The Twelve Steps
The 12 Steps as Ego Deflating Devices
What does Surrender Mean?
For reasons still obscure, the program and the fellowship of AA could cause a surrender which in turn would lead to a period of no drinking. It became ever more apparent that in everyone's psyche there existed an unconquerable ego which bitterly opposed any thought of defeat. Until that ego was somehow reduced or rendered ineffective, no likelihood of surrender could be anticipated.
AA, still very much in its infancy, was celebrating a third or fourth anniversary of one of the groups. The speaker immediately preceding me told in detail of the efforts of his local group—which consisted of two men—to get him to dry up and become its third member. After several months of vain efforts on their part and repeated nose dives on his, the speaker went on to say: "Finally, I got cut down to size and have been sober ever since," a matter of some two or three years. When my turn came to speak, I used his phrase "cut down to size" as a text around which to weave my remarks. Before long, out of the corner of my eye, I became conscious of a disconcerting stare. It was coming from the previous speaker.
It was perfectly clear: He was utterly amazed that he had said anything which made sense to a psychiatrist. The incident showed that two people, one approaching the matter clinically and the other relying on his own intuitive report of what had happened to him, both came up with exactly the same observation: the need for ego reduction. 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's, regardless of their veteran status, can ever relax their guard against a reviving ego.
The function of surrender in AA is now clear. It produces that stopping by causing the individual to say, "I quit. I give up on my headstrong ways. I've learned my lesson." Very often for the first time in that individual's adult career, he has encountered the necessary discipline that halts him in his headlong pace. Actually, he is lucky to have within him the capacity to surrender. It is that which differentiates him from the wild animals. And this happens because we can surrender and truly feel, "Thy will, not mine, be done."
Unfortunately, that ego will return unless the individual learns to accept a disciplined way of life, which means the tendency toward ego comeback is permanently checked.
This is not news to AA members. They have learned that a single surrender is not enough. Under the wise leadership of the AA "founding fathers" the need for continued endeavour to maintain that miracle has been steadily stressed. The Twelve Steps urge repeated inventories, not just one, and the Twelfth Step is in itself a routine reminder that one must work at preserving sobriety. Moreover, it is referred to as Twelfth Step work—which is exactly what it is. By that time, the miracle is for the other person.
-Dr. Harry M. Tiebout, M.D.
For reasons still obscure, the program and the fellowship of AA could cause a surrender which in turn would lead to a period of no drinking. It became ever more apparent that in everyone's psyche there existed an unconquerable ego which bitterly opposed any thought of defeat. Until that ego was somehow reduced or rendered ineffective, no likelihood of surrender could be anticipated.
AA, still very much in its infancy, was celebrating a third or fourth anniversary of one of the groups. The speaker immediately preceding me told in detail of the efforts of his local group—which consisted of two men—to get him to dry up and become its third member. After several months of vain efforts on their part and repeated nose dives on his, the speaker went on to say: "Finally, I got cut down to size and have been sober ever since," a matter of some two or three years. When my turn came to speak, I used his phrase "cut down to size" as a text around which to weave my remarks. Before long, out of the corner of my eye, I became conscious of a disconcerting stare. It was coming from the previous speaker.
It was perfectly clear: He was utterly amazed that he had said anything which made sense to a psychiatrist. The incident showed that two people, one approaching the matter clinically and the other relying on his own intuitive report of what had happened to him, both came up with exactly the same observation: the need for ego reduction. 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's, regardless of their veteran status, can ever relax their guard against a reviving ego.
The function of surrender in AA is now clear. It produces that stopping by causing the individual to say, "I quit. I give up on my headstrong ways. I've learned my lesson." Very often for the first time in that individual's adult career, he has encountered the necessary discipline that halts him in his headlong pace. Actually, he is lucky to have within him the capacity to surrender. It is that which differentiates him from the wild animals. And this happens because we can surrender and truly feel, "Thy will, not mine, be done."
Unfortunately, that ego will return unless the individual learns to accept a disciplined way of life, which means the tendency toward ego comeback is permanently checked.
This is not news to AA members. They have learned that a single surrender is not enough. Under the wise leadership of the AA "founding fathers" the need for continued endeavour to maintain that miracle has been steadily stressed. The Twelve Steps urge repeated inventories, not just one, and the Twelfth Step is in itself a routine reminder that one must work at preserving sobriety. Moreover, it is referred to as Twelfth Step work—which is exactly what it is. By that time, the miracle is for the other person.
-Dr. Harry M. Tiebout, M.D.
Grant Me The Serenity…
Fourth Step Inventory
These 4th step worksheets use the wording from Alcoholics Anonymous (the Big Book) pages 63-71. Text in italics is quoted from the Big Book. When the word “optional” is used in the worksheets, it means that the Big Book suggests doing this but does not suggest writing anything down. However, many people who have used these worksheets found it helpful to write down their flaws and their specific defects.
You may print additional copies of each worksheet, if needed. Most printers will allow you to print individual parts of a document. If you are using Microsoft Word in Windows, you can choose File: Print, then choose the ‘Current Page’ selector, and it will print the page that your mouse is active on. These worksheets are intended to be printed in “Landscape” position.
These worksheets are not officially produced or approved by Alcoholics Anonymous. They have been circulating unofficially among AA members for a long time in various versions. Their origin is unknown.
Helpful Hints
Preparation: before you start this written Fourth Step, read pages 63-71 in the Big Book and the Fourth Step in the Twelve Steps and Twelve Traditions.
Note:
1. This inventory is not an exercise in beating yourself up. Be scrupulously honest but be fair to yourself. Inventory your strengths as well as your defects.
2. The following checklist merely suggests what some people consider flaws. You must decide how they fit with your own moral code. Do not be limited by this list--add your other flaws and assets. It is in this Fourth Step that you begin to discover your values--what you consider right and wrong, functional and dysfunctional behavior--and how you live up to your standards.
3. This inventory is about who you are now, not who you were when you were drinking and taking drugs. Be careful, however, not to blame all past bad behavior on drinking and drugs if the seed of that bad behavior still exists in you.
4. Don't be discouraged when your character defects are not immediately lifted after you have completed your 5th Step--that is the work of the 6th and 7th Steps.
5. Prioritize! Spend most of your time on the 20% of your flaws that cause 80% of the trouble in your life. You can initially check off as many flaws as you want on the checklist but then prioritize to the 12 that cause the most trouble. If you list more than 12 flaws, you are probably beating yourself up!
Into Action: On the following list, check all of your defects and all of your assets. This is an inventory of both bad and good characteristics. Then discuss your defects (with your best example of each) on the Review of Flaws form.
Glossary of Words Used in Steps Four and Five
Moral Inventory.. A list of personality defects, violations of moral principles, defects in character, maladjustments, and dysfunctional behavior.
Character............... Moral vigor or firmness, especially as acquired through self-discipline.
Defect................... Lack of something necessary for completeness; flaw; weakness, fault; same as Shortcoming.
Dishonest.............. The act or practice of telling a lie, or of cheating, deceiving, stealing, etc.
Exact..................... Precise, detailed.
Fault...................... Something done wrongly, an error or mistake.
Fear....................... Painful emotion marked by alarm, dread, anxiety, agitation, uneasiness, apprehension, etc.
Frightened............. A temporary or continual state of Fear. Anxious.
Inconsiderate......... Without thought or consideration of others.
Nature................... The essential characteristic of a thing.
Self-centered......... Occupying or concerned only with one’s own affairs; same as Selfish.
Self-seeker............. A person who seeks only or mainly to further his own interests.
Selfish................... Too much concerned with one’s own welfare or interests and having little or no concern for others; same as self-centered.
Shortcoming.......... Falling short of what is expected or required; same as Defect.
Wrong................... Immoral, improper; not suitable or appropriate.
