Because this book has become the basic text for our Society and has helped such large numbers of alcoholic men and women to recovery, there exists a sentiment against any radical changes being made in it. Therefore, the first portion of this volume, describing the A.A. recovery program, has been left largely untouched.
But the personal history section has been considerably revised and enlarged in order to present a more accurate representation of our membership as it is today. When the book was first printed, we had scarcely 100 members all told, and every one of them was an almost hopeless case of alcoholism. This has changed. A.A. now helps alcoholics in all stages of the disease. It reaches into every level of life and into nearly all occupations. Our membership now includes many young people. Women, who were at first very reluctant to approach A.A., have come forward in large numbers. Therefore the range of the story section has been broadened so that every alcoholic reader may find a reflection of him or herself in it.
As a souvenir of our past, the original Foreword has been preserved and is followed by a second on describing Alcoholics Anonymous of 1955.
Following the Forewords, there appears a section called “The Doctor’s Opinion.” This also has been kept intact, just as it was originally written in 1939 by the late Dr. William D. Silkworth, our Society’s great medical benefactor. Besides Dr. Silkworth’s original statement, there have been added, in the Appendices, a number of the medical and religious endorsements which have come to us in recent years.
On the last pages of this second edition will be found the Twelve Traditions of Alcoholics Anonymous, the principles upon which our A.A. groups function, together with the directions for getting in touch with A.A.
FOREWORD TO THE FIRST EDITION
This is the Foreword as it appeared in the first printing of the first edition in 1939
WE, OF Alcoholics Anonymous, are more than one hundred men and woman who have recovered from a seemingly hopeless state of mind and body. To show other alcoholics PRECISELY HOW WE HAVE RECOVERED is the main purpose of this book. For them, we hope these pages will prove so convincing that no further authentication will be necessary. We think this account of our experiences will help everyone to better understand the alcoholic. Many do not comprehend that the alcoholic is a very sick person. And besides, we are sure that our way of living has its advantages for all.
It is important that we remain anonymous because we are too few, at present to handle the overwhelming number of personal appeals which may result from this publication. Being mostly business or professional folk, we could not well carry on our occupations in such an event. We would like it understood that our alcoholic work is an avocation.
When writing or speaking publicly about alcoholism, we urge each of our Fellowship to omit his personal name, designating himself instead as “a member of Alcoholics Anonymous.”
Very earnestly we ask the press also, to observe this request, for otherwise we shall be greatly handicapped.
We are not an organization in the conventional sense of the word. There are no fees or dues whatsoever. The only requirement for membership is an honest desire to stop drinking. We are not allied with any particular faith, sect or denomination, nor do we oppose anyone. We simply wish to be helpful to those who are afflicted.
We shall be interested to hear from those who are getting results from this book, particularly form those who have commenced work with other alcoholics. We should like to be helpful to such cases.
Inquiry by scientific, medical, and religious societies will be welcomed.
FOREWORD TO SECOND EDITION
SINCE the original Foreword to this book was written in 1939, a wholesale miracle has taken place. Our earliest printing voiced the hope “that every alcoholic who journeys will find the Fellowship of Alcoholics Anonymous at his destination. Already,” continues the early text, “twos and threes and fives of us have sprung up in other communities.”
Sixteen years have elapsed between our first printing of this book and the presentation of 1955 of our second edition. In that brief space, Alcoholics Anonymous has mushroomed into nearly 6,000 groups whose membership is far above 150,000 recovered alcoholics. Groups are to be found in each of the United States and all of the provinces of Canada. A.A. has flourish- ing communities in the British Isles, the Scandinavian countries, South Africa, South America, Mexico, Alaska, Australia and Hawaii. All told, promising beginnings have been made in some 50 foreign countries and U.S. possessions. Some are just now taking shape in Asia. Many of our friends encourage us by saying that this is but a beginning, only the augury of a much larger future ahead.
The spark that was to flare into the first A.A. group was struck at Akron, Ohio in June 1935, during a talk between a New York stockbroker and an Akron physician. Six months earlier, the broker had been relieved of his drink obsession by a sudden spiritual experience, following a meeting with an alcoholic friend who had been in contact with the Oxford Groups of that day. He had also been greatly helped by the late Dr. William D. Silkworth, a New York specialist in alcoholism who is now accounted no less than a medical saint by A.A. members, and whose story of the early days of our Society appears in the next pages. From this doctor, the broker had learned the grave nature of alcoholism. Though he could not accept all the tenets of the Oxford Groups, he was convinced of the need for moral inventory, confession of personality defects, restitution to those harmed, helpfulness to others, and the necessity of belief in and dependance upon God.
