Tiebout Resources

Dr Tiebout’s first paper on AlcoholismTherapeutic Mechanisms of Alcoholics Anonymous
Tiebout Study GuideTiebout PDF
Speech at the 1955 AA International Convention in St. Louis – audioTiebout St.Louis 1955
Speech at the 1955 AA International Convention in St. Louis – transcriptAnonymity – the Ego Reducer
Speech at the 1960 AA International Convention in Long Beach – audioTiebout/Bill W. Long Beach 1960
Speech at the 1960 AA International Convention in Long Beach – transcriptEgo – a Dime a Dozen
Harry Tiebout ObituaryNew York Times, April 1966
Grapevine ArticlesUsed with permission
AA Grapevine – November 1963Treating the Causes of Alcoholism
AA Grapevine – April 1963What Does Surrender Mean?
AA Grapevine – September 1963When the Big “I” Becomes Nobody
AA Grapevine – September 1956Why Psychiatrists Fail With Alcoholics
AA Grapevine – July 1966In Memory of Harry – Bill W.
Tiebout Resources

Overview and Outline

Harry Tiebout
Harry Tiebout was a psychiatrist who had worked for years with alcoholics when he was first exposed to AA in 1935. He was astonished at how effective the AA program was in getting alcoholics to stop drinking. He started to make a close study of AA’s method and tried, with success, to apply it to his own therapeutic practice. Tiebout developed some ideas about why AA works for alcoholics. He expanded on those ideas in papers published in medical journals and talks given to professional medical societies over a period of  21 years. (The earliest paper in this collection was published in 1944 and the last in 1965.)

He decided that the alcoholics he was trying to treat were driven by an unconquerable infantile ego. He concluded that the infantile ego was in the subconscious, and resistant to the application of conscious reasoning. He theorized that this ego needed to be smashed and that a surrender had to occur in order to allow therapy to proceed and that this was what was happening to alcoholics when they “hit bottom.”  He insightfully described the ego characteristics of many of his alcoholic patients. For me, his viewpoint is invaluable in understanding the mental nature of the disease of alcoholism.

Tiebout acknowledges the need for God in AA in his first paper (not included here due to copyright restrictions) but other than that, he never uses the word “God” in the writings directed at his colleagues. The paper on ego factors is an exception. In that paper he does refer to the need for a “Deity” in AA, a couple of lines before he mentions Jesus as an example of a person that taught humility. That’s as close as he gets to sectarian religion, at least in the papers I know about. He is more expansive in his talk of God when his audience is made up of AAs. I think the reason for this is that talk of God in psychiatric circles was not popular in Tiebout’s day. Using the term might have aroused antipathy to the ideas he presents in his papers.

One other thing that I found difficult to understand coming from a 12 step perspective was that Tiebout  claimed that he was “treating the symptom” of alcoholism, meaning the drinking. He focusses on putting the plug in the jug rather than looking for underlying mental illnesses or neuroses. Again, his audience makes it clear why he does this. Psychiatrists of the day were ignoring the drinking and focussing on what they were trained to do: to identify and bring to light the unconscious motivations that drove the patients misbehavior with alcohol. AA started out with a realization that alcoholism itself, the “allergy of the body and obsession of the mind” had to be treated before moving on to a deep examination of “causes and conditions.”   Drying out made the rest of AA’s program possible and Tiebout was impressed by AA’s ability to do that.

So you can look at Tiebout as focussing on step 1. But he also addresses the second half of that step after the dash “- that our lives had become unmanageable.” His insight into the psychological makeup of the character of many  alcoholics is important information for someone trying to help an alcoholic who is suffering from active drinking, or to someone with years of sobriety who may be dealing with the effects of ego in their own lives and spiritual practice.

WHAT I TAKE AWAY FROM TIEBOUT:
  1. Alcoholism is a disease of the mind.
  2. I have a stubborn, large and immature ego.
  3. I have to smash that ego in order to get on with AA. (Surrender)
  4. My resistance is unconscious. I can smile and agree while secretly holding out.
  5. The ego has astonishing recuperative powers. I need a practice that continuously keeps it in check.

Memes and Themes

Dr Bob Smith, Dr Harry Tiebout and Bill Wilson