alcoholics anonymous

Alcoholics Anonymous (AA) is an international community of people claiming to be "alcoholics," who meet in groups. AA calls itself a "spiritual" program, and has roots in the oxford movement, a protestant group originally from oxford, england. A.A. was the first twelve-step program and was the source and has been the model for all similar recovery groups such as Gamblers Anonymous, Emotions Anonymous, Narcotics Anonymous, Sexaholics Anonymous, Sex Addicts Anonymous, Overeaters Anonymous, and Al-Anon/Alateen, among others.

A.A. teaches that to recover an alcoholic should abstain completely from alcohol.^[1] and offers a community of recovering people who help each other and "work" the twelve steps.

Alcoholics Anonymous is exclusively run by people who identify as alcoholics (aside from 7 out of 21 members of the A.A. Board of trustees who are listed as “nonalcoholic friends of the fellowship”^[2]). It meets in small groups around the country, and although it has a central communication office, each group is essentially autonomous of the others. Although it has been proven that A.A. is not more effective than the spontaneous recovery rate of alcoholics, A.A. members generally believe that it has a high success rate, which they attribute to their opinion that a recovering alcoholic has a special ability to bond and provide insight into the necessity of sobriety to the alcoholic.^[3]

History and development

Until the mid-1930s, alcoholics who did not have the financial means to hire a psychiatrist or admit themselves to a private sanitarium could find help only at state hospitals, in jails, or through street ministries.^[4] The founding of Alcoholics Anonymous marked the first approach to supporting the sustained recovery of the alcoholics, regardless of their financial standing.

A.A. was started by two alcoholics who first met on May 12, 1935. One was Bill Wilson, a New York Wall Street stock speculator; the other was Dr. Bob Smith, a medical doctor and surgeon from Akron, Ohio. In A.A. circles, the former is known as "Bill W." and the latter, "Dr. Bob."

Wilson had been sober for six months when he met Smith, although he had struggled with sobriety for years. In that time he had made several important discoveries about his own alcoholism.

First, he had learned from a New York doctor, William Duncan Silkworth, that alcoholism was not simply a moral weakness. Silkworth told Wilson that, in his view, alcoholism was akin to an allergy, in the sense that it produced abnormal reactions to alcohol that were not observed in non-alcoholic drinkers. A "phenomenon of craving" -- with the first drink the alcoholic finds it very difficult to stop. In addition, Dr. Silkworth theorized that alcoholics had a mental obsession that gave them reasons to return to alcohol after periods of sobriety, even knowing that they would then develop overwhelming cravings. This "double whammy" (as he called it) meant that the alcoholic could not stop once started, and could not stop from starting again. This explained the enormous recidivism rate of alcoholics.

Wilson also discovered that some alcoholics were able to recover on a spiritual basis. In one of their many discussions during Wilson's hospitalization at Towns, Silkworth had also informed Wilson that he could be healed by the Great Physician. By this, Silkworth meant Jesus Christ--advice Silkworth had also given to other patients, as Dr. Norman Vincent Peale recounts in his story about Charles in The Positive Power of Jesus Christ. This approach had been used by one of Wilson's old drinking buddies, Ebby Thacher, to stop drinking. Thacher had learned about the spiritual approach from Rowland H., an American business executive and alcoholic who had undergone treatment with the famous Swiss analytical psychologist Dr. Carl Jung. After a prolonged and unsuccessful period of therapy, Jung told Rowland that his case, like that of most alcoholics, was nearly hopeless. Rowland was horrified and begged Jung to tell him anything that might help. Jung replied there was only one hope: a genuine spiritual conversion experience. History, he said, had recorded isolated examples of recovery from alcoholism that appeared solely attributable to the spiritual conversion of the alcoholic. He told Rowland to seek out a conversion experience.^[5]

