Alcoholics Anonymous

Alcoholics Anonymous is a world-wide fellowship of alcoholics whose primary purpose is to stay sober and to carry the message of recovery to other alcoholics through the practice of the Twelve Steps. A.A. is the original twelve-step program and has been the source and model for all subsequent recovery groups such as Gamblers Anonymous, Narcotics Anonymous, Sexaholics Anonymous, Overeaters Anonymous, and Al-Anon/Alateen. The adaptability of the AA Twelve Step Program to these other addictive behaviors seems to suggest that recovery under this model almost always begins after the addicted person admits that they themselves are powerless to effect their own "cure." This acknowledgement is stated in the 1st Step: "We admitted we were powerless over alcohol——that our lives had become unmanageable."

The prior history of recovery from alcoholism is most closely associated with the salvation model in which the alcoholic is implored to undergo a spiritual renewal in order to overcome his drinking. Before the 1930s, alcoholism was primarily seen as a moral failure and hence recovery was to be found in a commitment to religious principles. Emotional appeals were made by preachers, pledges were signed, and the alcoholic was swept away on a tide of optimism, hopeful that some integral change had indeed occurred.

The general futility of this single minded approach was soon demonstrated when the great majority of alcoholics fell back into their "evil ways" and resumed drinking. The failure to remain sober reinforced the drunkard's belief, not to mention society's, that he was indeed morally defective. The institution of Prohibition in the 1920s and early 1930s, in which alcohol was to be denied to all US citizens, demonstrates the frustration of the Temperance Movement to stop the alcoholics from inflicting their harm upon society; moral appeals had failed to cure the problem and so now the law itself was to be employed to deny "the occasion of sin."

The belief underlying the moral approach is that every person has the power to choose; a bad choice is reflective of a bad person and so the person must be made good in order to choose well. The concept of a genetic, psychological, physical predisposition to alcoholism was not conceived of at that time and so a solution that took those ideas into consideration was not available.

One revolutionary aspect of Alcoholics Anonymous was to remove the problem of alcoholism from the moral sphere and put it into the perspective of an illness from which the alcoholic is suffering. Recovery ceased to mean that we had a bad person becoming good, but rather, we had a sick person becoming well. By defining alcoholism in this manner, the alcoholic could be free to analyse his behavior and its causes in a more clinical fashion and not be distracted by the anxiety of damnation that had previously dogged his heels. "I drink because I am an alcoholic, and if I stop drinking, I will not suffer the pains of my dis-ease."

Another vital aspect of Alcoholics Anonymous is that it is exclusively run by and peopled by other alcoholics. It is difficult for some non-alcoholics to understand the loneliness of an alcoholic or the despair he feels as he continues to ruin his life, seemingly of his own will, and an all-alcoholic group provides solace for some recovering from alcohol addiction.

Many have claimed A.A. to be the most successful treatment for alcoholism ever devised. Though some take issue with this claim - and A.A. itself makes no such formal claim - the opinion is widely accepted because no other program has attained the same level of prominence. Dissenters have argued that there are no controlled double blind scientific studies to back the claims and that reputable scientific research casts doubts on the effectiveness of such programs. One factor that complicates research into AA effectiveness is the difficulty of gathering statistical information on a membership that stresses anonymity as an essential characteristic of the fellowship.

A.A. literature describes a difference between an "alcoholic" and a "hard drinker," claiming that unlike a hard drinker, who may drink enough alcohol to cause gradual physical and mental impairment but nevertheless retains the ability to stop or moderate his or her drinking, given sufficiently strong reasons (Alcoholics Anonymous, p. 20-21)), an alcoholic has a disease which renders him/her bodily and mentally different from others. A.A. literature suggests that for effective recovery the diagnosis of ones own alcoholism must be made by oneself, and has no opinion on abstinence for others. There also exist a number of purely secular non-12 step programs which promote abstinence as a recovery goal, as well as programs which promote a goal of moderation for "problem drinkers" as opposed to "alcoholics." A listing can be found in the external links section of this article. None has achieved the same wide-spread use and recognition as AA, and none is without its own controversies.

Some people object to abstinence as a goal, preferring other programs which aim for moderation. Others advocate harm reduction as the most effective step towards addressing the immediate social problems caused by abuse of alcohol and other drugs. Many who have had some contact with A.A. have strong opinions, supportive and non-supportive, about A.A. Thus there is controversy about A.A.

