Co pyr i ght © 19 39 , 195 5, 19 76 , 200 1 by A lco h olic s A nonymou s W orld S ervice s, I nc .

A ll r i g hts r e s erv ed .

Fi rst E d i t i o n , sixt een p r i n ti ng s, 193 9 t o 19 55 S eco nd Editi on , sixt een p r i n ti ng s, 195 5 t o 197 4 Third Ed iti on , s e ven ty-f our pr in t i n g s, 1976 t o 2001

F our th Ed iti on , N ew an d R evi s ed 2001 Fi rst pri n ti ng , O c t o b er 2 001 Eigh t een th pr i n t i ng , A u gu st 2006

P er s onal st ori e s on p a ge s 407 , 47 6, 49 4, 5 3 1 , and 55 3 are copyrig ht ed © b y Th e A . A. G r a p ev ine , I nc ., and ar e r eprin t ed h ere wi th p e rmi ssi on .

This is A.A. General Service Conference -approved litera ture

A lco h olic s A nonymou s and A.A . are regi s t ered tr ad emark s ® of A . A. W o rld S er vice s , I nc .

L ibr a ry of C on g r ess C ontro l N umb e r : 200 109 4 693 ISBN 1 - 8 930 07-16-2

P rint e d in t h e U nit e d S t a t es o f A m e ric a

Preface

T HIS IS t h e fo urth ed it ion o f th e boo k “ Al c o ho l i c s An ony m o u s . ” The first editi o n appeared in Ap ril 1939, a n d in the follow i ng sixt een years, mo re t h an 30 0,00 0 copies we nt i n t o circ ulat ion.

The sec o n d ed ition , pu blishe d in 1955, reac hed a t o tal of more tha n 1, 15 0, 5 0 0 co pies. T h e t h ird edi t ion, w h ich came off press i n 1976, ac hieved a circula t ion of approxima t ely 19,550,000 i n all formats.

Because t h is b ook has bec o m e th e basic text for our Society and has helped suc h large num be rs of alcoholic men an d w o m e n t o recovery, ther e exists strong sentime n t agai nst any radical changes being made in it. Theref o re, the fir st po rti o n o f th is volume, desc ri bing the A . A. r e covery pr ogra m, ha s been le ft largely un touc hed i n t h e c o u rse of revisions made for the secon d , third, a n d fourth e d iti o ns. T h e section calle d “ Th e Do c t o r ’ s Opini o n ” has been kept intac t , just a s it was originally wri t ten in 1939 by the late Dr. William D. Silkworth, our Society ’ s g reat medical bene f actor.

The sec o n d ed ition ad ded th e appe ndices, the Twelve Tr aditions , and the direc t ion s f o r getti ng in to uch with A.A. Bu t the c h ief change was in the section of pers onal storie s, whic h was expan d ed to re flect the Fello wship ’ s gro w t h. “ Bill ’ s Story , ” “ Doc t or B o b ’ s Nightmare, ” a nd one othe r p e rsonal hi st ory fr om the firs t edi t io n were re taine d in tact; three were edited and one of t h ese w a s re titled; new ver sion s of tw o s t ories w e re w rit ten, with new titles ; t h irty co mple tely new s t orie s were ad ded ; and the story secti o n was divided into th ree par t s, u nder the s a me headings that are use d now.

In the third e d ition, Pa rt I ( “ Pioneer s of A . A. ” ) was left unc hanged . Ni ne of the st ori e s in Pa rt II ( “ They S t oppe d in Time ” ) were c a rried over fr om th e second edition; eight new

stories were a dded . I n Pa rt I II ( “ They L o st Nearly All ” ), ei ght stories were re tained ; five ne w one s were a dded .

This fourth e d ition includes the Twelve Concepts for World Service an d re vises the three secti o ns of pe rsonal s t ories a s foll ows. One n e w story has b een ad ded to Part I, a n d tw o tha t originally a ppe ared in Part III h ave been repositioned there; six st ories have be en delete d. Six of t h e s t ories i n Par t I I have been carried over, e l even new one s have been added, and eleven take n ou t. Part III n o w incl udes tw elve new stori e s; eight were removed (i n a dditi on t o the two th a t were tran sfer red to Part I).

