absolute certainty of the grave. Therefore, it becomes increasingly obvious that surrender is a sensible as well as a brave choice in this particular battle. Retrospectively, from a distance of some years after that final surrender, people who have fought and lost the battle against neurotransmission disease and finally accepted the need to surrender, come to see that it was the most sensible decision they ever took in their lives. What on earth had been the point of continuing to use addictive substances and processes that were so damaging? Why on earth did they ever believe that these substances and processes could have been so vital, so central to life itself? Why did they ever need to binge or starve, use alcohol or drugs? None of these things is of any fundamental i mportance to a happy life - but that recognition comes only retrospectively. At the time of surrender there is no such balanced perspective: addictive substances and processes really do seem at that time to be a central necessity of life. This is precisely why surrender is delayed for so long and why it is such a courageous act when its necessity is finally acknowledged.

Many people in the Anonymous Fellowships who work a Twelve Step programme, in relation to one addictive substance or another, may do so sincerely and determinedly yet still resist surrender to the battle against neurotransmission disease itself. They may be prepared to give up one substance but still be reluctant to acknowledge that they have to give up all the addictive substances and processes that affect them. They believe that they have done enough - or at least as much as could be reasonably expected of them - and they don't see why they should give up even more of their limited "pleasures". This "stinking thinking", as it is known in Alcoholics Anonymous, inevitably eventually leads back to relapse. Ultimately they need to examine whether it is worth having "pleasures" that can be so destructive. Is there really nothing else in life that can provide real pleasure without at the same time risking everything one holds dear?

We have a strange society in this respect: alcohol, nicotine, caffeine and sugar are often thought to be not only pleasurable but also necessary. Looked at dispassionately, this attitude is utterly bizarre. What about friendship? What about a love of literature and the arts? What about the innocence and beauty of spending time with children? All these things can be tragically put at risk when people think of mood-altering substances and processes as "pleasures" or "necessities". Ultimately there is a straight choice: to be chronically ill or chronically well. The rewards of working a Twelve Step programme are immense. Not only does one avoid the negative consequences of using mood-altering substances and processes, one gains a vast amount of time and opportunity for focused attention upon things that give real pleasure in life. In this respect, sufferers from neurotransmission disease are uniquely blessed in having a chronic illness from which full remission on a day-today basis is possible. The sufferers from rheumatoid arthritis, disseminated sclerosis, ankylosing spondylitis, motor neurone disease and even diabetes or psoriasis would be glad to know that they had the possibility of just one day of remission from their chronic illnesses.