It is a fact little appreciated that the presidents of America’s early universities were pioneers of what we would now call mental health care, and bear some credit for central features of today’s therapeutic institutions. These teachers, like today’s, felt an obligation to provide their students with guidance on how to overcome life’s inevitable stresses and setbacks.
But this was before the days of psychiatry and psychotherapy, which did not come into existence until the early twentieth century. Rather, the approach of these early university presidents was to integrate moral education into liberal education in the arts and sciences. Although the most highly acclaimed American colleges and universities today enjoy a reputation as secular institutions, it is often forgotten that nearly all of these schools started in the eighteenth and nineteenth centuries as seminaries under the leadership of staunchly Christian presidents, and that the therapeutic guidance they provided was given within avowedly religious contexts.
The typical centerpiece of the moral curriculum was a seminar, taught by the college president, that took up most of the senior year for undergraduate students and was designed to show them how to apply their newly acquired knowledge within a Christian context. University presidents of all denominations focused on the importance of good character and the dangers of vice and immorality.
Problems that are now thought of, at least to some extent, as mental health conditions — depression, discouragement, fear, loneliness, self-doubt, addiction, anxiety — were viewed in large part as consequences of the moral character of the students. Pursuing vengeance will depress us; a willingness to tell white lies leaves us anxious; manipulating others makes us lonely; and guilt can only be assuaged through some form of amends or atonement. Conversely, the college presidents taught their students that the proper application of moral and spiritual principles would enable them to build character and lead emotionally fulfilled and happy lives. While these principles were consistent with Christian theology, and their teaching often drew from the Books of Psalms and Proverbs, or the parables of Jesus, they were reinforced with similar observations by classical philosophers, such as Plato, Aristotle, Cicero, and Plotinus.
But students learned also that even though adherence to moral principles leads to real happiness, the immediate pleasures or advantages that come from compromising one’s values can blind us to how such actions often leave us miserable and unhappy in the end. Everybody is tempted to believe that some things are so worth having that unethical choices are justified to achieve them. By an act of great self-deception, the perceived gains overshadow the real losses.
Some are tempted by sensual pleasures, such as sex or drugs. But the list of temptations people feel also includes desires like vengefulness, masochism, and sadism, or even the self-righteous pursuit of appearing morally superior. Others compromise their values, not in pursuit of an immediate physical or psychological sensation, but for money, social position, or power. Samuel Stanhope Smith, a Presbyterian minister and the president of Princeton University from 1795 to 1812, wrote in his 1812 collection of lectures that the virtues, “when traced in all their relations, are found to form important links in the chain of general happiness. But, it is as true, that, frequently, that connexion does not immediately appear.”
Because people are not always aware of the relationship between their conduct and their emotional wellbeing yet are constantly surrounded by temptations to vice, they may even paint their sins as practical virtues and their virtues as impediments to success. This all-too-common moral failing led college presidents to insist that effective therapy required not minor adjustments to behavior but fundamental changes of character. The therapy that the senior seminars provided was not aimed at simply helping miserable students feel better in their present circumstances; instead, school presidents sought to confront the deeper moral cause of their students’ distress. Symptoms such as depression, guilt, loneliness, or indecision were seen as manifestations of specific moral and spiritual transgressions, which students needed to deliberately resist until the happiness that came with virtue made living well not only easy but intrinsically pleasurable.
For decades, many college presidents would illustrate this therapy with a particular incident from the Autobiography of Benjamin Franklin. The year was 1730, and young Franklin was still a struggling printer in Philadelphia. He had accepted the invitation of a rather dry minister to attend a series of sermons on morals, but was so put off by the first lecture that he refused to go again.
Nevertheless, the subject continued to fascinate him, and a few days later he decided — in what was perhaps the New World’s very first psychology experiment — to make a list of desirable character traits, practice them daily, and see what effect they might have on his life. This experiment was an inspired one, a Quaker friend commented, except that one virtue was notably lacking. “[He] kindly informed me,” Franklin later recalled, “that I was generally thought proud; that my pride show’d itself frequently in conversation; that I was not content with being in the right when discussing any point, but was overbearing and rather insolent.”
In spite of his initial resistance, Franklin finally agreed to give a week to humility and, deliberately censoring his most arrogant thoughts, made it “a rule to forbear all direct contradiction to the sentiments of others,” even the use of expressions “that imported a fix’d opinion: such as certainly, undoubtedly, &c.” As it turned out, the very virtue that Franklin initially neglected ended up having the most constructive impact on both his private life and public career: “And to this habit (after my character of integrity) I think it principally owing that I had early so much weight with my fellow citizens … and so much influence in public councils when I became a member.”
