                       ALCOHOLICS

                        ANONYMOUS
     ------------------------------------------------

                      The Story of

           How Many Thousands of Men and Women

             Have Recovered from Alcoholism


                 NEW AND REVISED EDITION












     ------------------------------------------------

        ALCOHOLICS ANONYMOUS WORLD SERVICES, INC.
                      NEW YORK CITY
                          1955

                        CONTENTS

Chapter                                                     Page
     Preface                                                  xi

     Foreword to First Edition                              xiii

     Foreword                                                 xv

     The Doctor's Opinion                                  xxiii

  1  Bill's Story                                              1

  2  There Is a Solution                                      17

  3  More About Alcoholism                                    30

  4  We Agnostics                                             44

  5  How It Works                                             58

  6  Into Action                                              72

  7  Working with Others                                      89

  8  To Wives                                                104

  9  The Family Afterward                                    122

 10  To Employers                                            136

 11  A Vision for You                                        151


                    PERSONAL STORIES

                    Pioneers of A.A.

     Doctor Bob's Nightmare                                  171
       A co-founder of Alcoholics Anonymous.  The
     birth of our society dates from his first day of
     permanent sobriety, June 10, 1935.
                            v
vi                      CONTENTS

                                                            Page
  1  Alcoholics Anonymous Number Three                       182
       Pioneer member of Akron's Group No. 1, the first
     A.A. group in the world.  He kept the faith; there-
     fore, he and countless others found a new life.

  2  He Had To Be Shown                                      193
       "Who is convinced against his will is of the same
     opinion still."  But not this man.

  3  He Thought He Could Drink Like a Gentle-
       Man                                                   210
       But he discovered that there are some gentlemen
     who can't drink.

  4  Women Suffer Too                                        222
       Despite great opportunities, alcohol nearly ended
     her life.  Early member, she spread the word among
     women in our pioneering period.

  5  The European Drinker                                    230
       Beer and wine were not the answer.

  6  The Vicious Cycle                                       238
       How it finally broke a Southerner's obstinacy and
     destined this salesman to start A.A. in Philadelphia.

  7  The News Hawk                                           251
       This newsman covered life from top to bottom;
     but he ended up, safely enough, in the middle.

  8  From Farm to City                                       261
       She tells how A.A. works when the going is
     rough.  A pioneer woman member of A.A.'s first
     group.

  9  The Man Who Mastered Fear                               275
       He spent eighteen years in running away; and
     then found he didn't have to run.  So he started
     A.A. in Detroit.
                        CONTENTS                  vii

                                                            Page
 10  He Sold Himself Short                                   287
       But he found that there was a Higher Power
     which had more faith in him than he had in him-
     self.  Thus, A.A. was born in Chicago.

 11  Home Brewmeister                                        297
       An originator of Cleveland's Group No. 3, this
     one fought Prohibition in vain.

 12  The Keys of the Kingdom                                 304
       This worldly lady helped to develop A.A. in Chi-
     cago and thus passed on her keys to many.


                      They Stopped in Time

  1  Rum, Radio and Rebellion                                317
       This man faced the last ditch when his wife's
     voice from 1300 miles away sent him to A.A.

  2  Fear of Fear                                            330
       This lady was cautious.  She decided she
     wouldn't let herself go in her drinking.  And she
     would never, never take that morning drink!

  3  The Professor and the Paradox                           336
       Says he, "We A.A.'s surrender to win; we give
     away to keep; we suffer to get well, and we die to
     live."

  4  A Flower of the South                                   343
       Somewhat faded, she nevertheless bloomed
     afresh. She still had her husband, her home and a
     chance to help start A.A. in Texas.

  5  Unto the Second Generation                              355
       A young veteran tells how a few rough experi-
     ences pushed him into A.A.--and how he was there-
     fore spared years of suffering.
viii               CONTENTS

                                                            Page
  6  His Conscience                                          365
       It was the only part of him that was soluble in
     alcohol.

