The Doctor's Opinion—Considerations—SA-adjusted version

The page number is that in the Big Book, fourth edition. The number after the colon is the paragraph number. 0 denotes the run-on of a paragraph starting on the previous page at the top of the page in question.

Read through the Doctor's Opinion to get an overview.

Say this prayer (or something that expresses the same idea, if you don't believe in God—perhaps resolve to be open-minded):

"God, I hereby renounce all preconceived opinions; please set aside for me my present habits of thought and my present views and prejudices; please jettison anything and everything that can stand in the way of my finding the truth; remove my fear of public opinion and of the disapproval of relatives or friends; help me see that my most cherished beliefs may be mistaken and that my ideas and views of life may be false and in need of recasting. Let me start again at the very beginning and learn life anew."

Before you begin, make a list of the types of sexual behaviour that are causing a problem because you are engaging in them excessively or at all, despite negative consequences:
  • Fantasy
  • Flirting or hunting for sex
  • Use of dating/hook-up apps
  • Masturbation
  • Porn
  • Fetishes
  • Predatory or pressurising behaviour
  • Sex with negative consequences
  • Other: ___________
We’re going to call this ‘acting out’.

Now consider these:

xxv:6 "I personally know scores of cases who were of the type with whom other methods had failed completely."


What else have you tried to stop acting out? What else have you tried to sort out your life?

xxvi:5 "It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact, to a considerable extent with some of us. But we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete."


xxx:5 "All these, and many more, have one symptom in common: They cannot start drinking without developing the phenomenon of craving. This phenomenon, as we have suggested, may be the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity. It has never been, by any treatment with which we are familiar, permanently eradicated. The only relief we have to suggest is entire abstinence."


The 'allergy' is the abnormal reaction—one not shared by healthy people—of habitually acting out more than you intend once you start.
When you start acting out, do you act out more than you intended?
Could this be because you were unhappy, deluded, or couldn't think straight?
Did you also act out when you weren't unhappy or deluded and could indeed think straight?
I continued acting out, regardless. What about you?

xxvii:6 "We doctors have realized for a long time that some form of moral psychology was of urgent importance to alcoholics, but its application presented difficulties beyond our conception. What with our ultramodern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge."


Can you think your way out of your acting out and / or problems?
Do you need a power of good / God in your life?

xxvii:8 ". . . the Power which pulls chronic alcoholics back from the gates of death."


Can you see how your acting out might kill you?

xxviii:1 ". . . We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve."


NB if the craving ever occurs, you're probably an addict.

Have you lost self-confidence? When?
Have you lost your reliance upon things human? When?
Have your problems piled up on you? When?
Have they become astonishing difficult to solve? When?

xxviii:4 "Men and women drink essentially because they like the effect produced by alcohol. The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one. They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few drinks - drinks which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to drink again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery."


What did acting out do for you?
Did you repeatedly return to the acting out even when acting out didn’t work or caused terrible consequences?
Are you restless, irritable, and discontented?
Can you see you need a solution to these if you are going to stay clean?

xxix:3 "Many types do not respond to the ordinary psychological approach."


Have an intellectual understanding of your problem plus common-sense tips kept you clean?

Wrap-up questions

44:1 "If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, . . .


When you honestly want to, can you quit entirely?
When you act out, do you have little control over how long you act out for or what you do?

44:1 . . . you are probably alcoholic. If that be the case, you may be suffering from an illness which only a spiritual experience will conquer."


That is the bad news. This is the good news:

xxix:1 "On the other hand—and strange as this may seem to those who do not understand—once a psychic change has occurred, the very same person who seemed doomed, who had so many problems he despaired of ever solving them, suddenly finds himself easily able to control his desire for alcohol, the only effort necessary being that required to follow a few simple rules."


The simple rules are getting a sponsor, working the steps, and having fellowship with other addicts and service in your life.