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Illustration · A statistician’s desk on a rainy day in 1945, with returned Grapevine questionnaires, a tally sheet and a desk calculator. Not drawn from a photograph.

New Haven and New York · 1945–1960

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AA’s magazine printed thirty-six questions, and the answers of 98 men became E. M. Jellinek’s phases of alcoholism.

“Big Light Can Be Shed on Alcoholism If A.A.s Fill This In and Return to Grapevine”

Headline over a questionnaire on the Grapevine’s front page · AA Grapevine, April 1945

Thirty-six questions

In April 1945 the Grapevine, AA’s monthly magazine, not yet a year old, gave its front page to a questionnaire under that headline. It listed thirty-six experiences, from “Get drunk?” and “Experience a blackout?” to “Reach what you regard as your lowest point?”, and asked readers to give the age at which each first happened. It didn’t say who wrote it.

The editors asked E. M. Jellinek of Yale, one of the two scientists on the Grapevine’s first front page, to “prepare a statistical analysis of the data.” The magazine had “a circulation of about 1,600 copies,” he wrote, and 158 forms came back. He set aside fifteen from women, seventeen that didn’t give the ages, and twenty-eight from one AA group whose members had “pooled their information and recorded their averages only.” That left “only 98 questionnaires of male alcoholics.”

From the men’s ages he drew a drinking history in phases, from a “prodromal phase” through a “basic phase,” marked by loss of control as the questionnaire defined it, to a “terminal phase.” Loss of control meant that in a drinking situation “he cannot stop at one or two drinks, but usually ends up drunk.” Yale’s Quarterly Journal of Studies on Alcohol printed his paper in 1946.

He warned about the numbers himself. “Such a small return gives rise to surmise on the possible selectiveness of the sample,” he wrote. In 1952 he redrew the phases from a fuller questionnaire “administered to over 2000 male alcoholics,” as the alcohol studies archive at Rutgers University puts it, and published them for the World Health Organization.

In 1960 his book The Disease Concept of Alcoholism described a variety of “alcoholisms,” only two “species” of which, as the historian William White sums it up, he thought “merited the designation of disease.”

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In the Grapevine

Thirty-six questions

How a circulation of about 1,600 became 98 men, and the ages those men gave.

Figures from Jellinek’s paper, “Phases in the Drinking History of Alcoholics” (1946); the questions as the Grapevine printed them. The ages are his averages.

CirculationJellinek’s figure for the Grapevine: “about 1,600 copies”

1,600

Forms sent backAbout one in ten

158

CountedMen, each answering for himself, with the ages filled in

98

Set aside: 15 forms from women, 17 that didn’t give the ages, and 28 from one group whose members pooled their answers.

The average man, question by question

Seven of the thirty-six questions, as printed, and the average age at which the 98 men said each first happened.

  1. No. 1“Get drunk?”18.8
  2. No. 2“Experience a blackout?”25.2
  3. No. 4“Begin to lose control of drinking?”27.6
  4. No. 7“Attempt to control your drinking by going on the wagon?”30.7
  5. No. 13“Start going on benders?”31.8
  6. No. 24“Have to be hospitalized as a result of drinking?”36.8
  7. No. 36“Reach what you regard as your lowest point?”40.7

Not every man answered every question: 60 had been hospitalized, and 80 had tried the wagon.

His own warning

Ninety-eight men, all of them in AA, gave these ages. “Interpretation of the data must be limited, therefore,” Jellinek wrote, “to alcoholics of the same types as those which populate Alcoholics Anonymous groups,” though he thought the sequence “may nevertheless be applicable to a fair majority of alcoholics.”

For a closer look

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Which issue the questions ran in and who wrote them, and a second list that reached newcomers; who drew the curve; and the kinds of alcoholism Jellinek counted as diseases.

Who wrote the questions

The questionnaire is on page one of the Grapevine’s April 1945 issue, Volume I, Number 11, in the scan used for this page. Jellinek’s paper says the magazine “published in its May 1945 issue a questionnaire designed for members of Alcoholics Anonymous.” The May issue, as scanned, has none.

Nobody signed it. Jellinek writes of “the designers of the Grapevine questionnaire,” and faults parts of their design. The Rutgers archive says it was “designed by and given to members of Alcoholics Anonymous.” The historian Ron Roizen guesses, by his own account, that Marty M., who had founded the National Committee for Education on Alcoholism the year before, “in all probability” designed it and gathered the answers. (People Like You tells her story.)

