Alcoholics Anonymous

Alcoholics Anonymous (known commonly as "A.A." or "AA") is a world-wide fellowship of alcoholics whose primary purpose is to stay sober and carry the message of recovery from alcoholism through the Twelve Steps. A.A. is the original twelve-step_program and has been the source and model for all subsequent and separate ones, such as Gamblers Anonymous, Narcotics Anonymous, Sexaholics Anonymous, Overeaters Anonymous, and Al-Anon/Alateen.

An earlier group for alcoholics, known as the Washingtonians, fell apart when it tried to branch out to different goals, which A.A. has tried to avoid.

There is some controversy over the A.A. approach of abstinence as a goal as opposed to other programs which aim for moderation. [1] It should be noted that A.A. suggests abstinence for the alcoholic only, considers alcoholism to be a diagnosis which can only be made by oneself, and has no opinion on abstinence for others.

History and development

A.A. was started by two alcoholics who first met on May 12, 1935. One was Bill Wilson (William Griffith Wilson), a New York stockbroker; the other was Dr. Bob Smith (Robert Holbrook 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."

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Dr Bob Smith (left) and Bill Wilson (right), the co-founders of A.A.

Wilson had been sober for some 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.

Firstly he had learned from a New York alcoholism specialist, Dr. William Duncan Silkworth, that alcoholism was not simply a moral weakness. Silkworth told Wilson, during one of Wilson's admissions to his drying-out clinic, that alcoholism had a pathological disease-like character. He 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; he called these reactions a "phenomenon of craving" -- once started drinking, the alcoholic finds it very difficult to stop. In addition, Dr. Silkworth told Wilson 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. This approach had been used by one of Wilson's old drinking buddies, Ebby Thacher, to get sober. 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 nigh on 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.

Rowland H. returned to America and found a means to a spiritual awakening through the Oxford Group, a self-styled first-Century Christian movement that advocated finding God through moral inventory, confession of defects, restitution, reliance upon God, and helping others. It appeared that a spiritual awakening would relieve alcoholics of the mental obsession that kept sending them back to alcoholism after periods of sobriety.

Finally, Wilson found that by sharing his personal alcoholic experience with other alcoholics, his own sobriety seemed to grow stronger and it helped the other person as well.

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 and together they put Wilson's discoveries into practice. 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 of which have remained virtually unchanged since then, has been a perennial best-seller. 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

Although some believe that A.A's success lies in the sense of support its members gain from attending regular meetings, many members, as well as A.A's literature, hold that the essence of the program is the Twelve Steps. The Steps incorporate Dr. Silkworth's description of the two-fold problem of physical allergy and mental obsession in Step One, Dr. Jung's description of the spiritual solution in Step Two, the Oxford Groups' method of reaching a spiritual awakening in Steps Three through Eleven, and Wilson's experience in helping others in Step Twelve. 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.)

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, usually of the same sex as the sponsee, and freely chosen by the sponsee.) The Steps are designed to help the alcoholic achieve a spiritual, emotional and mental state conducive to lasting sobriety. There are many long-term A.A. members who claim that working 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 working the A.A. program.

Most 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). Even members with decades of continuous sobriety still go to meetings regularly. There is no compulsion or requirement to attend. Members may attend as few or as many meetings as they wish, as frequently or infrequently as they like. However, new members are encouraged to go to 90 meetings in 90 days, and a sponsor may set his or her own expectations for a sponsee's attendance. No official membership or attendance records are kept at any level in A.A.

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

• Attendance at one meeting daily at least for 90 days or longer. Some people coming into A.A. have attended meetings daily for the first year.
• 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 one 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.
• Above all, avoiding the 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. 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, or may choose to never 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. A.A. is self-supporting and is not a charity. It accepts no subsidies from any non-A.A. source and donations of money or other items of value from such sources are not accepted.

A.A. receives proceeds from sale of its book Alcoholics Anonymous along with other A.A.-approved books and literature, which are periodically reviewed from a cost standpoint so that printed materials can be priced to be self-sustaining while not actually being a source of profit for the organization.

Many A.A. groups use the famous Serenity Prayer.

Beliefs about alcoholism

There is no official creed of A.A. belief about alcoholism, since individual members are free to believe whatever they wish based on their own experiences. Even the core twelve step program is presented to members as suggested rather than mandatory. However, many A.A. members share similar views on alcoholism and most would agree with the following statements:

* Alcoholism has no cure. Once an alcoholic, always an alcoholic. There is no way to make a "normal" drinker out of an alcoholic. Alcoholics who do not drink can recover and function in normal society, but should they drink again, their active alcoholism will re-emerge quickly and be as debilitating as before. This is true even in cases where alcoholics have remained sober for many years before relapsing.

* Alcoholism is a progressive illness. Over time, alcoholics who continue to drink will get worse. Those who keep drinking will often die from alcohol-related causes or be institutionalized (prison, hospital or asylum).

* The first drink does the damage. Once an alcoholic takes a drink, a powerful compulsion to keep drinking sets in. This makes moderation or controlled drinking difficult and in most cases impossible for the alcoholic. Thus the A.A. approach of abstinence. Without the first drink, the compulsion is greatly reduced and recovery becomes possible. Much of the A.A. program is intended to help the alcoholic stay stopped, thereby preventing the compulsive drinking cycle from starting.

* The desire to stop drinking needs to come from the alcoholic. This often happens as a result of the alcoholic realizing that his or her life has become unmanageable and that excessive drinking is the cause. A.A. members call this "hitting bottom" - a potentially life-changing moment when the alcoholic perceives an urgent need for major personal change.

