ABOUT SCAA

Sugar & Carbohydrate Addicts Anonymous (SCAA) is a Twelve-Step fellowship of individuals who share their experience, strength and hope with each other that they may solve their common problems and help others to recover from their eating disorders. The only requirement for membership is a desire to recover from sugar and carb addiction. There are no dues or fees for SCAA membership. We are self-supporting through our own contributions. SCAA is not allied with any sect, denomination, politics, organization or institution, does not wish to engage in any controversy. We neither endorse nor oppose any causes. Our primary purpose is to recover from sugar and carb addiction and to carry this message of recovery to others with eating disorders.

Our 7th Tradition states that SCAA is fully self-supporting, declining outside contributions. Contributions cover our expenses and can be made through Venmo, PayPal, or check. 

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Sugar and Bad Carbohydrate Addiction

Scientists who study brain imagery and function tell us that part of the ‘reward circuit’ is associated with addictive behaviors. In fact, the ‘reward areas’ of the brain triggered by cocaine and alcohol use are the same areas affected when one consumes sugar and certain types of carbohydrates. The resulting pleasurable sensations produced are due to the release of ‘feel-good neurotransmitters, such as dopamine, serotonin and endorphins. Foods that are high in sugar and carbohydrates often cause cravings.

Another Doctor’s Opinion

Revised Draft 5/16/2024

Jeff Sandoz, PhD, LMHC, MAP, ICDAC

Introduction

The purpose of this writing is three-fold. First of all, these words are a tribute to ‘The Doctor’s Opinion’ written by William Duncan Silkworth, M.D. in the book entitled Alcoholics Anonymous. Secondly, these remarks are an attempt to parallel and expand upon Dr. Silkworth’s pioneering ideas regarding the two-fold nature of alcohol addiction. Specifically, the mental obsession and the physical allergy that he proposed in 1939. Thirdly, and perhaps most importantly, is to underscore the importance of the spiritual experience which changes the person sufficiently enough to recover from one’s addiction. 

Initially, this opinion will expand on Dr. Silkworth’s ideas by focusing on the ‘addiction disconnection’—a process that pulls one apart from others, from God and from our very selves. People with addictions struggle in body, mind and spirit, a common condition that initially separates one from others. However, it is a condition that paradoxically unites all who struggle with a common peril—a peril that bonds together all of the individuals who are addicted and brings them together within a wonderfully supportive fellowship. AA co-founder, Bill W., the author of the book Alcoholics Anonymous emphasizes this point in the chapter entitled ‘There is a Solution’ which describes the common peril as “one element in the powerful cement which binds us.” (p. 17).

 Secondly, these concepts gravitate toward a ‘recovery reconnection’ as a common solution. The solution integrates aspects of recovery with daily maintenance practices—a process which highlights sponsorship and service, step-work and spirituality. What is crucial for the reader to understand is that recovery requires a ‘reconnection’ involving an emergence of a psychic change sufficient to recover, namely the vital spiritual experience as the result of the steps. 

Background

How am I qualified to elaborate on this topic? A background experience of over 40 years has provided me with some understanding of the dynamics of recovery within several 12 Step groups. In addition, such knowledge has been bolstered with research studies in various aspects of recovery and the resulting spiritual experience—research which culminated in a dissertation, numerous journal and book publications along with presentations at mental health and addiction conferences. Also, there has been the experience in academia as a college professor—teaching courses in the addictions for graduate and undergraduate students in counseling and psychology along with the training and the preparation of future counselors. Finally, having worked with individuals and their families with addiction-related issues as a clinician in private practice has provided a sensible approach to activities which heal family members.

The ‘Addiction Disconnection’ 

 The ‘addiction disconnection’ both fractures and fragments the individual, disrupting the body, mind and spirit unity. In my opinion, any perspective that fails to include this three-fold nature of addiction (the mental obsession, the physical allergy and the spiritual component) is doomed to failure. In order to recover from addiction, a wholistic view must incorporate these three essential elements. 

