The Magazine Articles of Dr. Arthur H. Cain





Harper's Magazine, February 1963

Alcoholics Anonymous: Cult or Cure?

by Arthur H. Cain

A useful idea has turned into a religious movement — and a hindrance to research, psychiatry, and to many alcoholics who need a different kind of help.

In the beginning "They" created Alcoholics Anonymous. ("They" have not yet been credited with the creation of the heavens and earth, but, if present trends continue, they will be.) "They are "W.W." and "Dr. Bob" — cofounders of a movement which is becoming one of America's most fanatical religious cults: "AA"

To be sure, the late Dr. Bob and the very current W.W. did not want to be deified. They joined forces in 1935 simply to help each other stop drinking. Today the fellowship they started claims a membership of over 300,000 "arrested" alcoholics in 85 countries. The A.A. idea was based on psychological and spiritual concepts very similar to those of Frank Buchman's then-famous Oxford Group. Conceived in Akron, Ohio, the first AA. Group was formed in New York City. In A.A.'s first five years no more than a few hundred people joined.

Then, in 1941, an article about A.A. by Jack Alexander appeared in the Saturday Evening Post and gave the movement an overnight boost. Membership leaped to over eight thousand by the end of the year.

A.A.'s basic tenet is that only an alcoholic can help another alcoholic; that psychiatric and other treatment is usually unsuccessful; but that alcoholics can, by banding together in a spirit of mutual help and understanding (and "by turning their lives over to God as they understand Him"), manage to lead relatively normal lives. Above all, they must face the fact that they must never again taken even one drink of alcohol.

As long as it restricted itself to informal organization and group "therapy," A.A. enjoyed — and deserved — universal respect. But a disquieting change has developed over the past fifteen years. A.A. is now highly formalized. The meetings, believed to be absolutely necessary, are ritualistic. And any suggestion to members that The Program is less than divine revelation evokes an irrational outcry.

I have no personal axe to grind. As a practicing psychologist who specializes in alcohol problems, I have been active since 1947 in both therapy and research. I have worked closely with Alcoholics Anonymous. I have also worked for the National Council on Alcoholism and for the Christopher D. Smithers Foundation, a charitable organization whose major interests are alcoholism and cancer.

I am disturbed by the fact that, for many members, A.A. is not as effective as it once was.

Moreover, I feel that much-needed scientific research is being diverted to other fields because of A.A.'s omniscient attitude. And I am not alone in my concern. Frequently in my practice, disillusioned men and women appeal to me: "Doctor, I've tried AA. over and over and I still can't stay sober. There must be something else dreadfully wrong with me! What is it?"

My friends in psychiatry, psychology, and pastoral counseling often ask me in discreet tones, "What's happening to AA?" Then, embarrassed at sounding critical, they add hastily, "It is a wonderful organization." Dr. E. M. Jellinek, dean of researchers in alcohol studies, pleaded at a workshop on alcoholism held at Columbia University in June 1959 that A.A. leave science alone — so that scientists might get along with the business of objective research into the problem.

While serving as public-relations counsel to the National Council on Alcoholism in 1959, I attended A.A. meetings in a dozen major cities. This personal survey of AA. groups convinced me that there is a widening breach not only between A.A. and scientists, but also between practicing A.A.s and other alcoholics.

What has happened to the excellent program that once helped alcoholics stop drinking when medicine and psychology failed? Why has A.A. become a cult that many men and women reverentially call "the greatest movement since the birth of Christianity"?

" UTILIZE — DON'T ANALYZE"

I attended my first A.A. meeting in 1947 and was enormously impressed by the sincerity of the members. They were not professional do-gooders. The speakers seemed genuinely "humble," not piously proud of their humility. The "A.A. Personality" — identifiable by a studied air of serenity and steadfast smile (which I have come to think of, uncharitably, as the "A.A. Smirk") — had not yet come into existence. It is a product of "AA.: the Cult" as opposed to "A.A.: the Fellowship."

