# What is the "spiritual malady"?

**In short:**
- The phrase is used once in the 1939 program text (pp. 1–164), on page 64, at the start of the Fourth Step inventory: "When the spiritual malady is overcome, we straighten out mentally and physically." (p. 64)
- In place, it's tied to resentment. The sentence before says of resentment, "From it stem all forms of spiritual disease" (p. 64).
- The passage adds the spiritual to the mental and physical; it doesn't replace them: "we have been not only mentally and physically ill, we have been spiritually sick" (p. 64).
- The book doesn't define the phrase further. The pages around it describe the sickness as self-centredness showing up as resentment and fear (pp. 62–68), and the remedy as the inventory and the Steps that follow.

## The sentences, in order (p. 64)

The book has just said that self was what defeated us, and turns to its "common manifestations" (p. 64). Then, in four sentences:

1. "Resentment is the 'number one' offender." (p. 64)
2. "It destroys more alcoholics than anything else." (p. 64)
3. "From it stem all forms of spiritual disease, for we have been not only mentally and physically ill, we have been spiritually sick." (p. 64)
4. "When the spiritual malady is overcome, we straighten out mentally and physically." (p. 64)

So "the spiritual malady" in sentence 4 points back to the "spiritual disease" and being "spiritually sick" of sentence 3, which the book says stems from resentment.

## What the sickness looks like in the pages around it

- **Its root is self.** Two pages earlier: "Selfishness—self-centeredness! That, we think, is the root of our troubles." (p. 62)
- **It cuts a person off.** Harbouring resentment, "we shut ourselves off from the sunlight of the Spirit" (p. 66), and "The insanity of alcohol returns and we drink again." (p. 66)
- **Fear runs through it.** "This short word somehow touches about every aspect of our lives." (p. 67)
- **It isn't only alcoholics who have it.** The book asks the reader to see that the people who wronged us "were perhaps spiritually sick" (p. 66), and "they, like ourselves, were sick too" (p. 67).

## "Malady" elsewhere in the book

Everywhere else in the main text, "malady" means alcoholism itself. Chapter 2 says that once "this malady has a real hold," drinkers are baffled (p. 23). Chapter 7 tells the helper to speak of alcoholism "as an illness, a fatal malady" (p. 92). Chapter 10 talks about explaining "alcoholism, the malady" to an employer (p. 138). The Foreword to the Second Edition (1955) says Dr. Bob began "to pursue the spiritual remedy for his malady" (p. xvi). Page 64 is the one place in the program text where the word is qualified as "spiritual." (One fourth-edition personal story, "A Vision of Recovery," uses the phrase too: the member writes that "the spiritual malady should be my main concern" (p. 499). That's a member's account from the stories, which change by edition, not the 1939 text.)

## Is alcoholism a "spiritual malady"?

The book doesn't use those words. What it says about alcoholism as a whole, to a reader who finds he can't quit or can't control the amount, is that "you may be suffering from an illness which only a spiritual experience will conquer" (p. 44), and that it is an illness of body and mind (p. xxvi). On p. 64 it says that underneath the mental and physical illness there was a spiritual one, and that dealing with that one straightens out the others.

The book is careful not to make that a cure. It makes room for medical help: although the members work out their solution "on the spiritual as well as an altruistic plane" (p. xxvi), they "favor hospitalization for the alcoholic who is very jittery or befogged" (p. xxvi). And after the Steps, "We are not cured of alcoholism." (p. 85)

## How it's overcome

The book doesn't give a separate method for the spiritual malady. The sentence sits at the start of the inventory, and what follows is the inventory itself: listing resentments, seeing the people involved as sick, praying, finding our own part, and looking at fear and sex conduct (pp. 64–70). After that come the Fifth through Ninth Steps in Chapter 6. See *How does the Big Book say to do Step 4?*

## Does context change the common reading?

It confirms that the book puts a spiritual sickness beneath the drinking. It complicates the shorthand "alcoholism is a spiritual malady." In the program text, the phrase is used once. It's tied to resentment and self, and it's named *alongside* being mentally and physically ill, not instead of them.

## Read it yourself
- Chapter 5, "How It Works" (pp. 58–71), free from A.A.: https://www.aa.org/sites/default/files/2021-11/en_bigbook_chapt5.pdf
- "The Doctor's Opinion" (pp. xxv–xxxii): https://www.aa.org/sites/default/files/2021-11/en_bigbook_foreworddoctorsopinion.pdf
- Related: *What does the Big Book mean by alcoholism as an illness?* · *Where is "resentment is the number one offender," and what does it mean?* · *Does the Big Book say alcohol is "but a symptom"? Is drinking the real problem?*
- The full book, *Alcoholics Anonymous*, is sold by A.A. World Services at https://onlineliterature.aa.org.

## Sources
| Source | Pages | First published |
|---|---|---|
| *Alcoholics Anonymous*, Chapter 5, "How It Works" | 62–70 | 1939 |
| *Alcoholics Anonymous*, "The Doctor's Opinion" | xxvi | 1939 |
| *Alcoholics Anonymous*, Chapters 2, 4, 6, 7 and 10 | 23, 44, 85, 92, 138 | 1939 |
| *Alcoholics Anonymous*, Foreword to the Second Edition | xvi | 1955 (after 1950) |
| *Alcoholics Anonymous*, personal story "A Vision of Recovery" (Part III) | 499 | personal story in the fourth edition (2001) |

Big Book page numbers are from the fourth edition (2001). The Preface says the program text "has been left largely untouched" since 1939 (p. xi); our sources have no first edition to compare page numbers against.

*Recovery Starts is independent and not affiliated with Alcoholics Anonymous. Quotations are brief and cited; the Big Book is © A.A. World Services, Inc.*