Another list went round AA in those years, and it came with a source attached. Sometime between 1948 and 1955, the intergroup office of New Jersey’s groups printed a pamphlet for newcomers, At Last A.A. It told them that “Both medicine and psychiatry are in accord that Alcoholism is a disease,” and gave them thirty-five yes-or-no questions, from “Do you require a drink the next morning?” to “Is drinking disturbing the harmony of your life?” The questions “WERE NOT formulated by ALCOHOLICS ANONYMOUS,” it said in capitals, but were the guide used by “JOHN HOPKINS UNIVERSITY HOSPITAL.”

One yes was a warning, two made it likely, and “to three or more you definitely are an alcoholic.” A 1961 report of Maryland’s Commission on Alcoholism credits Dr. Robert V. Seliger, a psychiatrist at Johns Hopkins, with “a liquor test consisting of 35 questions” for early signs of chronic alcoholism, in a guide for social workers of 1945. The pamphlet names no author.

The curve

The chart known as the Jellinek curve isn’t all his. Jellinek’s phases of 1952 ran one way, down. Max Glatt, a doctor who founded the alcoholism unit at Warlingham Park Hospital in England, noticed that his former patients described much the same recovery after they left, and added a climb back up. He published it in the British Journal of Addiction in July 1958. The curve kept Jellinek’s name out of respect, the Rutgers archive says.

Jellinek had first sketched the phases as a chart by 1950, for Yale’s summer school of alcohol studies. Rutgers’s archivists call that first sketch “Bunky’s Doodle,” after his nickname.

Two species

The Disease Concept of Alcoholism was published in 1960 by Hillhouse Press, the publisher for Yale’s Center of Alcohol Studies, on behalf of the Christopher D. Smithers Foundation. It named its kinds of alcoholism with Greek letters. The two it counted as diseases were gamma, marked by loss of control, an “inability to stop” once drinking has begun, and delta, by an “inability to abstain,” as three researchers summed them up in 1967.

Already in 1952, the Rutgers archive notes, the progression of phases “only applies to the class of alcoholics called ‘alcohol addicts.’” By 1960 he called them gamma alcoholics.

White called the book “the most widely cited (and least read) literary artifact of the modern alcoholism movement.”

Sources
  • AA Grapevine, June 1944, page 1 (the first issue).
  • AA Grapevine, Volume I, Number 11, April 1945, page 1, from the scan at silkworth.net.
  • E. M. Jellinek, “Phases in the Drinking History of Alcoholics: Analysis of a Survey Conducted by the Official Organ of Alcoholics Anonymous,” Quarterly Journal of Studies on Alcohol 7 (1946), pp. 1–88, from the copy at aaagnostica.org.
  • Judit Hajnal Ward, “From the CAS Archives: Phases of ‘Phases of Alcohol Addiction’ – The story behind Bunky’s Doodle,” Alcohol Studies Archives, Rutgers University, December 26, 2012 (sites.rutgers.edu).
  • “Jellinek Curve,” Alcohol Studies Archives digital exhibit, Rutgers University Libraries (exhibits.libraries.rutgers.edu).
  • Max M. Glatt, “Group therapy in alcoholism,” British Journal of Addiction 54, no. 2 (July 1958).
  • Juan Marconi, Klaus Fink and Laura Moya, “Experimental Study on Alcoholics with an ‘Inability to Stop,’” British Journal of Psychiatry, 1967 (cambridge.org).
  • Judit Hajnal Ward, “The ‘Disease Concept’ at the Alcohol Archive,” Alcohol Studies Archives, Rutgers University, April 26, 2023 (sites.rutgers.edu).
  • William L. White, “The Rebirth of the Disease Concept of Alcoholism in the 20th Century,” Counselor 1, no. 2 (2000), pp. 62–66, from the author’s papers at chestnut.org.
  • Ron Roizen, “What Time Do You Want it to Be? Finessing Science, Part Two,” Points, May 28, 2011 (pointshistory.org).
  • At Last A.A. Intergroup Office, A.A. Groups of New Jersey, Newark, undated (between 1948 and 1955). Pages 3 and 7, from photographs of a copy by Recovery Collectibles.
  • Maryland Commission on Alcoholism, Annotated List of Past Activities on Alcoholism in Maryland, 1935–1960, February 17, 1961, Appendix I (Robert V. Seliger and Victoria Cranford, A Guide on Alcoholism for Social Workers, 1945), Maryland State Archives (msa.maryland.gov).