Introduction
Alcohol abuse is one of the problems that are increasingly affecting modern-day society. The prevalence of this problem can to a large extent be blamed on the popularization of alcohol by the mass media. This factor has resulted in the prevalence of drinking reaching levels that may be considered risky. As a result, there has emerged a class of people who are unable to control their drinking habits, therefore, becoming alcoholics. Alcoholism has a negative effect on both the individual and the people he/she relates with. It is, therefore, necessary to come up with means to assist the individual who is suffering from alcoholism. Many organizations have come up to assist with this most notably of which is the Alcoholic Anonymous society.
The sobriety program of Alcoholic Anonymous (AA) aims at bringing about an “instance of self-transforming discourse and practice” (Yeung, 2007). By fully working the program, the individual is able to lead a stable life with total abstinence from alcohol. This paper shall set out to critically discuss the major features of the AA. The paper shall start by giving a concise but informative description of the Alcoholic Anonymous program. In addition to this, the merits and demerits of AA in the fight against alcohol abuse shall be articulated so as to demonstrate the effectiveness of AA in helping Alcoholics recover.
Alcoholics Anonymous and its major features
According to the Alcoholics Anonymous Australian website, AA is “a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism” (AA Australia, 2010). AA traces its birth to 1935 and was a result of the meeting of Dr. Robert Holbroom and a New York businessman, William Wilson (Bill). Bill was a recovering alcoholic who had managed to stay sober for a year but feared a relapse of the same. To assist reduce the risk of relapse, Bill was put into contact with Dr. Bob, therefore, beginning the joint effort at curbing drinking which would soon spread out as the well-established Alcoholics Anonymous. AA was begun as a tool for mutual support for recovering alcoholics.
AA has no affiliation with any religion, political or social and is self-funding through the contributions of its members. This informal society boasts of a membership of over 2million throughout the world with thousands of group meetings in each locality. In terms of membership, AA is open to any person, regardless of their race, creed, political affiliation or even sexual orientation. The only criterion for membership is the personal “desire to stop drinking” by the person as well as the prior alcohol addiction. AA includes meetings that are held at designated venues and attended by the members.
Open AA meetings are open to anyone, whether they are alcoholics or suffer from any other kind of addiction. This is because the twelve steps used by AA may be used to help in more than just alcohol abuse. However, closed AA meetings are restricted to people with drinking problems and so is the membership to AA (AA Australia, 2010).
The AA program has a manual known as the Big Book which acts as the official guide for AA members. Yeung (2007) spells out that the book contains the principles by which “current AA members guide their efforts at quitting drinking”. The acclaimed “Twelve Steps” to recovery are contained in this book. These steps are in essence a formula intended to result in a “total psychic change” in which the individual transforms his/her drinking and thinking and pursuits a sober lifestyle.
The Twelve Steps form the backbone of the AA program and are outlined in the Big Book that the society uses. The steps begin by an admittance of powerlessness over alcohol by the individual, proceed to surrendering to a higher power and end by the person having had a spiritual awakening which results in healing of the freedom from alcoholism.
A key principle is that the alcoholic can never be a normal drinker, drinking modestly due to a stable disposition. This being the case, the only way in which the alcoholic can reform is by aiming for a life of complete sobriety which can only be brought about by full abstinence from drinking. To assist in achieving this end, AA makes use of story telling which involves the members of the group telling stories of their past alcoholic experiences as well as their present.
O’Halloran (2008) states that AA story is a powerful affirmation of change attributed solely to high power. This is one of the attributes of AA which gives it a religion like appearance although the members of the society are adamant that the while the group has a lot of spiritualism, it is not a religious movement. Yeung (2007) suggests that AA as a program largely draws from the principles of Christian fellowship and is centered on the individual establishing a deeply personal relationship with a higher deity. Sobriety is achieved through spiritual awakening which results from this.
