This Naked Mind. Annie Grace

million members in 175 countries.³³ Let’s examine A.A.’s approach to alcoholism to understand what assumptions we, as a society, have made and how these assumptions translate into beliefs about alcoholism. A.A.’s primary documentation is informally called “The Big Book.” Its official title is Alcoholics Anonymous, the Story of How Many Thousands of Men and Women Have Recovered from Alcoholism. This book describes Dr. William D. Silkworth, who treated but did not cure Bill Wilson, founder of A.A. Dr. Silkworth specialized in treatment of alcoholism, and in 1934 he unsuccessfully treated a patient who he concluded was hopeless. When A.A. later cured this patient, Dr. Silkworth wrote this letter to Bill Wilson:

       We doctors have realized for a long time that some form of moral psychology was of urgent importance to alcoholics, but its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside of our synthetic knowledge.34

      Here, Dr. Silkworth recognizes that the solutions A.A. forwarded are successful beyond what the medical profession was able to offer. And the “ultra-modern” medicine of 1939 is still in use today.

      The letter goes on to speak about how, where medical procedures fell short, the “unselfishness and community spirit of recovered A.A. members, who want to help those afflicted, has been an astounding success.”³⁵

      I will quote the most important part of the letter directly:

       We believe . . . that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class [of people] and never occurs in the average temperate drinkers. These allergic types can never safely use alcohol in any form at all; and once having formed the habit [they have] found they cannot break it, once having lost their self.36

      The letter discusses the inadequacy the doctor feels in helping these alcoholics and that he is astounded to see how a psychological change—like inclusion in A.A.—allows alcoholics to heal. You may notice this letter contains a contradiction. How can alcohol be an allergen that is only activated once the habit is formed? It seems to indicate they believe alcohol to be a manifestation of an allergy but that they also must “form the habit” for that allergy to manifest. It makes more sense to believe that alcohol is an addictive substance to which any human can become addicted once enough is consumed.

      The idea that alcoholics differ physically from the rest of us was hypothesized without any corroboratory lab findings by a doctor who suspected some people suffered from an allergy to alcohol. Allergens are relatively easy to diagnose, and 76 years later we have not found an allergy to be responsible for the disease of alcoholism. But Dr. Silkworth needed an explanation for A.A.’s success in helping alcoholics for whom medical prowess failed.

      How did this belief, that a physical flaw differentiates regular drinkers from alcoholics, become so widely held? A.A.’s response to Dr. Silkworth’s theory is telling:

       In this statement he [Dr. Silkworth] confirms what we who have suffered alcoholic torture must believe—that the body of the alcoholic is quite as abnormal as his mind. It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact to a considerable extent with some of us. But we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete.37

      What a relief the pioneers of A.A. must have felt. It is wretched to feel that your mind is not strong enough to resist alcohol. How much better to believe something is wrong with your body, something out of your control. A physical flaw, in a sense, lets us off the hook for our inability to maintain control when drinking. The A.A. literature of today continues to perpetuate the theory that alcohol is an allergen. A booklet that is distributed at today’s meetings states,

       As far as we are concerned, alcoholism is an illness, a progressive illness which can never be ‘cured,’ but which, like some other illnesses, can be arrested . . . We are perfectly willing to admit that we are allergic to alcohol and that it is simply common sense to stay away from the source of our allergy.38

      “Us” and “Them”

      While A.A. saves many from alcoholism, I must point out the danger of the physical-flaw theory. Given the widespread drinking in our society, this theory can be dangerous. We continue drinking unchecked, often overlooking the danger of addiction, because we have come to believe alcoholism can only happen to other people. By the time we realize we have a problem, we are faced with self-diagnosing a fatal and incurable illness or admitting to being weak-willed and lacking self-control. We tend to avoid this horrific diagnosis until things have gotten so out of control we can no longer avoid the problem. In some ways this approach has defined alcoholism as a disease of denial. It is standard practice for drinkers to hit rock bottom before they seek help. When I told a friend I had stopped drinking, her immediate response was, “I can’t imagine what you must have been through in order to make that decision.” The assumption was clear: I must have had a rock-bottom experience.

      We see this physical-flaw theory play out in every A.A. meeting. The meeting starts with a round-robin of, “Hello, my name is ______, and I am an alcoholic.” By forcing me to name the problem—I am an alcoholic, a person with a physical flaw that gives alcohol unreasonable control over me—they make the affliction easier to deal with. Members of A.A. enjoy the fellowship of like-minded people fighting a similar battle, and through that community and support they find sobriety. But how does this physical-flaw theory affect drinkers who don’t (or won’t) consider the possibility that they have an incurable illness? Those who don’t (or won’t) consider themselves alcoholics?

      Instead of treating alcohol with caution because we know it to be dangerous and addictive, we reassure ourselves that we are different from those flawed people we know as alcoholics. I speak from experience. And no one treats this as an insult. The alcoholics themselves confirm they are “different” from the normal population. So, millions of “regular” drinkers go through their drinking lives with no fear that they might become alcoholics.

      We also believe that addiction to alcohol varies from other addictions because the rate of addiction happens differently for each person. We see many people who seem to “control” their drinking and can “take it or leave it.” So it’s difficult to understand why some people’s first sips launch them into full-blown dependence while others never reach that point. But it is not just alcoholics who systematically increase the amount they drink. Regular drinkers start off with just a few drinks and are soon consuming a nightly glass of wine. In fact, alcoholics start off as “regular” drinkers. In many cases it takes years for them to cross the indistinct line into alcoholism.

      The Blame Game 3.0: Alcoholic Genes

      The Big Book claims that alcoholism “is limited to this class [of people] and never occurs in the average temperate drinkers.”³⁹ The idea is that alcohol is not a problem for normal people and that many people can drink and suffer no physical, mental, or social ill effects, implying that alcohol is not a problem for normal people. Since 87% of the population drinks,⁴⁰ with those drinkers ranging from the person who only drinks during toasts at weddings to the degenerate sleeping in the gutter, it is not hard to see why society struggles to understand this disease.

      A.A. members describe themselves as a group of men and women who have discovered they cannot control their drinking.⁴¹ While I don’t agree that alcoholics have lost control due to a physical, mental, or emotional defect, I concur that an alcoholic should be defined as someone who no longer has the ability to restrain their drinking.

      I realize under this definition many alcoholics don’t recognize that they have lost control. Many more drinkers dwell in limbo. Usually, years separate the point where you start to wonder if you have a problem and the moment you accept it. Ten years after a tiny voice in my head began to question my nightly drinking I determined I had to stop denying it and change