Alcoholics Anonymous (AA)

Alcoholics Anonymous is a fellowship of problem drinkers, both men and women, who voluntarily join because they want to stop drinking and remain sober . It was started in the United States in the 1930s. Since then, it has been maintained by alcohol-troubled people who had themselves "hit bottom" and discovered that the troubles associated with their drinking far outweighed any pleasures it might provide. AA does not offer professional guidance such as counseling or therapy. The key to AA is the support members give each other.

See Organizations of Interest at the back of Volume 1 for address, telephone, and URL.

AA is not the only hope for alcoholics; nor is it everything they need. Even so, thousands of alcoholics in the United States and many other countries have become abstinent by following its program and attending meetings. AA has never attempted to keep formal membership lists, so it is difficult to get completely accurate figures on total membership at any given time. However, in 2001 there were an estimated 2.1 million members worldwide, with over 51,000 groups in the United States and over 100,000 groups worldwide.

The Twelve Steps of Alcoholics Anonymous

AA's program for remaining sober is called the Twelve Steps. The goal of AA is to have members come to accept and live according to the beliefs of all Twelve Steps, which build upon each other. A paraphrase of the Twelve Steps follows. Members of AA agree that:

1. They are powerless over alcohol—that their lives have become unmanageable.
2. They believe that a power greater than themselves can restore them to sanity.
3. They must turn their will and lives over to the care of God as they understand God.
4. They must make a searching and fearless moral inventory of themselves, examining where they have failed or not behaved toward themselves or others as they should.
5. They will admit to God, to themselves, and to another human being the exact nature of our their wrongs.
6. They are entirely ready to have God remove all these defects of character.
7. They must humbly ask God to remove their shortcomings.
8. They must make a list of all persons they have harmed, and become willing to make up for wrongs they have done.
9. They will make direct amends to these people wherever possible, except when to do so would injure them or others.
10. They will continue to examine their behavior and to admit promptly when they are wrong or behaved improperly.
11. They will seek through prayer and meditation to improve their conscious contact with God as they understand God, praying only for knowledge of God's will and the power to carry it out.
12. Having had a spiritual awakening as the result of these steps, they try to carry this message to other alcoholics and to practice these principles in all their affairs.

The steps are based on the experiences members have had in becoming and staying sober. At meetings both open to the public and "closed" (for members only), members closely examine the Twelve Steps and candidly tell about their drinking histories—their AA stories. Members describe for each other how the AA program has helped them to stay sober.

An AA group comes into being when two or more alcoholics join together to practice the AA program. There are no dues or fees for membership; AA is self-supporting and is not associated with any religious sect or denomination, political group, or other organization. It does not support or oppose any causes. AA is not set up as a centralized organization, although it does put out a monthly magazine, the Grapevine. Its board of trustees, consisting of fourteen alcoholic and seven nonalcoholic members, meets four times a year.

The Process of Joining AA

The typical AA member, or affiliate, has had a long and usually severe history of alcoholism. Certain events in an alcoholic's life set the stage for the person's interest in joining, or affiliating, with AA: Usually, he or she has heard positive comments about AA. Long-time drinking friendships have faded, but the drinker has formed a habit of sharing troubles with others. Quitting through sheer willpower seems impossible. Finally, if the alcoholic has also decided that drinking is causing many more problems than it is giving pleasure, the person is likely to attend an AA meeting.

Once the drinker has made a decision to follow the AA program, five phases follow: (1) first-stepping, (2) making a commitment, (3) accepting one's problem, (4) telling one's story, and (5) doing twelfth-step work.

First-stepping involves the initial contact with AA. The person goes to orientation meetings to learn about the group's ideas about alcoholism as a disease. He or she learns step one in the twelve-step program, an admission that the person feels powerless around or over alcohol. When a problem drinker is willing to say the words, "I admit that I am powerless over alcohol . . . and that my life has become unmanageable because of it," he or she has completed step one. An AA guide will then become the newcomer's sponsor and try to help the member reach the second stage, commitment. The AA group acts quickly to ensure that the newcomer will affiliate, challenging the newcomer to attend "ninety meetings in ninety days." The group seeks to keep a close watch over the newcomer, gently forcing the person to give up other commitments and spend a significant share of time with AA program affiliates or taking part in AA activities.