But one remark disturbed me even then. One man arose — a forerunner of the seer-and-pundit type now prevalent in A.A. — and declared, "There's an aggregate of two thousand years of drinking experience in this meeting room. If we don't understand alcoholism then nobody does." My own reaction was that nobody understood alcoholism (no one does now, either) and it was ludicrous for a group which admittedly had lost control of its drinking to claim superior knowledge of the subject.

As I began to attend meetings regularly, other aphorisms troubled me. One favorite cliché appeared to be of special importance and still is: "Utilize — don't analyze."

For some members this was fine. They were weary of trying to figure out how to drink normally; or how to endure sobriety now that it was achieved; or why they had become alcoholic in the first place. They were ready to accept blindly anything that would end the agonies of compulsive drinking.

But for others, such faith was impossible.

Some people simply must analyze — it is their most characteristic personality trait. Perhaps, during the early, frightening days of their newly found sobriety they take comfort in letting others think for them. But as their heads clear and their nerves stop quivering, the need to comprehend ideas intellectually is reasserted and they find themselves examining their own behavior with healthy curiosity. As one relapsed member mournfully described his "slip": "I had been dry for over a year and, like the window washer, stepped back to appraise my handiwork. I woke up two weeks later on the Flight Deck [the violent ward at Kings County Hospital] wondering what had happened."

Relapses occur frequently among such alcoholics trying to stay sober in A.A. Many A.A. members are unsympathetic to these less fortunate brothers, whom they regard as "hopeless psychotics" or "nuts who aren't 'real' alcoholics at all." Thus, we see in A.A. two disturbing tendencies: (1) to define an alcoholic as a person who stays sober in AA.; and (2) to relegate all other problem drinkers to the limbo of psychosis.

AAs are fond of quoting such "statistics" as: "Fifty per cent of all alcoholics coming into AA get sober and remain sober; 25 per cent have one or two slips, then 'get the program' and maintain sobriety; the other 25 per cent are either psychotic or not alcoholic at all."

A question arises: how do A.A. members garner these figures? Because A.A. considers itself a deliberately permissive fellowship made up of autonomous groups which do not keep exact records, no real statistics exist. Nevertheless, individual members advance these generalizations as incontrovertible truths.

This kind of misinterpretation has narrowed A.A.'s once flexible philosophy into exclusive dogma. One undesirable effect is that those alcoholics who are not able to make A.A. work for them lose all hope; they fear that nothing is left for them except insanity (Korsakoffs Syndrome or the dreaded "wet brain") or death. This is not so. Many alcoholics achieve a sobriety made happy and creative through medical, psychiatric, psychological, and pastoral techniques. The sometimes-tragic misunderstanding — that only AA can help — is fostered by A.A.'s growing rigidity.

If A.A.'s intolerance were confined to its own community, we could "live and let live," as it exhorts its members to do. But A.A.s are indefatigable crusaders who greatly influence the national crusade against alcoholism — a malady which today afflicts five million Americans and costs taxpayers and industry over a billion dollars annually, according the National Council on Alcoholism. The Department of Health, Education, and Welfare has called alcoholism the nation's fourth most serious public-health problem, ranking in importance with heart disease, cancer, and mental illness.

AAs hold key positions in city, state, and private agencies dealing with alcoholism. Many executive directors of local committees and information centers are members of AA. This means that public education on alcoholism is almost entirely in the hands of AAs. Furthermore, nearly all information about research, treatment, and community action is disseminated by public-relations directors who adhere to the A.A. party line. Thus, almost everything we read on alcoholism in newspapers and magazines is A.A. propaganda.

Zealous members spread this propaganda, not for personal gain, but to "flush out" alcoholics and help them share their own dubious serenity.

I have had the unnerving experience of hearing a spontaneous remark made by an AA speaker in New York on a Monday repeated as gospel in Chicago on the following Friday. Much worse, I have heard a federal department chief publicly parrot a "statistic" I knew had been invented by an A.A. the week before. It is perhaps no coincidence that the A.A. publication is known as "The Grapevine."

