ALCOHOLICS ANONYMOUS® is a fellowship of menand women who share their experience, strengthand hope with each other that they may solvetheir common problem and help others to recov-er from alcoholism. • The only requirement for membership is adesire to stop drinking. There are no dues or feesfor A.A. membership; we are self-supportingthrough our own contributions.• A.A. is not allied with any sect, denomination,politics, organization or institution; does not wishto engage in any controversy; neither endorsesnor opposes any causes.• Our primary purpose is to stay sober and helpother alcoholics to achieve sobriety.

Copyright © by A.A. Grapevine, Inc.;reprinted with permission

Copyright byAlcoholics Anonymous World Services, Inc.

475 Riverside DriveNew York, NY 10115

Mail address: Box 459, Grand Central StationNew York, NY 10163

www.aa.org

20M 06/13 (RP)

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Three Talks toMedical Societies

by Bill W.,Co-Founder of

Alcoholics Anonymous

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A.A.’s debt to medicine

Since its founding in 1935 the AlcoholicsAnonymous program of recovery from alcoholismhas had the support and encouragement of manyindividual members of the medical profession.

In addition, as A.A. has grown, many recog-nized groups comprising general practitioners andspecialists have become increasingly interestedin the unique A.A. approach to a serious health problem.

The three papers excerpted here include thefirst two detailed reports on the A.A. program tobe presented to formal assemblies of leading med-ical societies, together with a more recent sum-mary of the Fellowship’s progress. All three aremilestones in the growth of understanding of A.A.by one of its major allies — Medicine. Each pre-sentation was made by Bill W., co-founder of A.A.*

The most recent paper, presented before theNew York City Medical Society on Alcoholism inApril, 1958, appears first in this pamphlet. It isfollowed by an address to the section onNeurology and Psychiatry of the Medical Societyof New York at the Society’s Annual Meeting inMay, 1944. The third section contains excerptsfrom a presentation read at the 105th annual meet-ing of the American Psychiatric Association inMay, 1949, originally published in the AmericanJournal of Psychiatry for November, 1949.

The opinions and viewpoints expressed in thefollowing papers are intended solely to reflectA.A. experience and do not imply the endorse-ment of the medical groups before which theywere presented.

* Bill W. died January 24, 1971.

THE TWELVE STEPSOF ALCOHOLICS ANONYMOUS

1. We admitted we were powerless over alco-hol—that our lives had become unmanageable.

2. Came to believe that a Power greaterthan ourselves could restore us to sanity.

3. Made a decision to turn our will and ourlives over to the care of God as we understoodHim.

4. Made a searching and fearless moralinventory of ourselves.

5. Admitted to God, to ourselves and toanother human being the exact nature of ourwrongs.

6. Were entirely ready to have God removeall these defects of character.

7. Humbly asked Him to remove our short-comings.

8. Made a list of all persons we had harmed,and became willing to make amends to them all.

9. Made direct amends to such people wher-ever possible, except when to do so wouldinjure them or others.

10. Continued to take personal inventoryand when we were wrong promptly admitted it.

11. Sought through prayer and meditationto improve our conscious contact with God, aswe understood Him, praying only for knowl-edge of His will for us and the power to carrythat out.

12. Having had a spiritual awakening as theresult of these steps, we tried to carry thismessage to alcoholics, and to practice theseprinciples in all our affairs.

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Alcoholics Anonymous —beginnings and growth

By Bill W.

Presented to theNew York City Medical Society on Alcoholism

April 28, 1958

Fourteen years ago, I read a paper before theMedical Society of the State of New York at itsannual gathering. (See page 25) For us ofAlcoholics Anonymous, that was a history-makingevent; it marked the first time that any ofAmerica’s great medical associations had takenfavorable notice of our Fellowship. The physiciansof that day did far more than take notice of us;they received us with open arms and allowed ouraccount of A.A. to be published in their Journal.Reprints of that 1944 paper have since been scat-tered in tens of thousands of copies throughoutthe world, convincing physicians everywhere ofA.A.’s worth. What this perceptive and generousact has since meant to countless alcoholics andtheir families, only God Himself knows.

Keenly appreciative that the members of theNew York City Medical Society on Alcoholismhave in the same generous spirit invited me to behere tonight, it is with a sense of timeless grati-tude that I bring you greetings from those 250,000recovered alcoholics who now comprise our mem-bership in some 7,000 groups, here and abroad.*

Perhaps the better way to understand A.A.’smethods and results is to have a look at its begin-nings — at that time when medicine and religionentered into their benign partnership with us. Thispartnership is now the foundation of such successas we have since had.

Certainly nobody invented Alcoholics Anony-mous. A.A. is a synthesis of principles and atti-tudes which came to us from medicine and fromreligion. We alcoholics have simply streamlinedthose forces, adapting them to our special use in asociety where they can work effectively. Our

* As of 2013, membership exceeds 2,000,000 and more than114,600 groups are recorded.

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contribution was but the missing link in a chain ofrecovery which is now so significant and of suchpromise for the future.

Few people know that the first taproot ofA.A. hit paydirt some thirty years ago in a physi-cian’s office. Dr. Carl Jung, that great pioneer inpsychiatry, was talking to an alcoholic patient.This, in effect, is what happened:

The patient, a prominent American business-man, had gone the typical alcoholic route. He hadexhausted the possibilities of medicine and psychi-atry in the United States and had then come toDr. Jung as to a court of last resort. Carl Junghad treated him for a year and the patient, whomwe shall call Mr. R., felt confident that the hiddensprings underneath his compulsion to drink hadbeen discovered and removed. Nevertheless, hefound himself intoxicated within a short time afterleaving Dr. Jung’s care.

Now he was back, in a state of black despair.He asked Dr. Jung what the score was, and hegot it. In substance, Dr. Jung said, “for some timeafter you came here, I continued to believe thatyou might be one of those rare cases who couldmake a recovery. But I must now frankly tell youthat I have never seen a single case recoverthrough the psychiatric art where the neurosis isso severe as yours. Medicine has done all that itcan do for you, and that’s where you stand.”

Mr. R.’s depression deepened. He asked: “Isthere no exception; is this really the end of theline for me?”

“Well,” replied the doctor, “there are someexceptions, a very few. Here and there, once in awhile, alcoholics have had what are called vitalspiritual experiences. They appear to be in thenature of huge emotional displacements and rear-rangements. Ideas, emotions and attitudes whichwere once the guiding forces of these men aresuddenly cast to one side, and a completely newset of conceptions and motives begin to dominatethem. In fact, I have been trying to produce somesuch emotional rearrangement within you. Withmany types of neurotics, the methods which Iemploy are successful, but I have never beensuccessful with an alcoholic of your description.”

“But,” protested the patient, “I’m a religiousman, and I still have faith.” To this Dr. Jung

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replied, “Ordinary religious faith isn’t enough.What I’m talking about is a transforming experi-ence, a conversion experience, if you like. I canonly recommend that you place yourself in thereligious atmosphere of your own choice, that yourecognize your personal hopelessness, and thatyou cast yourself upon whatever God you thinkthere is. The lightning of the transforming experi-ence of conversion may then strike you. This youmust try — it is your only way out.” So spoke agreat and humble physician.

For the A.A.-to-be, this was a ten-strike. Sci-ence had pronounced Mr. R. virtually hopeless.Dr. Jung’s words had struck him at great depth,producing an immense deflation of his ego. Defla-tion at depth is today a cornerstone principle ofA.A. There in Dr. Jung’s office it was first em-ployed in our behalf.

The patient, Mr. R., chose the OxfordGroup of that day as his religious association andatmosphere. Terribly chastened and almost hope-less, he began to be active with it. To his intensejoy and astonishment, the obsession to drink pre-sently left him.

