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Sobriety, Science, and AA's Legacy
Alcoholics Anonymous at 75. We look at its legacy and its 12 steps through the lens of the latest science.

Credit: AP

Alcoholics Anonymous – AA – got its start 75 years ago this summer. 

Every AA member knows the story.  Of how alcoholic Bill Wilson saw God in his detox room, and went on to lay out the twelve steps of the AA path. 

It’s been a godsend for many.  Doesn’t work for all. 

And 75 years on, scientists are still trying to figure out exactly what it is that does work about AA.  “Higher power” is not exactly a scientific term. 

This Hour, On Point: AA at 75, and what science – and alcoholics – understand about the twelve-step way.


Brendan Koernercontributing editor at WIRED magazine. His latest article is “Secret of AA: After 75 Years, We Don’t Know How It Works.” He also writes Wired’s “Mr. Know-it-All” column.

Bill N.,twenty-year member of Alcoholics Anonymous.

Lee Ann Kaskutas, senior scientist at the Public Health Institute’s Alcohol Research Group.

Scott Tonigan, research professor in the Department of Psychology at the University of New Mexico.

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  • bob murphy

    AA saved my life. Thanks especially for this show. Anyone with a drinking problem needs to at least give AA a try. It works for some, not all, but sadly most alcoholics don’t ever get to one meeting.

  • django

    As an adolescent I was enroled in Allateen. I myself had never tried alcohol at that point but My step father was an alcoholic. Nothing ever made it through to me and I know it was because of the strong religious emphasis placed on the meetings. Let go and let god does NOT work for a 9 year old who doesn’t believe in god. The lord’s prayer did not help me escape any beatings or embarassment either. I wonder if Ms. Koerner can tell us if any of the biblical overtones have changed or are planning to change.

  • Gary

    I watched AA turn my father from a drunk into a self righteous religious drunk. The guilt made him angry, and then he became dangerous and violent as well. The indoctrination of God’s will into his pickled mind destroyed the man.

    It may work for some, but for others, its just one more reason to drink. He NEVER had a DISEASE! He had an addiction, and that’s how it should have been treated.

  • http://www.vickiarkens.com Vicki Arkens

    David Brooks, writing for the NY Times said, “In a culture that generally celebrates empowerment and self-esteem, A.A. begins with disempowerment. The goal is to get people to gain control over their lives, but it all begins with an act of surrender and an admission of weakness.” This is the essence of AA. Can science conclude anything from this?

  • John

    Penn and Teller did a great job debunking this fraud. There is no higher power. People are responsible for their own actions.

  • DL

    AA is founded on the principle of relying on a power greater than yourself to overcome something which would otherwise be impossible to do on your own. This is predicated on what is referred to in the AA steps and literature as the God of your understanding. Bill W and his wife Lois (who started Alanon and later Alateen) were Catholics and the tradition Catholicism colors many of writing, prayers and legacy of the AA, Alanon. (This is also true of 12 step program which use the AA Big Book and the AA Twelve Steps and Twelve Traditions). However, Bill W had the foresight and understanding that no religion could be the be-all-and-end-all for everyone, especially low-bottom alcoholics who are skeptical of any prescribed solution. This is why the first step which refers to God qualifies the word as “as we understood Him”. This understanding of God is defined by every individual member of the program and often changes throughout their experience with the 12 Steps. The God word is often the biggest fear of the skeptic of a 12 Step program. I have heard many definitions of the Word God in 12 Step rooms. The basic point however is that one accepts that they don’t have all the answers and is willing to look outside of one’s self/ego/thinking/behaviors for a solution to a seemingly unsolvable problem/compulsion/addiction.

  • Ellen Dibble

    I guess the Higher Power would never be Allah, since Muslims don’t drink. But I believe the Twelve Steps apply to other addictions too. I’m wondering how many higher powers create these transformations, as empirically proven.

  • John

    Many religous people could use a drink.

  • Jo

    The religious overtones of AA and Al-anon often do not work for people. The people in these groups are just as varied as anyone else: abusive, kind, self-righteous, accepting, etc. It is important to accept responsibility for your own actions in the context of addiction and maladjusted relationships. If the g*d stuff doesn’t work – find a community that has the same principles without the g*d stuff. Every group is different. Sometimes the high power is simply the wisdom of people who have have similar experiences.

  • Ellen Dibble

    I know the story of a woman who was court-ordered to participate in AA. However, she had ceased to be an alcoholic. Thus, AA would not allow her to participate. Thus, she lost her children to adoption.
    For that person, cognitive behavioral therapy, group or otherwise, twelve-step or otherwise, would help. But I guess, that is not free. But maybe some modern-day Bill Wilson can organize a CA (cognitive anonymous), which is self-sustaining, group-centered, with sponsors, and available often and everywhere, but not depending on religion for its basis, and not depending on having a specific addiction.
    That woman had to get herself addicted to alcohol in order to preserve her family.

  • http://www.venturacommenter.org F. William Bracy

    The human mind is a strange thing. It will insist that there are explanations for everything even when there are none. “Miracles” are generally the answer. Miracles, however, don’t occur beyond the body; they occur within the mind. Unfortunately, the line between fantasy and reality is so blurred that the logical workings of the brain cease to function as originally intended. Nothing demonstrates this malfunction better than religion, and when religion begins to permeate everything that appears to be beyond our grasp, we’re sunk.

  • Stacy

    AA just became another addiction in a long list of addictions for my father. For years my father planned his life around meetings. He just couldn’t get enough of sharing his story and being in the spotlight. On the nights and weekends that my father had custody of us, my brother and I were raised in the back of AA meeting rooms. At times I am thankful that it helped with his drinking – but nothing ever stopped his addictinve personality. He needed an 12 step program for AA meetings.

  • Meghan M

    I come from a family of many people who have struggled with alcohol. Some have worked the steps, others have not. I grew up with a grandmother who had some of the phases on refridgerator magnets, and even though I decided to never drink because of my family history I’ve encorporated some of the tenants. My particular favorite in stressful times is “let go and let God”.

    While not perfect for everyone, AA has definately made a positive impact on my life.

  • Ellen Dibble

    The woman I cited, I believe the basic problem was something closer to PTSD, from ongoing child abuse when she had been little, predisposing her to many things that would seem to someone else as “irrational,” a kind cognitive dissonance.
    I’m thinking many such people do become addicts, but in that case, she was pretty clear that alcohol was not the problem. In some ways, it had been the solution. But basically there needs to be a group she could join with co-sufferers — or a LOT of such groups so she could find a compatible one.

  • http://ncpr stillin

    It’s free. It works for many. I believe if my husband had ever humbled himself enough to even TRY one meeting, he would not be in the position he is in today. ) Blew a .22 and wrecked his precious bmw) . The idea of making amends to others and when wrong, promptly admit it, are very powerful steps. Lastly, I was raised with religion but I am not religious. I am a spiritual person due to my long affiliation with alanon, a partner of aa. I don’t care how science solves things. I like to think of my old anthropology teacher who said a modern doctor can tell you WHAT you have, but a witch doctor can tell you why YOU got it and the other 20 people around you didn’t. THAT’S spiritual to me. A great quote…religious people are afraid of going to hell, spiriutal people have been there. Alcoholism is hell for everyone around them too. Lastly, one of my sisters quit drinking on her own, very proud of it, would NEVER go to AA. She is so difficult to be around, due to her never confronting all the people she hurt, and absolutley mindless about how she treats people now. She could use the program.

  • Chuck

    I have four years sobriety in AA. The fellowship has saved my life. I came to AA due to a severe, long depression. I didnot know what else to do but drink. In AA, I found acceptance caring and incredible fellowship. I keep going to meetings. My higher power is the Gos I’d my faith. I pray to him daily for help. My life has changed in many ways, for the better.
    Beyond alcohol, I had to learn how to live.
    AA has saved my life.

  • BHA

    My step-father was a non-drinking alcoholic when my mother met him 40 years ago. He always said there is no such thing as a cured alcoholic, only a non-drinking alcoholic.

    He found his way with the help of AA. I don’t know how many years he had been sober when they met. He didn’t go to AA meetings every week when I knew him (he died 16 years ago) but every now and then he would attend one. At that time, I think the program for him was a support group not a ‘cure’ program.

    My mother drank bourbon on occasion and there was always a bottle in the house. Yet the closest my step-father got to drinking alcohol was ‘Near Beer’, a SAD substitute flavor wise for real beer.

  • Sally Gore

    With a lot of work and the help of others, I’ve been sober for more than 17 years. Early in sobriety, I relied upon AA a great deal. I knew many people who did not drink and/or did not have any issue with alcohol. What I didn’t know were any alcoholics – besides myself – and so meeting others who struggled staying away from drinking was important. Over the years, I have built a full and fulfilling life – a life in which I don’t need to deal with troubles or sadness or happiness or anything else with drinking. For me, that’s recovery.

    I don’t attend very many meetings today and admit that the one thing that troubles me about that is not the fact that I fear I will drink without that particular support system, but more that I’m not being part of a support system for others who need it. I hope I do that elsewhere, but sometimes feel I could do more. Bottom line for me, the two things of AA that work for me are (1) the support of other alcoholics and (2) acceptance of the fact that an individual is not the center of the universe (I’m resisting a LeBron James comment here!). There are a lot of things bigger than me. These ideas may well be foundational in many religious institutions and/or religions, but they’re hardly the sole property of them.

    One can be both humble and have a healthy feeling of self. With that in place, I don’t need to drink.

    Thanks for the program today!

  • Linda Midland

    I have seen AA save people. I do think the religious element is a problem for many. But the thing that works is the community, the comraderie, the sense that you are not alone. The humility is key, too, and the reminder that not everything is within your control. There is forgiveness there, too. Still, I go back to the community. People save one another in AA, and it’s very powerful.

  • peter nelson

    My wife and I wanted to get one of our relatives into an alcohol treatment program a few years ago. I have a good scientific background and I read the peer reviewed literature on adult alcohol treatment and I was appalled at the low quality of most of it: Small cohort size, poor selection criteria, sometimes no control groups, vague outcome criteria, and short followup-times.

    Given the HUGE cost of alcoholism why is the science so weak?

    (b ecause we couldn’t find research we had much confidence in, we changed our minds about spending so much money on a program )

  • Annie

    AA’s helped a lot of people, some with the carrot and some with the stick, but many more AREN’T helped by the ‘higher power / giving up control’ approach — myself included. If anything, one of the problems that led me and many others to drink is the fact that we had NO control over ourselves, our lives, our addictions.

    Alternatives that are often based on cognitive behavioural therapy approaches — such as SMART Recovery — can often provide extremely helpful alternatives to those who need to regain control of their lives, rather than relinquish it.

  • Ellen Dibble

    Interesting to hear that the group in AA functions in place of one’s damaged frontal cortex. It supplies reason and guidance.
    It just seems to me that religion too often teaches us NOT to think, but to float along on faith. BLOCK THAT THOUGHT.
    I took part in a Toastmaster’s group for a few years, and hear a few interesting points of comparison. Everyone speaks. Everyone is critiqued by everybody else — but never with the intention to demolish. A kind of group-think evolves. What should I call it? A kind of norm. But a group could certainly go maverick. Or certainly you could have your hung jury of a group, with someone going ballistic, so to speak. Grandstanding despite everyone complaining.

  • Janice Messier

    AA is a fine program, but there are other programs that are equally effective. SMART Recovery, (a free, abstinence based, self-empowering, science-based, higher power optional mutual help group) is a fine program, where many people find success and are able to gain their life back and live their life as opposed to going to meetings for life. There is not one solution for every problem. Thanks!

  • Anon

    I don’t think that AA or Al-Anon are perfect by any means, and I particularly chafe at the idea of a Higher Power. However, the notion of surrender in AA doesn’t mean that someone abdicates their own responsibility for their own behavior, but rather means they break through their denial that they can manage their raging addiction. And similarly for Al-Anon, it means that family and friends can let go of the idea that they can force their addict to change. In that context, even an atheist like me can embrace the steps, substituting An Inanimate Universe for God.

    Besides, in a time when Obamacare won’t even take effect until halfway through the Palin administration, you can’t argue with free group therapy.

  • Ellen Dibble

    Annie, I copied this from the web on CBT: “Cognitive-behavioral interventions combine cognitive
    and behavioral strategies to solve a variety of behavioral
    and psychological problems. They seek to
    ‘change a person’s irrational or faulty thinking and behaviors
    by educating the person and reinforcing positive
    experiences that will lead to fundamental changes
    in the way that person copes.’ In other words, by
    learning to shift or alter their thinking processes, clients
    can think more clearly about the choices they
    make and the behaviors in which they engage.”
    My question: How available is it? How much does it cost? Do you know anyone it DOESN’T work for?

  • Mari

    AA, at 75, has not aged well, in my opinion. I have seen AA used as a cover for all sorts of bad behavior. “The 13th step” is often the only one that many male members adhere to, religiously: that is, sexually preying upon young, female newcomers who have been recently persuaded that they are completely “powerless”.

    I have also seen many people use AA as an elite social club, depending on where the group meetings are held. If it’s in a wealthy suburb, you can bet that you will never see minorities welcomed unless they have been signed up a “guest speakers” for an hour. Recovering drunks are just a snobbish and closed-minded as practicing drunks.

    The proselytized zeitgeist in AA is: “I can do anything I want as long as I don’t take a drink today.”
    And, they do! “Self will run riot” is just as common in an AA meeting as it is on the crazy highways of the USA.

    George W.Bush is a prime example of an average “recovering” American drunk. As long as the egos of these people are stoked by their own self-righteousness, they can literally get away with murder, as long as they don’t drink.

    When I was first exposed to AA, as a young person whose mother was steeped in the cult, there was a focus on the 12 Traditions as well as the steps. Now, the traditions have been thrown out (“principles above personalities” went into the dumpster first) and it’s just “a selfish program”, to quote the cliche one hears at every meeting, repeated like a mantra- over and over again.

    Recovering drunks, in the 21st century, can easily drive a normal person to drink with their neo-puritanical, holier-than-thou judgments
    and abuse of “God” to justify their incurable, self-centered behaviors.

  • Irene Dwyer

    Every human civilization that has progressed beyond the cave (and a few that didn’t) has invoked universal powers of good and evil. Recovering alcoholics very much need to focus on “good”, however one might define good. Regular connection with other people committed to positive growth is extremely important. It is interesting in this regard to note that treatment for other chronic diseases has adopted the support group concept of AA.
    I have been sober in AA for 25 years; in fact, my sobriety date falls about the same time as AA’s anniversary. This month, four people in my town will celebrate anniversaries of 15, 20, 25 and 35 years, respectively; I think this supports one of my favorite AA sayings: “This Program Works.”
    “How does it work? It works well.”

  • AR.

    Please mention some other approaches that are now used, such as Smart Recovery. They do not use a religious, 12 step approach. They use more of a cognitive behavioral approach. It is now available in some metropolitan areas, and even some prisons. It is not as widespread as AA. But helpful to some who are not able to quit with AA.

  • John

    Palin administration? Have you fallen off the wagon?

  • kathy

    I went to an AA meeting for over-eaters. We had to sit around and each read out loud passages out of a manuel . It took one hour. Then several people spent time going over their stories. I found it incredibly boring, especially listening to people who just liked to hear themselves talk. I left thinking “why don’t these people get a life”? They also were extremist with their diets.

  • Penny

    My husband and my marriage benefited greatly from AA. Not only did it help him quit drinking, but it helped him identify the reasons why he drank, which led to so many other destructive behaviors. But I will say that AA is only as good as the meeting you attend. Some are great: some are truly the blind leading the blind, and can be quite dangerous for someone truly lost.

  • http://none Janet

    Daughter of an alcoholic father who was successful in AA for 14 years; it saved our family and allowed me to balance the difficult years with a wonderful relationship in the years before he died. I think an important anchor for him in AA was being of service to others, which he did with great dedication. He also took me along on weekend AA conferences and retreats and I met many delightful people on those trips.

    What I want to share now though, comes from reading a couple of books by Dr. F. Batmangelidj (not sure how to pronounce, but he is referred to as Dr. Batman by some of his readers). In his several books are stories of how dehydration plays a big role in alcoholism — and also in stopping it. One is called “You’re not Sick, You’re Thirsty”. I have come to believe that chronic and unwitting dehydration is a strong factor and contributor to the drive to drink. I hope this helps some of your listeners.

  • j.d. smith

    Kudos to AA for all of the good work done. I have never been in need of AA, however , I’ve been in a position to view many meetings and it seems to me that many members are trading one addiction for another, as I’ve noticed that a good many of the attendees chain smoke and drink coffee by the gallon. so from my perspective they still appear addicted to substances, just not alcohol.

  • karen murray

    i have been sober for 28 years as an active member of AA. i have never seen anyone come to AA really looking for sobriety-it’s been more like running away from drunkenness and all the consequences that go along with having black outs, car accidents, incarcerations. just staying away from a drink one day at a time, you start to learn how to cope with issues instead of drinking through them and helping others really works. i have truly seen many lives changed. some of the comments above especially about the enraged father-make me think he had a lot more problems that just alcoholism.

  • Ed Van Dorn

    I believe the primary flaw in studies to determine whether AA works is that most include all AA meeting attendees. There is no effort to seperate those forced to go or who attend half-heartedly from those who try their best to “thoroughly follow our path” or “precisely follow our direction”. In my experience in 20 years of AA there is a direct and powerful corelation between success and willingness to follow the program and the 12 Steps. I would like to see a study of success among those who claim they have done their best to “thoroughly follow our path”

  • Kristy H

    Pretty interesting comments…I have been sober in AA for 5 years and call it whatever you want…a cult, brainwashing, God Talk…blah, blah, it has helped me make my life so much better than I could ever imagine. Simple enough.

  • Lewis Woelk

    The issue you haven’t acknowledged or addressed is the concept that alcoholism is, in and of itself, a disease. I think anyone who hasn’t been subject to the intense brainwashing of AA or another twelve-step programs can see that alcoholism is a symptom, usually of a psychological problem. AA has to be for life because the core issue/s are never addressed or resolved.

  • Donna

    I am also a person in recovery for nearly 20 years now. I believe that the spiritual aspect of the AA program is the problem I had for years. However, when I realized that I had absolutely nowhere else to go, I used the support program as that….support for staying sober, support for learning to be responsible, not use the crisis to get by and live like a productive member of my community again.

    I would like to mention that I ended up in detox several times, rehab, etc. The first visit, I was convinced that I would literally disappear somehow if I got sober. That I would cease to exist. I created a contract for the counselor at detox, to guarantee that this would not occur. Of course, he never signed it and I still have that contract tucked away in a drawer. And I am still here…..

  • Quinn

    I celebrated my 1 year anniversary yesterday. My life has improved in ways that I did not think was possible. While both AA’s and non AA’s can micro analyze why AA works I have found for myself that it does not matter why it does, only that it does. I love AA and suggest for those who are looking to not only looking to stop drinking but are looking to improve their lives, I can’t do enough to extol the virtues of this program.

  • Ellen Dibble

    Mari posted: George W.Bush is a prime example of an average ‘recovering’ American drunk. As long as the egos of these people are stoked by their own self-righteousness, they can literally get away with murder, as long as they don’t drink.”

    Thank you for laying that out for us. I would never have dared, and I tend to blame the Republicans for “enabing” him, and I’m waiting for the “other side,” but I don’t know it.

  • Gary Barnes

    Is there anyone chatting that is from Albuquerque????

    I got sober there in 1983 and am hoping to connect with anyone from the “old gang”….

    Am in Buffalo, NY now… still sober… carrying the message as best I can…

    Much to say to anyone… is there an associated blog/website where I might get what I am looking for???


  • Elle

    Congratulations on one-year of continuous sobriety, Quinn!

    Thank you AA for giving me my life back.

  • Parker Nielson

    There are more than a few studies that suggest that the rate of recovery from AA is no better then the background rate of spontaneous recovery.

