and the Efficacy of the 12 Step Program
INTRODUCTION AND HISTORY
Founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio, Alcoholics Anonymous (AA), was founded to help alcoholics abstain from the consumption of alcohol and to “stay sober” through the sharing of their experiences with others who have had similar experiences in a protected environment.
The 12 Steps were developed later to help govern the fellowship and to establish a consistent approach to spiritual and character building endeavors. The Twelve Traditions were introduced in 1946 to help stabilize the fellowship and to establish a consistent approach to helping all members.
AA consists of a group of men and women who have abused alcohol to the point their drinking was out of control at some time during their life. It is a self-supporting, multi-racial, multi-gender, nonpolitical, organization. The AA groups are available in most metropolitan areas in the United States, as well as in most foreign countries. There are no age or education requirements for membership. It is open to anyone who wants to do something about his or her drinking problem. AA membership has spread to diverse cultures holding different beliefs and values. The worldwide membership is currently over two million. AA sprang from the Oxford Group that was a non-denominational Christian outreach where some members found the group to help them maintain sobriety. One member was Wilson’s former drinking buddy who “got religion” and maintained his sobriety. Wilson was encouraged and decided to follow the same path which led him to a brief abstinence from alcohol and a commitment to a higher power. Wilson soon after attended his first group gathering and within days, he admitted himself to a hospital for detoxification. While under the care of a doctor, he experienced severe withdrawal symptoms that included seeing a bright flash of light, which he felt to be God revealing Himself to him. Following his hospital discharge, Wilson joined the Oxford Group and recruited other alcoholics to the group. Wilson’s early efforts were ineffective; consequently, he changed his focus to a more scientific approach with less dependence on the spiritual.
Wilson’s first success came during a business trip to Akron, Ohio, where he was introduced to Dr. Robert Smith, a surgeon and Oxford Group member who was unable to stay sober. After thirty days of working with Wilson, Smith drank his last drink on June 10, 1935, the date marked by AA for its anniversaries. Bill discovered that new adherents could get sober by believing in each other and in the strength of this group. Men (no women were members yet) who had proven over and over again, by extremely painful experiences, that they could not get sober on their own had somehow become more powerful when two or three of them worked on their common problem. This, then—whatever it was that occurred among them—was what they could accept as a power greater than themselves. The initial reaction was that they did not need the Oxford Group; however, in 1955, Wilson acknowledged AA’s debt, saying “The Oxford Group had clearly shown us what to do. And just as importantly, we learned from them what “not to do”. Among the Oxford Group practices that AA retained were informal gatherings, a “changed-life” developed through “stages”, and working with others for no material gain, AA’s analogs for these are meetings, “the steps”, and sponsorship. AA’s tradition of anonymity was a reaction to the publicity-seeking practices of the Oxford Group, as well as AA’s wish to not promote itself.
The Basics of AA are:
- The program is free
- The program is structured around a set of “12- Steps and 12 Traditions”
to help the individual achieve and maintain abstinence from alcohol and or other drugs.
- The program has a spiritual content that includes acknowledgement of a higher power. Each individual defines that higher power in their own way.
- Meetings are often held in public places and are open to alcoholics and prospective AA members. Other AA meetings are “open” to anyone who wants to attend.
- The only requirement for membership is a desire to abstain from alcohol and or other drugs.
- You must have a severe drinking problem to join AA; however, anyone can attend open meetings.
