Alcoholics Anonymous, most commonly referred to as AA, is a support group for individuals seeking to recover from alcoholism. AA was cofounded in Akron, Ohio, in 1935, through a chance encounter between Dr. Bob (Bob Smith, M.D.) and Bill W. (Bill Wilson), both self-labeled alcoholics who had made many previously unsuccessful attempts to stop drinking. Unbeknownst to them at the time, a friendship began that would lead to the creation of the largest support group for alcoholics. The symbol for AA, which was presented at the International Convention in 1955, is a circle enclosing a triangle. The circle stands for the whole of AA, while the three arms of the triangle stand for AA’s three legacies: recovery, unity, and service.
AA is often referred to as a fellowship. There are no “rules” or “shoulds”; rather, there are Twelve Steps (suggestions for recovery that help each member’s sobriety) and Twelve Traditions (guaranteeing AA’s unity covering a guide to better ways of working and living). Because there is no formal membership, no one can be expelled from the group or punished. Members have the ability to interpret the program, as it is commonly called, as they like. Most alcoholics will not reach out to AA until they have hit “rock bottom” (had significant losses in their lives).
There is an estimated 1.7 million AA members in 150 countries. Membership is based solely on a desire to stop drinking. One need not be referred to AA, there is no formal registration process, no dues or fee to be paid, and no treatment plan developed. Participation is voluntary, not compulsory, although the criminal justice system may require AA attendance as a condition of probation or parole. The primary components of the AA model are to accept the label of being an “alcoholic,” admit loss of control of use of alcohol, express a desire to quit drinking, and to become or remain abstinent from all forms of alcohol and mood-altering drugs. AA functions primarily as a support group for people with a common problem; there is no professional facilitator or group leader. According to AA, groups, which consist of at least two members, are the primary vehicles through which recovery takes place. There are an estimated 100,000 groups worldwide.
The group provides a sense of hope for individuals and has been written about extensively in the group literature. It also allows for a shared sense of purpose, a feeling of progress, and a sense of optimism as individuals recover and see their own change as well as that in others. AA gives many people a sense of faith, which guides them through recovery. Due to the perceived popularity and success of AA, group counseling has become the most popular method of treatment for alcoholism.
Meetings, as the groups are referred to, are generally classified as open. Open meetings are available to anyone who wishes to attend, including longtime members and newcomers, alcoholic and nonalcoholic. Closed meetings are limited to individuals who identify themselves as members of the AA fellowship. Typically, closed meetings have a set of discussion topics (steps, the Big Book), and only AA members may attend. These meetings tend to be personal in nature or include an interpretation of the steps and traditions. Groups are available to meet many needs: newcomer groups for AA beginners; Big Book meetings, which center on the reading and interpretation of Alcoholic Anonymous; as well as groups that have been established to serve diverse populations, including women’s groups, gay and lesbian groups, business-men groups, Hispanic groups, and many others. Meeting times and places are published in newspapers, or a local contact phone number can be obtained through the yellow pages or the AA Web site. Most meetings are held in donated spaces, thus allowing the meeting to take place for free.
For AA, as the name implies, the concept of anonymity is central. This means that individuals use only first names in meetings and are cautioned against disclosing personal identification. It serves three basic purposes for the organization and the membership: It focuses the attention of the new members on the recovery process and away from prestige or grandiosity; through anonymous participation in AA, members can give up their ego-driven struggles; and it provides a safe haven from the stigma attached to alcoholism. AA members are called upon to take responsibility for their actions (past and present), and they can do so in an anonymous setting. Finally, anonymity allows for the inclusive nature of AA, allowing anyone to be a member and reducing self-aggrandizing, favoring instead a new humble self-image for recovering alcoholics. The idea of anonymity has been reduced to some degree over the years, as many members are not afraid to admit they are alcoholics. Generally, though, identities to the press are not revealed, and AA does not seek publicity.
A central tenet of AA is that recovery is a lifelong process, for which there is no treatment but rather a remission of the process through abstinence. Thus, AA members refer to themselves as recovering, not recovered, alcoholics. As social relationships are believed to contribute to relapse, AA calls for individuals in recovery to seek new “playmates,” implying that individuals must change their interests from consuming alcohol to other things. Those in recovery are urged to be aware of social relationships and activities that can assist in preventing relapse.