Returning to America, Mr. R. came upon anold school friend of mine, a chronic alcoholic. Thisfriend — whom we shall call Ebby — was about tobe committed to a state mental hospital. At thisjuncture another vital ingredient was added to theA.A. synthesis. Mr. R., the alcoholic, began talk-ing to Ebby, also an alcoholic and a kindred suf-ferer. This made for identification at depth, asecond cardinal A.A. principle. Over this bridgeof identification, Mr. R. passed Dr. Jung’s verdictof how hopeless, medically and psychiatrically,most alcoholics were. He then introduced Ebbyto the Oxford Group, where my friend promptlysobered up.

My friend Ebby well knew of my plight. I hadgone the familiar course. In the summer of 1934my doctor, William D. Silkworth, had given meup and had pronounced me hopeless. He had beenobliged to tell me that I was the victim of a neurot-ic compulsion to drink that no amount of willpower, education or treatment could check. Headded that I was also the victim of a bodilyderangement which might be in the nature of anallergy — a physical malfunction that virtually

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guaranteed brain damage, insanity or death. Hereagain the god of Science — which was then myonly god — had well deflated me. I was ready forthe message that was soon to come from my alco-holic friend Ebby.

He came to my house one day in November,1934, and sat across the kitchen table from mewhile I drank. No thanks, he didn’t want anyliquor, he said. Much surprised, I asked what hadgot into him. Looking straight at me, he said hehad “got religion.” This was a real crusher, anaffront to my scientific training. As politely aspossible, I asked what brand of religion he had.

Then he told me of his conversations with Mr.R., and how hopeless alcoholism really was, ac-cording to Dr. Carl Jung. Added to Dr. Silkworth’sverdict, this was the worst possible news. I washard hit. Next Ebby enumerated the principles hehad learned from the Oxford Group. Though hethought these good people sometimes too aggres-sive, he certainly couldn’t find any fault with mostof their basic teachings. After all, these teachingshad sobered him up.

In substance, here they are, as my friendapplied them to himself in 1934:

1. Ebby admitted that he was powerless tomanage his own life.

2. He became honest with himself as neverbefore; made an “examination of conscience.”

3. He made a rigorous confession of his per-sonal defects and thus quit living alone with hisproblems.

4. He surveyed his distorted relations withother people, visiting them to make what amendshe could.

5. He resolved to devote himself to helpingothers in need, without the usual demand forpersonal prestige or material gain.

6. By meditation, he sought God’s directionfor his life and the help to practice these principlesof conduct at all times.

This sounded pretty naive to me. Nevertheless,my friend stuck to the plain tale of what had hap-pened. He related how, practicing these simpleprecepts, his drinking had unaccountably stopped.Fear and isolation had left, and he had received aconsiderable peace of mind. With no hard disci-plines nor any great resolves, these changes

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began to appear the moment he conformed. Hisrelease from alcohol seemed to be a byproduct.Though sober but months, he felt sure he had abasic answer. Wisely avoiding arguments, he thentook his leave. The spark that was to becomeAlcoholics Anonymous had been struck. One alco-holic had been talking to another, making a deepidentification with me and bringing the principlesof recovery within my reach.

At first, my friend’s story generated mixedemotions; I was drawn and revolted by turns. Mysolitary drinking went on for some weeks, but Icould not forget his visit. Several themes coursedin my mind: first, that his evident state of releasewas strangely and immensely convincing; second,that he had been pronounced hopeless by compe-tent doctors; third, that these age-old precepts,when transmitted by him, struck me with greatpower; fourth, that I could not, and would not,go along with any God concept, that there wouldbe no conversion nonsense for me. Often tryingto divert my thoughts, I found it no use. By cordsof understanding, suffering and simple verity,another alcoholic had bound me to him. I couldnot break away.

One morning, after my gin,this realizationwelled up. “Who are you,” I asked, “to choosehow you are going to get well? Beggars are notchoosers. Supposing medicine said carcinoma wasyour trouble. You would not turn to Pond’s Ex-tract. In abject haste you would beg a doctor tokill those hellish cancer cells. If he couldn’t stopthem, and you thought religious conversionmight, your pride would fly away. If need be, youwould stand in a public square, crying ‘Amen’along with other victims. What difference then,” Ireflected, “between you and the cancer victim? Hissick body crumbles. Likewise, your personalitycrumbles, your obsession consigns you to mad-ness or the undertaker. Are you going to try yourfriend’s formula — or not?”

Of course, I did try. In December, 1934, Iappeared at Towns Hospital, New York. My oldfriend, Dr. William Silkworth, shook his head.Soon free of sedation and alcohol, I felt horriblydepressed. My friend Ebby turned up. Thoughglad to see him, I shrank a little. I fearedevangelism, but nothing of the sort happened.

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After some small talk, I again asked him for hisneat little formula for recovery. Quietly andsanely, without the slightest pressure, he told me.Then he left.

Lying there in conflict, I dropped into the black-est depression I had ever known. Momentarilymy prideful obstinacy was crushed. I cried out,“Now I’m ready to do anything — anything toreceive what my friend Ebby has.” Though Icertainly didn’t really expect anything, I did makethis frantic appeal: “If there be a God, will Heshow Himself!” The result was instant, electric,beyond description. The place seemed to light up,blinding white. I knew only ecstasy and seemedon a mountain. A great wind blew, enveloping andpenetrating me. To me, it was not of air, but ofSpirit. Blazing, there came the tremendousthought “You are a free man.” Then the ecstasysubsided. Still on the bed, I now found myself ina new world of consciousness which was suffusedby a Presence. One with the universe, a greatpeace stole over me. I thought, “So this is theGod of the preachers, this is the Great Reality.”But soon my so-called reason returned, my mod-ern education took over. I thought I must becrazy, and I became terribly frightened.

Dr. Silkworth, a medical saint if ever there wasone, came in to hear my trembling account of thisphenomenon. After questioning me carefully, heassured me that I was not mad, that I had perhapsundergone a psychic experience which mightsolve my problem. Skeptical man of sciencethough he then was, this was most kind andastute. If he had said, “hallucination,” I might nowbe dead. To him I shall ever be eternally grateful.

Good fortune pursued me. Ebby broughtme a book entitled “Varieties of Religious Experi-ence” and I devoured it. Written by William James,the psychologist, it suggests that the conversionexperience can have objective reality. Conversiondoes alter motivation, and does semi-automaticallyenable a person to be and to do the formerlyimpossible. Significant it was that marked conver-sion experiences came mostly to individuals whoknew complete defeat in a controlling area of life.The book certainly showed variety. But whetherthese experiences were bright or dim, cataclysmicor gradual, theological or intellectual in bearing,

such conversions did have a common denomina-tor — they did change utterly defeated people. Sodeclared William James, the father of modern psy-chology. The shoe fit, and I have tried to wear itever since.

For drunks, the obvious answer was deflationat depth, and more of it. That seemed as plain asa pikestaff. I had been trained as an engineer, sothe views of this authoritative psychologist meanteverything to me. This eminent scientist of themind had confirmed everything that Dr. Jung hadsaid, and had extensively documented all heclaimed. Thus William James firmed up the foun-dation on which I and many another have stoodall these years. I haven’t had a drink of alcoholsince 1934.

Armored now by utter conviction, and forti-fied by my characteristic power-drive, I took off tocure alcoholics wholesale. It was twin-jet pro-pulsion; difficulties meant nothing. The vast con-ceit of my project never occurred to me. I pressedthe assault for six months, and my home was filledwith alcoholics. Harangues with scores producednot the slightest results. (Disappointingly, Ebby,my friend of the kitchen table, who was sickerthan I realized, took little interest in these otheralcoholics. This fact may have caused his back-slides later on, though he did make his eventualrecovery.) But I had found that working withalcoholics had a huge bearing on my own sobriety.Nevertheless, none of my prospects were gettingsober. Why was this?