The AA/12 step program is over seventy years old, a testament to its value in the addiction recovery process. It was visualized during the time co-founder Bill Wilson was writing the Big Book in 1938. As he was writing he became aware that a book was not sufficient within its self to enable people to overcome alcoholism; consequently, he and a host of others (including Dr Bob) began to develop a more comprehensive program for recovery. The focus was for people to share their experiences with use and abuse of alcohol and their attempts to overcome their alcoholism. It utilized an individual’ belief/value system and guidelines (Traditions) to establish governess and to standardize the process of sharing their experiences. A number of steps already existed based on their personal experiences with the group and mostly by word-of-mouth; Wilsons’ intent was to put what existed under a single format and expand the program as needed. Wilson stated that writing the steps required, “no more than a few minutes”. He said that it was only when I came to the end of the writing that I re-read and counted them. Curiously enough, they numbered twelve and required almost no editing.” Those original 12 steps featured the use of God on several occasions, which Wilson reduced down to the minimum. The famous qualifier “as we understood Him” was not added until later. Beyond that, according to Wilson, the 12 steps “stand today almost exactly as they were first written.”
Alcoholics Anonymous is an international organization of individuals who have struggled with drinking at some point in their lives. It is supported by its members, and it operates independently of any outside funding. It is not affiliated with any religious or political group. The goal is to promote sobriety by “carrying its message” to suffering alcoholics. All AA members remain anonymous. The anonymity removes the stigma of identification and recognition and allows participants a more comfortable experience in recovery. Alcoholics Anonymous is open to all persons regardless of age, gender or ethnicity. A question that often comes up is whether AA is a religious organization or not? The answer is somewhat vague in that it originally focused on religion as a means to sobriety. But the program has since adopted a more spiritual focus rather than a God-centric one.
THE 12 STEPS
In the “Big Book”—the central text of AA that outlines the program—the twelve steps are defined as a “set of principles, spiritual in nature, when practiced as a way of life, can help expel the obsession to drink and enable the sufferer to become happily and usefully whole.” The 12 steps of AA along with a brief explanation of each are as follows:
- We admitted we were powerless over alcohol – that our lives had become unmanageable.
Many alcoholics have a hard time admitting that they can’t control their alcohol use. Most truly believe they can stop any time they want to; however, history and experience has proven that this is seldom the case. Once they acknowledge that they are unable to stop on their own, the recovery process can begin.
- Came to believe that a power greater than ourselves could restore us to sanity.
AA believes that people who are addicted to alcohol need to look to something or someone greater than themselves to recover. Sometimes a friend or a sponsor can fill this role. Oftentimes it takes a power greater than themselves. Those working the steps are free to choose whatever higher power works for them.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
This is the stage where the individual admits that he or she is unable to control their drinking. Typically, for this step, the alcoholic consciously decides to turn themselves over to whatever or whomever they believe their higher power to be. With this release often comes recovery.
- 4. Made a searching and fearless moral inventory of ourselves.
This step requires self-examination that can be uncomfortable, but honesty is essential in this process. The key is to identify any areas of past regret, embarrassment, guilt or anger.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
The key to this step is one getting honest with himself or herself and involves admitting to past poor decisions and questionable behaviors. Often, members will share this information with others and their sponsor.
- We’re entirely ready to have God remove all these defects of character.
This is a surrender of self and an admission that they are ready to accept help from any source.
- Humbly asked Him to remove our shortcomings.
This is a continuation of the surrender process that began in Step 6. It also infers that the recovering alcoholic is not strong enough to overcome his or her weaknesses on their own.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
The identification of individuals they have wronged through their alcoholism. The wrongs are left to the discretion of the individual and generally covers a range of inappropriate behaviors.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
This is a difficult step for many alcoholics; consequently, support from other members and their sponsor may be required to guide the individual through this process.
- Continued to take personal inventory and when we were wrong promptly admitted it.
Self-monitoring is essential for this step along with a willingness to change behavioral patterns that have led to inappropriate actions.
- 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.
This encourages a relationship and commitment to a higher power.
- 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 affair.
This step encourages members to help others in their recovery. Many members become sponsors once they have completed the 12 steps. Since AA appeared in 1939, the program has helped millions of men and women recover from alcoholism.