  7  The Housewife Who Drank at Home                         375
       She hid her bottles in the clothes hampers and in
     the dresser drawers.  She realized what she was be-
     coming.  In A.A. she discovered she had lost noth-
     ing and had found everything.

  8  It Might Have Been Worse                                382
       Alcohol was a looming cloud in this banker's
     bright sky.  With rare foresight he realized it could
     become a tornado.

  9  Physician, Heal Thyself!                                393
       Psychiatrist and surgeon, he had lost his way until
     he realized that God, not he, was the Great Healer.

 10  Stars Don't Fall                                        401
       A titled lady, her chief loss was self-respect.
     When the overcast lifted, the stars were there as
     before.

 11  Me, an Alcoholic?                                       419
       Barleycorn's wringer squeezed this author--but
     he escaped quite whole.

 12  New Vision for a Sculptor                               426
       His conscience hurt him as much as his drinking.
     But that was years ago.


                      They Lost Nearly All

  1  Joe's Woes                                              445
       These were only beginning when he hit Bellevue
     for the thirty-fifth time.  He still had the state hos-
     pital ahead of him; and even after A.A., a heart-
     breaking test of his new-found faith.
                        CONTENTS                  ix

                                                            Page
  2  Our Southern Friend                                     460
       Pioneer A.A., minister's son, and southern farmer,
     "Who am I," said he, "to say there is no God?"

  3  Jim's Story                                             471
       This physician, the originator of A.A.'s first col-
     ored group, but badly caught in the toils, tells of
     his release and of how freedom came as he worked
     among his own people.

  4  Promoted to Chronic                                     485
       This career girl preferred solitary drinking, the
     blackout kind, often hoping she'd stay that way for
     keeps.  But Providence had other ideas.

  5  The Prisoner Freed                                      495
       After twenty years in prison for murder, he knew
     A.A. was the spot for him...if he wanted to stay
     on the outside.

  6  There's Nothing the Matter with Me!                     499
       That's what the man said as he hocked his shoes
     for the price of two bottles of Sneaky Pete.  He
     drank bayzo, canned heat, and shoe polish.  He did
     a phony routine in A.A. for a while.  And then he
     got hold of the real thing.

  7  Desperation Drinking                                    509
       He was drinking to hold on to his job, to hold on
     to his wife, to hold on to his sanity.  Finally he was
     drinking to keep away from those little men, and those
     strange voices, and the organ music that came out
     of the walls.

  8  Annie the Cop Fighter                                   514
       For thirty-five years she fought God, man, and the
     police force to keep on being what she wanted to 
     be--a drunk.  But a telephone call from a gin mill
x                       CONTENTS

                                                            Page
     where she was celebrating Mother's Day brought
     in the nosey A.A.'s to change her life.

  9  The Career Officer                                      523
       A British officer, this Irishman--that is, until
     brandy "retired" him.  But this proved only a tem-
     porary set-back.  He survived to become a main-
     stay of A.A. in Eire.

 10  The Independent Blonde                                  532
       The lady was blonde, self-supporting, and self-
     sufficient.  Then she began slamming doors, kicking
     shins, and waking up in psychopathic wards.  At
     last the day came when all this changed.

 11  He Who Loses His Life                                   540
       An ambitious playwright, his brains got so far
     ahead of his emotions that he collapsed into sui-
     cidal drinking.  To learn to live, he nearly died.

 12  Freedom from Bondage                                    553
       Young when she joined, this A.A. believes her
     serious drinking was the result of even deeper de-
     fects.  She here tells how she was set free.

     Appendices                                              563
       1. The A.A. Tradition
       2. Spiritual Experience
       3. The Medical View of A.A.
       4. The Lasker Award
       5. The Religious View on A.A.
       6. How to Get in Touch with A.A.



                         PREFACE

   THIS IS the second edition of the book "Alcoholics
Anonymous," which made its first appearance in
April 1939.  More than 300,000 copies of the first
edition are now in circulation.