Footnotes to the list on following page:
1Dr. Bob’s Fourth Step List; in “He Sold Himself Short,” (Alcoholics Anonymous , p. 292)
2Seven Deadly Sins (Twelve Steps and Twelve Traditions, p. 48)
3Clarence Snyder’s Fourth Step List (one of the original 40 members of AA, see “Home Brewmeister,” Alcoholics Anonymous, pp. 297-303)
4Boy Scout Law, Robert Binkey's The Official Boy Scout Handbook (10th edition, 1990)
Checklist of Flaws and Assets
4 Character Defect Opposite Asset 4
aggressive, belligerent good-natured, gentle
angry2 forgiving, calm, generous
apathetic interested, concerned, alert
apprehensive, afraid calm, courageous
argumentative, quarrelsome agreeable
arrogant, insolent unassuming, humble
attacking, critical fair, self-restrained
avoidant faces problems and acts
blocking honest, intuitive
boastful modest, humble
careless1 careful, painstaking, concerned
cheating honest
competitive (socially) cooperative
compulsive free
conceited1,self-important humble, modest
contradictory, oppositional reasonable, agreeable
contrary, intractable, pigheaded reasonable
controlling lets go, esp. of other's lives
cowardly brave4
critical3 non-judgmental, praising, tolerant,
cynical open-minded
deceitful guileless, honest
defensive open to criticism
defiant, contemptuous respectful
denying honest, accepting
dependent accepts help but is self-reliant
depressed, morose| hopeful, optimistic, cheerful4
dirty, poor hygiene clean4
dishonest3 honest
disloyal, treacherous faithful, loyal4
disobedient obedient4
disrespectful, insolent respectful, reverent4
enabling setting boundaries, tough love
envying2,3 empathetic, generous, admiring
evasive, deceitful candid, straightforward
exaggerating honest, realistic
faithless, disloyal reliable, faithful
falsely modest honest, has self-esteem
falsely prideful2,3 modest, humble
fantasizing, unrealistic practical, realistic
fearful3 confident, courageous
forgetful responsible
gluttonous2, excessive moderate
gossiping3 closed-mouth, kind, praising
greedy2,3 moderate, generous, sharing
hateful3 forgiving, loving, concerned for others
hypersensitive tolerant, doesn't personalize
ill-tempered1, bitchy good-tempered, calm
impatient3 patient
impulsive, reckless consistent, considered actions
inconsiderate thoughtful, considerate
indecisive, timid firm, decisive
indifferent, apathetic, aloof caring
inflexible, stubborn open-minded, flexible
insecure, anxious self-confident, secure
insincere3, hypocritical sincere, honest
intolerant1 tolerant, understanding, patient
irresponsible, reckless responsible
isolating, solitary sociable, outgoing
jealous1,3 trusting, generous, admiring
judgmental broadminded, tolerant
justifying (own actions) honest, frank, candid
lack of purpose purposeful
lazy, indolent industrious, conscientious
loud tasteful, quiet
lustful2 healthy sexuality
lying3 honest
manipulative candid, honest, non-controlling
masked, closed honest, open, candid
nagging supportive
narrow minded open minded
obscene, crude modest, courteous
over emotional emotionally stable
perfectionist realistic goals
pessimistic realistic, hopeful, optimistic, trusting
possessive generous
prejudiced open-minded
procrastinates3 disciplined, acts promptly
projecting (negative) clear sighted, optimistic
rationalizing candid, honest
resentful1,3, bitter, hateful forgiving
resisting growing willing to grow
rude, discourteous polite, courteous4
sarcastic1 praising, tolerant
self-important3 humble, modest
self-centered caring of others
self-destructive, self-defeating self-fulfilling
self-hating self-accepting, loving
self-justifying3 admitting wrongs, humble
self-pitying3 grateful, realistic, accepting
self-righteous humble, understanding
self-seeking3 selfless, concerned for others
selfish1,3 altruistic, concerned with others
shy outgoing
slothful (lazy)2,3 industrious, taking action
spiteful, malicious forgiving
stealing honest
stubborn open-minded, willing
sullen cheerful
superior, grandiose, pretentious humble
superstitious realistic, no magical thinking
suspicious trusting
tense calm, serene
thinking negatively3 being positive
treacherous trustworthy
undisciplined, self-indulgent disciplined
unfair fair
unfriendly, hostile, bitchy friendly4
ungrateful thankful, grateful
unkind, mean, malicious, spiteful kind4
unsupportive of others supportive
untrustworthy, unreliable, dishonest trustworthy4
useless, destructive helpful4
vain modest, humble
vindictive forgiving
violent gentle
vulgar3 polite
wasteful thrifty4
willful accepting of the inevitable
withdrawn outgoing
wordy, verbose frank, to the point, succinct
Other dysfunctional ways of acting, feeling or thinking which cause me or others pain (specify in the following Review of Flaws).
See source footnotes on page 2.
Instructions for Completion
First, we searched out the flaws in our make-up which caused our failure.
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REVIEW OF FLAWS
(optional)
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#
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Flaw
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Give an example of this specific flaw in your life.
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RESENTMENTS
Here is a list of people, institutions and principles that may be helpful in getting started. Feel free to add to this list.
PEOPLE
Father
Mother
In-Laws
Boyfriends
Husbands
Girlfriends
Wives
Lovers
Brothers
Sisters
Cousins
Aunts
Uncles
Sponsors
Employers
Employees
Co-Workers
12-Step Friends
Acquaintances
Best Friends
Childhood Friends
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Life-long Friends
School Friends
Teachers
Clergy
Creditors
Doctors
Judges
Lawyers
Parole Officers
Police
Probation Officers
INSTITUTIONS
Authority
Bible
Child Protection
Church
Correctional System
Education System
Government
Law
Marriage
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Health/Mental Health System
Nationality
Philosophy
Races
Religion
Society
PRINCIPLES
Adultery
Death
God-Deity
Golden Rule
Heaven
Hell
Jesus Christ
Life After Death
Original Sin
Retribution
Satan
Seven Deadly Sins
Sin
Ten Commandments
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Instructions for Completion
Complete each column top to bottom before proceeding to the next column.
For example, list all names first, all causes second, etc. List real resentments, not imaginary or theoretical resentment. Is the resentment a problem for you? Does it cause you pain?
Column 1 In dealing with resentments, we set them on paper. We listed people, institutions or principles with whom we were angry.
Column 2 We asked ourselves why we were angry.
Column 3 On our grudge list, we set opposite each name our injuries. Was it our self-esteem, our security, our ambitions, our personal, or sex relations which had been interfered with?
Column 4 Referring to our list again. Putting out of our minds the wrongs others had done, we resolutely looked for our own mistakes. Where had we been selfish, dishonest, self-seeking and frightened?
Column 5 This Column is optional. List specific other defects to show your participation in the resentments.
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REVIEW OF RESENTMENTS
“SELF”
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Reading from left to right we now see the resentment (Column 1), the cause (Column 2), the part of self that had been affected (Column 3), and the exact nature of the defect within us that allowed the resentment to surface and block us off from God’s will (Columns 4 and 5).
Tip: try and list resentments in groups, i.e. family, school, relationships, work, etc.
COLUMN 1 COLUMN 2
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Self-esteem
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Security
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Ambitions
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Personal Relationships
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Sex Relations
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Selfish
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Dishonest
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Self-seeking
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Frightened
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#
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I’m resentfulat:
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The Cause:
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#
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I’m resentful at:
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The Cause
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Self-esteem
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Security
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Ambitions
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Personal Relationships
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Sex Relations
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Selfish
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Dishonest
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Self-seeking
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Frightened
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Resentments Review
FEARS
Do not be restricted by this list. It is just to help you get started. List your fears on the next pages.
abandonment
aging
anger
authority figures
being alone
being deceived
being found out
being myself
change
compliments
confrontation
creditors
death
denial, my
disapproval
disease
divorce
embarrassment
employment
facing myself
failure
fear
feelings
financial insecurity
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flying
fourth & fifth steps
future, the
getting fat or thin
God
going home
going out on a “whim”
having children
homelessness
homosexuality
honesty
humiliation
hurting others
I’m a fraud and others will find out
incarceration
intimacy
IRS, the
letting go
living
loneliness
losing hope
love
mediocrity
money
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needing anyone
not being good enough
not being happy
not being liked
not being perfect
people (specify who)
police, the
poverty
procrastination
rape
rejection
relationships
resentments, my
responsibility
risks
saying that I can’t do something
sex
sponsor, my
success
unemployment
unknown, the
violence
work
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Instructions for Completion
Complete column 1 from top to bottom before proceeding to the next column.
Ask yourself if the fear is a problem in your life. Be realistic. Discuss significant fears, not theoretical or imaginary fears.