Rowland H. returned to America, became a member the Oxford Group. Rowland mastered their life-changing techniques and overcame alcoholism. The group was a self-styled first-Century Christian movement founded by Frank Buchman, a protestant evangelist, about 1919. It advocated finding God through moral inventory, confession of defects, restitution, reliance upon God, and helping others. It appeared, from the successes of several alcoholics in the Oxford Group that a conversion experience (which they chose to call a spiritual experience) would relieve alcoholics of the mental obsession that kept sending them back to alcoholism after periods of sobriety. Wilson later (Alcoholics Anonymous comes of age, New York: Harper; 1957, p. 39) credited A.A.'s ideas of self examination, acknowledgement of character defects, restitution for harm done, and working with others, to the teachings of Wilson's friend, Rev. Samuel Moor Shoemaker and the Oxford Group. Later in an article published in A.A.'s Grapevine, Wilson said that every idea in Steps Three through Twelve came directly from Shoemaker's teaching.^[6]

Following one of Wilson's relapses, he returned to the hospital where he was sedated and detoxified. He prayed in bed during his recovery: "If there be a God, will He show himself! The result was instant, electric, beyond description. The place seemed to light up, blinding white. I knew only ecstasy and seemed on a mountain. A great wind blew, enveloping and penetrating me. To me, it was not of air, but of Spirit. Blazing, there came the tremendous thought. 'You are a free man.' Then the ecstasy subsided. I now found myself in a new world of consciousness which was suffused by a Presence. One with the universe, a great peace stole over me." Wilson exclaimed: "So this is the God of the preachers."^[7]

Wilson questioned whether he had a genuine religious experience (see also peak experiences) or was on the verge of madness. Dr. Silkworth advised him that "hopeless alcoholics" sometimes report conversion experiences before being "turned around" toward recovery. He referred Wilson to William James' Varieties of Religious Experience and directed him to Lectures IX and X, dealing with conversion. James states in the first paragraph of Lecture IX, "To be converted, to be regenerated, to receive grace, to experience religion, to gain an assurance, are so many phrases which denote the process, gradual or sudden, by which a self hitherto divided, and consciously wrong, inferior and unhappy, becomes unified and consciously right, superior and happy, in consequence of its firmer hold upon religious realities. This at least is what conversion signifies in general terms, whether or not we believe that a direct divine operation is needed to bring such a moral change about." Lecture VIII, "The Divided Self" also refers to the condition before conversion. In When A.A. Came of Age, Wilson states that Dr. Silkworth "reminded me of Professor William James's observation that truly transforming spiritual experiences are nearly always founded on calamity and collapse."

Wilson could hardly have escaped reading the dramatic tales of other alcoholics' conversions at the altar of rescue missions. And, in fact, it was Bill's friend Ebby who had first gone to Calvary Rescue Mission and knelt at the altar, concluding: "I've got religion." Wilson in turn went to Calvary Rescue Mission, listened to the hymns, Bible reading, and testimonials and then went to the altar himself. Wilson himself twice wrote in his autobiographical manuscripts: "For sure, I'd been born again;" and wrote a letter stating he too had "got religion."

In keeping with practices in the Salvation Army, the Missions, and the Oxford Group itself, Wilson bought into the slogan: "You have to give it away to keep it." Importantly, Wilson found that his own sobriety seemed to grow stronger when he shared his personal alcoholic experience with other alcoholics. Wilson was on the verge of a relapse on a business trip to Akron. In a hotel lobby, he decided to phone local ministers and ask if they knew of alcoholics he could talk to. Dr. Smith's little group of Oxford Group people and alcoholic families had been praying for Smith's healing. And Wilson's phone call to Henrietta Seiberling caused her to exclaim, "You are manna from heaven." And she introduced Wilson to Smith. Had it not been for Wilson's decision to reach out to a fellow sufferer, AA would not exist today.

These were the ideas that he presented to Smith, who had been struggling with his own chronic drinking addiction. The two struck up a solid friendship. For three months, they studied the Bible, held long discussions, and reviewed Oxford Group ideas. Together they fashioned Akron's pioneer recovery program. Smith's last drink is said to have been June 10, 1935, and that is considered within A.A. to be the date of the founding of A.A. Their first publication in 1939, Alcoholics Anonymous, the first 164 pages, have been a perennial best-seller. The fellowship began to be called "Alcoholics Anonymous" after the publication of this book. Given this start, it is no surprise that A.A. groups and members are frequently called "Friends of Bill W."

