Alcoholics Anonymous

Alcoholics Anonymous (A.A.) is an organization created in 1935 by two men who had a desire to stop drinking and become sober. Today, this group offers friendship, understanding, and hope to other people struggling to recover from alcoholism. The A.A. organization is based on the Twelve Steps. The only requirement to join is a desire to stop drinking. Alcoholism has long been the common denominator for many social ills, affecting areas of personal finance, legal status, personal and business relationships, and long-term health. Unlike programs in the self-help movement, A.A. is focused on mutual help.

The Alcoholics Anonymous Philosophy

A key to their philosophy is that A.A. views alcoholics as lacking the ability to control their drinking once they begin and that help outside the self is needed to gain and maintain sobriety. Although A.A. and its members do not seek out alcoholics who would benefit from A.A., they espouse the notion that those who seek help must be taught that alcoholism cannot be cured, but it can be treated via total abstinence. The typical path of A.A. participants is to first hit rock bottom because of their drinking habits, then to attend A.A. to become sober, and then to continue in a state of recovery by attending A.A. meetings.

Alcoholics Anonymous Meetings

It is in the A.A. meetings where the therapeutic value of talking comes into play; talking topics are limited to those relating only to alcohol. Meetings generally include a recitation of the Twelve Steps, a motivational speaker (usually a member), and the Serenity Prayer. Outside of these core elements, the meetings are quite autonomous in that they are member driven, and each group creates its own culture and traditions.

The meetings are designed to offer each member an outlet to talk about personal alcohol-related experiences and to hear the stories of others; the therapeutic value of such talk has been the core of the program. The interpersonal climate of the A.A. meeting is one that typically encourages relationships based on the common goal of abstinence. In addition, the meetings offer members a place to meet new friends, hear inspirational speakers, and socialize in an alcohol-free environment.

The open meetings allow for anyone to attend with the pledge to not reveal the names of the participants. The closed meetings are only for A.A. members so they can discuss problems and situations that are specific to alcohol; closed meetings also give the newcomers opportunities to ask questions of veteran A.A. members. A.A. meetings are available in most towns and cities all across the United States and in 150 countries.

A.A. meetings in an online environment are the most recent advancement and source for support. Online meetings exist for convenience and for those who are unable to attend meetings due to geographic locale, or physical inability to attend due to lack of mobility.

Eighty-six percent of A.A. members belong to a home group, which is the meeting group they primarily attend; this group is where the member volunteers time, gives support, makes friends, and receives support from other members. In addition to attending meetings with the home group, A.A. members often seek out and attend meetings when they are away from home. Listings of A.A. meetings are found in newspapers, A.A. booklets, and through word of mouth. Often groups are formed based on demographics or particular needs; these include meetings for beginners, women only, men only, gay or lesbian individuals, nonsmokers, and Spanish speakers, to name a few.

Medical and mental health professionals, the courts, and clergy often recommend A.A. to problem drinkers. However, A.A. is not affiliated with any church, prison, or institution.

Alcoholics Anonymous Sponsorship

A.A. advocates and encourages new members to seek out the guidance of a sponsor, someone who has been in the program and worked through the steps. Seventy-eight percent of A.A. members have a sponsor, and the majority of those sought out sponsors within the first 90 days of joining A.A. Sponsor relationships can be long- or short-term and may change over time depending on the needs of the member. These volunteer sponsors are not counselors but rather mentors or coaches; they are supportive by responding when requested, but they do not give advice. The sponsor-based relationship can become very personal and for many is the key to staying sober and continuing to attend meetings. Sponsorship helps not only the A.A. member in need but also the sponsor, who finds it therapeutic to help someone else through a difficult time.

Al-Anon and Alateen

Separate organizations exist for those people touched by alcoholism in one form or another. These groups comprise parents, spouses, children, friends, or anyone who has a connection with a problem drinker. Members attend sessions similar to A.A. meetings, where they share their experiences in a safe and healing environment, and they can join in discussions or be silent depending on their needs. Whether or not the person with the drinking problem attends A. A., these meetings are a place to go for help and hope. Concerns about drinking, relapse, deception, money problems, self-esteem, threats, public embarrassment, abuse, anger, and many other topics are shared by people who have first-hand experience dealing with alcoholic significant others. Like A.A. meetings, Al-Anon and Alateen meetings are free and their locations can be found in the phone book, through A.A., or online.

Downside to Alcoholics Anonymous

As is the case with any organization, not everyone finds the good experienced by those who succeed in and continue to stay with A.A. A 1998 federal study found that just 26% of clients seeking treatment for addiction had problems only with alcohol, so many A.A. members may be faced with dual addictions (e.g., to cocaine, heroine, marijuana, or methamphetamine as well as to alcohol). These members may be particularly vulnerable to relapse and are encouraged to seek out other 12-step programs.