All changes made ove r the years in the Big Book (A .A. members ’ fond nickname f o r this vol u m e ) have had t h e same p u r p os e: t o represe n t the curre nt memb ership of Alc o holics An onym ou s more acc ura t e l y, and thereby to reac h m o re alcoholics. If you have a drinkin g pr oblem, we h o pe tha t y o u may pa use i n reading one o f t h e fo rt y-tw o pe rs onal st ories an d t h i n k: “ Yes, that happened to me ” ; or , m o re importa n t, “ Yes, I ’ ve felt like tha t ” ; or , most im porta n t, “ Yes , I believe this p r ogra m can w o rk for me to o. ”

FOREWORD TO FIRST EDITION

This is the Fore word as it appeared in the firs t printing of the first edition in 1939.

W E, OF Alcoholics Anonymou s , a r e mor e than one hundr ed men and women wh o h a ve rec o v ered fro m a se emin gly h o p eless sta te o f min d a n d b o d y . To sh ow oth e r a l c o h o lic s precisely how we have recovered is th e ma in p u r p o se of th is b ook. F o r them , we hope these pages wi ll prove so convinci ng that no further auth enticatio n will be necessary. W e think this accou n t of our exper iences will help ever yo ne to better under s t and the alcoholi c. Many do not com p r e hend that th e alcoholic is a ver y s ick p e rson . An d b e s i d e s, we a r e su r e th a t ou r wa y o f liv in g h a s its a d v a n ta ges for all.

It is imp o rta n t t h a t we rema in a n onymo u s beca us e we ar e too few, at present to handle the overwhel ming number of per s o nal appeal s which may result from this publication. Be in g mos t ly b u s in ess o r p r ofe ssion a l folk, we c o u l d not well c a rry on ou r oc c u pa tion s in su c h a n ev en t. W e wou l d like it u n d erstood th a t ou r a l c o h o lic work is a n a v o c a tion .

When wr iting or s p eaking publi c ly about al coholi s m , we ur ge each of our Fellows hip to omit his per s o nal name, des ignating hims elf ins t ead as “ a member of Alcoholi cs Anony m ous . ”

Very ea rn e s tly w e a s k th e p r es s a l so, to ob se rv e t h is req u e st, fo r other w is e we s h all be gr eatly handic a p p ed.

We ar e not an or ganization in th e co n v en tiona l sen s e of th e wor d . Th ere a r e n o fee s o r d u es wh a tsoev er. Th e on ly req u i remen t fo r me m b ersh ip is an honest desire to stop drinking. We are not allied with any particul ar fa ith , sec t o r d e n o min a tion , n o r d o we op p o se a n y o n e . W e simp ly wish to be helpful to those who are af flicted.

W e sh a ll b e in terest ed to h ea r fr om th ose wh o a r e gettin g re su lts from th is b ook, p a rtic u l a r ly from th os e wh o h a v e c o mmen c ed work with oth er a l c o h o lic s. W e s h ou ld like to b e h e lp fu l to su c h ca ses.

Inquir y by s c ien t ific, medical, and r e ligious s o cieties will be welc omed.

ALCOHOLICS ANONYMOUS

FORE WORD TO SE CON D E D ITION

F i gures give n in this forew ord describe the Fellowship as it was in 195 5.

S INCE the origina l Foreword to this book was written in 1939 , a wholesale miracle has taken place. Our earliest printing voic ed the hope “ that every a l c o holic who jo urneys wi ll fi nd the Fellowsh i p o f Alcoholics Anonymous a t his destin ation. Alread y, ” continues the early text “ twos and threes and fives of us hav e sprung u p in other communities. ”

Sixteen ye ars have e l a p sed betwee n our first printing of this book and the presentation in 1955 o f o u r second edition. In that brief space, Alcoholics Anonymous has mushroo m ed into nearly 6,000 gr oups whose membership is far above 150,000 recovered alcoholics. Groups are to be found in each of the U n ited States and all of the provinces of Cana da. A.A. has flourish ing comm un ities in the British Isles, the Sc a ndina via n co untries, Sout h Africa, Sou t h America, Me xico, Alask a , Australia an d Haw a i i . All t o ld, promising be ginnings have b een made in some 50 foreign countries a n d U. S. possessions . Some ar e just now ta king shape in Asia . Man y of our friends en courage us b y saying that this is b u t a beginning , only the augury of a much larger future ahead.