Slowly, the defects of my approach came tolight. Something like a religious crank, I wasobsessed with the idea that everybody must havea “spiritual experience” just like mine. I forgotthat James had said that there were many varietiesof the transforming experience. My brother alco-holics just stared incredulously or joshed meabout my “hot flash.” Of course, this spoiled thepotent identification that it was so necessary toestablish with them. I had turned evangelist.Clearly the approach had to be altered. What hadcome to me in six minutes might require sixmonths with others. I had to learn that words werethings, that one had to be prudent.

At this juncture — the spring of 1935 — Dr.Silkworth pointed out to me that I had forgotten

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all about deflation at depth. I had simply turnedpreacher. Said he, “Why don’t you pour the grimmedical facts into these people before you doanything else? Have you forgotten what WilliamJames said about ego deflation at depth? Givethem the medical business, and give it to themhard. Skip that account of your ‘hot flash.’ Reciteyour symptoms extensively, so as to get an iden-tification at depth. When you do this, your pros-pects may become willing to adopt the simplemoral precepts you have been trying to teach.”Here was a most vital contribution to the synthe-sis. Once again it had been made by a physician.

The emphasis was straightaway shifted from“sin” to sickness — the fatal malady — alcoholism.We quoted several doctors to the effect thatalcoholism was more lethal than cancer; that itconsisted of an obsession of the mind coupled toincreasing body sensitivity. These were our twinogres — Madness and Death. We leaned heavilyon Dr. Jung’s statement of how hopeless thecondition could be, and then poured that devastat-ing dose into every drunk within range. To mod-ern man, science is omnipotent — virtually a god.Hence if science passed a death sentence on thedrunk, and we placed that fearful verdict on ouralcoholic transmission belt, one victim talking toanother, it might shatter the listener completely.Then the alcoholic might turn to the God of thetheologian, there being no other place to go.Whatever truth there was in this device, it cer-tainly had practical merit. Immediately our wholeatmosphere changed. Things began to look up.

A few months later, I was introduced to Dr.Robert S., an Akron surgeon. He was an alcoholicin a bad way. This time there was no preachmentfrom me. I told him of my experience and of whatI knew about alcoholism. Because we understoodand needed each other, there was genuine mutu-ality for the first time. This marked the end of mypreaching attitude. This idea of mutual need addedthe final ingredient to the synthesis of medicine,religion and the alcoholic’s experience which isnow Alcoholics Anonymous.

ÒDr. Bob,Ó a very grim case, sobered almostimmediately and never took a drink to the time ofhis death in 1950. He and I soon commenced towork on numbers of alcoholics that we found at

the Akron City Hospital. Almost immediately therewas a recovery, and then another. The first suc-cessful A.A. group had been formed. Returning toNew York in the fall of 1935, this time with all theingredients of recovery, another groupsoon took shape in this city.

Nevertheless, progress of the Akron and NewYork Groups was painfully slow for the next fewyears. Hundreds of cases were tried, but only afew responded. Near the close of 1937, however,forty were sober and we began to be far moresure of ourselves. We saw that we had a formulawhich might — carried from one alcoholic to thenext — eventually produce, chain-style, a verylarge number of recoveries. So came the question:“How can our good news be spread to the millionsof alcoholics in America and throughout theworld?” One basic answer seemed to be in lit-erature, detailing our methods. Another need wasfor widespread publicity which would bring greatnumbers of cases to us.

By the spring of 1939, our Society had pro-duced a book which was called “AlcoholicsAnonymous.” In this volume, our methods werecarefully described. For the sake of greater clarityand thoroughness, the word-of-mouth programwhich my friend Ebby had given to me wasenlarged into what we now call A.A.’s “TwelveSuggested Steps for recovery.” (See p. 7.) Thiswas the backbone of our book. To substantiateA.A. methods, our book included twenty-eightcase histories. We hoped that these stories mightfully identify us with readers at a distance, andthey certainly have. As we had withdrawn from theOxford Group, our Fellowship adopted the nameof our book, “Alcoholics Anonymous,” as its own.The advent of that volume marked a historicalturning point. In the twenty years since, this basictext has gained a circulation of nearly 400,000copies.* Countless alcoholics have sobered withno other aid than reading this volume and practic-ing its principles.

Our next need was publicity, and it was forth-coming. Fulton Oursler, the noted editor andwriter, printed a piece in Liberty magazine about usin 1939. The following year, John D. Rockefeller,Jr., gave A.A. a dinner which was widely publi-

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* In 2013, distribution passed 33,400,000.

cized. The next year, 1941, there was a feature arti-cle in the Saturday Evening Post. This story alonebrought us thousands of new people. As we gainedsize, we also gained in effectiveness. The recoveryrate went way up. Of all those who really triedA.A., a large percent made it at once, others finallymade it; and still others, if they stayed with us,were definitely improved. Our high recovery ratehas since held, even with those who first wrotetheir stories in the original edition of “AlcoholicsAnonymous.” In fact, 75 percent of these finallyachieved sobriety. Only 25 percent died or wentmad. Most of those still alive have now been soberfor an average of twenty years.

In our early days, and since, we have foundthat great numbers of alcoholics approach us andthen turn away — maybe three out of five, today.But we have happily learned that the majority ofthem later return, provided they are not toopsychopathic or too brain-damaged. Once theyhave learned from the lips of other alcoholics thatthey are beset by an often fatal malady, theirfurther drinking only turns up the screw. Eventu-ally they are forced back into A.A.; they must door die. Sometimes this happens years after thefirst exposure. The ultimate recovery rate in A.A.is therefore a lot higher than we at first thoughtit could be.

Another development of recent years has beena source of much comfort. In our early time, wecould only deal with last-gasp cases. Nothing couldbe done until alcohol had nearly wrecked its vic-tim. But nowadays we don’t always have to waitwhile sufferers plumb these depths. We can nowhelp alcoholics to see where they are headed —before they “hit bottom.” In consequence, half oftoday’s membership in A.A. is composed of farmilder cases. Very often, the family, the job, andthe victim’s health are relatively unimpaired. Evenpotential cases are today approaching us, peoplewho have suffered only a little. Here and abroad,too, our Society is making much headway in cross-ing every barrier of race, creed and circumstance.

Yet we must humbly reflect that AlcoholicsAnonymous has so far made only a scratch uponthe total problem of alcoholism. Here in the UnitedStates, we have helped to sober up scarcely five percent of the total alcoholic population of 4,500,000.

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The reasons are these: We can’t deal withalcoholics who are too psychopathic or brain-dam-aged; many alcoholics don’t like our methods andthey look for an easier or different way; millionsstill cling to the rationalization that their troublesare wholly due to their personal circumstancesand are therefore somebody else’s fault. To getthe alcoholic or the potential alcoholic to admitthat he is the victim of an often fatal and progres-sive malady is usually a very difficult matter. Thisis the big problem that still faces all of us, whetherphysicians, clergymen, families or friends. How-ever, there is much reason to hope. One of thegreatest reasons for hope lies in what you physi-cians are already doing — and may still do.Perhaps some of you may be asking, “How can wehelp still more effectively?”

Here we A.A.’s can offer nothing authoritative,but we do feel we can make some helpful sugges-tions. Consider the family physician. Only a fewyears ago, a drunk was mostly a nuisance. Thephysician and the hospital could get him overrough hangovers. A little comfort might be af-forded the family, but little else could be done.

Now the situation is different. Nearly every cityand hamlet in this country has an A.A. group. Yetall too often, the alcoholic will not try A.A. Thisis just where the family physician can so oftenstep in. He is the one usually called upon whenreal trouble starts to loom. After getting thevictim sobered up and the family quieted down,he can frankly tell the alcoholic what ails him. Hecan do the same thing for his patients that CarlJung did for “Mr. R.” and that Dr. Silkworth didfor me. This is to make it clear to the reluctantdrunk that he has contracted a progressive andoften fatal malady, that he can’t get well by him-self, that he needs lots of help. Since a great deal istoday known about the emotional and metabolicdeficiencies of the alcoholic, family physicians candocument their presentation in a far more convinc-ing manner than could our early pioneer doctors .

