June 1945

A Prescription for Sobriety

(Editor’s note: In the opinion of the staff, the In the opinion of a man who has profession to Support A.A. and having importance of the following interview lies in the fact guided scores of alcoholics into A.A. that it represents the deductions of a man who is in administered to at least 10,000 the unique position of being able to appraise A.A. alcoholics, the attempt to make this kind during the last ten years, he also as both an ‘insider’ and an “outsider’, as both an of compromise is one of the most appreciates the fact that a “slipNfor an old friend of A.A. and an M.D. who began working common causes of failure to get a safe A.A. involves an extra degree of remorse with alcoholics long before A.A. was conceived.) hold on A.A. Dr. W.D. Silkworth, genial and misery. and beloved little patriarch at Town’s Dr. Silkworth is particularly . Anyone who tried to impress an emphatic on one point. alcoholic with the approach, “you can’t Hospital, New York, for 12 years and now also in charge of the new A.A. ward ”Slips’ are not the fault of A.A. I have your cake and eat it, too,” would have heard patients complain when probably draw a scornful, “So what! who at Knickerbocker, also New York, defines it as the “alcoholic double-cross.” brought in for another ‘drying outd,that wants to eat cake? Tony, make it a A.A. failed them. The truth, of coune, is double this time.” “The majority who slip after periods of sobriety,” says Dr. Silkworth, that they failed A.A. The same idea expressed as, ” ~ u tthis mental maneuvering to “You can’t have your bottle and drink it, “have double-crossed themselves into thinking that somehow they can have the transfer the blame is obviously another too,” might get his attention because to a indication of fallacious thinking. It is drinking alcoholic a fresh unopened unopened bottle and drink it, too. Even though they have been in A.A. and going another symptom of the disease.” bottle, brimming brightly with abundance, A quick way to get Dr. Silkworth’s is a symbol of good things to come. He to meetings, and following parts of the program, they have accepted it with appraisal of A.A. is to ask him how he knows, well enough, of course, that he thinks “slips” can be prevented. can’t drink it and still have it, but he reservations somewhere. They actually have been only one step ahead of a “First,” he explains, “let’s blocks his mind to the inevitability of that remember the cause, The A.A. who horrible moment when the last bottle will drink. Then they begin playing around +. with the notion they can drink a little and ‘slips’ has not accepted the A.A. program be empty. in its entirety. He has a reservatioh, Or The untapped bottle remains a still have the good things of A.A. The outcome is as inevitable as the bottle reservations. He’s tried to make a symbbl to the non-drinking alcoholic, at compromise. Frequently, of course, he least to the alcoholic who has dried up in becoming empty once it has been opened by the alcoholic.” will say he doesn’t know why he reverted A.A. So long as it stands unopened it to drink. He means that sincerely, and, represents drinks he has not taken – and When Dr. Silkworth discusses A.A. “slips” his usually cheerful face becomes as a matter of fact, he may not be aware the good things of life he has found by of any reason. But if his thoughts can be not drinking. serious, even a little grim. Through his long years of practice in the field, he has probed deeply enough a reason can Yet now and then a persevering usually be found in the form of a soul tries to have both the figurative and become increasingly sympathetic, not case-hardened, to the alcoholic. He reservation.” the liquid contents of the bottle. He tries “The preventative, therefore, is to make an impossible compromise. understands what they experience. Having been one of the first in his acceptance of the A.A. program and A.A.

principles without any reservations. This former mental obsession. It is the vital attempt the emotional appeal, working brings us to what I call the moral issue principal of A.A., without which A.A. both the patient and myself into a lather. and to what I have always believed from would have failed even as other forms of He might be moved to the point of the very first to be the essence of A.A. treatment have failed. shaking hands dramatically and telling “Why does this moral issue and “To be sure, A.A. offers a number me, with tears streaming down his face, belief in a power greater than oneself of highly useful tools or props. Its group that he was never going to take another appear to be the essential principle of therapy is very effective. I have seen drink. And I knew that the probability was A.A.? First, an important comparison is countless demonstrations of how well that he would drink again within two found in the fact that all other plans your ’24-hour-plan’ operates. The weeks or less. involving psychoanalysis, will power, principal of working with other alcoholics “Since I have been working with restraint and other ingenuous idea have has a sound psychological basis. All of A.A. the comparative percentage of failed in 95 per cent of the cases. A these features of the program are successful results has increased to an second is that all movements of reform extremely important. amazing extent. minus a moral issue have passed into “But in my opinion, the key oblivion. ‘The percentage of principle which makes A.A. work where success that A.A. has scored leaves no “Whatever may be the opinions other plans have proved inadequate is doubt that it has something more than one professes in the matter of philosophy the way of life it proposes based upon we doctors can . offer. It is, I am – whether one is a spiritualist or a the belief of the individual in a Power convinced, your second step. Once the scientific materialist – one should greater than himself and faith that this A.A. alcoholic has grasped that, he will recognize the reciprocal influence which Power is all-sufficient to destroy the have no more ‘slips’.” the moral and physical exert upon each obsession which possessed him and was other. Alcoholism is a mental and destroying him mentally and physically. physical issue. Physically a man has “For many years I faced this developed an illness. He cannot use alcoholic problem being sure of one alcohol in moderation, at least not for a scientific fact – that detoxication by period of enduring length. If the alcoholic medical treatment must precede any starts to drink, he sooner or later psychiatric approach. I have tried many develops the phenomenon of craving. of these orthodox psychiatric approaches Mentally this same alcoholic develops an and invented some new ones of my own. obsessive type of thinking which, in itself With some patients I would be coldly a neurosis, offers an unfavourable analytical, if they were of the so-called prognosis through former plans of ‘scientific’ type who is apt to have a treatment. Physically science does not superior attitude toward anything know why a man cannot drink in emotional or ‘spiritual. With others, I moderation. But through moral would try the ‘scare’ method, telling them psychology – a new interpretation of an that if they continued to drink they would old idea – A.A. has been able to solve his kill themselves. With still others, I would