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DR Silkworth and slips

Old 01-18-2009, 06:20 PM
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DR Silkworth and slips

This is what the good Dr had to say on the subject:

Slips and Human Nature

by William Duncan Silkworth, M.D.

The mystery of slips is not so deep as it may appear. While it does seem odd that an alcoholic, who has restored himself to a dignified place among his fellowmen and continues dry for years, should suddenly throw all his happiness overboard and find himself again in mortal peril of drowning in liquor, often the reason is simple.

People are inclined to say, "there is something peculiar about alcoholics. They seem to be well, yet at any moment they may turn back to their old ways. You can never be sure."

This is largely twaddle. The alcoholic is a sick person. Under the technique of Alcoholics Anonymous he gets well - that is to say, his disease is arrested. There is nothing unpredictable about him any more than there is anything weird about a person who has arrested diabetes.

Let's get it clear, once and for all, that alcoholics are human beings. Then we can safeguard ourselves intelligently against most slips.

In both professional and lay circles, there is a tendency to label everything that an alcoholic may do as "alcoholic behavior." The truth is, it is simple human nature.

It is very wrong to consider any of the personality traits observed in liquor addicts as peculiar to the alcoholic. Emotional and mental quirks are classified as symptoms of alcoholism merely because alcoholics have them, yet those same quirks can be found among non-alcoholics too. Actually they are symptoms of mankind!

Of course, the alcoholic himself tends to think of himself as different, somebody special, with unique tendencies and reactions. Many psychiatrists, doctors, and therapists carry the same idea to extremes in their analyses and treatment of alcoholics.

Sometimes they make a complicated mystery of a condition which is found in all human beings, whether they drink whiskey or buttermilk.

To be sure, alcoholism, like every other disease, does manifest itself in some unique ways. It does have a number of baffling peculiarities which differ from those of all other diseases.

At the same time, any of the symptoms and much of the behavior of alcoholism are closely paralleled and even duplicated in other diseases.

The slip is a relapse! It is a relapse that occurs after the alcoholic has stopped drinking and started on the A.A. program of recovery. Slips usually occur in the early states of the alcoholic's A.A. indoctrination, before he has had time to learn enough of the A.A. techniques and A.A. philosophy to give him a solid footing. But slips may also occur after an alcoholic has been a member of A.A. for many months or even several years, and it is in this kind, above all, that often finds a marked similarity between the alcoholic's behavior and that of "normal" victims of other diseases.

No one is startled by the fact that relapses are not uncommon among arrested tubercular patients. But here is a startling fact - the cause is often the same as the cause which leads to slips for the alcoholic.

It happens this way: When a tubercular patient recovers sufficiently to be released from the sanitarium, the doctor gives him careful instructions for the way he is to live when he gets home. He must drink plenty of milk. He must refrain from smoking. He must obey other stringent rules.

For the first several months, perhaps for several years, the patient follows directions. But as his strength increases and he feels fully recovered, he becomes slack. There may come the night when he decides he can stay up until ten o'clock. When he does this, nothing untoward happens. Soon he is disregarding the directions given him when he left the sanitarium. Eventually he has a relapse.

The same tragedy can be found in cardiac cases. After the heart attack, the patient is put on a strict rests schedule. Frightened, he naturally follows directions obediently for a long time. He, too, goes to bed early, avoids exercise such as walking upstairs, quits smoking, and leads a Spartan life. Eventually, though there comes a day, after he has been feeling good for months or several years, when he feels he has regained his strength, and has also recovered from his fright. If the elevator is out of repair one day, he walks up the three flights of stairs. Or he decides to go to a party - or do just a little smoking - or take a cocktail or two. If no serious aftereffects follow the first departure from the rigorous schedule prescribed, he may try it again, until he suffers a relapse.

In both cardiac and tubercular cases, the acts which led to the relapses were preceded by wrong thinking. The patient in each case rationalized himself out of a sense of his own perilous reality. He deliberately turned away from his knowledge of the fact that he had been the victim of a serious disease. He grew overconfident. He decided he didn't have to follow directions.