   Because this book has become the basic text for our
Society and has helped such large numbers of alcoholic
men and women to recovery, there exists a sentiment
against any radical changes being made in it.  There-
fore, the first portion of this volume, describing the
A.A. recovery program, has been left largely un-
touched.

   But the personal history section has been consider-
ably revised and enlarged in order to present a more
accurate representation of our membership as it is
today.  When the book was first printed, we had
scarcely 100 members all told, and every one of them
was an almost hopeless case of alcoholism.  This has
changed.  A.A. now helps alcoholics in all stages of
the disease.  It reaches into every level of life and
into nearly all occupations.  Our membership now
includes many young people.  Women, who were at
first very reluctant to approach A.A., have come for-
ward in large numbers.  Therefore the range of the
story section has been broadened so that every alco-
holic reader may find a reflection of him or herself
in it.

   As a souvenir of our past, the original Foreword has
                               xi
xii                      PREFACE

been preserved and is followed by a second on de-
scribing Alcoholics Anonymous of 1955.

   Following the Forewords, there appears a section
called "The Doctor's Opinion."  This also has been
kept intact, just as it was originally written in 1939 by
the late Dr. William D. Silkworth, our Society's great
medical benefactor.  Besides Dr. Silkworth's original
statement, there have been added, in the Appendices,
a number of the medical and religious endorsements
which have come to us in recent years.

   On the last pages of this second edition will be
found the Twelve Traditions of Alcoholics Anony-
mous, the principles upon which our A.A. groups
function, together with the directions for getting in touch
with A.A.

             FOREWORD TO THE FIRST EDITION 

    This is the Foreword as it appeared in the first
          printing of the first edition in 1939

   WE, OF Alcoholics Anonymous, are more
than one hundred men and woman who have re-
covered from a seemingly hopeless state of mind and
body.  To show other alcoholics PRECISELY HOW WE
HAVE RECOVERED is the main purpose of this book.  For
them, we hope these pages will prove so convincing
that no further authentication will be necessary.  We
think this account of our experiences will help every-
one to better understand the alcoholic.  Many do not
comprehend that the alcoholic is a very sick person.
And besides, we are sure that our way of living has
its advantages for all.

   It is important that we remain anonymous because
we are too few, at present to handle the overwhelm-
ing number of personal appeals which may result
from this publication.  Being mostly business or pro-
fessional folk, we could not well carry on our occupa-
tions in such an event.  We would like it understood
that our alcoholic work is an avocation.

   When writing or speaking publicly about alcohol-
ism, we urge each of our Fellowship to omit his
personal name, designating himself instead as "a
member of Alcoholics Anonymous."

   Very earnestly we ask the press also, to observe this
request, for otherwise we shall be greatly handi-
capped.

   We are not an organization in the conventional
                          xiii
xiv           FOREWORD TO THE FIRST EDITION

sense of the word.  There are no fees or dues what-
soever.  The only requirement for membership is an
honest desire to stop drinking.  We are not allied with
any particular faith, sect or denomination, nor do we
oppose anyone.  We simply wish to be helpful to those
who are afflicted.

   We shall be interested to hear from those who are
getting results from this book, particularly form those
who have commenced work with other alcoholics.  We
should like to be helpful to such cases.

   Inquiry by scientific, medical, and religious societies
will be welcomed.

                                   ALCOHOLICS ANONYMOUS

               FOREWORD TO SECOND EDITION

   SINCE the original Foreword to this book was
written in 1939, a wholesale miracle has taken
place.  Our earliest printing voiced the hope "that
every alcoholic who journeys will find the Fellowship
of Alcoholics Anonymous at his destination.  Already,"
continues the early text, "twos and threes and fives of
us have sprung up in other communities."