The AA Grapevine is the international journal of Alcoholics Anonymous. It is written, edited, illustrated, and read by A.A. members and others interested in the A.A. program of recovery from the disease of alcoholism.

The growth of A.A., especially in its early years, was striking. In 2002, the General Service Office of Alcoholics Anonymous reported more than 100,000 A.A. groups in 150 countries, with a total membership of approximately two million alcoholics.

How the A.A. program works

Some members believe that A.A's success lies in the sense of support its members gain from attending regular meetings. Far more members, as well as A.A's literature, hold that the essence of the program is having a "spiritual awakening" [originally called a spiritual experience] through the application of the Twelve Steps. The process of working the Steps is sometimes summed up as "Trust God, clean house, and help others." (See twelve-step program for a list of the steps themselves.) One great description of meetings comes from Dr. W.W. Bauer who spoke for the American Medical Association in 1946 when he stated " Alcoholics Anonymous are no crusaders: not a temperance society. They know that they must never drink. They help others with similar problems...In this atmosphere the alcoholic often overcomes his excessive concentration upon himself. Learning to depend upon a higher power and absorb himself in his work with other alcoholics, he remains sober day by day. The days add up into weeks, the weeks into months and years (Alcoholics Anonymous, Appendix III p 570)."A.A. members are encouraged to "work the Steps", usually with the guidance of a voluntary sponsor. (A sponsor is a more experienced member who has worked the Steps before.) The Steps are designed to help the alcoholic achieve a spiritual, emotional and mental state conducive to lasting sobriety. Many A.A. members believe finding God through the application of the Steps has freed them entirely from the urge to drink alcohol. Whereas staying sober was once difficult and uncertain, these members report that sobriety is now much easier, provided they keep enlarging their spiritual life.

Some members regard attendance at A.A. meetings as important to their sobriety (although there are groups in A.A. made up of loners and members living in remote locations who communicate by mail and internet). Many members who achieved initial sobriety through AA have completed their return to life and no longer participate in meetings, however most studies done show that regular meeting attendance significantly improves the chances of continued sobriety.

With the above in mind, a typical individual program of recovery for a newcomer may include:

• Above all, avoiding the first drink.
• Attendance at one or more meetings daily for 90 days or longer. Some people coming into A.A. have attended meetings daily for the first year. While this recommendation is found nowhere in A.A. literature, it is often heard in meetings and many sponsors, having attended "90-in-90" themselves as newcomers, strongly advise sponsees to do the same. Some suggest that this recommendation may have originally come out of treatment centres; graduating patients were advised to attend many A.A. meetings, presumably in an effort to acquire a new peer group of abstinent friends to reinforce the effects of treatment. Within A.A., this is referred to as "staying away from slippery people and slippery places" or "changing playgrounds and playmates".
• Contact with one's sponsor daily in order to work the Steps and to discuss whatever problems one may be having in one's life, problems which may, if not addressed, lead the alcoholic to take the first drink: "One [drink] is too many and a thousand [drinks] never enough."
• Daily prayer and/or meditation, as suggested by Step 11: "Sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of his will for us and the power to carry that out."
• Daily attention to Step 10: "Continued to take personal inventory and when we were wrong, promptly admitted it."
• Service work, which, for the newcomer, can be as uncomplicated as making coffee at meetings, helping to set up and break down tables and chairs, etc.

It will be noted that the program is to be worked daily. Dr. Bob cited the Sermon on the Mount for the phrase 'one day at a time.' Members of AA frequently say, "I'm a winner today, no matter what happens, as long as I don't pick up that first drink."

A common feature of A.A. meetings is that members are asked to speak to the group about their experience with alcoholism and recovery. However, there is no requirement to speak. Some members speak every time they are asked; others simply sit and listen in meetings for years before they say anything; some may choose never to speak.