In the third phase, acceptance of a drinking problem begins with the phrase, "I'm Chris X and I'm an alcoholic." Throughout the initial weeks and months, the group presses newcomers, sometimes gently but sometimes forcefully, to realize that they are alcoholics. Accepting that one is an alcoholic can occur immediately or after a long process.

In the fourth phase, the group encourages newcomers to tell their stories to the entire group at an open meeting. Telling one's story to the public is an act of commitment that demonstrates one is a genuine AA member, and members greet this act with applause and congratulations.

In the final phase, the person must perform the program's twelfth step, a promise to remain in the process of recovery: "Having had a spiritual awakening as a result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs." One of AA's basic philosophies is that alcoholism is not a disease from which people can recover once and for all. Instead, they are always in the process of recovering. To remain sober, then, a member must remain active in AA and carry the program to those who are still active alcoholics. By doing twelfth-step work, members reinforce their membership and their new definition of themselves as recovering alcoholics.

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While in the process of affiliation, some recovering AA members have a relapse into drinking. This relapse is called "slipping." Most AA members respond to another's slipping with sympathy and understanding, feelings that strengthen group solidarity. Seeing another person slip also strengthens recovering members' resolve to remain abstinent.

Criticism of AA

Critics of AA argue that the program is not a successful treatment for general populations of alcoholics. They say that only certain kinds of alcoholics benefit from the Twelve Steps—members must have a particular emotional makeup and a readiness for the treatment strategy. Those who do not fit comfortably into the AA world may slip—and slipping makes them feel that they cannot regain control. As a result, critics say that AA can hurt the chances for some alcoholics to remain sober. Others claim that AA rejects scientific research that contradicts its own beliefs about alcoholism. Finally, some critics point out that the AA commitment may interfere with other serious commitments in a person's life, such as work and family.

Adaptation of AA to Other Disorders

Despite the criticisms that have been directed against AA, its format and beliefs have helped many individuals, and the AA program has been applied to a wide variety of other addictions and behavior disorders. Narcotics Anonymous (NA) applies the AA pattern to narcotic drug addicts. Marijuana Anonymous uses a twelve-step system to help marijuana users learn to abstain. AA's beliefs and strategies have also been adapted to help people with gambling, eating, and excessive buying disorders. Al-Anon family groups and Alateen groups have adapted AA's philosophy to family, children, and friends of problem drinkers. Veteran AA members point to these other programs as evidence that AA's influence goes well beyond its impact on AA members. They argue that this widespread adaptation to other disorders demonstrates the essential value and appeal of the AA program.

See Organizations of Interest at the back of Volume 1 for address, telephone, and URL.

see also Al-Anon; Alateen; Alcohol Treatment: Behavioral Approaches; Alcohol Treatment: Medications; Treatment Types: An Overview.

THE SPREAD OF THE TWELVE STEP PROGRAM

Many organizations have adopted AA's Twelve Step program, including: Narcotics Anonymous, Marijuana Anonymous, Cocaine Anonymous, Chemically Dependent Anonymous, Co-Dependents Anonymous, Compulsive Eaters Anonymous, Debtors Anonymous, Cancer Anonymous, ARTS Anonymous, Depressed Anonymous, Diabetics Anonymous, Eating Addictions Anonymous, Families Anonymous, Food Addicts Anonymous, Gamblers Anonymous, Incest Survivors Anonymous, Manic Depressives Anonymous, Methadone Anonymous, Nicotine Anonymous, Overeaters Anonymous, Recovering Anonymous, Sex Addicts Anonymous, Sexual Recovery Anonymous, Workaholics Anonymous, and many more.