Here's To Your Health has already paid tribute to many doctors who heavily influenced Alcoholics Anonymous, and this week I will quote another doctor: "It was from Bill Wilson that I heard the need for alcoholics to hit bottom, of the necessity for accepting a higher power, of the indispensability of humility. These ideas had never crossed my professional horizon and certainly had never influenced my thinking or attitudes. Revolutionary as they were, they nevertheless made sense, and I found myself embarked on a tour of discovery. I recently tried this new brand of psychotherapy, designed to promote hitting bottom. For reasons completely unknown, the patient experienced a conversion, which brought them into a positive state of mind. Led by the newly found spiritual elements, the patient started attending various churches in town. One Monday the patient entered my office with eyes ablaze, and at once commenced talking." "I know what happened to me! I heard it in church yesterday. I surrendered!" With that word "surrender", my patient handed me my first real awareness of what happens during the period of hitting bottom."
Alcoholics fight any admission of being licked, of admitting that they are powerless, but if and when they quit fighting, admit they are licked and admit their powerlessness and surrender there is hope. If they do not surrender, a thousand crises can hit them and nothing constructive will happen! The need to induce surrender became a new therapeutic goal.
During the past decade (1945-55) treating alcoholism centered primarily upon the problem of ego reduction. I have made a little progress and I shall attempt to acquaint you with some of my findings and relate them to the AA scene as I see it.
The fact of hitting bottom to produce surrender which cut the ego to size was evident fairly soon. In time two additional facts manifested themselves. The first was that a reduced ego has marvelous recuperative powers. The second was that surrender is an essential disciplinary function and experience. It is common knowledge that a return of the full-fledged ego can happen at any time. Years of sobriety are no insurance against its resurgence. No AA, regardless of his or her veteran status, can ever relax their guard against the encroachments of a reviving ego. Recently one AA reported to another he was suffering from "Halo-tosis," a reference to the smugness and self-complacency, which so easily can creep into the individuals with years of sobriety behind them.
The assumption that one has all the answers, and the contrary, that one needs to know, no other answers, but AA are two indicators of trouble. In both cases open-mindedness is notably absent.
Everybody knows this type is doomed, but it's perhaps not equally clear that it is the ego slowly making its comeback that's causing the problem.
Dr. Harry M. Tiebout, Psychiatrist