   Sixteen years have elapsed between our first printing
of this book and the presentation of 1955 of our second
edition.  In that brief space, Alcoholics Anonymous
has mushroomed into nearly 6,000 groups whose mem-
bership is far above 150,000 recovered alcoholics.
Groups are to be found in each of the United States
and all of the provinces of Canada.  A.A. has flourish-
ing communities in the British Isles, the Scandinavian
countries, South Africa, South America, Mexico,
Alaska, Australia and Hawaii.  All told, promising
beginnings have been made in some 50 foreign coun-
tries and U.S.  possessions.  Some are just now taking
shape in Asia.  Many of our friends encourage us by
saying that this is but a beginning, only the augury of
a much larger future ahead.

   The spark that was to flare into the first A.A. group
was struck at Akron, Ohio in June 1935, during a talk
between a New York stockbroker and an Akron
physician.  Six months earlier, the broker had been
relieved of his drink obsession by a sudden spiritual

                           xv
xvi                     FOREWORD

experience, following a meeting with an alcoholic
friend who had been in contact with the Oxford
Groups of that day.  He had also been greatly helped
by the late Dr.  William D.  Silkworth, a New York
specialist in alcoholism who is now accounted no less
than a medical saint by A.A. members, and whose
story of the early days of our Society appears in the
next pages.  From this doctor, the broker had learned
the grave nature of alcoholism.  Though he could not
accept all the tenets of the Oxford Groups, he was
convinced of the need for moral inventory, confession
of personality defects, restitution to those harmed,
helpfulness to others, and the necessity of belief in and
dependance upon God.  

   Prior to his journey to Akron, the broker had worked
hard with many alcoholics on the theory that only an
alcoholic could help an alcoholic, but he had suc-
ceeded only in keeping sober himself.  The broker had
gone to Akron on a business venture which had
collapsed, leaving him greatly in fear that he might
start drinking again.  He suddenly realized that in
order to save himself he must carry his message to
another alcoholic.  That alcoholic turned out to be
the Akron physician.

   This physician had repeatedly tried spiritual means
to resolve his alcoholic dilemma but had failed.  But
when the broker gave him Dr.  Silkworth's description
of alcoholism and its hopelessness, the physician began
to pursue the spiritual remedy for his malady with a
willingness he had never again up to the moment of
his death in 1950.  This seemed to prove that one
alcoholic could affect another as no nonalcoholic
                        FOREWORD                  xvii

could.  It also indicated that strenuous work, one
alcoholic with another, was vital to permanent re-
covery.

   Hence the two men set to work almost frantically
upon alcoholics arriving in the ward of the Akron
City Hospital.  Their very first case, a desperate one,
recovered immediately and became A.A. number
three.  He never had another drink.  This work at
Akron continued through the summer of 1935.  There
were many failures, but there was an occasional heart-
ening success.  When the broker returned to New York
in the fall of 1935, the first A.A. group had actually
been formed, though no one realized it at the time.

   A second small group promptly took shape at New
York, to be followed in 1937 with the start of a third
at Cleveland.  Besides these, there were scattered
alcoholics who had picked up the basic ideas in Akron
or New York who were trying to form groups in other
cities.  By late 1937, the number of members having
substantial sobriety time behind them was sufficient
to convince the membership that a new light had
entered the dark world of the alcoholic.

   It was now time, the struggling groups thought, to
place their message and unique experience before the
world.  This determination bore fruit in the spring of
1939 by the publication of this volume.  The member-
ship had then reached about 100 men and women.
The fledgling society, which had been nameless, now
began to be called Alcoholics Anonymous, from the
title of its own book.  The flying-blind period ended
and A.A. entered a new phase of its pioneering time.

