h’ebrurt t’y 19$fJ./ Si;;rfi1 (tents

111,fi,{f il,ai’n e

mc0}l0llc$ [t\l0t\lYnll0lj$ CIJI 0R CIIRE? BY Al’thur H, Cain

}I0tttl T0 TILL A BAPTI$T tH0tul fi MET}|00I$T by George }larmon

T]lE ilEXT MAY0R 0t ilElltl Y0Rl(? hy Marion l(, $andnrs

T}lE $CUIPT0B tll}l0 EMBARRA$$E$ $All FRAllCl$C0 by Donouan Bess

Iil$lm Tffi AIR f0HC[ ACA0IMY hy0auidBorofl

Also: Louis Auchincloss, Joseph l(ratt, $yluia Wright

Janet Halverson

alcoholics can, by banding together in a spirit ARTHUR H. CAIN of mutual help and understanding (1nd by “turning their lives over to God as they undersmnd Him”), manage to lead relatively normal lives. Above all, they must face the fact that they must never again take even one drink of alcohol. As long as it restricted itself to informal organization and group “tllerapy,” A.A’ enjoyed- Alcoholics Ind deserved-universal ing change has resPect. But a disquiet- ‘developed over the past fifteen years. A.A. is now highly formalized’ The meetings, believed to be absolutely necessary, are Anonymous: riiualistic. And any suggestion to members that The Program is less than divine revelation evokes an irrational outcry. I have no personal axe to grind’ As a praccult or cure? ticing psychologist who specializes in alcohol p.obiems, I have been active since 1947 in both it.rupy and research. I have worked closely with Alcoliotics Anonymous. I have also worked for the National Council on Alcoholism and for the A uselul id’ea has turned, into a religious Christopher D. Smithers Foundation, a charitanxol)etnent-and a hindrance to research, ble organization whose major interests are alcopsychiatry, and, to rnany alcoholics who need holism and cancer. a d,ifferent hind ol helP. I arn disturbed by the fact that, for many members, A.A. is not as effective as it once was’ Moreover, I feel that much-needed scientific research is being diverted to other fields because of A’A.’s f iS THE beginning “They” created Alco- omniscient attitude. And I am not alone in my I froli.t Anonymous. (“They” have not yet been concern. Frequently in my practice, disillusioned credited with the creation of the heavens and men and women appeal to me: “Doctor’ I’ve earth but, if Present trentls continue, they will be.) “They;’ are “W.W'” and “Dr’ Bob”- tried A.A. over and over and I still can’t stay sober. There must be something else dreadfully cofounders of a movement which is becoming wrong with me! What is it?” one of America’s mosl fanaticai religious cults: “A.4.” ivl/ triends in psychiatry, psychology, and To be sure, the late Dr. Bob and the very cur- pastoral counseling often ask me in discreet tones, “What’s happening to A’A’?” Then’ emrent W.W. did not want to be cleified’ They barrassed ,t ,ornding critical, they add hastily’ joined forces in 1935 simply to help each other stop drinking. Today the fellowship they startecl “lt is a wonderful organization”‘ Dr’ E’ M’ -[ellinek, dean of researchers in alcohol studies’ .lrim, a membership of over 300,000 “arrested” pleaded at a workshoP on alcoholism held at alcoholics in 85 countries. Thc A’A’ iclea was ‘Columbia University in June 1959 that A’A’ based on psychological and spiritual concePts leave science alone-so that scientists might get very similai io those of Frank Buchman’s thenalong with the business of objective research famo.rs Oxford Group. Conceived in Akron’ Ohio, the first A’A. SrouP was formed in New into the Problem. While ierving as public-relations counsel to York City. In A’A.’s first five years no more than a few hundred PeoPle joined’ the National Council on Alcoholism in 1959′ Then, in 1941, an article about A’A’ by Jack I attended A.A. meetings in a dozen major cities’ Alexander appeared in the Saturday Eaening This personal survey of A’A’ groups convinced boost’ me th;t there is a widening breach not only be- Post and guui tfr” movement an overnight thousand by tween A.A. and scientists, but alio between Membersiip leapecl to over eight practicing A.A.s and other alcoholics’ the end of the Year. What has happened to the excellent Program A.A.’s basic renet is that only an alcoholic can that once helped alcoholics stop drinking when help another alcoholic; that psychiatric and medicine and psychology failed? Why has A’A’ other treatment rs usually unsttccessful; but that