The spark that was to flare in to the first A.A. gr oup was struck at Akron, Ohio, in J une 1935, during a talk between a New York stockbroker and an Akron phys i cian. Six months earlier, the broker had be en re lie ved of his drink

obsession by a sudden spirit ua l experie n ce, follow i n g a meetin g wit h an alcoholic fr iend who h a d bee n in co ntact with the O x f o rd Groups of that day. H e had also be en greatly h el p e d by the late Dr. Will ia m D. Sil kworth, a New York specia li st in alco holis m who is no w ac counte d no less than a m ed i c a l saint by A. A. members, and whose story of the early days of our Society appe ars in the next page s.

From this doctor, the broker had learn ed the grav e nature of alcoholism . Though he coul d not accept all the tenets of the Oxford G r oups, he was convince d of the need for moral inve ntory, confession of perso nality def ects, restitution to those harme d , helpfulnes s to others, and the n eces s ity of belief in a nd depe nde nce upon God.

Prior to his journey to Akron, the broker had worke d hard with m a n y alcoholics on the theory tha t only an a l co holic could help an alcoholic, b u t he had su c- ceede d only in keeping sobe r himself. The broker had gone to Akron on a business vent ure wh ic h ha d collapse d, leaving h i m g r eatly in fear that he might start drink i ng aga i n. He sud d en ly realiz ed that in order to s ave himself he must carry his message to another alco h o lic. T h at alc o holic turn ed out to be the Akron physician.

This phys i c i a n ha d repeat edly tried sp iritual mea n s to resolve his a l coholic dilem m a b u t had f a iled. But wh en the broker gave him Dr. Silk worth ’ s description of alcoholism and its hopelessness, the phys i cian beg a n to pursue the spiritu a l rem edy for his m a la dy with a willing ness h e had never before been able to muster. He sobered, never to drink again up to the moment of his death in 1950. This seemed to pr ove that one alcoho lic cou l d affect a n other as no nonalcoho lic could. It a l so indicated that strenuous work, one alc o holic with a n ot her, was vital to permanent recovery.

Hence the two men set to work almost frantically u p on alcoho lics arr i ving in the ward of the Akron City Hospita l . The i r very fir s t case, a des p erate one, recovered imme diately and bec a me A.A. number three. He ne ver ha d another drin k. This work at Akron contin-ue d throu g h the summer of 1935. There were ma ny failures, but there was an occ a siona l hearten i ng s u ccess. Whe n the broker returned to New York in th e fall of 1935, the first A.A. group ha d ac tually be en f o rmed, thoug h no one realized it at the time.

A second sm all grou p pro m ptly took sh ape at New Y o rk, to be followed in 1937 with the start of a t h ird at Cleveland. Besides thes e, there were scattered alcoholics who had picked up the basic ideas in Akron or New York who were trying to for m groups in other cities. By late 1937, the num ber of members h avin g substantial sobriety time behind them was sufficient to convince t h e members h ip that a ne w lig h t had e n tere d the dark world of the alcoho lic.

It was now time, the struggling groups thought, to place their messag e and uniqu e exper i en ce b efore the world. This determination bore fruit in the spring of 1939 by the pub li cation o f this volume. The me mbe rship h a d the n reache d a b ou t 100 men an d wome n. Th e fledg lin g society, wh ich had be en na meless, now beg a n to be ca lle d Alcoholics Anonymous, fr om th e title of its own book. The flying-b lind p eriod end ed and A.A. ent ered a ne w p h ase of its pioneer ing time.

With the a p p earan ce of the ne w book a great deal be gan to happen. Dr. Harry Emers o n Fosdick, the noted cler gyman, reviewed it with approval. In the fall of 1939 Fulton Oursler, then editor of Liberty, printed a pie c e in his magaz i n e, called “ Alcoholics and God. ” This brought a rush of 80 0 frantic inquiries into the little New York office

wh ich mea n wh ile h a d be en estab lishe d. Each in qu iry was painstakingly answ ered; pamp hlets and books were sent out. Business men, trave lin g out of existing groups, were referred to th ese prospective ne wcomer s. New groups started up a n d it was foun d, to the astonish ment of everyone, that A.A. ’ s mess age could be transmitted in the mail as well as by word of mo uth. By th e end of 1939 it was estimated that 800 alcoholi cs were on their way to recovery.