It is very gratifying to know that today thesubject of alcoholism is being taught in many ofour medical schools. In any case, the facts aboutalcoholism are easy to obtain. Organizations likethe National Council on Alcoholism, the YaleSchool of Alcoholic Studies,* plus innumerable

* Since 1962, the Rutgers School of Alcohol Studies.

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state rehabilitation and clinical efforts, are readysources of helpful knowledge. So armed, the fam-ily physician can — as we say in A.A. — “softenup” the drunk so that he will be willing to take alook at our Fellowship. Or, if he balks at A.A.,he may be directed to a clinic, a psychiatrist, oran understanding pastor. At this stage, the mainthing is that he recognize his illness and that hestart to do something about it.

If the family physicianÕs job is carefullydone,the results are often immediate. If the firstattempt doesn’t work, the chances are better thaneven that persistent and successive approacheswill bring results. These simple procedures donot rob the family physician of much time, nor willthey be necessarily hard on the patient’s pocket-book. A concerted effort of this sort by familyphysicians everywhere could not fail to achieveimmense results. In fact, the effect of the familyphysician’s work of this sort has already beengreat. And for this, I would like to set on ourrecord the very special thanks of A.A. to them.

Now we come to the specialist, usually thepsychiatrist. I’m glad to say that psychiatrists ingreat numbers are referring alcoholics to A.A. — even psychiatrists who more or less specialize onalcoholics. Their understanding of alcoholics isnow great. Their patience and their tolerance ofus, and of A.A., have been monumental.

In 1949, for example, the American PsychiatricAssociation allowed me to read a paper on A.A.before a section of its Annual Meeting (see page39). As these doctors specialize in emotional dis-orders — and alcoholism is certainly one of them— this act of theirs has always seemed to me awonderful example of fine humility and generosity.The reprints of even that one paper have had avast effect, worldwide. I’m sure that we A.A.’shave never been sufficiently appreciative of all ofthis. It used to be the fashion among some of usin A.A. to decry psychiatry, even medical aid ofany description, save that barely needed for sob-ering up. We pointed to the failures of psychiatryand of religion. We were apt to thump our chestsand exclaim, “Look at us. We can do it, but theycan’t!” It is therefore with great relief that I canreport this to be a vanishing attitude. ThoughtfulA.A. members everywhere realize that psychia-

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trists and physicians helped to bring our Societyinto being in the first place and have held up ourhands ever since.

We also realize that the discoveries of the psy-chiatrist and the biochemist have vast implica-tions for us alcoholics. Indeed, these discoveriesare today far more than implications. Your presi-dent and other pioneers in and outside your soci-ety have been achieving notable results for along time, many of their patients having madegood recoveries without any A.A. at all. It shouldhere be noted that some of the recovery meth-ods employed outside A.A. are quite in contradic-tion to A.A. principles and practice. Never -theless, we of A.A. ought to applaud the fact thatcertain of these efforts are meeting with increas-ing success.

We know, too, that psychiatry can often releasethe big neurotic overhang from which many of ussuffer after A.A. has sobered us. We know thatpsychiatrists have sent us innumerable alcoholicswho would have never otherwise approachedA.A., and many clinics have done likewise. Weclearly see that by pooling our resources we cando together what could never be accomplished inseparation, or in shortsighted criticism and in competition.

Therefore I would like to make a pledgeto the whole medical fraternity that A.A. willalways stand ready to cooperate, that A.A. willnever trespass upon medicine, that our memberswho feel the call will increasingly help in thosegreat enterprises of education, rehabilitation andresearch which are now going forward with such promise.

So menacing is the growing specter of alcohol-ism that nothing short of the total resources ofsociety can hope to vanquish or much lessen thestrength of our very dangerous adversary, JohnBarleycorn. The subtlety and power of the alcohol-ic’s malady is revealed on every page of mankind’shistory — and never so starkly and so destructive-ly as in this century.

When our combined understanding and knowl-edge have been fully massed and applied, we ofA.A. know that we shall find our friends of medi-cine in the very front rank — just where so manyof you are already standing today.

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When such an array of benign and cooperativeaction is in full readiness, it can, and will, surelybe a great tomorrow for that vast host of menwho suffer from alcoholism and from all its darkand baleful consequences.

Statement on alcoholism

The American Medical Association identifies al-coholism as a complex disease with biological, psy-chological and sociological components and recog-nizes medicine’s responsibility in behalf of affectedpersons. The Association recognizes that there aremultiple forms of alcoholism, and that each patientshould be evaluated and treated in an individual-ized and comprehensive manner.

— House of DelegatesAmerican Medical Association, 1971

Is Alcoholismreally an illness?

The American Medical Association and theWorld Health Organization, as well as many otherprofessional groups, regard alcoholism as a disease.The judiciary and law-makers also are recognizingit as a disease.

Some authorities continue to see alcoholism onlyas an expression of underlying emotional problems.Others see it starting as a symptom which precedesan illness and requires treatment in itself

The Committee on Alcoholism and Drug Depen-dence of the American Medical Association definesalcoholism as an illness in which there is preoccu-pation with alcohol and loss of control over itsconsumption, as a type of drug dependence that canharm a person’s health and interfere with his abilityto work and get along with other people.

The alcoholic usually drinks heavily and gets drunkoften. Quantity and frequency, however, are only onesign. Although some alcoholics actually drink less thansome social drinkers, this does not change their basiccondition nor make it less serious. The key factor is lossof control and craving for the drug, alcohol.

Physical disabilities and difficulties adjusting tolife may contribute to the development of the illness,as well as result from it. Drinking by one’s self: ordrinking early in the morning, may be signs ofalcoholism, but they are not always present.

Similarly, living on skid row, being irresponsibleand other behavior commonly regarded as funda-mental to alcoholism, are neither limited to thedisorder nor necessarily part of it. In fact, the classof alcoholics made up of financially successful pro-fessional persons may well be one of the largest,and certainly one of the most seriously neglected,groups in this country.

— From the pamphlet “The Illness Called Alco-holism,” published by the American MedicalAssociation (Committee on Alcoholism andDrug Dependence, Council on Mental Health,Department of Health Education); reprintedwith permission.

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Basic concepts ofAlcoholics Anonymous

By Bill W.

Excerpts from an address presented to theMedical Society of the State of New YorkSection on Neurology and Psychiatry

Annual Meeting, New York, N.Y., May 1944

Alcoholics Anonymous has but one purpose —one objective only — “to help other alcoholics torecover from their illness.”

Nothing is asked of the alcoholic approachingus save a desire on his part to get well. Hesubscribes to no membership requirements — nofees or dues — nor is a belief in any particularpoint of view, medical or religious, demanded ofhim. As a group we take no position on any contro-versial question. Emphatically we are not evange-lists or reformers. Being alcoholics who haverecovered, we aim to help only those who want toget well. We do this because we have found thatworking with other alcoholics plays such a vitalpart in keeping us all sober.

You may inquire, “Just how does A.A. work?”I cannot fully answer that question. Many A.A.techniques have been adopted after a ten-yearprocess of trial and error which has led to someinteresting results. But, as laymen, we doubt ourown ability to explain them. We can only tell youwhat we do, and what seems, from our point ofview, to happen to us.

At the very outset we would like it made everso clear that A.A. is a synthetic concept — asynthetic gadget, as it were, drawing upon theresources of medicine, psychiatry, religion, andour own experience of drinking and recovery. Youwill search in vain for a single new fundamental.We have merely streamlined old and proved prin-ciples of psychiatry and religion into such formsthat the alcoholic will accept them. And then wehave created a society of his own kind where hecan enthusiastically put these very principles towork on himself and other sufferers.