Dr. Silkworth described the condition of the alcoholic as being “restless, irritable and discontented” (Alcoholics Anonymous, p. xxvi). The restless body communicates imbalances in the form of irresistible cravings. The mind produces seductive and haunting images that both fuel and fire the desire to seek relief and then overindulge. Together, the body and mind join forces and the individual becomes irritable, often expressed in fear, anger and resentment—all of which increase the intensity, frequency and duration of the cravings. The discontented spirit becomes desolate and desperate, seeking relief in material things, rather than seeking a conscious contact with a higher power. 

As such, ‘The Doctor’s Opinion’ emphasized that the individuals in recovery “must work out our solution on the spiritual as well as an altruistic plane” (Alcoholics Anonymous, p. xxiv). Therefore, it is crucial for the person “to be of maximum service to God and the people about us” (Alcoholics Anonymous, p. 77). Finally, with regard to spiritual issues “we really have . . . a daily reprieve contingent on the maintenance of our spiritual condition” (Alcoholics Anonymous, p. 85).

Furthermore, the individual is not in one’s right mind as evidenced by a loss of perspective that renders the person incapable of determining exactly how much is enough. The internal gauge is broken and consistently gives a false reading and as a result, perception becomes warped. The ongoing betrayal of a substance leaves one heartbroken in that one’s overindulgence which once promised feelings of satisfaction, empowerment and pleasure now guarantees only disappointment, discouragement and pain. 

All of the aforementioned symptoms are aspects of the disturbed functioning of the individual, fragmented by addiction. Broken in the battle with addiction, one is further fractured as aspects of the whole person (body, mind and spirit) are now at odds, manifesting the discord and disruption of an addicted brain. The addicted individual's mind will lie and delude one into returning to the addictive behavior or substance. Dr. Silkworth described this tendency, indicating that one “cannot after a time differentiate the true from the false,” (Alcoholics Anonymous, p. xxvi).

Some of the major factors associated with this disconnection include 1) trauma which changes the trajectory of one’s life, 2) genetics which seems to activate the inherited weak links, 3) active pursuit of a substance/behavior and brain alteration, 4) environmental stress and the lack of adequate emotional bonding/attachment with family, 5) adaptation of brain chemicals (neurotransmitters) and 6) changes in spirituality. 

The next section will examine these six factors in greater depth as one progresses through the various stages of addiction and recovery. In addition, the focus will remain within the contextual themes of disconnection and reconnection.

Trauma

Although trauma can take several external forms, such as physical, verbal or sexual abuse, the resulting effect disturbs one’s trajectory in life and often leads toward addiction. The internal impact of trauma manifests itself with an assault of self-defeating thoughts and unpleasant emotional states that constantly barrage the individual, creating a frantic sense of urgency and impending disaster. Seeking relief from this discomfort, one searches for something external to gain a sense of internal power or control. In some cases, the response is to ‘self-medicate’ as an attempt to stop the onslaught of worry and anxiety, anger and fear. However, the unfortunate consequence is to abuse or overuse a substance which in turn prompts changes in brain chemistry and results in disturbed thinking. Poor judgment and acting on impulse further the misdirection of one’s life, pushing one onto the wrong path. Rigid thinking, combined with disturbed, unsettled emotions push the person to pursue a faster pace toward relief and raise the level of ‘self-medication’. Perception becomes distorted and puzzling. Spirituality is transformed into idolatry as one chases after the next euphoric high.

With regard to food, specifically sugar and carbs, a series of persistent ‘false hunger’ messages are being sent to the brain like a faulty circuit in the automobile dashboard that is transmitting the wrong message.

As with all addictions, one develops an inordinate attachment to something which becomes the central focus, or activity in one’s life. What drives the alcoholic to seek alcohol, the drug addict to pursue drugs or the sugar and carb addict to crave certain foods of choice? The answer is a lack of power, as that is the dilemma of the addicted individual (Alcoholics Anonymous, p. 44). The purpose of the object, substance, or behavior associated with the addiction is to provide an individual with a specific desired result—a mood change, a sense of exhilaration, a relief from pain or boredom. The common denominator of these desired results is to attain power, albeit a false sense of power, a misleading comfort, or simply, to temporarily provide a brief, bogus sense of security. The end-result strips away the power of a sane mind, leaving one emotionally empty, bereft of joy with a restless, troubled soul. 