In the spring of 1940, John D. Rockefeller, Jr. gave a din n er for many of his frie nds to which he in vite d A.A. members to t e ll their stories. News of this got on the world wires; in qu iries poured in again a nd m a ny peop le we nt to the bookstores to get the book “ Alcoholics Anonymo u s. ’’ By M a rch 1941 t h e membership had shot up to 2,00 0. Then Jack Ale x a n d er wrote a feature artic l e in the Satu rd ay Evening Post and p l a c ed s u ch a compe l lin g picture of A.A. before the general public that alcoholics in nee d of help really de luge d us. By the c l ose of 1941, A.A. number ed 8,00 0 members. The mushr ooming pr ocess was in f u ll swin g. A.A. had be come a nation al institution.

Our Societ y then e n tered a fearsome a nd e x cit i ng adolescent period. The test th at it faced was th is: Could these large numbers of erstwhile erratic alco holics successfully meet and wo rk together? Would there be quarre ls over members h ip , leadersh ip, and money ? Would there be striv i ngs for powe r and prestig e? Would t h e r e be schisms wh ic h would split A.A. apart? S oon A.A. was beset by these ver y problems on every side and in every g r oup. But out of this frightening and at first disrupting exper i ence the conviction grew that A.A. ’ s had to hang together or die separ a tely. We had to u n ify our Fellowship or pass off the scene.

As we discov ered the prin cip l es by wh ich the ind i v i dua l alcoho lic cou l d live, so we had to evolv e princ i p l es b y wh ich th e A.A. groups an d A.A. as a whole cou l d su rvive and function effectively. It was thought that no alcoholic man or wom a n cou l d b e e x clud ed from our Society; that our leaders might serve but ne ver gov e rn ; th a t each grou p was to be aut o nomous and there was to be no professional class of therapy. There were to be no fe es or dues; our expe nses wer e to be met by our own voluntary contribut ions . There was to be the least possible organizat i on, even in our service center s. Our public relations were to be based upon attraction rather tha n promotion. It was dec i d e d that all mem b ers ought to be anony m ous a t the level of press, radio, TV a nd films. And in no circumstances should we give endorsements, make alliances, or enter public controversies.

This was the substance of A.A. ’ s Twelv e Trad itions, wh ich are stated in full on page 561 of this bo ok. Though none of these principles had the force of rules or laws, they had become so widely accepted by 1950 that they were confirme d by our first Internationa l Conference held at Cleve l a nd. T o day the rem a rkab le unity of A. A. is on e of the greatest assets that our Society has.

While the internal difficult ie s of our adolescent perio d were be ing ironed out, pu blic ac cept an ce of A.A. grew by leaps and bounds. For this there were two princ i p a l reasons: the large number s of recoveries, and reunit ed homes. Thes e made their impressio n s everywhere. Of alcoho lics wh o came to A.A. and really tried, 50% got sober at once an d remaine d that way; 25% sobered u p afte r some relapses, a nd among the re mainder, tho s e who staye d on with A.A. showed improvemen t. Other thousands came to a few A.A. meetings a nd a t first decide d they d i d n ’ t want the program. But great numbers of these — about two out of three — began to return as time pass ed.

Another reason for the wide acceptance of A.A. was the ministration of friends — friends in me dic i ne, re lig ion, and the press, together with in numer ab le others who be c a me our able a nd persistent ad vocates. With out such sup p ort,

A.A. could ha ve ma de only the slowest progress. Some of the recommendat i ons of A.A. ’ s early medical and religious friends will b e found furth e r on in this book.

Alcoholi cs Anonymous is not a relig iou s organizatio n . Neith e r does A.A. take any particular med i ca l poin t of view, though we cooperate wid ely with t h e men of med i cine as well as with the men of religion.

Alcohol be in g no respecte r of p e rson s, w e a re an a ccu ra te cross section of America, and in distant lands, the same democrat ic e v ening- up pr ocess is now going on. By personal re ligious affiliation, we in clud e Catho-lics, Protestants, Jews, Hindus, and a spr i nk ling of Mosle m s and Buddhists. More than 15% of us are women.

At present, our membership is py ra mi di n g a t th e ra te of about twent y per cent a year. So far, upon the total problem of several mi ll ion actu a l a nd potentia l al coholics in the world, we have mad e only a scrat c h. In a ll prob ability, we sha ll n eve r be able to touch more th an a fa ir fraction of the alco hol p r oblem in all its ramifications. Upon therapy for the alcoholic himself, we surely ha v e no monopoly. Yet it is our great hope that all those who have as yet fou nd no answer may begin to find one in the pages of this book and will prese n tly join us on th e hig h road to a new freed om.