Then, too, we have tried hard to capitalize ourone great natural advantage. That advantage is,

of course, our personal experience as drinkerswho have recovered. How often do doctors andclergymen throw up their hands when after ex-haustive treatment or exhortation, the alcoholicstill insists, “But you don’t understand me. Younever did any serious drinking yourself so howcan you? Neither can you show me many whohave recovered.”

Now when one alcoholicwho has got welltalks to another who hasn’t, such objections sel-dom arise, for the new man sees in a few minutesthat he is talking to a kindred spirit, one whounderstands. Neither can the recovered A.A.member be deceived, for he knows every trick,every rationalization of the drinking game. So theusual barriers go down with a crash. Mutual con-fidence, that indispensable of all therapy, followsas surely as day does night. And if this absolutelynecessary rapport is not forthcoming at once it isalmost certain to develop when the new man hasmet other A.A.’s. Someone will, as we say, “clickwith him.”

As soon as that happens we have a good chanceof selling our prospect those very essentials whichyou doctors have so long advocated, and the prob-lem drinker finds our Society a congenial place towork them out for himself and his fellow alcoholic.For the first time in years he thinks himself under-stood and he feels useful; uniquely useful indeed,as he takes his own turn promoting the recoveryof others. No matter what the outer world stillthinks of him he now knows that he can get well,for he stands in the midst of scores of cases worsethan his own who have attained the goal. Andthere are other cases precisely like his own — apressure of testimony which usually overwhelmshim. If he doesn’t succumb at once, he will almostsurely do so later when Barleycorn builds a stillhotter fire under him, thus blocking off all hisother carefully planned exits from dilemma. Thespeaker recalls seventy-five failures during the firstthree years of A.A. — people we utterly gave up.During the past seven years sixty-two of thesecases have returned to us, most of them now mak-ing good. They tell us they returned because theyknew they would die or go mad if they didn’t.Having tried everything else within their means,having exhausted their pet rationalizations, they

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came back and took their medicine. That is whywe never need evangelize alcoholics. If still intheir right minds they come back, since they havebeen well exposed to A.A.

Now to recapitulate. Alcoholics Anonymous hasmade two major contributions to the program ofpsychiatry and religion:

1. Our ability, as ex-drinkers, to secure theconfidence of the new man — to “build a transmis-sion line into him.”

2. The provision of an understanding societyof ex-drinkers in which the newcomer can suc-cessfully apply the principles of medicine and re-ligion to himself and others.

So far as we A.A.’s are concerned, these prin-ciples, now used by us every day, seem to be insurprising agreement. Let’s compare briefly whatin a general way medicine and religion tell thealcoholic:1. Medicine says:The alcoholic needs a person -

ality change.Religion says: The alcoholic needs a changeof heart, a spiritual awakening.

2. Medicine says: The patient ought to beanalyzed and should make a full and honestmental catharsis.Religion says: The alcoholic should makeexamination of the “conscience” and a con-fession — or a moral inventory and a frank discussion.

3. Medicine says: Serious “personality defects”must be eliminated through accurate self-knowledge and realistic readjustment to life.Religion says: Character defects (sins) canbe eliminated by acquiring more honesty,humility, unselfishness, tolerance, generosity,love, etc.

4. Medicine says:The alcoholic neurotic re-treats from life, is a picture of anxiety andabnormal self-concern; he withdraws from the “herd.”Religion says:The alcoholic’s basic troubleis self-centeredness. Filled with fear and self-seeking, he has forgotten the “Brotherhoodof Man.”

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5. Medicine says:The alcoholic must find “anew compelling interest in life,” must “getback into the herd.” Should find an interestingoccupation, should join clubs, social activities,political parties or discover hobbies to take theplace of alcohol.Religion says: The alcoholic should learn the“expulsive power of a new affection,” love ofserving man, of serving God. He must “losehis life to find it,” he should join the church,and there find self-forgetfulness in service. For“faith without works is dead.”

Thus far religion and medicineare seen inhearty accord. But in one respect they do differ.When the doctor has shown the alcoholic hisunderlying difficulties and has prescribed a pro-gram of readjustment, he says to him, “Now thatyou understand what is required for recovery youshould no longer depend on me. You must dependon yourself. You go do it.”

Clearly then, the object of the doctor is to makethe patient self-sufficient and largely if not whollydependent upon himself.

Religion does not attempt this. It says that faithin self is not enough, even for a nonalcoholic. Theclergyman says that we shall have to find anddepend upon a Higher Power — God. He advisesprayer and frankly recommends an attitude ofunwavering reliance upon Him who presides overall. By this means we discover a strength muchbeyond our own resources.

So, the main difference seems to add up to this:Medicine says, “Know yourself, be strong andyou will be able to face life.”

Religion says, “Know thyself, ask God forpower and you become truly free.”

In Alcoholics Anonymous the new man may tryeither method. He sometimes eliminates “thespiritual angle” from the Twelve Suggested Stepsto recovery and wholly relies upon honesty, toler-ance, and “working with others.”* But it is curiousand interesting to note that faith always comes tothose who try this simple approach with an openmind — and in the meantime they stay sober. If,however, the spiritual content of the Twelve Steps

* The Twelve Steps of the A.A. program are repro-duced at the front of this pamphlet.

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is actively denied, they can seldom remain dry.That is our A.A. experience everywhere. Westress the spiritual simply because thousands ofus have found we can’t do without it.

Boiled down, these Steps mean, simply:

a. Admission of alcoholismb. Personality analysis and catharsisc. Adjustment of personal relationsd. Dependence upon some Higher Powere. Working with other alcoholics

Most strongly, we point out that adherence tothese principles is not a condition of A.A. member-ship. Any alcoholic who admits he has a problemis an A.A. member regardless of how much hedisagrees with the program. Based upon our ex-perience, the whole program is a suggestion only.The alcoholic, objecting at first to the spiritualfactor, is urged to keep an open mind, meanwhiletreating his own A.A. group as a power greaterthan himself. Under these conditions the new-comer commences to undergo a personalitychange at such a rate and of such dimensions thathe cannot fully account for it on the basis ofself-realization and self-discipline. Not only doeshis alcoholic obsession disappear, but he findshimself progressively free of fear, resentment andinferiority. These changes seem to have comeabout almost automatically. Hence he concludesthat a Power greater than himself must indeedhave been at work. Having come to this point, hebegins to form his own concept of God. He thendevelops confidence in that concept which growsas he gets proof in everyday life that his new faithactually works, really produces results.

This is what most A.A.’s are trying to say whenthey talk about a spiritual experience. They meana certain quality of personality change which, intheir belief, could not have occurred without thehelp and presence of the creative Spirit of the universe.

With the average A.A., many months mayelapse before he is aware of faith in the spiritualsense. Yet I know scarcely an A.A. member ofmore than a year’s standing who still thinks histransformation wholly a psychological phenome-non based entirely upon his own normal

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resources. Almost every one of our members willtell you that, while he may not go along with a cler-gyman’s concept of God, he has developed one ofhis own on which he can positively depend — onewhich works for him.

We A.A.Õs are quite indifferentto whatpeople may call this spiritual experience of ours.But to us it looks very much like conversion, thevery thing most alcoholics have sworn they neverwould have. In fact, I am beginning to believe thatwe shall have to call it just that, for I know ourgood friend Dr. Harry Tiebout* is sitting here inthis room. As you may know, he is the psychiatristwho recently told his own professional society,the American Psychiatric Association, that whatwe A.A.’s get is conversion — sure enough andno fooling! And if the spirit of that great psycho-logist, William James, could be consulted, he’ddoubtless refer us to his famous book, “Varietiesof Religious Experience,” where personalitychange through the “educational variety of spiritu-al experience or conversion” is so ably explored.Whatever this mysterious process is, it certainlyseems to work, and with us who are on the wayto the asylum or the undertaker anything thatworks looks very, very good indeed.