A.A. does not charge membership fees to attend meetings, but instead relies on whatever donations members choose to give to cover basic costs like room rental, coffee, etc. Contributions from members are limited to a maximum annual amount. At the local level, A.A. groups are self-supporting and not a charity. At the national level, A.A. is not self-supporting. About half of its sustenance comes from sales of the literature, mostly written by Wilson, and for which he received royalties. Local groups contribute to the national level. It accepts subsidies, as well, from two non-A.A. sources: literature sales to non-AA entities as well as cash from AA convention sites.

A.A. receives proceeds from sale of its book Alcoholics Anonymous along with other A.A. published books and literature, which are periodically reviewed from a cost standpoint. Revenues from literature sales constitute more than 50% of the income for the General Service Office.

Beliefs about alcoholism

- In the article Alcoholics Anonymous and the Disease Concept of Alcoholism, noted A.A. historian Ernest Kurtz, PhD.,[2] wrote, "The closest the book Alcoholics Anonymous comes to a definition of alcoholism appears on p.44, at the conclusion of the first paragraph of the 'We Agnostics' chapter, where we are told that alcoholism 'is an illness which only a spiritual experience will conquer'."[3]. In 1960 Bill Wilson gave a speech to the National Catholic Clergy Conference on Alcoholism[4]. During the ensuing question and answer discussion Wilson was asked why he did not use the term disease when he spoke of alcoholism in that speech. He replied,

"We AA's have never called alcoholism a disease because, technically speaking it is not a disease entity. For example there is no such thing as heart disease. Instead there are many separate heart ailments, or combinations of them. It is something like that with alcoholism. Therefore we do not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Therefore we always call it an illness, or a malady, -- a far safer term for us to use."[5]

Although A.A. lacks an official, singular definition of alcoholism William Duncan Silkworth, M.D. contributed the chapter in the A.A. basic text of Alcoholics Anonymous entitled "The Doctor's Opinion". That chapter would become one of the more influential pieces in A.A. thought. He wrote "...they had one symptom in common: they cannot start drinking without developing the phenomenon of craving, this phenomenon, as we have suggested, may be the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity. (Alcoholics Anonymous 4th ed. pxxx)" That allergy takes the form of a craving which is explained earlier in the chapter when he states "the phenomenon of craving is limited to this class [alcoholics] and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it...(AA xxviii)" Alcoholics Anonymous offers a solution that will create a "spiritual experience" or complete change in the persons outlook on life and alcoholism (aa apendixII p. 567).

Structure

The affairs of A.A. are governed broadly by A.A.'s Twelve Traditions. A.A. has a minimal amount of organized structure. There is no hierarchy of leaders and no formal control structure. These traditions were set out because of the experience of the groups in the first 13 years of organization. Through trial and error the Twelve Traditions where set into place as suggestions for organizing the fellowship.(see Twelve Steps/Twelve Traditions for more information). People who accept service positions within the Fellowship are known only as "trusted servants." Individual A.A. members and groups cannot be compelled to do anything by "higher" A.A. authorities. Each A.A. group, small or large, is considered a self-supporting and self-governing entity. A.A. does maintain offices and service centres which have the task of co-ordinating activities like printing literature, responding to public enquiries and organizing state or national conferences. These offices are funded by local A.A. members and are directly responsible to the A.A. groups in the region or country they represent. (For more information, see A.A.'s Twelve Traditions as set out in the A.A. "Big Book" Alcoholics Anonymous and discussed in detail in the A.A. book Twelve Steps and Twelve Traditions.)

A.A., religion, and the law

U.S. judges sometimes require attendance at AA meetings as a condition of probation or parole or as an element of a sentence for defendants convicted of a crime. A federal appeals court ruled in 1999 that doing so compromises the Establishment Clause of the First Amendment right not to have religion dictated to them by government - because A.A. practices and doctrine are (in the words of the district court judge who wrote Griffin v. Coughlin [6]) "unequivocally religious". In that ruling it was also noted "adherence to the A.A. fellowship entails engagement in religious activity and religious proselytization. In "working" the 12 steps, participants become actively involved in seeking God through prayer, confessing wrongs and asking for removal of shortcomings." The United States Supreme Court denied certiorari and let this decision stand.