Column 1 We reviewed our fears thoroughly. We put them on paper, even though we had no resentment in connection with them.
Column 2 We asked ourselves why we had them.
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REVIEW OF FEARS
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COLUMN 1 COLUMN 2
#
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I’m fearful of:
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Why do I have the fear?
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Instructions for Completion
Complete each column top to bottom before going on to the next column.
Column 1 We reviewed our sex conduct over the years past. Whom had we hurt?
Column 2 Where had we been selfish, dishonest or inconsiderate?
Column 3 Did we unjustifiably arouse jealousy, suspicion or bitterness?
Column 4 Where were we at fault?
Column 5 What should we have done instead?
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REVIEW OF SEX CONDUCT
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COL. 2 COL. 3
COLUMN 1
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Selfish
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Dishonest
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Inconsiderate
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Jealousy
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Suspicion
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Bitterness
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COLUMN 4
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COLUMN 5
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#
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Whom did I harm?
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Where was I at fault?
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What should I have done instead?
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COL. 2 COL. 3
COLUMN 1
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Selfish
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Dishonest
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Inconsiderate
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Jealousy
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Suspicion
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Bitterness
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COLUMN 4
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COLUMN 5
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#
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Whom did I harm?
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Where was I at fault?
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What should I have done instead?
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Sex Conduct Review
THE EGO FACTORS
IN SURRENDER IN ALCOHOLISM
Harry M. Tiebout, M.D.
Introduction:
In the past 15 years, my understanding of the nature of alcoholism as a disease has been influenced largely by insight into the mechanisms at work in the Alcoholics Anonymous process. Some years ago I stated that A.A., to succeed, must induce a surrender on the -part of the individual I. More recently, I discussed the idea of compliance acting as a barrier to that real acceptance which a surrender produces. On this occasion I propose to extend my observations by discussing (a) what factors in the individual must surrender, and (b) how the surrender reaction changes the inner psychic picture.
The first question, what factors in the individual must surrender received passing attention in the article on compliance. There, relative to the difficulty of surrender, I noted that "the presence of an apparently unconquerable ego became evident. It was this ego which had to become humble." The first part of the present communication will be devoted to an elaboration of the nature of this ego factor.
Use of the word "ego" involves always the possibility of confusion of meaning. For a time, therefore, I considered a substitute term. That idea was set aside because, despite possible misinterpretation, the word ego is current in everyday language in exactly the sense in which it will be employed in this discussion. The expression, "he has an inflated ego," is self-explanatory. It evokes the picture of a pompous, self-important, strutting individual whose inferiorities are masked by a surface assurance. Such a person appears thick-skinned, insensitive, nearly impervious to the existence of others, a completely self-centered individual who plows unthinkingly through life, intent on gathering unto himself all the comforts and satisfactions available. He is generally considered the epitome of selfishness, and there the matter rests.
This popular view of ego, while it may not have scientific foundation, has one decided value: it possesses a meaning and can convey a concept which the average person can grasp. This concept of the inflated ego recognizes the common ancestor of a whole series of traits, namely, that they are all manifestations of an underlying feeling state in which personal considerations are first and foremost.
The existence of this ego has long been recognized, but a difficulty in terminology still remains. Part of the difficulty arises from the use of the word ego, in psychiatric and psychological circles, to designate those elements of the psyche which are supposed to rule psychic life. Freud divided mental life into three major subdivisions: the id, the ego and the superego. The first, he stated, contains the feeling of life on a deep, instinctual level; the third is occupied by the conscience, whose function is to put brakes on the impulses arising within the id. The ego should act as mediator between the demands of the id and the restraints of the superego, which might be over-zealous and bigoted. Freud's own research was concerned mainly with the activities of the id and the superego. The void he left with respect to the ego is one that his followers are endeavoring to fill, but as yet with no generally accepted conclusions.
In the past 15 years, my understanding of the nature of alcoholism as a disease has been influenced largely by insight into the mechanisms at work in the Alcoholics Anonymous process. Some years ago I stated that A.A., to succeed, must induce a surrender on the -part of the individual I. More recently, I discussed the idea of compliance acting as a barrier to that real acceptance which a surrender produces. On this occasion I propose to extend my observations by discussing (a) what factors in the individual must surrender, and (b) how the surrender reaction changes the inner psychic picture.
The first question, what factors in the individual must surrender received passing attention in the article on compliance. There, relative to the difficulty of surrender, I noted that "the presence of an apparently unconquerable ego became evident. It was this ego which had to become humble." The first part of the present communication will be devoted to an elaboration of the nature of this ego factor.
Use of the word "ego" involves always the possibility of confusion of meaning. For a time, therefore, I considered a substitute term. That idea was set aside because, despite possible misinterpretation, the word ego is current in everyday language in exactly the sense in which it will be employed in this discussion. The expression, "he has an inflated ego," is self-explanatory. It evokes the picture of a pompous, self-important, strutting individual whose inferiorities are masked by a surface assurance. Such a person appears thick-skinned, insensitive, nearly impervious to the existence of others, a completely self-centered individual who plows unthinkingly through life, intent on gathering unto himself all the comforts and satisfactions available. He is generally considered the epitome of selfishness, and there the matter rests.
This popular view of ego, while it may not have scientific foundation, has one decided value: it possesses a meaning and can convey a concept which the average person can grasp. This concept of the inflated ego recognizes the common ancestor of a whole series of traits, namely, that they are all manifestations of an underlying feeling state in which personal considerations are first and foremost.
The existence of this ego has long been recognized, but a difficulty in terminology still remains. Part of the difficulty arises from the use of the word ego, in psychiatric and psychological circles, to designate those elements of the psyche which are supposed to rule psychic life. Freud divided mental life into three major subdivisions: the id, the ego and the superego. The first, he stated, contains the feeling of life on a deep, instinctual level; the third is occupied by the conscience, whose function is to put brakes on the impulses arising within the id. The ego should act as mediator between the demands of the id and the restraints of the superego, which might be over-zealous and bigoted. Freud's own research was concerned mainly with the activities of the id and the superego. The void he left with respect to the ego is one that his followers are endeavoring to fill, but as yet with no generally accepted conclusions.
Ego: By Two Definitions
The word ego, however has been preempted by the psychiatrists and psychologists, although they do not always agree among themselves about the meaning to be attached to it. The resulting confusion is the more lamentable because almost everyone, layman or scientist, would agree on the concept of the inflated ego. It would be helpful if other terms were found for the ego concepts about which there are differing views.
The solution for this dilemma will be to indicate with a capital E the big Ego, and without a capital to identify the personality aspect which Freud had in mind when he placed ego between id and superego.3
With this disposition of the problem of terminology, it is now possible to consider the first issue, namely, the Ego factors in the alcoholic which, through surrender, become humble. The concept of the enlarged Ego, as noted previously, is available to common observation. Those who do not recognize it in themselves can always see it in some member of their family or among friends and acquaintances -- not to mention patients. Everyone knows egotistical people and has a perfectly clear idea of what the word means. Besides egotistical, and the series of words mentioned earlier, adjectives which help to round out the portrait of the egotistical person are prideful, arrogant, pushing, dominating, attention seeking, aggressive, opinionated, headstrong, stubborn, determined and impatient.
All these terms are inadequate, however, because they describe only surface features without conveying any feeling of the inner essence from which the Ego springs. Unless some appreciation for the source of the Ego is gained, the dynamic import is lost and the term may seem merely a form of name calling. It is easy to say someone has a big Ego without awareness of what is really happening in the deep layers of that person's mind, without perception of the Ego. Nor is it a matter of intellect. The need here is to lay hold of the inner feeling elements upon which the activity of the Ego rests. Only when these elements become clear can the fundamental basis of the Ego also be clarified.
It is convenient, for the exposition of this inner functioning, to reverse the usual sequence and to present a conclusion in advance of the evidence on which it is based. This is, briefly, that the Ego is made up of the persisting elements, in the adult psyche, of the original nature of the child.