Trauma deepens with added environmental stress, especially when combined with a loss of emotional support inevitably leading one to seek relief. Dr. Silkworth noted that addiction produces a mental obsession that one can continue to pursue one’s path with reckless abandon and without harm. The addicted individual's thoughts center around the substance and/or behavior fortified with flights of fantasy and grandiosity. This mental obsession to continue on this track is so overpowering that it drives out all other thoughts that are contrary to the addictive path. Based upon such misleading thoughts, drives and cravings, poor decisions are made. 

Just as the compass needle points true north, a normal brain is capable of directing proper thoughts to guide the individual toward the appropriate desired goal. However, just as a magnet when placed in close proximity to a compass can provide a false reading, so too the addicted brain can misdirect the individual when there are persistent thoughts about the object of one’s desire. Such obsessive thoughts churn up disturbing emotions which prompt one to pursue a path of addiction that leads to self-destruction or death. The pleasurable sensation, both elusive and seductive, is so powerful that despite admitting that it is injurious, the mind becomes deluded. Reminding us once again of Dr. Silkworth’s statement that one cannot differentiate what is true from what is false (Alcoholics Anonymous, p. xxvi).

There is an eerie parallel of the addict’s brain and the compass that is seen in the Disney movie series Pirates of the Caribbean. Captain Jack Sparrow's unusual navigational instrument, a compass, doesn't point true north, but instead points in the direction of the thing its holder wants most. And if one were to betray the compass, then in retaliation, the compass would unleash one’s greatest fear. So, too, for the one who is addicted. For if one does not follow the guidance of the compass, then one is hit with a tsunami of fear.

Genetics 

Research indicates that there is a genetic component in certain types of addiction. I firmly believe that there is an interaction between what genes are inherited from parents with the behaviors that are learned (and associated stress) within one’s family of origin. In any event, Dr. Silkworth commented that “the body of the alcoholic is quite as abnormal as the mind,” (Alcoholics Anonymous, p. xxvi). And yet, the abusing behavior not only continues, but accelerates. Such is the tendency for addictions and the dysfunctional family dynamics to reinforce one another in an ongoing feedback loop. 

Active Pursuit and Brain Alteration

The active pursuit of some external coping mechanism and seeking relief in a substance or behavior throws one off balance bodily, mentally and spiritually as one seeks something to fill up the inner emptiness. Such pursuit in the form of an addiction, as mentioned previously, disturbs brain function. In addition, while experiencing physical withdrawal, the body suffers heightened levels of pain. Such a combination, disturbed thinking and physical discomfort, drives one deeper into addiction by pursuing any risky behaviors which promise pleasure and relieve pain. 

SPECT scans of addicted brains reveal what looks like ‘physical’ holes or empty spaces. However, the empty spaces are ‘functional’ holes—dormant pockets within structures of the brain that have gone offline due to toxicity, poor circulation or neurotransmitters gone awry. Can these dormant areas get back online? It depends upon abstinence and the level of recovery-based activities that reboot those idle areas. 

Environmental Stress and Emotional Bonding

When there are continual and unresolved issues within the family such as addiction, the dynamics will be chaotic and dysfunctional. Interpersonal stress builds and the quality of relationships among family members deteriorates and interferes with proper bonding and proper emotional attachment. Many fail to realize that addictions are a ‘family disease’ and the non-addicted family members are as ill as the addicted individual. Family members of the addicted must find a 12 Step support group (such as Al anon or Nar anon) to deal with and resolve emotional issues such as anger and fear, hurt and lack of forgiveness. If such issues are not being actively resolved then the serenity and peace of mind of all family members will be in jeopardy and the chance of relapse will be increased.

Quite often, the non-addicted person appears baffled by the addict’s behavior and fails to understand what is happening within the mind, body and soul of the addicted individual. As such, relationships are strained. Further complicating the issue is the statement that sugar and carbohydrates are legal. What the non-addicted individual fails to comprehend is that the addiction to sugar and carbs is similar to other addictions—a process that can be grasped with an understanding of hormones and neurotransmitters, those tiny chemical messages which drive the neural functioning within the nervous system. 

