The Big Book’s Answer to Relapse Prevention

Our Big Book of Alcoholics Anonymous promises us that “When the spiritual malady is overcome, we straighten out mentally and physically.”

Imagine three layers. The first layer is our bodily reaction to alcohol when we ingest it — the physical craving. Under that is the second layer: the insanity of the mind just before the first drink — the mental obsession. Under that is the third layer: the inward condition that triggers the second layer, which in turn triggers the first — the “spiritual malady.” Symptoms of this “third layer” as described in the Big Book include:

  1. being restless, irritable, and discontented (page xxvi),
  2. having trouble with personal relationships,
  3. not being able to control our emotional natures,
  4. being a prey to (or suffering from) misery and depression,
  5. not being able to make a living (or a happy and successful life),
  6. having feelings of uselessness,
  7. being full of fear,
  8. unhappiness,
  9. inability to be of real help to other people (page 52),
  10. being like “the actor who wants to run the whole show” (pages 60-61),
  11. being “driven by a hundred forms of fear, self-delusion, self-seeking, and self-pity” (page 62),
  12. self-will run riot (page 62),
  13. leading a double life (page 73),
  14. living like a tornado running through the lives of others (page 82), and
  15. exhibiting selfish and inconsiderate habits.

These name just a few of the symptoms of the “spiritual malady” that’s described throughout our text. But still in all, these are just symptoms of the “spiritual malady.”

What is the driving force of these symptoms?

On page 62 the text explains that “Selfishness-self-centeredness! That, we think, is the root of our troubles.” This “SELFISHNESS-self-centeredness” (or the “ego”, as some people refer to it) drives us to respond to life situations with the above “symptoms” as well as disorders and addictions other than alcoholism.

If this selfishness-self-centeredness continues to manifest in an alcoholic’s life — EVEN IN SOMEONE WHO IS NOT DRINKING AND CONTINUES TO ATTEND MEETINGS – and the ego is not smashed and re-smashed by continuous application of all twelve steps, the sober (or “just not drinking”) alcoholic is sure to drink again eventually… or even worse, continue to live miserably being “undrunk” (better known as a “dry drunk”). This is why we see people with 10 years in AA wind up in mental institutions — AND THEY HAVEN’T HAD A DROP TO DRINK!

If you are suffering from symptoms of the spiritual malady, use these clarifying questions to ascertain where the problem lies.

  • Has it been a while since you’ve taken another alcoholic through the Steps? How long?
  • Has it been a while since you have gone through the steps? How long?
  • Have you ever taken all of AA’s Twelve Steps?
  • Have you done more than one 4th Step inventory? Have you omitted anything?
  • Have you completed all your 9th Step amends wherever possible? What remains to be done?
  • Is there something wrong in your life that you will not face and make right? What is it?
  • Is there a habit or indulgence you will not give up? What is it?
  • Is there a person you will not forgive? Who is it?
  • Is there a wrong relationship in your life you will not give up? What or Who is it?
  • Is there a restitution you will not make?
  • Is there something God has already told you to do that you will not obey? What is it?
  • Are you working with the disciplines and practices of steps Ten and Eleven (self-examination, meditation and prayer)… consistently… EVERY DAY?

On pages 14 and 15 of the Big Book of A.A., Bill W. writes, “For if an alcoholic failed to perfect and enlarge his spiritual life through work and self-sacrifice for others, he could not survive the certain trials and low spots ahead. If he did not work, he would surely drink again, and if he drank, he would surely die. Then faith would be dead indeed. With us it is just like that.”

4 thoughts on “The Big Book’s Answer to Relapse Prevention

  1. can’t tell you how grateful I am to find this online……Deepest thanks to whomever took the time to put this up here…..6 years sober in October….god, aa, old school sponsor, and a lot of tears, laughs, and lumps on my head….haha…some of them literal lumps on my head!!…….what a miracle this gift of AA is….thank you god.

  2. Am working with a sponsee who’s slipped and this article has really guided me as to how to work with her. Thank you so much

  3. just admitted my latest relapse to my AA friends yesterday and today. Have
    had probably 7 or 8 the last 11 years. i work AA with others, alone, with God,etc. i pray. i help others. For me as an alcoholic, long term sobriety has been elusive. But the effort to continue is worth it. i know I feel better when I am in frequent contact with God. Old Timers, be kind to us relapsers. We need each others support, not shame. Shame, remorse and guilt follow my relapses. They are self induced.

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