Alcoholics Anonymous was founded 80
years ago. It has spawned a host of other groups dealing with every
manner of compulsion, writes Chris Stokel-Walker.
"My name is Peter and I'm an alcoholic."
It's
a familiar phrase even to those who have never attended a meeting of
Alcoholics Anonymous. When Peter introduces himself to 40 others in a
small room just off Newcastle's main shopping thoroughfare, on a sunny
Saturday morning, he receives a warm welcome back in unison.
Everyone
here shares a drink dependency, though they come from hugely different
walks of life. The format of the meeting is simple - an introduction, a
reading, one member explaining their story, then a free-for-all
discussion for others to share their concerns, their triumphs, and their
thoughts.
Peter began to drink at the age of 11. "By the age of
legal drinking in the UK I was being admitted to local alcoholic units;
in and out of doctors; in and out of police cells. Everything in my life
really deteriorated." But Peter hasn't tasted alcohol in 34 years, and
he attributes his sobriety to Alcoholics Anonymous.
All members talk about "working through the 12 steps" that form the
cornerstone of the programme. The first of the steps, published four
years after AA began, reads: "We admitted we were powerless over alcohol
- that our lives had become unmanageable."
The 12 steps outline a
plan of recovery to overcome addiction, which involves submitting to a
higher spiritual power and admitting that alcoholism is an ongoing
problem. Founded by Bill Wilson and Bob Smith in Akron, Ohio, AA grew
out of a Christian organisation - the Oxford Group.
The group is marking 80 years from the moment Wilson helped Smith -
10 June 1935 was the latter's last drink. That social element of AA, the
importance of "sponsors" in the process, is as well known as any of the
steps.
Today, there are 115,326 Alcoholics Anonymous groups in
175 different countries, according to the group's latest estimates,
with more than two million members. There are 60,143 groups in the
United States alone.
According to a study in 1998, 90% of private
substance abuse treatment centres based in the US model their treatment
on the 12 steps. The principles have provided a basis for other 12-steps
groups with no affiliation to mainstream AA.
THE 12 STEPS
We admitted we were powerless over alcohol - that our lives had become unmanageable
Came to believe that a Power greater than ourselves could restore us to sanity
Made a decision to turn our will and our lives over to the care of God as we understood Him
Made a searching and fearless moral inventory of ourselves
Admitted to God, to ourselves and to another human being the exact nature of our wrongs
Were entirely ready to have God remove all these defects of character
Humbly asked Him to remove our shortcomings
Made a list of all persons we had harmed, and became willing to make amends to them all
Made direct amends to such people wherever possible, except when to do so would injure them or others
Continued to take personal inventory and when we were wrong promptly admitted it
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
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
Source: Alcoholics Anonymous Great Britain These
include Narcotics Anonymous, the more specific Marijuana Anonymous,
Gamblers Anonymous, Workaholics Anonymous and Sexaholics Anonymous.
Clutterers Anonymous deals with those with hoarding problems.
Underearners Anonymous offers support for those suffering an "inability
to provide for one's needs". Support for loved ones of those going
through addiction is on offer at Families Anonymous.
On Monday
alone there were four Narcotics Anonymous meetings in Manchester, a
Marijuana Anonymous meeting in Fitzrovia, central London, and an
Overeaters Anonymous session in Cannock. For some of the smaller groups,
if there's no dedicated meeting available, addicts are advised to go to
AA as a substitute.
Across England, Wales and Scotland, 687
different Alcoholics Anonymous meetings took place on Monday, with 113
chapters coming together in London alone.
"If you look at any
12-step programme, the only significant difference really is the first
part of the first step," says Peter, who attends AA meetings and
organises Emotions Anonymous meetings in the North East of England.
The
latter group deals with issues as diverse as low self-esteem,
resentment, fear, anger, indecision, perfectionism, forgiveness,
depression, grief, shame and anxiety.
"I think there's a
fellowship for every particular human condition," Peter jokes. "But I
can understand that, because apart from the first part of the first
step, the rest of the programme is a programme for living."
Most fellowships offer Skype sessions, where you'll be greeted in the
same way, any hour of the day by welcoming peers always happy to
listen, and you'll say the same words: "My name is… and I'm addicted to
…"
"The 12 steps are very applicable to any other addiction," says
Amy Krentzman of the University of Minnesota's School of Social Work,
who has conducted research into Alcoholics Anonymous and other 12-step
programmes.
"They modify the language, but it's the same basic
programme, the same basic steps, and other people have got well from
following them."
The "helper" theory, first coined in the 1960s,
helps explain AA's efficacy, says Krentzman. The helper ends up feeling
better too. Most, if not all, of those running 12-step groups are
themselves undergoing treatment for addiction.
In countless
movies and TV shows - from the Sopranos to Mad Men to House of Cards to
the West Wing - the sponsor-addict relationship crops up. Sponsors act
as a spiritual, emotional and practical guide.
Treatment is
always ongoing in AA, unlike some other traditional rehabilitation
programmes which offer short programmes followed by the addict coping
largely alone.
Marijuana Anonymous has "exactly the same format",
explains Thomas, a member. "It has the 12 steps, and various stories
that illustrate the practical application of those steps, and stories
from people who have gone through the experience and gone sober."
These spin-off groups are not explicitly endorsed by Alcoholics
Anonymous World Services (AAWS), which oversees the organisation's
copyrights. But AAWS does grant permission for groups to use the 12
steps.
And AA's principles are still regularly criticised. Some dislike the
quasi-religious element, others the emphasis on complete abstinence
rather than the possibility of moderate consumption. There's also a new
film - The 13th Step - about sexual assaults carried out by AA members
on other members.
But perhaps the greatest criticism is from
those who want concrete evidence that this widely accepted programme
actually produces results.
"The evidence is that it works very
well for some people," says Krentzman. A review of scientific studies of
Alcoholics Anonymous' success in aiding sobriety in 2006 found that "no
experimental studies unequivocally demonstrated the effectiveness of
AA".
Dr Lance Dodes, a former substance abuse treatment
specialist, wrote in a book about 12-step programmes that: "Alcoholics
Anonymous was proclaimed the correct treatment for alcoholism over 75
years ago despite the absence of any scientific evidence of the
approach's efficacy, and we have been on the wrong path ever since."
Another
bone of contention is that porting across the 12-step programme to
other areas offers cultural legitimacy to the idea of a wide range of
compulsions as addictive diseases.
Scientists continue to be
divided over whether food addiction really exists. They are torn as to
whether sex addiction is real or not. It does not, for example, appear
in the American Psychiatric Association's list of mental disorders.
But for many, the programme is effective. Krentzman notes: "It works
because of a psychological process, a social process, a spiritual
process. Because of the way it gives people a sense of community and
knowing other people who have the same problem."
That's something
Jennifer, who attends Overeaters Anonymous, agrees with. She joined the
group in 2008, when she was 37 years old and 17-and-a-half stone. Today,
she is at a more manageable weight, and attributes that to her ongoing
relationship with the fellowship of overeaters.
"When I'd been to
therapists and they were telling me to try things, they had no
experience of it themselves," she says. "There's something about one
addict helping another addict. There was an authenticity to what they
were saying."
"It's a very simple programme for complicated
people," Thomas says, "and it seems to withstand a lot of questioning
from outside and within, which can't be said for a lot of rehab
philosophies."
In the AA meeting in Newcastle, 40 people sit and
share stories of addiction. Aftewards, there are firm handshakes and
friendly conversations - smiles and shared jokes.
One by one,
they file out the door into the crowds toting shopping bags, looking
like anyone else. But in their mind, they carry an extra weight with
them throughout the week.
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