Adaptation of Brain Chemicals (neurotransmitters) 

When the original ‘Doctor's Opinion’ was written in the 1930s, food and drink were largely pure and untouched which stands in sharp contrast to the way things are today. Consumers, subjected to an ever-increasing pace of life, are seduced through the eyes with various enticing images in aggressive marketing campaigns from the food industry. As a result, emotions are equally overwhelmed with visual stimuli that tantalize the appetites especially for eating and drinking. 

Today the food is not the same. Preservatives and food additives, designed to improve the flavor and aroma of food and prolong product shelf-life, are found in the majority of highly flavored snacks and processed foods. Some additives can trigger allergic reactions and possibly lead to other serious health issues. The downside of these flavorings and stabilizers is that they evoke undesirable changes in mind and body by altering a person’s mood and behavior. One type of flavor enhancer, known as an excitotoxin, is added regularly to foods and drinks, such as monosodium glutamate, saccharin and aspartame. 

Excitotoxins are designed to stimulate the taste cells on the tongue. However, in addition to producing an exciting response from the taste buds, excitotoxins can alter the chemistry of the brain especially the parts of the brain that control behavior and emotions. Excessive consumption of excitotoxins can lead to cravings and have the potential to damage brain cells through over-stimulation.

For some consumers, these additives evoke a variety of reactions such as hyperactivity, insomnia and irritability. Some of these additives block the body’s sensations of satiation and stimulate the feeling of hunger resulting in a person’s eating much more than initially intended.

When some individuals consume a food additive like sugar, the response is stimulation as sugar hijacks the dopamine system by providing feelings of pleasure and euphoria. The result is not only pleasurable but motivates one to consume more sugar to regain the same experience of reward. However, with the abrupt discontinuation of sugar, some individuals experience cravings for more. Other health issues such as diabetes and obesity often follow suit and the person’s life can become unmanageable.

While the nervous system utilizes distinct types of chemical messages to work, these neurotransmitters allow the brain to move muscles, discern emotions and to provide the brain with sensory information about one’s environment. However, the effectiveness of these neurotransmitters can be compromised by diseases, accidents, addictions, interpersonal relationships and now food additives. There is hope, as the return of normal functioning of the neurotransmitters can reappear once one has begun the path of recovery in a 12 Step Program. This component of examining neurotransmitters in the brain represents a new frontier in the addiction field as most healthcare professionals today do not understand how detoxification and addiction affect the neurochemical systems of their patients. 

Changes in Spirituality and the ‘Recovery Reconnection’ 

 How does one change spiritually? And more importantly, how does the recovery reconnection process begin?

Driven by the addiction, one becomes an idolator—seeking the substance or the behavior that promises solace or euphoria but demands the complete sacrifice of everyone or everything the addicted person loves or holds dear. The only hope for recovery resides in a life-changing spiritual experience.

Recovery requires a reconnection with oneself and with others. Both types of ‘reconnection’ necessitate integrating the 12 Step Program into one’s life and having a vital spiritual experience as the result of the steps. Recovery involves healing the trauma or at least reducing the negative effects which adjust the trajectory of one’s life by helping one to get back on the proper path. While one’s inherited genetic make-up has been altered, one may find solace in the steps which support emotional balance. Refraining from addictive behaviors along with ongoing abstinence from mood and mind-altering substances is the starting point to get one onto the path of recovery. Reduction of environmental stress and the promotion of healthy emotional bonding can be enhanced with the aid of counseling in various formats. 

However, the most crucial reconnective element is the daily intensive work with a 12 Step Sponsor. The purpose of frequent Sponsor contact, especially early in recovery, is to guide the Newcomer with constant reminders to do things differently, replacing self-destructive behaviors with a new set of principles that are in alignment with the regular maintenance practices of a 12 Step Program. Such daily contact with a Sponsor provides the Newcomer with an opportunity to change gradually by repeatedly making the right choices to take the right actions. Such change involves moving away from selfish, self-indulgent and self-centered behaviors which set one’s life into destructive patterns. The Newcomer is challenged by the Sponsor to “. . . think about the twenty-four hours ahead. We consider our plans for the day. Before we begin, we ask God to direct our thinking, especially asking that it be divorced from self-pity, dishonest or self-seeking motives,” (Alcoholics Anonymous, p. 86). 

