The "Missing Piece"

Dr. William D Silkworth
(1873-1951)

Recently, when re-reading The Doctor's Opinion in the 'Big Book' of  Alcoholics Anonymous, I was struck by the fundamental difficulty that both Dr. Silkworth and Carl Jung, himself, were faced with in treating alcoholics. Both knew that "an entire psychic change" could alleviate the alcoholic addict's difficulties, yet both were faced with their inability to trigger such a change. There was a "missing piece" somewhere. Indeed, Dr. Silkworth explicitly admits this. "Faced with this problem," he notes, "if a doctor is honest with himself, he must sometimes feel his own inadequacy. Although he gives all that is within him, it often is not enough. One feels that something more than human power is needed to produce the essential psychic change." (Emphasis added.)

At page 27 in the 'Big Book,' Dr. Jung admits to the same basic futility of effort in working with Rowland H. (that "certain American businessman") which Dr. Silkworth faced when working with Bill.

"Here and there, once in a while," Jung told Rowland, "alcoholics have had what are called vital spiritual experiences. To me these occurrences are phenomena. They appear to be in the nature of huge emotional displacements and rearrangements. Ideas, emotions and attitudes which were once the guiding forces of these men are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate them."

"In fact," he pointed out, "I have been trying to produce some such emotional rearrangement within you. With many individuals the methods I have employed are successful, but I have never been successful with an alcoholic of your description."

Dr Carl G. Jung
(1875-1961)

 Rowland was initially relieved upon hearing this, pointing out to Jung that he had long been a "churchman." This, however, as Jung pointed, was not enough as "in his case (that) did not spell the necessary vital spiritual experience." Rowland was dismissed by Jung with the advice that he associate himself with some unspecified religious body that might (just might) help him find such a vital spiritual experience.

As fate would have it, upon his return to America Rowland associated himself with the then-popular Oxford Group which had adopted a series of concrete steps that an individual could take in order to effect a closer relationship with his or her God. As part of those steps, Rowland altruistically reached out to Ebby Thatcher, and Ebby reached out to Bill W. The rest is A.A. history.

Bill W. and his sponsor, Ebby T.

Yet, when one looks back at this improbable chain of events that would lead to the further recovery of millions of alcoholics and addicts of all stripes worldwide, one sees that two unique factors were at play when Ebby reached out to Bill that was not the case when Bill was being attended by Doctor Silkworth.

First and foremost, as Bill pointed out many times, he was able to identify "at depth" with Ebby. Here was an alcoholic who should be drinking but was not. Secondly, and just as importantly, Ebby had a concrete solution - a program of action - that Bill could (and eventually did) utilize to effect the "vital spiritual experience" that would relieve him of his alcoholism. Rowland and Ebby had found "the missing piece." Dr. Silkworth could identify the problem, as could Jung, but neither had the mechanics of a "moral psychology" that could help bring about a spiritual awakening.

The word-of-mouth program that Ebby passed on to Bill was simple:

1.  Ebby admitted that he was powerless to manage his own life.
2.  He became honest with himself as never before; made an "examination of consciousness."
3.  He made a rigorous confession of his personal defects and thus quit living alone with his problems.
4.  He surveyed his distorted relations with other people, visiting them to make what amends he could.
5.  He resolved to devote himself to helping others in need, without the usual demand for personal prestige or material gain.
6.  By meditation, he sought God's direction for his life and the help to practice these principles of conduct at all times.

(Source: Three Talks to Medical Societies by Bill W., Co-Founder of A.A.)

This word-of-mouth exposition of the Oxford Group's program (which Bill would later expand "for the sake of greater clarity and thoroughness" into A.A.'s Twelve Steps) was "the missing piece" that both Silkworth and Jung lacked. These steps (in their final form) would be the concrete things that an alcoholic addict (or an addict of any kind) could do in order to produce "the entire psychic change" posited by Silkworth and described by Jung. ("Ideas, emotions and attitudes which were once the guiding forces of these men are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate them.")

