Friday, September 01, 2006

Keep Coming Back! A.A. Handbook: Sept. 1, 2006


Keep Coming Back! A.A. Handbook
For Salvation army center of hope
Table Of Contents

Complete Serenity Prayer…………………………………………………………………..1

Definition of Alcoholism…………………………………………………………………….2

Why Study A.A. History?………………………………..…………………………………..3

AA celebrates its origin--Bill W.'s meeting with Dr. Bob…………………………….……5

Where Did The 12 Steps Come From?………………………………………….…..………6

Bill Wilson's Letter To Dr. Carl Jung, Jan 23, 1961……………………….…………..….11

Dr. Carl Jung’s Letter to Bill Wilson: January 30, 1961……………………………….....14

Relapse Prevention…………………………………………………………….……..………15

PRAYER OF PEACE ~ St. Francis of Assisi……………………………………………….16

Nicholas A. Pace, MD on Relapse…………………………………………………………...17

The 12-Steps of Alcoholics Anonymous……………………………………………………. 20

The Complete Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, and the Wisdom to know the difference. Living one day at a time; enjoying one moment at a time; accepting hardship as the pathway to peace. Taking, as He did, this sinful world as it is, not as I would have it. Trusting that He will make all things right if I surrender to His Will; that I may be reasonably happy in this life, and supremely happy with Him forever in the next. Amen!”
~ By Reinhold Neibuhr ~

"And ye shall know the truth, and the truth shall make you free.”
~~ John 8:32

Definition of Alcoholism = Approved by the Boards of Directors of the National Council on Alcoholism and Drug Dependence, Inc. (February 3, 1990) and the American Society of Addiction Medicine (February 25, 1990).

"Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic: impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial."
"Primary" refers to the nature of alcoholism as a disease entity in addition to and separate from other pathophysiologic states which may be associated with it.

"Primary" suggests that alcoholism, as an addiction, is not a symptom of an underlying disease state.

"Disease" means an involuntary disability. It represents the sum of the abnormal phenomena displayed by a group of individuals. These phenomena are associated with a specified common set of characteristics by which these individuals differ from the norm, and which places them at a disadvantage.

"Often progressive and fatal" means that the disease persists over time and that physical, emotional, and social changes are often cumulative and may progress as drinking continues. Alcoholism causes premature death through overdose, organic complications involving the brain, liver, heart and many other organs, and by contributing to suicide, homicide, motor vehicle crashes, and other traumatic events.

"Impaired control" means the inability to limit alcohol use or to consistently limit on any drinking occasion the duration of the episode, the quantity consumed, and/or the behavioral consequences of drinking.

"Preoccupation" in association with alcohol use indicates excessive, focused attention given to the drug alcohol, its effects, and/or its use. The relative value thus assigned to alcohol by the individual often leads to a diversion of energies away from important life concerns.

"Adverse consequences" are alcohol-related problems or impairments in such areas as: physical health (e.g., alcohol withdrawal syndromes, liver disease, gastritis, anemia, neurological disorders); psychological functioning (e.g., impairments in cognition, changes in mood and behavior); interpersonal functioning (e.g., marital problems and child abuse, impaired social relationships); occupational functioning (e.g., scholastic or job problems); and legal, financial, or spiritual problems.

"Denial" is used here not only in the psychoanalytic sense of a single psychological
defense mechanism disavowing the significance of events, but more broadly to include a range
of psychological maneuvers designed to reduce awareness of the fact that alcohol use is
the cause of an individual's problems rather than a solution to those problems.
Denial becomes an integral part of the disease and a major obstacle to recovery.
Why Study A.A. History?

This article is written by nationally recognized historian and oft-quoted Alcoholics Anonymous archivist Mitchell K.

Why study, or for that matter, even discuss the history of Alcoholics Anonymous? What difference would it make? How could it affect how we live and work our own individual recovery? Who cares?

In a quote attributed to Carl Sandburg, he summed it up when he wrote;

"Whenever a civilization or society declines (or perishes) there is
always one condition present - they forgot where they came from."

This quote, often used by Frank M., Archivist for AA General Services gives a warning to present and future generations of AA members to "Keep It Green."

The Washingtonians, The Oxford Group and others forgot where they came from. They watered-down and made changes to their respective movements which eventually led to their demise. AA members could take notice and begin to learn their roots. The history of AA can be both educational and fascinating and help in making the recovery process a fruitful one.

Bill W. stated in 1940 that of those entering AA, 50 percent never drank again. 25 percent remained sober throughout their lives after experiencing some early difficulties and the remaining 25 percent could not be accounted for. Bill stated that 75 percent of AA members back then got well -- they recovered.

Group records indicate that in Cleveland, Ohio there was a 93 percent success rate for recovery in the early 1940's. Could these astounding figures be attributed to the fact that only low-bottom alcoholics came into AA? Could they be attributed to the lack of multiple addictions? We think not.

Early records indicate that though a great number of early members were considered as low-bottom, there were many who entered AA before losing everything. Both Dr. Bob and Bill had difficulties with drugs other than alcohol. Bill struggled with these problems until his death in 1971.

Why did they stay sober?
The original members of AA, between 1935 and 1939 went to only one meeting per week, and that meeting wasn't an AA meeting - they were Oxford Group meetings. They got well and they recovered. Why?

There was no 90-in-90 back then. It is not even mentioned in the first 164 pages of the Big Book. There were no conventions, retreats or treatment centers, as we know them today. There weren't even the 12 Steps until 1938. Why did they stay sober, on a continuous basis until their deaths?

People in AA state that it takes time to get through the Steps. "A Step a year," some even say. This writer has even heard some in AA say that after two years in the Program, they are still working on Step One, or Two or Three.

