Foreword 4
Bill's Story

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 of 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 exproblem 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 solution 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 feel 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 of 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 than 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 be a case of pathological mental deterioration. He had 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.

The 12 Steps

Bill Wilson

Fact #1

Fact #2

Fact #1

This man and over one hundred others appear to have recovered.

Fact #2

I personally know scores of cases who were of the type with whom other methods had failed completely.

Spiritual

The spiritual aspect of our program is our journey in seeking the higher power that will provide answers to all our problems.

The spiritual journey on the Road of Happy Destiny, the 12 steps, that takes us closer and closer to the Higher Power.

APPROACHED References

Among the many points Bill Wilson makes over and over in the Big Book is that it is the responsibility, the obligation of those who are living in the solution as the result of the steps to approach the newcomer or someone who is struggling or suffering. The attitude found in today's recovery culture of "if they want it bad enough, they'll come and ask me for help" is nowhere to be found in the Big Book.

Or, how about giving phone numbers to newcomers without taking theirs and making the first contact yourself? Clearly we expect too much from the newcomer. How many of us when new were able to pick up the phone and talk to a total stranger about our problems, fears or God?

So, what follows is a partial list of references to "making the approach". As this is a work in progress, we welcome any additions you may find.

  1. "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."(Doctor's Opinion, pg. xxiv)
  2. "He had come to pass his experience along to me" (Bill's Story, pg. 9:7)
  3. "That the man who is making the approach has had the same difficulty, that he obviously knows what he is talking about" (There Is A Solution, Pg. 18:5)
  4. "After such an approach many take up their beds and walk again." (There Is A Solution, Pg. 19:0)
  5. "When, therefore, we were approached by those in whom the problem had been solved, there was nothing left for us but to pick up the simple kit of spiritual tools laid at our feet." (There Is A Solution, Pg. 25:1)
  6. "This is our twelfth suggestion: Carry this message to other alcoholics!" (Working With Others pg. 89:1)
  7. "You can easily find some by asking a few doctors, ministers, priests or hospitals." (Working With Others pg. 89:1)
  8. "You need this information to put yourself in his place, to see how you would like him to approach you if the tables were turned." (Working With Others pg. 90:2)
  9. Approach through a doctor or an institution is a better bet. (Working With Others pg. 91:1)
  10. When your man is better, the doctor might suggest a visit from you. (Working With Others pg. 91:2)
  11. Call on him while he is still jittery. (Working With Others pg. 91:2)
  12. Your job now is to be at the place where you may be of maximum helpfulness to others…(Working With Others pg. 102:2)
  13. …so never hesitate to go anywhere if you can be helpful. (Working With Others pg. 102:2)
  14. You should not hesitate to visit the most sordid spot on earth on such an errand. (Working With Others pg. 102:2)
  15. When we see a man sinking into the mire that is alcoholism, we give him first aid…(The Family Afterwards Pg. 132:1)
  16. …and place what we have at his disposal. (The Family Afterwards Pg. 132:1)
  17. Following his discharge, we contacted him. (To Employers 139:1)
  18. We think this method of approach will accomplish several things. (To Employers 148:3)
  19. The other day an approach was made to the vice president of a large industrial concern. He remarked: "I'm glad you fellows got over your drinking." (To Employers 148:4)
  20. They will approach still other sick ones and fellowships of Alcoholics Anonymous may spring up in each city and hamlet (A Vision For You pg. 153:2)
  21. In the chapter "Working With Others" you gathered an idea of how we approach and aid others to health. (A Vision For You pg. 153:3)
  22. Every few days this doctor suggests our approach to one of his patients. (A Vision For You pg. 162:1)

The Solution

There are two subjects presented in this book:

  1. Alcoholism
  2. Spiritual Experience

Moral Psychology

Spiritual Experience | Change in Personality

Reclamation of the Alcoholic.

The purpose of moral psychology then is to assist alcoholics in overcoming their perspective of extreme self-centeredness and encourage them to adopt an attitude of consideration and care for others. In Silkworth's opinion, this shift of perspective away from self and toward others was of paramount importance in keeping alcoholics from taking their next drink.

SCHABERG, WILLIAM H.. WRITING THE BIG BOOK

Spiritual Experience

Medical Capacities

Most up-to-date

Powers of God

Experience

Dr. Silkworth's second letter

Psychological Rehabilitation Of Alcoholics

by William D. Silkworth, M.D.

The Medical Record, July 19, 1939

This is an expanded letter from Silky, parts of which can be found in the Big Book pages xxiii to xxx called "The Doctor's Opinion".