Alcoholics Anonymous is hostile to criticism from any source. "All we ask is to be left alone," they cry. But they do not leave the American public alone. They influence public-health officials; they write extensively; they take positions on medical subjects such as diet and drugs (tranquilizers, sedatives, and stimulants all fall under the rubric of "goof-balls" to AA), and hold themselves up as final arbiters on any matter pertaining to alcoholism.

One result of this authoritarianism is that well-meaning laymen organize committees and sponsor "research'' — which leads qualified professionals to assume that the job of fighting alcoholism is getting done. But it isn't — largely because of a basic fallacy in A.A. thinking: that it takes an alcoholic to understand an alcoholic. The trouble lies in defining the word "understanding." Scientists agree that alcoholics are more empathetic to other alcoholics than anyone else; but when they venture the opinion that trained specialists might be better equipped to conduct formal treatment and research than untrained alcoholics, they run into a storm of protest.

AAs seem almost afraid that science will come up with a "cure" (an absolutely taboo word in the A.A. lexicon) and render A.A. unnecessary.

"What will we do if someone discovers a pill that cures alcoholism? It's our dedication that's keeping us sober and serene!" the executive-director of an influential agency on alcoholism recently said to me.

Needless to say, this person and most of this agency's staff are practicing members of AA. All are dedicated to combating alcoholism. But just as sobriety is a vocation for many A.A.s, for many agency people it is a career.

SOBRIETY . . . NOT SLAVERY

Another dangerous aspect of A.A. as a religious cult is the concept of sobriety as the ultimate goal of life. The very word "sobriety" has taken on a religious flavor and is uttered with hushed awe, rather than spoken of as a condition necessary to health and happiness. Practically all members who have passed the pigeon, or novice, stage speak of the quality of so-and-so's sobriety, as if evaluating degrees of spirituality.

Sobriety has, indeed, become the A.A.'s end which justifies any means. I know men whose wives work and support them so that they may devote their full time to "A.A. Work." I have talked with these women at Al-Anon meetings (groups formed especially for the spouses of alcoholics). Most are not complaining about their lot as A.A. wives; they insist that anything is better than living with a practicing alcoholic. But other women confess that eating, sleeping, and talking A.A. twenty-four hours a day is almost worse than having an alcoholic husband. The masculine point of view was summed up by a legendary souse at a bar who indignantly denied that he was an alcoholic. "I'm no blankety-blank alcoholic," he shouted, "I'm a drunk!" When asked about the difference he retorted, "Alcoholics have to go to those blankety-blank meetings all the time!"

I have heard husbands of alcoholics complain that A.A. has become a network of women's auxiliaries devoted to gossip and the "chanting of A.A. litanies such as, There but for the Grace of God.. . '; 'Easy does it'; and 'Living one day at a time."'

A.A. dogmatism has prevented many people from seeking a more moderate solution: sobriety in Alcoholics Anonymous without slavery to it.

And there are still other possibilities such as psychotherapy or pastoral counseling. But AAs would probably retort, justifiably, that they'll stick to what they've got until something better comes along. Many alcoholics who come to A.A. have had unhappy experiences with psychologists or psychiatrists. Some therapists follow their own party lines, usually Freudian, too strictly and write off alcoholism as "just a symptom of some underlying emotional disorder" — implying that once the disorder is uncovered the problem of alcoholism will automatically be solved. Too many alcoholics are worsened by this oversimplified approach. Many others instinctively know better, especially when psychoanalysts begin probing their Oedipal Situations. However, most psychotherapists now understand that alcoholism is a complex, distinct illness and must be treated accordingly.