Prior to his journey to Akron, the broker had worked hard with many alcoholics on the theory that only an alcoholic could help an alcoholic, but he had succeeded only in keeping sober himself. The broker had gone to Akron on a business venture which had collapsed, leaving him greatly in fear that he might start drinking again. He suddenly realized that in order to save himself he must carry his message to another alcoholic. That alcoholic turned out to be the Akron physician.
This physician had repeatedly tried spiritual means to resolve his alcoholic dilemma but had failed. But when the broker gave him Dr. Silkworth’s description of alcoholism and its hopelessness, the physician began to pursue the spiritual remedy for his malady with a willingness he had never again up to the moment of his death in 1950. This seemed to prove that one alcoholic could affect another as no nonalcoholic could. It also indicated that strenuous work, one alcoholic with another, was vital to permanent recovery.
Hence the two men set to work almost frantically upon alcoholics arriving in the ward of the Akron City Hospital. Their very first case, a desperate one, recovered immediately and became A.A. number three. He never had another drink. This work at Akron continued through the summer of 1935. There were many failures, but there was an occasional heartening success. When the broker returned to New York in the fall of 1935, the first A.A. group had actually been formed, though no one realized it at the time.
A second small group promptly took shape at New York, to be followed in 1937 with the start of a third at Cleveland. Besides these, there were scattered alcoholics who had picked up the basic ideas in Akron or New York who were trying to form groups in other cities. By late 1937, the number of members having substantial sobriety time behind them was sufficient to convince the membership that a new light had entered the dark world of the alcoholic.
It was now time, the struggling groups thought, to place their message and unique experience before the world. This determination bore fruit in the spring of 1939 by the publication of this volume. The membership had then reached about 100 men and women. The fledgling society, which had been nameless, now began to be called Alcoholics Anonymous, from the title of its own book. The flying-blind period ended and A.A. entered a new phase of its pioneering time.
With the appearance of the new book a great deal began to happen. Dr. Harry Emerson Fosdick, the noted clergyman, reviewed it with approval. In the fall of 1939 Fulton Oursler, the editor of “Liberty,” printed a piece in his magazine, called “Alcoholics and God.” This brought a rush of 800 frantic inquiries into the little New York office which meanwhile had been established. Each inquiry was painstakingly answered; pamphlets and books were sent out. Businessmen, traveling out of existing groups, were referred to these prospective newcomers. New groups started up and it was found, to the astonishment of everyone, that A.A.’s message could be transmitted in the mail as well as by word of mouth. By the end of 1939 it was estimated that 800 alcoholics were on their way to recovery.
In the spring of 1940, John D. Rockefeller, Jr. gave a dinner for many of his friends to which he invited A.A. members to tell their stories. News of this got on the world wires; inquiries poured in again and many people went to the bookstores to get the book “Alcoholics Anonymous.” By March 1941 the membership had shot up to 2,000. Then Jack Alexander wrote a feature article in the “Saturday Evening Post” and placed such a compelling picture of A.A. before the general public that alcoholics in need of help really deluged us. By the close of 1941, A.A. numbered 8,000 members. The mushrooming process was in full swing, A.A. had become a national institution.
Our Society then entered a fearsome and exciting adolescent period. The test that it faced was this: Could these large numbers of erstwhile erratic alcoholics successfully meet and work together? Would there be quarrels over membership, leadership and money? Would there be strivings for power and prestige? Would there be schisms which would split A.A. apart? Soon A.A. was beset by these very problems on every side and in every group. But out of this frightening and at first disrupting experience the conviction grew that A.A.’s had to hang together or die separately. We had to unify our Fellowship or pass off the scene.
As we discovered the principles by which the individual alcoholic could live, so we had to evolve principles by which the A.A. groups and A.A. as a whole could survive and function effectively. It was thought that no alcoholic man or woman could be excluded from our Society; that our leaders might serve but not govern; that each group was to be autonomous and there was to be no professional class of therapy. There were to be no fees or dues; our expenses were to be met by our own voluntary contributions. There was to be the least possible organization, even in our service centers. Our public relations were to be based upon attraction rather than promotion. It was decided that all members ought to be anonymous at the level of press, radio, TV and films. And in no circumstances should we give endorsements, make alliances, or enter public controversies.
This was the substance of A.A.’s Twelve Traditions, which are stated in full on page 564 of this book. Though none of these principles had the force of rules or laws, they had become so widely accepted by 1950 that they were confirmed by our first International Conference held at Cleveland. Today the remarkable unity of A.A. is one of the greatest assets that our Society has.