For those who are in that position, or listening to those who state that it can take up to 12 months, or longer, to go through the Steps, I urge you to read from the last paragraph on page 290 through the end of the first paragraph on page 293 in the Big Book. After reading these important pages, ask yourself why it was suggested that you take your time, remaining in the problem and not fully celebrating the solution?

The Big Book of Alcoholics Anonymous and the way of life described within its pages is probably the most sane way of living possible. It promises a changed life, removal of obsession, removal of fear and being "rocketed into a fourth dimension of existence of which we have not even dreamed."

No daily meetings
Were these people who wrote the book long-term members of AA? Did they have decades of recovery behind them, which gave them the wisdom to write such a "prescription for a miracle?"

The longest term of sobriety for those who wrote this book was just over four years. The average was about eighteen months. All were relative newcomers, those who wrote and described what this writer and many others describe as the greatest spiritual movement of the 20th Century.

They didn't have the benefit of daily meetings, many didn't have telephones and there were no 28-day treatment centers. What they did have was a program of recovery and determination to do whatever it took to stop drinking forever.

The study of the history of AA will show you what it was that worked so many wonders which resulted in so many miracles. Learning about where AA came from and what they did will give you an idea of what they had. Remember, "If you have decided you want what we have and are willing to go to any lengths to get it..."

Strengthening the fellowship
It is this writer's hope and prayer that a continuing dialogue and forum be made available to study the history of AA. Hopefully, this continuing open discussion will not only serve to strengthen your personal recovery but also begin the serve to strengthen AA as a whole.

Revolving Door Recovery will eventually lead AA towards the fate of the Washingtonians and the Oxford Group. For the sake of the future generations of alcoholics and those addicted to other drugs, I pray that AA remain strong.

I invite any questions, answers and even debates from those on the Internet. Let us together delve into the history of AA and share our experience, strength and hope with each other so that we can stay sober and help others to recover.

Mitchell K.

AA celebrates its origin--Bill W.'s meeting with Dr. Bob

On May 11, 1935, Bill W. encountered a threat to his newfound sobriety. During a business trip to Ohio, he found himself standing in the lobby of a hotel, craving a drink. With growing anxiety he contemplated his options.

Bill narrowed his choices to two: order a cocktail in the hotel bar or call another recovering alcoholic and ask for help in staying sober.

Bill knew that this choice came with high stakes. As an alcoholic who had nearly drunk himself to death, he'd endured four hospital stays for "detox." During his last visit he'd hit bottom and cried out for divine mercy: "If there be a God, let him show himself." At that moment, Bill felt a white light blaze through his hospital room. He was seized with "an ecstasy beyond description" and concluded that he was free from any need for alcohol.

But there was no divine blaze in the lobby of the Mayflower Hotel in Akron -- only the dim lights of the bar and the lure of a drink.

Pacing through the lobby, Bill passed the bar and found a church directory. Within minutes he was on the phone with a local minister. A series of calls put him in touch with an alcoholic surgeon named Dr. Bob. Bill arranged to visit the doctor at home.

Dr. Bob initially agreed to see Bill for only 15 minutes, but their meeting lasted for hours. Bill simply told of his drinking history and Bob identified with it immediately. Bill thanked Bob for hearing him out -- for his fellowship. "I know now that I'm not going to take another drink," Bill said, "and I'm grateful to you."

But the relationship did not end there. Bill stayed with Dr. Bob for the next three weeks. Through their friendship, Dr. Bob also gained sobriety. The surgeon never took another drink after June 10, 1935. That day -- Dr. Bob's "dry date" -- is officially counted as the start of Alcoholics Anonymous.

Bill and Bob began working with other alcoholics, helping them achieve sobriety one day at a time. Four years later, they published the book Alcoholics Anonymous, which explained their Twelve Step program of recovery.

Articles about AA started appearing in the popular press, and the group's membership swelled. In 1950, the year of AA's first International Convention, there were about 3,500 member groups.

Today, over 98,000 groups across the world are registered with AA's General Service Office; AA's international membership stands at nearly two million.

AA is the first therapeutic social movement dealing with alcoholism that's outlived its founders and keeps expanding. AA's longevity stems from three factors:

· One is that AA makes no stand on whether beverage alcohol is good or bad. Temperance movements and prohibition tried to label the product as being evil. AA does not.

· A second thing is the spiritual approach. When seeking help, AA asks you to
name your own higher power. And your higher power can be different than anyone else's.

· Third, AA's founders laid out a unique plan. Though the organization includes delegates at state and district levels, the local groups remain autonomous. So AA is actually a corporation upside down, with all the authority coming from the bottom.

By combining this creative structure with individual freedom of interpretation, AA keeps growing. Originally seen as an enclave of white Christian males, the organization now embraces women, people of color, agnostics and even atheists. And in the core principles of Twelve Step recovery, such as telling the truth, asking for help, and making amends, people keep discovering universal aspects of healing.

Two new biographies of Bill W., including his autobiography, Bill W.: My First 40 Years, have been published by Hazelden. For more information on these and other AA historical items, visit Hazelden's online bookstore or call 1-888-535-9485.

--Published May 22, 2000

Where Did The 12 Steps Come From?

A Fragment of History by Bill W. + July 1953 A.A. Grapevine

AAs are always asking: "Where did the Twelve Steps come from?" In the last analysis, perhaps nobody knows. Yet some of the events which led to their formulation are as clear to me as though they took place yesterday.

So far as people were concerned, the main channels of inspiration for our Steps were three in number -- the Oxford Groups, Dr. William D. Silkworth of Towns Hospital and the famed psychologist, William James, called by some the father of modern psychology. The story of how these streams of influence were brought together and how they led to the writing of our Twelve Steps is exciting and in spots downright incredible.