Another major feature of AA is their many slogans which form a part of the AA meeting. These slogans reflect the prevailing views held by the members and in fact act as an expression of a shared understanding by the AA community (O’Halloran, 2008). The use of slogans accentuates group membership in as much the same way as different subgroups (such as doctors, lawyers, sport fans etc) use a stock of phrases that mark group membership. The use of these slogans therefore indicates affiliations and helps maintain solidarity among members. O’Halloran (2008) suggests that the phrases can be used as mantras to ward off impulses to drink therefore increasing the likelihood of the program to succeed for an individual.
Advantages of AA
It is a generally accepted notion in therapeutic circles that before any therapeutic treatments can be administered and effected, there must be an acceptance of the existence of a problem by the person who needs help (Yeung, 2007). Evidence of this recognition of a problem and acceptance of the same can be seen from the AA meetings introductions whereby the alcoholic introduces himself by saying their names followed by the confession that “I’m an alcoholic” (Bufe, 1998, p.1). Therefore, AA obligates the member to face his/her drinking problem and only after the person has done this can there be hope of recovery.
.AA is not the only means through which alcoholics can be helped to recover and therapy as provided by professional therapists is an equally potent means. However, AA has an inherent advantage owing to the lack of a hierarchical structure.
The emotional support and persuasive power that comes about from the peer meetings can sometimes be greater than that of a therapist. Galanter and Kaskutas (2008, p.148) reveal that in therapy, “while group leaders possess authority compared to members, a leader’s supportive comment may be suspect as a perfunctory role requirement”. This means that the leaders input no matter how sincere may be seen as something simply said as part of the job and hence devoid of sincerity. As such, the likelihood of the AA program resulting in positive change in a person is increased due to the inherent credibility and honesty that AA exudes.
Studies reveal that people who help others in the context of mutual help groups reap great benefits from their involvement in the same (Galanter & Kaskutas, 2008; Riessman, 1965). This is especially true for the sponsorship program of the AA whereby both the helper and the recipient share a common problem (alcoholism in this case). The reason for this is that the helper (who is also a sufferer) will become more committed to solve their own problems by offering advice and encouragement to others (Galanter & Kaskutas, 2008). This is one of the key strengths of AA over other alcoholism recovery programs. The altruism that AA fosters through having members help other group members by sharing and giving moral support results in many successes.
The treatment costs for alcohol-related problems are in some instances prohibitively high for a majority of the population. Bufe (1998) reveals that as long as the early 1990s, the average cost of inpatient treatments averaged an excess of $14000 for a 28 day stay. Much of these costs were justified as for catering for the detoxification process which is one of the treatment processes that alcoholics are offered. Most of the detoxification was unnecessary and had not useful results to the patient. Contrasting this with AA’s which are absolutely free; it is evident that AA is accessible to more people than other treatment options.
All recovering alcoholics are predisposed to relapse and as such, relapse prevention strategies present the best means for ensuring sustainable recovery from alcoholism. Haber et al (2009) articulates that relapse prevention approaches are aimed at helping the patient identify situations which resulted in excessive drinking and to use appropriate cognitive and behavioral strategies to avoid the same. The programs also provide coping skills and support for the patient. These are all roles that the AA program achieves through its peer-based system.
Disadvantages of AA
One of the outspoken critics of the AA program Bufe (1998) accuses the group of using guilt as a device to cause behavior in its members. He goes on to articulate that guilt is inherent in the AA dogma with the revered 12 steps having references of “shortcomings”, “defects of character” and other negative terms that invariably lead to the reinforcement of guilt in the members. When a member slips back into his/her drinking habits after attending the AA meetings, they experience unpleasant feelings of guilt and have a considerable loss of self prestige and pride. While this is ideally a good thing since it reinforces the need for AA program, Bufe (1998) states that it may result in members feeling hopeless and seeing the AA program as their only hope for sobriety.