By his own admission, Franklin never achieved anything close to perfect humility through his experiment, but he nevertheless became “by the endeavor, a better and a happier man than I otherwise should have been, if I had not attempted it.” Viewing Franklin’s experience as a model for self-improvement, the college presidents in charge of senior seminars emphasized the importance of cultivating the virtue of humility and avoiding the sin of pride. As devout Christians, they departed from the deist Franklin’s example to some extent, instructing their students that they should let their lives be guided not by proud, individualistic self-determination but by God’s will, as discerned both personally, through intuition, and socially, through fellowship with other believers. Nonbelievers who doubted the usefulness of living in accordance with God’s will were instructed to “act as if” God existed and were promised that, with time, the emotional benefits of living spiritually would become obvious.
Within the academy, this basic prescription for earthly happiness — in the words of Williams College President Mark Hopkins, “as your character is, so will your destiny be” — reigned supreme for almost three centuries, from Harvard’s founding in 1636 until the early twentieth century. As campus populations grew to the point where it became impractical for one person to conduct a seminar for all seniors, college presidents reorganized their ideas into series of Sunday sermons, which undergraduates regularly attended.
Off campus, books based on their class outlines, chapel sermons, and lectures were widely popular from the end of the American Revolution until the First World War. These works, in turn, influenced movements ranging from Christian Science and the Salvation Army to the explosion of business-education programs emphasizing character and personal integrity. Acres of Diamonds (1890), based on a lecture by Baptist minister and Temple University founding president Russell Conwell, remains one of the most successful business self-help tracts in American history. (Temple University football players still wear diamond trim on their collars in commemoration of Conwell, and the lecture is the inspiration for the school’s mission statement.)
One of the most prominent public missions of the college presidents was the prevention and treatment of alcoholism. School leaders like Edward Hitchcock, president of Amherst from 1845 to 1854, recognized drunkenness as a major social problem and devoted their energies to both defining it as a moral sickness and supporting solutions based on character improvement. Reverend Jesse Appleton, president of Bowdoin College from 1807 to 1819, delivered the first annual discourse before the Bath Temperance Society on May 11, 1813; Jeremiah Day, president of Yale College from 1817 to 1846, became the first president of the Connecticut State Temperance Society in 1829; and many others were involved in the temperance movement across the country.
The principles of confession, moral reformation, and the surrender to divine guidance, all key features of the senior seminars, were central to a number of nineteenth-century recovery movements as well. The most prominent of these were the Washingtonian Movement of the 1840s, which claimed to have helped 600,000 alcoholics; its outgrowth, the Martha Washingtonians, a support group organized by and for relatives of alcoholics; the Independent Order of the Good Templars, a secretive society founded in 1851 that claimed more than 400,000 recovered alcoholics; and the “Red Ribbon” and “Blue Ribbon” reform clubs of the 1870s, which stressed the importance of recovered alcoholics reaching out to help those still drinking.
Spiritual approaches to health and happiness advocated by academic leaders, still very popular at the end of the nineteenth century, served as an important counterweight to the growing influence of biological determinism on social thought. While the incipient eugenics movement viewed the lesson of evolution to be that success or failure in life is genetically foreordained, the therapeutic and self-help camps continued to hold that positive life changes were within each person’s power to pursue.
Of particular note at the turn of the twentieth century is the Emmanuel Movement, which offered what might be considered the first psychotherapy programs for the general public aimed not at curing the worst psychiatric problems but at helping people who were psychologically healthy yet nonetheless unhappy. In 1905, Dr. Joseph Pratt of Massachusetts General Hospital, looking to expand access to tuberculosis treatment for Boston’s poor, enlisted the aid of the Episcopal priest Elwood Worcester, whose parish, Emmanuel Church, was soon hosting classes on the medical advantages of rest, nutrition, and fresh air. With the success of this initial project, Worcester took the lead in broadening the mission to serve the “nervously and morally diseased,” fostering collaboration between doctors at Boston-area medical schools and the Episcopal clergy to establish a church-based clinic where (alongside regular clinical offerings) trained lay therapists taught healthy people to apply spiritual and moral principles to various emotional problems.