FOREWORD TO THIRD EDITION

B Y M a rch 1976, when this editio n went to the printer, the total worldwide members h ip of Alcoho lics Anonymo u s was conservatively estimated at more than 1,000, 000 , with almost 28,00 0 groups meeting in over 90 countries.

Surve ys of groups in the U n ited States a nd Ca nad a in dic a te that A.A. is reach in g out, not only to more and more people, b u t to a wider a n d wid er range. Women now make up more than one-fourth of the membership; amo n g newer memb ers, the proportion is nearly one- third. Se ven percent of the A.A. ’ s surveyed are less than 30 years of age — among them, many in their teens.

The b a sic principles of the A.A. progra m, it app e ars, hold good for individuals wit h many different lifestyles, just as the program has brought recovery to those of many different nat i onalit ies. The Twelve Steps that summarize the program may b e ca lle d los Doce Pasos in one co untry, les Douze Et apes in anoth er, but they trace exactly the same pat h to recovery that was blazed by the earliest memb ers of Alcoholics Anonymous.

In spite of the great incre a se in the siz e and the s p an of this Fellowship, at its core it re mains simple and personal. Each day, some where in the world, recovery begins when one alcoho lic ta lk s with a n othe r alcoholic, s h aring experience, strength, and hope.

FORE WORD TO FOURTH E D ITION

T HIS fourth edition of “ Alcoholics Ano n ymous ” came off press in November 2001, at th e start of a new millennium. Sin c e the th ird edit ion was pub lish ed in 1976, worldwide membership of A.A. has just about doubled, to an estimated two million or more, with nearly 100,800 groups meeting in approximately 150 countries around the world.

Literature has played a major role in A.A. ’ s growth, and a striking p h e n omenon of the past qu arter-century has been the explosion of translations of our basic literat ure in to man y la ngu a ges and dia l e c ts. In countr y after country where the A. A. seed was plante d, it has taken root, slowly at first, then growing by le ap s and bounds when literature has be come a vaila ble. Cur r ently, “ Alco holics Anonymous ” has bee n tran slated into forty-three languages.

As the message of recovery has reached larger numbers of people, it has also touched the liv es of a vastly greate r variety of suffering alcoho lics. When the phrase “ We are people who n o rmally wou l d not mix ” (page 17 of this book) was written in 1939, it ref e rred to a Fellowship composed large l y of me n (an d a few women) with quite similar social, ethnic, an d e c onomic ba c kgrounds. Like so much o f A.A. ’ s basic text, those words have prov ed to be far more visionar y than the founding member s could ever have imagine d . The stories added to this edition represent a members h ip whose chara c teristic s — of age, gender, race, a nd c u lture — have widene d an d have deep en ed to encom p ass virtu a lly everyone the first 100 members could have hoped t o reach.

While our lit erature has preserved the integrity of the A.A. message, swe eping ch ang e s in society as a whole are reflected in new customs and practices within the Fellowsh i p. Tak i ng a d v a n t age of techn o logica l ad va nces, for example, A.A. member s wi th com p u t ers can particip ate

in me etings o n line, shar ing with fellow a l coholics acro ss the country or around the world. In any me eting, a n ywh ere, A.A. ’ s share exper i ence, strength, and hope with each other, in order to stay sob e r and help o t her alcoho lics.

M o dem-to-modem or face-to-face, A.A. ’ s speak the lang ua ge of the heart in a l l its power a n d simp licity.

THE DOCTORS OPI NION

W E OF Alcoholics Anon ymous be lie v e that the rea d er wi ll be interested in the medica l estimate of the plan of recovery des c ribe d in this book. Convincing testimo n y must surely c o me from medic a l men who have had exper i ence with the suffering s of our members and have witnessed our return to heal th. A we ll-k n own doctor, chief phys i ci an at a nationa l l y pr omine n t hospita l spec ia liz ing i n alcoho lic an d drug ad diction, gave Alco holics Anon y m ous this letter:

To Whom It May Concer n:

I hav e spec ia lize d in th e treatment of al coholism for man y years.