Structure

The affairs of A.A. are governed broadly by A.A.'s Twelve Traditions and the Twelve Concepts. A.A. has a minimal amount of organized structure. There is no hierarchy of leaders and no formal control structure. 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 continue to offer defendants the choice of attending A.A., or going to prison. A federal appeals court ruled in 1999 that doing so compromises Americans' constitutional right not to have religion dictated to them by government - because A.A. suggests that a belief in a higher power (and willingness to turn one's will and life over to it, per the third step) is necessary to achieve recovery. This case did not create a precedent, and the U.S. Supreme Court has not ruled on the issue.

A.A. World Services Inc. [the legal entity of the program as a whole] and A.A.'s General Service Office [the legal entity of A.A. in the U.S. and Canada] do not favor coercion regarding meeting attendance. A.A. experience long suggests that the program works best for people who seek sobriety of their own free will. The Third Tradition of A.A. states "The only requirement for A.A. membership is a desire to stop drinking." Those forced to attend meetings may not have any desire to stop drinking. Nevertheless, it is true that some members claim to owe their recovery to the fact they were ordered to go to A.A. by a judge or doctor. A.A. welcomes everyone at its meetings, including those who are there only because a court or other external authority compelled them.

The A.A. program contains spiritual ideas, but it does not promote any particular religion over others, and it has worked for adherents of many faiths, including Christians, Buddhists, Jews and Muslims as well as for many who identify with no religion. Nevertheless, since it suggests that the recovering alcoholic seeks help from a "Higher Power," some atheists find themselves unable to accept A.A.'s Twelve Steps and instead seek out secular alternatives. Many others have been able to adapt the concept of a "Higher Power" in a manner that works for them, and there is a chapter of the book Alcoholics Anonymous called "We Agnostics" that speaks directly to agnostics and agnosticism. It counsels that even those members who "thought we were atheists or agnostics" were able to "lay aside prejudice and express even a willingness to believe in a Power greater than ourselves ... even though it was impossible for any of us to fully define or comprehend that Power, which is God" and "had to stop doubting the power of God" because "deep down in every man, woman, and child, is the fundamental idea of God." (quotes from Alcoholics Anonymous, 4th Edition, p. 44, 46, 52, 55) Many alcoholics arrive at A.A. with a strong disbelief or resentment towards spiritual ideas. For some this may change over time.

Heard at meetings: "I don't have any spiritual beliefs, but I do have a spiritual practice" and "You've got to pray, goddamnit, and you've got to have a higher power, and I don't give a good goddamn if your higher power is that coffee table."

Many alcoholics who arrive at A.A. without belief in a god use the group itself as their "Higher Power." One such alcoholic defined "GOD" as "Group Of Drunks" until he was able to discover a spiritual concept of God which worked for him. Others may focus on the program itself, defining "GOD" as "Good Orderly Direction." On the other hand, newcomers are cautioned that it is unwise to use any one person, such as a sponsor, as their higher power in that all individual human beings are fallible and, in the case of another recovering alcoholic, no matter how long his or her sobriety, capable of relapse. The basic idea is that, in order to recover, the alcoholic must "surrender," meaning that he or she must admit his or her powerlessness over alcohol and unmanagability of life and must stop depending only on self, while beginning to rely on help from a "power greater than [one's self]," whatever the precise nature of that power. Many recovering alcoholics would agree with the statement: "I had done things my way long enough, and all it got me was drunk. I decided it was time to start following directions."

Ironically, it has been the experience of some A.A. "old timers" (recovering alcoholics with many years of uninterrupted sobriety) that active alcoholics who seek recovery in A.A. without having a prior religious concept of God may have a better chance of lasting recovery than their more religious counterparts. This seems to be true because the former may find it easier to focus on working the program itself, instead of using previously-held religious beliefs as a rationalization for seeking an "easier softer way." However, as stated elsewhere, many people who come to A.A. with all sorts of religious beliefs, or the lack thereof, have found long-lasting recovery from alcoholism in A.A. "one day at a time."

Controversial system

There is serious dispute in some quarters as to how well A.A. works and whether other approaches to treatment might work better. In some areas of rehabilitation theory and practice, the A.A. program has fallen out of favour, often due to the fact that its approach to recovery is viewed by some as imposing unacceptable religious values on participants. This issue is often controversial in treatment facilities where government funds are received.

As far as scientific research is concerned, the picture is unclear. There have been research studies that support the value of the A.A. program as well as studies that question its effectiveness. While there is little doubt A.A. has worked very well for many alcoholics, it is also clear that it does not have the answer for every alcoholic — perhaps not even the answer for most alcoholics. This fact has long been acknowledged by A.A. itself. The A.A. program works best for those alcoholics willing and able to accept recovery on a spiritual basis, however each individual chooses to define that concept.

There has also been some criticism that A.A. is a type of cult, wherein members feel controlled or guilty (see the external links below). While some members and ex-members may have felt this way, most would reject this criticism as ill-informed. It is well-established that A.A. has no control over its members, since there are no rules or regulations, there is no form of punishment or discipline, and there are no identifying membership records. People join or leave A.A. at anytime as they see fit, and many do so offering nothing but their first name and no other information about themselves.

Literature

• Alcoholics Anonymous Comes of Age. A Brief History of A.A., New York: Alcoholics Anonymous, 1990, ISBN 091685602X.

For more literature, see Bill W., Literature; Dr. Bob, Literature; Twelve-step program, Literature.

External links

Official A.A. links -

• A.A. home page
• The A.A. Grapevine

There are many unofficial A.A. sites on the internet -

• Example of Regional Unofficial Site

Critical links

• The Orange Papers: One Man's Analysis of Alcoholics Anonymous
• A Cult Called A.A.
• Mind Control Tactics Of Alcoholics Anonymous
• Is Alcoholics Anonymous a Cult? An Old Question Revisited