THE TWELVE TRADITIONS
The Traditions govern the organization and provide the structure by which it maintains its unity and relates itself to the world about it, the way it lives and grows. The Traditions recommend that members remain anonymous in public media, altruistically helping other alcoholics and avoiding official affiliations with other organization. The Traditions also recommend that those representing AA avoid dogma and coercive hierarchies. Subsequent fellowships such as Narcotics Anonymous have adopted and adapted the Twelve Steps and the Twelve Traditions to their respective primary purposes. The Traditions are also used to help resolve conflicts within the organization as well as with outside organizations. Most twelve-step programs have adopted these or similar traditions. The Twelve Traditions of Alcoholics Anonymous are as follows:
- Our common welfare should come first; personal recovery depends upon AA unity.
- For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
- The only requirement for AA membership is a desire to stop drinking.
- Each group should be autonomous except in matters affecting other groups or AA as a whole.
- Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
- An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
- Every AA group ought to be fully self-supporting, declining outside contributions.
- Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
- AA, as such, ought never to be organized; but we may create service boards or committees directly responsible to those they serve.
- Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
- Our public relations policy is based on attraction rather than promotion; we need always to maintain personal anonymity at the level of press, radio, and films.
- .Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.
The Traditions recommend that members remain anonymous in public media and in their efforts to help other addicts. The Traditions also recommend that those representing AA avoid public attention whenever possible. The unique characteristics associated with an addicts’ drug of choice has led to the formation of over 200 different and unique self-help organizations. For example it is common to find Cocaine Anonymous, Crystal Meth Anonymous, Marijuana Anonymous, Nicotine Anonymous and a host of others in most metropolitan areas of the USA. It is also common to fine self-help organizations related to behavioral issues such as compulsion for, and/or addiction to, gambling, food, sex, and work and others.
The Serenity Prayer
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
enjoying one moment at a time;
accepting hardships as the pathway to peace;
taking, as He did, this sinful world
as it is, not as I would have it;
trusting that He will make all things right
if I surrender to His Will;
that I may be reasonably happy in this life
and supremely happy with Him
forever in the next.
The prayer is primarily commonly attributed to Protestant theologian Renhold Niebuhr, who composed it in the 1940’s. According to its website, Alcoholics Anonymous adopted it and began including it in AA materials in 1942, which may have done more to canonize it than any other cultural use of the prayer.
Early in 1942, writes Bill W., in A.A. Comes of Age, a New York member, Jack, brought to everyone’s attention a caption in a routine New York Herald Tribune obituary that read:
“God grant us the serenity to accept the things we cannot change, courage to change the things we can, and wisdom to know the difference.”“Never had we seen so much A.A. in so few words,” Bill writes. Someone suggested that the prayer be printed on a small, wallet-sized card, to be included in every piece of outgoing mail.
Ruth Hock, the Fellowship’s first (and nonalcoholic) secretary, contacted Henry S., a Washington D.C. member, and a professional printer, asking him what it would cost to order a bulk printing.
Early in World War II, with Dr. Niebuhr’s permission, the prayer was printed on cards and distributed to the troops by the U.S.O. By then it had also been reprinted by the National Council of Churches, as well as Alcoholics Anonymous.
MEDALLIONS And CHIPSWhile not officially a part of Alcoholics Anonymous, the chip system is used throughout the country, and throughout the world for that matter, to mark special milestones in recovery. Various medallions are used to signify and mark varying lengths of abstinence from alcohol. These special tokens, usually about the size of a poker chip, are often given to those in recovery by their home group, sponsors (spiritual mentors), or even special friends or family members. Their intent is both to celebrate the accomplishment and to remind the recipient of their daily commitment to their personal recovery.Needless to say, it’s not the medallions themselves that keep recovering individuals sober. The importance is in the meaning behind the tokens. As those in recovery receive special tokens for one month, then two, then three months, and so on – the medallions generate a sense of pride for fulfilling their commitment to their recovery. Often a simple glance at a special token can provide motivation to continue to remain abstinent even when the thought of drinking arises. Jokingly, many “old-timers” have said to those new in recovery, “should the thought or desire to drink occur, place the medallion in your mouth. Once it dissolves, it’s then safe to take the drink.”