In late 1934 I attended a patien t who, though he had been a compete n t businessma n of g ood earning capacity, was an alcoho lic of a type I ha d c o me to regard as hope less.

In the course of his third treatment he acq uire d cert ain ideas concer nin g a possib l e mea n s of recovery. As part of his reha bilita t ion he com m enc ed to present his con c eptions to other alcoholics, impre ssing upo n th em that they must do like w ise w i th stil l others. This has be come the b a sis of a rapidly gro w ing fello wship of these men and the i r fa milies. This m a n an d over one h undre d others appe ar to have recovered.

I personally know scores of cases who were of the type with whom other methods ha d faile d comp le tely.

These facts appear to be of extreme me dical importance; beca use of the extraordina r y possibilitie s of rapid growth inh erent in t h is group the y may mark a new epo c h in the

ann a ls of alco holism. T h es e men m ay well h ave a remedy for thousands of such situations.

You may re ly absolutely on an ything th ey say a b out themselves.

Very truly yo urs, Will ia m D. S ilk worth, M. D.

The p h ys icia n who, at our request, gav e us this lette r, has been k i nd enough to enlar ge upon his views in another statement which follows. In this statement he confir ms what we who have suffere d alcoholic torture must believe — that the body of the alcoholic is quite as a b n o rmal as his m i nd. I t did not satis f y us to be told that we co u l d not control our drinking just because we were maladjust e d to life, that we were i n full f l ight from rea lity, or were outright mental defectives. These t h ings were true to some extent, in fact, to a considerable extent with some of us. But we are sure that our bodies were sick e n ed as w ell. I n our be lief, any pict ure of the alcoholic wh ic h lea v e s out this phy sica l factor is inco mplete.

The doctor ’ s theory that we have an a lle rgy to alcohol interests us. As layme n , our opin ion as to its soundn ess may, of course, mean little . But as expr oblem dr ink e rs, we can sa y that h i s exp l a n atio n ma kes goo d sense. It explains many things for which we cannot otherwise account.

Though we work out ou r solution on th e spiritu a l as wel l as a n al tru i sti c p l an e, w e favor hospitaliz a t ion for the alcoholi c who is very jittery or befogged. More o ften than not, it is imperative that a man ’ s br ain be cleare d before he is

approa che d , as he has the n a better ch ance of und erstand i n g and acce pting wh at we h ave to offer.

The doctor writes:

The subject presented in this book seems to me to be of paramo unt importance to those afflicte d wit h alcoholic add i ction.

I say this afte r many years ’ exper i en ce a s Med i ca l D i rector of one of the oldest hospit als in the country treating alcoho lic an d drug ad diction.

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

We doctors have realized for a long time that some form of moral psy c ho logy was of urgen t im portance to alcoh o lics, but its ap plic ation presen t ed difficu ltie s beyond our conception. What with our ul tra-moder n standards, our scient ific a p p r oach to everything, we ar e perha p s no t well equipped to apply the powers of good that lie outside our synthetic kno w le dge.

M a ny years ago one of the lead ing cont ributors to this book came un der our care in th is hospita l an d wh ile here he acq uire d some ide a s wh ic h he put into practic al a p p l ication at once.

Later, he requested the pr ivilege of be ing allowe d to tell his story to other patients he re and with some misgiving, we conse n ted. The c a ses we ha ve follo wed throug h have been most interesting; in f act, many of them are amazing. The unself ishness of these men as we have come to know them, the ent i re abse nce o f profit motive, and the i r commu nity s p irit, is i nde e d insp iri n g to one who has

labored long and wear ily in this alcoholic fie l d. T h ey bel i eve in the m selves, a nd still more i n the Power wh ich pulls chron i c alcoho lics b a ck from the gates of death.

Of course an alcoho lic ou g h t to be freed from his ph ysica l craving for liquor, and th is ofte n requires a defin i te hospital procedure, b efore psychologica l meas u r es can be of maxim u m be nefit.

We believe, and so suggested a few year s ago, that the action of alco hol on thes e chronic alcoh o lics is a man i festatio n of an allerg y; that the ph enomenon of craving is lim ited to this class and n ever occurs in the averag e temp erate drin ker . These allerg ic types can n ever safely use alc o hol in a n y form at all; a n d once ha vin g formed the h a bit a nd foun d they c a n n ot break it, once hav i ng lost their self-confidenc e, their r elianc e upon things hum an, the i r problems pile up on them and b ecome astonishingly difficult to solve.