For sure, Alcoholics Anonymous has "no monopoly" on this. There are, as William James points out in The Varieties of Religious Experience, "a multitude of ways in which men have discovered God." (Alcoholics Anonymous, page 28.) Yet, whether by Providence or happenstance, there was a confluence of events that brought the work of Jung, Silkworth and Frank Buchan's Oxford Groups together, and from this confluence of events sprang the miracle of Alcoholics Anonymous. Seventy-five-odd years later, the "missing piece" that bridges medicine, psychology and spirituality (i.e., the Twelve Steps) remains as effective as ever in relieving alcoholic addiction. Jung's helpful prescription "spiritus contra spiritum" still applies, and without the practical steps to bring this spiritus into our lives, millions of recovered alcoholic addicts (and others) would have likely died of their disease.

Our lives in recovery still depend on how well we practice the principles that Rowland, Ebby, Bill, Dr. Bob and so many others found in this "missing piece" of the alcoholism equation. There is a solution to alcoholic addiction, and "it (still) works if we work it."

Establishing "Conscious Contact" with God

"In meditation," we read in the 'Big Book' of Alcoholics Anonymous (at page 69)," we ask God what we should do about each specific matter. The answer will come, if we want it."

This instruction dealing with our sex relations, and simple on its face, is found in the instructions for how to do Step Four, yet its forward looking implications are for Step Nine and (perhaps more importantly) for Step 12, where we endeavour to "practice these principles in all our affairs." Its inclusion in Step Four is an indication that as part of Step Two and Step Three we have already begun to seek out, through the practice of prayer and meditation, a conscious contact with God.

Indeed, the "word-of-mouth program" from the Oxford Group that Ebby T. passed on to Bill W. stressed the need for daily periods of meditation. In the "Three Talks to Medical Societies" pamphlet, we read that the sixth 'step' that Ebby relayed to Bill was: "By meditation, (we) sought God's direction for (our) life and help to practice these principles of conduct at all times." Similarly, Step Eleven in A.A.'s suggested program of action says that we seek "through prayer and meditation to improve our conscious contact" with the God of our understanding.  If we are to "improve our conscious contact with God," we must have already established such conscious contact at some earlier point in the Steps.

All of this implies, of course, that meditation is one of the fundamental practices that facilitates the spiritual awakening that is necessary for recovery from alcoholic addiction, and that we are faced with the necessity of practicing meditation even before we hit Step Four. It implies, it would seem, that beginning the practice of meditation is an integral part of "turning our will and our lives over to the care of God as we understand Him" in Step Three, for without it we are flying blind.

Steps Four through Step Nine will, of course, relieve the sufferer of many of the punishing thoughts and emotions based on past events that fuel his or her sense of discomfort, irritability, restlessness and discontent, but it is in the state of higher God-consciousness attained in meditation that we find real release. Thus, we are urged to make time for a period of quiet each morning before we start the affairs of the day, seeking guidance for what we should do; and we are urged to take a similar period of quiet each evening, before we retire to bed.

By establishing such a routine we find a place of quiet consciousness to which we can retreat when the going gets tough during our day, and in which we can recollect ourselves and what we are aiming at - i.e., to be of maximum service to God and our fellow beings. It is, as a plaque on Dr. Bob's desk says, "to have a blessed home in (ourselves) where (we) can go in and shut the door and pray to (our God) in secret and be at peace, as in a deep sea of calmness, when all around and about is seeming trouble."

Bill's Reflections on A.A. . . . Its History, Message and Solution

"Three Talks" Pamphlet

Of all the pamphlets published by Alcoholics Anonymous, perhaps the most helpful - at least for beginning members who have taken Step One and admitted their alcoholism and personal powerlessness - is the "Three Talks to Medical Societies by Bill W., co-founder of AA," pamphlet. Certainly, it is the only pamphlet that is referred to directly in the Big Book (in Appendix III, "The Medical View on A.A.") The "Three Talks" pamphlet provides beginners with a brief, yet concise, history of A.A., its message  and "solution."

Taken from Bill's 1958 presentation to the New York City Medical Society on Alcoholism, the first of the "Three Talks" is particularly helpful, giving a precise synopsis of how A.A. came to be formed, how the program works, and just what A.A.'s "solution" for the suffering alcoholic is.