" ARRESTED" OR "RECOVERED"

But AAs veer to the other extreme. They assert vehemently that there's nothing wrong with alcoholics except alcohol, and all the alcoholic has to do is to stay away from that first drink. (There is a standard gag in A.A. about the alcoholic who always orders two drinks and only drinks the second one.) The facts are: (1) the alcoholic obviously wouldn't be an alcoholic if it weren't for alcohol (what would he be?) and he certainly must abstain from it if he is to get well; but (2) he undoubtedly is suffering from some sort of psychological disorder: emotional, mental, or social. Unfortunately, "psychology" is a synonym for "psychosis" to most A.A.s. When a recent Ph.D. dissertation on alcoholism was published in popular book form (Seven Sinners, by Arthur King, Harcourt, Brace and World, 1961), A.A.s immediately took the author to task for suggesting that alcoholics could be placed in categories of psychopathology like any other victims of a behavior disorder: the manic-depressive or compulsive-obsessive cases, for example, complicated by uncontrolled drinking. "What was the big idea of saying alcoholics were a bunch of nuts," A.A.s demanded. Yet, they insist that "alcoholism is a disease. The President of the National Council of Alcoholism, an exceptional executive with a scientific mind, goes further, calling alcoholism a respectable disease. It can happen to anyone, he implies, and should not have social or moral stigma attached to it. I couldn't agree more heartily.

But AAs prefer to regard alcoholism as a purely physical disease: organic, glandular, metabolic, dietary — anything but mental. The only time this dread word is used is in an AA. definition of alcoholism: "A physical allergy, coupled with a mental compulsion."

According to the American Medical Association (Journal of the American Medical Association, May 25, 1957), "alcoholism can be classified into (1) primary alcoholism, which includes (a) those patients who from the very first drink of an alcoholic beverage are unable to control their desire for it and (b) those who through use over a great many years have developed an inability to take a drink or leave it alone and have become like group (a); and (2) secondary alcoholism, which includes those who use alcohol for its sedative action as a means of escape from reality and, in particular, from their personal problems. . . . This secondary group comprises by far the majority of patients suffering from alcoholism; however, most alcoholic patients prefer to be in the primary group." (Emphasis mine.)

By refusing to take into account problems of mental confusion, emotional immaturity, and social maladjustment, A.A.s are seriously hindering not only their own recovery, but scientific research as well.

If AAs are to be rescued from fanaticism, they must thoroughly understand two crucial words — "arrested" and "recovered." These are terms used to describe alcoholics who do not drink any more. Most members of A.A. fall into the former category; that is, they have arrested the development of their disease and have learned to live with it. To these men and women, alcoholism is something real in itself, like an incurable cancer. "Once an alcoholic, always an alcoholic" is one of A.A.'s most holy doctrines. They mean that once a person has lost control of his drinking he will never again be able to drink normally, even to the extent of one glass of beer. He must work regularly at the business of not taking that first drink.

This means he must practice A.A. in all his affairs; attend meetings without fail; do "Twelfth Step Work" (the analogy between A.A.'s "Twelve Steps" and the Ten Commandments is unmistakable); and proselyte other alcoholics into Alcoholics Anonymous. If he doesn't live AA., he's sunk. He gets drunk again sooner or later and — alcoholism being in the dogma of AA a progressive disease — he'll be worse off than ever.

It is true, of course, that the drinking alcoholic becomes worse and worse in his drinking behavior. But what A.A. does is to superimpose this concept on the behavior of the non-drinking alcoholic. According to A.A., the disease itself progresses. This is erroneous thinking. An alcoholic who relapses after a period of abstinence may very well get sicker than ever, but because he has aged, not because his alcoholism has "progressed."

The term "recovered" means something different: it implies that the patient's alcoholism is no longer a problem. He may not be able to drink normally again, although some investigators such as D. L. Davies, Dean of the Institute of Psychiatry at the Maudsley Hospital, London, believe there are many such cases. This hospital's work has been conscientiously reported by the Quarterly Journal of Studies on Alcohol (at the Rutgers Center of Alcohol Studies; "Normal Drinking in Recovered Alcohol Addicts"' March 1962). Here is an excellent example of the true scientific method, for the Quarterly Journal reports both fact and theory. It is not surprising that Dr. Davies' article has been either ignored by A.A., or brushed off with typical illogic: "Well, if these people drink normally, then they couldn't have been alcoholics in the first place." No AAs I queried had actually read the piece, though all were firm in their denunciation of it. I have heard A.A.s say that the report was immoral on the grounds that they might be tempted to drink again after hearing of it. Scientific truth was of no consequence.

