What is meant by mental obsession and the obsessional character of alcoholism?

A - Well, as I understand it, we are all born with the freedom of choice. The degree of this varies from person to person, and from area to area in our lives. In the case of neurotic people, our instincts take on certain patterns and directions, sometimes so compulsive they cannot be broken by any ordinary effort of the will. The alcoholic's compulsion to drink is like that. As a smoker, for example, I have a deeply ingrained habit - I'm almost an addict. But I do not think that this habit is an actual obsession.

Doubtless it could be broken by an act of my own will. If badly enough hurt, I could in all probability give up tobacco. Should smoking repeatedly land me in Bellevue Hospital, I doubt that I would make the trip many times before quitting. But with my alcoholism, well, that was something else again. No amount of desire to stop, no amount of punishment, could enable me to quit. What was once a habit of drinking became an obsession of drinking -- genuine lunacy.

Perhaps a little more should be said about the obsessional character of alcoholism. When our fellowship was about three years old some of us called on Dr. Lawrence Kolb, then Assistant Surgeon General of the United States. He said that our report of progress had given him his first hope for alcoholics in general. Not long before, the U.S. Public Health Department had thought of trying to do something about the alcoholic situation. After a careful survey of the obsessional character of our malady, this had been given up. Indeed, Dr. Kolb felt that dope addicts had a far better chance.

Accordingly, the government had built a hospital for their treatment at Lexington, Kentucky. But for alcoholics -- well, there simply wasn't any use at all, so he thought.

Nevertheless, many people still go on insisting that the alcoholic is not a sick man -- that he is simply weak or willful, and sinful. Even today we often hear the remark "That drunk could get well if he wanted to."

There is no doubt, too, that the deeply obsessional character of the alcoholic's drinking is obscured by the fact that drinking is a socially acceptable custom. By contrast, stealing, or let us say shop-lifting, is not. Practically everybody has heard of that form of lunacy known as kleptomania. Oftentimes kleptomaniacs are splendid people in all other respects. Yet they are under an absolute compulsion to steal -- just for the kick. A kleptomaniac enters a store a pockets a piece of merchandise. He is arrested and lands in the police station. The judge gives him a jail term. He is stigmatized and humiliated. Just like the alcoholic, he swears that

never, never will he do this again.

On his release from the jail, he wanders down the street past a department store. Unaccountably he is drawn inside. He sees, for example, a red tin fire truck, a child's toy. He instantly forgets all about his misery in the jail. He begins to rationalize. He says, "Well, this little fire engine is of no real value. The store won't miss it." So he pockets the toy, the store detective collars him, he is right back in the clink. Everybody recognizes this type of stealing as sheer lunacy.

Now, let's compare this behavior with that of an alcoholic. He, too, has landed in jail. He has already lost family and friends. He suffers heavy stigma and guilt. He has been physically tortured by his hangover. Like the kleptomaniac he swears that he will never get into this fix again. Perhaps he actually knows that he is an alcoholic. He may understand just what that means and may be fully aware of what the fearful risk of that first drink is.

Upon his release from jail, the alcoholic behaves just like the kleptomaniac. He passes a bar and at the first temptation may say, "No, I must not go inside there; liquor is not for me." But when lie arrives at the next drinking place, he is gripped by a rationalization. Perhaps he says, "Well, one beer won't hurt me. After all, beer isn't liquor." Completely unmindful of his recent miseries, he steps inside. He takes that fatal first drink. The following day, the police have him again. His fellow citizens continue to say that he is weak or willful. Actually he is just as crazy as the kleptomaniac ever was. At this stage, his free will in regard to alcoholism has evaporated. He cannot very well be held accountable for his behavior. (The N.C.C.A. 'Blue Book', Vol. 12, 1960)

Bill W