The reader is reminded of the quotation that in early recovery, the Newcomer discovers one’s purpose—“Our real purpose is to fit ourselves to be of maximum service to God and to the people about us,” (Alcoholics Anonymous, p. 77). In addition, the Sponsor frequently reminds the Newcomer of the source of the problem. “Selfishness—self-centeredness! That we think is the root of our troubles,” (Alcoholics Anonymous, p. 62). And how the Newcomer must act against the selfish, self-centered impulses whenever they arise. Although these temptations will occur, the Newcomer is urged to act differently, by dealing with anger, fear and resentments with specific prayers in the book, Alcoholics Anonymous. In doing so, the Newcomer brings thoughts, emotions and behaviors into alignment with the principles of the 12 Step Program. 

Sponsorship – Linchpin Analogy

In the olden days, when wagons were in fashion, a linchpin was used to hold wagon wheels in place. This strategically placed metal cylinder inserted at the end of an axle was crucial in maintaining forward motion. The same can be said for the process of sponsorship within a 12 Step Program, as the Newcomer moves from a position of addiction to one of recovery. Furthermore, the Sponsor balances the wheel of recovery by holding key aspects firmly in place. These aspects, in turn, enable the Newcomer to balance the ’reconnection’ process of internal integration with step-work, spirituality and service to others in recovery.

  The Sponsor acts as a mentor or a guide, prompting the Newcomer to move forward—toward a life based upon solid life-principles which promote a healthy lifestyle. The Sponsor urges the Newcomer to move beyond the immediate pleasure of one’s former behaviors and to think of the painful consequences that resulted from a life based upon inconsistent principles which were corrupted for the gain of the moment. 

As stated previously, the problem of the addicted person is a lack of power.   Furthermore, that ‘problem’ manifests itself in two ways. The first is that the will of the alcoholic is weakened, (Alcoholics Anonymous, p. 7) and the second is with regard to memory. In closer inspection, the memory dysfunction is two-fold. Initially, “We are unable, at certain times, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago,” (Alcoholics Anonymous, p. 24). And secondly, there is the aspect of a distraction within addiction, prompting the addicted person to move away from something unpleasant or to avoid something painful. Both aspects seem to produce the same result. Namely, an emotional disconnect—a process by which the person begins mentally to “zone out” in order to counter disturbing thoughts and to stop feeling unpleasant emotions. Sponsorship helps the Newcomer to be aware of these tendencies and to develop ways to remember and refrain from these ‘absent-minded’ tendencies.

The solution to the problem is found not only within a fellowship which supports these individuals by guiding them along the 12 Step Program but also to bring them to a higher power who will change them from within with a vital spiritual experience. The Sponsor is now acting as a newly developed conscience, sort of a Jiminy Cricket character to the wayward Pinocchio.

How does one find a Sponsor? In meetings one hears the story of another. The Newcomer identifies with the experience of another person. Reconnection begins  when one notices that one has the same feelings, the same thoughts and the same behaviors as the individual telling the story. The Newcomer ponders this idea: How is it that this individual who has the same symptoms that I do, is now sober or abstinent? Curiosity sparks within the Newcomer along with the emergence of a newfound willingness. This willingness prompts the Newcomer to move from a position of desperation into desire—a yearning to learn how to do things differently. Thus, begins sponsorship, the desire to participate in a daily journey in recovery with one who is more experienced and who has traversed the path of the 12 Steps. Consequently, the person decides to take action on a daily basis whether to move forward by choosing sobriety, or not. 

So, what actually transpires between the Newcomer and the Sponsor? There is a process which includes ten different phases. 

1)  During the daily encounter, the Sponsor will align the thoughts, feelings and behaviors of the Newcomer with the principles of the 12 Steps.

