Alcoholics Anonymous: One Man’s Analysis of the Criticisms
Alcoholics Anonymous is no stranger to controversy. It has the tendency to evoke praise from many, and disdain from just as many. Despite the divide, whether you’re a believer or not, AA generally has the reputation of having helped millions of suffering alcoholics achieve sobriety. In 1935, at its birth, AA was revolutionary as the first of its kind to successfully synthesize parts of psychology, philosophy, theology, and democracy into a workable method of recovery from alcoholism without any knowledge of genetic or biochemical causes of addiction. For over 75 years, AA has more than just endured the test of time: it has permeated our justice system, the 12 Steps are implemented in public and private treatment centers, and there are over two million members world wide who volunteer to ensure that AA is accessible in a community near you. Needless to say, Alcoholics Anonymous is the most prominent support group for alcoholics in the universe. But prominence alone has not been able to shield AA from the sword of criticism.
AA allows for various types of alcoholics to work its program of recovery; however, because of the complexity and individualized nature of the illness, AA may not meet every single alcoholic’s needs. In AA, there is a strong emphasis on the group, and a time consuming commitment to AA’s program of recovery, which may not necessarily be what a successful recovery requires for all alcoholics or problem drinkers. Further, if a person doesn’t click with their group or find the tenets of AA useful, AA will not be effective. In a recovery program such as AA, an alcoholic needs to be motivated and committed to working such a program regardless of the severity of his or her illness, which may not work for all those afflicted.
Legal criticisms over the Constitutional reach of the government arose as courts began sentencing offenders into AA, which led to a number of lawsuits. In Griffin v. Couglin, the New York Court of Appeals for the Second Circuit ruled that forcing inmates to AA is a violation of the First Amendment because of what the Court found to be the religious nature of the program, although the Court didn’t recognize AA as a religion. The ruling was based off of AA’s emphasis on a “Supreme Being” as seen in the 12 Steps and other readings. There are now a number of alternative and effective methods to the 12 Step doctrine.
Today, the widespread use of the world wide interweb has given every one under the moon with a computer and an opinion the ability to voice their objections to AA, which has blurred the impression of AA as a lowly and impoverished community-driven support group to an imperial evil mastermind. It’s easy for blogs and website commentators to recklessly spread extreme and uncompromising arguments that minimize a diverse group with over 75 years of members and over 2 million current members into a narrow one-size-fits-all stereotype, and to reduce the genuine and meaningful experiences of many to cancerous and destructive ways of thinking. Unfortunately, as in many other cases, these are the types of arguments that tend to drive the public debate.
One of the more popular arguments widely circulating on the net, that powerlessness over alcohol equals helplessness over life, comes from AA’s first step, which states: we admitted we were powerless over alcohol – that our lives had become unmanageable. Backed by the weight of an opinion, the argument takes a leap in logic to infer that admitting powerlessness over one substance will uncompromisingly result in helplessness over all choices in life. The problem with this logic is that there are many substances that will undoubtedly harm a human being. Admitting powerlessness over, for example, cyanide will not subliminally transform a person into a mindless monster who’s hell bent on consuming all-things-cyanide within reach because a person knows they will die if he or she drinks cyanide. Being aware of the toxic effects of cyanide, like alcohol, will probably save his or her life.
Another common argument against AA is that AA is a religious organization. This argument comes from AA’s emphasis on a higher power, which can be found in the 12 Steps, because depending on how you’re counting, five, six, or seven of the 12 Steps reference a Supreme Being in some variation. The claim is based on the notion that an alcoholic, to stay sober, must relinquish control of his or her life to a higher power of his or her understanding or God. While many people in AA can and do believe this, AA can and does work for alcoholics who don’t believe in God. The popular Recovery Model for treating mental health and substance abuse disorders has gained widespread use over the past 20 years. This approach to recovery gradually developed as a growing number of ex-patients, identifying themselves as either survivors of psychiatry or mental health, began to campaign for better services and user-led alternatives back in the 1980′s. The World Health Organization (WHO) conducted a string of studies from the 1970′s to 1990′s, which involved applying a patient-driven approach to treating mental health disorders based on the self-help nature of AA. Surprisingly high rates of recovery along with the grassroots campaign for better services led to agencies such as the National Association of Social Workers, the American Psychiatric Association, and the Surgeon General (to name a few) professionally recognizing the Recovery Model as an effective approach to treating mental health and substance abuse disorders, and advocating its use today.
