The Missing Piece: The Spiritual Malady

The Missing Piece: The Spiritual Malady by Mike L., West Orange, NJ for “Carry THIS Message” Group, West Orange, NJ

From “The Doctor’s Opinion” to the end of “More About Alcoholism” the Big Book discusses the first part of Step 1, which states, “We admitted we were powerless over alcohol”. We’ve discussed, studied, and internalized material from the “Doctor’s Opinion” to page 23 to see how we’re powerless over alcohol bodily. We’ve used pages 23 – 43 to help us experience how we’ve been powerless mentally. Now I’d like to talk about a part of our “disease” which is seldom discussed in meetings nowadays: the “spiritual malady.”

We often hear people say something like, “I have a three-fold disease: body, mind, and spirit.”

When you ask them to describe what they mean by that statement, they seem to have a firm grasp on the fact that we alcoholics suffer from “an allergy of the body and an obsession of the mind” — that once I put any alcohol in my system whatsoever it sets off a craving for more alcohol. And when I’m stone cold sober, at my very best, the thought will occur to me to take a drink — or sometimes I think very little about it or not at all, and I come to out of a blackout after having experienced what page 42 refers to as a “strange mental blank spot.” And of course this vicious cycle of my mind continuously taking me back to a drink and my body dooming me to not drink like “normal” people puts me in a senseless series of sprees and it makes it virtually impossible to stop.


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It is agreed that the “mental obsession” is the part of our “disease” which leads to the first drink; and it’s the first drink that triggers the “phenomenon of craving.” But, what about the part of my “disease” that triggers the mental obsession in the first place? Why is it that people who have remained abstinent from drinking in Alcoholics Anonymous for 1 year… 2 years… 5 years… 10 years… and in some cases even 20 years or more, go back to drinking?

We know the physical craving does not cause these people to drink because it’s been medically proven that after a few days of not drinking the alcohol is processed out of the body. And, if you’ve been in the AA Fellowship for a while, for most people, the mental obsession dissipates. So why is it that after a long period of sobriety many people in our fellowship return to drinking — EVEN WHEN THEY DON’T WANT TO? What is the third fold of our illness that triggers the mental obsession — WHEN NOT DRINKING — HAVING BEEN SEPARATED FROM ALCOHOL FOR A LONG PERIOD OF TIME?

Through closely examining our Big Book, along with much experience and practice with our Twelve Steps, as well as vigorous work with other alcoholics, the “missing piece” of Step 1 appears to be what is referred to on page 64 as the “spiritual malady.”

Now, let me attempt to discuss the second half of Step 1: ” — that our lives had become unmanageable.”

For a long time I thought my life was unmanageable because of all the crazy insane things I did while drinking — like the car accidents, hurting people when I didn’t mean to, failed relationships, loss of jobs, family dysfunction, jails, asylums, etc.

Finally, someone explained to me that those things are not the insanity that the Big Book talks about; nor are those things why the alcoholic’s life becomes unmanageable.

Of course those things can be classified as “unmanageability” — but they are external unmanageability. The unmanageability that the 1st Step is pointing to is the INWARD unmanageability of our lives — the restlessness, irritability, and discontentment that most alcoholics have even BEFORE they ever picked up their first drink. There are many names for this “inward unmanageability”. Some refer to it as “untreated alcoholism.” Others use the term “bedevilments”, which comes from page 52 of the Big Book (which I’ll be discussing in a moment). Page 64 simply refers to this “inward unmanageability” as “the spiritual malady.”

Our book promises us that “When the spiritual malady is overcome, we straighten out mentally and physically.” The mental and physical factors of alcoholism are put into remission AFTER the “spiritual malady” is overcome — which means I’m still in danger of drinking until I have a spiritual awakening — whether I think so or not.

Two key points I’d like to focus on from this point forward:

  1. What really is this “spiritual malady” and how, if left untreated, can it drive an alcoholic back to drinking?
  2. What is the remedy for it? (By the way, our Big Book answers both of those questions in masterly detail in Chapters 4 – 11.) What is this “spiritual malady” we alcoholics suffer from and how can “untreated alcoholism” cause an alcoholic to return to drinking — EVEN WHEN HE/SHE DOESN’T WANT TO?

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:

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