One of the tenets of AA explicitly states that “Alcoholics Anonymous should remain forever nonprofessional”. This is an ideology that is strictly enforced and the Alcoholic Anonymous Australia (2010) states that AA “doesn’t have clinics, doctors, counselors or psychologies. All members are themselves recovering from alcoholism”. This presents a very major disadvantage for the AA since it cannot reap the benefit of professional personnel who are well versed with alcohol abuse. This therefore reduces the effectiveness of AA since while it may be able to assist some members through the sponsorship program, members who are in need of more help cannot find it in the AA.
Alcohol abuse is a real problem that may have life threatening implications to the alcohol abuser. Haber et al (2009) reveals that individuals who intake large amounts of alcohol may experience a withdrawal syndrome on stoppage of the consumption. The authors go on to note that these withdrawals may result in severe and life threatening complications such as seizures and delirium if the withdrawal is poorly managed or all together unsupervised.
Considering the fact that AA is an informal society run by non professionals who are themselves recovering alcoholics, it is conceivable that the society lacks the expertise to deal with the alcohol related problems that may arise as members try to end their addictions. AA advocates total abstinence from alcohol since the alcoholic is seen as being unable to control his drinking. Members of AA are therefore predisposed to suffer from withdrawal symptoms as a result of the AA ideologies they follow. Alcohol withdrawal symptoms (some of which may be life threatening) may inflict the members and without the professional assistance required to deal with the same, the outcomes may be fatal.
One of the philosophies that AA advances is that the alcoholic has a lack of choice, will power and so cannot control his drinking habits. This is articulated by the assertion “for reasons yet obscure, we (the alcoholics) have lost the power of choice in drink” (Yeung, 2007, p.52). The members also express their weakness through the process of surrendering and admitting one’s limited power to change their lives on their own. This can be seen to be a detrimental attribute of AA since it removes personal accountability and responsibility which are very important values in the society. A society in which a person cannot be held responsible for their own actions since they claim to “lack the choice and will power” would inevitably collapse.
Discussion and Conclusion
Alcoholism is a problem that affects many members of our society and for this reason, programs that assist in recovery from the same should be pursued. This paper has set out to discuss one of the programs that purport to assist in dealing with alcoholism: the Alcoholic Anonymous program. From the discussions presented in this paper, it is clear that AA is not only a popular but also a highly effective means for overcoming alcohol abuse though the use of the Twelve Steps. By following the steps, AA members shift from being in isolation to being aligned with something greater than themselves bringing about healing.
While it is true that AA does have a number of weaknesses most notably of which is the induction of feelings of guilt and to some extent helplessness in its members, even its critics acknowledge that AA does not manipulate its members for the personal advantage of any one person or group of people. Considering the fact that the number of people consuming alcohol at high risk levels has been on the rise over the last ten decades, the need for means to solve the problem of alcoholism is high now more than ever. Societies such as AA are therefore very relevant and should be utilized even more to assist solve the problem of alcohol abuse in our society.
References
Alcoholics Anonymous Australia (2010). What is AA. Web.
Bufe, C. (1998). Alcoholics Anonymous: Cult or Cure? Arizona: Sharp Press.
Galanter, M. & Kaskutas, L.A. (2008). Research on Alcoholics Anonymous and Spirituality in Addiction Recovery: the Twelve-step Program Model, Spiritually Oriented Recovery, Twelve-step Membership, Effectiveness and Outcome Research. Cengage Learning.
Haber, P. et al (2009). Treatment of Alcohol Problems: Companion Documents to the Guidelines for the Treatment of Alcohol Problems. Australian Government Department of Health and Ageing.
O’Halloran, S. (2003) Participant Observation of Alcoholics Anonymous: Contrasting Roles of the Ethnographer and Ethnomethodologist.
O’Halloran, S. (2008). Talking Oneself Sober: the Discourse of Alcoholics Anonymous. Cambria Press.
Yeung, S. (2007). Working the Program: Technologies of Self and Citizenship in Alcoholics Anonymous. Web.