additional stuff from the past. (2014)

My Experience in Alcoholics Anonymous

by Philip K Springer, MD

September 21, 2014

     Earlier in this so-so book I have indicated that there were some early signs of addiction, which I ignored or didn't have sense enough to understand. In a recent meeting of Alcoholics Anonymous I declared myself as being sober for the past 32 years. But the real sense of the matter is that I have only been feeling some serenity in the past 10 years. I had quit drinking long before I made any attempt to deal in depth with the 12 steps of Alcoholics Anonymous or its ramifications the traditions of Alcoholics Anonymous. We also have the 12 Promises, which need to be considered as well in every day of our life as alcoholics. With that said I need to remind the reader that being a psychiatrist is difficult as a member of Alcoholics Anonymous because I have to turn my back to a certain extent on some of the basic issues in modern psychiatry.

      Medication is a far overdone issue in in the battle against mental illness. Victor Frankl does not mention medication as an issue in his book, Man's Search for Meaning.  Recently, in the Gainesville Sun, our local newspaper, Prof. Jamie Smolen wrote an article on the tragic link between depression, addiction and suicide says this and I quote “Management of the diseases with anti-craving and antidepressant medications is essential in all cases". This can be seen as blowing the horn of psychiatry and the income that it derives from patients. He is contending that the brain can be dealt with as one would deal with other organs such as the liver or spleen. There been many books written about the mind in relation to the brain and the brain in relation to the soul and the soul in relation to the essence of self. In 2014 there is a concerted effort on the part of many working in science and medicine to carve out the heart and soul as a feature of the human beings existence in the world. I choose otherwise though I cannot make God appear to those who would attempt to erase God from our presence.

       I set out to avoid statistical analysis and give you what I knew had happened in my experience as a psychiatrist without regard to the MMPI or any other testing. I can tell you that I believe that we are not necessarily moving ahead when we move into neural circuitry or brain chemistry. These factors such as brain chemistry and neural circuitry could let others and especially doctors know more about us but would it help us know more about ourselves or improve our lot in life?

      I have indicated elsewhere the importance of perspective and self-awareness and how that self-awareness develops over time. One of the tool that psychiatry and psychology use is that we cannot be self-aware in much the same way as specific religions telling us we can reach God through the church.  In New York City today over half of all dwellings are occupied by only one person which means to me that we are more and more isolated even though we are more crowded together. We've even divided up into blue and red states or blue and red states of mind. People are even writing about the genetics of being a Republican or Democrat. Families are perhaps more shattered and divided than ever before. People are constantly complaining that they thought they had friends until they needed them and then it appeared that no one showed up. I believe that the friend in our lives is a necessary does not happen on Facebook while sitting in a New York apartment. I mention these issue of church, psychology, psychiatry and now also the media

     Harry Stack Sullivan believed that one develops emotionally during adolescence through a reflection from one's friends during that stage of life. The adolescent peer understand us in a way that we want to be understood and believe that we are justified and will come in the world. This is perhaps just an amplification of all the other times in life but it is a marker and should be noted. He drank alcohol throughout his workday but just as with Churchill, no one found it totally objectionable. I would've certainly appreciated being able to drink during the workday but I never did it. Times have changed and we are much more aware of each other's substance use. But I was very aware of the numbing effect of alcohol even during the days of abstinence. This numbing effect is in my estimation the primary rationale for many in the healing professions to use alcohol. I found myself using alcohol to sleep and to dampen the intensity filled in the previous day's work which included patient suicide and many conflictual situation which brought anguish to me but the numbing effect of alcohol. Finding this too numbing I would try to regain sensitivity with marijuana but this was not a solution by any test of the imagination. Some 32 years ago I ceased alcohol and marijuana and gradually became more sensitive to my family and to my patients. This for a period of time brought about a tremendous increase in cigarette smoking. So much of the middle years of my life were fraught with the struggling with addiction: first alcohol then marijuana and from the beginning, tobacco.

     Although every writer is in danger of saying we are now at a crossroads of justice. Just as Snoopy began book with it was a dark and dreary night I hope I am not too dramatic. However, we can see some things today if we are willing to look at them. We see the frightening but exhilarating historical acceleration. What I mean by that is that each person’s life in the present generation is going through a faster series of transitions than the lives in the previous generation. It does make for an interesting problem and Einstein mentioned that the world that we have made as a result of the level of thinking we have done thus far creates problems that we cannot solve at the present level at which we created them. Given this being true do we need to slow anything down and if so how do we go about it?