49 become a cult that many men and women holics trying to stay sober .in A.A. Many reverentially call “the greatest movement since A.A. members are unsympathetic to these Iess the birth of Christianity”? fortunate brothers, whom they regarcl as .,hope_ Iess psychotics” or .,nuts who aren’t ,real’ alcotoUTI L1Z1.-DON’T holics at all.” Thus, we see in A.A. two clisturb- ANAL1.ZET ing rendencies: (l) to define the alcoholic as f OTTENDED my first A.A. meeting in a person who stays sober in A.A.; ancl (2\ to L 1947 and was enormously impressed by the relegate all other problem clrinkers ro rhe limbo sincerity of the members. They were not profes- of psychosis sional do-gooders. The speakers seemecl genu- A.A.s are fond of quorin€i such ..sratisrics,, as: inely “humble,” not piously proud of their “Fifty per cent o[ all alcoholics coming into A.A. humility. The “A.A. personality’,-identifiable get sober and remain sober; 25 per cent have one by a studied air of serenity and steaclfast smile or two slips, then ‘get the program, ancl maintain (which I have come to think of, uncharitably, as sobriety; the other 2b per cent are either psythe “A.A. Smirk”)-had nor yer come inro ex_ chotic or not alcoholic at all.’, istence. It is a product of “A.A.: the Cult,, as A question arises: how do A.A. members opposed to “A.A.: the Fellowship.” garner these figures? Because A.A. consiclers But one remark disturbed me even then. One itself deliberately permissive fellowship macle man arose-a forerunner ol the seer-and_pundit up of-aautonomous groups which do not keep type now prevalent in A.A.-ancl declared, exact records, no real statistics exist. Neverthe_ “There’s an aggregate of two thotrsand years of less, individual members aclvance these gen_ drinking experience in this meeting room. If eralizations as incontrovertible truths. we don’t understand alcoholism then nobody This kind of misinterpretarion has narrowecl does.” My own reaction was that nobody under- A.A.’s once flexible phitosophy into exclusive stood alcoholism (no one does now, either) ancl dogma. One undesirable effect is that those aI_ it was ludicrous for a group which admitteclly coholics who are not able to make A.A. work had lost control of its drinking to claim superior for them lose all hope; they fear that nothing is knowledge of the subject. Ieft for them except insanity (Korsakoff,s Syn_ As I began to attend meetings regularly, other drome or the dreaded ..wet brain,,) or cleath. aphorisms troubled me. One favorite clich6 ap- This is nor so. Many alcoholics achieve a sobriety peared to be of special importance and still is: made happy and crearive through meclical, psy_ “Utilize-don’t analyze.’ chiatric, psychological, ancl pastoral techniqtres. For some members this was fine. They were The sometimes tragic misunderstancling_tl-rat weary of trying to fig;ure our how to drink o.nlf e. can help-is fostered by A.A.’s growing normally; or how to endure sobriety now that it -A rigidity. was achieved; or why they had become alcoholic If A.A.’s intolerance were confinecl to its own i1 the first place. They were ready to accepr community, we could “live and let live,,, as it blindly anything that would end the agonies of exhorts its members to do. But A.A.s are incompulsive drinking. defatigable crusaders who greatly influence the But for orhers, such faith was impossible. Some national crusade against alcoholism-a malady people simply must analyze-it is their most which today affiicts five million Americans and. characteristic personality trair. perhaps, during costs taxpayers ancl industry over a billion dolthe early, frightening days of their .newly found lars annually, according to rhe National Council sobriety they take comforr in letting others think on Alcoholism. The Deparrment of Health, Edu_ for them. Bur as their heads clear and their cation, and Welfare has called alcoholism the nerves stop quivering, the need to comprehend nation’s fourth mosr serious public-health prob_ ideas intellectually is reasserrecl and they find lem, ranking in importance with hearr disease, themselves examining their own behavior with cancer, and mental illness. healthy curiosity. As one relapsed member mournfully described his “slip”: “I had been dry for over a year and, like the window washer, Arthur H. Cain,who has a ph.D. from, Colu,rn- stepped back to appraise my handiwork. I woke 2y “\d is a grad,uate -of the yal,e (now Rutgers) S_choo-l ol Alcohol Studies, is the author ol o,y”oun’g up two weeks later on rhe Flight Deck [the P.eoyle and-Drinhing,” to be pwblished by iohn Dai. violent ward ar Kings County Hospital] wondering what had happened.” A licensed psychologist practicing in’New yoik City, Relapses occur frequently among such alco- .Dr. Cain re_cently mad,e a ,esiarch tour ol the world stud,ying d,rinking custon,,s and, sexu,al habits.

