Lay Therapy

From PRIMER ON ALCOHOLISM, by Marty Mann, 1950. Chapter 12, pages 139-145.

The term "lay therapy" means, literally, treatment by laymen. In the field of alcoholism, it is a term, which usually means a particular method of treating alcoholics, a method which is also known as the "Peabody method," after the man who developed it and described it in his book The Common Sense of Drinking. Peabody himself was taught by Courtenay Baylor, to whom his book is dedicated, but so far as is known he was the first to devote himself entirely to the treatment of alcoholics, and to achieve considerable success in this field in the late 1920’s and early 1930’s.

The treatment, like all treatments, which have had any success, is predicated upon the assumption that, while alcoholism cannot be "cured," it can be successfully arrested if the alcoholic can be helped to eliminate drinking from his life completely. The Peabody method of achieving this goal is a system of psychological re-education, designed specifically to teach the alcoholic to accept the fact that he can never drink again, and to further teach him ways and means by which he can adapt himself to a life without drinking. Peabody summarized his technique as follows:

The treatment consists in instructing a man how to train his mind so that he carries out a sustained course of conduct consistent with the theories of his most mature intellectual self, how to form new habits and stick to them, and conversely how to eliminate the unsatisfactory method of trying to adapt himself to his environment through the medium of alcohol. The re-education is comprised of the following steps:—

1. A mental analysis is made wherein the drinker learns that certain actions and systems of thinking, past as well as present, have directed him on the unfortunate course he has been pursuing, by creating doubts, fears, and conflicts. When these are removed his energy is free to take up more interesting and constructive occupations.

2. Various factors contribute to an abnormal state of tension, which drink temporarily releases, only to aggravate it in the long run. This tension can be permanently removed by learning formal relaxation and suggestion.

3. The unconscious mind can be influenced by suggestion so that it co—operates with the conscious to bring about a consistent, intelligent course, of action.

4. Actions (where they are not mere reflexes) are the direct result of thoughts. Experience has proved over and over again that thoughts can be definitely controlled and directed when it seems desirable to do so.

5. As the body and the mind are indivisible parts of the same organism, the mind is naturally much more efficient in the execution of new ideas if it is functioning in a sound body. To this end the elements of a normal, healthy hygiene should be followed. If there is any actual or suspected disability it should be attended to by a competent physician.

6. The alcoholic is to a large extent demoralized and disintegrated. To overcome this condition a direct attack must be made on the small habits of daily efficiency. Alcohol is too strong an enemy to fight with untrained forces. To this end living by a self-made and self-imposed schedule will accomplish three very important results: (a) The individual is continuously occupied; (b) he is conscious that he is doing something concrete about his problem (in contrast to mere intellectualizing); (c) he trains himself constantly in minor ways to obey his own commands. This develops an ability to say "Yes" when he means, "Yes," and "No" when he means "No."

7. Various unexpected pitfalls into which people have previously slipped are carefully explained so that the drinker is forewarned and forearmed as much as possible against the future.

8. Some means of self—expression, some outlet or hobby to satisfy the urge to create, some means of absorbing the will—power must be energetically sought. The mind cannot dwell on the subject of not drinking all the time, important as it may be. It must be diverted, intrigued, and if possible, inspired. This does not always happen until the cure is completed, but if it can take place earlier it is a good assistance to rapid recovery.

9. The individual is only an inferior person as long as he continues to drink. The same driving force that has brought disintegration, if given a chance under conditions of sobriety, will carry him beyond the level of achievement attained by his average contemporary. He has an energy within which must be utilized constructively or it will destroy him.

What Dr. Milton Harrington says of people with strong instinctive tendencies, seems to be equally applicable to alcoholics. Instinctive tendencies, he says, "drive some upward to success, while in others, who are unable to direct them into satisfactory channels, they are dammed up, find outlet in unhealthy ways, and so, instead of doing useful work, react on the mind to distort and destroy it."

It is obvious that this method requires time and effort on the part of both therapist and patient. Peabody himself calculated that it took from 60 to 100 hours, stretched over a year or more. It is equally obvious that the patient must be not only willing, but ready to give full co-operation to such a process. Peabody defined those to whom his method was applicable as follows: .

"Scientific treatment for the eradication of the drink habit can be successfully applied to sane men who have come to realize that drink has definitely disintegrated them to a point where they are no longer able to control themselves, but who would sincerely like to eliminate the habit if they could be shown how to do so."

This is clear enough, but there is something else, which Peabody nowhere states in his book. There is an X-factor in this method, and it lies in the personal qualifications of the therapists who teach the method. Peabody was an alcoholic who had recovered through a similar method taught by Courtenay Baylor. Peabody’s followers who became therapists were men who had recovered by this method. Therein, perhaps, lies one of the secrets of the success, which the method attained. Peabody undoubtedly knew that no one else was quite as likely to have the necessary attitude of sympathetic understanding, the complete knowledge of the tortuous workings of the alcoholic mind, and the essential patience, which are primary requisites for dealing with these difficult cases. Naturally, the mere fact that a man was an alcoholic who had recovered was not enough to make him a therapist of a technique as complicated as this one; only a few of Peabody’s patients were trained by him to teach the method. But these few accomplished a heroic work during the 1930’s, when little else was being done for alcoholics.

This work showed that the Peabody Method was effective with a considerable number of alcoholics. It is still effective today with some alcoholics, for it has a particular appeal to certain types, and they and their families should know of its existence. Especially in the middle and upper income brackets there are many alcoholics who still hold jobs, who still have what they think of as "a position to keep up." These people often find it extremely difficult, if not impossible, either to consult a psychiatrist or to seek help from a group such as Alcoholics Anonymous. In the first instance they fear that going to a psychiatrist means an admission of mental weakness or abnormality; in the second, any group approach is repugnant to them, for many reasons. The reasons for such hesitations may be invalid, but are nevertheless very real barriers, which effectively prevent some alcoholics from getting the help, which they desperately need.