The primary philosophy of AA is outlined in what is commonly referred to as the “Big Book,” or Alcoholics Anonymous, first written by Bill Wilson in 1967. The book consisted mainly of the Twelve Steps, which each AA member is encouraged to complete sequentially. The first step, “We admitted we were powerless over alcohol—that our lives had become unmanageable,” is essentially the foundation of AA philosophy; recovery cannot begin until the person admits that he or she is powerless. The steps that follow the first step reinforce the notion that alcohol consumption is insane, is egocentric, and leads to a pattern of self-destruction and harm to others. There is no time frame or particular pattern for step completion; however, most members end up reviewing steps periodically as a way of maintaining their recovery. The concept of completing the Twelve Steps appears overwhelming to many alcoholics; however, the goal is not to complete each one in perfection but rather to grow spiritually. The steps serve as a guide to progress for the alcoholic and are believed to be open to interpretation rather than absolutes.
We admitted we were powerless over alcohol—that our lives had become unmanageable.
Came to believe that a Power greater than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made a direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
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.
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.
An AA guiding principle is that no one can beat alcohol alone. The alcoholic must submit to a Higher Power (most often God) that he or she needs assistance. This reference to a Higher Power in the Twelve Steps is sometimes criticized as including religion. Although the cofounders did not intend for AA to have any religious roots, they believed spirituality played a large role in recovery. The spiritual experience is deemed to give the person new motivation, providing a fresh rebirth and a new opportunity. It is believed that a spiritual awakening can banish the desire to drink. A belief in God is not essential for AA members. However, the belief in a “Higher Power, Power greater than” is essential, as is living by spiritual principles.
AA believes that the self-appraisal portion of the steps is not enough, as people are prone to rationalizations and wishful thinking. Thus, the use of a sponsor is recommended, that is, talking to another person who will provide direct comment and counsel about one’s situation. Sponsors are members who are identified as having a relatively long period of sobriety and can act as resource persons to new members, or “pigeons.” The sponsor gives advice and direction. The sponsor is supposed to be able to see through resistances and share his or her experience with the new member as a form of ongoing support. The sponsor can assist the member with avoiding relapse, attending meetings, and working the steps of AA. As with much of AA, there is no formal training for sponsors; rather, they rely on their own experience and recovery to assist others.
In addition to the Twelve Steps, there are the Twelve Traditions of AA. During its first decade, the AA fellowship had accumulated enough experience to assist in establishing a set of group attitudes and principles that were deemed necessary to maintain the survival of the informal structure of the fellowship. In 1946, the cofounders and early members published these as the Twelve Traditions of Alcoholics Anonymous. They were accepted and endorsed by the membership as a whole at the International Convention of AA in Cleveland, Ohio, in 1950. The Twelve Traditions emphasize AA unity, the importance of a higher power, lack of membership requirements, avoiding endorsements, refusal of outside contributions, the necessity of peer support over professional intervention, avoidance of taking a position on outside issues, and the importance of personal autonomy.
Although the Twelve Traditions are not specifically binding on any group, an overwhelming majority of members have adopted them. The Twelve Traditions are neither rules nor regulations nor laws. Members adhere to the Twelve Traditions because they ought to and want to. In an effort to keep AA neutral and focused on its mission, contributions by outside sources are not accepted and from individual AA members are limited to $1,000 a year. AA does not lend its name or logo to any treatment facility organization.
The influence of AA and its Twelve Steps is currently observed in treatments for many other problems, including overeating, gambling, and codependency. There has been tremendous social and political pressure to apply the Twelve Step concept and disease–abstinence model to all psychoactive substances. Approaches based on the AA Twelve-Step model dominate the substance abuse treatment field and are likely to remain influential and popular for years to come.
Big Book The; Bill W.; Recovery; Support Groups; Twelve Steps
The Twelve Steps are reprinted with permission of Alcoholics Anonymous World Services, Inc.
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