The expression "recovered alcoholic" means that the patient no longer has to treat himself or take treatment from others at least twice a week for the rest of his life. He accepts life without alcohol; he makes certain adjustments within himself and in his attitude toward society; and he gets back into the mainstream of life. He might devote part of his time to helping alcoholics or others-probably he does — but because he can and wants to, not as a device to keep himself sober.

TRY A.A. FIRST, BUT...

There are many such recovered alcoholics, both in and out of Alcoholics Anonymous. These men and women have learned one thing: neither A.A. nor psychotherapy, nor any other treatment is more than a bridge between alcoholism and real recovery. Good bridges, perhaps. I still believe that A.A. provides the best possible way, at present, for most alcoholics to get sober and start a new life without alcohol. Others need some form of psychotherapy and/or pastoral counseling — perhaps in conjunction with A.A. These disciplines are especially helpful to people who cannot, without professional guidance, sincerely practice certain of A.A.'s Twelve Steps, such as Step Four — "Make a Searching and Fearless Inventory of Ourselves"; or Step Ten — "Continue to Take Personal Inventory and When We Are Wrong Promptly Admit It"; or those Steps that refer to "a Power greater than ourselves."

Alcoholics Anonymous is not a sustaining Way of Life. Sobriety can never be a satisfactory ultimate goal; it is, after all, merely the absence of intoxication. It is what one does with one's sobriety that is important. AA. is a man-made means for attaining this sobriety.

Alcoholics Anonymous should not be a cult for the retardation of the "arrested" alcoholic. I do not suggest for a moment that a single A.A. quit the fellowship. On the contrary, I strongly urge sticking with it. To anyone who is having trouble with alcohol I say: try A.A. first; it's the answer for most people.

But to those who insist upon serving A.A. as if it were a holy and apostolic church, I say, Beware. Observe those members who seem genuinely serene. Talk with those who have been in A.A. a long time and who really practice "live and let live." Though A.A. is an important part of their lives, it is an adjunct, not the whole. They have crossed the bridge from arrested alcoholism to true recovery.

And if even then they cannot stay sober and happy, they should not despair. There are other ways, other bridges — physicians and psychiatrists, psychologists and pastoral counselors, who are capable and anxious to help them. Some specialize in helping alcoholics who have conscientiously tried A.A. and failed. Most agree that there's no such person as a hopeless alcoholic.

A.A. as a group must recognize its real function: to serve as a bridge from the hospital or the jail to the church — or to a sustaining personal belief that life is worthwhile. It must not pose as a spiritual movement that provides everything the alcoholic needs to fulfill his destiny. It must not teach its young (as it does in Alateen, its Sunday School for the children of alcoholics) such catechisms as: "We will always be grateful to Alateen for giving us a way of life and a wonderful healthy program to live by and enjoy." It must realize that "the actual coffee pot Anne used to make the first A.A. coffee" (shown in "Alcoholics Anonymous Come of Age," Harper 1957, a commentary on the A.A. bible, Alcoholics Anonymous, Works Publishing Company, 1946) is not the Holy Grail. The cake and coffee served after meetings are just refreshments, not the body and blood of Jesus Christ.

Only then will Alcoholics Anonymous "come of age." Then, perhaps, more of its members will become "recovered" instead of "arrested" alcoholics. Science may then be stimulated to further research. And those alcoholics who are unable to make A.A. work for them may look elsewhere and find their serenity, too.

Arthur H. Cain, who has a Ph.D. from Columbia and is a graduate of Yale (now Rutgers) School of Alcohol Studies, is the author of Young People and Drinking, to be published by John Day. A licensed psychologist practicing in New York City, Dr. Cain recently made a research tour of the world studying drinking customs and sexual habits.





From the September 19, 1964 Saturday Evening Post

ALCOHOLICS CAN BE CURED — DESPITE A.A.

By Dr. Arthur H. Cain

An expert charges that Alcoholics anonymous has become a dogmatic cult
that blocks medical progress and hampers many members' lives.

