Alcoholics Anonymous (AA) has been a popular method of recovery from alcoholism for the past 75 years. The primary text of AA, entitled Alcoholics Anonymous: How Many Men and Women Recovered from Alcoholism, otherwise known as the “Big Book,” has served an essential role in describing and disseminating AA’s 12-Step program of recovery. It should be noted from the outset that, according to AA’s preamble, “AA is a fellowship of men and women whose primary purpose is to stay sober and help other alcoholics achieve sobriety. . . The only requirement for membership is a desire to stop drinking.” Therefore, the ideas expressed in the Big Book cannot necessarily be considered representative of the views of all AA members. Nevertheless, many members of AA do subscribe to the ideas set forth within the Big Book, particularly with respect to the ideology of alcoholism that is described. This essay addresses the chapter from the Big Book, entitled “The Doctor’s Opinion,” which was penned by Dr. William Duncan Silkworth at Bill Wilson’s request with the objective of lending medical credibility to AA’s approach. In particular, I am concerned with interpreting the primary themes and insights of “The Doctor’s Opinion,” along with other writings from Silkworth, on the subject of alcoholism within the context of the findings of contemporary neuroscience related to alcoholism. The rationale for this essay comes in light of the numerous public criticisms aimed at discrediting the Big Book’s articulation of alcoholism. My primary objective is to show that the essential alcoholism-related understanding of Dr. Silkworth remains relevant, even today.
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