Grandberg V. Ashland County is another example concerning judicially-mandated A.A. attendance and the Establishment Clause. In that case the Federal 7th Circuit Court ruled, "Alcoholics Anonymous materials and the testimony of the witness established beyond a doubt that religious activities, as defined in constitutional law, were a part of the treatment program. The distinction between religion and spirituality is meaningless, and serves merely to confuse the issue." In Warner v Orange County Department of Probation, where a man convicted of drunk driving was sentenced to A.A. The court found that the county was guilty of “coercing the plaintiff into participating in religious exercises, an act which tends toward the establishment of a state religious faith.”

Discussion of the merits of A.A.

(Note: in this section, BB refers to The Big Book, aka Alcoholics Anonymous, 3rd Edition, by the first 100 members of Alcoholics Anonymous, and 12x12 refers to Twelve Steps and Twelve Traditions, by William G. Wilson) Note: in 2001 the 4th edition of Alcoholics Anonymous, was released. The first 164 pages (including the doctors opinion), of the BB have been left intact and only minor statistics and edits have occurred since the book's initial publication in 1939. In every edition the stories have been reviewed to try and give the best representation of the current population of AA.

AA's supporters

Supporters claim that AA is an indispensable support group for people seeking to free themselves of an addiction to alcohol. Some of their arguments include:

• The American Medical Association supports the disease model of alcoholism that was developed in the early part of the 20th century and embraced by AA.
• A large amount of anecdotal evidence in which people assert that joining AA saved their lives [7] [8] [9] [10]
• Many members find that AA is fun. While meetings can be serious, they can also be filled with laughter. Social activities such as dances, picnics, and conventions are enjoyed by great numbers of AAs. Many members discover that their fears of never again having fun after quitting drinking have proven false. Many AA's believe that engaging in therapeutic recreation that does not include alcohol helps them to stay away from drinking.
• Because of the large number of AA groups (over 100,000 worldwide as of 2001), AA members are free to try different groups until they find groups that they enjoy. Because AA members come from all walks of life and every segment of society, there is a tremendous amount of variety within the fellowship. Not only do these facts make it difficult to generalize about AA groups, but these circumstances allow for a level of flexibility that accommodates the sobriety needs of a large spectrum of recovering alcoholics.
• According to the BB, "Our primary purpose is to stay sober and to help others to achieve sobriety." Thus, AA is not a social movement and is not involved in trying to reshape society or to affect communities or their values. AA prefers to appeal to potential members through "attraction rather than promotion."

AA's critics

Specific criticisms of AA (some of whom go so far as to call AA a cult) include:

• There have been at least three randomized clinical trials that studied the effectiveness of AA. Specifically: Ditman et al. 1967; Brandsma et al. 1980; Walsh et al. 1991.
  • Ditman found that participation in A.A. increased the alcoholics' rate of multiple arrests for public drunkenness.[1]
  • Brandsma found that A.A. increased the rate of binge drinking. After several months of indoctrination with A.A. 12-Step dogma, the alcoholics in A.A. were doing five times as much binge drinking as a control group that got no treatment at all, and nine times as much binge drinking as another group that got Rational Behavior Therapy. Brandsma alleges that teaching people that they are alcoholics who are powerless over alcohol yields very bad results and that it becomes a self-fulfilling prediction -- they relapse and binge drink as if they really were powerless over alcohol.[2]

See also

• Addiction
• Addiction Medicine
• Alcoholism
• Cult
• Christianity
• E. Morton Jellinek
• Moderation Management

Notes

1. ^ The A.A. Fact File, 'The Recovery Program'
2. ^ The A.A. Fact File, 'The Structure of A.A.'
3. ^ The A.A. Fact Files, 'The Recovery Program'
4. ^ Encarta Encyclopedia
5. ^ Finlay, Steven W., "Influence of Carl Jung and William James on the Origin of Alcoholics Anonymous", Review of General Psychology, March 2000, V.4, No.1, [1]
6. ^ See Dick B., New Light on Alcoholism.
7. ^ Three talks to medical societies by Bill W., co-founder of Alcoholics Anonymous. New York; Alcoholics Anonymous World Services; 1973, p.10; Bill W. My First Forty Years, Hazelden).