Many of us will remember the Oxford Groups as a modern evangelical movement which flourished in the 1920's and early 30's, led by a one-time Lutheran minister, Dr. Frank Buchman. The Oxford Groups of that day threw heavy emphasis on personal work, one member with another. AA's Twelfth Step had its origin in that vital practice. The moral backbone of the "O.G." was absolute honesty, absolute purity, absolute unselfishness and absolute love. They also practiced a type of confession, which they called "sharing"; the making of amends for harms done they called "restitution." They believed deeply in their "quiet time," a meditation practiced by groups and individuals alike, in which the guidance of God was sought for every detail of living, great or small.

These basic ideas were not new; they could have been found elsewhere. But the saving thing for us first alcoholics who contacted the Oxford Groupers was that they laid great stress on these particular principles. And fortunate for us was the fact that the Groupers took special pains not to interfere with one's personal religious views. Their society, like ours later on, saw the need to be strictly non-denominational.

In the late summer of 1934, my well-loved alcoholic friend and schoolmate "Ebbie" had fallen in with these good folks and had promptly sobered up. Being an alcoholic, and rather on the obstinate side, he hadn't been able to "buy" all the Oxford Group ideas and attitudes. Nevertheless, he was moved by their deep sincerity and felt mighty grateful for the fact that their ministrations had, for the time being, lifted his obsession to drink.

When he arrived in New York in the late fall of 1934, Ebbie thought at once of me. On a bleak November day he rang up. Soon he was looking at me across our kitchen table at 182 Clinton Street, Brooklyn, New York. As I remember that conversation, he constantly used phrases like these: "I found I couldn't run my own life;" "I had to get honest with myself and somebody else;" "I had to make restitution for the damage I had done;" "I had to pray to God for guidance and strength, even though I wasn't sure there was any God;" "And after I'd tried hard to do these things I found that my craving for alcohol left." Then over and over Ebbie would say something like this: "Bill, it isn't a bit like being on the water wagon. You don't fight the desire to drink -- you get released from it. I never had such a feeling before."

Such was the sum of what Ebbie had extracted from his Oxford Group friends and had transmitted to me that day. While these simple ideas were not new, they certainly hit me like tons of brick. Today we understand just why that was . . . one alcoholic was talking to another as no one else can.

Two or three weeks later, December 11th to be exact, I staggered into the Charles B. Towns Hospital, that famous drying-out emporium on Central Park West, New York City. I'd been there before, so I knew and already loved the doctor in charge -- Dr. Silkworth. It was he who was soon to contribute a very great idea without which AA could never had succeeded. For years he had been proclaiming alcoholism an illness, an obsession of the mind coupled with an allergy of the body. By now I knew this meant me. I also understood what a fatal combination these twin ogres could be. Of course, I'd once hoped to be among the small percentage of victims who now and then escape their vengeance. But this outside hope was now gone. I was about to hit bottom. That verdict of science -- the obsession that condemned me to drink and the allergy that condemned me to die -- was about to do the trick. That's where the medical science, personified by this benign little doctor, began to fit it in. Held in the hands of one alcoholic talking to the next, this double-edged truth was a sledgehammer which could shatter the tough alcoholic's ego at depth and lay him wide open to the grace of God.

In my case it was of course Dr. Silkworth who swung the sledge while my friend Ebbie carried to me the spiritual principles and the grace which brought on my sudden spiritual awakening at the hospital three days later. [Dec. 14, 1934] I immediately knew that I was a free man. And with this astonishing experience came a feeling of wonderful certainty that great numbers of alcoholics might one day enjoy the priceless gift which had been bestowed upon me.

Third Influence
At this point a third stream of influence entered my life through the pages of William James' book, "Varieties of Religious Experience." Somebody had brought it to my hospital room. Following my sudden experience, Dr. Silkworth had taken great pains to convince me that I was not hallucinated. But William James did even more. Not only, he said, could spiritual experiences make people saner, they could transform men and women so that they could do, feel and believe what had hitherto been impossible to them. It mattered little whether these awakenings were sudden or gradual, their variety could be almost infinite. But the biggest payoff of that noted book was this: in most of the cases described, those who had been transformed were hopeless people. In some controlling area of their lives they had met absolute defeat. Well, that was me all right. In complete defeat, with no hope or faith whatever, I had made an appeal to a Higher Power. I had taken Step One of today's AA program -- "admitted we were powerless over alcohol, that our lives had become unmanageable." I'd also taken Step Three -- "made a decision to turn our will and our lives over to God as we understood him." Thus was I set free. It was just as simple, yet just as mysterious, as that.

These realizations were so exciting that I instantly joined up with the Oxford Groups. But to their consternation I insisted on devoting myself exclusively to drunks. This was disturbing to the O.G.'s on two counts. Firstly, they wanted to help save the whole world. Secondly, their luck with drunks had been poor. Just as I joined they had been working over a batch of alcoholics who had proved disappointing indeed. One of them, it was rumored, had flippantly cast his shoe through a valuable stained glass window of an Episcopal church across the alley from O.G. headquarters. Neither did they take kindly to my repeated declaration that it shouldn't take long to sober up all the drunks in the world. They rightly declared that my conceit was still immense.

Something Missing
After some six months of violent exertion with scores of alcoholics which I found at a nearby mission and Towns Hospital, it began to look like the Groupers were right. I hadn't sobered up anybody. In Brooklyn we always had a houseful of drinkers living with us, sometimes as many as five. My valiant wife, Lois, once arrived home from work to find three of them fairly tight. They were whaling each other with two-by-fours. Though events like these slowed me down somewhat, the persistent conviction that a way to sobriety could be found never seemed to leave me. There was, though, one bright spot. My sponsor, Ebbie, still clung precariously to his new-found sobriety.