In 1908, Worcester, along with another priest named Samuel McComb and the neurologist Isador H. Coriat, published Religion and Medicine: The Moral Control of Nervous Disorders, which went through ten printings during its first year. Worcester’s clinic prospered for more than two decades, after which he and McComb published another successful book on spiritual cures for everyday psychological problems called Body, Mind, and Spirit. Eventually, however, Worcester’s insistence on treating not only emotional but also many physical ailments from a religious perspective upset medical doctors and limited the growth of his movement.
But just as interest in the Emmanuel Movement was beginning to decline, the spiritual therapy of the old-time college presidents again resurfaced, this time in a format that eventually inspired a mass following. In 1921, an American Lutheran pastor named Frank Buchman started a loosely knit association called “A First Century Christian Fellowship” — or the “Oxford Group,” as it came to be known — which over the next two decades attracted tens of thousands of adherents worldwide. (The name “Oxford Group” originated in South Africa, when a railway porter mistook the home address of two traveling members from Oxford, England for the name of their organization. The African press perpetuated the error, and the name stuck.) Based on the premise that psychological misery stemmed from moral failing, the Oxford Group urged members to be rigorously honest in all their affairs, to confess moral and ethical lapses in meetings with other members, to refrain from judging others, to make amends for past wrongdoings, and to seek God’s guidance through meditation and by testing one’s thoughts in conversation with other Christians.
According to press accounts of the day, the Oxford Group had no official membership list, dues, paid leaders, theological creed, or regular meetings, but simply the determination of adherents to solve their personal problems by meeting locally with like-minded Christians in small groups. Wealthier members traveled the world at their own expense to stimulate interest in the movement — Buchman himself attended the 1936 Berlin Olympics in the naïve hope of “changing Nazis” — and publications from the New York World-Telegram newspaper to Good Housekeeping magazine provided favorable coverage.
But by the early 1940s the popularity of the Oxford Group began to decline, in large part because the public had begun to associate its fervor with Christian revivalism, which was viewed with some suspicion by both mainstream Protestants and Roman Catholics. (Also, in response to events in Europe, the organization was renamed Moral Re-Armament in 1938, which likely did not help to shake that association.) But the spiritual prescription it championed was already morphing into another therapeutic movement, one that harked back to the very social problem that most concerned the early college presidents: alcoholism.
An alcoholic named William Griffith Wilson, who had recovered through a spiritual experience in a New York City hospital in the early 1930s after exhausting other avenues of treatment, found that the best way to maintain his sobriety was by attending Oxford Group meetings in Manhattan. During a business trip to Ohio, he successfully used some of the techniques he had picked up at these meetings to help Robert Holbrook Smith, a doctor whom friends and family had given up as a hopeless drunk; in 1935, the two set out to create a support group, drawing on the Oxford Group’s principles, to help other alcoholics. They called their new organization Alcoholics Anonymous, or AA.
Many of the therapeutic methods developed by Wilson and Smith (known to their followers as Bill W. and Dr. Bob) were certainly different from anything those early college presidents imagined. New members were advised to attend daily meetings with other alcoholics, to find among the fellowship a guide or “sponsor” of the same sex with whom they could discuss personal problems, to eventually take responsibility for running meetings themselves, and to repeatedly discuss and practice twelve spiritual principles or “steps” considered essential to maintaining sobriety. Members were encouraged to reach out to alcoholics in their communities, but also to respect the confidence of whatever was said at meetings, lest participants be discouraged from speaking honestly.
Yet the underlying intellectual message conveyed to struggling alcoholics was remarkably similar to what an early-eighteenth-century college student would have learned in the senior seminar: turn the direction of your life over to the care of God, atone for sins of the past, strive to act morally until what seems difficult becomes easy and habitual, and sustain a spiritual fellowship with like-minded believers.
One of the striking features about AA is its development of a condensed form of self-talk, or sloganeering, to keep recovering alcoholics from drinking in stressful situations. Phrases such as “Easy Does It,” “Live and Let Live,” “One Day at a Time,” “Keep It Simple,” and “Let Go and Let God” were constantly repeated at meetings. Like many Judeo-Christian sayings derived from Proverbs and the Book of Psalms, these were aphorisms that new members often thought ridiculous, superficial, or childish, but eventually came to rely on as both useful and deeply insightful. (These sayings also owe something to the legacy of Benjamin Franklin, a prolific author of durable self-help slogans.)
It is impossible to measure precisely the psychological benefit of AA’s spiritual therapy over the eight decades since its founding. According to Bill Wilson himself, half of the alcoholics who “came to AA and really tried … got sober at once and remained that way.” But what Wilson meant by “really tried” and “remained” has never been rigorously defined.