2)  The Sponsor will encourage the Newcomer to look at the 24 hours ahead and examine the people, places and things that the Newcomer will encounter during that time frame. 

3)  The Sponsor focuses with special attention on those things that place the Newcomer in an emotional danger zone—environmental triggers which threaten one to fall into a relapse by returning to previous addictive behaviors.

4)  In examining those people, places and events, the Sponsor focuses on the emotional baggage which would prompt the Newcomer to seek relief by indulging in the addictive substance or behavior.

5)  The emotional baggage generally focuses on the evocation of fear, anger and resentment.

6)  The Sponsor points out to the Newcomer a series of specific prayers that target each emotion. These prayers, found in the book Alcoholics Anonymous, help one to deal with fear, anger and resentment by directing those emotional states to one's higher power.

7)  The Sponsor reminds the Newcomer to “pause, when agitated or doubtful, and ask for the right thought or action,” (Alcoholics Anonymous, p. 87).

8)  The Sponsor directs the Newcomer to pray, to the higher power so that the Newcomer is not acting upon character deficits and defects.

9)  This change in direction not only fosters a spiritual reconnection but also places the Newcomer, “in much less danger of excitement, fear, anger, worry, self-pity or foolish decisions,” Alcoholics Anonymous, p. 88).

 10) Now the Newcomer utilizes the newfound energy to be of service to other individuals who are in need. Thus, the reconnection with others has begun.

In summary, the mentor or Sponsor guides the Newcomer to seek the will of a power greater than oneself, and to remain open to change, reminding the Newcomer once again “to be of maximum service to God and the people about us” (Alcoholics Anonymous, p. 77). 

Results of Sponsorship -A Sawtooth Analogy

Years ago, an AA member shared with me the following story which is an extremely useful analogy. As he was a carpenter by trade, he would often try to cut wood with a saw while inebriated and would over shoot his thrust with the saw. As a result of his overreach, the teeth of the saw would strike a cinderblock and become misaligned. The repair was simple. He would place the saw on its side making it flat upon a concrete sidewalk. Taking a hammer, he would flatten the saw teeth flush against the level surface of the sidewalk and then flip the saw over and repeat the process to straighten out the misaligned teeth on the other side. He then commented that the same process occurred each time he met with his Sponsor (metaphorically speaking) in that like the misaligned teeth being put back in place, so too his thoughts, feelings and behaviors would be set right and fall into proper alignment on a daily basis.

Over time, his daily encounters with his Sponsor culminated with a spiritual reconnection as his 12 Step work promoted a vital spiritual experience. Although his recovery began and was maintained through sponsorship and service, step-work and spirituality, there is one very powerful way to connect emotionally with others within 12 Step Groups and that is through storytelling of ‘what we used to be like, what happened, and what we are like now,’ (Alcoholics Anonymous, p. 58).

Telling One’s Story

Jesuit priest, Anthony de Mello told me over forty years ago that he believed that the shortest distance between a truth and a human being was through a story. The AA Historian, Ernie Kurtz, communicated to me that what bonds a person to a 12 Step group is when someone else in a meeting tells you the story of your own addicted life—thus propelling you to find out how you are going to recover and later on your story will unfold and change for the better. 

One of the main vehicles in the recovery process is storytelling. Recent research (2010) by Princeton Professor Uri Hasson revealed that verbal communication is a joint activity. Specifically, the process of storytelling triggers neural coupling by activating certain areas of the storyteller’s brain and simultaneously engaging the same areas of the listener’s brain. There is additional research indicating that storytelling promotes changes in certain neurotransmitters such as dopamine, oxytocin and endorphins associated with positive emotional states and adrenaline and cortisol associated with stress and agitated emotional states. 

Storytelling, along with the supportive dynamics of 12 Step groups, can have a positive effect on sluggish brain areas left dormant after years of abuse. In addition, the active learning process occurs when a 12 Step Sponsor rekindles the sections of the brain lulled into inactivity by abuse as a result of toxicity, poor circulation or brain neurotransmitters pushed off balance. 

