Doctor’s Opinion – Recovered 785

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“The Doctor’s Opinion” contains two letters written by William D. Silkworth, a man whose name is well-known to those who is familiar with the history of AA. In this chapter, There is also some brief writing by Bill Wilson, the co-founder of Alcoholics Anonymous. Bill W. penned the bulk of the Big Book’s core chapters, but “The Doctor’s Opinion” primarily belongs to Silkworth. It was written at a time when AA was just beginning to establish itself as a new outlet of recovery for people afflicted with what was rapidly becoming viewed as a disease.

Some may think that the big book is just for alcoholics, but many who are addicted to other substances will learn much of their condition from the views espoused by Silkworth in “The Doctor’s Opinion.” Tonight, we will talk about Silkworth’s writings, as well as how lessons from “The Doctor’s Opinion” have relevance in our own lives. This is the chapter that is meant to first establish a basic understanding of recovery.

Let’s start with the author of the chapter. Who was the author and what were his credentials?

1. What were Dr. Silkworth’s qualifications? (Pg. XXIII)

The book says that he is a:
chief physician at a nationally prominent hospital specializing in alcoholic and drug addiction

Does this impress?
When you first found out about Silkworth, what did you think?
What has been your experience with medical doctors and alcoholism and recovery?

2. What must we believe to be essential in defining Alcoholism? (Pg. XXIV)

Silkworth makes the statement that the body of the alcoholic is quite as abnormal as his mind
What does this mean to you?
What did you think made an alcoholic before program?
What did you think of this essential belief when you were new?
What do you think now?

4. How does the doctor explain the allergy in his letter? (Pg. XXVI)

Let’s read the part where Doctor Silkworth presents the theory that alcoholism is like an allergy:

We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.

What is your reaction to these statements?
What do you remember as important when you were new?
How do you react to this now?
What part of this impacts you today?
Your thoughts?

5. Why, according to the doctor, do men and women drink? (Pg. XXVII)

Why do people drink?
Let’s read what the doctor says:
Men and women drink essentially because they like the effect produced by alcohol.

What is the difference between enjoying and obsessing

6. How does the doctor describe the “cycle” of alcoholism? (Pg XXVII)

Let’s talk about how Silkworth describes the cycle of alcoholism.

Here is the text

They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few drinks-drinks which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to drink again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery.

Can you relate?
How do you react to this today?
How did you react when you were new?

7. What, according to the doctor, is required to recover? (Pg. XXVII)

Here is what the doctor says is necessary for recovery

This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery.

What was your reaction when you first understood this?
What do you think now?

Let’s read what the book says about the effectiveness of will power against alcoholism.

8. Does the doctor hold that alcoholism is simply a problem of mental control? (Pg. XXVIII)

I do not hold with those who believe that alcoholism is entirely a problem of mental control. I have had many men who had, for example, worked a period of months on some problem or business deal which was to be settled on a certain date, favorably to them. They took a drink a day or so prior to the date, and then the phenomenon of craving at once became paramount to all other interests so that the important appointment was not met. These men were not drinking to escape; they were drinking to overcome a craving beyond their mental control.


9. What do all classes of alcoholic have in common? (Pg. XXVIII)
they cannot start drinking without developing the phenomenon of craving. This phenomenon, as we have suggested, may be the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity. It has never been, by any treatment with which we are familiar, permanently eradicated. The only relief we have to suggest is entire abstinence.

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