Some A.A. members are coerced to attend meetings; according to A.A.’s 2004 Membership Survey, 11% of their clientele attend meetings because of a court order. Coercion to attend meetings goes against the premise and criterion that to belong to A.A. one must have the desire to stop drinking alcohol. Other forms of coercion come from family members and employers. There are no statistics to determine the continued success of those who were introduced to A.A. under coercion.

The core A.A. requirement of total abstinence comes from the belief that one drink inevitably leads to another and another. The debate between models of total abstinence and controlled drinking has raged for decades; the opinion of A.A. leaders and counselors is unyielding. Younger people and those with a shorter history of problem drinking are more apt to strive for controlled drinking instead of total abstinence.

The implied belief in God, a higher power, or some notion of spirituality (step 3 in the 12-step plan) is another reason some resist A.A. However, A.A. proclaims that there is no requirement to believe in any spiritual entity to be successful in A.A. but rather to know that success cannot be achieved on one’s own. Other elements of receiving help outside of the self include sponsors, therapists, medical assistance, role models, and nondrinking friendships.

Another criticism of A.A. is that it does not address the medical side of alcoholism. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) states that alcohol withdrawal occurs with the termination of heavy and prolonged alcohol use; such use is typical of a new A.A. member. Although A.A. acknowledges that alcoholism is a disease and that medical problems stem from withdrawal, it does not employ professionals to assist with alleviating the physical pain associated with the cessation of alcohol.

Alcoholics Anonymous as a Counseling Strategy

Knowledge of A.A. and what it has to offer may be a therapeutic bridge for clients who have questions and concerns about this path. Counselors’ familiarity with A.A.’s Twelve Steps and the core beliefs and expectations of members may serve well the alcoholic or problem drinker who is searching for the strategy that works best for him or her.

Knowing where a client is in the alcoholism treatment process and what A.A. has to offer provides another option to improve the client’s life situation. Counselors may attend open meetings to get a sense of the diversity, problems, and life issues discussed in local groups and how they might meet the client’s needs. Familiarity with the tools offered and the benefits of Al-Anon and Alateen groups may also be helpful when referrals are requested.

Encouraging clients to attend meetings where they can openly discuss their feelings with others in similar situations may lead to their empowerment and increased self-esteem. Healing properties that exist in groups include members who admit defeat while they still attend meetings and offer hope to newcomers. Positive and uplifting communication behaviors are evident as members allow hidden feelings and emotions to be shown to others where they can be worked through in a safe environment. Stories are shared without shame, and members learn from each other as all the stories blend together. A sense of understanding, friendship, and care evolves as members tell their truths and share their wisdom with each other.

Group counseling is a powerful tool for clients who are struggling to face each day without alcohol in their lives. Knowing they have a circle of people, including their sponsors who understand their dependency and despair and other members who have been in that situation before, allows them to become and remain sober. Being part of an empathic group where members all share the same goals of fighting alcoholism may instill a sense of harmony in a previously chaotic world.

Alcoholics Anonymous Twelve Steps

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  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.
  12. 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.

References:

  1. Alcoholics Anonymous. (1983). Questions and Answers on Sponsorship [Brochure]. Conference approved literature. New York: A. A. World Services.
  2. Alcoholics Anonymous. (1984). This is AA . . . an introduction to the AA recovery program [Brochure]. Conference approved literature. New York: A. A. World Services.
  3. Alcoholics Anonymous. (1990). The AA Group . . . Where it all begins [Brochure]. Conference approved literature. New York: A. A. World Services.
  4. Alcoholics Anonymous. (2005). 2004 Membership Survey [Brochure]. Conference approved literature. New York: A. A. World Services.
  5. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
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  9. M. T. (2001). AA Unmasked. The Village Voice, 46(19), n.p. Perkinson, R. R. (2004). Treating alcoholism: Helping your clients find the road to recovery. Hoboken, NJ: Wiley.
  10. Selle, R. R. (2000). Leo Hennigan: Alcoholism’s nemesis. The World and I, 15(6), n.p.
  11. VanLear, C. A., Sheehan, M., Withers, L. S., & Walker, R. A. (2005). AA Online: The enactment of supportive computer mediated communication. Western Journal of Communication, 69(1), 5-26.
  12. Velleman, R. (2001). Counselling for alcohol problems. (2nd ed.). London: Sage.
  13. White, W. L., & Edwards, T. (2000). [Review of the book Resisting 12-step coercion: How to fight forced participation in AA, NA, or 12-step treatment]. Contemporary Drug Problems, 27(3), 669-675.
  14. Zweben, J. E. (1995). The therapist’s role in early and ongoing recovery. In S. Brown (Ed.), Treating alcoholism (pp. 197-230). San Francisco: Jossey-Bass.

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