The Recovery Model consists of a list of core elements widely shown to be essential to recovery, such as a sense of hope, sense of self, a secure base, supportive relationships, self-determination, coping strategies, and meaning. These elements vary in degree from person to person and may not all apply, but generally, as a practical approach to recovery, AA can be and has been utilized to satisfy these elements regardless of a belief in a higher power or God.
Some of the language found in AA’s writings must be taken in context with the time period in which AA was created. The language has never been updated, nor ever will be according to AA’s policy, which vowed to preserve its historical value. Despite some of the dated social references and general language, AA can serve a person’s recovery whether a person believes in God or not. Whether you’re atheist, agnostic, or deeply religious, there are several very separate working components to AA that are designed to be utilized as the user sees fit.
The second component is motivation and commitment. Working AA’s program of recovery takes self-determination. And this isn’t referring to AA’s popular slogan “it works if you work it.” But for AA to be effective, there’s a real element that a person’s psychological, biological, and social experience must agree with AA in a way that such a person can find hope, meaning, supportive relationships, a secure base, and coping strategies relevant to getting sober. Regularly attending meetings and working the 12 Steps is an ongoing commitment which takes motivation that’s dependent solely on the individual.
Fourth, service work is another component by which alcoholics model responsible behavior through taking on a wide-variety of commitments that they’re held accountable for – which can be as basic as just giving a ride, answering phones, or public speaking in front of groups. Service work can often involve working with other people, but can just as often not. This helps reintegrate a person into society, thereby establishing a sense of community.
Applying the current Recovery Model, the formulaic nature of the 12 Steps coupled with AA’s deliberately loose policy of “take what you need and leave the rest” allows for varying degrees of belief in a higher power, or lackthereof, to utilize the 12 Steps and the other components of AA as needed. And the manner and degree by which all of these components are carried out are as varied as AA’s two million members. There are many different brands of AA and not one outweighs the other. An alcoholic just needs to discover what brand is for them. A higher power or God can have as much or as little to do with recovery as needed.
The word “cult” isn’t exactly used as a constructive criticism either. The word is used to conjure up images of Jim Jones force-feeding Kool-aid laced with cyanide down the throats of his Temple followers in Jonestown, Guyana, not simply a group bound together in respect of the same ideal as “cult” is defined by your nearest dictionary. Put another way, the “cult” argument is telling people that AA will literally kill an alcoholic if drinking doesn’t kill them first. AA’s founder, Bill W., is commonly pointed to as the “Jim Jones” that members loyally worship, although he’s been dead since 1971. But the reality is, AA members don’t worship Bill W. any more than, say for example, Americans worship George Washington – they’re both celebrated for their contributions in history, but to say they’re worshiped would be an overstatement, to say the least. Rather, using such language to describe such a large diverse group creates nothing more than a prejudice. Labeling alcoholics who attend AA as cult members dehumanizes the wide range of people and beliefs found in AA, and creates a bigoted against stereotype, which is not reflective of AA membership.
AA’s large network of sober people is one of the most supportive aspects for recovery, but AA wields no power over its members or outside society. The way AA is set up as an organization prevents it from having such leverage. AA is ran from the ground up, meaning, each group is its own boss. AA’s central office in New York (AA World Services) wields little influence over any particular group because groups are completely autonomous from one another and the central office. To use an analogy, AA groups are like little countries, whereas AA World Services is like the United Nations. Groups are independent from one another and AA’s central office in New York, and are free to conduct their meetings in whatever manner they see fit, as long as AA as a whole isn’t affected. But if the group’s practices do happen to affect AA as a whole, like the United Nations, there isn’t much AA World Services can do about it anyway – except maybe write the group a letter expressing disappointment. Your lowly and broke AA meeting down the street is nothing more than an self-reliant and free of charge support group ran by alcoholics in your community.