History and development
A.A. was started by two alcoholics who first met on May 12, 1935. One was Bill Wilson (William Griffith Wilson), a New York stockbroker; the other was Dr. Bob Smith (Robert Holbrook Smith), a medical doctor and surgeon from Akron, Ohio. In A.A. circles, the former is known as "Bill W." and the latter, "Dr. Bob."



Wilson had been sober since December 11th, 1934 (six months) when he met Smith, although he had struggled with sobriety for years. In that time he had made several important discoveries about his own alcoholism.

Firstly he had learned from a New York alcoholism specialist, Dr. William Duncan Silkworth, that alcoholism was not simply a moral weakness. Silkworth told Wilson, during one of Wilson's admissions to his drying-out clinic, that alcoholism had a pathological disease-like character. He told Wilson that, in his view, alcoholism was akin to an allergy, in the sense that it produced abnormal reactions to alcohol that were not observed in non-alcoholic drinkers; he called these reactions a "phenomenon of craving" -- once started drinking, the alcoholic finds it very difficult to stop. In addition, Dr. Silkworth told Wilson that alcoholics had a mental obsession that gave them reasons to return to alcohol after periods of sobriety, even knowing that they would then develop overwhelming cravings. This "double whammy" (as he called it) meant that the alcoholic could not stop once started, and could not stop from starting again. This explained the enormous recidivism rate of alcoholics.

Wilson also discovered that some alcoholics were able to recover on a spiritual basis. This approach had been used by one of Wilson's old drinking buddies, Ebby Thacher, to get sober. Thacher had learned about the spiritual approach from Rowland H., an American business executive and alcoholic who had undergone treatment with the famous Swiss analytical psychologist Dr. Carl Jung. After a prolonged and unsuccessful period of therapy, Jung told Rowland that his case, like that of most alcoholics, was nigh on hopeless. Rowland was horrified and begged Jung to tell him anything that might help. Jung replied there was only one hope: a genuine spiritual conversion experience. History, he said, had recorded isolated examples of recovery from alcoholism that appeared solely attributable to the spiritual conversion of the alcoholic. He told Rowland to seek out a conversion experience.

Rowland H. returned to America and found a means to a spiritual awakening through the Oxford Group, a self-styled first-Century Christian movement founded by Frank Buchman that advocated finding god through moral inventory, confession of defects, restitution, reliance upon god, and helping others. It appeared that a spiritual awakening would relieve alcoholics of the mental obsession that kept sending them back to alcoholism after periods of sobriety. Note that Wilson later (Alcoholics Anonymous comes of age, New York: Harper; 1957, p. 39) credited A.A.'s ideas of self examination, acknowledgement of character defects, restitution for harm done, and working with others, to the religious influence of Rev. Samuel Moor Shoemaker and the Oxford Group Movement.

Following one of Wilson's relapses, he returned to the hospital where he was sedated and detoxified. He prayed in bed during his recovery: "If there be a God, will He show himself! The result was instant, electric, beyond description. The place seemed to light up, blinding white. I knew only ecstasy and seemed on a mountain. A great wind blew, enveloping and penetrating me. To me, it was not of air, but of Spirit. Blazing, there came the tremendous thought. 'You are a free man.' Then the ecstasy subsided. I now found myself in a new world of consciousness which was suffused by a Presence. One with the universe, a great peace stole over me" (Three talks to medical societies by Bill W., co-founder of Alcoholics Anonymous. New York; Alcoholics Anonymous World Services; 1973, p.10).

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

James' Lectures IX and X discussed the conversion of "Mr. S. H. Hadley, who after his conversion became an active and useful rescuer of drunkards in New York." His footnote 104 states "I have abridged Mr. Hadley's account. For other conversions of drunkards, see his pamphlet, Rescue Mission Work, published at the Old Jerry McAuley Water Street Mission, New York City.  A striking collection of cases also appears in the appendix to Professor Leuba's article."

William James cited the works of James H. Leuba and Edwin D. Starbuck frequently. Leuba quoted sections of Autobiography by John B. Gough, who describes his depression as an alcoholic. Leuba also points out that self-surrender is necessary for conversion. He quotes S. H. Hadley and comments "In this record the approach towards complete surrender can be followed step by step. He has laid aside pride enough to respond to the invitation and thereby confess publicly his inability to cease drinking. Old crimes, and that which the settlement of them will require of him, pass before his mind; for a moment he hesitates to accept the attitude towards them which submission to God would demand. His humble prayer for succour, and its effect, indicate that all the resistance of which he is conscious had given away, and that, as he called upon Christ, he threw himself unreservedly at his feet."