  • Gary Barnes

    About the “Power Greater than Ourselves”… I am an atheist… I recently (four or five years ago) became a Quaker… They believe in the “Light Within”… “God” in every human being… The discussion – on the radio, spoke of the frontal cortex and the Group substituting for that “normal regulator”… There can be Something when we work together that amounts to being “more than ourselves”… a Power Greater than Us alone…

  • Andrew

    What are the sociological implications of AA? What effect does that have?

  • Pauline

    I, too, am grateful for AA because I attended Alanon meetings for at least ten years and still get together with my “sisters” from the meetings.

  • http://hnicwatch.blogspot.com/ Irami Osei-Frimpong

    The spiritual element of AA may not reduce to science, especially if it’s tied to human dignity and our rational capacity. In the same way that our rationality leads us to arithmetic truths, reflecting on our rationality may allow us to hear the call of the moral law or God or whatever you want to call it. This call reveals our freedom and capacity to not be slaves, determined by our desires, these desires include desires to drink.

    Trying to reduce my knowledge that 2 + 2 = 4 to a matter of brain chemistry, or may awareness of God or the moral law to a matter of brain chemistry is profoundedly wrong headed. Instead of interviewing scientists, On Point should have had philosophers. Kant and Aristotle can tell us more about why the 12 step programs works than a room full of FMRI machines.

  • Ian H.

    I have been a sober member of Alcoholics Anonymous since October 9, 2007. AA works for me because I am willing to work the program of action as described in the basic text, “Alcoholics Anonymous.” Though I go to many meetings and enjoy the fellowship found in them, alcoholism is deadly, and I mustn’t stop there. I suffered from a spiritual malady that I was once able to treat by drinking. As my disease progressed, my solution became a debilitating problem. I came to AA and found people that had experienced the same hell, but that had found a solution for my issue. The meetings provide support, but the 12-steps provide the change. Thank God that my sobriety isn’t contingent upon scientific studies, success rates, and discussions about my cerebral cortex. I know many people who rely strictly on going to the meetings that cant stay sober, but I don’t know ANYONE who THOROUGHLY works the 12 step recovery program that has a problem staying away from a drink today. It works if you work it, ask one of us to show you how.

  • Annie

    @Ellen D –

    My question: How available is it? How much does it cost? Do you know anyone it DOESN’T work for?

    it’s available through groups like SMART recovery (smartrecovery.org), as well as through individual and group therapy. In the metro-Boston area (where I live), there are several SMART groups that are well established and have helped a lot of people, accepting only donations — no fees.

    I’ve known people for whom it doesn’t work. The common denominator among them is that they’re unable to work it, keep at it, etc. The Why of that varies from person to person.

  • BHA

    “AA is no better then the background rate of spontaneous recovery”

    Spontaneous recovery? Like someone just wakes up one morning and no longer has a desire to drink?

    Any recovery happens only through hard work. If AA is no more successful than any other method, that is fine. There was enough discussion above that it doesn’t work for everyone. Religion does not solve problems for everyone either. But for those who believe their God will help them make it through rough times, it works for them.

  • Gary Barnes

    A comment for Sally Gore…

    If you feel that there is a bit of less/loss to YOUR spiritual condition because you are not there for the new (or others) person… then I would suggest that you get to meetings so that WE all can “win”

  • John

    Anecdotal evidence does not make up for the lack of any scientific proof that this works. Success rates should be provable if they are real. Hiding behind religion/spirituality, etc isn’t persuasive.

  • Anonymous

    Please keep my identity anonymous. Thank you.

    I have been a sober member of AA for 23 years.
    AA has saved a lot of lives, but it is certainly not for everybody. It is not even for people who may need it. It is definitely for people who want it.

    Here is my theory:
    It takes away the ego and gives back self-esteem.

  • Mari

    “George W. Bush is responsible for every death in Iraq related to his “Hussein has WMD’s. Oops he doesn’t, but is a bad guy and we need to get rid of him” war.”
    Posted by BHA
    I think Bush was on a “dry drunk” for 8 years, drunk on the power he grabbed, starting with the rigged election in 2000. Sadly, his legacy as a born-again warlord is one long, nightmarish hangover for the rest of the world. If he had just stayed drunk, we might all have been spared from his gross ineptitude as a president.

  • Julia

    Here’s the link to the story in Wired magazine this month on this topic.


    For the most part, the story was accurate. A few little things that weren’t exactly spot on about how AA operates, but otherwise well done.

    AA doesn’t claim to be the only way for people to get sober. It does provide a road map for a new way of life. In the early days, AA reported a 75% success rate. Today in many places the program is watered down from the original. A helpful book for getting the full benefit is “Back to Basics” by Wally P. You do all 12 steps in four meetings over four weeks. That’s how it worked in the beginning.

  • J.J.

    Hello Everyone,

    First let me say that I come from an alcoholic family and myself developed into an alcoholic and heroin addict. I hated A.A. and understand people’s fears and concerns. I hit a severe bottom and was broken and gave A.A. a try and it changed and saved my life. I don’t believe in a God, but understand that I am not God. The world and other people’s behaviors are out of my control. At seven years sober I don’t go to a lot of meetings and I have studied but not done the steps, but I spend a lot of time with spiritual people and sober people. Some people in A.A. have suggested that I might want to play it more by the book but I know that is because they care for me even if it sometimes feels like pressure. I play on a 12 Step kickball team. I try not get too self involved. I donate my time. For me I am a happier and healthier person, but I needed A.A. and a support system to help me learn how to live as a sober adult. There is no way that I can do this alone. I take what I need from A.A. and try to give back. I can’t really explain it, but it is like joining a gym. I have to work hard on being spiritually, emotional and physically fit. There is no easy path to happiness for me. It requires sacrifice and work. The easiest way to explain the very vague notion that I have of a God is that God exists in between my thoughts. Spiritually my goal is to quiet my mind and downplay my ego. When it all comes together it feels as though I am floating in the river of life rather than fighting the river and drowning in it. Acceptance plays a huge role in that as does gratitude.

    I found this episode a little sad, and Tom’s tone skeptical. Until you go through something like this it is hard to explain. The main reason for this is that it is not an intellectual exercise, it is an emotional one. What I mean by that is that it is something that has to do with the heart and not just the mind. Academics and intellectuals have a real hard time with this. All this can get kinda new agey but I have found that when I quiet my mind and downplay my ego and open my heart and experience my emotions I lead a much more rewarding life. For an addict this is incredibly difficult because my life was spent trying to control and change my emotional state. Before if I went to a party and had social anxiety I drank and it went away but it came with sacrificing my judgement and truly insane behavior. It took years to become comfortable enough in my own skin to go to big parties and get rid of that self centered fear, but now I have a blast and it doesn’t come with all the negative consequences. I get to experience the situation sober which is amazing especially if the group is experiencing something like music or a sporting event that is transcendent. I will say that as an observer when people have a drink or two it can be fun to be around them, but after that it tends to go down hill and people tend to loose respect for others and become very selfish. I can only imagine what I looked like. Of course in my distorted mind I thought I looked great.

    I once had a complete hatred for A.A. then I become zealot but it is that kind of black and white thinking that got me in trouble in the first place. I don’t really think of it that way anyway. A.A. is what I make it and that changes on a daily basis. What other people think is their own business. Besides the only requirement for A.A. is a desire to quit drinking. The rest is all a suggestion, and I firmly believe that.

    Being free from addiction is amazing and has lead to an amazing life, but it is a lot of work especially in the beginning and having help and support makes it so much easier.

  • mike

    Willingness is the key. It is not a religious cult. Clearly the writer has never been to Santa barbara AA. The traditions will also give a better understanding of how it works.

  • noel hodnett

    I went to my first AA two weeks ago, I had been trying to stop drinking on my own without success. I would never have considered myself an alcoholic until I had an incident under the influence of alcohol which left me with no other choice but to get help. It was not easy to walk into that first meeting and not easy to state my first name and that I am an alcoholic. however, when I walked out that first meeting I knew I was not alone and that I had a place to go for help. The people at that first meeting were very supportive and open to sharing their story. Since that first meeting I have attended 10 and I actually look forward to attening the daily meetings. A funny this is that I find such order and structure to AA meetings without it being forced on me compared to my work environment where I work in sr. management at the corporate level and find the AA meeting so much more real and honest compared to any of the meetings I attend at work. I intend to stay in the program because I have to stay sober and at least now AA has been a tremendous help to me. I never dreamed that I would ever be where I am and involved in an organization like AA. I had a hard time initially with the “GOD” aspect of AA however, I read Bill’s comments on “GOD” in the big book & that put that concern at rest for me.

  • mike

    idiot writer

  • Brett

    Interesting comments on the forum for this “hour.”

    The three most common therapy forms offered these days when one goes to seek help from a psychologist or counselor-therapist are “behavioral,” “cognitive behavioral” and “psychoanalytical.” By far the most popular, widely used, and successful of the three would be CBT; although, often therapists will use some form of all three, with behavioral and psychoanalytical disciplines as adjuncts.

    I would say that if one had to put AA in a category of therapies, it would be “amateur group therapy,” meaning it is not clinically sound or professional, it presumes that all people respond in the same way to the same therapeutic approach (and, additionally, have the same system of beliefs), and it is “performed” always in groups or with other amateurs performing support functions outside of the group (over the phone or in private meetings with a sponsor, etc.)

    When AA counts its successes, it literally counts only its successes! It does not count those who’ve failed, quit, have relapsed, etc. I believe it has helped quite a number of people; or, I should say, a number of people have quit drinking or taking drugs while participating in the AA/NA model. Of the success stories, that is all that is “measured.” When one looks closely at this flawed data collection system of throwing out data not indicating success in conjunction with collecting data on one behavioral aspect of a problem only, in conjunction with reporting only anecdotal information from success subjects, AA doesn’t really have much to boast about.

    Any form of therapy will work for addiction if the person addicted is ready to stop (it is safe to say that if one simply stops drinking and does nothing else, one has about the same chance of success as going to AA, and AA can’t refute this). If AA were to promote more truth in advertising, as it were, it could only really say something like: if you have an addiction to alcohol/ drugs and are ready to quit drinking/taking drugs, you may be suited to having AA help you.

    Another tragedy of the ubiquitousness of the AA model in substance abuse treatment is that it so ubiquitous. All subsidized substance abuse programs will have twelve-step models of some form. All court ordered substance abuse programs are twelve-step programs. If you want the better “therapies” you’re gonna have to pay, and pay dearly. And, even those therapies don’t have mountains of information about comparing one form of therapy to another or getting objective and detailed data compilation on a given therapy, etc.

    “Buying” therapy and a therapist is a bit like buying a car, only WITHOUT a good guide such as consumer reports! I use the analogy of buying a car because it is very much like selling and buying something when you go seeking therapy. The therapist advertises his/her success/superior therapeutic approach (phone book, TV, radio, etc.). The therapy itself is promoted in books, on radio and television programs, and in all manner of advertising models, etc. Sometimes you buy a lemon, and sometimes you buy a Mercedes.

    Trial and error of which therapies will work for you or which therapists you “click” with is important to the process. And therein lies the rub! When one is at “bottom, ” a place where one is most likely to be open to the idea of receiving help and participating fully in one’s own therapy, one is also in a place, psychologically, that is not conducive to being a self advocate. One has to be able to say, “this form of therapy is not working for me and I need to go elsewhere,” or, “my therapist and I don’t seem to be making progress and there is tension and elements of lack of professionalism, so I need to seek therapy with another therapist” are not the kinds of accurate self-empowering statements someone who is in most need can make rationally.

    If the catchphrase “whatever works” is the only criterion for success, then I would say AA is successful. If it works for you, then great. The problem with AA is not only in knowing what to do when it doesn’t work, but in analyzing why, specifically, it did not work and which elements of a problem it helped and which elements it did not (and which it may have even been exacerbated).

  • anon

    A lot of people with no understanding of AA seem to have very strong opinions. AA is not religious. AA is very diverse and tolerant. While there may be some groups that are aggressively christian and god-oriented, what I mostly hear in Boston is “your higher power can be anyone, so long as he/she isn’t you”. I’m totally comfortable as an agnostic, using the group as my higher power. The point is that alcoholics tend to be spectacularly self centered, and relying on something outside their egomaniacal brains, like the advice of an AA sponsor, is necessary for recovery.

    The fact is that AA transforms lives. This is not a theory, I’ve experienced it for 19 years. I think the most important part of the program is the willingness of AAs to devote unbelievable amounts of time and love in helping a newcomer. Actually, the communal spirit in AA reminds me of the hippy scene in the 60s and 70s, without the drugs.

  • Jim M.

    Sober in AA for nearly 12 years here-4283 days,one at a time. Yet I am a firm atheist! I do have faith in a power greater than myself that helps me negotiate life. There are a lot of agnostics and atheists in the program, coexisting with the theists.It’s a good way to develop patience and tolerance. AA works if you work it.

  • robin

    The members of the AA community are probably living a better life than those who are not alcoholics. Why is it so controversial being taught to “live in the moment” and do the right thing for oneself and for others?

  • Greg Sureck

    you expressed yourself very well. I wish every treatment center and therapist would print out your response and give it to new patients.
    “Cognitive therapy” may help some. It doesn’t really work all that well. Has good press. AA is very close to “reality therapy” as per William Glasser. Summed up as behavior has consequences.

  • Mel H.

    There is an appendix at the back of the Alcoholics Anonymous book about the nature of a spiritual experience. I am really glad this was pointed out to me early in my recovery. I was agnostic and resistant to religious ideas. I might have bolted as too many people do. I am grateful there isn’t a specific AA higher power, and the journey of the steps is to try and find one that works for you.
    One other thing I feel is important is in AA’s book it says that the world is endowed with many professionals who can help. It says don’t hesitate to use them. I am glad I was actually sentenced to go to Cognitive therapy by a court. I feel like I had the best of both worlds.
    In the meetings I like, we talk about how to live sober and work on our other problems, beyond drinking. I have been sober 27 years, and am grateful for the support I can get to enjoy life beyond the desire to drink.
    There are many damaged people who attend meetings but the program as a whole shouldn’t be judged by them.

  • William

    I wonder if the late Senator Ted Kennedy went to any AA programs in order get sober. I read before it was his second wife that was a big influence on his giving up the bottle.

  • Mary G.

    Don’t be so dismissive about the San Antonio conference! This was 60,000 alcoholics that celebrated for three days including completely filling the Alamodome three times for our festivities. There were folks from all over the world… and the largest convention ever held in San Antonio.
    It’s once every five years… look for us in Atlanta 2015!

  • anon

    Mel H is right about AA not competing with or criticizing medical professionals or dictating the nature of the higher power. AA also doesn’t tell anyone that they have to join AA. There is a passage in the 12&12 saying that we should suggest to those who aren’t sure if they are alcoholics to “try some more controlled drinking” and see how it works out.

    In 19 years I have NEVER ONCE heard someone tell a newcomer who/what the higher power has to be.

  • http://www.onpointradio.org judy cooper

    I found the program very interesting and well balanced. I have been sober in AA for 26 years. I am very grateful for the people who shared their experiences, strengths, and hopes with me, so I could put together this sober productive life. For all its warts, lumps and bumps, AA is a lifesaver for many. It all comes down to commitment and follow through…not easy, but simple.

  • Jim H.

    It’s amazing to me how much misinformation is spread about a fellowship that has helped so many people.

    Higher power doesn’t have to mean God. For many it is the collective wisdom and experience of the fellowship; for others the deeper Self, in a Jungian sense. A Taoist would refer to the Great Man/Woman within the psyche. To talk about AA as religious or cult-like is just to miss the point of how AA was founded and operates. Unlike a cult, it demands nothing of its members; unlike almost all religions there is no required set of beliefs or specification about anyone’s higher power.

    Bill and Lois Wilson were not Catholics and it is the third step, not the first, that speaks of a “God of our understanding.”

    To say someone didn’t have a disease but an addiction is to completely miss the point of addiction. I’m a psychotherapist and work with many recovering alcoholics. Alcoholism, like other addictions, is a disease, and follows the morbid course of disease unless it is arrested.

    For someone to have a “strong scientific background” and find research results on alcoholism and recovery “disappointing” and therefore not help someone enter a treatment program is to do a very cursory review of the empirical evidence. I have found those who are too knowledgeable for recovery programs to be those in the most trouble.

    Brett makes good points about the lack of solid data regarding AA’s success rate but misses the point in comparing it to various forms of “professional therapy.” Members of AA could tell him that recovering alcoholics often benefit from therapy IN CONJUNCTION with AA meetings. Few people can afford daily therapy with a therapist but they can attend three meetings a day while in the early stages of sobriety–for free. As for amateur group therapy–I have to laugh. I have trained with psychiatrists and psychologists who were completely clueless about addiction but offered such “professional” group therapy. At an AA meeting, a newcomer can at least be certain that he is in with people who know about alcoholism/addiction from personal experience–and it is my experience as a professional therapist that personal experience often means a lot more than an advanced degree. I have a Ph.D. and nineteen years of sobriety–the latter is a lot more valuable in m work with those in recovery.

  • Brett

    Jim H.,
    I would agree that people who have had their own experiences abusing substances and stopping substance abuse make the best counselors for people who have problems with addiction. I find that therapists who have had no personal experiences with substance abuse often can appear Pollyannaish and lack credibility with the patient. Building trust can become more difficult. Trust building may be an advantage in AA.

    Make no mistake about it, Jim, I don’t miss any points as far as utilizing therapies in conjunction with other therapies. I’ve mentioned how therapists will use therapies as adjunct therapies to their primary therapeutic approach. You must also know that I am a MH counselor and believe very strongly that any one discipline is less effective than employing a bit of many. Simply because, as you state, “Members of AA could tell him [me] that recovering alcoholics often benefit from therapy IN CONJUNCTION with AA meetings,” does not mean AA in and of itself becomes a better therapeutic form; it simply means that other forms of therapy can be beneficial as adjuncts to the AA approach.

    As far as the “amateur group therapy” bit…you wouldn’t call it professional group therapy would you? And your argument, that you’ve seen clueless psychiatrists and psychologists conduct poorly orchestrated “professional” group therapy, kind of wrongfully maligns professionalism because of a few bad professionals. It’s an argument of, “well I’ve seen bad “professional” group therapy, so why is “amateur” so bad?” Jim, come on, is this how you intend to defend AA? With such ad hominem appeals and what amount to sophomoric debates, are you really looking at AA (or other therapies, for that matter) as objectively as you intend? On the one hand, I can agree with you–after over three decades in the MH field, I can say I’ve seen more bad therapists and programs than good ones–that professional therapies can often fall short and AA can help people; on the other hand, AA, as well as disciplines in clinical approaches, need to show some valid metric (beyond the anecdotal) as to their efficacy.

    I would also agree that because AA is free, it is very accessible. I would disagree with your comparison of AA “costs” to daily professional therapy costs or the fact that someone can attend AA three times a day, etc., as some kind of advantage of AA. I have seen the “three times a day” phenomenon to be very counterproductive for one thing; and, I would say that going to “professional” therapy once a day would be counterproductive, as well. (Again, the cost issue is more sophomoric debate, less objective examination of AA.) People need help sometimes in between therapy sessions and AA meetings, sure, but, to set up a structure of “constant therapy,” if you will, makes the transition away from the nature of professional therapy, or the reduction of social aspects of AA, even more difficult. The key to success is in hoping to see dealing with one’s difficulties as more like breathing. If I went to a therapist and he/she recommended I go to therapy every day, or the absurd three times a day, I would (and should) get as far away from that therapist as possible. I feel that if a person has decided to stop drinking and needs to check in with someone three times a day, then he/she really isn’t ready to stop drinking.

    I’m sure you are a fine therapist, and I’m sure your experiences with addiction and sobriety/recovery serve you well, it’s just that I wouldn’t discount your professionalism, or professionalism in and of itself, so quickly. I would also add that the quality of AA programs varies greatly; I would not criticize AA because of that. I would criticize AA based on its therapeutic model, its data on success, and its lack of data on failure. It is important to state, once again, that if AA helps a person, and this is what works, go with it; this is as an individual thing, though, finding help for oneself rather than looking at AA objectively in terms of overall therapeutic value.

