As a doctor I don’t claim to be an authority on alcoholism. In some phases of the illness, however, I have acquired a specialized knowledge that is not taught in medical schools or developed in actual medical practice.
During my years of “research” into the subject, I drank myself out of my profession and into mental hospitals and jails. Such is the nature of our disease that I used my knowledge of medical and psychiatric techniques to thwart and outwit my colleagues who were trying to help me. So successful were my unconscious self-deceptions and my deliberate evasions of truth that I eventually freed myself of all professional and manly obligations and became a wino on skid row, as well as a frequent occupant of the drunk tank.
Today, it is my good fortune to have been sober for more than six years, and to have had restored to me the privilege of practicing medicine and surgery in the state of California. The fact that I am sober today is due, I firmly believe, to the grace of God and to my efforts to apply the principles of Alcoholics Anonymous to all my problems, one day at a time.
Does this mean that I, a doctor, am negating the efforts of medicine and psychiatry in treating my alcoholism and that of other sufferers from this disease? Definitely not. Many of us AAs, cocky in our present sobriety, would be dead if it had not been for the contributions of medical science.
Like many other alcoholics, however, I could not apply these aids or utilize any insights until I became sober in AA. Why this should be so is often as puzzling to my professional colleagues as to my fellow alcoholics to whom the phenomenon has occurred.
Over the past few years, in thinking about what happened to me, and what continues to happen as I try to apply the principles of AA, I have worked out a concept that may be helpful in understanding the emotional and mental aspects of the illness of alcoholism.
I call it the Tree Analogy.
Before going further I wish to make it clear that I am in accord with the medical view, held by AA, that alcoholism is a physical allergy combined with an obsession of the mind. Don’t look for a root labeled physical allergy on the diagram, though. We are dealing with factors that respond to what the alcoholic thinks and does, of himself. So far it is a literal fact that no human power can remove the physical allergy.
As indicated in the drawing, the Tree of Alcoholism has many roots, many causes, physical as well as mental. These are the feelings and emotions, many of them unrecognized consciously; and they include anxiety, self-pity, insecurity, jealousy, hostility, resentments, sex disturbances and remorse.
Since the most prominent common symptom we alcoholics present to anyone who sees us is our excessive compulsive drinking, I have so labeled the trunk, this tree’s most prominent part.
The fruits of our tree are painfully well known to most alcoholics, but to list a few of the wretched crop: lost jobs, jails, broken homes, drunk driving, adultery, hot checks, and repeated sojourns in hospitals and sanitariums.
Of the two classical approaches used by doctors in the treatment of disease, one scientific and proper method is to establish and identify the basic causes of the disease, the “roots.”
To draw from my own experience as an alcoholic, I went to psychiatrists for more than four years, intermittently seeking help for my drinking problem. During the course of treatment I continued to drink, even while experiencing increasing economic, social and moral difficulties as the result of my drinking.
Many of my fellow AAs have gone through similar attempts through this psychiatric approach, hoping to find and eliminate the roots and thereby remove the visible symptoms of excessive drinking and the bitter fruits.
If you’ve ever tried to dig up a tree by the roots, I don’t need to tell you it’s a laborious, exasperating job. Moreover, just as no two personalities are identical, the root pattern differs from tree to tree. A long period of therapy involving almost infinitesimally detailed psychic “surgery” would be required to achieve success.
Let’s lay aside our shovels and picks, and look for another method of removing our Tree.
In medicine there’s the second classical method of treatment: the symptomatic approach. You go to Doc Jones and tell him you’ve got a headache, an upset stomach, or that you’re constipated. Doc gives you a shot, or some pills, or writes out a prescription, and that’s the end of the therapy from Doc Jones. The great bulk of treatment in the United States, whether from a general practitioner or a specialist, is of the symptomatic type–and in many cases this is all the treatment needed. The symptoms vanish; the causes of complaint disappear so completely that the patient forgets all about them, even to the point of forgetting to pay Doc Jones.
If, every time you went to the doctor, he sat down to analyze every complaint you made, and traced it to its physiological, biochemical or psychological roots, you’d need the fortune of Rockefeller and the time of Methuselah to complete the therapy.
Possibly you weren’t aware of it at the time, but on certain Twelfth Step calls you have undoubtedly employed the “symptomatic approach” in dealing with an alcoholic.
