Alcohol Is Not Optional

Alcohol Is Not Optional

One of the most frequently quoted lines in Alcoholics Anonymous is:

"Our liquor was but a symptom."

In many contemporary discussions of recovery, this sentence is often interpreted to mean that alcohol is not really the problem. The focus then shifts to resentment, fear, trauma, relationships, emotional immaturity, character defects, family history, or other underlying causes and conditions.

Yet Dr. Silkworth's diagnosis in The Doctor's Opinion proceeds very differently.

He does not diagnose alcoholism by the presence of resentment. Non-alcoholics have resentments.

He does not diagnose alcoholism by the presence of fear. Non-alcoholics have fears.

He does not diagnose alcoholism by selfishness, dishonesty, pride, anxiety, depression, trauma, or relationship difficulties. Every one of these conditions is common among people who are not alcoholics.

In fact, all of these characteristics may be present or absent in any individual alcoholic. None is required for the diagnosis.

What is required is alcohol.

As Dr. Silkworth observed:

"All these, and many others, have one symptom in common: they cannot start drinking without developing the phenomenon of craving."

The physician's diagnosis rests upon the alcoholic's unique relationship with alcohol itself. Remove alcohol from the equation and there may still be suffering, fear, resentment, or emotional disturbance—but there is no basis for diagnosing alcoholism.

This leads to a simple observation:

Alcohol is the only symptom required for the diagnosis of alcoholism.

Everything else may be important. Everything else may deserve attention. Everything else may affect the quality of a person's life.

But every one of those other symptoms also plagues non-alcoholics.

Alcohol is different.

It is the one element common to every alcoholic inventory. It is the one indispensable fact without which the diagnosis itself disappears.

This is why some of us are cautious when we hear the phrase, "Our liquor was but a symptom."

If interpreted to mean that alcohol is secondary or optional, the statement can inadvertently move attention away from the very thing that distinguishes the alcoholic from everyone else.

In a modern therapeutic framework, alcohol may become one symptom among many.

In Dr. Silkworth's framework, alcohol is not optional.

It is the defining symptom of alcoholism itself.