     But I need to explain what has been so difficult in accommodating my relation to Alcoholics Anonymous and my chosen field of psychiatry. To digress a bit I will say that my main interest from the time I was an undergraduate at the University of Florida in abnormal psychology my single question was how does a person improve or change when a mental illnesses is present. I saw some things that were disturbing in general practice and matches by disturbing in a positive way as I saw changes in people that I did not expect. There was nothing in the literature that tell me how this came about but people were getting better from mental illness without psychiatric intervention. How did this happen? What were the inner workings of this change? Jumping forward to my early experience in Alcoholics Anonymous that really didn't happen until about 35 years ago I found that people got better for mental illness while very active in Alcoholics Anonymous; but the causes continued to be obscure. This was an essential ministry from a permitting many years. But like many phenomena that are seen in the human behavior the cause was very simple and rather direct. I just kept missing it and primarily because I was working from the psychiatric nomenclature and diagnostic nomenclature such as anxiety neurosis major depression and schizophrenia. I had seen a number of people in Alcoholics Anonymous who went into the program with full force recover from bipolar disorder. But the problems and schizophrenia, anxiety neurosis and major depression were less obvious.

While working with this challenge I read a great deal on personality, child development and so-called personality disorders. I did not get my answers in these areas either. But gradually came to light was that all the people that I had seen as a general practitioner and all the people that I had seen while attending Alcoholics Anonymous as well as my own patients who were active in Alcoholics Anonymous, made major changes through their effort to change issues of personality which can be translated as problems in character defect problems and character development but the net result was the same. In the preamble of our Alcoholics Anonymous literature it says and I quote rarely have we seen a person fail even those with grave mental disorders if they had the capacity to be honest with themselves. This is a striking issue and cannot be over-emphasized.

     The human personality is more than any other feature of human behavior a stubborn and difficult to change from very early on in life. Stella Chess for example, thought of babies as having from the first few months of life, as an easy babies, difficult babies, and hard to warm up babies. She believes that the key to developing these youngsters into more appropriate behavior was recognizing these personality templates and giving the emerging child recognition of that template and building upon that foundation. In other words it was not in Stella Chess scheme of things to try to turn a difficult baby into an easy baby. She recognized the substrate or foundation of the human personality has being very solid. 

     I think we do makes attempts to slow things down by having elaborate weddings and complex so birthday parties and ponderous funerals but this is just a phenomenon as we have recognized for many years. We have not put anything new into our lives which would slow it down enough to be able to see better. You can always see more walking through your neighborhood than driving through it. You can even see riding more bicycle than when driving through it. But that doesn't solve the problem of historical acceleration.

     Our youngsters are trying to solve this intuitively by playing computer games which requires instantaneous judgment, rapid reflexes and a willingness to play the game over and over again hoping that will come out better the next time. But I don't think this solves too much but I mentioned that to give some credence to the intelligence of youngster’s intuition. What else can we do to slow things down so that we can see them better?

     One of the things that can slow things down so that we can see them better is listed in the DSM-IV and V as an illness. I believe depression as it is experienced outside of the more genetically derived illness is a way of slowing things down so that we can see them more clearly but more painfully. Depression often comes about during periods of intense breathtaking change in our environment in in our own personal way of dealing with things. However we treat this often with chemicals such as Prozac was served at best to give us the notion that unreality was more tolerable than reality. We do have children and adolescents who have severe depression and we also have children and youngsters who have conditions which we are now labeling as attention deficit hyperactive disorder but are in essence just another form of depression. They are given this diagnosis in order to extract a fee for service and provide a name for something we don't understand.

     Looking into Frankl's experience in the Nazi concentration camp a day could seem longer than a week. Why was this and how is it pertinent to us today? We do seem to speed through each day hoping to be able to sort things out at a later time but we find and trying to sleep the events of the day run back and forth through our mind and prevent us from falling asleep and even worse prevent us from sorting anything out.

     Some people come into our midst and make a splash with a very simple recommendation of a technique for slowing things down. This is meditation, which is packaged and repackaged but boils down to a slowing things down and a clearing the mind of thoughts, which are largely negative. Eckhart Tolle has written several books on the subject because it is so simple that he repeats the theme over and over again in each book.  He even goes to a strenuous attempt to speak very slowly and provide long pauses between sentences, but the net effect is similar to a Catholic have several sets of rosary beads.  Meanwhile as we watch television we are fighting the commentators trying to jam or more words and to fewer and fewer minutes. This is what our daily life is about and Eckhart Tolle has given us one possible solution for our malady.