   With the appearance of the new book a great deal
began to happen.  Dr.  Harry Emerson Fosdick, the
xviii                   FOREWORD

noted clergyman, reviewed it with approval.  In the
fall of 1939 Fulton Oursler, the editor of "Liberty,"
printed a piece in his magazine, called "Alcoholics and
God."  This brought a rush of 800 frantic inquiries
into the little New York office which meanwhile had
been established.  Each inquiry was painstakingly
answered; pamphlets and books were sent out.  Busi-
nessmen, traveling out of existing groups, were
referred to these prospective newcomers.  New groups
started up and it was found, to the astonishment of
everyone, that A.A.'s message could be transmitted in
the mail as well as by word of mouth.  By the end of
1939 it was estimated that 800 alcoholics were on
their way to recovery.

   In the spring of 1940, John D. Rockefeller, Jr. gave
a dinner for many of his friends to which he invited
A.A. members to tell their stories.  News of this got on
the world wires; inquiries poured in again and many
people went to the bookstores to get the book "Alco-
holics Anonymous."  By March 1941 the membership
had shot up to 2,000.  Then Jack Alexander wrote a
feature article in the "Saturday Evening Post" and
placed such a compelling picture of A.A. before the
general public that alcoholics in need of help really
deluged us.  By the close of 1941, A.A. numbered 8,000
members.  The mushrooming process was in full swing,
A.A. had become a national institution.

   Our Society then entered a fearsome and exciting
adolescent period.  The test that it faced was this:
Could these large numbers of erstwhile erratic alco-
holics successfully meet and work together?  Would
there be quarrels over membership, leadership and
money?  Would there be strivings for power and
                        FOREWORD                  xix

prestige?  Would there be schisms which would split
A.A. apart?  Soon A.A. was beset by these very prob-
lems on every side and in every group.  But out of this
frightening and at first disrupting experience the con-
viction grew that A.A.'s had to hang together or die
separately.  We had to unify our Fellowship or pass
off the scene.

   As we discovered the principles by which the indi-
vidual alcoholic could live, so we had to evolve prin-
ciples by which the A.A. groups and A.A. as a whole
could survive and function effectively.  It was thought
that no alcoholic man or woman could be excluded
from our Society; that our leaders might serve but
not govern; that each group was to be autonomous
and there was to be no professional class of therapy.
There were to be no fees or dues; our expenses were
to be met by our own voluntary contributions.  There
was to be the least possible organization, even in our
service centers.  Our public relations were to be based
upon attraction rather than promotion.  It was decided
that all members ought to be anonymous at the level
of press, radio, TV and films.  And in no circumstances
should we give endorsements, make alliances, or enter
public controversies.  
   This was the substance of A.A.'s Twelve Traditions,
which are stated in full on page 564 of this book.
Though none of these principles had the force of rules
or laws, they had become so widely accepted by 1950
that they were confirmed by our first International
Conference held at Cleveland.  Today the remarkable
unity of A.A. is one of the greatest assets that our
Society has.  
   While the internal difficulties of our adolescent
xx                      FOREWORD

period were being ironed out, public acceptance of
A.A. grew by leaps and bounds.  For this there were
two principal reasons: the large numbers of recoveries,
and reunited homes.  These made their impressions
everywhere.  Of alcoholics who came to A.A. and
really tried, 50% got sober at once and remained that
way; 25% sobered up after some relapses, and among
the remainder, those who stayed on with A.A. showed
improvement.  Other thousands came to a few A.A.
meetings and at first decided they didn't want the
program.  But great numbers of these--about two out
of three--began to return as time passed.

   Another reason for the wide acceptance of A.A. was
the ministration of friends--friends in medicine,
religion, and the press, together with innumerable
others who became our able and persistent advocates.
Without such support, A.A. could have made only the
slowest progress.  Some of the recommendations of
A.A.'s early medical and religious friends will be found
further on in this book.

   Alcoholics Anonymous is not a religious organiza-
tion.  Neither does A.A. take any particular medical
point of view, though we cooperate widely with the
men of medicine as well as with the men of religion.

   Alcohol being no respecter of persons, we are an
accurate cross section of America, and in distant lands,
the same democratic evening-up process is now going
on.  By personal religious affiliation, we include Catho-
lics, Protestants, Jews, Hindus, and a sprinkling of
Moslems and Buddhists.  More than fifteen per cent
of us are women.