Here’s an example from my own AA experience. A friend and I, responding to a Twelfth Step call, found a drunk passed out on the floor, surrounded by empty beer cans. In the back of the house two young children were wailing. From the looks of the empty refrigerator the kids had been without milk for two or three days. My friend and I ignored the drunk. While I cleaned up the kids, my fellow AA went out and bought some groceries to feed them. Those hungry, neglected children were plainly not the cause but the symptoms of that parent’s alcoholism–but at the moment we treated the symptoms.
How many times, after a binge, have we gone to our doctor to complain of a queasy stomach, headache and inability to sleep? Were we honest enough to explain, “Doc, I’ve been drunk for a week!”?
The doctor, on hearing our complaints, may do one or more of several possible things. He may pull out a syringe, or a prescription pad. Sometimes he may put us to bed, when we haven’t eaten for days, and run glucose and vitamins into our arm. If our hands are shaky he may give us a barbiturate (goof ball) or tranquilizer to calm us down. In all this he is treating the symptoms. But the basic root of the thing that is wrong with us is still there.
Unless we do something about the basic structure of that thing, it is going to grow, like trees grow. It will get bigger, and bear more and more anti-social fruit: trouble and difficulty. Sometimes this fruit is so rotten you have to pull a little of it off the tree, or it stinks.
For years medicine tried to find the roots, but each case was different. It was a hopeless task.
Then less than thirty years ago, along came a new therapy, a new way of treating the disease–the program of Alcoholics Anonymous, compounded by two “hopeless” drunks–one a doctor, remember? As described in the Big Book, when Bill and Dr. Bob carried the message to AA Number Three, “there was much talk about the mental state preceding the first drink.” This is a program of recovery, not only from alcoholism, but from the causesof alcoholism; the things that made us drunks in the first place, whether physical or mental.
Early in my AA life I noted this significant fact: when speakers talked at a meeting there was almost always a direct parallel between the length of their sobriety and the emphasis they put on the spiritual phases of this program. Men and women who have long, sustained periods of uninterrupted sobriety are to me, walking, living examples of the spiritual values of AA. This is not coincidence; this is a clinical entity that must be recognized as laboratory fact in the treatment of this very insidious disease.
If clinical aspects indicate that spiritual values are proportional to periods of sobriety, then those wishing to remain sober will do well to apply themselves to the spiritual side of the program.
My own experiences, including my lost practice, many nights in jail, and scattered contacts with AA, finally brought me to the realization that if I were going to stay sober, it was necessary for me to embrace the Third Step without any equivocation. I knew I must make a decision to turn my will and my life over to the care of God as I understood him. It wasn’t until I embraced the Third Step that there was any fundamental change in the structure of my “tree” of drunkenness.
Self-knowledge is not enough to help keep us sober. Alcoholics do not recover by merely agreeing with the principles of AA. To recover, alcoholics must live those principles. Knowledge of our illness as explained in the book “Alcoholics Anonymous” makes it necessary–in fact it directs, prompts and guides us to turn to God for help.
For some the mere mention of prayer evokes a mental block and the idea is rejected, because the word is included in a memory-package made up of stilted language, supposed hypocrisy, discipline and guilt. However, there is no standard form of prayer that we must use. The mistakes we have made in the past, the remorse that we feel about these mistakes, and a general desire to get well will guide us how we shall pray. The alcoholic, to achieve results, should not pray by rote; the words and the meaning of his prayer must have a direct, conscious connection with his shortcomings, his mistakes, his defects, or his positive goals.
We come before God as sick people, and we can offer no alibis. We have no defense. There is none. We stand before God subject to the weakness of our disease. We ask the Master Physician and Psychiatrist for an understanding of this illness, and we ask for God’s strong help in arresting it. It is only natural that we ask forgiveness for the wrongs we have committed. It is only natural that we ask God for protection from the resentments, the self-pity, the nameless fears that beset the alcoholic. From anger, intolerance, procrastination–we ask God’s protection from these things.
We ask for wisdom and understanding in order to do His will; for physical strength to stay sober, and for mental and emotional strength to keep our thinking straight.
Now to me there is nothing sensational or outstanding about an alcoholic praying to God, or to his own conception of a Higher Power. It’s a simple, sincere affair. The alcoholic has absolutely nothing to lose, because if he’s like most of us he’s lost it all anyway.
In his prayer there is the chance that the alcoholic, like some of us, will gain sobriety, gain a little sane thought and behavior, a little peace of mind, perhaps a little happiness for himself, and his loved ones.
There is a latent power within every human being that will and does respond to a conscious contact with God, as he understands Him or his present acceptance of a Higher Power.