What was the reason for all these fiascoes? If Ebbie and I could achieve sobriety, why couldn't all the rest find it too? Some of those we'd worked on certainly wanted to get well. We speculated day and night why nothing much had happened to them. Maybe they couldn't stand the spiritual pace of the Oxford Group's four absolutes of honesty, purity, unselfishness, and love. In fact some of the alcoholics declared that this was the trouble. The aggressive pressure upon them to get good overnight would make them fly high as geese for a few weeks and then flop dismally. They complained, too, about another form of coercion -- something the Oxford Groupers called "guidance for others." A "team" composed of non-alcoholic Groupers would sit down with an alcoholic and after a "quiet time" would come up with precise instructions as to how the alcoholic should run his own life. As grateful as we were to our O.G. friends, this was sometimes tough to take. It obviously had something to do with the wholesale skidding that went on.

But this wasn't the entire reason for failure. After months I saw the trouble was mainly in me. I had become very aggressive, very cocksure. I talked a lot about my sudden spiritual experience, as though it was something very special. I had been playing the double role of teacher and preacher. In my exhortations I'd forgotten all about the medical side of our malady, and that need for deflation at depth so emphasized by William James had been neglected. We weren't using that medical sledgehammer that Dr. Silkworth had so providentially given us.

Finally, one day, Dr. Silkworth took me back down to my right size. Said he, "Bill, why don't you quit talking so much about that bright light experience of yours, it sounds too crazy. Though I'm convinced that nothing but better morals will make alcoholics really well, I do think you have got the cart before the horse. The point is that alcoholics won't buy all this moral exhortation until they convince themselves that they must. If I were you I'd go after them on the medical basis first. While it has never done any good for me to tell them how fatal their malady is, it might be a very different story if you, a formerly hopeless alcoholic, gave them the bad news. Because of this identification you naturally have with alcoholics, you might be able to penetrate where I can't. Give them the medical business first, and give it to them hard. This might soften them up so they will accept the principles that will really get them well."

Then Came Akron
Shortly after this history-making conversation, I found myself in Akron, Ohio, on a business venture which promptly collapsed. Alone in the town, I was scared to death of getting drunk. I was no longer a teacher or a preacher, I was an alcoholic who knew that he needed another alcoholic as much as that one could possibly need me. Driven by that urge, I was soon face to face with Dr. Bob. It was at once evident that Dr. Bob knew more of the spiritual things than I did. He also had been in touch with the Oxford Groupers at Akron. But somehow he simply couldn't get sober. Following Dr. Silkworth's advice, I used the medical sledgehammer. I told him what alcoholism was and just how fatal it could be. Apparently this did something to Dr. Bob. On June 10, 1935, he sobered up, never to drink again. When, in 1939, Dr. Bob's story first appeared in the book, Alcoholics Anonymous, he put one paragraph of it in italics. Speaking of me, he said: "Of far more importance was the fact that he was the first living human with whom I had ever talked, who knew what he was talking about in regard to alcoholism from actual experience. In other words, he talked my language."

The Missing Link
Dr. Silkworth had indeed supplied us the missing link without which the chain of principles now forged into our Twelve Steps could never have been complete. Then and there, the spark that was to become Alcoholics Anonymous had been struck.

During the next three years after Dr. Bob's recovery our growing groups at Akron, New York and Cleveland evolved the so-called word-of-mouth program of our pioneering time. As we commenced to form a society separate from the Oxford Group, we began to state our principles something like this:

1. We admitted that we were powerless over alcohol.

2. We got honest with ourselves.

3. We got honest with another person, in confidence.

4. We made amends for harms done others.

5. We worked with other alcoholics without demand for prestige or money.

6. We prayed to God to help us to do these things as best we could.

Though these principles were advocated according to the whim or liking of each of us, and though in Akron and Cleveland they still stuck by the O.G. absolutes of honesty, purity, unselfishness and love, this was the gist of our message to incoming alcoholics up to 1939, when our present Twelve Steps were put to paper.

I well remember the evening on which the Twelve Steps was written. I was lying in bed quite dejected and suffering from one of my imaginary ulcer attacks. Four chapters of the book, Alcoholics Anonymous, had been roughed out and read in meetings at Akron and New York. We quickly found that everybody wanted to be an author. The hassles as to what should go into our new book were terrific. For example, some wanted a purely psychological book, which would draw in alcoholics without scaring them. We could tell them about the "God business" afterwards. A few, led by our wonderful southern friend, Fitz M., wanted a fairly religious book infused with some of the dogma we had picked up from the churches and missions which had tried to help us. The louder the arguments, the more I felt in the middle. It appeared that I wasn't going to be the author at all. I was only going to be an umpire who would decide the contents of the book. This didn't mean, though, that there wasn't terrific enthusiasm for the undertaking. Every one of us was wildly excited at the possibility of getting our message before all those countless alcoholics who still didn't know.

Having arrived at Chapter Five, it seemed high time to state what our program really was. I remember running over in my mind the word-of-mouth phrases then in current use. Jotting these down, they added up to the six named above. Then came the idea that our program ought to be more accurately and clearly stated. Distant readers would have to have precise set of principles. Knowing the alcoholic's ability to rationalize, something airtight would have to be written. We couldn't let the reader wiggle out anywhere. Besides, a more complete statement would help in the chapters to come where we would need to show exactly how the recovery program ought to be worked.

12 Steps in 30 Minutes
At length I began to write on a cheap yellow tablet. I split the word-of-mouth program up into smaller pieces, meanwhile enlarging its scope considerably. Uninspired as I felt, I was surprised that in a short time, perhaps half an hour, I had set down certain principles which, on being counted, turned out to be twelve in number. And for some unaccountable reason, I had moved the idea of God into the Second Step, right up front. Besides, I had named God very liberally throughout the other steps. In one of the steps I had even suggested that the newcomer get down on his knees.

When this document was shown to our New York meeting the protests were many and loud. Our agnostic friends didn't go at all for the idea of kneeling. Others said we were talking altogether too much about God. And anyhow, why should there be twelve steps when we had done fine on six? Let's keep it simple, they said.

