March 1954

In this article Dr. Tiebont continves his observations on “tbe nndamrntal 4. Perfedionistic and rigidly idealistic; pbenoaena wbicb go on wben nn dcobolic responds f n a d l y rr 5. Weighed down by an overpowering sense of loneliness and isolation; Alcoholics Anonymous.” Written originally for a magazine in tbe field of religion,* it describes how tbe inflnencrs wbicb most A h recogniu ar 6. Egocentric and all that implies in the way of a basically self-centered spiritual “should release tbe positive otmtial wbicb resides in rbr urron- orientation; sciow:’ Tbe article will be pnblisbeBin two parts. 7. Defiant, either consciously or unconsciously; \ 8. Walled off and dwelling, to a large extent, in a world apart from others. Conversion The personality of the alcoholic as thus described marks the pre-conversion state of the individual. After the conversion in personality has taken place and its full effects have had a chance to develop, a totally different picture is to be noted. In a sense the change can be compared to the switch from a depressed, anxious state to one Psychological of mild excitement. Gone is the tendency to be tense and low-spirited and in its place there is a lightness and sense of ease which pervades all thinking aad feeling. Similarly the tendency to be aggressive or at least stubborn Phenomenon disappears and instead there emerges, to use a phrase current in AA, a capacity to be “sweetly reasonable.” The problems of inferiority and superiority drop out and in their stead patients think and feel in terms of “live and let live,” (In the Treatment of the Alcoholic1 a s t a k of mind which permits them to accept humbly and without rancor BY HARRY M. TIEBOUT, M.D. their difference from their fellows and at the same time permits them to accept Part I the diflerence of their fellows from them. Moreover, along with this new N this article I wish to present in greater detail and I hope more explicitly, a capacity to “live and let live,” patients have a new ability to feel that way I Topicture of the changes which transpire during a conversion experience. begin with, let me first define the word conversion as it has come to have about themselves. They no longer drive themselves so vigorously nor criticize tbrmselves so harshly, which results in the disappearance of the perfectionistic meaning for me. As I see it, conversion is a psychological event in which there tendency with its idealistic overtones. They not only become gentler with the world but gentler with themselves. is a major shift in personality manifestation. Whereas, before, the patient was swayed by a set of predominantly hostile, negative attitudes, after the conversion process, the patient is swayed by a set of predominantly positive, LONELINESS DISAPPEARS afiirmative ones. This shift, which may happen instantaneously or over a period of time, is to be considered a purely psychological phenomenon, which can be Perhaps the most striking change of a11 is the total loss of the sinse of studied independently of the factors which may bring it about. isolation and loneliness. The alcoholic patient does not feel merely isolated My initial observations were made on alcoholics and it is that group which ~nd alone; he feels that he actually exists in a world apart from other people I shall use as an example. and that something almost tangible keeps him from any deep human contact. During the course of the,alcoholic illness, there develops a personality pattern Variously he calls this almost tangible something a wall, a shell, a barrier. One with a characteristic negative, hostile coloring. Included in this pattern is a patient dreamed of it as a moat between himself and the world. Whatever tendency to be: it is, it vanishes with a conversion experience and in its place the patient 1. Tense and depressed; a begins to feel, perhaps for the first time in his life, a sense of the nearness and reality of other people. This feeling of nearness is closely akin to non- 2. Aggressive, or at least quietly stubborn; sensual love and is described in such terms as “a great feeling of humanity,” 3. Oppressed with a sense i f inferiority, at the same time secretly hnrboriog “a real inner friendliness toward people,” and “now I feel nice to everybody feelings of superior worth; and I think they feel nice to me.” Others in telling of the disappearance of Putord Pq&lo(lj, A&il1951 the wall will say that they can really like people and be tolerant of them,

even if they know much about them which once would have kindled strongly hostile attitudes. The breaking through of the wall by the patient does something more than bring the patient closer to life. It actually makes him feel freer to meet life. More than the patient has ever realized, the wall has acted to give him a sense of being confined and restricted. When the wall suddenly melts as in a sweeping personality turnabout there develops a peculiar phenomenon which people conversant with religion refer to as “a release of power.” By “release of power” they are trying to describe a sensation of freedom and inner strength which comes when people find themselves liberated or released from the confines of their psychological wall. This state of ecstasy, for that is what it is, represents, therefore, a time when the individual is at least momentarily able utterly and without reservation to identify himself with his environment, to unite himself totally and without hostility to all that goes on about him. Conflict, tension, doubt, anxiety, hostility, all dissolve as though they were nothing and the individual discovers himself on an exalted plane where he feels he is in communion with God, man, and all the creative forces of the universe.

MOST E X P E R I E N C E S ARE GRADUAL A rapid conversion with the corresponding ecstatic accompaniment does not fall to the lot of many people nor is it to be considered a sign of orderly healthy growth and maturing. I bring it in at this time because it portrays in stark outline the emotional reaction to the dissolution of the wall. In the more common conversion experience which comes about over a period of time, the disappearance of this inner barrier to effective relationship with the outer world is a gradual process, and, being gradual, is not accompanied by the transports of joy which crop out when the change is sudden and climactic. And as the wall goes. self-reliance, self-confidence, a real willingness to trust one’s own feelings breaks through and gives the individual, as one patient expressed it, a feeling that “Now I can function in this world, being a part of it.” The change in personality just described is a composite picture resulting from observations on members of AA whom I personally have known, and a group of six of my patients.

(Editor’s Note: Part I1 of Dr. TiebonJs article will appear in the April issue of Tbr Grapevine. In the second balf of “Conversion a~ a Psychological Phenomenon,” he presents detailed material on an alcoholic who vnderwent the personality cbangu indicated. He also raiser-and answerssome pertinent nestions concerning the role of spiritual principles in recovery from Aoholism.)