    I don’t think it is such a good idea to rely purely on the opinions of those who have been successful in AA and give testimonials about it. It seems a bit dismissive and defensive (as well as a kind of exclusionary mentality that can become unhealthy) for AA members to look at the rest of the world as uninformed outsiders, however some modicum of truth there may be in a thought such as that. I have heard so much of that “you can’t be objective about AA because you don’t know it from the inside” stuff over the years…in fact, it seems objectivity would be difficult for someone who has been successful using AA.

  • Ellen Dibble

    Doesn’t a competent, confident, and reputable professional in mental health follow more or less the path of the “good mother” whose intention is to liberate the child, help the child find his or her own more suitable milieux for support and continuance?
    Brett’s point that people who have hit bottom are least likely to easily identify the best helping modality is interesting. They might have something like what I’ve heard of as the Stockholm sydrome? Where one feels one has to approve of one’s victimizer because otherwise I am associating with something that debases me. (Or look at the last posts on the Jessica Stern onpoint hour — I think last Friday, about terrorism and trauma; someone cites Eric Fromm, the psychoanalyst on the “commercial personality,” that sees the powerful — i.e., successful, rich — as the ideal and domination/sadism becomes ever more the norm in the society.) If a patient/client feels exclusively claimed by a practitioner, it might assist in helping a person with bonding difficulties to learn bonding. Not very healthy bonding. A bonding that is to the commercial advantage of that practitioner.
    So it was refreshing to read Brett’s piece.
    Jim H, it is surely true that to the extent alcoholics almost by definition have lost the ability to get the kind of boost family and friends can give to others, most particularly because those most able to help would not be alcoholics — well. Oops, I’m off the track. I meant to end up that those with experience with the particular problem are obviously the best choice. Not necessarily the whole solution but a good part of it.
    I have been through swaths of my life where I’ve known exactly that I need someone to sit across from and just look in their eyes and know the shared humanity of an I and a Thou, and called a local therapist. Just someone to be there when it’s all too much and I feel I’m falling (so to speak), maybe every few weeks. A human escape valve; I knew it could work for me. The answer? Not possible. No can do.

  • Eddie

    My dad died drunk in a veteran’s home. My mom died drunk in her home. I’m an alcoholic. And I’m alive. And I go to meetings and have done for 24 years. And my life today is, and has been, good. Good job. Good wife. Good friends. “Good Orderly Direction” – aka GOD. It’s not for everyone. Doesn’t work for everyone. What does?

  • Barb G.

    My dad attended one AA meeting in 1962 and said, “I don’t need that and I can quit on my own.” Fortunately, he did and remained sober until his death in 1973. However, after 30 years of drinking, my sister has been sober for six years following an Intervention, rehab and AA. As she says, “It’s one day at a time.” My son is sober through AA, for the second time in six years. He says his first attempt was half-hearted; this time he attended a variety of meetings in different local towns and found that finding the right meetings is a key to his sobriety. AA has clearly had a significant, positive impact on our family.

  • anon

    Brett, that is an impressively convoluted expression of your defensiveness about AA. I have met a few other “MH counselors” who were uneasy about competition from amateurs, but fortunately they are in the minority. I hope you don’t do too much harm with your attitude.

  • Brooke Lowry

    It is also important to note that there are other Anonymous programs such as Emotional Anonymous. My Mother found it through a therapist and has found it very helpful for her. She says it follows the same 12 steps but focuses on ones feelings of not being in control of ones emotions.
    Thank you.

  • Jeff T

    Brett said: “AA, as well as disciplines in clinical approaches, need to show some valid metric (beyond the anecdotal) as to their efficacy.” No it doesn’t. It’s a voluntary program. It receives no public funding. It works for some, it doesn’t work for others. If you’re charging money – you better demonstrate some efficacy (how many actually do?). If you’re a free voluntary group, you need not “prove” anything.

    AA is not allowed to promote itself or solicit members so if you come to it you’re making that choice. If it works for you, great! If it doesn’t, find something else, but for your sake Stop Drinking if it’s ruining your life.

  • gary wagner

    Very briefly (you will get my point without my having to write pages and pages of definitions and explanations), alcoholics are persons with ‘addictive personalities’. They need SOMETHING in their lives in order to function satisfactorily beyond what ‘normal’ folks need. AA meetings, like other social constructs (square dancing, whatever…), do add a useful and healthy dimension to the daily lives of persons who like that sort of thing, but primarily, for the alcoholic, AA just replaces a destructive addiction with a more-or-less healthy one. THAT’S why it works, and why the people who use it frequently do so for decades, even for their entire lives. It’s that very simple… no mystery at all. Thank you very much. I’ll just take my $500,000.00 now for my two-year study.

  • Brett

    Jeff T,
    AA presents itself as a way to stop drinking and to recover from alcoholism. It also takes donations from its members. Additionally, it is a foundation for many other twelve-step programs (some funded by other means than donations). Courts order those convicted to attend twelve-step programs. Many institutions use AA, e.g., hospitals, prisons, etc. For brief periods of time some members get paid for services incidental to AA as an organization.

    AA also boasts success; and, in a sense, its members’ testimonials are a kind of advertisement for the organization. Without a large membership, AA would not exist. Without donations (there is a code of “love and service” regarding donations, as well as an emphasis on the “spirit of sacrifice” with respect to the act of donation) AA would not exist.

    It has to either define itself as some kind of therapeutic organization designed to help alcoholics end their addiction or some kind of spiritual organization, or a mixture of both. Yet, AA members get defensive if either is intimated. “It is not a spiritual organization! It’s not a form of therapy!”

    Because it boasts claims (claims that not only include success in stopping drinking) it could be considered offering people false hope if indeed it is not any more successful for a member than not being a member with regard to recovery from alcoholism.

    If you had a leather belt attached to electrodes and claimed it cured cancer, and you would not accept any money for it, yet you would accept donations, you’d better believe you would have to back up your claims with some kind of clinical evidence that your claims have some validity!

    Desperate people will do anything to get out of desperation, whether it’s cancer, alcoholism, schizophrenia or whatever, at the least to claim an organization helps people recover from alcoholism, not to mention that it also takes donations that it devotes to organizational finances, means it has some ethical obligation to have some real data to back up its claims.

    AA wants to use the disease model of alcoholism, but it doesn’t wish to be scrutinized in any clinical way? I’m sorry, you’d have to do better than say it is free so it doesn’t have to prove anything! A lot of other therapies are practiced through private, non-profit agencies, with participants paying nothing or very little for services; does that mean they don’t have to prove success, even if they boast it? BTW, you only think other therapies don’t have to prove themselves. Anytime a behavioral, cognitive behavioral or analytical therapy is used in a therapeutic setting, very clear criteria under which they will be practiced, and very clear goals and objectives and measurable outcomes, have to be included.

    AA also has a whole series of strategies (a pamphlet called, “Self-Support: Where Money and Spirituality MIx”) on how to get around things like paying rent, covering overhead expenses, hosting social events, etc.The General Service Board of AA, Inc., the mother organization, as it were, has tax-exempt status. Local AA entities need their own tax-exempt I.D. number, and they usually have a tax exempt I.D. (under the 501-C-3 code). This separation between the main organization and local chapters in terms of tax-exempt status is intentional on the part of the organization; this prevents it from being viewed by the IRS as a charitable organization. The G.S.O. carries things like liability insurance, they have a main headquarters, and so on and so on. How they handle their finances and acquire capital is very similar to how a church organization operates or how a private non-profit organization operates.

  • Jeff T

    So many words – so little value.

    AA is what it is and it helps a lot of people.

    What could be the motivation of those who attack it? To force people to pay MH professionals?

  • Jason M

    Read a lot of comments, some good some bad. As an AA member myself I can concretely say that it is an amazing program that is designed to help. That is the beauty of it, the simplicity. It’s primary purpose is to help people get, and stay, sober. There is no hidden agenda, no kool-aid to drink or robes to wear. The religious aspect is the god of YOUR understanding. It can be a Group Of Drunks, or Jesus, or Buddha, or Mohammed, or Karma, or anything you want. AA’s beauty is it’s focus: Getting and staying sober. Period. Anyone who says AA is anything different is completely wrong.

  • Brett

    “AA is what it is and it helps a lot of people.”

    If you read all of my comments, you’d see I acknowledge that AA helps some people…but how many is the question! ;-) Sorry, but this IS the topic for discussion. Maybe you should have just called it a day after reading one comment that it helped somebody if any other viewpoint seems not worth examining.

    “What could be the motivation of those who attack it? To force people to pay MH professionals?”

    Don’t you think you are being just a tad reactive and overly dramatic? Aside from saying I think AA should subject itself to some clinical scrutiny I’ve said nothing derogatory about the organization. I’ve also said nothing about AA that is false or misleading.

    If you have been paying attention, you would focus on the fact that I also said I think ALL therapeutic approaches and disciplines should be held to a certain standard of efficacy using some sort of valid measurement. (You even quote me saying so in your July 9th, 10:57pm comment, yet you choose to prefer to emphasize what you perceive as an attack on AA.

    If it or any attempt to help someone is so wonderfully powerful, couldn’t it withstand a little scrutiny? Or is that just for other approaches you don’t like?

    I get it…it’s free, and you, or someone you know, or have heard of, have been helped by it. Well, is that all we need to think about? Thinking about why some people fail in AA or how AA addresses psycho-social needs, or what components of AA have real value and what parts may be harmful in a therapeutic sense…those things don’t matter at all?

    No one needs to think about options and have informed decisions when they seek help? And the best argument you can come up with is that AA should never be subject to any scrutiny because it is free?

    I am not commenting on here to be a cheerleader for AA (or any other approach to substance abuse for that matter). I have worked closely for over thirty years with people who have primary diagnoses of some type of mental illness and often secondary conditions of some type of substance abuse. It behooves me to question any and all therapies. I have seen AA’s successes and failures, and I have seen the way human services/psychology fields, as well as our judicial system, blindly embrace AA. Why? Because in a way it is the best band-aid for a compound fracture… as you say, it’s free!

    BTW, the “so many words, so little value” seems a little mean spirited and unnecessary, but then was your objective to debate points of differing opinion? Or perhaps you simply felt some irrational sense that by my questioning AA”s results and organizational structure I have by extension attacked you?

  • Ellen Dibble

    It would be a little dull to have wall-to-wall testimonials, of which there must be millions. The program is not designed for plain boosterism. It isn’t selling any book.
    There are so many healing modalities under the title of Chinese, Ayurvedic, Zen, homeopathic, not to mention all the various approaches of different schools of psychotherapy. And brain science changing by the month. And neuropharmacology changing by the month. My point is that unless you just want the insurance companies to pay for anything (and the courts to order anything), then some method of evaluation is in order. And AA, per most of the posts, doesn’t really lend itself to that, which sad experience of many subjected to “treatment” (starting from those who, like Ted Kennedy’s sister, were lobotomized, and on and on) suggests really should be undertaken.
    If AA is about as ubiquitous as kitchen coffee klatches, one wonders why? Go if it is what you need, or part of what you need. Otherwise look elsewhere.
    So I’m wondering what sort of data could be collected from something so freewheeling. And don’t underestimate the value of simply having AA (and NA and so on) available. Like a bank account that’s never drawn on, it is a resource whether it’s used or not. I haven’t heard/read much about people who got burned by AA; when there are many groups, one can shift to a more compatible one. I do think the “anonymous” part reflects to some extent the way the members might be protecting one another from legal intrusion. Lists of those who attended meetings, to my knowledge, seem a bit unreliable, created after the fact and so on. And AA members will show up in court for a fellow member. Lawyers will advise clients not to keep records, and one can see why. A lawyer can’t subpoena records kept in the ordinary course of business if none are kept. At least in this organization, deniability is kept by its sheer looseness. A therapist can be in position to have a client sign a release and be required to provide access to all that therapist’s records. I don’t think AA can be asked to do the same.
    It’s a little like the husband/wife immunity. The members can be a little out of bounds.
    If AA were scrutinized, all of that would go.
    So Brett, can you suggest a study, how it might be conducted?

  • anon

    Brett, do you really think statements like “if AA helps a person, go with it” disguise your overall hostile and defensive attitude? What is the problem? AA is an organization with no gvt funds, no highly paid executives or professionals, no advanced degrees, nobody dispensing pharmaceuticals, that has helped countless people all over the world. It’s nothing but people helping people, and yes, sorry, the bond with a fellow sufferer is the magic ingredient that you professionals can’t match.

    “I would criticize AA based on its therapeutic model, its data on success, and its lack of data on failure.”

    Why do you think it’s necessary to criticize AA at all? We’re just a bunch of drunks trying to get sober, we’re not pseudo-scientists writing a paper for you to referee.

  • Biff Rocko

    I am an atheist, and with the help of the fellowship of AA, I have been sober almost 5 years now . it is unfortunate, but too many people read too much into the GOD part of the program. Fortunately for me, I learned god can be whatever I want it to be. That being said, I am concerned that AA is being hijacked by those who are far too religious and as a result, people who could otherwise be helped are being scare off by those shoving religion down their throats.

  • Vic

    I was pursuaded into AA after a long binge and went regularly for 6 months, then not since. I have binged a couple times since. Okay, it works sometimes. How many sure-fire cures are there for serious substance abuse? None unless a person wants to reform, and more importantly can muster the inner strength to do it, and some people also need support. We don’t all have supportive families or communities, indeed the families can be enablers and the communities can be enablers. But at AA everyone knows why they are there and everyone sympathizes, it is a community with a firm purpose. Alcoholism is an insidious urge that can kill you and maim your life, bad things happen and one has to find a way to come to terms with the guilt and the damage, and find tools to overcome whatever it is gnawing at them that makes them.

    Everyone should attend an AA meeting at least once to witness the sincerity and humility. Okay perhaps it becomes a role to play for some, consciously or not, but we cannot police the purity of intentions, just keep ourselves on our own development. There are a crystal clear message at every meeting. I don’t go anymore but I won’t forget what I heard and take heed of the clear warnings in the stories of hitting ‘rock bottom’

    The starting point of admitting you are helpless is not much of a submission since an alcoholic at rock bottom is helpless whether is it admitted or not. Have any of you AA naysayers ever hit rock bottom? It’s not pretty. One might even be at death’s doorstep.

    The books mention God, but never at a meeting was there ever any pressure to be a believer. Maybe this is because my meetings were in a college town, but basically if you’re in AA you’re admitting that you aren’t in a position to proscribe anything to anybody else, you’ve already proved you’re helpless against alcohol, and this is a real bond of trust and respect, so there is not much of a problem with hidden agendas at these meetings of people who know what it is like to be helpless and desperate. I don’t believe in any religious superstitions, so my higher power became my future (the past being useless) but at AA it is not of strict importance what the higher power is as long as you can grasp the concept, that you need to pull yourself out of the day to day noise of life and see something larger in it, and if you can then that can be a potent tool for recovery.

  • Brett

    “…do you really think statements like ‘if AA helps a person, go with it’ disguise your overall hostile and defensive attitude? What is the problem?”

    “Why do you think it’s necessary to criticize AA at all? We’re just a bunch of drunks trying to get sober, we’re not pseudo-scientists writing a paper for you to referee.” -anon

    Wow…sorry if I struck a nerve. You sound as if you think that when I make positive statements about AA, I am not to be believed, that my so-called negative statements are being engineered and manipulated using those?!?! You sound a bit paranoid, as Jeff T. sounds. This forum discussion is not merely to serve AA members and make them feel good, nor is it to encourage others to join AA. If that is your goal, then that is your goal.

    Again, I’ve seen how the system utilizes AA, which is beyond a personal positive view. When I look at the numbers of people who haven’t been helped by it, in addition to seeing how much failure to succeed at an attempt at sobriety can damage a person, set him back, make him delve further into his addiction…yeah, I am concerned at the boosterism that goes along with AA.

    So, anything other than AA with regard to substance abuse treatment is “pseudo science,” yet you and your ilk are the ones to be offended?

    To say that I am hostile and defensive is a pretty skewed take on what I am saying, and it seems a bit hypocritical. I’ve worked with literally hundreds of people who’ve attended AA over the years, and the ones who need an array of services and alternatives to treatment the most get handed the “AA is the one and only option.” Thankfully, that is starting to change, as other treatments are becoming more affordable and are being covered, so a financial burden isn’t the one factor determining the decision of treatment for a person. Courts are starting to offer alternatives to twelve-step programs, which is a good thing. Also, the medical community is starting to really embrace the idea of utilizing an array of therapies to provide treatment for a person in need. But, for a long time the only option has been a twelve-step program, unless one has had money or particular savvy with the human service field.

    I am NOT looking at AA through the lens of one person who has been helped and what it means to me personally as it has helped me, etc., as you may be looking at it, nor am I looking at AA with a particular axe to grind but at the organization and at the way it has modified certain principals over the years, not because they were therapeutic adjustments but because the “organization” has wanted to increase membership. One example is the “higher power” principal. It used to mean looking at something beyond oneself through a Judeo-Christian lens. The “organization” at some point decided that this limited membership, so it became whatever the alcoholic wants it to mean. Just like anything that becomes incorporated and wishes to grow, at some point the organization makes decisions based on what best feeds the organization. This is true of AA; this is true of the mental health field.

    If you must know, as far as “therapies” go, I am very critical of psychoanalysis. It may help some people, though. “Hostile,” “defensive” toward it as a discipline? Hardly, but I am more critical of it than I am AA as a therapeutic approach. I’m sure someone is out there going, “wait a minute, I am being helped by psychoanalysis!” I am not critical of people who find something in it, I am critical of the efficacy of its approach based on data. Should it have been touted as the great savior that it once was? When the psychiatric/psychology community embraced it so much, did that hinder progress? I’m sure Freud helped some people, and some people (it’s hard to believe) in the field still embrace his approach! That doesn’t make his theories any more valid in this 21st Century.

    I wouldn’t say that AA is simply “a bunch of drunks trying to get sober” any more than Catholicism is just a group of people who are on a spiritual journey trying to answer the meaning of life; they are much more than that. One can criticize the Catholic church and yet completely understand what compels a Catholic to continue pursuing that faith.

    I am glad, anon, that you’ve found a solution to your substance abuse problem. I am concerned about what happens that prevents a person from utilizing a program as it was intended. If AA falls short in some cases, I would like to understand why beyond blaming the person in some way, or simply saying it is not for everyone, so go find something else (AA is too much entrenched in the human service field to dismiss its integral presence).

    In many respects what seems failure on the part of AA or any therapy is really the nature of addiction at play…the relapse and recovery cycle. AA, as I’ve said, has only modified its approach to accommodate the need for more members and not to advance its methodology, or even to conceptually evolve its view of addressing the recovery-relapse cycle phenomenon. Yet, it is very clearly married to the “disease model.” This is a contradiction.

    Over the years, many interesting, controversial and successful therapies have been tried in response to substance abuse. Few have been given any support by the medical or judicial community. AA sure has! There are many reasons for this, not all have to do with AA being therapeutically sound, either. It is distinctly American (although other countries have in the last few decades adopted versions of it), it has a Protestant foundation and has a religiosity to it (something Americans like as an alternative to out-and-out church-going as a way to get salvation), it is free, it never has to be monitored for efficacy, governments don’t have to worry about budgets; in fact, they like AA because it reduces the burden of their responsibility, communities consider it a charitable organization, yet it is not (by IRS definition, and by purposeful design by the organization to prevent liability and IRS tax laws from determining how certain aspects of the organization will be run). There is a political factor to AA in communities, so to speak, and the very design of the organization is intended to keep it from scrutiny.

  • Anonamouse

    I am an Al-anon member. My ex-wife had a severe addition to alcohol as did both of her grandparents and brother. Rehab, counseling and AA did not help her. She wanted to sober up but could not. Clearly, there is a physiological component to alcoholism that AA and counseling cannot cure. It is up to science to figure out the issues with brain chemistry that cause pain that causes the alcoholic to drink.