Certain aspects of the infant's psyche may be usefully examined. There are three factors which should receive mention. The first is, as Freud observed in his priceless phrase "His Majesty the Baby," that the infant is born ruler of all he surveys. He comes from the Nirvana of the womb, where he is usually the sole occupant, and he clings to that omnipotence with an innocence, yet determination, which baffles parent after parent. The second, stemming directly from the monarch within, is that the infant tolerates frustration poorly and lets the world know it readily. The third significant aspect of the child's original psyche is its tendency to do everything in a hurry. Observe youngsters on the beach: they run rather than walk. Observe them coming on a visit: the younger ones tear from the car while their elder siblings adopt a more leisurely pace. The three-year-olds, and more so the twos, cannot engage in play requiring long periods of concentration. Whatever they are doing must be done quickly. As the same children age, they gradually become able to stick to one activity for longer times.
Thus at the start of life the psyche (1) assumes its own omnipotence, (2) cannot accept frustrations and (3) functions at a tempo allegretto with a good deal of staccato and vivace thrown in.
Now the question is, "If the infantile psyche persists into adult life, how will its presence be manifested?"
In general, when infantile traits continue into adulthood, the person is spoken of as immature, a label often applied with little comprehension of the reason for its accuracy. It is necessary to link these three traits from the original psyche with immaturity and, at the same time, show how they affect the adult psyche. If this is done, not only will the correctness of the appellation "immature" be apparent but, moreover, a feeling for the nature of the unconscious underpinnings of the Ego will have been created.
Recognising Immaturity
Two steps can aid in recognizing the relationship between immaturity and a continuance of the infantile elements. The first is, by an act of imagination, to set these original traits into an adult unconscious. The validity of this procedure is founded upon modern knowledge of the nature of the forces operating in the unconscious of people of mature age. The second step is to estimate the effect that the prolongation of these infantile qualities will have upon the adult individual.
This attempt should not strain the imagination severely. Take, for instance, the third of the qualities common to the original psychic state, namely, the tendency to act hurriedly. If that tendency prevails in the unconscious, what must the result be? The individual will certainly do everything in a hurry. He will think fast, talk fast and live fast, or he will spend an inordinate amount of time and energy holding his fast-driving proclivities in check.
Often the net result will be an oscillation between periods of speeding ahead followed by periods during which the direction of the force is reversed, the brakes (superego) being applied in equally vigorous fashion. The parallel of this in the behavior of the alcoholic will not be lost on those who have had experience with this class of patients.
Let us take the same trait of doing everything in a hurry and apply it to the word "immature." Few will deny that jumping at conclusions, doing things as speedily as possible, give evidence of immaturity. It is youth that drives fast, thinks fast, feels fast, moves fast, acts hastily in most situations. There can be little question that one of the hallmarks of the immature is the proneness to be under inner pressure for accomplishment. Big plans, big schemes, big hopes abound, unfortunately not matched by an ability to produce. But the effect upon the adult of the persisting infantile quality to do everything in less than sufficient time can now be seen in a clearer light. The adult trait is surely a survival from the original psyche of the infant.
The two other surviving qualities of the infantile psyche similarly contribute to the picture of immaturity and also, indirectly, help to clarify the nature of the Ego with a capital E. The first of these, the feeling of omnipotence, when carried over into adult life, affects the individual in ways easily anticipated. Omnipotence is, of course, associated with royalty, if not divinity. The unconscious result of the persistence of this trait is that its bearer harbors a belief of his own special role and in his own exceptional rights. Such a person finds it well-nigh impossible to function happily on
an ordinary level. Obsessed with divine afflatus, the thought of operating in the lowly and humble areas of life is most distressing to him. The very idea that such a place is all one is capable of occupying is in itself a blow to the Ego, which reacts with a sense of inferiority at its failure to fill a more distinguished position. Moreover, any success becomes merely Ego fodder, boosting the individual's rating of himself to increasingly unrealistic proportions as the king side eagerly drinks in this evidence of special worth.
The ability to administer the affairs of state, both large and small, is taken for granted. The belief that he is a natural executive placed in the wrong job merely confirms his conviction that, at best, he is the victim of lack of appreciation, and at worst, of sabotage by jealous people who set up roadblocks to his progress. The world is inhabited by selfish people, intent only on their own advancement.
The genesis of all this is beyond his perception. To tell him that his reactions spring from the demands of an inner unsatisfied king is to invite incredulity and disbelief, so far from the conscious mind are any such thoughts or feelings. People who openly continue to cling to their claims of divine prerogative usually end up in a world especially constructed for their care. In others, the omnipotence pressures are rather better buried. The individual may admit that, in many ways, he acts like a spoiled brat, but he is scarcely conscious of the extent of the tendency, nor how deeply rooted it may be. He, like most people, resolutely avoids a careful look because the recognition of any such inner attitudes is highly disturbing. The unconscious credence in one's special prerogatives savors too much of straight selfishness to be anything but unpleasant to contemplate.
And so, for the most part, people remain happily ignorant of the unconscious' drives which push them around. They may wonder why they tend to boil inside and wish they could free themselves from a constant sense of uneasiness and unsettlement. They may recognize that they seem jittery and easily excited and' long for the time when they can meet life more calmly and maturely; they may hate their tendency to become rattled. But their insight into the origin of all this is next to nothing, if not a complete blank. The king lies deep below the surface, far out of sight.
Inability to Accept Frustration
The last trait carried over from infancy is the inability to accept frustration. In an obvious sense, this inability is another aspect of the king within, since one of the prerogatives of royalty is to proceed without interruption. For the king to wait is an
affront to the royal rank, a slap at his majesty. The ramifications of this inability to endure frustration are so widespread, and the significance of much that occurs in the behavior of the alcoholic is so far-reaching, that it seems advisable to discuss this trait under a separate heading.
As already indicated, on the surface the inability of the king to accept frustration is absolutely logical. The wish of the king is the law of the land, and especially in the land of infancy. Any frustration is clearly a direct threat to the status of his majesty, whose whole being is challenged by the untoward interruption.
Even more significant is another aspect of this inner imperiousness. Behind it lies the assumption that the individual should not be stopped. Again, this is logical if one considers how an absolute monarch operates. He simply does not expect to be stopped; as he wills, so will he do. This trait, persisting in the unconscious, furnishes a constant pressure driving the individual forward. It says, in essence, "I am unstoppable!"
The unconscious which cannot be stopped views life entirely from the angle of whether or not a stopping is likely, imminent, or not at all in the picture. When a stopping is likely, there is worry and perhaps depression. When it seems imminent, there is anxiety bordering on panic, and when the threat is removed, there is relief and gaiety. Health is equated with a feeling of buoyancy and smooth sailing ahead, a sense of "I feel wonderful!" Sickness, contrariwise, means lacking vim, vigor and vitality, and is burdened with a sense of "I'm not getting anywhere." The need to "get somewhere" to "be on the go," and the consequent suffering from eternal restlessness, is still another direct effect of an inner inability to be stopped or, expressed otherwise, to accept the fact that one is limited. The king not only cannot accept the normal frustrations of life but, because of his inordinate driving ahead, is constantly creating unnecessary roadblocks by virtue of his own insistence on barging ahead, thus causing added trouble for himself.
Of course, on some occasions, the king gets stopped, and stopped totally. Illness, arrest, sometimes the rules and regulations of life, will halt him. Then he marks time, complies if need be, waiting for the return of freedom, which he celebrates in the time-honored fashion if he is an alcoholic: he gets drunk, initiating a phase when there is no stopping him.
The immaturity of such a person is readily evident. He is impatient of delay, can never let matters evolve; he must have a blueprint to follow outlining clearly a path through the jungle of life. The wisdom of the ages is merely shackling tradition which should make way for the freshness, the insouciance of youth. The value of staying where one is, and working out one's destiny in the here and now, is not
suspected. The 24-hour principle would be confining for one whose inner life brooks no confinement. The unstoppable person seeks life, fun, adventure, excitement, and discovers he is on a perpetual whirligig which carries him continuously ahead but, of course, in a circle. The unstoppable person has not time for growth. He must always, inwardly, feel immature.
This, then, is how the carry-over of infantile traits affects the adult so encumbered. He is possessed by an inner king who not only must do things in a hurry, but has no capacity for taking frustration in stride. He seeks a life which will not stop him and finds himself in a ceaseless rat race.
All this is part and parcel of the big Ego. The individual has no choice. He cannot select one characteristic and hang on to that, shedding other more obviously undesirable traits. It is all or nothing. For example, the driving person usually has plenty of energy, sparkle, vivacity. He stands out as a most attractive human being. Clinging to that quality, however, merely insures the continuance of excessive drive and Ego, with all the pains attendant upon a life based on those qualities. The sacrifice of the Ego elements must be total, or they will soon regain their ascendancy.