This sort of heated discussion went on for days and nights. But out of it all there came a ten-strike for Alcoholics Anonymous. Our agnostic contingent, speared by Hank P. and Jim B., finally convinced us that we must make it easier for people like themselves by using such terms as "a Higher Power" or "God as we understand Him!" Those expressions, as we so well know today, have proved lifesavers for many an alcoholic. They have enabled thousands of us to make a beginning where none could have been made had we left the steps just as I originally wrote them. Happily for us there were no other changes in the original draft and the number of steps stood at twelve. Little did we then guess that our Twelve Steps would soon be widely approved by clergymen of all denominations and even by our latter-day friends, the psychiatrists.

This little fragment of history ought to convince the most skeptical that nobody invented Alcoholics Anonymous.

It just the grace of God.
Bill Wilson's Letter To Dr. Carl Jung , Jan 23, 1961

The below is the text of the letter dated 1/23/61, written by Bill Wilson to the eminent Swiss psychologist & psychiatrist Dr. Carl Gustav Jung. Bill considered it a long overdue note of appreciation for Dr. Jung's contribution to A.A.'s solution for alcoholism. The Big Book refers to part of the story on pages 26 & 27. This letter elicited Dr. Jung's immediate reply.
My dear Dr. Jung:

This letter of great appreciation has been very long overdue.

May I first introduce myself as Bill W., a co-founder of the Society of Alcoholics Anonymous. Though you have surely heard of us, I doubt if you are aware that a certain conversation you once had with one of your patients, a Mr. Rowland H., back in the early 1930's, did play a critical role in the founding of our Fellowship.

Though Rowland H. has long since passed away, the recollections of his remarkable experience while under treatment by you has definitely become part of AA history. Our remembrance of Rowland H.'s statements about his experience with you is as follows:

Having exhausted other means of recovery from his alcoholism, it was about 1931 that he became your patient. I believe he remained under your care for perhaps a year. His admiration for you was boundless, and he left you with a feeling of much confidence.

To his great consternation, he soon relapsed into intoxication. Certain that you were his "court of last resort," he again returned to your care. Then followed the conversation between you that was to become the first link in the chain of events that led to the founding of Alcoholics Anonymous.

My recollection of his account of that conversation is this: First of all, you frankly told him of his hopelessness, so far as any further medical or psychiatric treatment might be concerned. This candid and humble statement of yours was beyond doubt the first foundation stone upon which our Society has since been built.

Coming from you, one he so trusted and admired, the impact upon him was immense. When he then asked you if there was any other hope, you told him that there might be, provided he could become the subject of a spiritual or religious experience - in short, a genuine conversion. You pointed out how such an experience, if brought about, might remotivate him when nothing else could. But you did caution, though, that while such experiences had sometimes brought recovery to alcoholics, they were, nevertheless, comparatively rare. You recommended that he place himself in a religious atmosphere and hope for the best. This I believe was the substance of your advice.

Shortly thereafter, Mr. H. joined the Oxford Groups, an evangelical movement then at the height of its success in Europe, and one with which you are doubtless familiar. You will remember their large emphasis upon the principles of self-survey, confession, restitution, and the giving of oneself in service to others. They strongly stressed meditation and prayer. In these surroundings, Rowland H. did find a conversion experience that released him for the time being from his compulsion to drink.

Returning to New York, he became very active with the "O.G." here, then led by an Episcopal clergyman, Dr. Samuel Shoemaker. Dr. Shoemaker had been one of the founders of that movement, and his was a powerful personality that carried immense sincerity and conviction.

At this time (1932-34) the Oxford Groups had already sobered a number of alcoholics, and Rowland, feeling that he could especially identify with these sufferers, addressed himself to the help of still others. One of these chanced to be an old schoolmate of mine, Edwin T. ("Ebby"). He had been threatened with commitment to an institution, but Mr. H. and another ex-alcoholic "O.G." member procured his parole and helped to bring about his sobriety.

Meanwhile, I had run the course of alcoholism and was threatened with commitment myself. Fortunately I had fallen under the care of a physician - a Dr. William D. Silkworth - who was wonderfully capable of understanding alcoholics. But just as you had given up on Rowland, so had he given me up. It was his theory that alcoholism had two components - an obsession that compelled the sufferer to drink against his will and interest, and some sort of metabolism difficulty, which he then called an allergy. The alcoholic's compulsion guaranteed that the alcoholic's drinking would go on, and the allergy made sure that the sufferer would finally deteriorate, go insane, or die. Though I had been one of the few he had thought it possible to help, he was finally obliged to tell me of my hopelessness; I, too, would have to be locked up. To me, this was a shattering blow. Just as Rowland had been made ready for his conversion experience by you, so had my wonderful friend, Dr. Silkworth, prepared me.

Hearing of my plight, my friend Edwin T. came to see me at my home where I was drinking. By then, it was November 1934. I had long marked my friend Edwin for a hopeless case. Yet there he was in a very evident state of "release" which could by no means accounted for by his mere association for a very short time with the Oxford Groups. Yet this obvious state of release, as distinguished from the usual depression, was tremendously convincing. Because he was a kindred sufferer, he could unquestionably communicate with me at great depth. I knew at once I must find an experience like his, or die.

Again I returned to Dr. Silkworth's care where I could be once more sobered and so gain a clearer view of my friend's experience of release, and of Rowland H.'s approach to him.

Clear once more of alcohol, I found myself terribly depressed. This seemed to be caused by my inability to gain the slightest faith. Edwin T. again visited me and repeated the simple Oxford Groups' formulas. Soon after he left me I became even more depressed. In utter despair I cried out, "If there be a God, will He show Himself." There immediately came to me an illumination of enormous impact and dimension, something which I have since tried to describe in the book "Alcoholics Anonymous" and in "AA Comes of Age", basic texts which I am sending you.