    Even with such a physiological cure, it is my experience that the alcoholic will benefit by the fellowship AA affords. Alcoholics and their family members develop personality issues because of the family disease. These issues must be worked through and corrected to reach a happy, productive lifestyle. AA and Al-anon are designed to help both sides of alcoholism correct these issues. Diligent work is required by the participant to reach their goals. Many are not willing to provide the sweat equity required.

    As far as the religious aspect that many are railing against, a higher power may be any being, deity or concept the participant wishes. For me, Al-anon caused me to believe that the “Universe” wanted me to survive the storm of my wife’s disease and to thrive in my new life.

    I am grateful that my divorce lawyer strongly encouraged me to go to counseling and Al-anon. Now that I am on the other side of divorce, I am at peace with my ex and the our past, and ready for the future free of anger, bitterness and grief. Life is worth living again.

    Alcoholics and their families should not suffer alone. Whether it be AA, NA, Al-anon, or some other program, get some help. If one program doesn’t work, find another. There is a better way to go through life than the misery of alcoholism and addition.

  • Rose

    I have read with interest many of the comments here, and find that so many people blame AA for the behavior or attitudes of some of the members. One should keep in mind that AA does not promise to make us perfect. We are not a hotbed of mental health when we arrive at the doors of our first meeting, and, depending on how long we participate and how actively we try to change our thinking and behavior, we can remain pretty sick puppies.

    One should remember that a drunken horse thief who simply quits drinking becomes a sober horse thief. S/he may be
    a pretty unhappy horse thief to boot, if s/he doesn’t find a way to live more happily without the booze. AA does not cure anything, but it does help us to stop drinking and for many people who do follow the suggestions, it teaches us to be happy with not drinking.

    One person wrote, concerning congnitive behavior therapy: “In other words, by learning to shift or alter their thinking processes, clients can think more clearly about the choices they make and the behaviors in which they engage.” AA does that for me – through the practice of the 12 steps. AA does not require me to believe in God, but asks that I only accept that I am not. When I think I can control my addictions, or other people’s behavior, I am thinking that I have power that I, in fact, do not have. Once I am able to accept that I do NOT have that power, I am willing to seek help from other sources, and therein lies real power. I am not completely powerless – only powerless by myself.

    So saying, AA is not a religious program, but it is a spiritual one. A religion tells you what to believe; a spiritual one helps you believe in something, but does not tell you what that has to be. AA is no more religious than the United States of America. It was founded on Christian principles, but is open to anyone. Yes, there are some Christian rituals, prayers, or other references to God in the literature or customs because of their origins (think “In God we Trust” on our money or listen to the words of America the Beautiful) but nobody says you have to believe in Jesus as God, or Mohammed, or anyone or anything else.

    As for the science of it all – I don’t presume to understand, nor do I need to. For me, the proof is in the pudding. I have done what was suggested, I have changed my thinking processes and approaches to become more openminded, and I have not had a drink in 23 years. I still can be a real jerk sometimes, and make foolish choices, and behave badly in some circumstances, but at least I know how to make my amends when I hurt someone, I have good relationships today,am more happy than not, and have not been arrested for stealing horses either :-)

  • Brett

    Ellen D.,
    There have been some independent studies done on AA. The problem is that the only data they can gather is from anecdotal testimonials from individuals who like/have been helped by AA.

    Of the studies I’ve looked at over the years, the findings either draw the conclusion that AA doesn’t fare any better than any other treatment, or that they are inclusive–needing further study.

    Perhaps some controlled studies involving “placebo control” in conjunction with uniform therapy delivery studied longitudinally? AA, you see, won’t allow that.
    AA has its own subjective reporting in its “Triennial Surveys.” They mostly track membership to determine success, attrition rates.

    I don’t quite buy your assertion that if AA were to be studied, that members would lose their anonymity.At least AA could be studied more than simply doing a head count could it not?

    Why would an organization that wishes to help people as individuals getting through a grave problem not wish to set up individual plans with goals, objectives, areas of emphasis, etc.? That might turn people off, in wanting to become members, as it were, perhaps?

    You say you’ve never heard of anyone “burned” by AA. I don’t like the characterization of being “burned.” It sets up a black and white scenario of AA either works or it doesn’t; or, no one has been “burned” that you know of, so what’s the harm, or it must be good because of all of the posotive testimonials, and so on…How many people have you talked to about AA’s success? Tens? Twenties? There are well over a million members; and, they claim something like 25% success (I’m ball parking it) after a year (success defined as membership). What happened to the other 75%? One third drop out after one month. What compels the other two-thirds to stay? By the end of the first quarter, something like 50% have dropped out. What becomes the stumbling block in the first three months? Understandably, the attrition rate slows down considerably after a year.
    The Triennial Survey has changed the way it measures success over the past decade or so. It used to place more weight on the first thirty day measure. Now it emphasizes success more among those who stay. So, it is a bit like saying, of the successful trials, all were successful. What kind of data collection is that?

  • Ellen Dibble

    Brett, if 25% is the success rate of AA, given the numbers who give it a try, that is absolutely huge. Huge.
    What you’re saying, if I understand, is that the other 75% (the ones who turn up in your practice, for instance) have been made to feel like failures.
    Not only have they failed at life, ending up helpless to an addiction. No. Beyond that, they have failed at Alcoholics Anonymous. They can and probably do blame AA, and AA might say that’s part of an addictive personality: to refuse to take responsibility; to blame the Other.
    However, you’re saying the other 75% need not view themselves as flunking AA. I guess that would be getting an FF.
    No, there needs to be a way of directing that 75% to the therapies that will help them, and make them feel like succeeders.
    Above, there are plenty who speak of the sweat-equity, the persistence, that makes AA effective rather than, um, trite. (What word to use?)
    I’m pretty sure Brett would say that other alternatives — ones where a person is more likely to be shelling out a fair amount of cash along the way — are no walk in the park either. You can’t self-congratulate yourself out of a crash-landing.
    Or can you…

  • Brett

    You do kind of hit on some of the sentiments I have been trying to express (apparently I also seem to be offending in the process ;-)). Before I go further, though, I want to get the 25% (or so) out of the way. That percentage is about the same as with other treatments, and isn’t far from the mark of those who quit cold turkey, so to speak, or rather seek no help. The number is not that significant when one considers it is merely a head count (or continued membership) with no other criterion being considered; and, it denotes only those staying with the program over one year, and it is based on AA’s data only. I am questioning the method of data collection, not in terms of corruptibility or conspiracy, but in terms of “what does it mean?” Or “can anything be truly gleaned by it?” Anyway…

    I usually keep the “two-year idea” in mind (I think I came upon that idea when I was in therapy many years ago after my fiance was killed), meaning any perceived loss (which is what I believe is at the foundation of any mental health issue–aside from classic mental disorders) takes about two years to recover from fully. I believe, with therapy, one can navigate back to a reasonable life before that and with less trauma if the therapy works, generally. Expecting an even quicker recovery without any kind of relapse, or in falling back into previous stages of grief, I believe, is unrealistic. Perhaps that is what gives those numbers from AA significance? Perhaps those who drop out or feel they’ve “failed” at AA place too much of an expectation on themselves and the situation. Maybe some even devote some of that “sweat equity” but don’t give the work enough time? Maybe they feel after the thirty-day mark (and I’m glad AA has put that emphasis in the background) or sixty-day mark, etc., they think they are supposed to feel transformed in some profound way, especially when they hear from others, who have put in the time and work, proclaiming a developed sense of self-realization?

    The reason I’d like to see some scrutiny applied to AA is not to unravel it or to debunk it or to point a finger at its failings, as some may perceive, but it is to truly analyze what works and what doesn’t. As commenter gary wanger explained in his light-hearted humorous tone, there is a large social component to AA, which is positive, for the most part. It provides an environment where someone can re-learn social function without alcohol! Many people who abuse substances are often lonely and shy underneath it all, and they use those substances to insulate themselves from perceived feelings of inadequacy or social discomfort, but in AA they get a huge warm embrace by a group who is ostensibly like they are, etc. This is good and a key element. Group “therapy,” as it were, works best when people perceive they are alone in their problems, as it shows them they are not.

    Maybe some fail, though, because of the social nature of AA? I.e., everyone around you is extolling the virtues of sobriety, of feeling “clean and serene,” of making it through a rough patch and coming out the other side feeling stronger, etc., and you say those same things, but inside you are feeling you are being phony, and you are the same ass you’ve always been…and where’s that drink, the little voice says to quiet those feelings–that one little escape–and you relapse, and you are ashamed, and you overcompensate (or “decompensate” I should say) for that by pushing others away (maybe so they won’t find out how phony you’ve been or how you haven’t kept up with the sweat equity), and so on. I’ve heard many variations on this theme in people with whom I’ve worked (BTW, I don’t have a practice–never have; I have been a case manager for a county agency and have also worked in group homes, halfway houses, institutions, etc., as a MH counselor). I usually try to steer a person to other therapies in these cases because it is counter-productive to approach the mess as “you haven’t put in the sweat equity,” or “you blame others, now take a look at yourself” (I’m a behaviorist first, after all); I would be modeling the very blaming behavior I am trying to get the person away from!

    I usually have the approach that, okay, anything we as human beings undertake worth doing is difficult, and it is a cruel world out there, with all sorts of personalities flying about…envision what kind of person you want to be and envision how you can strategize through this difficult world to find some modicum of peace and happiness in being the person you want to be. You don’t have to figure everything out at once, just maybe one piece of it (this is my version of the “one-day-at-a time” except I don’t use time as a marker, but I use a behavioral plan, of sorts, so it becomes a “one-task-at-a-time”). So talk turns into strategy, which turns into action, which is behavior, which turns into behavioral changes. The plan could include investigating resources for the person to start CBT with a therapist, setting objectives for myself and for the person for whom I am working. Another component of the plan could be to look at situational elements of specific problem encounters a person may have with others and play out scenarios wherein strategies are examined to determine better social approaches. I might assign some “homework” for the next week, so the person has to report back on difficult encounters and how he/she used practiced strategies to produce a more desirable outcome; or, “here’s a list of CBT therapists in our area, investigate over the next week and we’ll talk about what you’ve found out and what your strategy will be”…oops, I’m digressing!

    Another important component to the social part of the AA approach is an environment of unconditional acceptance where trust and empathic understanding is established straight away, a feeling that those around you truly understand and accept you, a sense that they do know what you go through…this is crucial to the initial stages of a good, therapeutic environment. I always tell people who seek counseling that if on the first visit the therapist plays tough with you, and plays the “break your spirit to challenge your assumptions” game, then drop the clinician like a hot potato. There is plenty of time later (maybe after the third visit) for challenges and making you work at “coming clean” about your perceptions, tough love, etc. The therapist has to first establish trust and convey to the person seeking counseling that he/she is there to listen, there to understand, and there to be on your side. Once that is established, then the challenges to perceptions, and “homework,” and independence, so to speak, can begin. (Another mistake by some therapists would be the therapist who creates codependence by not challenging after establishing trust.)

    I would like to see more transparency (such an overused word, don’t you think?) of AA because certain elements ARE working and could be culled and enhanced. Listening to testimonials doesn’t necessarily provide that analysis in and of itself. AND, people get defensive, as “anon” displayed in his crack about my expecting members to be “pseudo-scientists” and that I want to “referee” their opinions, or that AA doesn’t need any scrutiny. There was something about the “other” in his/her sentiment, too, about “professionals.” It is unfortunate that “professionals” can be painted so broadly and with a snap judgement brush. If a therapist is only ever going to be an “other,” then find another therapist (or ignore therapists who comment on blogs! ;-)). If all therapists are to be viewed as “others”…what does that say about the whole blame thing? What does that say about how a person views our psychological make-up as part of the human condition?

    Last night, I was playing a gig where people were getting drunk. Mostly it was a typical scene of people getting silly or “tipsy.” I did observe a few who seemed to have a problem–an ugly and marked personality shift after a few drinks, that sort of thing. On the way home, I kept thinking about different types of substance abusers…I believe some are shy, very sensitive people, who maybe have the soul of a poet or the innocence of a child, and they abuse substances to insulate themselves from the cruelty of the world, to make themselves tough to the external yet more in touch with it at the same time (give them a nurturing environment surrounded by other sensitive and kind, confident people). Some maybe are simply compulsive, with addictive personalities (end the compulsivity toward a given substance by removing the substance from the environment and replacing that substance with a desirable compulsion). Still others seem to have some personality disorder, perhaps compounded by the environment (in which case, substance abuse is more a symptom of a much larger problem, so stopping the substance abuse in and of itself doesn’t really address the problem). In the first two scenarios, making some behavioral changes seems to show promise. The third “type” seems to be the one that is not helped by behavioral means or by traditional therapies, in a sustained way. Maybe AA can’t address the third “type”? Maybe the third “type” can’t yet be helped by anything we currently know about? Maybe these different “types” in some way explain how some people can be abused as children and come through the other side intact, or why some withdraw and hurt themselves, or why some become monsters themselves?

  • anon

    “Wow…sorry if I struck a nerve. You sound as if you think that when I make positive statements about AA, I am not to be believed, that my so-called negative statements are being engineered and manipulated using those?!?! You sound a bit paranoid, as Jeff T. sounds.”

    LOL, suggesting that one’s comments “struck a nerve” is a pretty standard and transparent tactic. Look to your own nerves, with your very long and convoluted arguments, Brett.

    Yes, I think that your positive comments about AA look like an attempt to appear objective, and the negative comments look like where your heart is. No need for paranoia, people argue like that all the time.

    You have made some really absurd statements:

    “I feel that if a person has decided to stop drinking and needs to check in with someone three times a day, then he/she really isn’t ready to stop drinking.”

    Unbelievable. A lot of AAs, in early sobriety or in difficult times, will check in at a meeting or with a sponsor 3 times a day, while not drinking. Would you find it troubling if someone who was “not ready to stop drinking”, according to your theories, was not drinking? Would you suggest that they should start drinking again, until they met your standards? Or do you think that someone who used to spend 3 hours a day in a bar is not better off spending 3 hrs a day in AA, not drinking?

    Of course, nobody could afford such intensive care outside of free AA.

    BTW, while AA, and I, respect the medical profession, I’m really concerned that “MH counseling” increasingly consists of pharmaceutical dispensing. Why is that? Is it just cheaper than spending the time needed to get at root causes?

  • Ellen Dibble

    Brett, Speaking of Faith, the Public Radio program with Krista Tippett this morning presented John Paul Lederach –
    http://speakingoffaith.publicradio.org/programs/2010/art-of-peace/ — author of “When Blood and Bones Cry Out: Journeys through the Soundscape of Healing and Reconciliation.” He is a mediator on an international scale. Conflict resolution (achieving peace) and healing seem to have a lot in common. I especially thought of you because of your music, shall I call it, “practice.” According to Lederach, agreements can be achieved, acceptable policy can be established, but it doesn’t take root if it comes from on high. It doesn’t trickle down. The grassroots have to make it happen. And he sees crucial roles for poetry (haiku in particular) and for music, rhythm, repetition. For the haiku, he says that change (reconciliation? healing?) requires nonlinear thinking, instead of seeing black and white, either/or, right/wrong, us/them, one sees the complexity, and he says the people approaching reconciliation speak in haiku, that is, complexity into simplicity, where one “side” incorporates the perspective of the “other” into their own. There is a selection of such haikus from meetings that he has heard people state in the flow of conversation. Capturing the fullest complexity in the fewest words, “Maybe this is as good as it will get — peaceful bigotry,” from Northern Ireland. As to music, he says that the violence and the exclusion/denials will erupt until music “fixes” the transformation. “Fixes” is my word. He says that the funders of his (Mennonite) efforts want linear results, and he mentions that nobody asks for validation for the repetitions of mass at Catholic churches. There is nothing wrong with singing the same song over and over. They (Krista in this case) cite Pete Seeger getting all his audiences to sing during the Civil Rights struggle. “This Land is Your Land,” and eventually it sounds right.
    The question is how to get a decision not only into policy (and behavior) but into the subconscious. I like the idea of nonlinear verbal communication, sort of neocubism in words.
    Some people here are trying to make everything linear, like an emotional straitjacket.
    I think I get a feel for where AA works and how, and I think I have a feel for where therapists can be no help either. Court cases I transcribe are full of people knowing the DSM, diagnostic and statistical manual, like a bible, and I guess the originalists, the sojourners?, are saying that the more people fail the better; they are then off their/our radar and out of the way, not competing for scarce resources maybe. “Don’t try to understand or help, not through insurance that we all pay for, not through taxes either.” If AA doesn’t help, just get small. And don’t ask why.
    Is there snake-charming music available?

  • Brett

    I’m not sure of your point, really, but you always make the conversation interesting and elevate it, which I appreciate very much. I find myself agreeing with individual statements in your last comment, but when I tie them together, I am not sure of the overall point (well, maybe in a non-verbal way, I do understand).

    Thanks for the link; I’ll have to check it out. Maybe what you are getting at may become more clear!

    I do want to respond to one thing you said, though: “agreements can be achieved, acceptable policy can be established, but it doesn’t take root if it comes from on high.” What I thought of there (how it relates to therapy) was how the relationship between therapist and person receiving therapy, if it is a therapeutic and healthy one, is one of negotiation.

    Anyway, I’ll listen to the program! Maybe when I put the program together with your comment I’ll find better focus. At the least, what you say sparks a lot of interesting and reaffirming thoughts, and that is the true gem of your presence on this forum.

  • Brett

    “Unbelievable. A lot of AAs, in early sobriety or in difficult times, will check in at a meeting or with a sponsor 3 times a day, while not drinking. Would you find it troubling if someone who was “not ready to stop drinking”, according to your theories, was not drinking? Would you suggest that they should start drinking again, until they met your standards?” -anon

    My concern about the 3x’s a day thing, or even questioning what might not be so positive about AA: CODEPENDENCY! Yes, “needing” to have support from a “therapeutic agent” 3x’s a day would be troublesome. Simply not drinking for brief periods of time or how frequently a person engages in treatment should not be the measurements for a successful treatment of problems with alcohol. There is no “frequency” “standard” by which a person should receive treatment (some treatment is around the clock in a treatment facility), but seeing a sponsor 3x’s a day runs the risk of not being healthy. Some sponsors might be really smart and savvy and know how to recognize appropriate “intervention” and interaction with a new member, but AA does not have its sponsors trained or licensed or monitored for standards of care, etc. This is also one of the downsides to AA.

    Because I feel that these could be some of the not so sound aspects of the AA model, you think I might believe a person should continue drinking???

    Also, there is a marked distinction between an MH Counselor and a psychiatrist.

    You’re arguments are degenerating into a “well, well, but, but what about too much psychotropic medication prescribed by your side!!” kind of thing…please…sorry if I offended you and I am glad you found what you needed in AA.

  • anon

    Brett, as I said, your announcements that my arguments have degenerated and that your arguments “hit a nerve” reveal more about you than about me.

    You are now basically repeating the old, old claim that AA simply replaces addiction to alcohol with addiction to AA. I hope you can see that heavy reliance on AA is no as destructive as heavy reliance on alcohol! Furthermore, I wrote about 3x a day in early sobriety or in difficult times. 3x a day is not the norm, but I see nothing unhealthy in relying intensively on a great support network in particularly stressful times. It sure beats going into a bar. I also see unemployed AAs going to a lot of meetings. Where’s the harm? I wonder if you’d make the same criticism of people who are active in a church or nonprofit? Remember, the beauty of AA is that it is win-win. If someone is looking for a lot of support, they may be helping someone else, too. In fact one of the great AA principles is that the best way to help yourself is to help someone else.

    You also go on about the “uneven” nature of AA. I’ve found that human activity is uneven. In the MH profession, there are fantastic individuals and scum who have sex with their patients. There are those who understand and appreciate AA and there are those who are defensive about amateurs invading their territory. My sponsor says “some meetings spread the message, some spread the disease”. AAs are pretty good at sorting this out.