Literature

• Alcoholics Anonymous: The story of how Many Thousands of Men and Women Have Recovered From Alcoholism Fourth Ed., New York, Alcoholics Anonymous World Services, Inc. 2001 ISBN 1-893007-16-2
• Alcoholics Anonymous Comes of Age. A Brief History of A.A., New York: Alcoholics Anonymous, 1990, ISBN 0-916856-02-X.
• For more literature, see Bill W., Literature; Dr. Bob, Literature; Twelve-step program, Literature.
• "Alcoholics Anonymous" by Jack Alexander, Saturday Evening Post, March 1, 1941
• The Drunkard's Best Friend by Jack Alexander, Saturday Evening Post, April 1, 1950
• Dick B., Turning Point: A History of Early A.A. Spiritual Roots and Successes. 1997 [11]
• Dick B., The James Club and The Original A.A. Program's Absolute Essentials. Paradise Research Publications, Inc., 2005. [12]

References

Dramatic portrayals

• My Name is Bill W.[13] Story of the founders of AA (1989). Starring James Woods as Bill W, James Garner as Dr. Bob, JoBeth Williams as Bill's wife, Lois. Also released as Anonymous Hero
• Days of Wine and Roses[14] An early portrayal of AA (1962)
• South Park [15] Parodied AA in the December 7, 2005 episode ("Bloody Mary")
• The Simpsons Homer Simpson is sentenced to attend AA meetings in the episode Duffless. In the episode 'Round Springfield, Barney Gumble is trying AA, but quickly falls back to drinking.
• Courage To Change The Things We Can (New York: 1960) a novel by James Audain.
• The West Wing, as relates to Leo McGarry.
• Minus One: A Twelve-Step Journey (Haworth Press: 2004)-- a novel portraying a lesbian woman's first year of recovery in AA, by Bridget Bufford.

External links

• A.A. Research - Alcohol and Drugs History Society

Official A.A. links

• Alcoholics Anonymous official website
• Alcoholics Anonymous (aka the "Big Book"), 4th edition (online)
• The A.A. Grapevine: The International Journal Of Alcoholics Anonymous

Unofficial A.A. sites on the internet

• http://www.dickb.com/index.shtml (Early A.A. History)
• http://www.dickb-blog.com (articles, audio, resources)
• PlugInTheJug.com: An online 24/7 AA Meeting Place
• The Unofficial Website for AA Related Information
• Example of Regional Unofficial Site
• Staying Cyber: An AA Meeting for the WWW
• AA Big Book
• The Washing Machine
• AA History and Trivia
• Online Intergroup of AA
• Online group in French: Alcooliques Anonymes AA-FRANCITE
• GlennS's AA blog & Friends of Bill W blogring
• About.com Guide to Alcoholism / Substance Abuse Recovery
• How to find AA in England, Scotland and Wales, UK

Testimonials (Stories of Recovery via AA)

• Recovery Stories--from MemoryWiki
• Horror Stories

Critical links

• More Revealed: A Critical Analysis of Alcoholics Anonymous
• The Orange Papers
• Allegations of "Mind Control" in A.A.
• Is A.A. a Cult?
• Alcoholics Anonymous: Cult Or Cure?
• Stanton Peele PhD, national AA and 12-Step treatment critic
• Religious Movements (U Virginia)

Links to AA alternatives

Abstinence based programs

• Rational Recovery
• SMART Recovery
• SOS - Secular Organizations for Sobriety
• Lifering
• WFS - Women For Sobriety

Moderation/harm reduction based programs

• MM - Moderation Management
• My Way Out