Learning To Live
Those who view the prospect of life without abundant drive as unutterably dull and boring should examine the life of members of Alcoholics Anonymous who have truly adopted the A.A. program. They will see people who have been stopped -- and who, therefore, do not have to go anywhere -- but people who are learning, for the first time in their lives, to live. They are neither dull nor wishy-washy. Quite the contrary, they are alive and interested in the realities about them. They see things in the large,are tolerant, open-minded, not close-minded bulling ahead. They are receptive to the wonders in the world about them, including the presence of a Deity who makes all this possible. They are the ones who are really living. The attainment of such a way of life is no mean accomplishment.
Preliminary to this discussion, the conclusion was offered that the Ego was a residual of the initial feeling life of the infant. It should be evident that the immaturity characteristically found in the make-up of the alcoholic is a persistence of the original state of the child. In connection with the description of the manifestations which denote a large and active Ego, it should be recalled that the presence in the unconscious of such Ego forces may be quite out of reach of conscious observation. Only through the acting and feeling of the individual can their existence be suspected.
Now the answer to the first question raised herein, namely, what part of the alcoholic must surrender, is obvious: it is the Ego element.
Life without Ego is no new conception. Two thousand years ago, Christ preached the necessity of losing one's life in order to find it again. He did not say Ego, but that was what he had in mind. The analysts of our time recognize the same truth; they talk also about ego reduction. Freud saw therapy as a running battle between the original narcissism of the infant (his term for Ego) and the therapist whose task it was to reduce that original state to more manageable proportions. Since Freud could not conceive of life without some measure of Ego, he never resolved the riddle of how contentment is achieved; for him, man to the end was doomed to strife and unhappiness, his dearest desires sure to be frustrated by an unfriendly world.
In his studies on the addictions, Rado3 more explicitly asserts that the Ego must be reduced. He first portrays the Ego as follows: "Once it was a baby, radiant with self-esteem, full of belief in the omnipotence of its wishes, of its thoughts, gestures and words." Then, on the process of Ego-reduction: "But the child's megalomania melted away under the inexorable pressure of experience. Its sense of its own sovereignty had to make room for a more modest self evaluation. This process, first described by Freud, may be designated the reduction in size of the original ego; it is a painful procedure and one that is possibly never completely carried out."
No Compromise With Ego
Like Freud, Rado thinks only in terms of reduction; the need for the complete elimination of Ego is a stand which they cannot bring themselves to assume. Hence they unwittingly advocate the retention of some infantile traits, with no clear awareness that trading with the devil, the Ego, no matter how carefully safeguarded,' merely keeps him alive and likely at any occasion to erupt full force into action. There can be no successful compromise with Ego, a fact not sufficiently appreciated by many, if not most, therapists.
Thus the dilemma encountered in ego-reduction would be best resolved by recognizing that the old Ego must go and a new one take its place. Then no issue would arise about how much of the earliest elements may be retained. The answer, theoretically, is none. Actually the total banishment of the initial state is difficult to achieve. Man can only grow in the direction of its complete elimination. Its final expulsion is a goal which we can only hope.
The second question raised here is, "How does the surrender reaction change the inner psychic picture?" This question is based on a presupposition, namely that surrender is an emotional step in which the Ego, at least for the time being, acknowledges that it is no longer supreme. This acknowledgment is valueless if limited to consciousness; it must be accompanied by similar feelings in the unconscious. For the alcoholic, surrender is marked by the admission of being powerless over alcohol. His sobriety has that quality of peace and tranquility which makes for a lasting quiet within only if the surrender is effective in the unconscious and permanent as well.
The effects of surrender upon the psyche are extremely logical: The traits listed as~characteristic of the Ego influence are canceled out. The opposite of king is the commoner. Appropriately, Alcoholics Anonymous stresses humility. The opposite of impatience is the ability to take things in stride, to make an inner reality of the slogan, "Easy does it." The opposite of drive is staying in one position where one can be open-minded, receptive and responsive.
This picture of the non-Ego type of person might be amplified in many directions but to do so would serve no immediate purpose. To have discussed the effect of the Ego upon behavior, and to have pointed out what may happen when the Ego is at least temporarily knocked out of action, is sufficient to, make the point of this communication: It is the Ego which is the arch-enemy of sobriety, and it is the Ego which must be disposed of if the individual is to attain a now way of life
Up to this point, no clinical material has been submitted to confirm the ideas presented. Their validity will be apparent to many therapists. One brief citation from clinical experience will be offered, however, in the hope that it may serve as a concrete illustration of these ideas.
The patient, a man in his late 30's, had a long history of alcoholism with 7 years of futile attempts to recover through Alcoholics Anonymous, interspersed with countless admissions to "drying out" places. Then, for reasons not totally clear, he decided to take a drastic step. He determined to enter a sanitorium and place himself in the hands of a psychiatrist, a hitherto unheard of venom. We planned to arrange for a limited stay at a sanitarium where he could have regular interviews with me.
From the outset, he was undeniably in earnest, although it was only after the first interview that he really let go and could talk freely about himself and the things that were going on inside him. After the usual preliminaries, the first interview started with a discussion of feelings and how they operate. The patient was questioned about the word Ego as used at A.A. meetings. He confessed his ignorance of its true meaning and listened with interest to brief remarks on how it works. Before long, he was locating in himself some of the Ego forces which hitherto he had been vigorously denying because they savored too much of vanity and selfishness with that recognition, the patient made a revealing remark. He said, in all sincerity, "My goodness, I never knew that. You don't do your thinking up here (pointing to his head), you think down here where you feel" placing his hands on his stomach. He was learning that his feelings had a "mind" of their own and that unless he heeded what they were saying, he could easily get into trouble. He was facing the actuality of his Ego as a feeling element in his life, a step he was able to take because he was no longer going at full steam ahead. His decision to place himself under care, a surrender of a sort, had quieted him and made him receptive, able to observe what was going on in himself. It was the beginning of a real inventory.
The next insight he uncovered was even more startling. He had been requested routinely to report any dreams he would have. Much to his surprise, they appeared regularly during the period of contact. In his fifth dream, the patient found himself locked up in an institution because of his drinking. The interpretation offered, based upon relevant materials, was that the patient equated any kind of stopping with being locked up; that his real difficulty lay in the fact that he could not tolerate being stopped, and abstaining was merely another stopping he could not take. The patient's reaction to the interpretation was most significant. He remained silent for some little time; then he began to talk, saying, "I tell you, Doc, it was like this. I'd get drunk, maybe stay on it 2 or 3 days, then I'd go into one of those drying out places where I'd stay 5 or 6 days and I'd be all over wanting a drink. Then I'd come out and stay sober, maybe a week, 'maybe a month, but pretty soon the thought would come into my mind, I want to drink! Maybe I'd go into a tavern and maybe not, but sooner or later I'd go and I'd order a drink, but I wouldn't drink it right off. I'd put it on the bar and I'd look at it and I'd think and then I'd look and think: King for a day!" The connection between Ego and his own conduct had become explicit, as well as the relationship between not being stopped and Ego. He saw clearly that when he took that drink, he was the boss once more. Any previous reduction of Ego had been only temporary.
In treatment, the problem is to make that reduction permanent. Therapy is centered on the ways and means, first, of bringing the Ego to earth, and second, keeping it there. The discussion of this methodology would be out of place here, but it is relevant to emphasize one point, namely the astonishing capacity of the Ego to pass out of the picture and then reenter it, blithe and intact. A patient's dream neatly depicted this quality. This patient dreamt that he was on the twelfth floor balcony of a New York hotel. He threw a rubber ball to the pavement below and saw it rebound to the level of the balcony. Much to his amazement, the ball again dropped and again rebounded to the same height. This continued for an indefinite period and, as he was watching, a clock in a neighboring church spire struck nine. Like the cat with nine lives, the Ego has a marvelous capacity to scramble back to safety -- a little ruffled, perhaps, but soon operating with all its former aplomb, convinced once more that now it, the Ego, can master all events and push on ahead.