    I really was curious if you could shed some light on the MH profession tending towards being primarily a drug prescriber.

  • Ellen Dibble

    I think, anon, that maybe part of the prescribing that anchors the helping professions is related to the even greater cost (than pharmaceuticals) of having highly trained professionals do the work. Now it seems a less highly paid MH worker does the one-on-one, and relies on the psychiatrist to do the prescribing. Apparently this works pretty well, besides costing less.
    I don’t buy the argument that AA is a substitute addiction, but I think Brett might be in a better position than I to consider this. It could be said some of us use this forum as an addiction. There is usually someone here thinking about and talking about a common interest or problem, which solves the disconnect bit if that figures into life’s burden. But the whole internet does that. A global addiction. So what.

  • Brett

    I listened to the “Speaking of Faith” program with guest John Paul Lederach late last night. One of my mentors from college and my early years in human services decided to become a mediator. Lederach sort of reminded me of him.

    When my family first moved to rural Virginia in the late 1960′s, there was a large Mennonite community in the area. I had never had experiences with people of their kind. The Mennonite kids seemed very reserved and socially to themselves but very emotionally mature at the same time…

    Anyway, Lederach used language in an interesting way. Of his “moral imagination,” if I had just seen the phrase written somewhere it would have been a turn off. But he used it in a very creative way. (I hope some conservative type doesn’t co-opt the phrase for ill-gotten, manipulative purposes!) ;-) I also thought the phrase, “paradoxical curiosity” was interesting, because a paradox is not too far from complementarity in meaning.

    I liked the “soup story” from Nepal. I also enjoyed the Oliver Wendell Holmes (the Elder) quote about not giving a fig for simplicity on this side of complexity but gladly giving his life for simplicity on the other side of complexity (a paraphrase) which set the stage for Lederach’s Haiku discussion. The one: “gods and men love maps; they draw borders with pens that split lives like an ax” seems to fit a lot of reasons conflicts start. I also thought Lederahc’s idea of listening to poetry in conversation was very validating; I do that a lot.

    I thought he was stretching the constraints of language a bit (not a bad thing necessarily) in comparing people going around in circles in conflict to repetition in music or ritualized social events. I understand that he was getting at the hope/resoluition part of conflict resolution, that just when it seems things are at an impasse, with each “meeting,” lessons are learned and the next encounter becomes less inhibited by stumbling blocks (there is a learning curve that goes on in the course of a conflict resolution).

    When I used to supervise staff in my previous county job, I would have them work on some project together not related to the conflicts they were having. This kind of reminded me of the drumming and unified singing mentioned on the show.

  • Brett

    There was a sort of “house keeping” conflict at my group home a couple of weeks ago. (Much of what happens in an MH group home happens in any home with a group dynamic.) A woman resident (I’ll call her Sue) who has suffered from chronic clinical depression most of her life, and has been plagued by OCD (to the power of ten!) for most of her life, was going to make a birthday cake for another resident’s birthday that evening. A third resident (I’ll call him John) who has schizophrenia with paranoid thoughts, etc. had eaten a stick of butter the very morning Sue was to begin making the cake, and there was no butter left in the house (we were not scheduled to shop for groceries until the next day). Sue had had her mind’s plan disrupted and has had John pull little stunts against her a lot (although he claims everyone is out to get him). An argument ensued. John, luckily, admitted to eating the butter, which is when I stepped in. I asked John if he’d be willing to go to the store to replace the butter that morning; he agreed. I asked Sue, that, if she had the butter within the next hour to start baking, would she be satisfied with that resolution and the conflict going no further. She said, yes. Sue never seems to hold on to conflicts or ever is vindictive, so I knew she was on board; I had John at least agreeing to replace the butter, but I wasn’t sure he was ready to let go of the conflict. Later, before he left the house to go to the store, I said to him privately, “John, I appreciate your going to the store to get the butter, and am glad this is behind you and Sue. Just between you and me…It doesn’t matter to me, but I’m curious, why did you eat the stick of butter this morning?” He said, “because it was hostile toward me!” I laughed (John has a wicked sense of humor and has the capacity for self-deprecation); he was making fun of one of his diagnoses. I said something like, “you have a very good sense of humor; it takes a strong person to laugh at himself and save face at the same time…You have to admit, Sue can make a really delicious cake, can’t she?” “Yes,” he said. John likes to give toasts in groups at parties and likes to give compliments when he is in the right mood, so I said, “I hope you have one of your special toasts for ‘Tom’ (the birthday guy) as well as for Sue’s cake tonight.” He said he did. The party went well and the toast was sweet.

  • Brett

    If you are thinking that I am going to defend the field of psychiatry to bolster my points, you are mistaken. My “discipline,” if you must, is more behavioral and cognitive therapies. When I began in the field in the late 1970′s, the institutional model of keeping people heavily medicated to minimize problems and keep the labor aspects of the field’s costs down was thrown out the window. Human service agencies began to use a different paradigm with programs; medication was only used in rare circumstances and a strong use of behavioral and cognitive therapies became the order of the day.

    In addition to throwing out the old institutional paradigm of medication came viewing disruptive behavior as something that was better served by other means than aversive therapy, i.e., mechanical restraints such as straight jackets, splints, “seclusion” rooms, etc., had been used extensively prior to the deinstitutional movement of the 1970′s. The field was revolutionized! Yet, the cost was causing the field to become undone. Put that in conjunction with heavy budget cuts during the Reagan years (which has continued on to today), the field, although successful–particularly when one considers the droves of people being deinstitutionalized–was suffering from a red ink problem.

    Also, what was required of staff was not only an extensive understanding of various discipline’s and a highly developed skill set but a certain breed of person who could withstand the threat of violence from patients without internalizing it and without using the model of restraint (mechanical or chemical). I am glad to have started in the field at that time because my mentors taught me well how to handle a number of different situations.

    Then came the 1990′s! There was an explosion of new generation psychotropic medications that promised not only better management of illness but fewer long-term undesirable (often-times irreversible) effects. This was followed by more budget cuts in the early 1990′s. Agencies began to hire a different breed of counselor and began to use less expensive clinical staff. So, instead of hiring someone who had a master’s and several years experience on the front lines, so to speak, the field began to hire people in their early twenties who were still in school for their bachelor’s. And, therapists? Psychologists were less utilized and those with master’s and little or no practical therapy experiences were put in the roles of therapists. The field also began to shift from a behavioral or cognitive model back to an institutional one, relying on an old medical/psychiatric one. Psychiatrists became more utilized but at a very unengaged level; most see the patient briefly every couple of months in an office visit merely to adjust medication levels up or down or prescribe some other medication.

    It has been so painful for me to watch all of the progress we made in the ’70′s and ’80′s erode in the last twenty years back to seeing people overly medicated and seeing many agencies, at the most, pay lip service to behavioral and cognitive therapies. Many staff I see have little interest in truly working on problems long term with patients. Cost is an issue (hiring competent staff takes money) and high levels of qualified management is also an issue (it is easier to manage a program and a second-rate staff when medication keeps patients docile). I am very much against PRN orders in MH group homes, day-treatment facilities, etc., because it is too easy for staff to to be tired of dealing with a person, set that person off in some way (either deliberately or through incompetence), and then give a PRN to make for a smoother evening.

    Another painful thing to witness in the last twenty years has been the over prescription of medication to adolescent people having troubles in the general population. I am a musician, and one of my side jobs is to teach music; I see all kinds of young people. Over the last twenty years young people have been getting prescribed all sorts of psychotropic medications for anxiety, depression, etc. Much of it is unnecessary. Much of the medication is prescribed by their PCP after a brief office visit.

    One of my music student’s, about ten years ago (he was around 20 then) began to tell me of his experiences in being given medication for this or that (and being given a diagnosis of this or that) after I told him some of my background. I said that I am no expert but that by what he was describing–and based on my experiences–indicated he had suffered from something many other young people who were very creative and very sensitive had experienced; that, while painful, seemed a kind of normal response to his environment as he described it. I also told him of a therapist friend who might be able to help him see strategies for dealing with certain things without his being labeled or medicated. I also encouraged him to keep a journal, to write stories and poetry and songs, to play music, to perform in public, to surround himself with like-minded people, etc. I know him today as a very together person who has much more wisdom, insight, and is much more unflappable than many people my own age.

    So, this is how I see the problem. The flip side is that some medication is necessary in my work. I currently work with people who have severe classic mental illnesses: schizophrenia, severe bipolar disorder, chronic clinical depression. Of people with schizophrenia, medication means the difference between a person being sort of “normal” in his/her thinking and daily coping (as well as a life without persistent auditory/visual hallucinations) and a descent into utter madness, as well as being a danger to themselves and others. Of severe bipolar disorder, this often goes from something completely off the charts to something quite manageable with medication. Of chronic depression, a combination of medication and cognitive therapies seem to work best. All of the people in the program where I work get some sort of cognitive therapy outside the home in addition to a group process-type dynamic within the home. It is important to note that if those illnesses are left untreated with medication, particularly schizophrenia and bipolar (the severe kind) they become degenerative in nature and the person’s mind sort of cave’s in on itself.

    The “do more with less” paradigm has shifted a bit in my field and therapies like CBT have become more available. In the general public, the embrace of psychotropics seen in the 1990′s has had a push back of sorts. So this gives me some hope for the future.

    Thanks for being curious, anon, I rarely get to describe that part of my work.

    You know, I was reading and thinking about AA last night, (of the latter) about why it might work for some and not for others. Among many things I thought (and I do have a genuine concern about codependency–as does AA itself if one looks at their literature advising sponsors; and, you have to admit, even more than an inherent desire to drink, alcoholics seem experts at naturally developing codependent relationships, it’s kind of an underlying problem with alcoholics) has to do with cultural identity versus stigmatization. Some alcoholics see AA as stigmatizing; some see it as a proud part of an identity. Of the former, maybe they are the ones not successful with AA; of the latter, maybe that is the group who are successful? I think the “uneven” nature of let’s say sponsorship is an inherent flaw of the approach in how they get advised and not the result of bad people. Sponsors give each other advice all the time (there are websites devoted to this advice giving); additionally, AA advises them to attend social AA functions, dinners, etc. to get advice on how to handle sponsorship. This seems to be the only training other than having worked the steps. That is what promotes the “unevenness.” If you visit those advice sights, some of the sponsors’ ideas are ridiculous and indicate they should not be giving anyone advice or having any power over anyone. One I saw was a sponsor saying he has developed a list of seven questions. He said he gives the “newcomer” a writing assignment to answer the questions. He says he expects the questions to be answered by the next day and sets up a meeting for the next day to get the assignment–and these are difficult questions requiring a person to be really in touch with his feelings and able to articulate them. The sponsor said that if he finds any procrastination on the part of the newcomer, he decides the person isn’t sincere and drops his sponsorship and moves on to someone else. I’m sure many sponsors are smarter than this, but I have talked to a few sponsors who seem to have some really potentially damaging ideas, not because they are bad people, are sexual predators, etc., but because they might not be getting training other than how to indoctrinate (AA’s word not mine) someone into the program.

    The literature about sponsorship also delves a little into ground rules and when to tell someone is not ready to be sober or that limits should be set on the frequency of meetings/phone calls…this is a good thing, but AA doesn’t spell out what they are talking about or mention strategies beyond “the newcomer is not ready” or to give advice to remove oneself from sponsorship of that person. How, for example, should a person admitting to having a relapse be handled? An untrained person could cause a lot of backsliding if this is handled wrong.

    I do see many of your points, and they have validity, but you have to understand that you may be seeing the successful end of AA while am seeing the not so successful end of AA. I’m sure the truth about how they help people falls somewhere in a median of those. Could they improve how they help people? Not at all you think? You don’t care? I am just someone threatened by amateurs?

  • Ellen Dibble

    Brett, I’m glad you heard the SOF Lederach piece. Where I live, one can train in mediation/arbitration from one of the local agencies in a few months of weekends, which I did. I think a lot of lawyers were getting the additional training in order to settle more things out of court. Anyway, I wasn’t sorry I did it.
    As to the why of eating a quarter pound of butter, I can tell you. I used to eat a quarter pound of either butter or margarine from time to time. I lived about 20 years with food allergies to just about everything, including an allergy that kicks in after 8 to 12 hours and then lands me with a flattening and untreatable headache for four or five days. That’s from anything with sugar or vinegar, mushrooms, overripe fruit, cottage cheese, yogurt, anything canned. That’s just one allergy (Candida). That wasn’t diagnosed till I was 35. But one is allergic to the protein, not the fat, so a quarter pound of fat would satisfy me. I didn’t have to explain it to an obsessive-compulsive cake baker, but I did tell it to a psychoanalyst, who thought I would do better with soda crackers. In any case, I remained a mystery to the physicians of all stripes for a very long time, and a mystery to myself. I mention this to you because it’s possible your schizophrenic has no idea why he really eats butter, but his body has determined it doesn’t make him sick. His better angels are making him eat butter. When he eats the cake (if he is allergic), in a day or so he’ll be a basket case, in whatever way his body does that. (Example of how the medical profession overdiagnoses what they have identified and know how to treat, while the real problem might be something else altogether.)
    How that relates to AA? Well, they have identified addiction and AA, as problem and treatment, and they will try a bed of Procrustes (stretch you to fit it, or cut off the overhang at the foot) on all possible comers: You addict? You go to AA.

  • Ted Hoppe

    The early history described here is a little off base. Look up Rowland Hazzard lll. He was the person who was told by Carl Jung that only a life altering religious experience could save him. He then joined the Oxford Group and saved, Bill Wilson’s drinking buddy, Ebby Thacher, from the mental hospital. It was Thacher who told Bill W about the Oxford Group.

    In my personal studies into addiction I have found the root cause to be associated with the inability to form meaningful relationships. If you read the comments of pro AA supporters, they make statement such as, “AA saved my life.” Well, this is just not an accurate statement. What is accurate is that the individual, with the help from others, with whom they form trusting relationships with, was able to maintain sobriety, to the point that their body and mind could heal. The concept about a sponsor is also about forming a trusting relationship.

    On Point broadcasted a program on Aug. 11 2009 that asked the question, “Is Addiction A Matter of Choice?” Research shows that 80% of addicts quick by themselves. (Gene M. Heyman 2009) For the remaining 20% the problem, as well as the solution, seems to be “Relationships”

  • Ellen Dibble

    I haven’t checked out the Gene M. Heyman 2009 cite, but I’m wondering if the 80 percent of addicts who quit by themselves (I think I remember that coming up at that earlier OnPoint hour) includes the Irish. I’m not anti-Irish, but to read Frank McCourt (Angela’s Ashes…), alcohol was the interpersonal glue for that culture, and not with the kind of moderation the French proclaim. The 20 percent who can’t achieve the culturally accepted norm of inebriation would be the ones who can’t find the accepted norm of relationships.
    Just thinking of someone I’ve met who seems forever struggling to be on the wagon, this one also seems to have a childlike ability to misconstrue just about anything, including relationships. Religion had seemed to color the perceptions, censoring the antennae functioning, though now there are diagnoses for that, Asperger’s syndrome for instance. I’m sure it can run in families, traditions of interpersonal distancing or dishonesty, and AA seems to teach (in that case of the individual I mentioned) a lot about the proper forms for relationship, but not a lot about differentiating the forms of trusting relatedness from the actuality (a terribly intricate undertaking), which reminds us that one might try to adopt a randomly selected group as friends, but there is nothing random about the actual set of people one evolves to depend upon, these trusted in this way, those trusted for that.

  • Ishmael

    Wonder if there is anything significant about the length of postings for this particular program. People seem to be considerably more verbose than usual, and I wonder if verbal ability has any linkage with success in AA.

    This is one of the more repetitive programs I’ve heard on On Point, and there really seems to be no “conclusion” possible, at least for now. All you can really say, evidently, is that if people who are determined to stop drinking alcohol decide to meet occasionally they will stop drinking and meet occasionally. It also sounds like a sobriety cult, with all that entails, at least partially.

  • anon

    Brett, thanks for the thoughtful reply. I’m glad that we agree on over-medication. I don’t object to psych meds. However I think they are prescribed more as a first resort than as a last resort. I think financial pressure is a big part of that, and the clout of big pharma must be a factor.

    I see AA as a miraculous program that transforms lives. One of the famous shrinks called Bill Wilson “the foremost social architect of the 20′th century”. It’s free and its run by the participants. Alcoholics are famously distrustful of authority, and more structure could destroy it. Yes. I’m afraid that my attitude is to not try to fix what isn’t broke, possibly damaging it in the process. It’s too bad that it doesn’t work for everyone, but the net result is still wonderful.

    I don’t share your concern about AA co-dependency. Again, it’s a hell of a lot better than dependency on alcohol, and the “3x a day” cases we discussed are rare and usually limited to early sobriety or times of trouble, when I again see no problem. Depending on a group of AA friends is a vast improvement over isolating with a bottle.

    Of course we talk a lot about who gets it and who does not. My experience is that a really hard crash combined with an extremely warm welcome to AA is a big part of it. Along the lines of what you are saying about unevenness, the newcomer has to find the right group. In my case I was steered to where I needed to be by the people who reached out to me in early sobriety. I see that kind of guidance being given all the time.

  • loninappleton

    The comment from Mari early on reflects my experience best.

    What I have not seen in this long list of continuing comments is something related to what Mari had said about predatory behavior and the so-called 13th step and that is the notion of the AA Holy Man (or woman for that matter.) The AA Holy man is one of the elders in the program and the meeting structure. He or she is pretty easy to spot. For this and other reasons my AA experience was about 2 years. That was 17 years ago.

    The advice is: find your way in if you have to, but also know how to find your way out.

    During one meeting after the AA Holy Man gave one his allegories I mentioned the saying from Native tribes: “the wisdom of the elders is often overrated.” This is only true depending on which side of the Holy Man argument you prefer.

  • anon

    AA is an organization of human beings, some of whom are very sick, and some of whom will treat a newcomer with extraordinary love, wisdom, and commitment of time. It’s not that hard to find what you need with the hundreds of meetings in Boston, tho I understand that nothing is truly easy in fragile early sobriety.

  • Anonymous

    Wired Makeovers: Upgrade Your Workspaces
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    18.07Secret of AA: After 75 Years, We Don’t Know How It Works
    By Brendan I. Koerner June 23, 2010 | 12:00 am | Wired July 2010
    Some 1.2 million people belong to one of AA’s 55,000 meeting groups in the US.
    Photo: Christian Stoll
    The church will be closed tomorrow, and the drunks are freaking out. An elderly lady in a prim white blouse has just delivered the bad news, with deep apologies: A major blizzard is scheduled to wallop Manhattan tonight, and up to a foot of snow will cover the ground by dawn. The church, located on the Upper West Side, can’t ask its staff to risk a dangerous commute. Unfortunately, that means it must cancel the Alcoholics Anonymous meeting held daily in the basement.

    A worried murmur ripples through the room. “Wha… what are we supposed to do?” asks a woman in her mid-twenties with smudged black eyeliner. She’s in rough shape, having emerged from a multiday alcohol-and-cocaine bender that morning. “The snow, it’s going to close everything,” she says, her cigarette-addled voice tinged with panic. “Everything!” She’s on the verge of tears.

    A mustachioed man in skintight jeans stands and reads off the number for a hotline that provides up-to-the-minute meeting schedules. He assures his fellow alcoholics that some groups will still convene tomorrow despite the weather. Anyone who needs an AA fix will be able to get one, though it may require an icy trek across the city.

    That won’t be a problem for a thickset man in a baggy beige sweat suit. “Doesn’t matter how much snow we get—a foot, 10 feet piled up in front of the door,” he says. “I will leave my apartment tomorrow and go find a meeting.”

    He clasps his hands together and draws them to his heart: “You understand me? I need this.” Daily meetings, the man says, are all that prevent him from winding up dead in the gutter, shoes gone because he sold them for booze or crack. And he hasn’t had a drink in more than a decade.