It is time we made a thorough investigation of Alcoholics Anonymous in the interest of our public health. A.A. is identified in the public mind as a God-fearing fellowship of 350,000 "arrested alcoholics" who keep one another sober and rescue others from the horrors of alcoholism. Unfortunately, A.A. has become a dogmatic cult whose chapters too often turn sobriety into slavery to A.A. Because of its narrow outlook, Alcoholics Anonymous prevents thousands from ever being cured. Moreover A.A has retarded scientific research into one of America's most serious health problems.

My own experience with A.A. began in 1947. As a psychologist and investigator into the causes and cure of uncontrolled drinking, I have attended about 500 A.A. meetings in over 40 states and a dozen foreign countries. At first I was tremendously impressed with A.A.'s altruistic efforts in alcoholics' behalf. Its members would perform prodigies of selfless service, no matter what the hour by meeting the helpless and sodden in hospitals, flophouses and homes, and offering their sympathy, a helping hand, and their own example that temptation could be withstood. At the weekly meetings, which all A.A. members attended, there was a true sense of humility and a devout belief in God (We "came to believe that a Power greater than ourselves could restore us to sanity") and the fellowship of man — the original tenets of A.A. New members were given the freedom to question A.A.'s guiding principles codified in the Twelve Traditions and the Twelve Steps of Recovery.'

Over the years a disturbing change began to take place. As an increasing number of alcoholics joined A.A. chapters, many turned out to be misfits who had rejected Christianity, Judaism or the Kiwanis Club. Dogmatic and opinionated in their nonbeliefs, they found in A.A. an instrument for a new kind of bigotry. Their only meaning in life was that they had heroically become "arrested" alcoholics. Arrogant egoists, they soon dominated many of A.A.'s 10,000 chapters. Weekly meetings, once spontaneous and exciting, became formalized and ritualistic. Anyone who questioned A.A.'s principles or even expressed curiosity was handed the slogan, Utilize, Don't Analyze, and told to sit down. The desire to help others degenerated. As one disheartened former A.A. member told me, "I felt nobody cared what happened to Mary W. I felt they were just interested in another alcoholic who would become another notch in their belts. I felt as if I was being pressed into serving their cause and building up their oligarchy."

With this growing dogmatism came a Dark Ages attitude toward any scientist who might differ with official A.A. doctrine. According to the A.A. litany, alcoholism is a physical disease which can never be cured: "Once an alcoholic, always an alcoholic." The corollary is: "A reformed alcoholic must live A.A. from day to day and never leave A.A."

Actually, there is no scientific evidence that alcoholism is an incurable, physical disease. According to current evidence, the origin of uncontrolled drinking is psychological. A person drinks to ease anxiety, depression, boredom, guilt, timidity, inarticulateness. An alcoholic learns to become one; he is not born that way. This means that many alcoholics can return to normal drinking without fear of ending up on Skid Row. Over the past 17 years I have treated more than 50 alcoholics who no longer need to attend meetings or receive treatment. Most important, over 20 of my patients have learned to drink normally, to use alcohol as a beverage, not a psychological crutch.

Yet when scientists have reported similar findings, A.A. members have often set out to discredit them. In 1957 Doctors Melvin L. Selzer and William Holloway of the University of Michigan came up with the then startling report that 13 confirmed alcoholics had become social drinkers. Because of the pressure of an influential A.A. member, the state agency that provided the funds for the study virtually ordered the two scientists to omit what it called these "embarrassing" findings. Doctor Selzer published his findings anyway.

In 1962 Dr. D.L. Davies, after a study at Maudsley Hospital in London, declared that seven men who had been alcoholics were able to drink normally after treatment, some had been drinking without problems for as long as 11 years. Doctor Davies concluded that 'the generally accepted view that no alcohol addict can ever again drink normally should be modified." Some A.A. members branded the scientist's report "immoral, because it might cause some members to drink."

Dr. E. M. Jellinek, a cofounder of the Yale School of Alcohol Studies and a dean of researchers in the field of alcoholism until his death in 1963, was drawing on his own experience when he declared: " ... Alcoholics Anonymous have naturally created the picture of alcoholism in their own image ... and there is every reason why the student of alcoholism should emancipate himself from accepting this exclusiveness as propounded by A.A."

