AA Big Book Quotes on the Role of Health in Recovery

AABB pageQuote
Foreward
2nd Edition
19
Neither does A.A. take any particular medical point of view, though we cooperate widely with (medical professionals) the men of medicine
DO
xv
that the body of the alcoholic is quite as abnormal as his mind.

… we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete.
xv-xviwe favor hospitalization for the alcoholic who is very jittery or befogged. More often than not, it is imperative that a man’s brain be cleared before he is approached, as he has then a better chance of understanding and accepting what we have to offer. 
xviiOf course an alcoholic ought to be freed from his physical craving for liquor, and this often requires a definite hospital procedure, before psychological measures can be of maximum benefit.
Bills Story
7
I was placed in a nationally-known hospital for the mental and physical rehabilitation of alcoholics. Under the so-called belladonna treatment my brain cleared.
Bills Story
13
Treatment seemed wise, for I showed signs of delirium tremens.
19Of necessity there will have to be discussion of matters medical, psychiatric, social, and religious. We are aware that these matters are, from their very nature, controversial. Nothing would please us so much as to write a book which would contain no basis for contention or argument. We shall do our utmost to achieve that ideal. Most of us sense that real tolerance of other people’s shortcomings and viewpoints and a respect for their opinions are attitudes which make us
64for we have been not only mentally and physically ill, we have been spiritually sick.
133But this does not mean that we disregard human health measures. God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such persons…
Their services are often indispensable in treating a newcomer and in following his case afterward.
141Your understanding treatment of their cases will pay dividends. Perhaps you have such a man in mind. He wants to quit drinking and you want to help him, even if it be only a matter of good business. You now know more about alcoholism. You can see that he is mentally and physically sick.
142-3For most alcoholics who are drinking, or who are just getting over a spree, a certain amount of physical treatment is desirable, even imperative. The matter of physical treatment should, of course, be referred to your own doctor. Whatever the method, its object is to thoroughly clear mind and body of the effects of alcohol. In competent hands, this seldom takes long nor is it very expensive. Your man will fare better if placed in such physical condition that he can think straight and no longer craves liquor. If you propose such a procedure to him, it may be necessary to advance the cost of treatment, but we believe it should be made plain that any expense will later be deducted from his pay. It is better for him to feel fully responsible.

If your man accepts your offer, it should be pointed out that physical treatment is but a small part of the picture. Though you are providing him with the best possible medical attention, he should understand that he must undergo a change of heart.
144We suggest you draw the book (AABB) to the attention of the doctor who is to attend your patient during treatment.
161the same thing (approaching alcoholics in treatment for alcoholism) is taking place in many eastern cities. In one of these there is a well-known hospital for the treatment of alcoholic and drug addiction.

Recovery from Transgender feelings in SA

This member applies SA principles to recovery from transgender feelings

Here is how he summarizes his approach to recovery:

– Starting in early childhood I developed a behaviour pattern of compulsively fantasizing about being a woman.

– I became convinced that the only way I could have a fulfilling life was actually to become a woman.

– I came to the recognition that my condition was really a form of addiction – that I was using my fantasies the way an alcoholic reaches for the bottle.

– I found a way to recover from my addiction that does not involve changing my gender identity.

https://tsanon.blogspot.com

He defines his transgender feelings as lust:

Also because SA identifies what I’m really addicted to and gives it a name: lust. The stuff that goes on in my head, the chemical I can flood my brain with just by playing a fantasy on my internal DVD player. And this means that there’s more to being really sober than giving up external behaviours, vital though that is…

In particular, I’ve accepted that for me there is no such thing as an “innocent” fantasy of being a woman. They’re all sexual and they will all lead me to the “hard stuff” before I know where I am. So the time to stop is as soon as I become aware of what’s popping up inside my head.

https://tsanon.blogspot.com

The whole blog is a fascinating read!

Threefold Recovery Workshop

The missing physical aspect of sexual recovery

The concept of Threefold Recovery comes directly from Alcoholics Anonymous and Sexaholics Anonymous literature and early AA history.

The image of the cart before the horse represents the approach to threefold recovery that has occurred in many 12-step programs including SA. Threefold recovery, originating in AA, incorporates the physical, emotional and spiritual elements. Unawareness of the significant part medical treatment played in early AA, and in the absence of sufficient medical science, physical healing has largely been limited to sobriety. Incorporating the physical aspect helps creates the horsepower to support sustainable and rewarding sobriety and recovery for more members.

Workshop contents

Read more

My Threefold Recovery Story

This is the full, unedited version of an article from the December 2019 edition of Essay (p28), the official SA newsletter.