My release from the alcohol obsession was immediate. At once I knew I was a free man. Shortly following my experience, my friend Edwin came to the hospital, bringing me a copy of William James' "Varieties of Religious Experience". This book gave me the realization that most conversion experiences, whatever their variety, do have a common denominator of ego collapse at depth. The individual faces an impossible dilemma. In my case the dilemma had been created by my compulsive drinking and the deep feeling of hopelessness had been vastly deepened by my doctor. It was deepened still more by my alcoholic friend when he acquainted me with your verdict of hopelessness respecting Rowland H.

In the wake of my spiritual experience there came a vision of a society of alcoholics, each identifying with and transmitting his experience to the next - chain style. If each sufferer were to carry the news of the scientific hopelessness of alcoholism to each new prospect, he might be able to lay every newcomer wide open to a transforming spiritual experience. This concept proved to be the foundation of such success as Alcoholics Anonymous has since achieved. This has made conversion experiences - nearly every variety reported by James - available on an almost wholesale basis. Our sustained recoveries over the last quarter century number about 300,000. In America and through the world there are today 8,000 AA groups.

So to you, to Dr. Shoemaker of the Oxford Groups, to William James, and to my own physician, Dr. Silkworth, we of AA owe this tremendous benefaction. As you will now clearly see, this astonishing chain of events actually started long ago in your consulting room, and it was directly founded upon your own humility and deep perception.

Very many thoughtful AAs are students of your writings. Because of your conviction that man is something more than intellect, emotion, and two dollars worth of chemicals, you have especially endeared yourself to us.

How our Society grew, developed its Traditions for unity, and structured its functioning will be seen in the texts and pamphlet material that I am sending you.

You will also be interested to learn that in addition to the "spiritual experience," many AAs report a great variety of psychic phenomena, the cumulative weight of which is very considerable. Other members have - following their recovery in AA - been much helped by your practitioners. A few have been intrigued by the "I Ching" and your remarkable introduction to that work.

Please be certain that your place in the affection, and in the history of the Fellowship, is like no other.

Gratefully yours,
William G. W.
Co-founder Alcoholics Anonymous
Letter to Bill Wilson from Dr. Carl Jung: January 30, 1961

Dear Mr. Wilson,
Your letter has been very welcome indeed.

I had no news from Roland H. anymore and often wondered what has been his fate. Our conversation which he has adequately reported to you had an aspect of which he did not know. The reason that I could not tell him everything was that those days I had to be exceedingly careful of what I said. I had found out that I was misunderstood in every possible way. Thus I was very careful when I talked to Roland H. But what I really thought about was the result of many experiences with men of his kind.

His craving for alcohol was the equivalent, on a low level, of the spiritual thirst of our being for wholeness, expressed in medieval language: the union with God.* 1)

How could one formulate such an insight in a language that is not misunderstood in our days?

The only right and legitimate way to such an experience is that it happens to you in reality and it can only happen to you when you walk on a path which leads you to higher understanding. You might be led to that goal by an act of grace or through a personal and honest contact with friends, or through a higher education of the mind beyond the confines of mere rationalism. I see from your letter that Roland H. has chosen the second way, which was, under the circumstances, obviously the best one.

I am strongly convinced that the evil principle prevailing in this world leads the unrecognized spiritual need into perdition, if it is not counteracted either by real religious insight or by the protective wall of human community. An ordinary man, not protected by an action from above and isolated in society, cannot resist the power of evil, which is called very aptly the Devil. But the use of such words arouses so many mistakes that one can only keep aloof from them as much as possible.

These are the reasons why I could not give a full and sufficient explanation to Roland H., but I am risking it with you because I conclude from your very decent and honest letter that you have acquired a point of view above the misleading platitudes one usually hears about alcoholism.

You see, "alcohol" in Latin is "spiritus" and you use the same word for the highest religious experience as well as for the most depraving poison. The helpful formula therefore is: spiritus contra spiritum.

Thanking you again for your kind letter
I remain
Yours sincerely
C. G. Jung
1) “As the hart panteth after the brooks, so panteth my heart after thee O Lord.”
~ Psalm 42--1
Relapse Prevention

People in dual recovery learn to identify the warning signs that may lead to a lapse in their abstinence and take positive steps to stay clean and sober. At the same time, they follow a practical plan that addresses their emotional or psychiatric illness in a positive and constructive way. The quicker they learn to spot these signs and signals the sooner they can take positive action for their own well-being and dual recovery.

Many factors can lead to a relapse or flare-up to one or both of our no-fault illnesses. A flare-up of psychiatric symptoms can leave us more vulnerable to relapsing on drugs or alcohol. Drinking and drugging can lead to a flare-up of our psychiatric illness. Alcohol and drugs can also change the effects of psychiatric medications with unpredictable results. Maintaining abstinence allows us the freedom to grow as individuals and manage our no-fault illnesses in the healthiest possible way.

In chemical dependency, relapse is the act of taking that first drink or drug after being deliberately clean and sober for a time. It helps though to view relapse as a process that begins well in advance of that act. People who have relapsed can usually point back to certain things that they thought and did long before they actually drank or used that eventually caused the relapse. They may have become complacent in their program of recovery in some way or refused to ask for help when they needed it. Each persons relapse factors are unique to them, their diagnosis, and personal plan of recovery.

