive Airways Pressure) machine was prescribed to deal with it. It worked, and still works beautifully. The quality of my slumber improved enormously. But I still couldn’t get much more than about five hours of sleep.

Earlier, I had come across a book on Cognitive Behavioural Therapy-Insomnia (or CBT-I), called Sink Into Sleep by Judith Davidson, PhD, which helped me to understand that another part of the problem might be bad sleep habits.

For habits, read unhelpful neural pathways.

Here, in my words, is Dr. Davidson’s six step program to restore sleep.

1. Your attitude towards your bed is critical. It is not for reading, eating, listening to music, watching television or lying there, resting. Use it only for actual sleep, or having sex.
2. If you are used to going to bed early, pick a much later bedtime so that you are really tired before you turn out the light.
3. If you wake in the night and can’t return to sleep in 15 minutes, get up and stay up until you’re tired again, and then go back to bed. And, if necessary, repeat the procedure.
4. Pick a workable time to get up, and get out of bed in the morning as soon as you wake. Or, if it’s before the alarm, and you can’t get back to sleep after 15 minutes, get up without lingering.
5. If you feel short of sleep the next day, nap after lunch for no more than an hour as long as it is before 3 p.m.
6. Keep a sleep diary, and provided you are sleeping longer, incrementally, you may start going to bed earlier, bit by bit, as your sleep time lengthens.

For me, the altered neural pathway that these suggestions have produced means an extra hour or two of sleep per day.

I sometimes wonder if the sophisticated critics who have labelled AA  a religious cult have any real idea of how the program works. I suspect that they, like some of the alcoholics who can’t seem to get sober in AA, are distracted  by details.

As we are in a position to know, some people are put off by all the “God” references. Others find the slogans Mickey Mouse, and the words of wisdom heard around the rooms mere gobbledygook. These people may find some of our pronouncements less than profound, and annoyingly trivial. I think they miss the point.

Like those earnest, usually older members who walk around clutching copies of the Big Book bristling with bookmarks, every  page a rainbow of highlights, all of the characters and sayings and rituals help provide an upbeat sober ambience and enhance the effectiveness of our primary weapon against alcoholism, the AA meeting.

When alcoholics become members of AA, they’re not just joining an organization. They’re adopting a whole new culture, guaranteed, as we used to say, to spoil their drinking. Friendships made in AA rival blood ties with relatives. In a sense they are like the relationships established by comrades-in-arms on the battlefield. They’re rooted in shared fear, misery and in having been to hell and back together.

As Dr. Doidge writes,

All addiction involves long-term, sometimes lifelong, neuroplastic change in the brain. For addicts, moderation is impossible, and they must avoid the substance or activity completely if they are to avoid addictive behaviours.

Alcoholics Anonymous insists that there are no “former alcoholics” and makes people who haven’t had a drink for decades introduce themselves at a meeting by saying “My name is John, and I am an alcoholic”. In terms of plasticity, they are often correct.

I now realize that the Twelve Steps, with or without God in them, can also be considered a Cognitive Behavioural Therapy program for Alcoholism, or CBT-A, to invent an acronym.

But it isn’t just the steps that help us make cognitive changes. Everything we do and say and and come to know in this unique culture contributes to the formation of neural pathways designed for sobriety.

Take the slogans, for example, which vary from meeting to meeting:

One Day at a Time; First Things First; You are no Longer Alone; Keep it Simple; Easy Does It; Remember When; Live and Let Live; Keep an Open Mind; Keep Coming Back; and last, but not least for many AA members, Let Go and Let God; and But for the Grace of God. These words become embedded in our sobriety.

And then there are the simple truths, heard around the rooms, that if uttered in the right place and at the right time can have the impact of a sledgehammer. I’ll quote just one example from Joe C’s Beyond Belief, the basis of his January 4 entry: “You will never wake up sober and wish you had a drink last night”.

They all, in capsule form, remind us of the new paths we must travel to get or hang on to sobriety. So do the chips we give out,  the most important  for a simple desire to stop drinking, and others for the number of months we have lasted on our way to a cake and a first year medallion. Any fuss we make reinforces the  wonderful fellowship of sobriety. And  familiar readings comfort us.

I have learned, over the years, to blur out the “G” word in the usual readings and concentrate on the encouraging overall thrust of the message. I once had a boss who knew he had good ideas but couldn’t articulate them as he would have liked,  so he’d wrap up his suggestion by saying “not those words, but that music”. We usually got the idea.

I often think of my old Toronto friend, “Mac” R, a TV producer, painter and sculptor, and merchant seaman during the Second World War. He died sober after more than 30 years of being an atheist in AA, and he always recognized the need to change, not just goals and behaviour, but how we envisaged ourselves in our new roles.

“I had to stop thinking of myself as a two-fisted drinker”, he once told me, “and think of myself as a two-fisted non-drinker”. I was just a booze-fighter of the one-fisted variety, one-fisted for pounding the table and smashing inanimate crockery, but I got Mac’s message. Change!

I am not yet home and dry, as the saying goes. But I love life and find I am more and more conscious of how much I have to be grateful for. As Marya Hornbacher points out in Waiting: A Nonbelievers Higher Power, feeling grateful is a form of prayer, despite the absence of an addressee.

I remember the sharp intakes of breath in Toronto AA meetings 40 years ago whenever a frequent speaker of the day would begin his trademark declaration; “My name is so-and-so and I will never drink again…” followed by a calculated pause and a broad grin, and then the final words, “… as long as I follow the Twelve Steps of the AA program”.

So it is with some misgiving that I say now that I don’t believe the neural pathway I now follow will ever allow me to drink again, any more than the old one influenced me to quit.  I am not the same person I used to be, so perhaps I can get away with it.

In the 1950’s, in New York, I interviewed a Hollywood actor named Forrest Tucker – well known for his tough guy roles. Over lunch, he told me he was an advocate of the fad adage of the moment, “You Are What You Eat”.

“I’d rather be a steak than a cream puff”, I remember him saying.

Well, in AA, perhaps, it could be said “We Are What We Drink”. If so, I can honestly say “I’d rather be a glass of freshly squeezed orange juice than a vodka martini”. And if that isn’t evidence of radical neurological change, I’d like to know what is.

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