Today, participation in Alcoholics Anonymous (AA) meetings is often considered an indispensable part of the rehab and aftercare process for individuals in recovery from an alcohol use disorder. As the National Council on Alcoholism and Drug Dependence notes, the following data reflects some of the many challenges alcohol abuse presents to the welfare of individuals and society at large:
- Alcoholism has been found to be the third leading cause of lifestyle-related deaths in the US.
- Each year, approximately 88,000 people die in America due to alcohol abuse.
- On average, death due to alcohol abuse cuts approximately 30 years off a person’s life.
- Up to 40 percent of the available space in US hospitals is used annually to treat the side effects of alcohol use or abuse.
It is well known that Prohibition (1920-1933) was a failed experiment. The re-legalization of alcohol after the repeal of Prohibition is a main contributor to the alcohol abuse problem of today. But recovery is as much a part of the history of alcohol abuse in America as Prohibition, the repeal of Prohibition, and the billion-dollar alcohol industry thriving today. To understand the importance of Alcoholics Anonymous in rehab treatment, it is helpful to consider the history of AA in brief. It’s an entirely unique story and an inspirational one.
How AA Got Started
The year is 1935. Bill Wilson is an unemployed stockbroker who has been personally ravaged not only by the Great Depression, but also by his alcohol abuse. Wilson, a New Yorker, sets out for Akron, Ohio ,in 1935, hoping to succeed in a rubber company venture. At this time, he is also keen on recovering from alcohol abuse, but he is struggling.
Six months earlier, a friend took him to an Oxford Group meeting. The Oxford Group is mainly composed of Episcopalians, and part of their organization is committed to helping their members overcome alcohol abuse through spiritual means. Most interestingly, this agenda was inspired by the world-famous and much-respected psychologist Carl Jung (the father of analytic theory, whereas Sigmund Freud is the father of psychoanalytic theory). Jung believed that the spirit could heal the body of ills, including alcohol abuse and other addictions. This would have been considered radical thinking at the time.
As it turns out, within a week of being in Akron, Wilson figures out that his work efforts will not succeed. He wants to be sober, but he’s struggling not to get intoxicated in the face of his dire circumstances. Wilson calls a local church, hoping it might have an Oxford Group. As it goes, the pastor connects Wilson with someone who then quickly connects him to Dr. Bob Smith, a surgeon in Akron. Dr. Bob (as he is called) also has a history of abusing alcohol and wants to quit. Wilson and Dr. Bob connect, and the two men form a strong bond of friendship and help each other maintain sobriety. Wilson moves into Dr. Bob’s house.
Together, Wilson and Dr. Bob help people experiencing alcohol abuse. In some cases, a person stays in Dr. Bob’s attic and gets intensive treatment (including sedation and counseling). In other cases, people come to meetings that friends of Dr. Bob host. These meetings expand beyond the local Oxford Group, and over time, they come to be called Alcoholics Anonymous meetings. Some members who gain abstinence end up going home to other states, like Wilson, and starting local meetings. From there, the AA meeting network spreads. Wilson and Dr. Bob made AA their life’s work, and author books together, including the Big Book in 1939 (its published name is Alcoholics Anonymous). The Big Book is the basic text of AA and sets forth the first written articulation of the 12-Step method. Numerous additional books followed, refining AA guidance and wisdom.
Today, quick facts on AA show that there are over 100,000 AA groups throughout the world, and the average member has more than eight years of sobriety. However, it is well documented that the effectiveness of AA meetings is impossible to quantify, as much of the experience is subjective and recovery is a complex process. Relapse, for instance, does not designate a failure, since it is part of the recovery process. For this reason, and others, it is exceptionally difficult to come up with a set of criteria against which to evaluate the effectiveness of AA. But going by the sheer number of meetings and participants, as well as the integration of this program into accredited rehab programs, there is a general consensus that AA works.
Why AA Is Important in Recovery
Even a brief review of the history of AA reflects that, at its most basic level, it started with a complete focus on recovery and continues to have that mission today. It is especially significant that AA was founded by the very type of people whom the program seeks to help. But beyond its origins, what are some of the reasons AA is considered to be important to the recovery process today?
Clifford N. Lazarus, PhD, provides some answers. According to Lazarus, writing for Psychology Today, a primary reason AA works is that is based on similar principles as Cognitive Behavioral Therapy (CBT). Today, CBT is a research-based therapy used in most rehab centers to address addiction to different drugs of abuse. The following are some of the ways that the AA approach and CBT are similar and beneficial to the recovery process:
- These methods emphasize the need for recovering individuals to meaningfully change the way they think and act. In addition, there is a focus on taking personal responsibility for one’s thoughts, actions, and decisions. Personal ownership of the recovery process is key.
- The 12-Step program, like CBT, is a behaviorally oriented processes. The AA method advises its members to environmental factors, such as the people they hang out with, the places they frequent, and the things they do that support alcohol abuse.
- When recovering individuals change the way they act, they also change the way they think and feel. Behaviors, thoughts, and emotions are interconnected, so changing one will naturally lead to a change in the others. AA teachings may focus on actions, such as making amends, but really this process is working to change a person’s thought processes. A sober mindset begets a sober life, and vice versa.
- The spiritual underpinnings of AA orient individuals to accept themselves and their circumstances while at the same time providing hope for change.
- AA encourages its members to cultivate self-awareness. Along the wisdom to know better is to do better, AA provides guidance on how to watch one’s own thoughts and behaviors, face one’s fears, and take responsibility for one’s actions.
- AA helps people to heal themselves through working to heal others. AA founders, Wilson and Dr. Bob, discovered that their support of one another was instrumental to maintaining their sobriety (and they both did so for the rest of their lives). The AA fellowship provides each person with the opportunity to help the group, which is a key to recovery.
It is important to note that some individuals may not find AA meetings to be effective. In some instances, a person may disagree with the faith-based nature of AA. Again, this group evolved out of the Oxford Group (a religious group) and always maintained that members would benefit by surrendering to God (or a higher power, as some prefer this language). If this is a person’s main objection to AA, it is helpful to know that there are non-faith-based groups, such as SMART Recovery, which can provide the benefits of mutual aid without the spiritual focus.
In other instances, a person may find AA to be ineffective because of the specific group dynamics at play within a particular local meeting. It bears mention, however, that there may be a radical difference between AA philosophy and its execution at the level of group meetings. If members of AA meetings are not acting in the spirit of AA, then it’s not really an AA group in substance, just in name. To know a suitable group from a non-suitable group, it would benefit a person to understand the principles of AA. AA makes free literature available to anyone who needs it. The library is also a potential source for this information. A helpful practice would be to learn about AA from AA literature and then practice its principles in meetings and in everyday life.
There is a great benefit to participating in AA groups during a rehab stay (and it may be a mandatory part of the programming). Although AA is not therapist-led, AA meetings that are onsite at a rehab should be expected to honor the letter and spirit of this method. If a person in recovery has exposure to a strong and dedicated group, it will be that much easier to find a suitable group after program completion. Of course, many people have an ongoing positive experience with AA and credit this fellowship with being a main player in abstinence maintenance. Experiences may vary but one thing is certain: AA has a history of providing innumerable benefits to individuals in recovery.