In a study of carefully recorded histories of alcoholics in our hospital, two important facts appear to be outstanding. Expressed briefly, they are:

  1. A majority or our patients do not wish to have an alcoholic problem. They lead busy lives & would like to enjoy the fruits of their efforts, but they cannot stop the use of alcohol.
  2. These patients cannot use alcohol in moderation.

The allergic nature of true alcoholism was postulated in a previous paper. We then endeavored to show that alcohol does not become a problem to every person who uses it, & that the use of alcohol in itself does not produce a chronic alcoholic.

The phenomenon of craving must be present as a manifestation of an allergy. Once established in an individual, one drink creates a desire for more. It sets this person aside as a separate entity. It creates a conflict that ends in a form of neurosis.

Looking further at the record of these unfortunates, we find that the majority could not drink in moderation from the very beginning. Whether 20, 30, or 50 years of age, they soon become a problem to themselves & to their friends.

Now in analyzing these alcoholic-minded persons, there is no one physical or psychical fact that is sufficiently constant to justify its use as the basis of an accepted theory. Such phrases as "escape from reality" & "inferiority complex" hold true for some, but not all, while heredity, only son, & implied spoiling in childhood, account for a few more. They all lead to confusion & have no answer.

Eliminate the constitutional psychopaths, the moral & mental defectives, & there remains a large class, neurotic in type, for whom something is worth doing. Remember we are discussing the chronic alcoholic, not the man who drinks more than is good for him but has no resulting problem.

Apparently all these people – good, bad & indifferent – have one thing in common: they cannot drink in moderation. We believe they show manifestations of an allergy to alcohol. They may abstain from use of alcohol for a month or a year, but on taking it again in any form, they at once establish the phenomenon of craving. This fact is well known to all alcoholics & creates their major problems in the early stages of their drinking habits. They complain about it, too.

Why, we naturally ask, in the early years of drinking, while they still have the ability to choose, do these people not solve this problem by the complete discontinuance of alcohol? Some do, but many are like the rest of us who do things we know we should not, but like to do them anyway. Many really believe they can drink as they see others doing, & enjoy themselves. For many reasons, most of which are social or even physical, the idea of drinking is developed gradually. As this idea advances, daily life becomes more secure, but these men are unwilling to accept the facts as presented to them. The act of drinking (in the end damaging) is followed by certain comfortable emotional states that make it a pleasure. They prove to themselves that they can stop drinking by going on the wagon for varying periods, but even as life becomes more complicated, they still persist in that old, original idea. Up to this time, in what one might call the first period of alcoholism there are methods employed to help these persons return to a normal life & accept the fact that their old idea of drinking must be discarded forever. We ourselves have treated some of them with permanent results, but the majority continues along the primrose path. The history of these people & their families present from now on, one of the real tragedies of human life & is too well known to comment on further here.

This begins the second stage. Understood by no-one & not understanding themselves, they enter an ever-widening circle, remorse, penance, new transgressions, new penance, until they lose all capacity for spontaneous action. They sacrifice themselves for a perversive idea & defying the law of nature (allergy) operating in their case, pay the penalty. They have lost all pleasure in normal life. Based on their underlying neurotic nature, they develop a compulsion type of thinking, and, although not a true compulsion neurosis, it is surely a borderline type. The patient now acts under what has been called by Wechsler a psychic imperative, the dreaded terminal state of paralysis of the will. The predisposing factor in bringing about this definite state of insecurity is the conflict brought about by alcoholism.

It is not within the scope of this paper to discuss the complications of the obsessional neurosis, which are, in fact, the most elastic of all the neuroses, but in this particular type it seems to permit a retreat from the ever-increasing anxieties induced by the advancing chronic alcoholism. This compulsive thinking is apparently a purely intellectual process occurring more frequently among persons of relatively higher intellectual attainment, from which class, by the way, comes the average chronic alcoholic.

The characteristic of all compulsion types of thinking is the relatively good insight that accompanies them. The victim knows his impulse to drink is wrong but he is helpless before it. Wives may plead, friends argue, & employers threaten, but he is no longer amenable to impression. He is unable to resolve between opposing impulses. He cries out in agony, "I must stop, I cannot be like this; but I cannot stop; someone must help me."

If he has sufficient means, he has by now been treated by psychiatrists, good men, who fully realize the unfavorable prognosis, but who, often without remuneration, give freely of their time to help the victim. I have often seen psychoanalysis of an alcoholic, instead of breaking up the compulsive thinking; start the person further theorizing on his own illness.

We know that, as a rule, the only relief from psychoanalysis is in making the so-called transfer, & experience has taught us that this is gratifyingly successful if accomplished. If successful, it must be based on respect & confidence on the part of the patient. It can seldom be accomplished in this class of patients, except by one who has suffered in the same manner & has recovered. In other words, to accomplish the transfer of this compulsive idea by the plan we have seen developed, an ex-alcoholic who has recovered by the same means be the medium employed. Such a medium can explain convincingly, not only that the transfer of the compulsive thinking can be made, but also he can prove how he did it himself successfully.