The capacity of the Ego to bypass experience is astounding and would be humorous were it not so tragic in its consequences. Cutting the individual down to size and making the results last is a task never completely accomplished. The possibility of a return of his Ego must be faced by every alcoholic. If it does return, he may refrain from drinking, but he will surely go on a "dry drunk," with all the old feelings and attitudes once more asserting themselves and making sobriety a shambles of discontent and restlessness. Not until the ego is decisively retired can peace and quiet again prevail. As one sees this struggle in process, the need for the helping hand of a Deity becomes clearer. Mere man alone all too often seems powerless to stay the force of his Ego. He needs assistance and needs it urgently.
Summary
In the process of surrender which the alcoholic necessarily undergoes before his alcoholism can be arrested, the part of the personality which must surrender is the inflated Ego. This aspect of personality was identified as immature traits carried over from infancy into adulthood, specifically, a feeling of omnipotence, inability to tolerate frustration, and excessive drive, exhibited in the need to do all things precipitously. The manner in which surrender affects the Ego was discussed and illustrated briefly from clinical experience. The object of therapy is to permanently replace the old Ego and its activity.
References:
I Tiebout, H.M. "The Act of Surrender in the Therapeutic Process." With special reference to alcoholism. Quart. J. Stud. Aic. 10: 48-58, 1949.
Tiebout, H.M. "Surrender Versus Compliance in Therapy". With special reference to alcoholism. Quart. J. Stud. Aic. 14: 58-68,1953.
Rado, S. "The Psychoanalysis of Pharmachothymia (drug addiction). The clinical picture." Psychoanal. Quart. 2: 1-23, 1933.
The word ego, however has been preempted by the psychiatrists and psychologists, although they do not always agree among themselves about the meaning to be attached to it. The resulting confusion is the more lamentable because almost everyone, layman or scientist, would agree on the concept of the inflated ego. It would be helpful if other terms were found for the ego concepts about which there are differing views.
The solution for this dilemma will be to indicate with a capital E the big Ego, and without a capital to identify the personality aspect which Freud had in mind when he placed ego between id and superego.3
With this disposition of the problem of terminology, it is now possible to consider the first issue, namely, the Ego factors in the alcoholic which, through surrender, become humble. The concept of the enlarged Ego, as noted previously, is available to common observation. Those who do not recognize it in themselves can always see it in some member of their family or among friends and acquaintances -- not to mention patients. Everyone knows egotistical people and has a perfectly clear idea of what the word means. Besides egotistical, and the series of words mentioned earlier, adjectives which help to round out the portrait of the egotistical person are prideful, arrogant, pushing, dominating, attention seeking, aggressive, opinionated, headstrong, stubborn, determined and impatient.
All these terms are inadequate, however, because they describe only surface features without conveying any feeling of the inner essence from which the Ego springs. Unless some appreciation for the source of the Ego is gained, the dynamic import is lost and the term may seem merely a form of name calling. It is easy to say someone has a big Ego without awareness of what is really happening in the deep layers of that person's mind, without perception of the Ego. Nor is it a matter of intellect. The need here is to lay hold of the inner feeling elements upon which the activity of the Ego rests. Only when these elements become clear can the fundamental basis of the Ego also be clarified.
It is convenient, for the exposition of this inner functioning, to reverse the usual sequence and to present a conclusion in advance of the evidence on which it is based. This is, briefly, that the Ego is made up of the persisting elements, in the adult psyche, of the original nature of the child.
Certain aspects of the infant's psyche may be usefully examined. There are three factors which should receive mention. The first is, as Freud observed in his priceless phrase "His Majesty the Baby," that the infant is born ruler of all he surveys. He comes from the Nirvana of the womb, where he is usually the sole occupant, and he clings to that omnipotence with an innocence, yet determination, which baffles parent after parent. The second, stemming directly from the monarch within, is that the infant tolerates frustration poorly and lets the world know it readily. The third significant aspect of the child's original psyche is its tendency to do everything in a hurry. Observe youngsters on the beach: they run rather than walk. Observe them coming on a visit: the younger ones tear from the car while their elder siblings adopt a more leisurely pace. The three-year-olds, and more so the twos, cannot engage in play requiring long periods of concentration. Whatever they are doing must be done quickly. As the same children age, they gradually become able to stick to one activity for longer times.
Thus at the start of life the psyche (1) assumes its own omnipotence, (2) cannot accept frustrations and (3) functions at a tempo allegretto with a good deal of staccato and vivace thrown in.
Now the question is, "If the infantile psyche persists into adult life, how will its presence be manifested?"
In general, when infantile traits continue into adulthood, the person is spoken of as immature, a label often applied with little comprehension of the reason for its accuracy. It is necessary to link these three traits from the original psyche with immaturity and, at the same time, show how they affect the adult psyche. If this is done, not only will the correctness of the appellation "immature" be apparent but, moreover, a feeling for the nature of the unconscious underpinnings of the Ego will have been created.
Recognising Immaturity
Two steps can aid in recognizing the relationship between immaturity and a continuance of the infantile elements. The first is, by an act of imagination, to set these original traits into an adult unconscious. The validity of this procedure is founded upon modern knowledge of the nature of the forces operating in the unconscious of people of mature age. The second step is to estimate the effect that the prolongation of these infantile qualities will have upon the adult individual.
This attempt should not strain the imagination severely. Take, for instance, the third of the qualities common to the original psychic state, namely, the tendency to act hurriedly. If that tendency prevails in the unconscious, what must the result be? The individual will certainly do everything in a hurry. He will think fast, talk fast and live fast, or he will spend an inordinate amount of time and energy holding his fast-driving proclivities in check.
Often the net result will be an oscillation between periods of speeding ahead followed by periods during which the direction of the force is reversed, the brakes (superego) being applied in equally vigorous fashion. The parallel of this in the behavior of the alcoholic will not be lost on those who have had experience with this class of patients.
Let us take the same trait of doing everything in a hurry and apply it to the word "immature." Few will deny that jumping at conclusions, doing things as speedily as possible, give evidence of immaturity. It is youth that drives fast, thinks fast, feels fast, moves fast, acts hastily in most situations. There can be little question that one of the hallmarks of the immature is the proneness to be under inner pressure for accomplishment. Big plans, big schemes, big hopes abound, unfortunately not matched by an ability to produce. But the effect upon the adult of the persisting infantile quality to do everything in less than sufficient time can now be seen in a clearer light. The adult trait is surely a survival from the original psyche of the infant.
The two other surviving qualities of the infantile psyche similarly contribute to the picture of immaturity and also, indirectly, help to clarify the nature of the Ego with a capital E. The first of these, the feeling of omnipotence, when carried over into adult life, affects the individual in ways easily anticipated. Omnipotence is, of course, associated with royalty, if not divinity. The unconscious result of the persistence of this trait is that its bearer harbors a belief of his own special role and in his own exceptional rights. Such a person finds it well-nigh impossible to function happily on
an ordinary level. Obsessed with divine afflatus, the thought of operating in the lowly and humble areas of life is most distressing to him. The very idea that such a place is all one is capable of occupying is in itself a blow to the Ego, which reacts with a sense of inferiority at its failure to fill a more distinguished position. Moreover, any success becomes merely Ego fodder, boosting the individual's rating of himself to increasingly unrealistic proportions as the king side eagerly drinks in this evidence of special worth.
The ability to administer the affairs of state, both large and small, is taken for granted. The belief that he is a natural executive placed in the wrong job merely confirms his conviction that, at best, he is the victim of lack of appreciation, and at worst, of sabotage by jealous people who set up roadblocks to his progress. The world is inhabited by selfish people, intent only on their own advancement.
The genesis of all this is beyond his perception. To tell him that his reactions spring from the demands of an inner unsatisfied king is to invite incredulity and disbelief, so far from the conscious mind are any such thoughts or feelings. People who openly continue to cling to their claims of divine prerogative usually end up in a world especially constructed for their care. In others, the omnipotence pressures are rather better buried. The individual may admit that, in many ways, he acts like a spoiled brat, but he is scarcely conscious of the extent of the tendency, nor how deeply rooted it may be. He, like most people, resolutely avoids a careful look because the recognition of any such inner attitudes is highly disturbing. The unconscious credence in one's special prerogatives savors too much of straight selfishness to be anything but unpleasant to contemplate.