During the addiction process, key systems of normal brain functioning run amok, creating a falling domino effect in various realms; socially, physically, mentally, emotionally and spiritually. However, the process of hearing one’s story as told by another in a 12 Step meeting, along with other 12 Step activities such as step-work and service in helping others, can help to reactivate one’s brain and promote a vital spiritual experience.

Conversion Experience as the Result of the Steps

Dr. Silkworth, in ‘The Doctor’s Opinion,’ summarizes the effect of the spiritual experience, “once a psychic change has occurred, the very same person who seemed doomed, who had so many problems he despaired of ever solving them, suddenly finds himself easily abled to control his desire for alcohol, the only effort necessary being that required to follow a few simple rules,” (Alcoholics Anonymous, p. xxvii). 

The author of the book, Alcoholics Anonymous, found it necessary to expound upon the process of the psychic change with a clarification in subsequent editions of the spiritual experience, which can be found in Appendix II of the book. Here, the author informs the reader of the two types of this phenomenon, based upon speed of onset—namely sudden or slow. The sudden type is described as “an immediate and overwhelming ‘God -consciousness’ followed at once by a vast change in feeling and outlook,” (Alcoholics Anonymous, p. 567). This sudden type, noted in literature, can be found in the conversion of St. Paul as found in Acts 9 and also in Ebenezer Scrooge waking up on Christmas morning in the Charles Dickens classic, A Christmas Carol. The slow type, described in Appendix II, develops “slowly over a period of time,” (Alcoholics Anonymous, p. 567). In essence, the term ‘spiritual experience’ or ‘spiritual awakening’ describes a “personality change sufficient to bring about recovery” (Alcoholics Anonymous, p. 567). While the terms spiritual experience and spiritual awakening have caused some confusion, the end result is the same, recovery. On the one hand, the term spiritual experience refers to a sudden and quite spectacular personality change and is considered to be extremely rare. On the other hand, the spiritual awakening is a slower and more gradual process that is more common among recovering alcoholics after completing the 12 Steps. 

My research confirmed this with these findings; approximately 22% (sudden), 72% (slow) and 6% having both types. The type of spiritual event is not important, but the most important result is that an individual demonstrates a personality change sufficient to recover. Dr. Harry Tiebout, a psychiatrist friend of AA co-founder Bill W. described the process of conversion as hitting bottom, maintaining a level of humility, surrendering and an ego reduction.

Bill W., the author of the book, Alcoholics Anonymous, claimed to have had multiple conversion experiences: 1) when he met Lois [his future wife], 2) on the transport ship Lancashire en route to England in WWI, 3) in Winchester Cathedral during WWI, 4) with Ebby Thatcher in the Towns hospital by means of the steps of the Oxford Group, 5) with Fr. Dowling after completing his 5th Step and 6) taking LSD under medical supervision before it became illegal.

 One AA member reported to me in a personal communication that whenever changing sponsors, he would go through another 4th and 5th Step. The result was either a sudden or slow conversion event that seems to reconnect the individual’s mind, body and spirit, thus reversing the damage from a disease that disconnected the same person from God, from others and also oneself.

Conclusion - Essential Step-Work

There have been dramatic changes in the past 85 years since ‘The Doctor’s Opinion’ was written. Since that time many of the observations made by Dr. Silkworth and the early 12 Step pioneers have been not only verified but expanded upon by research, technology and evidence-based best practices in the field of the addictions. Tried and true traditions associated with the recovery process are still practiced today which emphasize the importance of sponsorship and service, step-work and spirituality as well as storytelling.

In closing, I wish to highlight one key finding from my research and that is the essential requirement of completing the 12 Steps. Specifically, of special importance was the confirming discovery that completion of Steps 4, 5, 8 and 9 was a crucial prerequisite to having a spiritual experience. Therefore, I cannot emphasize enough how important it is for the fractured and fragmented individual laden with addictions to work the Steps in order to become free. And what is crucial for you, the reader, to understand is that recovery requires a ‘reconnection’ involving an emergence of a psychic change sufficient to recover, namely the vital spiritual experience as the result of the steps.