Starbuck describes conversion following what A.A. came to refer to as "hitting rock bottom." When "the divine urging has become imperative and irresistible. Here is the critical point, the tragic moment. The subject resorts to evasion of good influences, pointing out the perfection of the present self, the imperfection of others, and anything to preserve the old self intact. It is more often a distress, a deep undefinable feeling of reluctance, which is perhaps a complex of all surface considerations which a thorough break in habits and associations would involve. He continues until complete exhaustion takes away the power of striving; he becomes nothing; his will is broken; he surrenders himself to the higher forces that are trying to claim him; he accepts the higher life as his own."

Most importantly, Wilson found that his own sobriety seemed to grow stronger when he shared his personal alcoholic experience with other alcoholics. Wilson was on the verge of a relapse on a business trip to Akron. In a hotel lobby, he decided to phone local ministers and ask if they knew of alcoholics he could talk to. Thus he was introduced to Smith. Had it not been for Wilson's decision to reach out to a fellow sufferer, AA would not exist today.

These were the ideas that he presented to Smith, who had been struggling with his own chronic drinking addiction. The two struck up a solid friendship and together they put Wilson's discoveries into practice. Smith's last drink is said to have been June 10, 1935, and that is considered within A.A. to be the date of the founding of A.A. Their first publication in 1939, Alcoholics Anonymous, the first 164 pages of which have remained virtually unchanged since then, has been a perennial best-seller. The fellowship began to be called "Alcoholics Anonymous" after the publication of this book. Given this start, it is no surprise that A.A. groups and members are frequently called "Friends of Bill W."

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

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

How the A.A. program works
Although some believe that A.A's success lies in the sense of support its members gain from attending regular meetings, many members, as well as A.A's literature, hold that the essence of the program is the Twelve Steps. The Steps incorporate Dr. Silkworth's description of the two-fold problem of physical allergy and mental obsession in Step One, Dr. Jung's description of the spiritual solution in Step Two, the Oxford Groups' method of reaching a spiritual awakening in Steps Three through Eleven, and Wilson's experience in helping others in Step Twelve. The process of working the Steps is sometimes summed up as "Trust god, clean house, and help others." (See twelve-step program for a list of the steps themselves.)

A.A. members are encouraged to "work the Steps", usually with the guidance of a voluntary sponsor. (A sponsor is a more experienced member who has worked the Steps before, usually of the same sex as the sponsee, and freely chosen - and just as freely "fired"- by the sponsee.) The Steps are designed to help the alcoholic achieve a spiritual, emotional and mental state conducive to lasting sobriety. There are many long-term A.A. members who claim that working the Steps has freed them entirely from the urge to drink alcohol. Whereas staying sober was once difficult and uncertain, these members report that sobriety is now much easier, provided they keep working the A.A. program.

Most members regard attendance at A.A. meetings as important to their sobriety (although there are groups in A.A. made up of loners and members living in remote locations who communicate by mail and internet). Even members with decades of continuous sobriety still go to meetings regularly. There is no compulsion or requirement to attend. Members may attend as few or as many meetings as they wish, as frequently or infrequently as they like. However, new members are encouraged to go to 90 meetings in 90 days, and a sponsor may set his or her own expectations for a sponsee's attendance. No official membership or attendance records are kept at any level in A.A. However there are annually published estimates which are available through AAs headquarters in New York City, known as "GSO" (General Service Office).

With the above in mind, a typical individual program of recovery for a newcomer may include:
 * Above all, avoiding the first drink.
 * Attendance at one or more meetings daily for 90 days or longer. Some people coming into A.A. have attended meetings daily for the first year. (Note: nowhere in A.A. literature is there a reference to frequent attendance at A.A. meetings. Many A.A.s believe this notion started in the treatment centre industry; graduating patients were advised to attend many A.A. meetings, presumably in an effort to acquire a new peer group of abstinent friends to reinforce the effects of treatment.  Regardless of source, this recommendation is consistent with a suggestion commonly heard in A.A. that one in recovery should "change playgrounds and playmates.")
 * Contact with one's sponsor daily in order to work the steps and to discuss whatever problems one may be having in one's life, problems which may, if not addressed, lead the alcoholic to take the first drink: "One [drink] is too many and one thousand [drinks] never enough."
 * Daily prayer and/or meditation, as suggested by Step 11: "Sought through prayer and meditation to improve our conscious contact with god as we understood him, praying only for knowledge of his will for us and the power to carry that out."
 * Daily attention to Step 10: "Continued to take personal inventory and when we were wrong, promptly admitted it."
 * Service work, which, for the newcomer, can be as uncomplicated as making coffee at meetings, helping to set up and break down tables and chairs, etc.