Relapse is usually caused by a combinations of factors. Some possible factors and warning signs
might be:

· Stopping medications on one’s own or against the advice of medical professionals
· Hanging around old drinking haunts and drug using friends – slippery places
· Isolating – not attending meetings – not using the telephone for support
· Keeping alcohol, drugs, and paraphernalia around the house for any reason
· Obsessive thinking about using drugs or drinking
· Failing to follow ones treatment plan – quitting therapy – skipping doctors appointments
· Feeling overconfident – that you no longer need support
· Relationship difficulties – ongoing serious conflicts – a spouse who still uses
· Setting unrealistic goals – perfectionism – being too hard on ourselves
· Changes in eating and sleeping patterns, personal hygiene, or energy levels
· Feeling overwhelmed – confused – useless – stressed out
· Constant boredom – irritability – lack of routine and structure in life
· Sudden changes in psychiatric symptoms
· Dwelling on resentments and past hurts – anger – unresolved conflicts
· Avoidance – refusing to deal with personal issues and other problems of daily living
· Engaging in obsessive behaviors – workaholism – gambling – sexual excess and acting out
· Major life changes – loss – grief – trauma – painful emotions – winning the lottery
· Ignoring relapse warning signs and triggers
Almost everyone in recovery has times when compelling thoughts of drinking or using drugs resurface. In early recovery, drinking or drugging dreams are not uncommon. It helps to remind ourselves that the reality of drinking and using has caused many problems in our lives. That no matter how bad things get, the benefits of staying abstinent will far outweigh any short-term relief that might be found in drugs or alcohol. Recovery takes time. Eventually the cravings, relapse dreams, and uncertainties of early recovery fade. When we are committed to dual recovery we slowly but surely develop a new confidence in our new way of life without drugs and alcohol.

Staying clean and sober and managing ones psychiatric symptoms constructively is an ongoing process. Abstinence and dealing positively with a dual disorder go hand in hand. DRA members build a personal inventory of recovery tools that help them meet these goals by staying involved in the process of dual recovery. An individual is in dual recovery when they are actively following a program that focuses on the recovery needs for both their chemical dependency and their psychiatric illness. People in dual recovery make sure to use some of their recovery tools each and every day. Their personal recovery tool kit serves as the best protection against a relapse.

By identifying things that put us at risk for relapse and using the various recovery tools on an ongoing basis, we try to prevent a relapse before it happens. We can periodically review our relapse prevention plans with our doctors, treatment professionals and sponsors and modify them as needed.

By becoming familiar with our triggers and warning signs, utilizing the various recovery tools, and having a practical plan of action, we greatly minimize the tendency to lapse back into our addictions. If and when lapses do happen, we do not judge or blame--we are not bad people. We seek progress not perfection. We simply learn what we can from the situation and move on with our program of dual recovery. Sharing our relapse experience with our sponsor, group, and helping professionals is an important way to figure out what went wrong. Our experience may also help others in recovery.
Lord, make me an instrument of Thy peace;
Where there is hatred, let me sow love;
Where there is injury, pardon;
Where there is doubt, faith;
Where there is despair, hope;
Where there is darkness, light;
Where there is sadness, joy.

O Divine Master,
Grant that I may not so much seek
to be consoled as to console;
to be understood as to understand;
to be loved as to love.

For it is in giving that we receive;
It is in pardoning that we are pardoned;
and it is in dying that we are born to eternal life.

Saint Francis of Assisi (1181-1226)
Nicholas A. Pace, MD on Relapse

Nicholas A. Pace, MD of New York, NY is founder, president and medical director of Pace Health Services, where he treats many alcoholic patients. An assistant professor at the New York University School of Medicine, he is a life member of the NCADD board of directors as well as the co-founder and past president of NCADD's New York City Affiliate.

Q Is relapse common among alcoholics and other drug addicts?

A Yes, unfortunately. We have a society that promotes the heavy use of alcohol and turns its back when someone relapses. That's because they treat addiction as moral weakness, not as a chronic medical problem. A recovering patient of mine left his appointment yesterday and before he got home, he counted 70 places beckoning him to drink in a 10-block radius, including liquor stores, bars and grocery stores with their beer ads. Then when he got home and turned on the television, he saw beer commercials and story lines filled with references to alcohol. Environmental cues like these often trigger relapse.

When you're an alcoholic or other drug addict, your biochemistry goes haywire too. Especially your liver, which metabolizes whatever drug you're addicted to. Hypoglycemia is common among active alcoholics, but instead of burning sugar they're burning alcohol. People in recovery need to understand that their body's craving for sugar often gets mixed up with their craving for alcohol. They need to find a substitute for alcohol to help them deal with the biological cravings caused by their fluctuating blood sugar. That's why there's always lots of candy around in AA [Alcoholics Anonymous] meetings. I advise my patients to use a hypoglycemic diet with six meals a day to avoid wide swings of their blood sugar.

In addition to a good healthy diet, I emphasize B complex vitamins. Thiamine, in particular, helps prevent delirium and tremors in alcoholics. Also L glutamine, an amino acid [available in health food stores]. It has a unique function in the brain and is said to offer a natural way to help the body fight off cravings.

Exercise also is very important in preventing relapse. I recommend that my patients develop a regular exercise routine, even if it's only "power walking" on a daily basis. During a good workout, the brain releases endorphins that create a "natural high," one that is certainly less potent than what they're used to, but a mood elevator nevertheless.

Q Is relapse more common with some drugs than others?

A Relapse among alcoholics may be more common simply because there are more alcoholics and because alcohol is so readily available as a social lubricant. The recovering alcoholic in particular faces enormous social pressure to drink. Think about it. When you go to a party, more often than not, you'll be offered a drink before anything else. When you're socializing with friends or co-workers, bars are common places to meet. But even if you go to a restaurant, the first question out of the waiter's mouth is "What would you like to drink?". Most people don't recognize how difficult we make it for recovering alcoholics to stay sober. If you know someone in recovery, try to be sensitive to what is, for them, a constant struggle. That's why I have plenty of soft drinks available whenever I entertain.
Some addicts say that the craving for cocaine is more powerful than that for other drugs. Tell that to an alcoholic in the early stages of recovery! A craving is a craving. What's important to keep in mind is that all addictive drugs have an effect on brain chemistry and liver function. Brain chemistry presents the biggest challenge to recovery because we don't fully understand the kinds of neurological changes long-term drug use causes. The liver, after all, can regenerate if the patient stops using and eats well.