And I’m very happy to say that many otherdistinguished members of your profession havepronounced our Twelve Steps good medicine.Clergymen of all denominations say they are goodreligion, and of course we A.A.’s like them be-cause they do work. Most ardently we hope thatevery physician here today will find himself ableto share this happy agreement. In the early yearsof A.A., it seemed to us alcoholics that we wan-dered in a sort of “no man’s land” which appearedto divide science and religion. But all that haschanged, since A.A. has now become a commonmeeting ground for both concepts.

Yes, Alcoholics Anonymous is a coopera?tive venture.All cases requiring a physical treat-ment are referred to you physicians. We frequent-ly work with the psychiatrist and often find thathe can do and say things to a patient which wecannot. He in turn avails himself of the fact that asex-alcoholics we can sometimes walk in where he

* Dr. Tiebout died in 1966.

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fears to tread. Throughout the country we are indaily touch with hospitals and sanatoriums, bothpublic and private. The enthusiastic support givenus by so many of your noted institutions is some-thing for which we are deeply grateful. The oppor-tunity to work with alcoholics means everything;to most of us it means life itself. Without thechance to forget our own troubles by helpingothers out of theirs, we would certainly perish.That is the heart of A.A. — it is our lifeblood.

We have torn still other pages from the Bookof Medicine, putting them to practical use. It isfrom you gentlemen we learn that alcoholism is acomplex malady; that abnormal drinking is but asymptom of personal maladjustment to life; that,as a class, we alcoholics are apt to be sensitive,emotionally immature, grandiose in our demandsupon ourselves and others; that we have usually“gone broke” on some dream ideal of perfection;that failing to realize the dream we sensitive folkescape cold reality by taking to the bottle; thatthis habit of escape finally turns into an obsession,or as you gentlemen put it, a compulsion to drinkso subtly powerful that no disaster, howevergreat, even near death or insanity, can, in mostcases, seem to break it; that we are the victimsof the age-old alcoholic dilemma: our obsessionguarantees that we shall go on drinking, but ourincreasing physical sensitivity guarantees that weshall go insane or die if we do.

When these facts, coming from the mouths ofyou gentlemen of science, are poured by an A.A.member into the person of another alcoholic, theystrike deep — the effect is shattering. That inflatedego, those elaborate rationalizations by which ourneurotic friend has been trying to erect self-suffi-ciency on a foundation of inferiority, begin to oozeout of him. Sometimes his deflation is like thecollapse of a toy balloon at the approach of a hotpoker. But deflation is just what we A.A.’s arelooking for. It is our universal experience thatunless we can start deflation, and so self-realiza-tion, we get nowhere at all. The more utterly wecan smash the delusion that the alcoholic can getover alcoholism “on his own,” or that somedayhe may be able to drink like a gentleman, themore successful we are bound to be.

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In fact we aim to produce a Òcrisis,Ótocause him to “hit bottom” as A.A.’s say. Of courseyou will understand that this is all done by indirec-tion. We never pronounce sentences nor do wetell any alcoholic what he must do. We don’t eventell him he is an alcoholic. Relating the serious-ness of our own cases, we leave him to draw hisconclusions. But once he has accepted the factthat he is an alcoholic and the further fact that heis powerless to recover unaided, the battle is halfwon. As the A.A.’s have it, “he is hooked.” Heis caught as if in a psychological vise. If the jawsof it do not grip him tightly enough at first, moredrinking will almost invariably turn up the screwto the point where he will cry — “enough.” Then,as we say, he is “softened up.” This reduces himto a state of complete dependence on whatever orwhoever can stop his drinking. He is in exactlythe same mental fix as the cancer patient whobecomes dependent, abjectly dependent if youwill, on what you men of science do for cancer.Better still he becomes “sweetly reasonable,”truly open-minded, as only the dying can be.

Under these conditions, accepting the spiritualimplications of the A.A. program presents nodifficulty even to the sophisticate. About half theA.A. members were once agnostics or atheists.This dispels the notion that we are effective onlywith the religiously susceptible.

These are some of the basic factorswhichperhaps partly account for such success as wehave had. I wish time permitted me to give youan intimate glimpse of our life together, of ourmeetings, of our social side, of those fastfriendships unlike any we had known before, ofour participation by thousands in the war effortand the armed services where so many A.A.’sare discovering they can face up to reality — nolonger institutionalized even within an A.A. group.We have found that God can be relied upon bothin Alaska and India, that strength can come outof weakness, that perhaps only those who havetasted the fruits of reliance upon a Higher Powercan fully understand the true meaning of personalliberty, freedom of the human spirit.

Surely, you who are here this morning mustrealize how much we A.A.’s are beholden to you,how much we have borrowed from you, how much

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we still depend upon you. For you have suppliedus ammunition which we have used as your layassistants — gun pointers for your artillery. I haveput out for inspection our version of the factorswhich bring about personality change, our methodof analysis, catharsis and adjustment. I have triedto show you a little of our great new compellinginterest in life — this Society where men andwomen understand each other, where the clamorsof self are lost in our great common objective,where we can learn enough of patience, tolerance,honesty, humility and service to subdue our for-mer masters: insecurity, resentment, and unsatis-fied dreams of power .

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Comment by

Foster Kennedy, M.D.*Neurologist, New York City

We have heard a truly moving and eloquentaddress, moving in its form and in its facts.

I have no doubt that a man who has curedhimself of the lust for alcohol has a far greaterpower for curing alcoholism than has a doctor whohas never been afflicted by the same curse.

No matter how sympathetic and patient thedoctor may be in the approach to his patient, thepatient is sure either to feel, or to imagine, con-descension to himself, or to get the notion thathe is being hectored by one of the minor prophets.

This organization of Alcoholics Anonymouscalls on two of the greatest reservoirs of powerknown to man, religion and that instinct for associ-ation with one’s fellows, which Trotter has calledthe “herd instinct.”

Religious faith has been described by MatthewArnold as a convinced belief in a power greaterthan ourselves that makes for righteousness, anda sense of helpfulness from this can be acquiredthrough a kind of spiritual conversion which mightwell be called a variety of religious experience.

The sick man’s association with those who,having been sick, have become or are becomingwell, is a therapeutic suggestion of cure and anobliteration of his feeling of being, in society, apariah; and his tapping of deep internal forces isshown by the great growth of this sturdy andbeneficent movement. Furthermore, this move-ment furnishes an objective of high emotionaldriving power in making every cured drunkard amissionary to the sick.

We physicians, I think, have always had diffi-culty in finding an occupation for our convalescentpatients of sufficient emotional driving power bywhich to replace the psychical results of the alco-hol that has been withdrawn.

These men grow filled with a holy zeal and

* Deceased

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their very zealousness keeps the missionarysteady while the next man is being cured.

I think our profession must take appreciativecognizance of this great therapeutic weapon. Ifwe do not do so we shall stand convicted of emo-tional sterility and of having lost the faith that moves mountains, without which medicinecan do little.

What do medicalauthorities think of A.A. ?*

In 1967 the American Medical Associationstated that membership in A.A. was still the mosteffective means of treating alcoholism and quotedDr. Ruth Fox, an eminent authority on alcoholismand then medical director of the National Councilon Alcoholism: “With its thousands of groups andits 300,000 recovered alcoholics [now upwards of2,000,000], A.A. has undoubtedly reached morecases than all the rest of us together. For patientswho can and will accept it, A.A. may be the onlyform of therapy needed.”

“I have the utmost respect for the work A.A.is doing, for its spirit, for its essential philosophyof mutual helpfulness. I lose no opportunity toexpress my endorsement publicly and privatelywhere it is of any concern.”