    The resolve is striking, though not entirely surprising. AA has been inspiring this sort of ardent devotion for 75 years. It was in June 1935, amid the gloom of the Great Depression, that a failed stockbroker and reformed lush named Bill Wilson founded the organization after meeting God in a hospital room. He codified his method in the 12 steps, the rules at the heart of AA. Entirely lacking in medical training, Wilson created the steps by cribbing ideas from religion and philosophy, then massaging them into a pithy list with a structure inspired by the Bible.

    The 200-word instruction set has since become the cornerstone of addiction treatment in this country, where an estimated 23 million people grapple with severe alcohol or drug abuse—more than twice the number of Americans afflicted with cancer. Some 1.2 million people belong to one of AA’s 55,000 meeting groups in the US, while countless others embark on the steps at one of the nation’s 11,000 professional treatment centers. Anyone who seeks help in curbing a drug or alcohol problem is bound to encounter Wilson’s system on the road to recovery.

    It’s all quite an achievement for a onetime broken-down drunk. And Wilson’s success is even more impressive when you consider that AA and its steps have become ubiquitous despite the fact that no one is quite sure how—or, for that matter, how well—they work. The organization is notoriously difficult to study, thanks to its insistence on anonymity and its fluid membership. And AA’s method, which requires “surrender” to a vaguely defined “higher power,” involves the kind of spiritual revelations that neuroscientists have only begun to explore.

    What we do know, however, is that despite all we’ve learned over the past few decades about psychology, neurology, and human behavior, contemporary medicine has yet to devise anything that works markedly better. “In my 20 years of treating addicts, I’ve never seen anything else that comes close to the 12 steps,” says Drew Pinsky, the addiction-medicine specialist who hosts VH1’s Celebrity Rehab. “In my world, if someone says they don’t want to do the 12 steps, I know they aren’t going to get better.”

    Wilson may have operated on intuition, but somehow he managed to tap into mechanisms that counter the complex psychological and neurological processes through which addiction wreaks havoc. And while AA’s ability to accomplish this remarkable feat is not yet understood, modern research into behavior dynamics and neuroscience is beginning to provide some tantalizing clues.

    One thing is certain, though: AA doesn’t work for everybody. In fact, it doesn’t work for the vast majority of people who try it. And understanding more about who it does help, and why, is likely our best shot at finally developing a system that improves on Wilson’s amateur scheme for living without the bottle.

    AA doesn’t work for everybody, but when it does, it can be transformative. Members receive tokens to mark periods of sobriety, from 24 hours to one month to 55 years.
    Photo: Todd Tankersley
    AA originated on the worst night of Bill Wilson’s life. It was December 14, 1934, and Wilson was drying out at Towns Hospital, a ritzy Manhattan detox center. He’d been there three times before, but he’d always returned to drinking soon after he was released. The 39-year-old had spent his entire adult life chasing the ecstasy he had felt upon tasting his first cocktail some 17 years earlier. That quest destroyed his career, landed him deeply in debt, and convinced doctors that he was destined for institutionalization.

    Wilson had been quite a mess when he checked in the day before, so the attending physician, William Silkworth, subjected him to a detox regimen known as the Belladonna Cure—hourly infusions of a hallucinogenic drug made from a poisonous plant. The drug was coursing through Wilson’s system when he received a visit from an old drinking buddy, Ebby Thacher, who had recently found religion and given up alcohol. Thacher pleaded with Wilson to do likewise. “Realize you are licked, admit it, and get willing to turn your life over to God,” Thacher counseled his desperate friend. Wilson, a confirmed agnostic, gagged at the thought of asking a supernatural being for help.

    But later, as he writhed in his hospital bed, still heavily under the influence of belladonna, Wilson decided to give God a try. “If there is a God, let Him show Himself!” he cried out. “I am ready to do anything. Anything!”

    What happened next is an essential piece of AA lore: A white light filled Wilson’s hospital room, and God revealed himself to the shattered stockbroker. “It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing,” he later said. “And then it burst upon me that I was a free man.” Wilson would never drink again.

    At that time, the conventional wisdom was that alcoholics simply lacked moral fortitude. The best science could offer was detoxification with an array of purgatives, followed by earnest pleas for the drinker to think of his loved ones. When this approach failed, alcoholics were often consigned to bleak state hospitals. But having come back from the edge himself, Wilson refused to believe his fellow inebriates were hopeless. He resolved to save them by teaching them to surrender to God, exactly as Thacher had taught him.

    Following Thacher’s lead, Wilson joined the Oxford Group, a Christian movement that was in vogue among wealthy mainstream Protestants. Headed by a an ex-YMCA missionary named Frank Buchman, who stirred controversy with his lavish lifestyle and attempts to convert Adolf Hitler, the Oxford Group combined religion with pop psychology, stressing that all people can achieve happiness through moral improvement. To help reach this goal, the organization’s members were encouraged to meet in private homes so they could study devotional literature together and share their inmost thoughts.

    In May 1935, while on an extended business trip to Akron, Ohio, Wilson began attending Oxford Group meetings at the home of a local industrialist. It was through the group that he met a surgeon and closet alcoholic named Robert Smith. For weeks, Wilson urged the oft-soused doctor to admit that only God could eliminate his compulsion to drink. Finally, on June 10, 1935, Smith (known to millions today as Dr. Bob) gave in. The date of Dr. Bob’s surrender became the official founding date of Alcoholics Anonymous.

    In its earliest days, AA existed within the confines of the Oxford Group, offering special meetings for members who wished to end their dependence on alcohol. But Wilson and his followers quickly broke away, in large part because Wilson dreamed of creating a truly mass movement, not one confined to the elites Buchman targeted. To spread his message of salvation, Wilson started writing what would become AA’s sacred text: Alcoholics Anonymous, now better known as the Big Book.

    The core of AA is found in chapter five, entitled “How It Works.” It is here that Wilson lists the 12 steps, which he first scrawled out in pencil in 1939. Wilson settled on the number 12 because there were 12 apostles.

    In writing the steps, Wilson drew on the Oxford Group’s precepts and borrowed heavily from William James’ classic The Varieties of Religious Experience, which Wilson read shortly after his belladonna-fueled revelation at Towns Hospital. He was deeply affected by an observation that James made regarding alcoholism: that the only cure for the affliction is “religiomania.” The steps were thus designed to induce an intense commitment, because Wilson wanted his system to be every bit as habit-forming as booze.

    The first steps famously ask members to admit their powerlessness over alcohol and to appeal to a higher power for help. Members are then required to enumerate their faults, share them with their meeting group, apologize to those they’ve wronged, and engage in regular prayer or meditation. Finally, the last step makes AA a lifelong duty: “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.” This requirement guarantees not only that current members will find new recruits but that they can never truly “graduate” from the program.

    Aside from the steps, AA has one other cardinal rule: anonymity. Wilson was adamant that the anonymous component of AA be taken seriously, not because of the social stigma associated with alcoholism, but rather to protect the nascent organization from ridicule. He explained the logic in a letter to a friend:

    [In the past], alcoholics who talked too much on public platforms were likely to become inflated and get drunk again. Our principle of anonymity, so far as the general public is concerned, partly corrects this difficulty by preventing any individual receiving a lot of newspaper or magazine publicity, then collapsing and discrediting AA.

    AA boomed in the early 1940s, aided by a glowing Saturday Evening Post profile and the public admission by a Cleveland Indians catcher, Rollie Hemsley, that joining the organization had done wonders for his game. Wilson and the founding members were not quite prepared for the sudden success. “You had really crazy things going on,” says William L. White, author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America. “Some AA groups were preparing to run AA hospitals, and there was this whole question of whether they should have paid AA missionaries. You even had some reports of AA groups drinking beers at their meetings.”

    The growing pains spurred Wilson to write AA’s governing principles, known as the 12 traditions. At a time when fraternal orders and churches with strict hierarchies dominated American social life, Wilson opted for something revolutionary: deliberate organizational chaos. He permitted each group to set its own rules, as long as they didn’t conflict with the traditions or the steps. Charging a fee was forbidden, as was the use of the AA brand to endorse anything that might generate revenue. “If you look at this on paper, it seems like it could never work,” White says. “It’s basically anarchy.” But this loose structure actually helped AA flourish. Not only could anyone start an AA group at any time, but they could tailor each meeting to suit regional or local tastes. And by condemning itself to poverty, AA maintained a posture of moral legitimacy.

    Despite the decision to forbid members from receiving pay for AA-related activity, it had no problem letting professional institutions integrate the 12 steps into their treatment programs. AA did not object when Hazelden, a Minnesota facility founded in 1947 as “a sanatorium for curable alcoholics of the professional class,” made the steps the foundation of its treatment model. Nor did AA try to stop the proliferation of steps-centered addiction groups from adopting the Anonymous name: Narcotics Anonymous, Gamblers Anonymous, Overeaters Anonymous. No money ever changed hands—the steps essentially served as open source code that anyone was free to build upon, adding whatever features they wished. (Food Addicts Anonymous, for example, requires its members to weigh their meals.)

    By the early 1950s, as AA membership reached 100,000, Wilson began to step back from his invention. Deeply depressed and an incorrigible chain smoker, he would go on to experiment with LSD before dying from emphysema in 1971. By that point, AA had become ingrained in American culture; even people who’d never touched a drop of liquor could name at least a few of the steps.

    “For nearly 30 years, I have been saying Alcoholics Anonymous is the most effective self-help group in the world,” advice columnist Ann Landers wrote in 1986. “The good accomplished by this fellowship is inestimable … God bless AA.”

    There’s no doubt that when AA works, it can be transformative. But what aspect of the program deserves most of the credit? Is it the act of surrendering to a higher power? The making of amends to people a drinker has wronged? The simple admission that you have a problem? Stunningly, even the most highly regarded AA experts have no idea. “These are questions we’ve been trying to answer for, golly, 30 or 40 years now,” says Lee Ann Kaskutas, senior scientist at the Alcohol Research Group in Emeryville, California. “We can’t find anything that completely holds water.”

    The problem is so vexing, in fact, that addiction professionals have largely accepted that AA itself will always be an enigma. But research in other fields—primarily behavior change and neurology—offers some insight into what exactly is happening in those church basements.

    To begin with, there is evidence that a big part of AA’s effectiveness may have nothing to do with the actual steps. It may derive from something more fundamental: the power of the group. Psychologists have long known that one of the best ways to change human behavior is to gather people with similar problems into groups, rather than treat them individually. The first to note this phenomenon was Joseph Pratt, a Boston physician who started organizing weekly meetings of tubercular patients in 1905. These groups were intended to teach members better health habits, but Pratt quickly realized they were also effective at lifting emotional spirits, by giving patients the chance to share their tales of hardship. (“In a common disease, they have a bond,” he would later observe.) More than 70 years later, after a review of nearly 200 articles on group therapy, a pair of Stanford University researchers pinpointed why the approach works so well: “Members find the group to be a compelling emotional experience; they develop close bonds with the other members and are deeply influenced by their acceptance and feedback.”

    Researchers continue to be surprised by just how powerful this effect is. For example, a study published last year in the journal Behavior Therapy concluded that group therapy is highly effective in treating post-traumatic stress disorder: 88.3 percent of the study’s subjects who underwent group therapy no longer exhibited PTSD symptoms after completing their sessions, versus just 31.3 percent of those who received minimal one-on-one interaction.

    The importance of this is reflected by the fact that the more deeply AA members commit to the group, rather than just the program, the better they fare. According to J. Scott Tonigan, a research professor at the University of New Mexico’s Center on Alcoholism, Substance Abuse, and Addictions, numerous studies show that AA members who become involved in activities like sponsorship—becoming a mentor to someone just starting out—are more likely to stay sober than those who simply attend meetings.

    Addiction-medicine specialists often raise the concern that AA meetings aren’t led by professionals. But there is evidence that this may actually help foster a sense of intimacy between members, since the fundamental AA relationship is between fellow alcoholics rather than between alcoholics and the therapist. These close social bonds allow members to slowly learn how to connect to others without the lubricating effects of alcohol. In a study published last year in Alcoholism Treatment Quarterly, Tonigan found that “participation in AA is associated with an increased sense of security, comfort, and mutuality in close relationships.”

    And close relationships, it turns out, have an even more profound effect on us than previously thought. A 2007 study of a Boston-area community, for example, found that a person’s odds of becoming obese increase by 71 percent if they have a same-sex friend who is also obese. (Wired covered the study in more detail in “The Buddy System,” issue 17.10.) And in April, a paper published in Annals of Internal Medicine concluded that a person is 50 percent more likely to be a heavy drinker if a friend or relative is a boozehound. Even if an alcoholic’s nonsober friends are outwardly supportive, simply being around people for whom drinking remains the norm can nudge someone into relapse. It is much safer to become immersed in AA’s culture, where activities such as studying the Big Book supplant hanging out with old acquaintances who tipple.

    As for the steps themselves, there is evidence that the act of public confession—enshrined in the fifth step—plays an especially crucial role in the recovery process. When AA members stand up and share their emotionally searing tales of lost weekends, ruined relationships, and other liquor-fueled low points, they develop new levels of self-awareness. And that process may help reinvigorate the prefrontal cortex, a part of the brain that is gravely weakened by alcohol abuse.

    To understand the prefrontal cortex’s role in both addiction and recovery, you first need to understand how alcohol affects the brain. Booze works its magic in an area called the mesolimbic pathway—the reward system. When we experience something pleasurable, like a fine meal or good sex, this pathway squirts out dopamine, a neurotransmitter that creates a feeling of bliss. This is how we learn to pursue behaviors that benefit us, our families, and our species.

    When alcohol hits the mesolimbic pathway, it triggers the rapid release of dopamine, thereby creating a pleasurable high. For most people, that buzz simply isn’t momentous enough to become the focal point of their lives. Or if it is, they are able to control their desire to chase it with reckless abandon. But others aren’t so fortunate: Whether by virtue of genes that make them unusually sensitive to dopamine’s effects, or circumstances that lead them to seek chemical solace, they cannot resist the siren call of booze.

    Once an alcoholic starts drinking heavily, the mesolimbic pathway responds by cutting down its production of dopamine. Alcohol also messes with the balance between two other neurotransmitters: GABA and glutamate. Alcohol spurs the release of more GABA, which inhibits neural activity, and clamps down on glutamate, which stimulates the brain. Combined with a shortage of dopamine, this makes the reward system increasingly lethargic, so it becomes harder and harder to rouse into action. That’s why long-term boozers must knock back seven or eight whiskeys just to feel “normal.” And why little else in life brings hardcore alcoholics pleasure of any kind.

    As dependence grows, alcoholics also lose the ability to properly regulate their behavior. This regulation is the responsibility of the prefrontal cortex, which is charged with keeping the rest of the brain apprised of the consequences of harmful actions. But mind-altering substances slowly rob the cortex of so-called synaptic plasticity, which makes it harder for neurons to communicate with one another. When this happens, alcoholics become less likely to stop drinking, since their prefrontal cortex cannot effectively warn of the dangers of bad habits.

    This is why even though some people may be fully cognizant of the problems that result from drinking, they don’t do anything to avoid them. “They’ll say, ‘Oh, my family is falling apart, I’ve been arrested twice,’” says Peter Kalivas, a neuroscientist at the Medical University of South Carolina in Charleston. “They can list all of these negative consequences, but they can’t take that information and manhandle their habits.”

    The loss of synaptic plasticity is thought to be a major reason why more than 90 percent of recovering alcoholics relapse at some point. The newly sober are constantly bombarded with sensory cues that their brain associates with their pleasurable habit. Because the synapses in their prefrontal cortex are still damaged, they have a tough time resisting the urges created by these triggers. Any small reminder of their former life—the scent of stale beer, the clink of toasting glasses—is enough to knock them off the wagon.

    AA, it seems, helps neutralize the power of these sensory cues by whipping the prefrontal cortex back into shape. Publicly revealing one’s deepest flaws and hearing others do likewise forces a person to confront the terrible consequences of their alcoholism—something that is very difficult to do all alone. This, in turn, prods the impaired prefrontal cortex into resuming its regulatory mission. “The brain is designed to respond to experiences,” says Steven Grant, chief of the clinical neuroscience branch of the National Institute on Drug Abuse. “I have no doubt that these therapeutic processes change the brain.” And the more that critical part of the brain is compelled to operate as designed, the more it springs back to its pre-addiction state. While it’s on the mend, AA functions as a temporary replacement—a prefrontal cortex made up of a cast of fellow drunks in a church basement, rather than neurons and synapses.

    Finally, the 12 steps address another major risk factor for relapse: stress. Recovering alcoholics are often burdened by memories of the nasty things they did while wasted. When they bump into old acquaintances they mistreated, the guilt can become overwhelming. The resulting stress causes their brains to secrete a hormone that releases corticotropin, which has been shown to cause relapse in alcohol-dependent lab rats.

    AA addresses this risk with the eighth and ninth steps, which require alcoholics to make amends to people they’ve wronged. This can alleviate feelings of guilt and in turn limit the stress that may undermine a person’s fragile sobriety.

    Bill W., as Wilson is known today, didn’t know the first thing about corticotropin-releasing hormone or the prefrontal cortex, of course. His only aim was to harness spirituality in the hopes of giving fellow alcoholics the strength to overcome their disease. But in developing a system to lead drunks to God, he accidentally created something that deeply affects the brain—a system that has now lasted for three-quarters of a century and shows no signs of disappearing.

    But how effective is AA? That seemingly simple question has proven maddeningly hard to answer. Ask an addiction researcher a straightforward question about AA’s success rate and you’ll invariably get a distressingly vague answer. Despite thousands of studies conducted over the decades, no one has yet satisfactorily explained why some succeed in AA while others don’t, or even what percentage of alcoholics who try the steps will eventually become sober as a result.

    A big part of the problem, of course, is AA’s strict anonymity policy, which makes it difficult for researchers to track members over months and years. It is also challenging to collect data from chronic substance abusers, a population that’s prone to lying. But researchers are most stymied by the fact that AA’s efficacy cannot be tested in a randomized experiment, the scientific gold standard.

    “If you try to randomly assign people to AA, you have a problem, because AA is free and is available all over the place,” says Alcohol Research Group’s Kaskutas. “Plus, some people will just hate it, and you can’t force them to keep going.” In other words, given the organization’s open-door membership policy, it would be nearly impossible for researchers to prevent people in a control group from sneaking off to an AA meeting and thereby tainting the data. On the other hand, many subjects would inevitably loathe AA and drop out of the study altogether.

    Another research quandary is how to account for the selection effect. AA is known for doing a better job of retaining drinkers who’ve hit rock bottom than those who still have a ways to fall. But having totally destroyed their lives, the most desperate alcoholics may already be committed to sobriety before ever setting foot inside a church basement. If so, it might be their personal commitment, rather than AA, that is ultimately responsible for their ability to quit.

    As a result of these complications, AA research tends to come to wildly divergent conclusions, often depending on an investigator’s biases. The group’s “cure rate” has been estimated at anywhere from 75 percent to 5 percent, extremes that seem far-fetched. Even the most widely cited (and carefully conducted) studies are often marred by obvious flaws. A 1999 meta-analysis of 21 existing studies, for example, concluded that AA members actually fared worse than drinkers who received no treatment at all. The authors acknowledged, however, that many of the subjects were coerced into attending AA by court order. Such forced attendees have little shot at benefiting from any sort of therapy—it’s widely agreed that a sincere desire to stop drinking is a mandatory prerequisite for getting sober.

    Yet a growing body of evidence suggests that while AA is certainly no miracle cure, people who become deeply involved in the program usually do well over the long haul. In a 2006 study, for example, two Stanford psychiatrists chronicled the fates of 628 alcoholics they managed to track over a 16-year period. They concluded that subjects who attended AA meetings frequently were more likely to be sober than those who merely dabbled in the organization. The University of New Mexico’s Tonigan says the relationship between first-year attendance and long-term sobriety is small but valid: In the language of statistics, the correlation is around 0.3, which is right on the borderline between weak and modest (0 meaning no relationship, and 1.0 being a perfect one-to-one relationship).