50 ALCOHOLICS ANONYMOUS A.A.s hold key positions in city, state, and and most of this agency’s staff are Practicing private agencies dealing with alcoholism. Many members of A.A. AII are dedicated to combating Lxecutive directors of local committees and alcoholism. But just as sobriety is a vocation for information centers are members of A.A. This many A.A.s, for many agency people it is a career. means that Public education on alcoholism is almost entirely in the hands of A.A’s. Further- SOBRIETY NOT SLAYERY more, nearly all information about research, treatment, and community action is disseminated NOTHER dangerous asPect of A.A. as by public-relations directors who adhere to the a religious cult is the concept of sobriety A.A-. party line. Thus, almost everything we read as tlle ultimate goal of life. The very word on alioholism in newspapers and magazines is “sobriety” has taken on a religious flavor and is A.A. propaganda. utterecl with hushed awe, rather than spoken of Zealous members spread this propaganda, not as a condition necessary to health and happiness’ for personal gain, but to “flush out” alcoholics Practically all members who have passed the and help them share their own dubious serenity’ pigeon, or novice, stage speak of the quality of I have had the unnerving experience of hearing io-ancl-so’s sobriety, as if evaluating degrees of a spontaneous remark made by an A’A’ speaker spirituality. in New York on a Monday repeated as gospel in Sobriety has, indeed, become the A.A.’s end Chicago on the following Friday. Nluch worse, which justifres any means. I know men whose I have heard a federal department chief publicly wives work and support them so that they may parrot a “statistic” I knew had been invented by devote their full time to “A’A’ Work.” I have an A.A. the week before. It is perhaps no co- talked with these women at Al-Anon meetings incidence that the A.A. publication is known as (groups formed especially for the spouses of al- “The Grapevine”‘ coholics). Nlost are not complaining about their Alcoholics Anonymous is hostile to criticism lot as A.A. wives; they insist that anything is from any source. “All we ask is to be left alone”‘ better than living with a Pracdcing alcoholic. they cry. But they do not leave the American But other women confess that eating, sleeping, public alone’ They influence public-health of- and talking A.A. twenty-four hours a day is alhcials; they write extensively; they take positions most worse than having an alcoholic husband. on medical subjects such as diet and drugs The masculine point of view was summed up by (tranquilizers, sedatives, and stimulants all fall a legendary souse at a bar who indignantly deunder the rubric of “goof-balls” to A’A’), and niecl tl”rat he was an alcoholic. “I’m no blanketyhold themselves up as frnal arbiters on any mat- blank alcoholic,” he shouted, “I’m a drunk!” ter pertaining to alcoholism’ When asked about the difference he retorted, dne result of this authoritarianism is that “Alcoholics have to go to those blankety-blank well-meaning laymen organize committees and meetings all the timel” sponsor “research”-which leads qualified pro- I have heard husbands of alcoholics complain fissionals to assume that the job of fighting al- that A.A. has become a network of women’s coholism is getting done’ But it isn’t-largely auxiliaries devoted to gossip and the “chanting because of a tasic fallacy in A’A’ thinking: that of A.A. litanies such as, ‘There but for the Grace it takes an alcoholic to understand an alcoholic’ of God . . .’; ‘Easy does it’; and ‘Living one day The trouble lies in defining the word “under- at a time.”‘ standing.” Scientists agree that alcoholics are A.A. dogmatism has Prevented many people more emPathetic to other alcoholics than anyone from seeking a more moderate solution: sobriety else; bui when they venture the opinion that in Alcoholics Anonymous without slavery to it. trained specialists might be better equipped to And there are still other possibilities, such conduct fbrmal treatment and research than un- as psychotheraPy or pastoral counseling. But trained alcoholics, they run into a storm of pro- A.A.s would probably retort, justifiably, that test. A.A.s seem almost afraid that science arill they’ll stick to what they’ve got until something come uP with a “cure” (an absolutely taboo word better comes along. IVIany alcoholics who come in the A.A. lexicon) and render A’A’ unnecessary’ to A.A. have had unhappy exPeriences with psy’ “What will we do if someone discovers a pill chologists or psychiatrists. Some therapists folthat cures alcoholism? It’s our dedication that’s low their own Party lines, usually Freudian, too keeping us sober and serene!” the executive di strictly and write off alcoholism as “lt J, a symP- ,”.4. of an influential agency on alcoholism re- tom of some underlying emotional disorder”cently said to me. Needless t’o $ay, this person implying that once the disorder is uncovered