Keep Coming Back, It Works If You Work It, a popular slogan used to close A.A. meetings suggests that when an individual puts the work in the outcome will be positive. With 81 years behind it, two million members and 115,000 groups worldwide it would be hard to not say it has something of offer.
The efficacy of AA/12 Step programs in treating addiction to alcohol and other drugs (AOD) is a complex subject with much debate as to its accuracy, effectiveness and repeatability. While newer studies have suggested an association between AA attendance and increased abstinence or other positive outcomes other studies have failed to verify or confirm a positive contribution due to AA/12 Step participation. Most of the studies have used data gathered from individuals attending meetings run under the auspices of the AA organization. Many investigators consider this a possible bias toward a favorable outcome.
A famous Saturday Evening Post article cited AA co-founder Bill Wilson as claiming its program enjoyed a 50% success rate immediately, and another 25% success rate after a relapse or two. The figures were repeated three years later in an article published in The American Journal of Psychiatry. These articles – and the success rates – have been cited repeatedly over the years by both supporters of 12 step programs as indicative of their success – and critics of the program, as indicative of their deliberate misinformation. Regardless of how one views the original assessment, it is very difficult to accurately pinpoint the efficacy of the 12 step programs due in part to their anonymous nature and an absolute refusal to release treatment data that could be used to identify a member; consequently, we will have to live with the information that is available until additional data is collected and analyzed.
Among the most recent assessments of the rates of success or failure comes from AA, entitled, “Alcoholics Anonymous Recovery Outcome Rates: Contemporary Myth and Misinterpretation” released on 1 January 2008. Its introduction states, “This paper is written for AA members and is intended for internal and public circulation as an item of AA historical and archival research. It is offered to help inform the AA membership and academic researchers of a widely circulated misinterpretation and mischaracterization of AA recovery outcomes” and it offers the following statistics for AA:
- Of those in their first month of AA meetings, 26% will still be attending at the end of that year.
- Of those in their fourth month of AA meetings attendance (i.e. have stayed beyond 90-days) 56% will still be attending AA at the end of that year.
- The 2004 Survey showed an increase in the length of sobriety over the 2001 Survey (as has every triennial survey since 1983).
- As of the 2004 Survey, long-term AA sobriety was so prevalent that the “Greater Than Five Years” range of previous surveys was subdivided into: 5-10 Years (14%) , >10 Years (36%), > 5 Years (50%).
- For growth of AA sobriety ranges, the 1983 Survey showed 25% of AA members sober over 5 years and the 2004 Survey showed 50% of AA members sober over 5 years.
- For growth of AA sobriety averages, the 1983 Survey found the average AA member sober for 4 years and the 2004 Survey found the average AA member sober for more than 8 years.
According to AA’s recent membership survey, 27% of members have been sober less than one year, 24% have 1–5 years sober, 13% have 5–10 years, 14% have 10–20 years, and 22% have more than 20 years sober. A review measuring the effectiveness of AA did not find any significant difference between the results of AA and twelve-step participation compared to other treatments. This appears to indicate that it is difficult (or nearly impossible) to value or separate out the contribution of one element of the treatment regimen. The conclusion is that the studies have failed to demonstrate that AA/12 step is a strong factor in preventing use and abuse of alcohol and other drugs when compared with other interventions. The uncertainty could be overcome with large samples with and without specific treatment modalities. I personally think there is a residual or latent “good” that may manifest its self in many participants sometime in the future. Again, this would be difficult to measure and probably more difficult to get the recovery industry to accept without a lot of research. The bottom line is that AA/12 step is effective and needs to be constantly improved and enhanced to increase its effectiveness.
As noted previously, nailing down precise numbers on the success rates of 12 step programs is almost impossible, and generally a very biased business.
Even so, the grassroots 12-step program remains the preferred prescription for achieving long-term sobriety.
Since the inception of Alcoholics Anonymous, the progenitor of 12-step programs, science has sometimes been at odds with the notion that laypeople can cure themselves.