The missing physical aspect of Threefold Recovery

I’ve lived most of my life in Australia. After being sexualized by an older boy, at age 5, I started acting out with my self and other boys. A few years later imagery became part of my MO. That deepened into pornography in my teens and relationships with much older men at 16, group sex and anonymous encounters by age 20.

I knew at the time there was something off about what I was doing but I was powerless to stop. I was seeking help continuously for my many difficulties with life.

I got the first hint of sexual recovery when I was travelling in the US at age 21 in 1980 when I came across a couple of isolated cases. It offered me hope. 12 Step became part of my life at age 30. By then I’d had 3 major relationships with men, each chaotic and dysfunctional in their own way.

I’d founded SA in Melbourne in 1992 after leaving another program. I immersed myself in service, step-work, sponsorship, conference recordings, local and international conferences. At 35 I began my first period of prolonged sobriety.

At some deep level, I knew it was all unsustainable. Even with all the inventory work, I sensed there was something deep inside I had trouble describing or identifying. After 8 years of sobriety, I lost it and struggled for the next 10 years.

In 2006 when visiting California, desperately in search of answers some members introduced me to the idea of brain scans to actually measure what was going on in my brain rather than just guessing.

My subsequent scans showed than even when sober and in recovery mode, my brain was a mess. They called it “highly dysregulated”. I began to learn how the health of my brain affected my ability to do sobriety and recovery. I retired early from work and went on disability to focus on the neglected physical aspect of recovery.

We saw that our problem was threefold: physical, emotional, and spiritual. Healing had to come about in all three.  SA Solution

The SA Solution is read frequently at meeting. Yet we rarely talk about the physical aspect of recovery, apart from sobriety and don’t get too hungry angry lonely or tired. I came to see that my inventory work was utterly incomplete until I added this physical element. As the White Book says “the whole person must be involved in recovery.” p 34

Dr. Silkworth in The Doctors Opinion chapter in AA Big Book writes that “any picture of the alcoholic which leaves out this physical factor is incomplete”. Modern medicine agrees. The Twelve Step program offers a solution that is worked out in the physical body which the Doctors Opinion clearly states may need medical treatment, ”before psychological measures can be of maximum benefit” p xv-xxvii

Dr Silkworth writes further “it is imperative that a man’s brain be cleared before he is approached, as he has then a better chance of understanding and accepting what we have to offer” pp xxv-xxvi Traditionally this has been interpreted to mean sober. As my various brain tests revealed there can be vastly more to clearing the brain than sobriety and step work. Dr Silkworth asks if I am fit for the work of recovery. I had no clue how unfit physically I was for recovery.

This healing of the physical body and brain is the missing piece of Threefold Recovery: the necessity for medical intervention, for many, before recovery can be sustainable. This is exactly what happened in early AA. Some early AA groups required hospitalization before entering AA. Dr Bob treated 5000 alcoholics medically. Sister Ignatia, called the Angel of AA, nursed 15,000 alcoholics in the early decades of AA. In the member stories from the first edition of the AA big book the word hospital is mentioned 100 times.

In SA member stories neither of the words hospital nor treatment is mentioned. Roy K, the SA founder had spinal fusion surgery and took medication daily for low thyroid. Untreated, both of those conditions can lead to mood and cognitive problems. SA may not exist if Roy did not have access to good medical treatment.

For myself, and the members I work with, the physical or medical aspect of recovery has been a key missing piece. I believe it is why sexual recovery programs, 12-step, religious and psychological have had such a high failure and burnout rate.

AA, Gamblers Anonymous, Adult Children of Alcoholics  and Marijuana Anonymous each have a Doctors Opinion in their official literature. Neither SA nor any of the other S programs have such literature. Why? Because the science has not been there to write it. This emerging science has proved the foundation of my current sobriety and enabled the program to become more effective in me and the members I work with. Dr. Burns Brady referred to this in his talks at SA Conferences. Until I’d done the physical/medical inventory work, recovery was something I could believe in, learn about or achieve with little reward on the effort. Ultimately that made it unsustainable.

There is a vast range of medical issues that can affect brain health and ultimately sobriety and recovery. These include gut health, nutrition, brain injuries, genetics, hormones, toxins. But it can be any medical issue that contributes to the buildup of stress, which leads us to the survival brain, where addiction lives.

I’ve adopted many of the nutrition and lifestyle habits of the 1930s that early AA members would have practised. We know now that these habits can make a profound difference for many with brain health.