BY ARTHUR H. CAIN 5I the problem of alcoholism will automatically holic beverage are unable to control their desire be solved. Too many alcoholics are worsened for it and (b) those who through use over a great by this oversimplified approach. Many others many years have developed an inability to take instinctively know better, especially when psy- a drink or leave it alone and have become like choanalysts begin probing their Oedipal Situa- group (a); and (2) secondary alcoholism, which tions. flowever, most psychotherapists rlow includes those who use alcohol for its sedative understand that alcoholism is a complex, distinct action as a means of escape from reality and, illness and must be treated accordingly. in particular, from their personal problems. . . . This secondary group comprises by far the o oARREsTED” oR c6RECovERED” majority of patients suffering from alcoholism; howeaer, m.ost alcoholic patients prefer to be in U T A.A.s veer to the other extreme. They th.e primary sroup.” (Italics mine.) assert vehemently that there’s nothing By refusing to take into account problems of wronE with alcoholics except alcohol, and all the mental confnsion, emotional immaturity, and alcoholic has to do is to stay away from that first social maladjustment, A.A.s are seriously hinderdrink. (There is a standard gag in A.A. about ing not only their own recovery, but scientific the alcoholic who always orders two drinks and research as well. only drinks the second one.) The facts are: If A.A.s are to be rescued from fanaticism, they (l) the alcoholic obviously wouldn’t be an alco- must thoroughly understand two crucial wordsholic if it weren’t for alcohol (what zoou,ld he “arrested” and “recovered.” These are terms be?) and he certainly must abstain from it if he used to describe alcoholics who do not drink any is to get well; but (2) he undoubtedly is suffering more. Most members of A.A. fall into the from some sort of psychological disorder: emo- former category; that is, they have arrested the tional, mental, or social. Unfortunately, “pry- development of their disease and have learned to chology” is a synonym for “psychosis” to most live with it. To these men and women, alco- A.A.s. When a recent Ph.D. dissertation on al- holism is something real in itself, like an incoholism was published in popular book [orm,* curable cancer. “Once an alcoholic, always an A.A.s immediately took the author to task for alcoholic” is one of A.A.’s most holy doctrines. suggesting that alcoholics could be placed in They mean that once a person has lost conrol of categories of psychopathology like any othe{ vic- his drinking he will never again be able to drink tims of a behavior disorder: the manic-depressive normally, even to the extent of one glass of beer. or compulsive-obsessive cases, for example, com- He must work regularly at the business of not plicated by uncontrolled drinking. What was the taking that first drink. big idea of saying alcoholics were a bunch of This means he must practice A.A. in all his .rrrti, A.A.s demanded. Yet, they insist that “al- affairs; attend meetings without fail; do “Twelfth coholism is a disease.” The President of the Step Work” (the analogy between A.A.’s “Tr,velve National Council of Alcoholism, an exceptional Steps” and the Ten Commandments is unmistakexecutive with a scientific mincl, goes further, able); and proselyte other alcoholics into Alcocalling alcoholism a respectable disease. It can holics Anonymous. If he doesn’t live A.A., he’s happen to anyone, he implies, and should not sunk. He gets drunk again sooner or later andhave social or moral stigma attached to it. I alcoholism being in the dogma of A.A. a progrescouldn’t agree more heartily. sive disease-he’ll be worse off than ever. But A.A.s prefer to regard alcoholism as a It is true, of course, that the drinking alcoholic purely physical disease: organic, glandular, meta- becomes worse and worse in his drinking bebolic, dietary-anything but mental. The only havior. But what A.A. does is to superimpose time this dread word is used is in an A.A. defini- this concept on the behavior of the non-drinking tion of alcoholism: “A physical allergy, coupled alcoholic. According to A.A., the disease itself with a mental compulsion.” progresses. This is erroneous thinking. An al- According to the American Medical Associa- coholic who relapses after a period of abstinence tion,f “alcoholism can be classified into (l) pri may very well get sicker than ever, but because mary alcoholism, which includes (u) those he has aged, not because his alcoholism has patients who from the very first drink of an alco- “progressed.” The term “recovered” means something difier- * Seuen Sinners, by Arthur King (Harcourt, Brace ent: it implies that the patiens’-E alcoholism is no and World, l96I). longer a-problem. He may not be able to drink I lournal of the American Medical Association, May 25, 1957. normally again, although some investigators