What is clear is that Alcoholics Anonymous has been one of America’s most prominent self-help programs — and, unlike the many self-help programs that are centered on cults of personality, its popularity has only grown after the death of its founders. Based on the number of local groups registered in the organization’s 2011 directories of national and international AA meetings, there are today more than two million active participants around the world.
Perhaps even more telling of AA’s success is the number of support groups that now use its spiritual approach for emotional problems other than alcoholism. Between 1947 and 1953, independent efforts in New York, California, and Kentucky, mostly by drug addicts who had been helped in AA meetings, led to the establishment of Narcotics Anonymous, which grew from approximately 200 members in 1960 to over a quarter million in 1990. AA and NA were followed by Gamblers Anonymous, Overeaters Anonymous, and programs dedicated to issues ranging from sexual promiscuity to shoplifting. According to William L. White, author of Slaying the Dragon: the History of Addiction Treatment and Recovery in America, there are now more than 400 distinct self-help organizations in America using the AA model.
The impact of these programs also gave rise to a quietly influential network of counselors known today as the Employee Assistance Program Association. It started in the 1940s as the Occupational Alcohol Program, a loose confederation of people helping business executives recover from alcoholism. It expanded its services in the 1970s when several San Francisco Bay Area companies — including Standard Oil, the Bechtel Corporation, Pacific Gas & Electric Company, and Wells Fargo Bank — encouraged local EAP counselors to assist workers suffering from stress, family and workplace conflict, financial difficulties, and drug-related problems.
Because of their historical association with Alcoholics Anonymous meetings, most EAPs share a spiritual outlook not typically associated with psychiatrists, psychologists, social workers, and other mental health professionals, although many mental health professionals have become certified EAP counselors and joined the association. Today there are 3,000 EAP professionals serving millions of employees in more than 40 countries.
Despite the long and impressive track record of spiritually based methods for helping people deal with emotional and psychological problems, movements like the Oxford Group and the senior seminars of the college presidents are not widely recognized as important to the history of psychotherapy. Part of the reason for this neglect undoubtedly lies with the difficulty of studying and documenting any therapy that requires its beneficiaries to confess and wrestle with significant moral failings. AA and its spinoffs all emphasize the word anonymous precisely because they want to create an atmosphere that guarantees participants’ immunity from outside scrutiny and public embarrassment. This focus on personal privacy, combined with the impracticality of running a control group, precludes the kind of rigorous research many scientists would prefer to conduct.
An additional difficulty is presented by the way that self-imposed character change can sometimes produce what those who are transformed by it call, following Wilson, a “sudden spiritual awakening,” which rapidly elevates their entire moral outlook. In reflecting on his own experience, Wilson found that it resonated with similar descriptions in Harvard psychologist William James’s 1902 classic The Varieties of Religious Experience. But this kind of psychological development is hard to measure empirically.
The therapeutic legacy of the senior seminars has also remained unrecognized in part because the university presidents themselves never thought of their work as inventing anything new. While Christian theology had always been quite clear that God makes no promises when it comes to material success, it does assert a close correspondence between righteous living and emotional wellbeing: “The path of the just is as the shining light, that shineth more and more unto the perfect day” (Proverbs 4:18); “The righteous also shall hold on his way, and he that hath clean hands shall be stronger and stronger” (Job 17:9); “They go from strength to strength” (Psalms 84:7); “They shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint” (Isaiah 40:31); “I have learned, in whatsoever state I am, therewith to be content” (Philippians 4:11); “A doer of the work, this man shall be blessed in his deed” (James 1:25).
In purveying these insights, most college presidents generally avoided going beyond their denominational boundaries. Such reluctance was hardly surprising, given that the presidents were all ordained ministers. But many seem to have understood that too much streamlining could undermine essential elements of faith, even the importance of Christ himself. While organizations like the Emmanuel Movement, the Oxford Group, and others tried to abstract common therapeutic principles that were not tied directly to any specific religious creeds, these popular attempts to create a spiritual therapy independent of organized religion failed to sustain their initial following.
The striking exception to this pattern is the therapeutic model developed by Alcoholics Anonymous — perhaps because AA and its spin-offs, while not explicitly religious organizations themselves, still employed religious ideas and associated with religious institutions. Seven of the original twelve steps contained religious language, referring to God, “Power greater than ourselves,” and the goal of “spiritual awakening.” AA also worked comfortably in tandem with churches from the very beginning. In the early 1940s, the growing concern of American businesses over the number of man-hours lost to alcohol and drugs led to the creation of a summer school for alcohol studies at Yale, which annually brought together executives and physicians with members of AA to discuss treatment-related issues. Many clergymen also participated in these summer schools and played a critical role in promoting AA with their local churches and community-service organizations. One result today is that the vast majority of anonymous group meetings are held in churches, many of which view their sponsorship of these programs as the most important part of their community outreach.