While the internal difficulties of our adolescent period were being ironed out, public acceptance of A.A. grew by leaps and bounds. For this there were two principal reasons: the large numbers of recoveries, and reunited homes. These made their impressions everywhere. Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with A.A. showed improvement. Other thousands came to a few A.A. meetings and at first decided they didn’t want the program. But great numbers of these–about two out of three–began to return as time passed.
Another reason for the wide acceptance of A.A. was the ministration of friends – friends in medicine, religion, and the press, together with innumerable others who became our able and persistent advocates. Without such support, A.A. could have made only the slowest progress. Some of the recommendations of A.A.’s early medical and religious friends will be found further on in this book.
Alcoholics Anonymous is not a religious organization. Neither does A.A. take any particular medical point of view, though we cooperate widely with the men of medicine as well as with the men of religion.
Alcohol being no respecter of persons, we are an accurate cross section of America, and in distant lands, the same democratic evening-up process is now going on. By personal religious affiliation, we include Catholics, Protestants, Jews, Hindus, and a sprinkling of Moslems and Buddhists. More than fifteen per cent of us are women.
At present, our membership is increasing at the rate of about seven per cent a year. So far, upon the total problem of several million actual and potential alcoholics in the world, we have made only a scratch. In all probability, we shall never be able to touch more than a fair fraction of the alcohol problem in all its ramifications. Upon therapy for the alcoholic himself, we surely have no monopoly. Yet it is our great hope that all those who have as yet found no answer may begin to find one in the pages of this book and will presently join us on the high road to a new freedom.
THE DOCTOR’S OPINION
WE OF Alcoholics Anonymous believe that the reader will be interested in the medical estimate of the plan of recovery described in this book. Convincing testimony must surely come from medical men who have had experience with the sufferings of our members and have witnessed our return to health. A well-known doctor, chief physician at a nationally prominent hospital specializing in alcoholic and drug addiction, gave Alcoholics Anonymous this letter:
To Whom It May Concern:
I have specialized in the treatment if alcoholism for many years.
In late 1934 I attended a patient who, though he had been a competent businessman of good earning capacity, was an alcoholic of a type I had come to regard as hopeless.
In the course of his third treatment he acquired certain ideas concerning a possible means of recovery. As part of his rehabilitation he commenced to present his conceptions to other alcoholics, impressing upon them that they must do likewise with still others. This has become the basis of a rapidly growing fellowship of these men and their families. This man and over one hundred others appear to have recovered.
I personally know scores of cases who were of the type with whom other methods had failed completely.
These facts appear to be of extreme medical importance; because of the extraordinary possibilities of rapid growth inherent in this group they may mark a new epoch in the annals of alcoholism. These men may well have a remedy for thousands of such situations.
You may rely absolutely on anything they say about themselves.
Very truly yours, William D. Silkworth, M.D.
The physician who, at our request, gave us this letter, has been kind enough to enlarge upon his views in another statement which follows. In this statement he confirms what we who have suffered alcoholic torture must believe–that the body of the alcoholic is quite as abnormal as his mind. It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact, to a considerable extent with some of us. But we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete.
The doctor’s theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little. But as ex-problem drinkers, we can say that his explanation makes good sense. It explains many things for which we cannot otherwise account.
Though we work out our solutions on the spiritual as well as an altruistic plane, we favor hospitalization for the alcoholic who is very jittery or befogged. More often than not, it is imperative that a man’s brain be cleared before he is approached, as he has then a better chance of understanding and accepting what we have to offer.
The doctor writes:
The subject presented in this book seems to me to be of paramount importance to those afflicted with alcoholic addiction.
I say this after many years’ experience as Medical Director of one of the oldest hospitals in the country treating alcoholic and drug addiction.
There was, therefore, a sense of real satisfaction when I was asked to contribute a few words on a subject which is covered in such masterly detail in these pages.
We doctors have realized for a long time that some form of moral psychology was of urgent importance to alcoholics, but its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge.
Many years ago one of the leading contributors to this book came under our care in this hospital and while here he acquired some ideas which he put into practical application at once.
Later, he requested the privilege of being allowed to tell his story to other patients here and with some misgiving, we consented. The cases we have followed through have been most interesting: in fact, many of them are amazing. The unselfishness of these men as we have come to know them, the entire absence of profit motive, and their community spirit, is indeed inspiring to one who has labored long and wearily in this alcoholic field. They believe in themselves, and still more in the Power which pulls chronic alcoholics back from the gates of death.
Of course an alcoholic ought to be freed from his physical craving for liquor, and this often requires a definite hospital procedure, before psychological measures can be of maximum benefit.
We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.
Frothy emotional appeal seldom suffices. The message which can interest and hold these alcoholic people must have depth and weight. In nearly all cases, their ideals must be grounded in a power greater than themselves, if they are to re-create their lives.