   At present, our membership is increasing at the
rate of about seven per cent a year.  So far, upon the
                        FOREWORD                  xxi

total problem of several million actual and potential
alcoholics in the world, we have made only a scratch.
In all probability, we shall never be able to touch more
than a fair fraction of the alcohol problem in all its
ramifications.  Upon therapy for the alcoholic himself,
we surely have no monopoly.  Yet it is our great hope
that all those who have as yet found no answer may
begin to find one in the pages of this book and will
presently join us on the high road to a new freedom.

                  THE DOCTOR'S OPINION

   WE OF Alcoholics Anonymous believe that the
reader will be interested in the medical esti-
mate of the plan of recovery described in this book.
Convincing testimony must surely come from medical
men who have had experience with the sufferings of
our members and have witnessed our return to health.
A well-known doctor, chief physician at a nationally
prominent hospital specializing in alcoholic and drug
addiction, gave Alcoholics Anonymous this letter:

  To Whom It May Concern:

    I have specialized in the treatment if alcoholism
  for many years.

    In late 1934 I attended a patient who, though he had
  been a competent businessman of good earning ca-
  pacity, was an alcoholic of a type I had come to regard
  as hopeless.

    In the course of his third treatment he acquired cer-
  tain ideas concerning a possible means of recovery.  As
  part of his rehabilitation he commenced to present his
  conceptions to other alcoholics, impressing upon them
  that they must do likewise with still others.  This has
  become the basis of a rapidly growing fellowship of
  these men and their families.  This man and over one
  hundred others appear to have recovered.

    I personally know scores of cases who were of the
  type with whom other methods had failed completely.

    These facts appear to be of extreme medical impor-
  tance; because of the extraordinary possibilities of rapid
                          xxiii
xxiv              THE DOCTOR'S OPINION

  growth inherent in this group they may mark a new
  epoch in the annals of alcoholism.  These men may
  well have a remedy for thousands of such situations. 

    You may rely absolutely on anything they say about
  themselves.
                    Very truly yours,
                         William D.  Silkworth, M.D. 

   The physician who, at our request, gave us this let-
ter, has been kind enough to enlarge upon his views in
another statement which follows.  In this statement he
confirms what we who have suffered alcoholic torture
must believe--that the body of the alcoholic is quite as
abnormal as his mind.  It did not satisfy us to be told
that we could not control our drinking just because we
were maladjusted to life, that we were in full flight
from reality, or were outright mental defectives.  These
things were true to some extent, in fact, to a consider-
able extent with some of us.  But we are sure that our
bodies were sickened as well.  In our belief, any pic-
ture of the alcoholic which leaves out this physical
factor is incomplete.

   The doctor's theory that we have an allergy to al-
cohol interests us.  As laymen, our opinion as to its
soundness may, of course, mean little.  But as ex-
problem drinkers, we can say that his explanation
makes good sense.  It explains many things for which
we cannot otherwise account.

   Though we work out our solutions on the spiritual as
well as an altruistic plane, we favor hospitalization for
the alcoholic who is very jittery or befogged.  More
often than not, it is imperative that a man's brain be
cleared before he is approached, as he has then a bet-
                  THE DOCTOR'S OPINION            xxv

ter chance of understanding and accepting what we
have to offer.

   The doctor writes:

    The subject presented in this book seems to me to be of
  paramount importance to those afflicted with alcoholic
  addiction.

    I say this after many years' experience as Medical
  Director of one of the oldest hospitals in the country treat-
  ing alcoholic and drug addiction.

    There was, therefore, a sense of real satisfaction when I
  was asked to contribute a few words on a subject which is
  covered in such masterly detail in these pages.

    We doctors have realized for a long time that some form
  of moral psychology was of urgent importance to alcoholics,
  but its application presented difficulties beyond our concep-
  tion.  What with our ultra-modern standards, our scientific
  approach to everything, we are perhaps not well equipped
  to apply the powers of good that lie outside our synthetic
  knowledge.