It will be noted that the program is to be worked daily and done so one day at a time. Frequently heard at meetings:  "I'm a winner today, no matter what happens, as long as I don't pick up that first drink."

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

A.A. does not charge membership fees to attend meetings, but instead relies on whatever donations members choose to give to cover basic costs like room rental, coffee, etc. Contributions from members are limited to a maximum annual amount. A.A. is self-supporting and is not a charity. It accepts no subsidies from any non-A.A. source and donations of money or other items of value from such sources are not accepted.

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

Many A.A. groups use the famous Serenity Prayer and many AA groups in the Southern United States often close their meeting with The Lord's Prayer.

Beliefs about alcoholism
There is no official creed of A.A. belief about alcoholism, since individual members are free to believe whatever they wish based on their own experiences. Even the core twelve step program is presented to members as suggested rather than mandatory. While AA literature states that "our twelve steps are only suggestions", many more traditionally-minded members claim that today's decreased emphasis on "Step Work" has resulted in a drastic decline in AA's success rate. In the early days of AA, say critics of today's meeting-centred brand of Alcoholics Anonymous, the 12 Steps were mandatory and attendance at meetings were optional. They claim that during this time, AA experienced 75-90% success rates of recovery. In recent years however, the Fellowship has shifted its views greatly and now many veteran AA members advise newcomers that meetings are mandatory while placing less emphasis on "working the steps". Some blame this lessened emphasis on The Twelve Steps for a first-time sobriety success rate of approximately 5%, according to an internal study conducted by AA Intergroup in 1988. Other estimates put overall success rates however somewhere between 5 and 10%. Given that AA's membership is by definition, anonymous, and its administrative body -- the General Service Office, General Service Board and annual General Service Conference -- acknowledges the importance of anonymity, no records are kept on AA members, so non-anecdotal data about success rates cannot be obtained from official AA sources.

Many A.A. members share similar views on alcoholism and most would agree with the following statements:


 * Alcoholism has no cure. Once an alcoholic, always an alcoholic. There is no way to make a "normal" drinker out of an alcoholic. Nor is there any way to make a non-alcoholic into an alcoholic. Alcoholics who do not drink can recover and function in normal society, but should they drink again, their active alcoholism will re-emerge quickly and be as debilitating as before. This is true even in cases where alcoholics have remained sober for many years before relapsing. The concept that "alcoholism has no cure" is one at variance with the remarks of A.A.'s two founders--each of whom specifically stated he had been "cured." So too A.A. Number Three (Bill D.) who stated he had been cured by the Lord. See Big Book, p. 191. In fact, for almost a decade after A.A.'s founding, all members from the mid-west and newspapers across U.S. trumpeted the fact that they had been cured and that the cure was reliance on the Creator. See Dick B. Cured; When Early AAs Were Cured and Why.


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


 * The first drink does the damage. Once an alcoholic takes a drink, a powerful craving for more alcohol sets in. This makes moderation or controlled drinking nearly impossible. Thus the A.A. approach of abstinence. Without the first drink, the craving cannot occur. Much of the A.A. program is intended to help the alcoholic stay stopped, thereby preventing the compulsive drinking cycle from starting.


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


 * An Alcoholic cannot recover on his or her own. An alcoholic needs (or will benefit from) the fellowship of the AA program. Contact with other alcoholics provides an essential ingredient to the process of recovery. AA meetings may be important, along with reading AA materials and working the steps -- but it is working with other alcoholics, helping and being helped, talking and interacting, that allow an alcoholic to do what he or she cannot do alone -- stay sober.

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

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

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

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

The A.A. program contains spiritual ideas, but it does not promote any particular religion over others, and it has worked for adherents of many faiths, including Christians, Buddhists, Jews and Muslims as well as for many who identify with no religion. Nevertheless, since it suggests that the recovering alcoholic seeks help from a "Higher Power," some atheists and those not looking for a "spiritual" solution find themselves unable to accept A.A.'s Twelve Steps and instead seek out secular alternatives. Many others have been able to adapt the concept of a "Higher Power" in a manner that works for them, and there is a chapter of the book Alcoholics Anonymous called "We Agnostics" that speaks directly to agnostics and agnosticism. It counsels that even those members who "thought we were atheists or agnostics" were able to "lay aside prejudice and express even a willingness to believe in a Power greater than ourselves ... even though it was impossible for any of us to fully define or comprehend that Power, which is god" and "had to stop doubting the power of god" because "deep down in every man, woman, and child, is the fundamental idea of god." (quotes from Alcoholics Anonymous, 4th Edition, p. 44, 46, 52, 55) Many alcoholics arrive at A.A. with a strong disbelief towards spiritual ideas. A.A. members usually counsel attendees with such beliefs to keep attending despite their perceived conflicting beliefs. The attitude towards these cases is usually the same as in the Alcoholics Anonymous book, they believe that eventually atheists and agnostics will "come around" to believing in a "higher power." Many agnostics and atheists find this attitude offensive and condescending, because they interpret such statements as being tantamount to saying that atheist and agnostics have simply not thought about the implications enough to come to see what A.A. adherents see as a basic "truth." It should also be noted that many believers reject AA's spiritualism as well.