Frothy emotional a ppe al s eldom suffice s. The messa ge wh ich can int erest and hold these alcoh o lic peo p le m u st have depth a nd we ig ht. In nearly all cas es, their ide a ls must be grounded in a po wer gr eater than themselves, if they are to re-create their lives.

If any fee l th at as psyc hiat rists directin g a hospita l for alcoho lics we appe ar somewhat sent ime n tal, let the m stand with us a while on the firing line, see the tragedies, the despairing wives, the little chil dre n ; let the solving of these problems bec o me a part of their da ily work, and eve n of their slee pin g moments, a nd the most cynical will not wonder th at we ha ve a cce pted an d en c o uraged th is movement. We feel, after many years of experie n ce , that we ha ve foun d nothing wh ich has contributed more t o the rehabilitation of these men th an the altruistic movement now growing up among them.

Men and wo men dr ink es sentia lly bec a u se they like the effect produc ed by alcoho l. Th e sensat ion is so elusive that, wh ile the y ad mit it is i n j u ri ous, they cannot after a time differentiate the true from the false. To them, their alcoho lic life seems the on ly no rmal one. They are restless, irritab l e a nd disconte nted, unless the y c a n ag ain expe rience the sense of ease an d com f ort which co mes at once by taking a few drinks — drinks which the y see others taking with impunit y . After they h ave s u cc um bed to the de sire again, as so man y do, a n d the phe nom enon of craving deve lops, the y pass throug h the we ll-k n own stages of a spree, emerging remorsef u l, wi th a fir m resolution not to drink aga i n. This is repeat ed over an d over, and un le ss this person can e x per i en ce an entire psy c h i c cha n ge ther e is very little ho pe of his recovery.

On the other han d — and st range as this may seem to those who do not u nderstan d — once a psy c h i c cha n ge has occurred, the very same pe rson who seemed doomed, who had so ma ny problems he despa i red of ever solving them, sudde nly fin d s himse l f ea sily a b le to control his des i re for alcoho l, the only effort necessary being that required to follow a few s i mp le ru les.

Men hav e cried out to me in sincere a n d desp airing appe al: “ Doctor, I cannot go on like this! I have everything to live for! I must st op, but I cannot! You must help me! ’’

Faced with t h is problem, if a do ctor is honest with h i mself, he must sometimes feel his own ina d e q uac y . Althou gh he gives a ll th at is in h i m, it o ften is not enough. One fe els that something m o re than hu m a n power is n eeded to produce the essentia l psyc hic cha n ge. Thoug h the aggreg ate of recoveries resulting from psychi atric ef fort is considerable, we ph ysicia n s must adm i t we ha ve m a d e little impre ssion upon the pro b le m as a wh ole. Ma ny ty pes do not respond to the ordina ry psyc hological a pproa ch.

I do not hold with those who believe th at alcoholism is entirely a pro b le m of mental control. I h ave h a d m a n y men who ha d, for exa m p l e, worked a per i od of months on some problem or b u siness de al wh ich was to be settled on a certain date, favorably to them. T h ey took a drink a day or so prior to the date, an d then the phe n o menon of craving at once became paramount to all other interests so t h at the important appointment was not met. These men were not d r i n ki n g to esc a p e ; th ey we re d r i n ki n g to ov e r c om e a craving b eyo nd the i r men t al control.

There are many situations wh ich arise out of the phe nomenon of craving whic h ca use m en to make the supreme sacr ifice rat h er th an continue to fight.

The c l assif i ca tion of alcoh o lic s seems most difficult, and in much detail is outside the scope of this book. There are, of course, the p s ychop aths who are emotionally u n stab le. We are all familia r with this ty pe. The y are always “ going on the wagon for ke eps. ’’ They ar e over-remorseful and make many resolutions, but never a decis i on.

There is the t y pe of man who is unwilling to admit that he can not take a drink. He plans var ious ways of drinking. He changes his brand or his e n vironment. There is the t y pe who alwa ys b elie ves that a fte r being entirely free from alcoho l for a period of tim e he ca n take a drink wit h out dang er. Ther e is the ma nic-de pressive type, who is, perha p s, the least un derstood by his friends, an d a b out whom a whole cha p ter could be wr itten.