After preliminary remarks, Bill dives right into the history and message of A.A., relating how Carl Jung told Oxford Grouper to-be, Rolland H. (that "certain American business man" described on page 26 of the Big Book) that once in a while a "vital spiritual experience" will remove an alcoholic's mania for drink. Bill describes this as the moment when "the first taproot of A.A. hit paydirt."

Importantly, Bill includes Dr. Jung's description of precisely how these "huge emotional displacements and rearrangements" affect the psyches of alcoholics:

"Ideas, emotions and attitudes which were once the guiding forces of these men are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate them."

(This, of course, is what happened to Bill when he had his sudden and abrupt "spiritual awakening" in Townes Hospital, a number of years after Jung spoke to Rolland H.)

Next, Bill relates how Rolland carried this message to the man who would become Bill's "sponsor," Ebby Thattcher, thereby establishing "the second cardinal principle of A.A." - the "identification at depth" of one alcoholic with another. (Elsewhere, he would call this principle, the only original idea in A.A.'s 'program,' everything else being "borrowed" from other sources, ancient and modern.)

Bill then tells how Ebby visited him at his home (the night that Bill's "gin would last longer than his preaching"), and he then sets out the simple, "word-of-mouth" program of action that Ebby had been working and offered to Bill, in the following manner:

1. Ebby admitted that he was powerless to manage his own life.
2. He became honest with himself as never before; made an "examination of conscience."
3. He made a rigorous confession of his personal defects and thus quit living alone with his problems.
4. He surveyed his distorted relations with other people, visiting them to make what amends he could.
5. He resolved to devote himself to helping others in need, without the usual demand for personal prestige or material gain.
6. By meditation, he sought God's direction for his life and the help to practice these principles of conduct at all times.

 (Bill later explains that, "For the sake of greater clarity and thoroughness, the word-of-mouth program which my friend Ebby had given me was enlarged into what we now call A.A.'s 'Twelve Suggested Steps for recovery.'")

Note that the only reference to "a Higher Power" is in Ebby's last point, that "by meditation" direction and help was sought. Of course, A.A.'s Step 11 says that it is "through meditation and prayer" that we seek "to improve our conscious contact with God" as we understand that conception. Yet, how many times do we hear continually relapsing A.A. members - and even season veterans - relating how they pray, pray, pray. And how many times do they mention meditation? This is no small point. Oxford Groupers and early A.A. members had a sustained practice of meditation or "quiet time" in the morning, before they made their plans for the day, and a similar meditation time at night.

"By meditation, he sought
          God's direction for his life . . ."

If all we do is "talk" to God - affirming and invoking God's presence and power in our lives - but never "listen" in meditatioin, how are we to effect a conscious contact. It is through meditation that we gain the ability to change the level and focus of our consciousness (from self-consciousness, which is the problem, to God-consciousness, which is the solution).

At Step 11 in the Twelve Steps and Twelve Traditions, Bill describes  how an interwoven and logically interrelated practice of "self-examination, meditation and prayer" will provide us with an "unshakeable foundation." Prayer, while beneficial in and of itself, is not sufficient. Meditation must be a part of our practice to gain the ultimate benefits that A.A. offers.

Finally, Bill relates his own sudden spiritual awakening, how William James' Varieties of Spiritual Experience confirmed the reality of his experience, and how the Varieties outlined that "ego deflation at depth," or "a complete defeat in a controlling area of life," is a necessary precondition for a true and effective spiritual experience.

The balance of the Three Talks pamphlet describes the contribution of Townes Hospital's Dr. Silkworth, his contribution that clarifies alcoholism is both an allergy of the body and an obsession of the mind, and the further growth of the A.A. movement.

Of course, alcoholism and addiction are no less a problem now than they were in 1958. Yet Bill's closing remarks to the medical professionals of New York is no less relevant. He concludes by making a pledge that "A.A. will always stand ready to cooperate" with the whole medical community. "When our combined understanding have been fully massed and applied," he presciently predicts, "we of A.A. know that we shall find our friends of medicine in the very front rank - just where so many of you are already standing today."

This last remark stands out when we consider that "detox" and "rehab" were not a part of the larger vocabulary in 1958. And yet, it clarifies the point that both A.A. and the medical/treatment center communities have a vital role to play in providing a "solution" to the still suffering alcoholic addict.