Many alcoholics who arrive at A.A. without belief in a god use the group itself as their "Higher Power." One such alcoholic defined "GOD" as "Group Of Drunks" until he was able to discover a spiritual concept of god which worked for him. Other A.A. members point out that there are many powers greater than one's self to choose from. The idea that this power must be God is not necessarily true for everyone. Some A.A. members choose some principle, such as the truth, or compassion, or the law of impermanence and constant change and surrender to that principle as their "higher power". Others may focus on the program itself, defining "GOD" as "Good Orderly Direction." On the other hand, newcomers are cautioned that it is unwise to use any one person, such as a sponsor, as their higher power in that all individual human beings are fallible and, in the case of another recovering alcoholic, no matter how long his or her sobriety, capable of relapse. The basic idea is that, in order to recover, the alcoholic must "surrender," meaning that he or she must admit his or her powerlessness over alcohol and unmanageability of life and must stop depending only on self, while beginning to rely on help from a "power greater than [one's self]," whatever the precise nature of that power. Many recovering alcoholics would agree with the statement: "I had done things my way long enough, and all it got me was drunk.  I decided it was time to start following directions."

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

Finally, many AA members would agree with the idea that most members *begin* AA involvement as a result of some form of coercion, whether from family, a spouse, a boss or supervisor, or the courts. Even those who are not pressured by others are nonetheless pressured by circumstances -- they have "hit rock bottom" and decided that the pain of drinking and the consequences of drinking are too severe to be tolerated. Regardless of initial pressures, many AA members come to value their involvement with the AA program and embrace sobriety for the benefits it brings them.

Discussion of the Merits of A.A.
Though there is little doubt that A.A. is the number one treatment for alcoholism in the world today, it has its detractors.

(Note: in this section, BB refers to The Big Book, aka Alcoholics Anonymous, 3rd Edition, by the first 100 members of Alcoholics Anonymous, and 12x12 refers to Twelve Steps and Twelve Traditions, by William G. Wilson) Note: in 2001 the 4th edition of Alcoholics Anonymous, was released. The first 164 pages (including the doctors opinion), of the BB have been left intact and unchanged since the book's initial publication in 1939. The only change in each edition, aside from some minor updating of the basic text from the first to the second edition, has been the addition and/or deletion of some of the stories in the back of the book.

AA's Supporters
On one hand, supporters claim that AA is an indispensable support group for people seeking to free themselves of an addiction to alcohol. Some things they cite include:


 * The American Medical Association supports the disease model of alcoholism that was developed in the early part of the 20th century and embraced by AA.
 * A large amount of anecdotal evidence in which people assert that joining AA saved their lives
 * Long-term sobriety lengths of 20, 30, or 40 or more years are not uncommon in AA.
 * Many members find that AA is fun. While meetings can be serious, they can also be filled with laughter.  Social activities such as dances, picnics, and conventions are enjoyed by great numbers of AAs.  Many members discover that their fears of never again having fun after quitting drinking have proven false.  Many AA's believe that engaging in therapeutic recreation that does not include alcohol helps them to stay away from drinking.
 * Because of the large number of AA groups (over 100,000 worldwide as of 2001), AA members are free to try different groups until they find groups that they enjoy. Because AA members come from all walks of life and every segment of society, there is a tremendous amount of variety within the fellowship.  Not only do these facts make it difficult to generalize about AA groups, but these circumstances allow for a level of flexibility that accommodates the sobriety needs of a large spectrum of recovering alcoholics.
 * The fact that AA does not require a belief in any specific higher power means that AA is not a religion. Since members are free to choose any higher power they like--including higher powers that are not spiritually based--and since members are allowed to change higher powers whenever they like, this agility facilitates a kind of transference that aids in recovery from alcoholism.  By this definition, an alcoholic is a person who has turned alcohol into a higher power.  By selecting an alternate higher power of his or her own choice and/or design, the alcoholic is able to achieve the psychological transference that topples alcohol as a higher power.  As the alcoholic progresses in recovery over months and years, this same flexibility allows the recovering alcoholic to switch to higher powers that are more individually appropriate to that AA member at that given time.
 * "Doing the footwork and turning over the results." Contrary to occasional criticism, the AA program encourages members to act as individuals and to think for themselves.  Not only must they design the pace of their own programs and choose their own higher powers with which to supplant alcohol, but they must do their own "footwork" in all areas of their lives.  The individual in AA is fully empowered to do his or her own footwork.  When the AA program speaks of "powerlessness," this applies to the results of the footwork.  This distinction is expressed in the words, "Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."  In life, footwork is always changeable by the individual, while results are often uncertain, unpredictable, and/or out of the individual's control.
 * The "Toolbox Principle." Many AA's see the program as a large "toolbox."  Not everyone feels comfortable with all of the tools all of the time.  Many AA's find that they can stay sober while using some tools and not others, or using different tools at different times.  This flexibility allows members to reach for the specific help they need at specific times, then use a different kind of help as circumstances fluctuate.
 * Enlightened self-interest: Many AA's believe that in order for an alcoholic to stay sober, he or she must be in the program for him- or herself.  According to this perspective, an AA member does not work the program for the sake of his family, his job, his community, or for the sake of any AA group or AA as a whole.  An alcoholic works the program for himself, and helps others primarily because it helps oneself.
 * Every AA member is free to have a sponsor of his or her own choice or not to have a sponsor at all. Some AA's have more than one sponsor at one time.  Some AA's have a sponsor or sponsors at the beginning of sobriety, then choose not to have sponsors later on.  A member may "fire" a sponsor at any time, and vice versa.  Because AA members are learning to become individually empowered, it is their responsibility to select appropriate sponsors and change sponsors when necessary.  The great variety of available sponsors is another aspect of the program's flexibility in terms of the shifting needs of individual members.
 * Many members and groups acknowledge that AA isn't the right program for everyone, and that there are effective alternatives for other individuals.
 * The 12 steps are suggestions rather than requirements (though "they are 'suggested' in the same way that, if you jump out of an airplane with a parachute, it is 'suggested' that you pull the ripcord" (Daily Reflections; A Book of Reflections by A.A. members for A.A. members, Alcoholics Anonymous World Services, Inc., pg. 344))
 * There are no official membership records, allowing members to come and go as they choose (see above for the exception to this, which AA itself does not sanction)
 * Despite Bill W.'s claim that members are "impersonally and severely disciplined from without" in a letter to Dr. Harry Tiebout (quoted in Not-God: A History of Alcoholics Anonymous, Ernest Kurtz, page 129, a book put out by a publisher which publishes much addiction literature), AA lacks any sort of formal disciplinary measures against members who fail to adhere strictly to the program
 * The claim that AA is spiritual, not religious, and that the requisite Higher Power can be anything including god (as the individual understands Him, according to the 3rd Step), the group itself (one slogan: "G.O.D.=Good Orderly Direction), a philosophical system, a dead person, the universe, nature, a principle or anything the individual member chooses to invent. AA philosophy acknowledges that all rational people admit the existence of powers greater than themselves, and that this is in fact one of the definitions of a rational person.
 * The slogan that says to "Take what you can use and leave the rest." Members are also reminded that AA will work for them only if they work the program.
 * The lack of a guru-like figure rising to fill the late Bill Wilson's shoes, lending credibility to the slogan that says "principles before personalities"
 * According to the BB, "Our primary purpose is to stay sober and to help others to achieve sobriety." Thus, AA is not a social movement and is not involved in trying to reshape society or to affect communities or their values.  AA prefers to appeal to potential members through "attraction rather than promotion."