    “I’ve been involved in a couple of meta-analyses of AA, which collapse the findings across many studies,” Tonigan says. “They generally all come to the same conclusion, which is that AA is beneficial for many but not all individuals, and that the benefit is modest but significant … I think that is, scientifically speaking, a very valid statement.”

    That statement is also supported by the results of a landmark study that examined how the steps perform when taught in clinical settings as opposed to church basements. Between 1989 and 1997, a multisite study called Project Match randomly assigned more than 1,700 alcoholics to one of three popular therapies used at professional treatment centers. The first was called 12-step facilitation, in which a licensed therapist guides patients through Bill Wilson’s method. The second was cognitive behavioral therapy, which trains alcoholics to identify the situations that spur them to drink, so they can avoid tempting circumstances. And the last was motivational enhancement therapy, a one-on-one interviewing process designed to sharpen a person’s reasons for getting sober.

    Project Match ultimately concluded that all three of these therapies were more or less equally effective at reducing alcohol intake among subjects. But 12-step facilitation clearly beat the competition in two important respects: It was more effective for alcoholics without other psychiatric problems, and it did a better job of inspiring total abstinence as opposed to a mere reduction in drinking. The steps, in other words, actually worked slightly better than therapies of more recent vintage, which were devised by medical professionals rather than an alcoholic stockbroker.

    AA is still far from ideal. The sad fact remains that the program’s failures vastly outnumber its success stories. According to Tonigan, upwards of 70 percent of people who pass through AA will never make it to their one-year anniversary, and relapse is common even among regular attendees. This raises an important question: Are there ways to improve Wilson’s aging system?

    AA is obviously not about to overhaul its 75-year-old formula. But there are a few alterations that would almost certainly make the program work for more people, starting with better quality control. Since no central body regulates the day-to-day operations of local groups, some meetings are dominated by ornery old-timers who delight in belittling newcomers. Others are prowled by men looking to introduce nubile newcomers to the “13th step”—AA slang for sexual exploitation. Finding a way to impose some basic oversight of such bad behavior would likely reduce the dropout rate.

    Some AA groups would also do well to shed their resistance to medication. There is nothing in the Big Book that forbids the use of prescription drugs, but there are plenty of meetings where such pharmaceutical aids are frowned upon. Perhaps this sentiment made sense back in AA’s formative years, when a variety of snake oils were touted as alcoholism cures. But today there are several medications that have been proven to decrease the odds of relapse. One such drug, acamprosate, restores a healthy balance between glutamate and GABA, two of the neurotransmitters that get out of whack in the brains of alcoholics. Naltrexone, commonly used to treat heroin addiction, appears effective at preventing relapse by alcoholics who possess a certain genetic variant related to an important mu-opioid receptor. Both can be valuable aids in the recovery process.

    But the best way to bolster AA’s success rate may be to increase the personalization of addiction medicine. “We’re starting to get an inkling that something about the initial state of the brain prior to therapy may be predictive as to whether that therapy will be a success,” says Grant of the National Institute on Drug Abuse. In other words, certain brains may be primed to respond well to some therapies and less so to others.

    NIDA and other government agencies are currently funding several studies that aim to use neural imaging technology to observe how various therapies affect addicted brains. One alcoholic might have a mesolimbic pathway that normalizes quickly after receiving a certain type of therapy, for example, while another will still suffer from dopamine disregulation despite receiving the same care. The hope is that these studies will reveal whether neurobiology can be used to predict a person’s odds of benefitting from one treatment over another. Perhaps there is one sort of mind that is cut out for the cognitive behavioral approach and another that can be helped only by the 12 steps.

    A person’s openness to the concept of spiritual rebirth, as determined by their neural makeup, could indicate whether they’ll embrace the steps. Last September, researchers from the National Institutes of Health found that people who claimed to enjoy “an intimate relationship with God” possess bigger-than-average right middle temporal cortices. And a Swedish study from 2003 suggests that people with fewer serotonin receptors may be more open to spiritual experiences.

    For the moment, though, there is no way to predict who will be transformed by AA. And often, the people who become Wilson’s most passionate disciples are those you’d least expect. “I always thought I was too smart for AA,” a bespectacled, Nordic-looking man named Gary shared at a meeting in Hell’s Kitchen this past winter. “I’m a classical musician, a math and statistics geek. I was the biggest agnostic you ever met. But I just wrecked my life with alcohol and drugs and codependent relationships.”

    And now, after more than four years in the program? “I know God exists,” he says. “I’m so happy I found AA.”

    Maybe one day we’ll discover that there’s a quirk in Gary’s genetic makeup that made his prefrontal cortex particularly susceptible to the 12 steps. But all that really matters now is that he’s sober.

    Contributing editor Brendan I. Koerner (brendan_koerner@wired.com) wrote about the pathogen UG99 in issue 18.03.

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    All fields required Posted by: McGowdog | 07/8/10 | 12:42 pm |
    The problem between me and church people is that … at the end of the day… when they stub their toe, they don’t drink. I drink.

    Posted by: freddytoledo | 07/8/10 | 3:24 pm |
    I’m a recovering heroin addict and an alcoholic, plus I’m from detroit. I have been able to stay straight for over 25 years in 5 different states by attending AA meetings. yes I was in long term treatment back in michigan where they sugested I attend meeting weekly. I would descibe my past life as horrible, drug and alcohol addiction is a terible life style for any human to choose and I chose it for myself. Dont know why or as was written above dont know how AA has kept my sober, but it has. Its true in the begining they told a group of roughly 20 people (that I was in)only 2 or 3 of you will make it. well I have and I really dont need to look else where. I’m a success story there is no doubt. I can only give credit to AA and the members at the meetings.

    Posted by: McGowdog | 07/8/10 | 5:53 pm |
    Good job Freddy. I would challenge your concept of choice. What you call a choice, I call an obsession. But once you have that booze in your system, can you “choose” to not get drunk? I doubt it. But, that’s semantics. You’re sober and clean now.

    Now… let’s go back to that treatment center when they were telling us that something like 2 or 3 of you will make it. What if they told us, “Something like 2 or 3 of you will make it… same as if you leave here now, get your money back, and go get sober and clean on your own.”

    That’s what we imply when we say “choice”. If we had a choice, choose to stop. Did we wake up and say, “Well, I think I need to suffer today.” No. We woke up and said, “How am I gonna get through today?” We had no clue what we were gonna do. If he had some booze or drugs handy, we started to get a clue, right? Non-alcoholics and non-addicts don’t start their day that way.

    So you got sober and you got clean. You do know something about how to get sober and clean. You just gave your testimony here. You have something to offer. You just did it here. So you do “know how it works.” If you did it, you surely know “how it works.” That’s just the way it works.

    We’ve been hearing from some folks who don’t know how it works and they want to tell us how it doesn’t work. Which one of us is insane?

    Posted by: Anonymous15 | 07/8/10 | 6:55 pm |
    Get your facts straight! I have been a member of AA for almost 16 years. I have never and never will stand before my group and take a 4th and 5th step. The 4th step is done alone and the 5th step is taken with a sponsor or trusted friend. These steps are intended to help us discover the defects in our character which have caused us to harm others. It is NOT public confession. Those who do this in a meeting or in front of a group are asking for more grief than they have already suffered. HOW It works through ruthless Honesty, Openmindedness, rather than contempt prior to investigation and Willingness to change the way we think and the way we live.

    Posted by: AGM | 07/8/10 | 8:40 pm |
    The article was a reasonable overview, and some of the science was interesting, but I was amused at how some scientists are having a hard time measuring the spiritual life.

    There was one big error: AA members are not required to announce their faults publicly to their home group. The author of the article was mixing up Steps 4-7 (primarily Step 5, which is done in private with a trusted, experienced individual and your higher power) with the practice of having a speaker at a group — an AA member who voluntarily discloses whatever he or she wishes to disclose.

    With 21 years of sobriety in AA, I can definitely say it’s turned my life around. I have a very good job and family, and I am at peace most of the time and do not desire alcohol anymore. I know many very successful people in AA. These are always the people who really understand it, work at it, and follow a spiritual path.

    Until you experience a spiritual awakening and practice the principles daily (which include prayer, meditation, amends, and working with others), whether through AA or church or something else, I don’t think it’s possible to understand the truth and beauty of such a life. When you’ve been through it, you know it’s real.

    Posted by: JStraw1963 | 07/8/10 | 11:07 pm |
    While the writer seriously mistated the process and setting of admitting the exact nature of our wrongs (that is, it is emphatically not a public confession), I didn’t see any reference to the one actual requirement (the only one) of AA: a desire to stop drinking. That’s the tough one.

    Posted by: rsusanb | 07/9/10 | 11:29 am |
    This article says it AA does not work for everybody who tries it. Perhaps not, but it does for work for anybody who works it.

    Posted by: peacewolf | 07/9/10 | 12:46 pm |
    I think Brendan wrote this while drunk.

    Posted by: McGowdog | 07/9/10 | 1:46 pm |
    I think a “desire to stop drinking” is wrong. It’s the erroneous and troublesome short form of the 3rd Tradition that brought that phrase about. On page 7, a “desire to stop drinking” didn’t do it for Bill. On page 18, they’re talking about a desire to be helpful. On page 24, “the most powerful desire to stop drinking is of absolutely no avail.” On page 32, we have the retired after 25 years of work slipper who had a desire to stop. He drank again and died in 4 years. On page 34, they assume the reader has the “desire to stop”. A sure sign that a real alcoholic is in trouble and needs help. If you DON’T desire to stop, then it’s simple. You drink. On page 63, we find it desirable to do the 3rd Step with someone else. On page 69 and 70, we find it desirable to seek marriage counseling, to see a srink, that type of thing… for our sex issues. On page 77, we find it good for the recipients of our amends to see we have a sincere desire to set right a wrong. On page 83, we learn to not shove the spiritual life down our families throats unless they express a desire to live upon spiritual principles. On page 95 in working with others, we’re not to push the God issue on him… if he/she is to find God the desire must come from within. On page 105, the wives are desiring that their own husbands can retain their respect while still drinking. On page 115, the wife’s desire to protect the alcoholic should not cause her to lie about him. On page 139, if you’re a boss and considering the firing of your alcoholic employee, it might be disirable to put aside your own drinking… or lack thereof. Again on page 146, the boss may want to curb the recovering (as in hasn’t done a set of steps yet) alcoholics desire to work 16 hours a day. On page 155, Bill met a Bob with “He had a desparate desire to stop, but saw no way out.” He didn’t even know he was an alcoholic, but suspected he was abnormal somehow.

    Here’s the front part of the 3rd Tradition Long Form; “Our membership ought to include all who suffer from alcoholism. Hence we may refuse none who wish to recover.” The mention of desire is not even in there.

    I’ve done a set of steps and they took. They worked. I’m recovered. I do NOT have a desire to stop drinking. I’m not drinking and I didn’t even think about drinking or not drinking.

    Read the 10th Step promises some time;

    And we have ceased fighting anything or anyone, even alcohol. For by this time sanity will have returned. We will seldom be interested in liquor. If tempted, we recoil from it as from a hot flame. We react sanely and normally, and we will find that this has happened automatically. We will see that our new attitude toward liquor has been given us without any thought or effort on our part. It just comes! That is the miracle of it. We are not fighting it, neither are we avoiding temptation. We feel as though we had been placed in a position of neutrality safe and protected. We have not even sworn off. Instead, the problem has been removed. It does not exist for us. We are neither cocky nor are we afraid. That is how we react so long as we keep in fit spiritual condition.

    It’s good stuff. Words are important. There is an A.A. program out there and it’s getting harder and harder to find.

    These anti/XAer dorks want to say out one side of their mouths that quitting drinking is the only way to stop drinking. You don’t need to go to A.A. to quit drinking because it’s a choice. Then on the other side of their lips, they utter, “I got shoved into the nasty big bad A.A. cult and they rape and kill people! Boo Hoo! The courts mandate people into A.A. and have their slips signed!”

    Well… if drinking is but a choice, why are you dorks getting thrown into A.A. all the time? If you don’t want to get mandated into A.A., do one of two things, a) don’t break the law, and b) don’t drink booze. Choose not to drink booze.

    It appears you are choosing to drink booze so you can get thrown into A.A. so you can turn around and moan about it. Your logic is SmcgowdogNOPES False!

    Have a nice weekend!

    Posted by: villa | 07/9/10 | 2:36 pm |
    I always laugh when I read articles that try to explain AA scientifically. It is like trying to explain God scientifically. We just don’t have the language. There is a chapter (5) in the big book that explain exactly how it works. In fact in is titled “How it Works” We alcoholics are bodily and mentally different from our fellows. We have an allergy to alcohol that creates and compulsion to drink, and once that drink is taken, we are powerless to stop. “We have the loss of the kind of power that keeps us from putting our hand on a hot stove,” and only a power greater than ourselves can restore us to sanity. The 12 steps create in us the psychic ability to establish a relationship with that higher power, or God. I drank from age 12 to 44 and in the end lost it all. Jobs, family, friends, home etc. Since working the 12 steps I have not had a drink in almost 16 years, am married, hold a job and have a good relationship with my 3 adult children. That is the miracle of AA. The author also needs to check his facts. Bill Wilson was not in the hospital when Ebby Thatcher visited him. He was home drinking. It was not admiited for his last stay at Towns hospital until later. Bill was visited by Ebby in late November 1934 after being released from the hospital, staying briefly sober, then drinking again on armistice day. Abby did visit him in the hospital during his last stay where Bill completed his 5th steo. Belladonna treatment is mentioned only for his second hospital stay. Also, we do not do our steps with the group. We do them with a sponsor, and we write out the 4th step. We share this with God, ourself and another human being. From our 4th and 5th steps we derive our 8th step list from which we make our amends. The 10th step promise that the problem will be removed has come true for me. I no longer desire whiskey, and don’t fight the urge to drink, it has been removed, and I believe that will continue as long as I remain in fit spiritual condition.

    Posted by: Dankus | 07/10/10 | 9:43 am |
    Genetics play a huge factor in my life with alcholism. My mother’s side of the family is drop dead proof that some are simply wired different than others and cannot drink “normally”. My mother is a recovering alcoholic, two of her brothers died from the disease, two other brothers were “saved” by AA. Six of my cousins had their lives screwed up with alchol and then got sober. Myself and my three sisters cannot drink. One has been sober 11 years (with a relapse), I have been sober 5 years and sadly another sister has let her life be taken over and destroyed by alcohol.

    I really tried to cut back, but never could. AA was the last place I wanted to go, but did because I desperately wanted to stop and could not. I went for about a year, stopped because it was becoming too consuming, never drank again and hope I don’t. The KEY to it working is you HAVE TO WANT TO QUIT…if you are being forced to go by the court or others you will fail. If you really want to quit and cannot on your own, it can work.

    Finally, there is a dark side to it. It becomes consuming; cult like too. I’ve seen people so consumed they stop working and throw their lives into it, attending multiple meetings a day. I have no doubt it has saved many hardcores from relapsing, but where the line between helpful and cult is, I cannot say.

    AA has saved my life. I learned early on not to force it on others. My experience is I’d have a better chance selling someone AMWAY than listening to an AA works speech. In closing, it you or someone you know really wants to quit and can’t, AA could work for them if they give it a chance. And like anything else in life, moderation is the key.

    Posted by: JStraw1963 | 07/10/10 | 10:39 am |
    I haven’t quibbled about AA for a long time, but it sort of reminds me of early sobriety, a pretty happy time for me. One of the most profound, yet inelegant, statements I ever heard at a meeting was an old-timer (a true “if it ain’t practical, it ain’t spiritual” kind of guy) saying: “you don’t get sober through your eyes or ears, you get through your a**, sitting in meetings.”

    While it may not say it all, it says a lot. One of the things it says to me is that words can describe some things, but not everything. For example, while “sober” may not mean precisely “not drinking,” “dry drunk” means pretty much nothing. Either you’re drunk (impaired, UTInfluence) or you’re not. You’re not drunk until, at the very least, you drink. I’ll concede however, that “dry drunk” may not have no meaning, afterall, but it doesn’t surely doesn’t mean “drunk,” even though that is a projected future outcome. Essentially, I’m just not sure where I’d ever draw the line: playing the lottery, going to casinos, strip clubs, on-line porn, law school, enrolling in seminary school, fully walking with Jesus, the Buddha, Y Yada Da Shi’ite, etc.)

    On the other hand, “desire to stop drinking” is a phrase that is pretty interesting. Had I the desire to stop drinking, I would have stopped, I think. The problem was, and what is a repeated theme of AA stories, is that, despite obvious and various good reasons to stop drinking, we [many of us] just didn’t want to [or care]. At least in my case, this “desire” developed as I sat in meetings, one day at a time. Not that I’m gay – and not that there’s anything wrong with that – but I kind of got the desire to stop drinking through my a**, best as I can tell. Somehow, I was able to buy in to the “means” before I really had any idea what the “ends” were. My take is that this is why this is such a “troublesome concept.” Nonetheless, it is also a helpful concept in addressing the newcomer whose motivations strongly tend toward the inscrutable. Court ordered, going through marriage counseling, EAP required, or just sick and tired of being sick and tired? I don’t know.

    So, finally I would say there is a grey area, exceedingly small in, for example, in the Clancey I. universe (get a sponsor, get a suit, get a job, stand in line to get into his renegade faction meetings) and exceedingly large in the more modern treatment center model that frequently recommends dual and multi-addiction treatment where drinking and real recovery is rarely even mentioned(see AA pamphlets regarding same – AA, officially, is pretty careful in not over-stepping its bounds).

    When the “world” nears it’s end, I believe that there will be cockroaches, Keith Richards and an AA meeting somewhere. Two out of three ain’t bad.

    Posted by: paulh46 | 07/11/10 | 12:45 pm |
    Great article many thanks for your hard work. Like a couple of the AAers I can see a few inaccuracies but I think overall the article is sympathetic and considered. It has fascinated me for years the way that AA works, and I like to read about scientific attemps to capture what is going on. Certainly a lot of it is to do with the dynamics of what goes on in the rooms, and what working the steps does to the conduct, and then the mental constructs, of the alcoholic.

    It’s a better life, this one, than the one I had before. I have swapped one set of imperfections that were hard to bear, for another set of imperfections that at least give me scope and room for growth and change, and for that I’m grateful

    Posted by: CVL | 07/12/10 | 8:56 am |
    All the studies in the world, by professionals, will never be able to define or quantify the methods of AA or God. AA doesn’t follow the rules of other organizations because, typically, its members are notorious rule breakers. So in general, the use of emperical, scientific study methods will never be able prove or disprove how AA works. We who have tried it have attempted to figure out abd explain ‘how it works’ and the answer is that we don’t know how it works but it works for ALL who want it enough to pray.

    The answer to who gets sober and who doesn’t is this: If a person calls on God in earnest he will receive the help he requests. God is available to everyone. God is a gentleman and never goes where he is not welcome. But if you seek God, He will find you where you are.

    All the studies of how the brain works and what chemicals are released when and why, will never be able to define how God enters into a life and changes it. Many people, outside of the addiction realm, have found freedom other troubling lifestyles through reliance on God. Go to a church and listen when members are asked to ‘give their testimony’ and you will hear the same declaration that AA’s make about the unexplanable yet undeniable power of God!

    In AA we learn to trust God. We don’t question what works; if it works what questions do you really need to ask?

    Posted by: metalpatriot | 07/12/10 | 10:05 am |
    Good, fairly balanced article I thought. I have attended AA and other 12 step meetings for 7-8 yrs and while I have relapsed briefly before, I’ve also had years of not drinking or drugging at a time (5+ yrs). The one thing that I saw that was incorrect in this article was that “Members are then required to enumerate their faults, share them with their meeting group”. This is not true. The 4th step is written out in private and shared with a trusted person, such as a sponsor or another member with more sobriety. I think the predecessor to AA, Oxford group, may have done this but certainly not AA or NA these days. That would be very destructive indeed.