Yet the success of the 12-step approach may ultimately be explained through medical science and psychology. Both offer substantive reasons for why it works.
PARTICIPATION AND ATTENDANCE AND HOW THIS EFFECTS OUTCOMES
Individuals who participate in 12-step tend to experience better alcohol and drug use outcomes than do individuals who do not participate in these groups.
The most common index of participation has been attendance at group meetings; however, attention should focus on aspects of involvement, as well, such as reading 12 step literature, working the steps, obtaining and interacting with a sponsor, becoming a sponsor, and doing service work.
ATTENDANCE AND SUBSTANCE USE OUTCOMES
Several studies have shown that self help group attendance is associated with good substance use outcomes. A large clinical trial by MATCH compared the outcome of 12-step facilitation, cognitive-behavioral, and motivational enhancement treatment for patients with alcohol use disorders. Clients who attended AA more often in each three month interval after treatment were more likely to maintain abstinence from alcohol in that interval. In addition, more frequent AA attendance in the first 3 months after treatment was related to a higher likelihood of abstinence and fewer alcohol-related consequences in the subsequent 3 months; these findings held for patients in each of the three types of treatment.
Comparable findings have been obtained in several other studies. For example, inpatients with alcohol use disorders who attended AA at least weekly reported more reductions in alcohol consumption and more abstinent days at a 6 month follow-up than did individuals who attended AA less frequently or those who did not attend at all. Alcohol-dependent individuals who participated
in self help groups in the first and second years after intensive outpatient treatment were more likely to be abstinent in the second and third years, respectively; attendance at two or more meetings per week was associated with less severe relapses.
Although there is much less empirical evidence, these findings apply to participation in Narcotics Anonymous (NA), as would be expected given the commonalities between AA and NA, which follow the same 12 steps and have similar literature, speaker and step meetings, and home groups and sponsors. Individuals who consistently attended NA at least weekly during a 12 month interval had lower levels of alcohol and marijuana use at follow-up than did those who attended NA less consistently. Among individuals with drug use disorders, those who participated only in AA, only in NA, or both in AA and NA had comparable I year abstinence rates, all of which were higher than the rate for individuals who did not participate in AA or NA.
Individuals who continue to attend self help groups over a longer interval are more likely to maintain abstinence than are individuals who stop attending. Patients with drug use disorders who participated in 12 step groups at least weekly at 6 month and 24 month follow-ups were more likely to maintain abstinence from both drugs and alcohol. In another study, continuous attendance at baseline and at 6 and 30 month follow-ups was associated with better substance use outcomes at each follow-up; in addition, 6 month attendance was associated with better 30 month outcomes. Individuals who discontinued attendance or attended intermittently had substance use levels that were similar to those of individuals who reported no regular attendance.
A prospective study of individuals with alcohol use disorders showed that a longer duration of attendance in AA in the first year after help seeking was associated with a higher likelihood of I year, 8 year, and I6 year abstinence and freedom from drinking problems. Moreover, after controlling for the duration of AA attendance in year I, the duration of attendance in years 2-3 and 4-8 was related to a higher likelihood of I6 year abstinence. Thus, individuals who continued to attend AA regularly over the long term experienced better substance use outcomes than those who did not. In addition, the combination of a longer duration of AA attendance and better drinking outcomes at the l year follow-up was associated with a lower mortality rate in the subsequent 15 years.
These findings hold for substance use disorder patients with different diagnoses. Individuals who attended more I2-step group meetings in the first 6 months after seeking treatment were found to be more likely to be abstinent at a 6 month follow-up; those who attended more meetings in the subsequent 6 months were more likely to be abstinent at a 12 month follow-up. Comparable findings were obtained for patients with alcohol use disorder diagnoses only, patients with drug use disorder diagnoses only, and patients with both drug and alcohol use disorder diagnoses. In general, the duration of self help group attendance is more strongly related to substance use outcomes than is the frequency of attendance. The benefits of self help groups do not appear to be dependent on attending 90 meetings in 90 days.