AA's Critics
Specific criticisms sometimes put forth by AA's critics (some of whom go so far as to call AA a cult) include:
 * There have been at least three randomized clinical trials that studied the effectiveness of AA. Specifically: Ditman et al. 1967; Brandsma et al. 1980; Walsh et al. 1991.
 * Dr. Ditman found that participation in A.A. increased the alcoholics' rate of rearrest for public drunkenness.[1]
 * Dr. Brandsma found that A.A. increased the rate of binge drinking. After several months of indoctrination with A.A. 12-Step dogma, the alcoholics in A.A. were doing five times as much binge drinking as a control group that got no treatment at all, and nine times as much binge drinking as another group that got Rational Behavior Therapy. Brandsma alleges that teaching people that they are alcoholics who are powerless over alcohol yields very bad results and that it becomes a self-fulfilling prediction -- they relapse and binge drink as if they really were powerless over alcohol.[2]
 * And Dr. Walsh found that the so-called "free" A.A. program was actually very expensive -- it messed up patients so that they required longer periods of costly hospitalization later on.[3]
 * While AA acknowledged in the foreword to the second edition of the Big Book that "we surely have no monopoly", one of the stories following the main text of the book still claims that AA is "the only remedy" to alcohol abuse (BB, pg. 259. Emphasis added.), despite some current research which shows that high percentages of alcohol abusers recover without medical treatment (Treatment of Drug Abuse and Addiction -- Part III, The Harvard Mental Health Letter, Volume 12, Number 4, October 1995, page 3.). Another study suggests that AA may be "no better than the natural history of the disease" in keeping people alive and sober (The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery, George E. Vaillant, pgs. 283-286.)
 * The claim that people who refuse to work the program thoroughly, or do but are not helped by it, are "constitutionally incapable of being honest with themselves" (BB, pg. 58.), implies that, by definition, the AA program itself is incapable of failure, provided that the alcoholic is properly motivated. This seems to deny the existence of honest, motivated individuals for whom the program doesn't work.  ("consitutionally incapable of being honest with themselves" has nothing to do with motivation and everything to do with being thorough through the steps and when the truth gets to be too much, backing down and not trudging through the rough spots.)
 * A lack of official checks and balances designed to keep sponsors from abusing their position (though sponsors can be fired at any time)
 * Claims that alcoholics are "doomed to an alcoholic death" unless they decide to "live on a spiritual basis" (each AA member being allowed to decide for himself what "spiritual basis" means) (BB, pg 44) and "Unless each A.A. member follows to the best of his ability our suggested Twelve Steps to recovery, he almost certainly signs his own death warrant." (12x12, pg. 174).
 * In the discussion of self-centeredness, statements such as "Sometimes they [other people] hurt us, seemingly without provocation, but we invariably find that at some point in the past we have made decisions based on self which later placed us in a position to be hurt." (BB, pg. 62. Emphasis added.) may be generalized so as to leave no room for instances where the victim was blameless, such as childhood sexual abuse or another form of mistreatment of either children or innocent adults unable to protect themselves. Many AA members interpret this to mean that blameless victims are at fault for continuing to be hurt by a past event, and not at fault for the past event itself. Some critics assert that this interpretation is incompatible with the text, saying that it clearly refers to the actual acts of others, not the victims' attitudes towards those acts, and suggests the problems of victims are that they have made "decisions based on self", that, later place them in a position to be hurt, not that they have chosen to remain affected by earlier hurts. On the other hand, supporters assert that the "decisions based on self" could have been, and in the case of blameless victims, clearly were, made after the event itself that occurred. An unofficial slogan sometimes heard in AA is "There are no victims, only volunteers." This clearly indicates the belief that nobody is ever victimised in any way that they could not have avoided. (Some AA members believe that these types of statements are only intended to warn against a habitual victim mentality. Some AA members understand that people can experience either innocent bad luck or be seriously victimized through no fault of their own.) In any case, the interpretation suggests that whether one continues to be hurt by previous abuse is something one can have full choice over, whereas physical and mental trauma resulting from victimisation might be chronic and something the victim is truly powerless over.
 * The claim that "If we were to live, we had to be free of anger." (BB, pg. 66) when psychologists say that while anger must be managed, it is not possible or healthy to do away with it entirely.  (Some AA members interpret "free of anger" to mean that one should not be enslaved by their anger, be a "rageaholic," or engage in habitual toxic anger, not to mean that they should have no anger at all.)
 * The "To Wives" chapter of the Big Book being written as advice from one wife of an alcoholic to another, when it was in fact written by Bill W. himself despite his wife Lois' desire to write it (Getting Better: Inside Alcoholics Anonymous, Nan Robertson, page 70-71; Pass It On, a publication of AA, page 200.)
 * Bill W.'s frequent use of first-person plural giving the implication that all alcohol abusers have similar defects of character (6th Step) and past experiences (examples: "...something had to be done about our vengeful resentments, self-pity, and unwarranted pride." 12x12, pg. 47. and "We never thought of making honesty, tolerance, and true love of man and god the daily basis of living." 12x12, pg. 72. Emphasis added.)
 * The contradiction between the BB's claim that "We will seldom be interested in liquor. "If tempted, we recoil from it as from a hot flame" We will see that our new attitude toward liquor has been given to us without any thought or effort on our part. It just comes! That is the miracle of it." (BB, pgs. 84-85) and Bill W.'s own statement that even co-founder Dr. Bob "was bothered very badly by the temptation to drink." "Unlike most of our crowd, I did not get over my craving for liquor much during the first two and one half years of abstinence." ["Dr. Bob's Nightmare"] (BB page 181) On the other hand, Dr. Bob's use of the word "craving" is consistent with the physical cravings described by Dr. Silkworth, not with the lack of the mental obsession to return to liquor that is described.
 * AA's heavy reliance on numerous slogans, including ones used to defer criticisms brought up during meetings, such as "Take the cotton out of your ears and put it in your mouth!"