Now that is precisely what happens with the alcoholic - the arrested alcoholic, or the alcoholic in A.A. who has a slip. Obviously, he decides to take a drink again some time before he actually takes it. He starts thinking wrong before he actually embarks on the course that leads to a slip.

There is no reason to charge the slip to alcoholic behavior or a second heart attack to cardiac behavior. The alcoholic slip is not a symptom of a psychotic condition. There's nothing screwy about it at all. The patient simply didn't follow directions.

For the alcoholic, A.A. offers the directions. A vital factor, or ingredient of the preventive, especially for the alcoholic, is sustained emotion. The alcoholic who learns some of the techniques or the mechanics of A.A. but misses the philosophy or the spirit may get tired off following directions - not because he is alcoholic, but because he is human. Rules and regulations irk almost anyone, because they are restraining, prohibitive, negative. The philosophy of A.A. however, is positive and provides ample sustained emotion - a sustained desire to follow directions voluntarily.

In any event, the psychology of the alcoholic is not as different as some people try to make it. The disease has certain physical differences, yes, and the alcoholic has problems peculiar to him, perhaps, in that he has been put on the defensive and consequently has developed frustrations. But in many instances, there is no more reason to be talking about "the alcoholic mind" than there is to try to describe something called "the cardiac mind" or the "TB mind."

I think we'll help the alcoholic more if we can first recognize that he is primarily a human being - afflicted with human nature.

Dr. Silkworth Grapevine index | Grapevine index
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Old 01-18-2009, 06:29 PM
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In both professional and lay circles, there is a tendency to label everything that an alcoholic may do as "alcoholic behavior." The truth is, it is simple human nature.
I found this to be very interesting. Human nature, so...

We are earth people too? Somehow I suspected as such.


The slip is a relapse! It is a relapse that occurs after the alcoholic has stopped drinking and started on the A.A. program of recovery. Slips usually occur in the early states of the alcoholic's A.A. indoctrination, before he has had time to learn enough of the A.A. techniques and A.A. philosophy to give him a solid footing. But slips may also occur after an alcoholic has been a member of A.A. for many months or even several years, and it is in this kind, above all, that often finds a marked similarity between the alcoholic's behavior and that of "normal" victims of other diseases.

No one is startled by the fact that relapses are not uncommon among arrested tubercular patients. But here is a startling fact - the cause is often the same as the cause which leads to slips for the alcoholic.
This could cause an argument at most meetings. We waste alot of time in AA arguing about slips and relapses. According to a professional who has worked with AA members it seems that maybe it is not such a fluke...
There is no reason to charge the slip to alcoholic behavior or a second heart attack to cardiac behavior. The alcoholic slip is not a symptom of a psychotic condition. There's nothing screwy about it at all. The patient simply didn't follow directions.
I like this.

My sponsor and I had a long conversation about slips this morning. He is pushing 80 and recently lost two men in AA near his age to drinking. He was talking about senility and what happens to the human mind when it begins to break down. Certain memories are stored from years ago ( Why some folks can remember things from decades ago but forget their grandchilds name). Now granted, we were just talking. Neither of us has any qualifications to determine who will relapse. But I thought his ponderings about forgetting were interesting in regards to relapse.
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Old 01-19-2009, 06:44 AM
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Let's get it clear, once and for all, that alcoholics are human beings. Then we can safeguard ourselves intelligently against most slips.