If any fell that as psychiatrists directing a hospital for alcoholics we appear somewhat sentimental, let them stand with us a while on the firing line, see the tragedies, the despairing wives, the little children; let the solving of these problems become a part of their daily work, and even of their sleeping moments, and the most cynical will not wonder that we have accepted and encouraged this movement. We feel, after many years if experience, that we have found nothing which has contributed more to the rehabilitation of these men than the altruistic movement now growing up among them.
Men and women drink essentially because they like the effect produced by alcohol. The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one. They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few drinks–drinks which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to drink again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery.
On the other hand–and strange as this may seem to those who do not understand–once a psychic change has occurred, the very same person who seemed doomed, who had so many problems he despaired of ever solving them, suddenly finds himself easily able to control his desire for alcohol, the only effort necessary being that required to follow a few simple rules.
Men have cried out to me in sincere and despairing appeal: “Doctor, I cannot go on like this! I have everything to live for! I must stop, but I cannot! You must help me!”
Faced with this problem, if a doctor is honest with himself, he must sometimes feel his own inadequacy. Although he gives all that is in him, it often is not enough. One feels that something more than human power is needed to produce the essential psychic change. Though the aggregate of recoveries resulting from psychiatric effort is considerable, we physicians must admit we have made little impression upon the problem as a whole. Many types do not respond to the ordinary psychological approach.
I do not hold with those who believe that alcoholism is entirely a problem of mental control. I have had many men who had, for example, worked a period of months on some problem or business deal which was to be settled on a certain date, favorably to them. They took a drink a day or so prior to the date, and then the phenomenon of craving at once became paramount to all other interests so that the important appointment was not met. These men were not drinking to escape; they were drinking to overcome a craving beyond their mental control.
There are many situations which arise out of the phenomenon of craving which cause men to make the supreme sacrifice rather then continue to fight.
The classification of alcoholics seems most difficult, and in much detail is outside the scope of this book. There are, of course, the psychopaths who are emotionally unstable. We are all familiar with this type. They are always “going on the wagon for keeps.” They are over-remorseful and make many resolutions, but never a decision.
There is the type of man who is unwilling to admit that he cannot take a drink. He plans various ways of drinking. He changes his brand or his environment. There is the type who always believes that after being entirely free from alcohol for a period of time he can take a drink without danger. There is the manic-depressive type, who is, perhaps, the least understood by his friends, and about whom a whole chapter could be written.
Then there are types entirely normal in every respect except in the effect alcohol has upon them. They are often able, intelligent, friendly people.
All these, and many others, have one symptom in common: they cannot start drinking without developing the phenomenon of craving. This phenomenon, as we have suggested, may be the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity. It has never been, by any treatment with which we are familiar, permanently eradicated. The only relief we have to suggest is entire abstinence.
This immediately precipitates us into a seething caldron of debate. Much has been written pro and con, but among physicians, the general opinion seems to be that most chronic alcoholics are doomed. What is the solution? Perhaps I can best answer this by relating one of my experiences.
About one year prior to this experience a man was brought in to be treated for chronic alcoholism. He had but partially recovered from a gastric hemorrhage and seemed to a case of pathological mental deterioration. He has lost everything worthwhile in life and was only living, one might say, to drink. He frankly admitted and believed that for him there was no hope. Following the elimination of alcohol, there was found to be no permanent brain injury. He accepted the plan outlined in this book. One year later he called to see me, and I experienced a very strange sensation. I knew the man by name, and partly recognized his features, but there all resemblance ended. From a trembling, despairing, nervous wreck, had emerged a man brimming over with self-reliance and contentment. I talked with him for some time, but was not able to bring myself to feel that I had known him before. To me he was a stranger, and so he left me. A long time has passed with no return to alcohol.
When I need a mental uplift, I often think of another case brought in by a physician prominent in New York. The patient had made his own diagnosis and deciding his situation hopeless, had hidden in a deserted barn determined to die. He was rescued by a searching party, and, in desperate condition, brought to me. Following his physical rehabilitation, he had a talk with me in which he frankly stated he thought the treatment a waste of effort, unless I could assure him, which no one ever had, that in the future he would have the “will power” to resist the impulse to drink.
His alcoholic problem was so complex and his depression so great, that we felt his only hope would be through what we then called “moral psychology”, and we doubted if even that would have any effect.
However, he did become “sold” on the ideas contained in this book. He has not had a drink for a great many years. I see him now and then and he is as fine a specimen of manhood as one could wish to meet.
I earnestly advise every alcoholic to read this book through, and though perhaps he came to scoff, he may remain to pray.
William D. Silkworth, M.D