Not only has A.A. interfered with scientific investigations, it has prevented medical and psychological treatment which runs counter to its own theories. At one New York City hospital, for instance, the physicians preferred using paraldehyde to treat acute intoxication. But then A.A. members implied that they would stop referring patients there if paraldehyde was used. The doctors were persuaded to switch to another drug, chloral hydrate. As the physician in charge of the alcoholics' ward explained, the A.A. non-scientists had discovered that paraldehyde was a form of alcohol. Actually, chloral hydrate is the more toxic drug. In fact, its indiscriminate use in another New York hospital has left some patients more intoxicated upon discharge than when they were admitted.

While A.A. adherents battle scientific inquiry that does not fit A.A.'s narrow theories, its chapters often attempt to assume control of members' lives. Purporting to offer everything needed for human fulfillment, the fellowship now boasts of a "ladies auxiliary," called Al-Anon, for spouses of members and even a division for members' children called Alateen. It suggests that the youngsters open their meetings by reciting this incantation: "We will always be grateful to Alateen for giving us a Way of Life and a wonderful, healthy program to live by and enjoy!" Implied is the distressing theory that there is no other way of life for alcoholics except that of A.A. — a life in which every waking hour is devoted to the struggle for sobriety.

The wife of a Texas member described some unfortunate consequences of A.A.'s creed that the struggle against alcohol must be the most important ambition in a member's life. "This must be placed above wives or husbands, children homes, or jobs. They must be ready to abandon these things at any time.... The tragic part is, some of them while searching for this sobriety and serenity actually do exactly that." How pervasive the obsession with A.A. can become was poignantly demonstrated by a patient who had come to me because of worries about her A.A. husband. He had proposed that they move their bed into the A.A. clubhouse so they might be "available 24 hours a day just in case an alcoholic wandered in."

For many members, of course, staying sober is a fierce challenge daily. But under the A.A. program, the lives of many are so sterile that their growth as human beings is hindered. Taught to rely on slogans and compulsive A.A. routine, some are unable to face the fact that they are alcoholics because they are psychologically sick. It is for this reason that many A.A. members never recover.

A New Hampshire novelist and former A.A. member, who has been continuously sober for eight years, described this human waste when he wrote me — "I have met members who are actually afraid to think. They have made a high fence of A.A., which shuts them out from all pleasurable and vital aspects of life."

Behind the A.A. fence the original principle that alcoholics must be humble before God has been turned into the dictum that alcoholics are God's chosen people. This theme is preached in meetings and through books and pamphlets. A typical illustration is a booklet titled. "Around the Clock With A.A.," published recently by an A.A. group in California.1 One passage declares: "God in His wisdom selected this group of men and women to be the purveyors of His goodness.... He went right to the drunkard, the so-called weakling of the world. Well might He have said to us: 'Unto your weak and feeble hands I have entrusted power beyond estimate. To you has been given that which has been denied the most learned of your fellows. Not to scientists or statesmen, not to wives or mothers, not even to my priests or ministers have I given this gift of helping other alcoholics which I entrust to you."' Such idolatry causes the believer to see himself as all-knowing, and turns the missionary into the zealot.

A.A.'s creeds not only infect its own members but pervade public education. Most of what we hear or read about alcoholism is inspired by A.A. adherents spouting A.A. dogmas. City, state and private agencies frequently fill all key posts with A.A. members. One western state actually requires that personnel assigned to its alcoholism program be A.A. members for at least two years. No professional experience is needed. The A.A. philosophy also dominates the National Council on Alcoholism, the only nationwide public-information agency on alcoholism. N.C.A., which is supported by public donations, has over 60 affiliated information committees scattered throughout the country. Although both N.C.A. and A.A. deny that they are officially connected, many members of N.C.A.'s staff and some directors are A.A. members. A.A. members serve as directors in eight out of ten N.C.A. information centers in the largest cities in the United States.