Dr Sikworth’s 1951 obituary in the AA Grapevine sums up the approach that my sponsor and I take with members. Like Dr Silkworth we “have no formulas….. no stock answers” and come “ to each new case with a wonderfully open mind” because “the unexpected was to be expected in alcoholism”

The steps changed my life. They helped me see what was going on in my lust. How I was wanting to feel like others looked and hoping sex and romance would do that for me. Also how I was running from challenging emotions. However, even with all the program work, sobriety and recovery were unsustainable until I started addressing the multiple physical/medical issues.

I am still in the middle of some of my lengthy treatment. Each stage of that treatment has made sobriety and recovery more sustainable. Men, particularly, have a poor history of seeking medical help. Surrendering denial and ignorance has been crucial here for me.

One member I work with asked me to tell his story. He’s a minister, in the program five years, sponsor says he does great step work yet had trouble maintaining long-term sobriety. His brain scan revealed a 40-year-old brain injury from childhood and PTSD. Further testing revealed almost zero impulse control! With comprehensive treatment, he now has his best sobriety ever and is carrying the message of Threefold Recovery to others.

By looking at the physical/medical issues with members, I saw less of them walk away from the program or recovery. I saw more of them progress, sometimes quite slowly, yet surely.

After working this way with members for a few years I recently developed a Threefold Recovery workshop which goes into more detail. It’s been presented here in Melbourne, also in Singapore. Workshop now available online.

I have been involved in religious, secular and 12 step sexual recovery programs since 1986. It’s been a graveyard of hopes, dreams, and hard work for far too many. By incorporating  the physical/medical aspect of recovery, those hopes, dreams and hard work have a greater chance of materializing into sustainable, rewarding recovery.

Recovery is spiritual but it’s not just spiritual. There’s a spiritual component to everything, but that doesn’t make everything solely spiritual.

The program works if you work it. But only if it’s worked in the context it was designed: Physical as well as emotional and spiritual.

© recoveryinsa.com November 2019

Does anyone mean anyone?

Does Tradition 3 in the AA 12 & 12 and the Responsibility Declaration tell us that SA must accommodate anyone with a sexual addiction?

Key quotes from  AA literature are:

  • ‘When anyone, anywhere, reaches out for help, I want the hand of A.A. always to be there. And for that: I am responsible.’ A.A.’s Responsibility Declaration
  • “neither punish nor deprive any A.A. of membership, that we must never compel anyone to pay anything, believe anything, or conform to anything?” AA 12 & 12 p 141
  • “You are an A.A. member if you say so.” AA 12 & 12 p 139

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SA founder Roy K on same-sex marriage

In 1998 Roy and I  were discussing by email some of the challenges to the SA Sobriety Definition on the same sex issue. In these emails, Roy, referring the campaigns to legalize same-sex marriage, wrote in an email “let them get married”. My understanding of what he was saying, was that the legalism of the same-sex marriage debate in the political sphere blurred what was a spiritual issue in SA. Roy came from a background of legalistic religion.

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“Sexual Orientation” is an outside issue in SA

The term “sexual orientation” is not mentioned anywhere in the main SA literature:  Sexaholics Anonymous (aka White Book), Recovery Continues, Step into Action books. The first time “sexual orientation” was directly addressed  in SA official literature was in Member Stories 1989 p 49, in a member’s story repeated in Member Stories 2007.   The member  wrote

I see now it was not an issue of “gay, straight, or bisexual.” It was an issue of addiction. Once I put my drug away, for one day at a time, these issues seemed to vanish.

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A firm and clear bottom line?

 In the SA main text, Sexaholics Anonymous (aka the White Book) the sobriety definition is described as a

“a firm and clear bottom line” (page 2).

“not a relative matter that we define for ourselves” (pages 1 & 191).

The concept of “marriage as you understand marriage” promoted prior to the Cleveland  Statement of Principle was neither firm nor clear. Rather it describes is a very “relative matter we define for ourselves” and one that can be defined and redefined at will. It would seem to refer to some sort of arrangement between any number of people with any combination of genders: in the SA literature there is no explicit definition of marriage as only 2 people, only use of the term “the spouse” indicating that sobriety in SA is within a monogamous marriage.

For the term marriage to be a “firm and clear bottom line” and not “a relative matter that we define for ourselves” it must have had a very specific meaning at the time the literature was written. The context of the times, the origins and history of SA, and our approved literature gives us much guidance as to what that meaning is.

The Cleveland Statement of Principle (aka Cleveland Clarification) merely removed any unintended ambiguity.