    Many years ago one of the leading contributors to this
  book came under our care in this hospital and while here
  he acquired some ideas which he put into practical applica-
  tion at once. 

    Later, he requested the privilege of being allowed to tell
  his story to other patients here and with some misgiving,
  we consented.  The cases we have followed through have
  been most interesting: in fact, many of them are amazing.
  The unselfishness of these men as we have come to know
  them, the entire absence of profit motive, and their com-
  munity spirit, is indeed inspiring to one who has labored
  long and wearily in this alcoholic field.  They believe in
  themselves, and still more in the Power which pulls chronic
  alcoholics back from the gates of death.

    Of course an alcoholic ought to be freed from his physical
xxvi              THE DOCTOR'S OPINION

  craving for liquor, and this often requires a definite hospital
  procedure, before psychological measures can be of maxi-
  mum benefit.

    We believe, and so suggested a few years ago, that the
  action of alcohol on these chronic alcoholics is a manifesta-
  tion of an allergy; that the phenomenon of craving is limited
  to this class and never occurs in the average temperate
  drinker.  These allergic types can never safely use alcohol
  in any form at all; and once having formed the habit and
  found they cannot break it, once having lost their self-
  confidence, their reliance upon things human, their prob-
  lems pile up on them and become astonishingly difficult
  to solve.  

    Frothy emotional appeal seldom suffices.  The message
  which can interest and hold these alcoholic people must
  have depth and weight.  In nearly all cases, their ideals
  must be grounded in a power greater than themselves, if
  they are to re-create their lives.

    If any fell that as psychiatrists directing a hospital for
  alcoholics we appear somewhat sentimental, let them stand
  with us a while on the firing line, see the tragedies, the
  despairing wives, the little children; let the solving of these
  problems become a part of their daily work, and even of
  their sleeping moments, and the most cynical will not
  wonder that we have accepted and encouraged this move-
  ment.  We feel, after many years if experience, that we
  have found nothing which has contributed more to the
  rehabilitation of these men than the altruistic movement
  now growing up among them.

    Men and women drink essentially because they like the
  effect produced by alcohol.  The sensation is so elusive that,
  while they admit it is injurious, they cannot after a time
  differentiate the true from the false.  To them, their alco-
  holic life seems the only normal one.  They are restless,
  irritable and discontented, unless they can again experience
                  THE DOCTOR'S OPINION            xxvii 

  the sense of ease and comfort which comes at once by tak-
  ing a few drinks--drinks which they see others taking with
  impunity.  After they have succumbed to the desire again,
  as so many do, and the phenomenon of craving develops,
  they pass through the well-known stages of a spree, emerg-
  ing remorseful, with a firm resolution not to drink again.
  This is repeated over and over, and unless this person can
  experience an entire psychic change there is very little hope
  of his recovery.

    On the other hand--and strange as this may seem to those
  who do not understand--once a psychic change has occurred,
  the very same person who seemed doomed, who had so
  many problems he despaired of ever solving them, suddenly
  finds himself easily able to control his desire for alcohol,
  the only effort necessary being that required to follow
  a few simple rules.

    Men have cried out to me in sincere and despairing ap-
  peal: "Doctor, I cannot go on like this!  I have everything
  to live for!  I must stop, but I cannot!  You must help me!"

    Faced with this problem, if a doctor is honest with him-
  self, he must sometimes feel his own inadequacy.  Although
  he gives all that is in him, it often is not enough.  One feels
  that something more than human power is needed to pro-
  duce the essential psychic change.  Though the aggregate
  of recoveries resulting from psychiatric effort is consider-
  able, we physicians must admit we have made little
  impression upon the problem as a whole.  Many types do
  not respond to the ordinary psychological approach.