And so, for the most part, people remain happily ignorant of the unconscious' drives which push them around. They may wonder why they tend to boil inside and wish they could free themselves from a constant sense of uneasiness and unsettlement. They may recognize that they seem jittery and easily excited and' long for the time when they can meet life more calmly and maturely; they may hate their tendency to become rattled. But their insight into the origin of all this is next to nothing, if not a complete blank. The king lies deep below the surface, far out of sight.
Inability to Accept Frustration
The last trait carried over from infancy is the inability to accept frustration. In an obvious sense, this inability is another aspect of the king within, since one of the prerogatives of royalty is to proceed without interruption. For the king to wait is an
affront to the royal rank, a slap at his majesty. The ramifications of this inability to endure frustration are so widespread, and the significance of much that occurs in the behavior of the alcoholic is so far-reaching, that it seems advisable to discuss this trait under a separate heading.
As already indicated, on the surface the inability of the king to accept frustration is absolutely logical. The wish of the king is the law of the land, and especially in the land of infancy. Any frustration is clearly a direct threat to the status of his majesty, whose whole being is challenged by the untoward interruption.
Even more significant is another aspect of this inner imperiousness. Behind it lies the assumption that the individual should not be stopped. Again, this is logical if one considers how an absolute monarch operates. He simply does not expect to be stopped; as he wills, so will he do. This trait, persisting in the unconscious, furnishes a constant pressure driving the individual forward. It says, in essence, "I am unstoppable!"
The unconscious which cannot be stopped views life entirely from the angle of whether or not a stopping is likely, imminent, or not at all in the picture. When a stopping is likely, there is worry and perhaps depression. When it seems imminent, there is anxiety bordering on panic, and when the threat is removed, there is relief and gaiety. Health is equated with a feeling of buoyancy and smooth sailing ahead, a sense of "I feel wonderful!" Sickness, contrariwise, means lacking vim, vigor and vitality, and is burdened with a sense of "I'm not getting anywhere." The need to "get somewhere" to "be on the go," and the consequent suffering from eternal restlessness, is still another direct effect of an inner inability to be stopped or, expressed otherwise, to accept the fact that one is limited. The king not only cannot accept the normal frustrations of life but, because of his inordinate driving ahead, is constantly creating unnecessary roadblocks by virtue of his own insistence on barging ahead, thus causing added trouble for himself.
Of course, on some occasions, the king gets stopped, and stopped totally. Illness, arrest, sometimes the rules and regulations of life, will halt him. Then he marks time, complies if need be, waiting for the return of freedom, which he celebrates in the time-honored fashion if he is an alcoholic: he gets drunk, initiating a phase when there is no stopping him.
The immaturity of such a person is readily evident. He is impatient of delay, can never let matters evolve; he must have a blueprint to follow outlining clearly a path through the jungle of life. The wisdom of the ages is merely shackling tradition which should make way for the freshness, the insouciance of youth. The value of staying where one is, and working out one's destiny in the here and now, is not
suspected. The 24-hour principle would be confining for one whose inner life brooks no confinement. The unstoppable person seeks life, fun, adventure, excitement, and discovers he is on a perpetual whirligig which carries him continuously ahead but, of course, in a circle. The unstoppable person has not time for growth. He must always, inwardly, feel immature.
This, then, is how the carry-over of infantile traits affects the adult so encumbered. He is possessed by an inner king who not only must do things in a hurry, but has no capacity for taking frustration in stride. He seeks a life which will not stop him and finds himself in a ceaseless rat race.
All this is part and parcel of the big Ego. The individual has no choice. He cannot select one characteristic and hang on to that, shedding other more obviously undesirable traits. It is all or nothing. For example, the driving person usually has plenty of energy, sparkle, vivacity. He stands out as a most attractive human being. Clinging to that quality, however, merely insures the continuance of excessive drive and Ego, with all the pains attendant upon a life based on those qualities. The sacrifice of the Ego elements must be total, or they will soon regain their ascendancy.
Learning To Live
Those who view the prospect of life without abundant drive as unutterably dull and boring should examine the life of members of Alcoholics Anonymous who have truly adopted the A.A. program. They will see people who have been stopped -- and who, therefore, do not have to go anywhere -- but people who are learning, for the first time in their lives, to live. They are neither dull nor wishy-washy. Quite the contrary, they are alive and interested in the realities about them. They see things in the large,are tolerant, open-minded, not close-minded bulling ahead. They are receptive to the wonders in the world about them, including the presence of a Deity who makes all this possible. They are the ones who are really living. The attainment of such a way of life is no mean accomplishment.
Preliminary to this discussion, the conclusion was offered that the Ego was a residual of the initial feeling life of the infant. It should be evident that the immaturity characteristically found in the make-up of the alcoholic is a persistence of the original state of the child. In connection with the description of the manifestations which denote a large and active Ego, it should be recalled that the presence in the unconscious of such Ego forces may be quite out of reach of conscious observation. Only through the acting and feeling of the individual can their existence be suspected.
Now the answer to the first question raised herein, namely, what part of the alcoholic must surrender, is obvious: it is the Ego element.
Life without Ego is no new conception. Two thousand years ago, Christ preached the necessity of losing one's life in order to find it again. He did not say Ego, but that was what he had in mind. The analysts of our time recognize the same truth; they talk also about ego reduction. Freud saw therapy as a running battle between the original narcissism of the infant (his term for Ego) and the therapist whose task it was to reduce that original state to more manageable proportions. Since Freud could not conceive of life without some measure of Ego, he never resolved the riddle of how contentment is achieved; for him, man to the end was doomed to strife and unhappiness, his dearest desires sure to be frustrated by an unfriendly world.
In his studies on the addictions, Rado3 more explicitly asserts that the Ego must be reduced. He first portrays the Ego as follows: "Once it was a baby, radiant with self-esteem, full of belief in the omnipotence of its wishes, of its thoughts, gestures and words." Then, on the process of Ego-reduction: "But the child's megalomania melted away under the inexorable pressure of experience. Its sense of its own sovereignty had to make room for a more modest self evaluation. This process, first described by Freud, may be designated the reduction in size of the original ego; it is a painful procedure and one that is possibly never completely carried out."
No Compromise With Ego
Like Freud, Rado thinks only in terms of reduction; the need for the complete elimination of Ego is a stand which they cannot bring themselves to assume. Hence they unwittingly advocate the retention of some infantile traits, with no clear awareness that trading with the devil, the Ego, no matter how carefully safeguarded,' merely keeps him alive and likely at any occasion to erupt full force into action. There can be no successful compromise with Ego, a fact not sufficiently appreciated by many, if not most, therapists.
Thus the dilemma encountered in ego-reduction would be best resolved by recognizing that the old Ego must go and a new one take its place. Then no issue would arise about how much of the earliest elements may be retained. The answer, theoretically, is none. Actually the total banishment of the initial state is difficult to achieve. Man can only grow in the direction of its complete elimination. Its final expulsion is a goal which we can only hope.
The second question raised here is, "How does the surrender reaction change the inner psychic picture?" This question is based on a presupposition, namely that surrender is an emotional step in which the Ego, at least for the time being, acknowledges that it is no longer supreme. This acknowledgment is valueless if limited to consciousness; it must be accompanied by similar feelings in the unconscious. For the alcoholic, surrender is marked by the admission of being powerless over alcohol. His sobriety has that quality of peace and tranquility which makes for a lasting quiet within only if the surrender is effective in the unconscious and permanent as well.
The effects of surrender upon the psyche are extremely logical: The traits listed as~characteristic of the Ego influence are canceled out. The opposite of king is the commoner. Appropriately, Alcoholics Anonymous stresses humility. The opposite of impatience is the ability to take things in stride, to make an inner reality of the slogan, "Easy does it." The opposite of drive is staying in one position where one can be open-minded, receptive and responsive.
This picture of the non-Ego type of person might be amplified in many directions but to do so would serve no immediate purpose. To have discussed the effect of the Ego upon behavior, and to have pointed out what may happen when the Ego is at least temporarily knocked out of action, is sufficient to, make the point of this communication: It is the Ego which is the arch-enemy of sobriety, and it is the Ego which must be disposed of if the individual is to attain a now way of life
Up to this point, no clinical material has been submitted to confirm the ideas presented. Their validity will be apparent to many therapists. One brief citation from clinical experience will be offered, however, in the hope that it may serve as a concrete illustration of these ideas.