Of course alcoholics need to remember that just because their liver function has returned to normal, it doesn't mean they can drink again. I find it's easier to use an analogy to explain this to my recovering patients than to go into the complicated medical reasons. I tell them that before they started drinking their liver was like a cucumber. Then alcohol turned it into a pickle. And we all know that pickles can't become cucumbers again.

Q What causes relapse?

A Addiction is what we call a "biopsychosocial" disease, which means that biology, psychology and a person's social environment all contribute to its development. Each one of these factors plays a role in relapse, which makes recovery more difficult for addicts than for patients suffering from other treatable medical conditions. The battle has only just begun once a patient completes detoxification. He or she may need to begin seeing an alcoholism or addictions counselor, a therapist or a psychiatrist who can help them deal with the psychosocial problems that may have contributed to their drinking or drug use. Depression is especially common among alcoholics, particularly women. Regular attendance at self-help groups like AA is important. AA will help alcoholics understand the scope of their disease and prevent them from becoming bitter and angry, or what are known as "dry drunks."

For recovery to be successful, people need to make major changes in their lives. I urge my patients to develop a plan of action to avoid relapse. It's a good idea for them to make a list of dangerous situations and how to deal with them. If they're invited to a wedding, let's say, they may want to plan to leave early. Or they may want to make sure in advance that a non-alcoholic beverage will be available at their table if they're going to be called upon to make a toast.

Patients need to examine their drinking or drugging lives carefully to decide what situations may have stimulated them to use. Maybe they'll find that every time they went to visit their mother they got into an argument and started to drink. If that's the case, it's probably not such a good idea for them to visit their mother in early sobriety or until they've worked with a therapist through the issues that cause these arguments.

Like they say in AA, stay away from or avoid the people, places and things that are going to remind you of drinking.

Q Are some alcoholics and other drug addicts at higher risk for relapse?

A Addicts without a strong support system are at the highest risk. Let's face it, if you're homeless, jobless or without a loving family, the deck is definitely stacked against you. Therefore, it's best to get patients into treatment before they lose everything.

The first year of sobriety is particularly tough because people have to give their bodies time to get healthy after dependence on a drug that has caused real physiological changes, including cognitive impairment. It takes the body a long time to rid itself of a drug's aftereffects on the brain and the nervous system.

Recovery is hard work; at a minimum it requires proper nutrition, exercise, medical follow-up, counseling and regular attendance at an appropriate self-help program.

Q Are there any danger signs associated with relapse?

A When an alcoholic or addict says he or she doesn't need to go to any more self-help meetings you can be sure that there's trouble ahead. It may mean "I don't want to go to AA because I don't consider myself an alcoholic. And I believe that I can drink again moderately." The same goes for abandoning their diet or exercise routine or deciding to stop taking prescribed medications such as Antabuse on their own.

Boredom and loneliness are other big concerns. Using takes up a lot of an addict's time. In the initial stages of recovery, they need to fill this lost time with frequent attendance at self-help groups that are filled with people who are going through exactly what they're going through.

Q Is there anything a recovering person can do if they feel that relapse is imminent?

A Obviously, staying away from negative influences and finding support is critical. Addicts have to replace their drug habits, with new, healthy habits. Participation in a self help group and a good relationship with a sponsor are the best defenses for a recovering person to confront the self-pity, complacency and dishonesty that often precede relapse.

AA has a very simple acronym, HALT. It means avoid getting hungry, angry, lonely or tired. Each of these areas is critical in recovery. When alcoholics get the urge to drink, they should eat something. Exercise. Get proper rest. Go to a meeting or call their sponsor. That way they can talk to someone else, particularly if they're upset or angry.

People need to be patient about alcoholism and other drug addiction. It takes time to recover. These illnesses are not something you get over in a couple of days.

Q What can the family and friends of an addicted person do to help prevent relapse?

A Understanding that addiction is a disease is key. Try your hardest not to be moralistic or punitive in dealing with an addict. Instead of making threats or getting angry, express your concern. Say "I'm afraid you're getting sick again" and urge them to go to a meeting and help them talk through their problems. But don't allow yourself to be manipulated either; offer to go to an open meeting of a self-help group with them.

My patients are full of guilt, shame and resentment about their alcoholism or addiction. These are all stigma-related and they interfere with the ability to recover. But we're dealing with a medical problem that's like other chronic diseases. Addicts are people, too, with a right to get well. They need the opportunity to redeem themselves. If you shut them out of your life, they don't have that opportunity.

Q Many alcoholics and other drug addicts in recovery relapse more than once. Does this mean they aren't as serious about their recovery as other addicts who have maintained their sobriety continuously since first achieving abstinence?
A Every case is different. Some people don't have the necessary support systems or they're facing another major crisis in their lives.

As much progress as we've made in educating the public about alcoholism and other drug addictions, most people still don't understand the chronic nature of these conditions. Because of the stigma that still surrounds drinking too much or using other drugs, the public often blames the addict when he or she relapses. This just isn't the case for patients who suffer from other behavior-related diseases. In fact, a University of Pennsylvania study has shown that addicted patients comply with treatment advice just as often as patients with asthma, hypertension or diabetes do.

We have a responsibility as a society, too. When a public figure in recovery has a slip the public should not become moralistic or punitive. They should realize that the more well-known the person is, the greater the stigma and the harder their fall. We need to be more forgiving and recognize that the people who suffer from the disease of addiction must be treated with compassion, not contempt.

The 12-Steps of Alcoholics Anonymous
Here are the steps we took, which are suggested as a Program of Recovery:

1. We admitted we were powerless over alcohol-that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
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 wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

The 12-Steps of Alcoholics Anonymous

Collected and Edited by Peta de Aztlan
CASA Field Coordinator
Sacramento, California, USA
Related CASA Links:
CASA 12-Steps Program Blog

CASA 12-Steps Recovery Group

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