With no inkling of how this legacy would play out, the early college presidents thus quite humbly saw themselves not as innovators or discoverers, but as clarifiers, showing undergraduates how the wisdom of biblical teaching was reflected throughout history: in works of ancient Greek and Roman philosophers, in the themes of great novelists and playwrights, and in the rapidly accumulating knowledge of science.
This brings us to the final and perhaps most significant reason that the history of spiritually based therapy is largely unknown: the image of Christian college presidents as a sophisticated group contributing to human progress simply does not fit with the common interpretation of American intellectual history as a triumph of secularism over narrow-minded religious prejudice.
In truth, Christian college presidents and other academic leaders were not only deeply religious, but were also champions of the scientific enterprise, establishing separate departments of physics, chemistry, biology, medicine, psychology, sociology, and engineering in the late 1800s, and fighting tirelessly to prevent state legislatures, wealthy alumni, and anti-intellectual movements from subverting academic freedom. Many of the first teachers of psychology, and of the related disciplines of sociology and social work, were themselves ordained ministers.
When in 1895 Columbia University president Nicholas Murray Butler stood before the annual meeting of the National Education Association in Denver to say that development of the soul and the mind “are two names for the same thing,” he was expressing a conviction shared by most of his peers, regardless of denomination, that religion and science both point in the same direction. In spite of their doctrinal differences, the leaders of almost every American college and university agreed with Williams College president Mark Hopkins: “If God has made a revelation in one mode, it must coincide with what he has revealed in another.”
And when ordained ministers ceased to play the dominant role in American colleges after World War I, it was not on account of their failings, but rather their very success. The effort of Christian presidents to create institutions dedicated to seeking truth in every profession had led to a proliferation of specializations in the sciences, arts, and humanities, which in turn reduced the relative influence of seminaries and departments of religion.
Education to meet the needs of modern industry, agriculture, medicine, and law had become so important that students no longer picked schools on the basis of denominational compatibility, and the rise of fraternities and sororities provided social support independent of religious fellowship. And before long, the exploding size of American colleges and universities forced trustees to stop appointing presidents from the ranks of prominent religious intellectuals and instead turn to the most capable fundraisers.
Even with the departure of the clergy from the offices of college presidents and the bracketing of seminaries within university communities, departments of psychiatry and psychology have never quite been able to eradicate the need for something like America’s early spiritual therapy. From the mysticism of Carl Jung, to Abraham Maslow’s work on the psychology of personal fulfillment, to the rise of the so-called “human potential” movement in the late 1960s, to the willingness of today’s cognitive scientists to acknowledge the importance of self-control, notions of a moral cure for emotional problems keep knocking on the academic door. They are even allowed in as long as concepts of God, Christ, and spirit are dutifully replaced with the conventional terms of psychotherapy, such as transpersonal, individuation, self-actualization, and peak experience.
If modern psychology has any practical reason to ignore the therapeutic wisdom of the old-time college presidents, it has less to do with their supposed intellectual inferiority than with the fact that the basic elements of their model — a long-term commitment to moral reform, a community of supportive peers, and a thoroughgoing reorientation of one’s life — are difficult to finance within the current medical system.
The brief exception that proved this rule occurred during the late 1970s, when the willingness of insurance companies to cover treatment programs for alcoholism and other addictions led to an explosion of hospital-based and freestanding programs. According to William L. White’s research, the number of private for-profit treatment centers increased 48 percent between 1979 and 1982 and an astonishing 475 percent between 1982 and 1990. Although most of these programs featured low-cost anonymous group meetings, the infrastructure of doctors, psychologists, and social workers cost more than the insurance providers could handle without prohibitive premium increases. When insurers used the idea of “managed care” to severely limit coverage for psychotherapy in the early 1990s, spiritual therapy for addictive and emotional disorders returned to church basements, where it still flourishes.
The college presidents who championed the principles of character and surrender to a divine calling lived in times of rapid technological advancement, changing social customs, and growing uncertainty about the ultimate meaning of life. Our day, of course, is not so different — and though the contribution of these academic leaders has been largely forgotten, their spiritual approach continues to help millions struggling with the eternal temptations, troubles, and torments of human life.
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Character Formation and the Origins of AA