    Posted by: brownsu | 07/12/10 | 3:53 pm |
    The article is fraught with historical errors about the events that lead up to Bill Wilson’s eventual sobriety and it is disturbingly inaccurate in its description of how the AA program actually functions. It seems to set forth what “everybody knows” about AA instead of providing an accurate snap shot of what the AA process actually is. This makes me question the validity of the second half of the article which supposedly reports the latest scientific theories regarding alcoholism. I can’t believe the first part of the article where the author has his facts all wrong (confusing step 5 with step 12, for instance), so I see no reason to believe the second part either!

    Posted by: anorthro | 07/13/10 | 3:16 pm |
    I got sober at 19 and have been sober since. I spent 7 years in AA. I think that AA can work, but I don’t think that it does work for everyone.

    I stopped going to meetings regularly about a year and a half ago because I started to do other things with my life. I was met with suspicion by the AA community. I was told that if I did not go to meetings, I would drink and eventually die. For a while, I believed that and I was terrified.

    AA does not work for me. I do not wish to be a part of a group that features such intense indoctrination.

    I have a full and happy life and I stay sober without AA. I do it by not drinking.

  • Anonymous

    I stopped going to meetings regularly about a year and a half ago because I started to do other things with my life. I was met with suspicion by the AA community. I was told that if I did not go to meetings, I would drink and eventually die. For a while, I believed that and I was terrified.

    AA does not work for me. I do not wish to be a part of a group that features such intense indoctrination.

    I have a full and happy life and I stay sober without AA. I do it by not drinking.

  • Ed Powers

    AA is not a religious program. It is a spiritual program that welcomes alcoholics whether they are believer non-believers. In my twenty-nine years of sobriety, I have known atheists, agnostics, nuns, priests, ministers, jews, protestants, catholics, hindus- people of every stripe imaginable- and theirs belief or lack of belief is not an issue. “our primary purpose is to stay sober and help other alcoholics achieve sobriety.” (The Preamble of AA)

  • Brett

    anon, from 10:48am.


  • Mark

    The bottom line:
    * One size does not fit all.
    * Don’t let anyone tell that their way is the only possible way.
    * If you fail at one method, try another. Eventually you’ll find the right one.

    This is true of smoking, drugs, depression, and so much more too.

    It’s more a matter of personality type than beliefs. Even some religious people will have more success with a different method.

  • Tim

    I’m calling BS on this one:

    I know the story of a woman who was court-ordered to participate in AA. However, she had ceased to be an alcoholic. Thus, AA would not allow her to participate. Thus, she lost her children to adoption.
    For that person, cognitive behavioral therapy, group or otherwise, twelve-step or otherwise, would help. But I guess, that is not free. But maybe some modern-day Bill Wilson can organize a CA (cognitive anonymous), which is self-sustaining, group-centered, with sponsors, and available often and everywhere, but not depending on religion for its basis, and not depending on having a specific addiction.
    That woman had to get herself addicted to alcohol in order to preserve her family.
    Posted by Ellen Dibble, on July 9th, 2010 at 11:20 AM

    I’ve never been to an AA meeting where they check to make sure you are a real alcoholic. Plus, there are both open (meaning anybody can attend) and closed meetings. She could have just went to the open ones……You are a member when you say you are – how much easier can it get.

    There seem to be a lot of detractors here. Nothing is perfect, but it sure works for me and a lot of people I know. And, like all things in life, it depends on what you put into it, too.

  • Ellen Dibble

    Tim, I think you agree with the judge who called it on that one. The matter came up for appeal, which means the judge didn’t buy it either.

  • Bubba

    Longtime Sober friend, Willard says “May Folks who don’t want AA, have Memories if Not Getting it. However, let that Not be their Punishment, but their Reward.”

  • http://www.Recoveryissexy.com Sparrow

    Great program.
    Cognitive behavioral therapy maintains that due to free will we can change our thinking and behavior.
    Religion maintains that we change our thinking and behavior by having a religious experience.
    Biomedicine maintains that drugs can change our thinking and behavior.
    None of these takes into account that free will can be lost in some circumstances. For example schizophrenia and bipolar.
    AA spans all these by recognising that free will has been lost in regard to alcohol and that some cognitive, behavioral, religion and drug therapy can help.
    The AA program, meetings, fellowship and a spiritual awakening combines all aspects of acceptance and action towards recovery – by example.
    Bill W. had to learn what worked and so do others.

  • Cherie’

    AA works if I work IT!! I spent 21 years in and out of AA before finally hitting what was my personal bottom. Today I have been sober since April 26, 2001. I attended both the San Antonio Convention this year and Toronto in 2005. I am thankful that AA has great revolving doors and I was always welcomed back with open arms. I had given up on AA in 1998, said IT does not work. In January 2001 I was led to an online AA meeting. There I found people just like me, all over the world with the same common problem. We were alcoholics and our lives had become unmanageable.

    AA does not force God on anyone. Our literature states “a God of our understanding”. There is a chapter in the Big Book to the Atheist and Agnostics.

    On page 30 it says, “We had to fully concede to our innermost selves that we were alcoholic. This is the first step in recovery”. The first 164 pages of the book give me the directions on how to stay sober a day at a time. The rest of the book are stories of those who have stayed sober through AA.

    Did you know there are now approximately 300 12 step programs based on AA’s 12 steps? To name a few, Narcotics Anonymous, Over eaters Anonymous, Cocaine Anonymous, Marijuana Anonymous, Gamblers Anonymous. Pretty much if someone has an addiction to anything they can find a 12 step program to help them.

    To those who have never attended an AA meeting, even if you are not an alcoholic you can attend Open AA meetings. I suggest those who are so against AA to visit an open meeting and find out just what we are all about.

    AA saved my life. I went from a nothing to a sober productive citizen. At age 47 I began college, achieved my Associates in Human Service Management Degree a few months ago. I am a Certified Addiction Counselor and facilitate substance abuse groups in our local prison.

    No AA may not work for everyone, but it works for this recovered alcoholic. I say recovered because due to the Grace of my God and AA I have not had a desire to drink at all since getting sober in AA.

    For information about online AA http://www.aa-intergroup.org/

    Today I am thankful that I am sober and its due to AA and the 12 steps. Today I carry the message to the still suffering alcoholic the best I can. I do service work and currently am serving as secretary of our local roundup. I also serve as secretary of our local Alano Club (a sober club with all the amenities of a bar without the booze) We do have fun in sobriety, we are after all, not a glum lot.

    No, AA does not work for everyone, but then again, perhaps those that AA does not seem to work for were like I was. In denial and not ready to change my life. Today life is a total turn around and I will be forever grateful to AA.

  • Dennis

    AA works for me. I was unable to stay sober until I came into AA. I’m an atheist. I look for the principle of each step and find a way to put that principle into action in my life. It’s not a perfect program and does not claim to be. People should have options, and AA is one of them.

  • http://? Kankakeebern

    Bill Wilson was asked by The medical and scientific communities repeatedly, “How does AA work?”

    His answer was, “Very well, thank you.”

  • http://www.clas.ufl.edu/users/ttravis/ Trysh Travis

    How and whether AA works is one set of questions. It’s also interesting to think about how the 12-Step model of addiction recovery became such a big part of American popular culture.

    I talk about this in my book, The Language of the Heart: The Recovery Movement from AA to Oprah Winfrey, which is available here: http://www.uncpress.unc.edu/browse/book_detail?title_id=1647.

  • Tim

    Ellen: I’ve been away. Thanks for your reply. I think the judge got it right in that case!

  • Gerald Fnord

    I have a lot of trouble with a court’s ordering a person to attend the meetings of a group that demand you reject one particular religious viewpoint on pain of prison, loss of driving priviliges, loss of custody, &c.

    As much as they may deny it, and more, A.A. does have a religious point-of-view: it demands that the participant either believe in an Higher Power or else lie about so believing. Morever, I think the powerlessness emphasised as part of A.A. has its roots in the Calvinist doctrine of Total Depravity, which I and many others (including many Christians)reject as abhorrent.

    A.A. consider themselves non-religious because they are non-denominational, but (as court rulings on non-denominational, enforced, prayer have made clear) this is a distinction without a difference in the context of government mandate.

    Until the courts base their actions on evidence, and provide a- and anti-religious alternatives to A.A., I don’t think we should in the current manner establish religion in this way.

  • Charlie W

    It is so disheartening to see how misunderstood the actual Program of A.A. is and who it is for. In the late 30s and early 40′s around 75% of people got sober, stayed sober and became productive people. Today it might be 2%! Why? People do not do what those men and women did way back then. Instead of going through a time-consuming and rigorous 12 step program and keeping with it, people go to 5-10 “meetings a week and hang on trying to find some sort of “god” which will allow them to return to doing what they always did. AA is not for “Alcohol Dependent” folks (a billing term in Insurance Companies) It is not for annoying drinkers or druggers and it is not for people who are “Medically Addicted” to a substance. The jargon of AA has filtered into Medical parlance and conversely, the jargon of Psychology has inflitrated the meaning of “Alcoholic” (which is a stupid name for this disease anyway). AA is a method, written down, for recovering from a seemingly hopeless state of mind and body, a crushed sense of spirit and a weird reaction to the ingestion of a substance… Booze or Cheese Cake, Pot or Meth, it really doesn’t matter. “Alcoholics” are different than those who drink stupidly, over eat on Thanksgiving and try to shed a few pounds, take a sleeping pill a couple of times a week and think then need it. No Alcoholics are not like other people. Here is an example: If a normal person, or a person who smokes pot and drinks a lot on weekends, or once in a while is an idiot about it and passes out at a wedding arrives at a party and finds out there is one bottle of wine, two joints in a baggie and two six packs of beer, he will probably stay and complain there wasn’t enough “stuff”. The Alcoholic will either leave very quickly or become very nervous and unhinged. Once he (or she) starts, the possibility of running out is too great a hazard.
    Nobody would like to have a different solution to true alcoholism than the average AA Meeting Goer, but we haven’t found one in 75 years. Medicine never did a thing, nor did psychiatry, nor have other “systems”. Those claiming non-AA methods and great success generally treat NON-ALCOHOLICS, just as the Doctors referred to in the book, “Alcoholics Anonymous”. Heavy Drinkers, Problem Drinkers, Mentally Disturbed folks, people with types of PTSD, all may use drugs and alcohol. Abused children may self-medicate and become physically addicted. But none of these are certain to be or “become” alcoholic.
    Since AA uses Anonymity to protect its members from drinking again, the public and the pseudo-experts twist that into secrecy. It is not the same at all. It just means nobody represents AA in the press, radio, TV or Internet (or any public published work). So anyone who wants to bash AA is free to do so and there will not be a public “expert” response. Why not? What is AA hiding? Not a thing! It is a response to the often repeated problem of one person going public and touting AA and its success, only to die soon thereafter from drinking. It happened often enough in the early days that it became a tradition of the Program. So understand this response is one guy, one Recovered Alcoholic. If you really want to find out about AA- go to an OPEN Big Book Study and read the basic text.

  • Linda V

    I love AA and have been clean and sober for 30+ years in the fellowship. The program is NOT religious but is definitely spiritual. The only requirement for membership is a desire to stop drinking. Closed meetings are for those who want to self identify as someone who wants to stop. Anyone can go to open meetings.

    My dad tried AA and thought they were a bunch of holy rollers. Two years later he died from Cirrhosis at the age of 43. I believe I was on the same path and it was only a matter of time before I reached the same end.

    I do believe that there is a power greater than myself and no matter how I want to define it in my own mind, I can tap into it and it WILL keep me sane and sober. That approach may not work for everyone but it can work for anyone who wants to give it a serious try.


  • luke

    I enjoyed the NPR interview and like many of the things I heard. Also Very much like in meetings I heard alot of sick people(my opinion) describe their failed or bad experience with A.A. Its sad to think that this could be the message that someone walks away from this pc. but its o.k. Most meetings ill hear similar sick stuff.

    Good luck to those who feel A.A. is ‘quackery’ etc

    But it works. It really does.

  • JH

    I have been in AA for over 18 years. Before AA, I drank everyday, had 4 DUI’s, no family speaking to me, fired from every job I had, no home, no care, the list is endless…..Now, after AA, I have a family, a home, a car, a great job, a GOD that I found in AA, and hold on to your whatever,,,, I have never had another drink or a DUI….you figure it out!!! Why do people feel the need to criticize something that more people than not believe in it? So much for America!

  • TerryJ

    Appreciate all the comments. I’d like to remind the AA members that we are encouraged to NOT use our last names in public forums. Anonymity is an important principle of our program for good reasons.

  • Joan

    I am a member of AlAnon for 23 years. My spouse has been sober for 33 years in AA, one son has 18 years, the other 4 years, both in AA. Please do not try to tell me that these programs do not work. There have been many points discussed in the previous comments; however the one I would like to discuss is the donations. Most people donate $1 a meeting. In some cases, due to inflation, $2 may be donated. This money goes to pay our rent (we are fully self supporting and will not accept outside contributions.) It also goes for written material, much of which is free to those who want it. At some meetings, coffee and snacks are served. If, for some reason, we have over $200 in our treasury, we donate the money to World Service Offices, or AA/AlAnon regional offices to help offset some of the expenses involved in helping alcoholics and relatives or friends that have been affected by alcoholism.

    As a member of an anonymous organization I would prefer that my last name not be used.

  • http://none Steve

    Of course Allah can be the Higher Power and, yes, there are Muslims who drink. There are AA groups meeting in nearly all Muslim nations – even the Islamic Republic of Iran.

    There may be other “programs” or solutions for the hideous disease of alcoholism/addiction. I found it compelling, though, that with 60,000+ self-professed alcoholics in attendance at the recent convention in San Antonio, none of those alternatives were being marketed or even presented in the surrounding commercial vendor areas. You’d think, if someone really did have something that worked better than AA, they’d have been there… They weren’t.

  • Michael L.

    How do AA, Al-Anon & Alateen work? Real Good for many of us!

    It works!– thanks to the Enlightenment 75 years ago of a couple of drunks, Bill W.& Dr. Bob S. It appears that the enlightenment was that one drunk can help another drunk not to drink for just one day… “A Day at A Time.” (KISS= “Keep it simple, stupid”)

    It was said that with his early efforts, Bill W. became distraught, because some of the drunks he was trying to help get sober… continued to drink. His wife Lois W. replied to him, “Of course it works…. YOU’RE sober, aren’t you?” And so it goes for 75 years and counting: one sober alcoholic trying to help another stay sober this one day.

    And it worked for her, too, by later establishing the same principles for families of Alcoholics in Al-Anon and Alateen.

    And I went to my first Al-Anon meeting in 1972… for the purpose of taking my then Alcoholic and drug using wife to her first AA meeting. Doctors, Psychiatrists, and professional drug rehabilitation programs did not work for her… So I wanted to go in with her to her first AA meeting; and those bunch of drunks had the nerve to tell me I didn’t belong there, but in the Al-Anon meeting of mostly their spouses. I was outraged … how could she get what she needed if I wasn’t there to guide her?

    She went to AA, but wasn’t ready yet; it took her a divorce and 27 years to find what worked for her in AA. But today she is clean and sober in AA, and living her life for real.

    And neither was I ready to listen to all those women in the Al-Anon meeting down in the basement meeting room. After SHE (the drunk) divorced ME (the sober and sane one,) I went to my second Al-Anon meeting 7 years later in 1979; this time I went for ME (not her,) I got a sponsor, and I worked the 12 Steps for ME. And 31 years later, I still live by those 12 Step Principles, even though my long suffering 1st wife took many more (27) years of pain and suffering to get there. Thank you, Lois & Bill W. and Dr. Bob S.

    I can’t explain scientifically how this spiritual (not religious) program works. All I know is that it works real well!

  • Lisa

    I find it hard to comprehend all the anger and hostility I see here and elsewhere directed at 12-Step programs. No, they do not work for everyone. They don’t claim to, and no 12-Step program ever makes anyone attend it. What the courts do, what treatment centers do . . . the fellowships of AA, NA, and the like have no control over. We don’t tell them to send people to us, neither do we tell them they can’t attend.

    As for myself, 12-Step has worked very well. I just celebrated 26 years clean in AA and NA, and nothing I tried before 12-Step ever worked for me. After the first seven years, I spent a number of years clean and sober away from meetings, but I came back because I prefer how my life goes when I’m in active attendance. No one yelled at me for leaving, and no one said I couldn’t come back.

    If the program isn’t working for a person, I’d suggest reflecting on one’s own actions or lack of them first, and if it still isn’t working, then to find something else. But don’t sit around being angry at something that does work for millions of people. Where’s the sense in that?

  • DaveF

    I’m a little late to this discussion but I’ll add my 2 cents anyhow. I’m a member of AA and have not had a drink in over 19 years as a result of attending AA metings regularly and working the AA program as best I could. A lot of the hostility to AA is misplaced. A good working “definition” of Alchoholic for the purposes of AA is somebody who cannot consistently stop drinking when they want to strop drinking once they’ve had one drink, who can’t consistently stay away from that first drink during the course of “normal” everyday life without making fundamental personal changes with outside help , and who has progressively less tolerance and control over their drinking as time passess if they don’t stop drinking completely. AA is for people who meet this description who actually want to stop drinking(not all really do). Most of the people who fit this description and willingly come to AA on their own have tried a whole host of other ways to stay sober to no avail. AA is FREE and accespts for membership anybody who says they want to stop drinking. Where I live we get a lot of people attending meetings and calling themselves alcoholic who have grave mental, emotional, and moral shortcomings and these things don’t go away just because they’re attending AA. Sometimes these problems even get worse after they start attending AA meetings, but not because of AA. I can tell you unequivocally for the type of person who fits the description of Alcoholic that I’ve provided there is no real alternative to AA.

  • Kphil

    Alcoholics Anonymous publishes a well-written, informative brochure entitled, “A Member’s Eye View of A.A.”. The brochure can be read online. What makes this article unique is the audience to which it was addressed: individuals who were in universities to obtain degrees to work with individuals with alcoholism and other psychological issues. I would highly recommend reading this brochure to gain an overview of the unique attributes of the Alcoholics Anonymous program and the author’s description of alcoholism as, “the slow deterioration of the human personality”.

    I will be interested to learn what information is gleaned from the in the Human Genome Study regarding the prevalence, development of alcoholism at the genetic level. In the meantime, it does appear that Alcoholics Anonymous can be a powerful tool for intervening in progression of the disease NOW.

Sep 15, 2014
In this Thursday, Sep. 11, 2014 photo, Middle Eastern leaders stand together during a family photo with of the Gulf Cooperation Council and regional partners at King Abdulaziz International Airport’s Royal Terminal in Jiddah, Saudi Arabia. (AP/Brendan Smialowski, Pool)

President Obama says he will build a coalition of partners in the Middle East to combat ISIS. We’ll do a reality check on who’s really stepping up for what.

Sep 15, 2014
This Monday, Sept. 27, 2010 file photo shows hikers on the South Kaibab Trail in Grand Canyon National Park, Ariz. (AP/Carson Walker)

Uproar over development plans for the Grand Canyon. We go to the Navajo Nation and the Canyon floor to see what’s at stake.

Sep 12, 2014
In this May 23, 2014, file photo, Janay Rice, left, looks on as her husband, Baltimore Ravens running back Ray Rice, speaks to the media during a news conference in Owings Mills, Md. (AP/Patrick Semansky)

#WhyIStayed. We’re looking at women in and out of relationships of domestic violence.

Sep 12, 2014
President Barack Obama meets with Congressional leaders in the Oval Office of the White House in Washington, Tuesday, Sept. 9, 2014, to discuss options for combating the Islamic State. (AP/Evan Vucci)

The President’s ISIS strategy. The Ray Rice video. Congress is back. Apple’s new watch. Our weekly news roundtable goes behind the headlines.

On Point Blog
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