We physicians 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 ultramodern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good lying outside our synthetic knowledge.

About four years ago, we hospitalized a young man for severe chronic alcoholism, &, while under our care he developed a plan that seemed to me to be a combination of psychology & religion. He never drank any form of alcohol again.

Later he requested the privilege of being allowed to tell his story to other patients &, perhaps 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 & their community spirit, are indeed inspiring to one who has labored long & wearily in the field of alcoholism. They believe in themselves, & still more in the Power which pulls chronic alcoholics back from the gates of death.

Of course, prior to & in preparation for the application of this plan, it is, in my opinion, essential to detoxicate the alcoholics by hospitalization. You then have a subject whose brain is clear & whose mind is receptive & temporarily free from his craving. I hesitate here to attempt even an outline of the plan as employed by these men. Sufficient to say, perhaps, that following many failures, they gradually devised a plan or procedure that led them to make this so-called transfer to one greater than themselves, to God.

The whole story is admirably told in a book written by them entitled "Alcoholics Anonymous". It would seem to me that they have wrung from the Eternal a new application of an old truth that is sufficient equipment to restore the patient in his fight for sobriety. The results seem to flow naturally from a follow-up of honest effort.

To make any such plan practical they have also projected this transfer beyond the individual to the group. The information of these men into groups, each one with the hand of fellowship passing on his experiences to others, helping those who have newly joined to adjust themselves, actively engaged in gathering in new members, seems to me the most practical application of their moral psychology, to assure their "transfer" of being permanent. (Although I have met some 30 or more of these ex-alcoholics. I relate my experience with two of them.)

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 & seemed to be a case of pathological mental deterioration. He had lost everything worthwhile in life, & was only living, one might say, to drink. He frankly admitted & 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 the book. One year later he called to see me, & I experienced a very strange sensation. I knew the man by name & partly recognized his features, but there all resemblance ended. From a trembling, despairing, nervous wreck, had emerged a man brimming over with self-reliance & 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, & so he left me. More than three years have now 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 City. The patient made his own diagnosis, & deciding that his condition was hopeless, had hidden in a deserted barn, determined to die. He was rescued by a searching party, & 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 time & effort unless I could assure him, which no one ever had, that in the future he could have the will power to resist the impulse to drink. His alcoholic problem was so complex, & his depression so great, that we felt his only hope would be through what we then called "moral psychology," & we doubted if even that would have any effect. However, he did adopt the ideas contained in this book. He has not had a drink for more than three years. I see him now & then, & he is as fine a specimen as one could wish to meet.

Bill Wilson acquired ideas from Dr. Silkworth. Those ideas were that we have a malady made up of a physical allergy and a mental obsession.

Alcoholism is a twofold condition:
  1. Physical
  2. Mental

Anytime the word craving is mentioned in this book, Bill is talking about the physical craving and NOT the mental obsession. You can't crave for alcohol if it is not in your body. If it is in your mind, you are thinking about alcohol, not craving.

CRAVING: No Longer A Phenomenon

Now back in the 1930's (the Phenomenon of Craving) was part of the Doctor's Opinion. In the 1930's they knew very little about metabolism. Today they know lots about it.

Metabolism:

  1. Today they know that if you put anything in your system such as a piece of bread or a piece of beefsteak, that the mind and body recognizes what that is.
  2. Certain organs in the body begin to produce some things called enzymes.
  3. These enzymes attack that food and begin to break it down and separate it into useable and non-useable items.
  4. What the body can use such as the proteins, amino acids and vitamins - the body will retain.
  5. What it can't use it will dissipate through the urinary and intestinal tract.

They call that metabolism. Today they have proven that The Doctor's Opinion is no longer just an opinion, its actually true. And just to stress the obvious: this is not "official" A.A. information. A.A. won't get involved into why we're allergic, because that "outside issue" might bring controversy. But this information, which was presented a few years ago by members of the medical community, is so interesting and has such depth and meaning for people like us, I think we would be remiss if we didn't look at it. So let's look at it for just a moment.

Take for example, the group of "normal/social" drinkers who are able to drink "safely". They are at ease with alcohol. They take a drink or two, and their mind and body sense it, the enzyme production starts, and the enzymes attack the alcohol.

1st Stage: The enzymes breaks it down into acetaldehyde

2nd Stage: then to diacetic acid

3rd Stage: then to acetone

Final Stage: In the final stages it becomes a simple carbohydrate made up of water, sugar, and carbon dioxide.