Criticisms specific to religious themes
Critics see the following points as evidence of religious themes in AA:


 * Many of the steps being adapted and altered from tenets that "came straight from Dr. Bob's and (Bill W.'s) own earlier association with the Oxford Groups" (The Language of the Heart, William G. Wilson, pg. 298), a Christian spiritual movement with which friends of theirs had been involved and which places a large emphasis on taking individual responsibility for the harm one has done to others and confession to god and another person.
 * Because "most alcoholics just wanted to find sobriety, nothing else", "The Oxford Groups' absolute concepts ... had to be fed with teaspoons rather than by buckets." (Alcoholics Anonymous Comes Of Age, William G. Wilson, pgs. 74-75.)
 * The statement that "At the moment we are trying to put our lives in order. But this is not an end in itself. Our real purpose is to fit ourselves to be of maximum service to god" ("god" or "higher power" being defined by the AA member himself, including non-spiritual, agnostic, or atheist beliefs) (BB, pg. 77)
 * "Being entirely ready to have god remove these defects of character" (sixth step), "or, if you wish, our sins" (12x12, pg. 48), and "praying only for knowledge of His will for us and the power to carry that out" (eleventh step)

Criticism of religious themes from religious groups
Several Traditionalist Catholics have expressed misgivings about what they term "the abominably liberal and indifferentist," nature of AA while at the same time acknowledging it should be cautiously tolerated to avoid the greater evil of alcoholism. A small number of ultra-conservative Protestants have expressed discomfort about what they believe to be New Thought, Jesuitic, or even occult aspects to Bill W's personal philosophy.

Literature
For more literature, see Bill W., Literature; Dr. Bob, Literature; Twelve-step program, Literature.
 * Alcoholics Anonymous Comes of Age. A Brief History of A.A., New York: Alcoholics Anonymous, 1990, ISBN 091685602X.
 * "Alcoholics Anonymous" by Jack Alexander, Saturday Evening Post, March 1, 1941
 * The Drunkard's Best Friend by Jack Alexander, Saturday Evening Post, April 1, 1950

Dramatic Portrayals

 * My Name is Bill W. Story of the founders of AA
 * Days of Wine and Roses An early portrayal of AA (1962)
 * South Park Parodied AA in the December 7, 2005 episode ("Bloody Mary")
 * The Simpsons Homer Simpson is sentenced to attend AA meetings in the episode Duffless. In the episode 'Round Springfield, Barney Gumble is trying AA, but quickly falls back to drinking.

Official A.A. links

 * A.A. home page
 * The A.A. Grapevine

Unofficial A.A. sites on the internet

 * The Unofficial Website for AA Related Information
 * Example of Regional Unofficial Site
 * Staying Cyber: An AA Meeting for the WWW
 * AA Big Book
 * The Washing Machine
 * AA History and Trivia
 * Online Intergroup of AA
 * GlennS's AA blog & Friends of Bill W blogring

Testimonials (Stories of Recovery via AA)

 * Recovery Stories--from MemoryWiki
 * Horror Stories

Critical links

 * Triple A Comix--AA In Satire
 * More Revealed: A Critical Analysis of Alcoholics Anonymous
 * The Orange Papers
 * Allegations of "Mind Control" in A.A.
 * Is A.A. a Cult?
 * AA Cult Or Cure?
 * Stanton Peele PhD, national AA and 12-Step treatment critic

Links to AA alternatives
Abstinence based programs
 * Rational Recovery
 * SMART Recovery
 * SOS - Secular Organizations for Sobriety
 * Lifering
 * WFS - Women For Sobriety

Moderation/harm reduction based programs
 * MM - Moderation Management
 * My Way Out