In both professional and lay circles, there is a tendency to label everything that an alcoholic may do as "alcoholic behavior." The truth is, it is simple human nature.
Good to read this today. Thanks Steve.
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Old 01-19-2009, 06:53 AM
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thanks Steve
good stuff-a keeper
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Old 01-19-2009, 07:02 AM
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I like the stuff about "alcoholic behavior" that he states in the article. I have had a tendancy to excuse all of my behaviors in this way. It seemed to rid me of the responsibility. After all, I was acting out wasn't I?
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Old 01-19-2009, 12:06 PM
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Steve,about the talk with your sponsor.I really liked that info you shared with us.It gives me a little more to consider regarding our older AA members.My sponsor is getting on up there in yrs too,and I am glad he still makes 5 meetings a week.
On the other hand,I have a AA friend who has demensia and he has been getting really sick lately.
He has went from a warmhearted,kind,gentle, helpfull man to a lonely guy who has gotten into a lot of trouble.All this helps me to grow in understanding.

people just don`t talk much about our older members and the problems they face unless they want to call them a bunch of grumpy oldtimers.
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Old 01-19-2009, 02:37 PM
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I agree, and have been guilty of labeling them myself. Glad you got something out of that
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Old 01-20-2009, 05:14 PM
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Intresting...Thanks Steve...
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Old 01-20-2009, 06:08 PM
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"I feel better, I don't need my medicine anymore and I don't need to follow my doctor's directions anymore." That is human nature.

This sort of thinking killed my father. He had three by-pass surgeries. After each one he would eat right, quit smoking and take better care of himself. At some point he would start smoking again and eating fried, fatty foods high in chloresterol. Then he would have another heart attack. He made it three years after his last by-pass and dropped dead of a massive heart attack.
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Old 01-21-2009, 04:24 AM
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Great article and great thread. I have heard quite a few folks in the rooms in my area say that now that they are sober and working a program they have become aware that the main reason they do make mistakes in life (Not just relapses) is because "They are human, not God!"
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Old 01-21-2009, 07:53 AM
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Very interesting! I enjoyed it.

I get annoyed when alcoholics describe various apects of themselves through the view point of alcoholism all the time, and the seeing themselves as completely different, referring to non-alcoholics as "normals" etc.
"Of course being an alcoholic I ate too much ice-cream", like other people don't eat too much ice-cream, lol. What I hear in meetings reinforces this type of thinking too.

I particularly liked the following...

The alcoholic who learns some of the techniques or the mechanics of A.A. but misses the philosophy or the spirit may get tired of following directions - not because he is alcoholic, but because he is human. Rules and regulations irk almost anyone, because they are restraining, prohibitive, negative. The philosophy of A.A. however, is positive and provides ample sustained emotion - a sustained desire to follow directions voluntarily.
At some point I think I understood and agreed with the spirit of the program, at that point "following directions" became pretty easy, I still struggle at times with some of it because it is challenging our old behaviours and requires change but in general being on the program has become second-nature to me now.
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Old 01-21-2009, 01:25 PM
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I'm most grateful to a gracious God for my sobriety, and unlike the tubercular or cardiac patient, I , if I avail myself of the fellowship, get a daily reminder of what it used to be like. I also get the chance to share what its like for me today and how I got here, thus keeping me grateful and safe.

It works if you share it.
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Old 01-21-2009, 04:29 PM
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I think what Silky is saying is that we get a daily reprieve based on our spiritual condition.
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Old 01-21-2009, 05:42 PM
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Thanks for this steve. I have given this kind of thing a lot of thought over the last year, for a couple of reasons.

The first one being being getting diagnosed with serious health problems and being able to see how similar coming to terms with these has been to coming to terms with the fact I am an alcoholic - at times it has been freaky.

The second one being that when I did my most recent 5th step with my sponsor, who is not an alcoholic but an al anon, she told me a lot of what I had written in my 5th step was 'normal' behavior for someone in my postion. I.e. age, back ground etc...

And thirdly because of the time I have spent going to SLAA and what I learnt there and in their literature. Some of the on going problems I have had in soberity have had nothing to do with alcoholism as such but sexual abuse, however I do know AA members who beleive differently, which is fine. But results speak for themselves and insanity is doing the same thing and expecting a different result right, alcoholic or not!

Thanks
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