      But I've yet to get to the central issue which I think is important to my own wellbeing in Alcoholics Anonymous. In the meeting this morning we were celebrating an AA birthday of a person who has helped me see myself with less derision and more humor than I had hoped for. It was a very good meeting and I felt at peace with everyone in the room. I had no sense of being a psychiatrist or Democrat are the octogenarian are a male person but rather as a fellow human being trying to understand myself and hoping I could gain insight into myself through others self-report. It was a success in every sense of the word and these meetings occur on a daily basis for me. Since I've been out of work for now all well over a year I've gone to early-morning meetings in Alcoholics Anonymous on a daily basis. It has given me the courage to continue on after my wife’s death. It is given me the courage to continue on after my brother's death and then the loss of my job and now it is giving me the courage to become a writer. If I write from my mind and my heart I do not generally know what I'm going to say at a time. But somehow to some kind of magical process it comes out all right. Though many people who read by major writings think they are great I realized that praise of writing is often easily obtained from friends but praise writing from enemies and over time would mean something far more striking but probably not more worthwhile.

      I also said in the meeting that I was tired of trying to die at 81 and it seemed foolish to continue on such nonsense. I want to now live at least another 10 years and hopefully I can do so as a writer. It will take a great deal of training for this to happen. But I know I have something to say still reach certain kinds of people and now we have in this generation the ability to reach everyone in the world who has an electronic means of communication. This is astounding and I must take advantage of it. God only knows how many people who are able to get a message that they have a reason to be on this planet and they can gain a purpose that will transcend their sense of their meagerness.

   At various places in this book I will attempt to bring together the emerging field of evolutionary psychiatry and the basic ideas presented in Alcoholics Anonymous. To be more accurate I should say evolutionary humanness rather than evolutionary psychiatry.  

     Specifically the idea that is presented in Alcoholics Anonymous meetings is that all suffer character defects, which can be dealt with by honesty and by the gradual reduction of the impact of these character defects on our daily lives. For instance in discussing evolutionary humanness and it is clear that the development of the human being aside from the cognitive complexity has been the gradual development of altruism from rudimentary origins but striving in the direction of an end of strife, unnecessary misery, and unnecessary and deplorable greed. We now know that in this plan we have every capability of providing each other with an honest life and honest way of going about it. Strife continues and greed continues but the evolution of a human being is also more obvious when we have an opportunity to look at it from all angles.

     Looking into Frankl's experience in the Nazi concentration camp a day could seem longer than a week. Why was this and how is it pertinent to us today? We do seem to speed through each day hoping to be able to sort things out at a later time but we find and trying to sleep the events of the day run back and forth through our mind and prevent us from falling asleep and even worse prevent us from sorting anything out.

Some people come into our midst and make a splash with a very simple recommendation of a technique for slowing things down. This is meditation, which is packaged and repackaged but boils down to a slowing things down and a clearing the mind of thoughts, which are largely negative.

      But I've yet to get to the central issue which I think is important in Alcoholics Anonymous. My struggles have to do mostly with shame. Shame is the noose that I have worn for many years. When I'm not wearing the noose I very nearly getting into trouble again. There are those who I greatly admire and feel very close to within Alcoholics Anonymous.  Most of my life has been fraught with shame but in early adolescence I learned to dose myself with a kind of remedy called masturbation.  Eventually I learned that all addiction has a circular pathway but at the time I felt if I masturbated enough I could keep my sexual thinking at a low roar. But my sexual thinking always led to masturbation and I must admit the feeling that I got from masturbation was as delicious as I have heard alcohol described in many meetings of AA. I trust that by the end of this chapter you will see drugs as a metaphor including testosterone, alcohol, cocaine and many other drugs as metaphors of the underlying problem, which is addiction. My addiction I mean that behavior which results in a serious life-changing bad outcome regardless of good intention. I do believe that the addiction to tobacco was far more difficult to deal with on a day-to-day basis than alcohol. There are peculiarities of alcohol that are worth considering as yielding horrendous deathly outcomes.

     The Big Book of Alcoholics Anonymous tells us “Remember that we deal with alcohol—cunning, baffling, I got powerful. Without help it is too much for us.” My semi-rational mind puzzled over “cunning” so much that I have often passed the thought of it off as idiotic. How can a simple chemical be cunning? For years alcohol appeared to me to have been a disaster for a few but for the most part it was a simple, legal and acceptable way of achieving relaxation. I only troubled myself a bit over the reason why some people became alcoholics.

     I didn't trouble myself to think about genetics until I became diabetic; then my three brothers became diabetic, and then my mother developed diabetes. Type II diabetes must be genetic I said with regret. But I see the younger folks who are grandchildren and children around me gobbling up sugar just like I used to. It is no wonder to me that we call mothers with some derision helicopter moms.  Recent research however might indicate that gut bacteria have a profound influence on type II diabetes development.