52 ALCOHOLICS ANONYMOUS such as D. L. Davies, Dean of the Institute of of Life. Sobriety can never be a satisfactory Psychiatry at the Maudsley Hospital, London, ultimate goal; it is, after all, merely the absence believe there are many such cases. This hos- of intoxication. It is what one does with one’s pital’s work has been conscientiously reported by sobriety that is important. A.A. is a man-made the Quarterly Journal of Studies on Alcohol (at means for attaining this sobriety. the Rutgers Center of Alcohol Studies).* Here Alcoholics Anonymous should not be a cult f or is an excellent example of the true scientific the retardation of the “arrested” alcoholic. I do method, for the Quarteily lournal reports both not suggest for a moment that a single A.A. quit fact and theory. It is not surprising that Dr. the fellowship. On the contrary, I strongly urge Davies’ article has been either ignored by A.A., sticking with it. To anyone who is having or brushed off with typical illogic: “Well, if these trouble with alcohol I say: try A.A. first; it’s the people drink normally, then they couldn’t have answer for most people. been alcoholics in the first place.” No A.A.s I But to those who insist uPon serving A.A. as queried had actually read the piece, though all if it were a holy and apostolic church, I say, were firm in their denunciation of it. I have Beware. Observe those members who seem genuheard A.A.s say that the report was immoral on inely serene. Talk with those who have been in the grounds that they might be temPted to drink A.A. a long time and who really practice “live again alter hearing of it. Scientific truth was of and 1et live.” Though A.A. is an important part no consequence. of their lives, it is an adjunct, not the whole. The expression “recovered alcoholic” means They have crossed the bridge from arrested althat the patient no longer has to treat himself coholism to true recovery. or take treatment from others at least twice a And if even then they cannot stay sober and week for the rest of his life. He accepts life with- hrppy, they should not despair. There are other out alcohol; he makes certain adjustments within ways, other bridges-physicians and psychiatrists, himself and in his attitude toward society; and psychologists and pastoral counselors, who are he gets back into the mainstream of life. He capable and anxious to help them. Some spemight devote part of his time to helping alco- cialize in helping alcoholics who have conscienholics or others-probably he does-but because tiously tried A.A. and failed. Most agree that he can and wants to, not as a device to keep him- there’s no such person as a hopeless alcoholic. self sober. A.A. as a group must recognize its real function: to serve as a bridge from the hospital or TRY A.A. FIRST, BUT… the jail to the church-or to a sustaining personal belief that life is worthwhile. It must not Pose H E R E are many such recovered alco- as a spiritual movement that provides everything holics, both in and out of Alcoholics the alcoholic needs to fulfill his destiny. It must Auonymous. These men and women have not teach its young (as it does in Alateen, its learned one thing: neither A.A. nor psycho- Sunday School for the children of alcoholics) therapy, nor any other treatment is more than a such catechisms as: “We will always be grateful briclge between alcoholism and real reco\rery. to Alateen for giving us a way of life and a won- Good briclges, perhaps. I still believe that A.A. derful healthy program to live by and enjoy.” It provicles the best possible way, at Present, lor must realize that “the actual coffee pot Anne most alcoholics to €iet sober and start a new life used to make the first A.A. coffee”* is not the without alcohol. Others need some form of psy- Holy Grail. The cake and coffee served after chotherapy and/or pastoral counseling-perhaps meetings are just refreshments, not the body and in conjunction with A.A. These disciplines are blood of Jesus Christ. especially helpful to people who cannot, without Only then will Alcoholics Anonymous “come professional guidance, sincerely practice certain of age.” Then, perhaps, more of its members will of A.A.’s Twelve Steps, such as Step For’rr-“Make become “recovered” instead qf “arrested” alco’ a Searching and Fearless Inventory of Our- holics. Science may then be stimulated to further selves”; or Step Ten-“Continue to Take Per- research. And those alcoholics who are unable to sonal Inventory and When We Are Wrong make A.A. work for them may look elsewhere Promptly Admit It”); or those Steps that refer and find their serenit], too. to “a Power greater than ourselves”‘ * Shown in Alcoholics Anonymous Comes of Age Alcoholics Anonymous is not a sustaining Way (Harper, 1957), a commentary on the A.A’ bible, * “Normal Drinking in Recovered Alcohol Ad- Alcoholics Anonymous (Works Publishing Company, dicts,” March 1962. r946). HarPer’s Magazine, February 196?