Karl Menninger, M.D.Menninger Foundation

“Perhaps the most effective treatment in therehabilitation of the alcoholic is a philosophy ofliving which is compatible with the individual andhis family, an absorbing faith in himself whichcomes only after he has learned to understandhimself, and a close association with others whoseexperiences parallel his own. The physician’scooperation with Alcoholics Anonymous is oneway of obtaining these things for his patient.”

Marvin A. Block, M.D., member of theAmerican Medical Association’s Committee

on Alcoholism and Drug Dependence

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* Also see pamphlet “A.A. as a Resource for the Health Care Professional.”

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The Society ofAlcoholics Anonymous

By Bill W.

Excerpts from an address presented to theAmerican Psychiatric Association

105th Annual MeetingMontreal, Quebec, May 1949

Alcoholics Anonymous is grateful for this invita-tion to appear before the American PsychiatricAssociation. It is a most happy circumstance.Being laymen we have naught but a story to tell,hence the quite personal and unscientific charac-ter of this narrative. Whatever their deeper impli-cations, the attitudes and events leading to theformation of Alcoholics Anonymous are easy toportray.

[The speaker here described his personal ex-perience in achieving sobriety, his early unsuc-cessful work with other alcoholics and his eventualmeeting, in Akron, Ohio, in May, 1935, with Dr.Bob S., who became the co-founder of AlcoholicsAnonymous.]

When I left Akron in September, 1935, threealcoholics were staying sober. Arrived at NewYork, I set to work and another A.A. group tookshape. But nothing was very sure; we still flew blind.

Then commenced a three-year season of trialand error eventuating in our textbook, “AlcoholicsAnonymous,” published in 1939.

That book, now the backbone of our A.A.Society, opens with a typical story of drinking andrecovery. Next comes a chapter of hope, entitled“There Is a Solution.” In A.A. vernacular twochapters describe alcoholism and the alcoholic,their object being, of course, to first identify andthen deflate. A chapter is devoted to softening upthe agnostic. This leads to the Twelve Steps ofpresent-day Alcoholics Anonymous. The heart of

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our therapy, and a practical way of life, these“Steps” are little but an amplified and streamlinedversion of the principles enumerated by my friendof the kitchen table.

The balance of the text is mostly devoted topractical application of these Twelve Steps, andto reducing inner resistances of the reader. Work-ing with other alcoholics is very heavily empha-sized. Chapters are devoted to wives, family re-lations, and employers. The final chapter picturesthe new Society and begs the recovered alcoholicto form a group himself. This ideology is thenshored up by thirty case histories, or ratherstories, written by A.A. members. These com-plete the identification and stir hope. The 400pages of “Alcoholics Anonymous” contain notheory; they narrate experience only.

When the book appeared in April, 1939, we hadabout 100 members. One-third of these had im-pressive sobriety records. The movement hadspread to Cleveland and drifted toward Chicagoand Detroit. In the East it inclined to Philadelphiaand Washington. There was an extraordinaryevent at Cleveland. The Plain Dealer publishedstrong pieces about us, backed by editorials. Abarrage of telephone calls descended on twentyA.A. members, mostly new people. A.A. book inhand, they took on all comers. New membersworked with the still newer. Two years later,Cleveland had garnered by this chain reactionhundreds of new members. The batting averagewas excellent. It was our first evidence that wemight digest huge members rapidly.

Then came great national publicity.TheSaturday Evening Post piece (March, 1941) shotthousands of frantic inquiries into our tiny NewYork office. This gave us lists of alcoholics inhundreds of cities. Businessmen traveling out ofestablished A.A. centers used these names tostart new groups. By sending literature and writ-ing often, A.A. groups sprung up by mail. Withno personal contact whatever, this was astound-ing. Clergy and medical men began to give theirapproval. I wish to say that Dr. Harry Tiebout,chairman of our discussion today, was the firstpsychiatrist ever to observe and befriend us.Alcoholics Anonymous mushroomed. The pio-neering had ended. We were on the U.S. map.

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[The speaker here summarized the size of the Society in 1949 — approximately, 80,000 mem-bers in 3,000 groups in thirty countries — and itsgeneral composition.]

Of alcoholics who stay with us and really try, alarge percent get sober at once and stay that way;others do so after some relapses; and still othersshow improvement. But many problem drinkersdo quit A.A. after a brief contact, maybe three orfour out of five. Some are too psychopathic ordamaged. But the majority have powerful rational-izations yet to be broken down. Exactly this doeshappen providing they get what A.A. calls a “goodexposure” on first contact. Alcohol then buildssuch a hot fire that they are finally driven back tous, often years later. These tell us that they had toreturn; it was A.A. or else. They had learned aboutalcoholism from alcoholics; they were hit harderthan they had known. Such cases leave us theagreeable impression that half our original expo-sures will eventually return, most of them torecover. So we just indoctrinate the newcomer.We never evangelize; Barleycorn will look afterthat. The clergy declare we have capitalized theDevil. These claims are considerable but we thinkthem conservative. The ultimate recovery rate willcertainly be larger than once supposed.

Such is a glimpse of our origin, central therapeu-tic idea, and quantity result. The qualitative result isassuredly too large a subject for this paper.

Alcoholics Anonymous is not a religious orga-nization; there is no dogma. The one theologicalproposition is a “Power greater than one’s self.”Even this concept is forced on no one. The new-comer merely immerses himself in our Societyand tries the program as best he can. Left alone,he will surely report the gradual onset of a trans-forming experience, call it what he may.Observers once thought A.A. could appeal onlyto the religiously susceptible. Yet our member-ship includes a former member of the AmericanAtheist Society and about 20,000 others almostas tough. The dying can become remarkablyopen-minded. Of course we speak little of con-version nowadays because so many people reallydread being God-bitten. But conversion, asbroadly described by James, does seem to beour basic process; all other devices are but thefoundation. When one alcoholic works with

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another, he but consolidates and sustains thatessential experience.

The forces of anarchy, democracy, and dicta-torship play impressive roles in the structure andcontainment of our Society; Barleycorn the TyrantDictator is quite impersonal. But Hitler never didhave a Gestapo half so effective. When the anar-chy of the alcoholic faces his tyrant, that alcoholicmust become a social animal or perish. Perforce,our Society has settled for the purest kind ofdemocracy. Naturally, the explosive potential ofour rather neurotic Fellowship is enormous. Aselsewhere, it gathers closely around those eternalprovocateurs: power, money, and sex.Throughout A.A. these subterranean volcanoeserupt at least a thousand times daily; explosionswe now view with some humor, considerablemagnanimity, and little fear at all. We think themvaluable object lessons for development. Ourdeep kinship, the urgency of our mission, theneed to abate our neurosis for contented survival;all these, together, with love for God and man,have contained us in surprising unity. Thereseems safety in numbers. Enough sandbags muf-fle any amount of dynamite. We think we are apretty secure, happy family. Drop by any A.A.meeting for a look.

Many an alcoholic is now sent to A.A.byhis own psychiatrist. Relieved of his drinking, hereturns to the doctor a far easier subject. Practi-cally every alcoholic’s wife has become, to a de-gree, his possessive mother. Most alcoholicwomen, if they still have a husband, live with abaffled father. This sometimes spells troubleaplenty. We A.A.’s certainly ought to know!

Now to conclude: we of A.A. try to be awarethat we may never touch but a segment of thetotal alcohol problem. We try to remember thatour growing success may prove a heady wine;that our own resources will always be limited. Sothen, will you men and women of medicine be ourpartners, physicians wielding well your invisiblescalpels, workers all, in our common cause? Welike to think Alcoholics Anonymous a middleground between medicine and religion, the miss-ing catalyst of a new synthesis. This to the endthat the millions who still suffer may presentlyissuefrom their darkness into the light of day!