  • The water would be dissipated through the urinary and intestinal tract
  • The sugar is a form of energy which the body will burn and store the excess as fat to be used at a later date
  • The carbon dioxide will be dissipated through the lungs

In the normal social drinker this takes place at the rate of approximately one ounce per hour. While it varies with different people, the average seems to be about one ounce per hour. And if they don't drink more than an ounce per hour >>> they can't get drunk. Their body metabolizes it, burns it up and gets rid of it at that rate. Very seldom do you see a social drinker consuming more than an ounce per hour. If you're with one of them and they're drinking more than an ounce an hour, you better get out of the way. Cause they're going to puke on you after a while. They'll either go to sleep or they'll puke on you, one of the two, every time.

Now, let's look at the Alcoholic, the one who cannot drink with impunity - he's at dis-ease with alcohol. And that separates us from the norm. When alcoholics put it in our body, the same thing happens. Their mind and body sense it, the enzyme production starts, and the enzymes attack the alcohol.

1st Stage: break it down to acetaldehyde

2nd Stage: then to diacetic acid

3rd Stage: then to acetone

Final stage: - - - - - - - - - - ->>It seems as though, in our bodies, the enzymes necessary to break it down from acetone to the simple carbohydrate, are not as they are in the body of the nonalcoholic. Therefore it stays in our body for a longer period of time as acetone. And: It is proven today, that acetone ingested into the human system that remains there for an appreciable period of time, will produce an actual physical craving for more of the same. This shows how alcohol is not completely processed through the alcoholic's body, and the resulting havoc it creates. In a non-alcoholic's body, that acetone goes through that final stage of conversion to simple carbohydrate so rapidly that the craving never occurs.

In our body it stays there long enough, thereby allowing that craving to develop – which demands a second drink….etc.

The Alcoholic's acetone level goes up - and if the acetone is what causes the craving, then the craving becomes harder with a second drink. Now you put in the third, and the acetone increases, causing the craving to intensify, and that demands a fourth >>>>>>as the acetone level increases with each drink, the craving becomes greater and greater and greater. Because the more you drink, the greater the craving……it's just endless once it starts. And, we know that Alcoholism is a progressive disease. This is true whether we are drinking, or sober twenty some odd years. In relation to the physical aspect, for each year that we grow a little older in sobriety, our bodies grow older too. And as the body ages, the production of enzymes needed to break down alcohol, slows down as well. If an alcoholic picks up a drink after twenty years of sobriety, the acetone that will now remain longer in his system will trigger stronger cravings than he has ever felt before. The drinking will be much worse and it will be much harder to stop if he so desires. We do not pick up where we left off; we pick up as if we never stopped. So not only do we have a physical illness, but it is progressive because of:

  • damage to the body, and also
  • due to the aging factor

Now that we can see that, we can hopefully accept the fact that we can no longer successfully drink alcohol. Until we could see this we always felt there had to be a way we could drink without getting drunk, and it damn near kills us. But now that we can see this - we can more readily accept the fact that we can no longer drink like "other people."

Willpower

Life is unmanageable | Second part of the first step

Interventions

Family telling me that my drinking is bad for me and everyone. Parents telling me to stop. Wife pleading me to stop. Other people telling me that I have a problem.

The message must come from the alcoholics who understand what I am going through.

I am creating something that was never here before. I am creating something brand new. It is a start of a new life. Once I am done with this work, I can look back and say that I am not the same person I was when I started this.

Insanity.
Believing in a lie.
Telling myself that this time it will be different.

AA

And filled with guilt, shame and remorse.

Obsession

Craving comes when we give in to the obsession.

Mind change.

Few simple rules = The 12 Steps

Willpower

Dr. Silkworth's Classification of Alcoholics:

  1. Psychopaths
  2. Denial
  3. Believes they can drink again after a time.
  4. Manic-depressive
  5. Normal in every respect
  6. Neurotic - emotionally and mentally disturbed (From the first edition)

Want more alcohol.

This is the opinion of the medical community.

But here's the AA's answer:
WE, OF Alcoholics Anonymous, are more than one hundred men and women who have recovered from a seemingly hopeless state of mind and body.

Hank Parkhurst

He was Bill's partner in writing the Book. He is not mentioned because he relapsed.

Hopeless

Detox

Worked the Steps

Spiritual Awakening

He had re-created his life.

Fitz Mayo | John Henry Fitzhugh Mayo | Our Southern Friend

When the group was trying to decide on a name for the book, Fitz, because of his close proximity to Washington, was asked to go to the Library of Congress and find out how many books were called "The Way Out." Fitz reported that the Library of Congress had 25 books entitled "The Way Out," and 12 entitled "The Way." There were none called "Alcoholics Anonymous." That settled the matter.

Obsession

The Steps

The Result | Spiritual Awakening

Foreword 4
Bill's Story