Thus, it is not surprising that N.C.A. continues to parrot the A.A. line that alcoholism is a "progressive disease for which there is no known cure, but which can only be arrested." Further, N.C.A. in a series of radio and TV commercials actually stated that the American Medical Association had declared alcoholism to be a disease, although the A.M.A. has restricted itself to general statements that the alcoholic is "sick." Time and again, I have heard public figures recite A.A.-N.C.A. myths and propaganda as if they were gospel.

I once heard Arthur Flemming, former Secretary of Health, Education and Welfare, read verbatim a pronouncement on alcoholism which I knew had been prepared a year earlier by N.C.A.'s public-relations firm. Flemming offered the now familiar "statistic" that there are five million alcoholics in the United States. This figure is based on a study Doctor Jellinek of Yale conducted 18 years ago in a small community; he thought he had found that three percent of the population were alcoholics. N.C.A. applied this percentage to the whole nation. Doctor Jellinek, a great physiologist but no statistician, repudiated his own formula in 1956. The five-million figure is only a guess, for — no scientific count of alcoholics has ever been made.

While N.C.A. issues well-intended but sometimes questionable facts and theories, A.A. officials, when pressed, often hide behind the famous Tenth Tradition, which states that "Alcoholics Anonymous has no opinion on outside issues, hence the A.A. name ought never be drawn into public controversy." This device enables members of A.A. to make outrageous assertions which A.A.'s headquarters promptly disavows when challenged. "Many people I have tried to help," said one Chicago member, "have abandoned the program just because they couldn't take the ex cathedra homilies on drugs, alcohol, psychiatry, medicine, sociology, biology, to name a few subjects on which they speak with authority."

Much of A.A.'s failure can be blamed, on a lack of forward-looking, constructive leadership. Writer Jerome Ellison recently spent several months as a paid consultant to A.A. evaluating the fellowship's publications and activities. At national headquarters in New York City, Ellison declared, committee politics took up half the working day, and gossip was venomous. Everybody was an expert, Ellison went on, "with a cluster of ideas closed to amendment." He related how one member had submitted to the A.A. monthly bulletin an article which showed that nearly all southern and a great many northern A.A. chapters were racially segregated, and that A.A. had failed to keep pace with the growing, problem of Negro alcoholism. The article was turned down on the ground that it "might disrupt A.A. unity."

Ellison's most damning indictment concerned the rule made by A.A.'s nonalcoholic board of trustees that no change can be made in A.A.'s theories on alcoholism, even though they are nearly a quarter of a century old. "Despite the fact that the rank and file teems with exciting, relevant, informed and up-to-the-minute experience," Ellison declared, "none of it is permitted to appear in book form. To publish such literature, it is felt, would be to risk heresy."

Needless to say, I do not suggest that A.A. be abolished or that a single member quit. That A.A. helps many thousands stay sober is obvious. But Alcoholics Anonymous should return to its original purpose of being a much-needed first-aid station. The "arrest" of uncontrolled drinking is the essential first step in becoming a recovered or cured alcoholic. During this critical period, the alcoholic needs the sympathy and understanding that only another alcoholic can give. But after three months or so, when the shakes have subsided and the cobwebs are beginning to clear, the recovering alcoholic should go ahead. He should not be taught that he must remain forever crippled and bound by the paralyzing concept "Once an alcoholic, always an alcoholic." It is at this point that the patient needs a different kind of understanding: an objective, dispassionate, clinical understanding that physicians, psychologists and pastoral counselors, not A.A. members, are trained to give. Only after he has undergone a rigorous and lengthy revision of his personality should he attempt to drink normally again, and then only if he desires to do so.

After all, sobriety in itself is not a way of life. It is simply the absence of intoxication. It is what one does with his sobriety and his life that is important.



Footnotes:


1) In the nineteen-sixties, Dr. Arthur Cain found that the "Why We Were Chosen By God" screed had been published recently in California, but he apparently did not know that it was already quite old — that it was originally a speech given by Judge John T. at the Fourth Anniversary of the Chicago Alcoholics Anonymous Group, on October 5, 1943. Full text here.



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