The patient, a man in his late 30's, had a long history of alcoholism with 7 years of futile attempts to recover through Alcoholics Anonymous, interspersed with countless admissions to "drying out" places. Then, for reasons not totally clear, he decided to take a drastic step. He determined to enter a sanitorium and place himself in the hands of a psychiatrist, a hitherto unheard of venom. We planned to arrange for a limited stay at a sanitarium where he could have regular interviews with me.
From the outset, he was undeniably in earnest, although it was only after the first interview that he really let go and could talk freely about himself and the things that were going on inside him. After the usual preliminaries, the first interview started with a discussion of feelings and how they operate. The patient was questioned about the word Ego as used at A.A. meetings. He confessed his ignorance of its true meaning and listened with interest to brief remarks on how it works. Before long, he was locating in himself some of the Ego forces which hitherto he had been vigorously denying because they savored too much of vanity and selfishness with that recognition, the patient made a revealing remark. He said, in all sincerity, "My goodness, I never knew that. You don't do your thinking up here (pointing to his head), you think down here where you feel" placing his hands on his stomach. He was learning that his feelings had a "mind" of their own and that unless he heeded what they were saying, he could easily get into trouble. He was facing the actuality of his Ego as a feeling element in his life, a step he was able to take because he was no longer going at full steam ahead. His decision to place himself under care, a surrender of a sort, had quieted him and made him receptive, able to observe what was going on in himself. It was the beginning of a real inventory.
The next insight he uncovered was even more startling. He had been requested routinely to report any dreams he would have. Much to his surprise, they appeared regularly during the period of contact. In his fifth dream, the patient found himself locked up in an institution because of his drinking. The interpretation offered, based upon relevant materials, was that the patient equated any kind of stopping with being locked up; that his real difficulty lay in the fact that he could not tolerate being stopped, and abstaining was merely another stopping he could not take. The patient's reaction to the interpretation was most significant. He remained silent for some little time; then he began to talk, saying, "I tell you, Doc, it was like this. I'd get drunk, maybe stay on it 2 or 3 days, then I'd go into one of those drying out places where I'd stay 5 or 6 days and I'd be all over wanting a drink. Then I'd come out and stay sober, maybe a week, 'maybe a month, but pretty soon the thought would come into my mind, I want to drink! Maybe I'd go into a tavern and maybe not, but sooner or later I'd go and I'd order a drink, but I wouldn't drink it right off. I'd put it on the bar and I'd look at it and I'd think and then I'd look and think: King for a day!" The connection between Ego and his own conduct had become explicit, as well as the relationship between not being stopped and Ego. He saw clearly that when he took that drink, he was the boss once more. Any previous reduction of Ego had been only temporary.
In treatment, the problem is to make that reduction permanent. Therapy is centered on the ways and means, first, of bringing the Ego to earth, and second, keeping it there. The discussion of this methodology would be out of place here, but it is relevant to emphasize one point, namely the astonishing capacity of the Ego to pass out of the picture and then reenter it, blithe and intact. A patient's dream neatly depicted this quality. This patient dreamt that he was on the twelfth floor balcony of a New York hotel. He threw a rubber ball to the pavement below and saw it rebound to the level of the balcony. Much to his amazement, the ball again dropped and again rebounded to the same height. This continued for an indefinite period and, as he was watching, a clock in a neighboring church spire struck nine. Like the cat with nine lives, the Ego has a marvelous capacity to scramble back to safety -- a little ruffled, perhaps, but soon operating with all its former aplomb, convinced once more that now it, the Ego, can master all events and push on ahead.
The capacity of the Ego to bypass experience is astounding and would be humorous were it not so tragic in its consequences. Cutting the individual down to size and making the results last is a task never completely accomplished. The possibility of a return of his Ego must be faced by every alcoholic. If it does return, he may refrain from drinking, but he will surely go on a "dry drunk," with all the old feelings and attitudes once more asserting themselves and making sobriety a shambles of discontent and restlessness. Not until the ego is decisively retired can peace and quiet again prevail. As one sees this struggle in process, the need for the helping hand of a Deity becomes clearer. Mere man alone all too often seems powerless to stay the force of his Ego. He needs assistance and needs it urgently.
Summary
In the process of surrender which the alcoholic necessarily undergoes before his alcoholism can be arrested, the part of the personality which must surrender is the inflated Ego. This aspect of personality was identified as immature traits carried over from infancy into adulthood, specifically, a feeling of omnipotence, inability to tolerate frustration, and excessive drive, exhibited in the need to do all things precipitously. The manner in which surrender affects the Ego was discussed and illustrated briefly from clinical experience. The object of therapy is to permanently replace the old Ego and its activity.
References:
I Tiebout, H.M. "The Act of Surrender in the Therapeutic Process." With special reference to alcoholism. Quart. J. Stud. Aic. 10: 48-58, 1949.
Tiebout, H.M. "Surrender Versus Compliance in Therapy". With special reference to alcoholism. Quart. J. Stud. Aic. 14: 58-68,1953.
Rado, S. "The Psychoanalysis of Pharmachothymia (drug addiction). The clinical picture." Psychoanal. Quart. 2: 1-23, 1933.
The Original Six Steps of AA
In Bill Wilson's own hand-writing.
Step 1: Admitted hopeless
Step 2: Got honest with self
Step 3: Got honest with another
Step 4: Made amends
Step 5: Helped others without demand
Step 6: Prayed to God as you understand him
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I Stand at the Door
By Sam Shoemaker (from the Oxford Group)
I stand by the door.
I neither go to far in, nor stay to far out.
The door is the most important door in the world -
It is the door through which men walk when they find God.
There is no use my going way inside and staying there,
When so many are still outside and they, as much as I,
Crave to know where the door is.
And all that so many ever find
Is only the wall where the door ought to be.
They creep along the wall like blind men,
With outstretched, groping hands,
Feeling for a door, knowing there must be a door,
Yet they never find it.
So I stand by the door.
The most tremendous thing in the world
Is for men to find that door - the door to God.
The most important thing that any man can do
Is to take hold of one of those blind, groping hands
And put it on the latch - the latch that only clicks
And opens to the man's own touch.
Men die outside the door, as starving beggars die
On cold nights in cruel cities in the dead of winter.
Die for want of what is within their grasp.
They live on the other side of it - live because they have not found it.
Nothing else matters compared to helping them find it,
And open it, and walk in, and find Him.
So I stand by the door.
Go in great saints; go all the way in -
Go way down into the cavernous cellars,
And way up into the spacious attics.
It is a vast, roomy house, this house where God is.
Go into the deepest of hidden casements,
Of withdrawal, of silence, of sainthood.
Some must inhabit those inner rooms
And know the depths and heights of God,
And call outside to the rest of us how wonderful it is.
Sometimes I take a deeper look in.
Sometimes venture in a little farther,
But my place seems closer to the opening.
So I stand by the door.
There is another reason why I stand there.
Some people get part way in and become afraid
Lest God and the zeal of His house devour them;
For God is so very great and asks all of us.
And these people feel a cosmic claustrophobia
And want to get out. 'Let me out!' they cry.
And the people way inside only terrify them more.
Somebody must be by the door to tell them that they are spoiled.
For the old life, they have seen too much:
One taste of God and nothing but God will do any more.
Somebody must be watching for the frightened
Who seek to sneak out just where they came in,
To tell them how much better it is inside.
The people too far in do not see how near these are
To leaving - preoccupied with the wonder of it all.
Somebody must watch for those who have entered the door
But would like to run away. So for them too,
I stand by the door.
I admire the people who go way in.
But I wish they would not forget how it was
Before they got in. Then they would be able to help
The people who have not yet even found the door.
Or the people who want to run away again from God.
You can go in too deeply and stay in too long
And forget the people outside the door.
As for me, I shall take my old accustomed place,
Near enough to God to hear Him and know He is there,
But not so far from men as not to hear them,
And remember they are there too.
Where? Outside the door -
Thousands of them. Millions of them.
But - more important for me -
One of them, two of them, ten of them.
Whose hands I am intended to put on the latch.
So I shall stand by the door and wait
For those who seek it.
'I had rather be a door-keeper
So I stand by the door.
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posted by Patrick at
2:01 AM
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