INVOLVEMENT AND SUBSTANCE USE OUTCOMES
Attendance is an important indicator of participation, but it may not adequately reflect an individual’s level of group involvement, as shown by such indicators as number of steps completed, acceptance of I2-step ideology, and self-identification as a group member. These and related aspects of involvement are relatively highly correlated with attendance; nevertheless, aspects of group involvement may be associated with substance use outcomes independent of the duration and frequency of attendance per se.
In support of this idea, individuals who were more accepting of I2 step ideology, especially belief in the need for lifelong attendance at 12 step meetings and the need to surrender to a higher power, were more likely to attend 12 step meetings at least weekly. Belief in 12 step ideology, specifically the idea that non problematic drug use was not possible, was associated with abstinence independent of the 12-step group attendance. In Project MATCH, AA attendance, the number of steps completed, and self-identification as an AA member were most closely associated with abstinence. The composite of these three items was more highly related to abstinence than was attendance by itself.
In a study of treatment for individuals with cocaine use disorders, active 12 step involvement in a given month predicted less cocaine use in the next month. Moreover, patients who increased their 12 step involvement in the first 3 months of treatment had better cocaine and other drug use outcomes in the next three months. Patients who regularly engaged in 12 step activities but attended meetings inconsistently had better drug use outcomes than did patients who attended consistently but did not regularly engage in 12 step activities. Maintaining passive attendance may indicate reluctance to fully embrace 12 step group ideology and the goal of abstinence. Individuals who attend self help groups but are unable to embrace key aspects of the program are less likely to benefit from it.
DELAY IN PARTICIPATION AND DROPOUT
Compared with individuals who begin to participate in self help groups either soon after initiating help seeking or during treatment, those who delay entering self help groups do not appear to benefit as much from them. For example, individuals who delayed participating in AA for more than a year after recognizing that they had an alcohol-related problem and initiating help seeking were more likely to have drinking problems and dependence symptoms 8 years later than were individuals who entered AA in a timely fashion. Moreover. these individuals experienced no better 8 year alcohol-related outcomes than did individuals who did not participate in AA at all. Individuals who entered AA but then dropped out also were more likely to relapse or remain nonremitted.
In support of these findings, it can be noted that patients who continued to participate in AA after a 6 month follow-up were more likely to maintain abstinence at 24 months than were patients who dropped out of AA. Patients who did not enter AA until after the 6 month followup were no more likely to be abstinent at 24 months than patients who did not attend AA at all. 91% of patients with substance use disorders attended at least one 12 step group meeting either during treatment or in the year after treatment; however, 40% of these individuals had dropped out by a I year follow-up. Compared with patients who continued to attend, those who dropped out were less likely to be abstinent or in remission and more likely to report substance-related problems at a I year follow-up.
Individuals who delay participating in self help groups may develop more severe substance use problems before they are motivated to obtain help and thus may have poorer prognoses than individuals who enter self help groups quickly. Most individuals who seek formal help for substance use disorders enter treatment and or self help groups relatively soon. Accordingly, individuals who hesitate to join these groups may be less motivated for recovery, find it harder to establish a relationship with a sponsor, and drop in and out of self help groups or attend only intermittently, a pattern that is associated with poorer outcomes.
The twelve-step approach is an established program with a set of guiding principles to direct a course of action for tackling problems whether it be related to alcoholism, drug addiction and/or other compulsions. Some meetings are known as dual-identity groups which encourage attendance from certain demographics. Some areas also have beginner’s groups as well as “old-timer” groups that limit who can share, or speak during the meeting, by the length of time the members have been in the fellowship.