    I do not hold with those who believe that alcoholism is
  entirely a problem of mental control.  I have had many
  men who had, for example, worked a period of months on
  some problem or business deal which was to be settled on
  a certain date, favorably to them.  They took a drink a day
  or so prior to the date, and then the phenomenon of craving
  at once became paramount to all other interests so that the
xxviii            THE DOCTOR'S OPINION

  important appointment was not met.  These men were not
  drinking to escape; they were drinking to overcome a crav-
  ing beyond their mental control.

    There are many situations which arise out of the phenom-
  enon of craving which cause men to make the supreme
  sacrifice rather then continue to fight.

    The classification of alcoholics seems most difficult, and
  in much detail is outside the scope of this book.  There are,
  of course, the psychopaths who are emotionally unstable.
  We are all familiar with this type.  They are always "going
  on the wagon for keeps."  They are over-remorseful and
  make many resolutions, but never a decision.

    There is the type of man who is unwilling to admit that
  he cannot take a drink.  He plans various ways of drinking.
  He changes his brand or his environment.  There is the type
  who always believes that after being entirely free from
  alcohol for a period of time he can take a drink without
  danger.   There is the manic-depressive type, who is, per-
  haps, the least understood by his friends, and about whom
  a whole chapter could be written.

    Then there are types entirely normal in every respect
  except in the effect alcohol has upon them.  They are often
  able, intelligent, friendly people.

    All these, and many others, have one symptom in com-
  mon: they cannot start drinking without developing the
  phenomenon of craving.  This phenomenon, as we have
  suggested, may be the manifestation of an allergy which
  differentiates these people, and sets them apart as a distinct
  entity.  It has never been, by any treatment with which we
  are familiar, permanently eradicated.  The only relief we
  have to suggest is entire abstinence.

    This immediately precipitates us into a seething caldron
  of debate.  Much has been written pro and con, but among
  physicians, the general opinion seems to be that most
  chronic alcoholics are doomed.
                  THE DOCTOR'S OPINION            xxix

    What is the solution?  Perhaps I can best answer this by
  relating one of my experiences.

    About one year prior to this experience a man was
  brought in to be treated for chronic alcoholism.  He had
  but partially recovered from a gastric hemorrhage and
  seemed to a case of pathological mental deterioration.
  He has lost everything worthwhile in life and was only
  living, one might say, to drink.  He frankly admitted and
  believed that for him there was no hope.  Following the
  elimination of alcohol, there was found to be no permanent
  brain injury.  He accepted the plan outlined in this book.
  One year later he called to see me, and I experienced a
  very strange sensation.  I knew the man by name, and
  partly recognized his features, but there all resemblance
  ended.  From a trembling, despairing, nervous wreck, had
  emerged a man brimming over with self-reliance and con-
  tentment.  I talked with him for some time, but was not
  able to bring myself to feel that I had known him before.
  To me he was a stranger, and so he left me.  A long time
  has passed with no return to alcohol.

    When I need a mental uplift, I often think of another
  case brought in by a physician prominent in New York.
  The patient had made his own diagnosis and deciding his
  situation hopeless, had hidden in a deserted barn deter-
  mined to die.  He was rescued by a searching party, and,
  in desperate condition, brought to me.  Following his
  physical rehabilitation, he had a talk with me in which he
  frankly stated he thought the treatment a waste of effort,
  unless I could assure him, which no one ever had, that in
  the future he would have the "will power" to resist the
  impulse to drink.

    His alcoholic problem was so complex and his depres-
  sion so great, that we felt his only hope would be through
  what we then called "moral psychology", and we doubted
  if even that would have any effect. 
xxx               THE DOCTOR'S OPINION

    However, he did become "sold" on the ideas contained
  in this book.  He has not had a drink for a great many years.
  I see him now and then and he is as fine a specimen of
  manhood as one could wish to meet.

    I earnestly advise every alcoholic to read this book
  through, and though perhaps he came to scoff, he may re-
  main to pray.

                              William D. Silkworth, M.D