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I am sure that none attending this great Hall ofMedicine will feel it untoward if I leave the lastword to our silent partner, Religion:

God grant us the serenity to accept the thingswe cannot change, courage to change the thingswe can, and wisdom to know the difference.

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THE TWELVE TRADITIONSOF ALCOHOLICS ANONYMOUS

1. Our common welfare should come first; personal recovery depends upon A.A. unity.

2. For our group purpose there is but oneultimate authority—a loving God as He mayexpress Himself in our group conscience. Ourleaders are but trusted servants; they do notgovern.

3. The only requirement for A.A. member-ship is a desire to stop drinking.

4. Each group should be autonomousexcept in matters affecting other groups orA.A. as a whole.

5. Each group has but one primary pur-pose—to carry its message to the alcoholicwho still suffers.

6. An A.A. group ought never endorse,finance, or lend the A.A. name to any relatedfacility or outside enterprise, lest problems ofmoney, property, and prestige divert us fromour primary purpose.

7. Every A.A. group ought to be fully self-supporting, declining outside contributions.

8. Alcoholics Anonymous should remainforever non-professional, but our service cen-ters may employ special workers.

9. A.A., as such, ought never be organized;but we may create service boards or commit-tees directly responsible to those they serve.

10. Alcoholics Anonymous has no opinionon outside issues; hence the A.A. name oughtnever be drawn into public controversy.

11. Our public relations policy is based onattraction rather than promotion; we needalways maintain personal anonymity at thelevel of press, radio, and films.

12. Anonymity is the spiritual foundation ofall our traditions, ever reminding us to placeprinciples before personalities.

THE TWELVE CONCEPTSFOR WORLD SERVICE

1. Final responsibility and ultimate authority for A.A.world services should always reside in the collective con-science of our whole Fellowship.

2. The General Service Conference of A.A. has become,for nearly every practical purpose, the active voice and theeffective conscience for our whole Society in its world affairs.

3. To insure effective leadership, we should endow eachelement of A.A. — the Conference, the General ServiceBoard and its service corporations, staffs, committees, andexecutives — with a traditional “Right of Decision.”

4. At all responsible levels, we ought to maintain a tradi-tional “Right of Participation,” allowing a voting representa-tion in reasonable proportion to the responsibility that eachmust discharge.

5. Throughout our structure, a traditional “Right ofAppeal” ought to prevail, so that minority opinion will beheard and personal grievances receive careful consideration.

6. The Conference recognizes that the chief initiative andactive responsibility in most world service matters should beexercised by the trustee members of the Conference actingas the General Service Board.

7. The Charter and Bylaws of the General Service Boardare legal instruments, empowering the trustees to manageand conduct world service affairs. The Conference Charteris not a legal document; it relies upon tradition and the A.A.purse for final effectiveness.

8. The trustees are the principal planners and administra-tors of overall policy and finance. They have custodial over-sight of the separately incorporated and constantly activeservices, exercising this through their ability to elect all thedirectors of these entities.

9. Good service leadership at all levels is indispensablefor our future functioning and safety. Primary world serviceleadership, once exercised by the founders, must necessari-ly be assumed by the trustees.

10. Every service responsibility should be matched by anequal service authority, with the scope of such authority welldefined.

11. The trustees should always have the best possiblecommittees, corporate service directors, executives, staffs,and consultants. Composition, qualifications, induction pro-cedures, and rights and duties will always be matters of seri-ous concern.

12. The Conference shall observe the spirit of A.A. tradi-tion, taking care that it never becomes the seat of perilouswealth or power; that sufficient operating funds and reservebe its prudent financial principle; that it place none of itsmembers in a position of unqualified authority over others;that it reach all important decisions by discussion, vote, and,whenever possible, by substantial unanimity; that its actionsnever be personally punitive nor an incitement to public con-troversy; that it never perform acts of government, and that,like the Society it serves, it will always remain democratic inthought and action.

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A.A. PUBLICATIONS Complete order forms available fromGeneral Service Office of ALCOHOLICS ANONYMOUS,Box 459, Grand Central Station, New York, NY 10163

BOOKS ___________________________________________________________________

ALCOHOLICS ANONYMOUS (regular, portable, large-print and abridged pocket editions) ALCOHOLICS ANONYMOUS COMES OF AGETWELVE STEPS AND TWELVE TRADITIONS

(regular, soft-cover, large-print, pocket and gift editions) EXPERIENCE, STRENGTH AND HOPEAS BILL SEES IT (regular & soft cover editions)DR. BOB AND THE GOOD OLDTIMERS“PASS IT ON”DAILY REFLECTIONS

BOOKLETS ___________________________________________________________________

CAME TO BELIEVELIVING SOBERA.A. IN PRISON: INMATE TO INMATE

PAMPHLETS ___________________________________________________________________

FREQUENTLY ASKED QUESTIONS ABOUT A.A.A.A. TRADITION—HOW IT DEVELOPEDMEMBERS OF THE CLERGY ASK ABOUT A.A.THREE TALKS TO MEDICAL SOCIETIES BY BILL W.ALCOHOLICS ANONYMOUS AS A RESOURCE FORTHE HEALTH CARE PROFESSIONAL

A.A. IN YOUR COMMUNITYIS A.A. FOR YOU?IS A.A. FOR ME?THIS IS A.A.A NEWCOMER ASKSIS THERE AN ALCOHOLIC IN THE WORKPLACE?DO YOU THINK YOU'RE DIFFERENT?A.A. FOR THE BLACK AND AFRICAN AMERICAN ALCOHOLICQUESTIONS AND ANSWERS ON SPONSORSHIPA.A. FOR THE WOMANA.A. FOR THE NATIVE NORTH AMERICANA.A. AND THE GAY/LESBIAN ALCOHOLICA.A. FOR THE OLDER ALCOHOLIC—NEVER TOO LATETHE JACK ALEXANDER ARTICLEYOUNG PEOPLE AND A.A.A.A. AND THE ARMED SERVICESTHE A.A. MEMBER—MEDICATIONS AND OTHER DRUGSIS THERE AN ALCOHOLIC IN YOUR LIFE?INSIDE A.A.THE A.A. GROUPG.S.R.MEMO TO AN INMATETHE TWELVE CONCEPTS ILLUSTRATEDTHE TWELVE TRADITIONS ILLUSTRATEDLET'S BE FRIENDLY WITH OUR FRIENDSHOW A.A. MEMBERS COOPERATEA.A. IN CORRECTIONAL FACILITIESA MESSAGE TO CORRECTIONS PROFESSIONALSA.A. IN TREATMENT SETTINGSBRIDGING THE GAPIF YOU ARE A PROFESSIONALA.A. MEMBERSHIP SURVEYA MEMBER'S-EYE VIEW OF ALCOHOLICS ANONYMOUSPROBLEMS OTHER THAN ALCOHOLUNDERSTANDING ANONYMITYTHE CO-FOUNDERS OF ALCOHOLICS ANONYMOUSSPEAKING AT NON-A.A. MEETINGSA BRIEF GUIDE TO A.A.A NEWCOMER ASKSWHAT HAPPENED TO JOE; IT HAPPENED TO ALICE

(Two full-color, comic-book style pamphlets)TOO YOUNG? (A cartoon pamphlet for teenagers)IT SURE BEATS SITTING IN A CELL

(An Illustrated pamphlet for inmates)

VIDEOS ___________________________________________________________

A.A.—AN INSIDE VIEWA.A. VIDEOS FOR YOUNG PEOPLEHOPE: ALCOHOLICS ANONYMOUSIT SURE BEATS SITTING IN A CELLCARRYING THE MESSAGE BEHIND THESE WALLSYOUR A.A. GENERAL SERVICE OFFICE,THE GRAPEVINE AND THE GENERAL SERVICE STRUCTURE

PERIODICALS __________________________________________________________

A.A. GRAPEVINE (monthly)LA VIÑA (bimonthly) june07