Whether it’s for money or power, cults in the “Jim Jones” sense of the word usually have a sinister motive. The problem with money being such a motive is the fact that the maximum amount any member can contribute per year is $3000 – apparently to maintain some level of moral standing. But most of that money goes to paying for the autonomous practices of groups, such as rent and other related obligations, so AA the organization only gets (for money) what groups are able and willing to donate. The central office has no control over groups, and the control that groups have over each other is nonexistent, so ultimate power seems an unlikely motive. The reality is that AA is a disjointed entity where all you need to form a group is a coffee pot, two people, a meeting place, and, optionally, if you want the group to be in the AA directory, a form sent in to the central office. That can be the extent to which any group is connected to the rest of AA, which is typically what you’ll find at your local AA meeting down the street.
Yet these arguments persist and use limited science as conclusive proof that AA should be destroyed. But any published peer-reviewed study ever done on the matter will highlight these difficulties in the section entitled “limitations.” Scientists explicitly stress that the results should not be taken as conclusive evidence of AA’s effectiveness because of the inherent difficulties and significant limitations faced in program evaluation research. Simply dismissing the limitations as some sort of nuance is similar to, say for example, dismissing evolution because it’s “just a theory.” And this isn’t to minimize the importance in studying AA, it’s to underscore a completely unacknowledged area by certain arguments.
The over-simplified criteria for success makes gaining accurate results for AA’s effectiveness difficult. Success in most studies is narrowly measured by total abstinence from alcohol. The problem: people coming into AA, and recovery in general, commonly struggle with sobriety for a period of time before achieving any extended length of sobriety; even seasoned attendees or members can periodically struggle with sobriety, having “slips,” after significant periods of abstinence. Yet in each case, a person’s life can significantly improve in conjunction with attending AA meetings as a result of gaining a support system and utilizing AA’s various components. But measured by total abstinence, AA would be ineffective when in fact there had been an effect. Measuring success by total abstinence in a program such as AA where relapse does not necessarily indicate failure may not accurately reflect AA’s overall effectiveness. This makes AA a difficult target to study for scientists, but a soft target for criticism.
There’s also a struggle to determine the number of meetings participants should attend to ensure a fair measure of AA’s effectiveness. Scientists have trouble determining whether sending participants to an AA meeting per day, per week, or per month will be adequate exposure to AA. Measuring the effectiveness of the 12 Steps is something else entirely. While there may be an ambiance of the 12 Steps in meetings, the Steps are largely meant for personal use outside of meetings. The Steps can be time consuming, and are mostly worked on alone or with a sponsor. Participants may never be adequately exposed to the 12 Steps, so studies just speak to the effectiveness of attending AA meetings, as opposed to the effectiveness of the 12 Steps. To date, scientists have had better luck in finding evidence of a Sasquatch in the hills of northern California than getting a measure of the 12 Steps, which in no way favors the Steps being neither effective nor ineffective.
The reality is, despite it’s misgivings, AA is mostly just a lowly and impoverished support group that meets once a week in your local church, alano, or John’s basement. It does not have any power over court-ordered treatments, nor do members claim to be medical experts. There is no “AA lobby” flexing its deathgrip on the U.S. government nor the treatment industry. At your local AA meeting, you’re more likely to find nine dollars in the donation basket than a conquest for power. AA is similar to support groups for domestic violence, grieving the death of a loved one, AIDS, or cancer survivors. Members of these groups are intentionally seeking nonprofessional help for a shared problem that’s difficult to deal with alone, and they find help in talking about their problems with other people who’ve been there. That’s it. Support groups don’t administer medicine, nor wield legal power. It’s talk therapy where the power of simply empathizing with another human being outweighs stereotyped AA dogma. There can be a support group for just about anything as long as no laws are broken. As long as there are people who find reassurance, comfort, and support in AA, it isn’t going anywhere. AA doesn’t have to work for everyone, or anyone for that matter, other than those who find refuge in it. People have the right to help themselves in whatever legal manner they see fit regardless of whether such a method is scientifically proven, which is why a dog literally makes better use of his time chasing his tail than certain criticisms waste on “exposing” AA. Criticisms would be much more productive and effective directed at the proper authorities which regulate treatment centers and laws.
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