Harry Tiebout - Clinical Work

Clinical Work

Tiebout was on the staff of New York Hospital, Westchester Division from 1922-24. He then began work in child guidance clinics in New York City, joining the Institute for Child Guidance as staff psychiatrist shortly after it was founded in 1927. The Institute was a well-funded center for training and research, dominated by psychoanalysis and specializing in "exhaustive case histories 75 pages long." During these years Tiebout was also on the staff of Cornell Medical School and the Payne Whitney Psychiatric Clinic.

In 1935 he became medical director of Blythewood Sanitarium in Greenwich, Connecticut. Privately owned, Blythewood was situated on a beautiful, rustic 50-acre (200,000 m2) estate once owned by Boss Tweed. At its peak, it had eight main buildings, eight cottages, a chapel, a building for occupational therapy, and a small golf course. There were no bars on the windows. Artistic and cultural pursuits were encouraged as part of the therapeutic program. Although the sanitarium was primarily for care of the mentally ill, it also provided care for alcoholics.

In 1939, Tiebout received a pre-publication copy of the book, Alcoholics Anonymous. After looking it over, he gave it to one of his patients, Marty Mann. She had been at Blythewood for over a year but seemed no closer to conquering her alcohol problem than when she arrived, so he considered her a good test of whether the book had value. At first she read the book eagerly, delighted to know for the first time that there was a name (alcoholism) for what ailed her. However, she was soon repelled by the overbearingly religious message and told Tiebout that she could never accept it. Tiebout, according to Mann's biographers Sally and David Brown, quietly encouraged her to keep reading. Eventually taking the book to heart, she had an epiphany during a crisis of resentment and fury and was converted.

Other references, also based on Mann's recollections, portray Tiebout's role a little differently. They describe an ongoing verbal battle lasting several months, in which Tiebout refused to accept Marty's rejection of the book. In the end, Mann did become an active member of AA and within a few years made education about alcoholism, and promotion of alcohol-abuse treatment, her second career. With Tiebout's support, she founded the National Council on Alcoholism (NCA).

Tiebout also became a friend and supporter of AA founder Bill Wilson, providing personal psychiatric care when Wilson developed depression in the 1940s. It was largely through Tiebout's influence that Bill Wilson was invited to speak at a New York state medical society meeting and then at a meeting of the American Psychiatric Association, and had his talk published in the American Journal of Psychiatry.