In accordance with the First Step, twelve-step groups emphasize self-admission by members of the problem they are recovering from. It is in this spirit that members often identify themselves along with an admission of their problem, often as “Hi, I’m Roger, and I’m a problem drinker”. The statement also generally includes an admission that the individual is “powerless within himself or herself” over the substance-abuse related behavior at issue. The strong inferences is that there is lack of control over this compulsion, which persists despite any negative consequences that the person may endure as a result. The First Step also infers that the individual is “powerless” over the substance-abuse related behavior at issue and lacks the ability to control his or her compulsion, which persists despite any negative consequences that the person may endure as a result.
As noted previously, the principles of AA have been used to form of other fellowships specifically designed for those recovering from various pathologies; each emphasizes recovery from the specific malady which brought the sufferer into the fellowship. Demographic preferences related to the addicts’ drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous, Pills Anonymous, Marijuana Anonymous and Nicotine Anonymous. Behavioral issues such as compulsion for, and/or addiction to, gambling, crime, food, sex, hoarding, and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Food Addicts in Recovery Anonymous, Sexual Compulsives Anonymous, Sex and Love Addicts Anonymous, Sex Addicts Anonymous, Emotions Anonymous, and Workaholics Anonymous. Also, Auxiliary groups such as Al-Anon and Nar-Anon, for friends and family members of alcoholics and addicts, respectively, are part of a response to treating addiction as a disease that is enabled by family systems. In some cases, where other twelve-step groups have adapted the guiding principles, these have been altered to emphasize principles important to those particular fellowships, and to remove gender-biased language.
The emotional obsession is described as the cognitive processes that cause the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as “unmanageable” refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.
FREQUENTLY ASKED QUESTION (from internet website)
- Is personal information protected?
Anonymity is the foundation of all AA traditions. Any information that is shared in AA is treated in a confidential and protected manner.
- Is it religious?
Alcoholics Anonymous has only one requirement for membership and that is the desire to stop drinking. There is room in AA for people of all shades of belief and non-belief. We have seen many people come to AA and refuse to accept our help because they become angry or upset when others talk of their beliefs. If you are unable to accept that others have a belief that you don’t, you will find it very difficult to come to terms with. If on the other hand you can be tolerant of other peoples’ right to believe in whatever they want to, you will find others tolerant of your rights to believe whatever you choose. Let’s make no bones about it; the 12 step regime that members follow has its origins in a Christian group. As a consequence you will see God mentioned quite often. Many members believe in God, and we have other members that come from and practice all sorts of religions; but also many are atheist or agnostic, so don’t be put off. Because it is a spiritual program (not religious) those who believe in some form of divinity often find it useful to incorporate the AA into their religious practices and vice versa. This is their choice, there is absolutely no requirement. What we all have in common is that the program helps us find an inner strength that we were previously unaware of, where we differ is attributing the source.
Whatever you do, please don’t let someone else’s religious beliefs prevent you from finding the solution that is available to you through Alcoholics Anonymous.
- Is it a cult?
Its members are not forced to attend meetings, they are free to leave at any time and the recovery program is simply a list of suggestions which while many do chose to follow, also many chose to go their own way about it. The majority of members quite happily fit the culture of AA into their normal life and belief systems.
- Must you be able to talk in groups and confess that you are an alcoholic?`
Nobody is forced or pressured to speak at an AA meeting or to declare themselves to be alcoholic. Newcomers benefit most from listening to the experience of speakers and will have the opportunity to speak to members on a one to one basis if they choose.
- What is the 12 Step Program?
It is a series of steps taken by the alcoholic which assist them to achieve and maintain sobriety. They include acceptance of the fact that they are alcoholic, learning to trust and rely on something outside of themselves for help, acknowledgement of and making amends for past behavior, changing present behavior and passing the help received on to other alcoholics.
- Can people attend another center while attending AA?
Yes, members can and do attend other treatment centers. Many people have come to AA through other centers. This continuity is useful in the recovery process.
- Does the AA program include a Philosophy of Recovery?
AA is based around the concept of recovery from a persisting, chronic illness prescriptive. It includes the philosophy elements of belief that everyone has the potential to recover and the inherent ability to lead a satisfying, useful life.