A fundamental lack of understanding has enabled many inaccurate myths about AA to take root.
I n the last few years, the movement to challenge Alcoholics Anonymous (AA) — the organization that has long been the standard-bearer in the fight to combat alcohol addiction — has intensified. Gabrielle Glaser, for one, seems to have made it her life’s work to disprove the efficacy of AA. In 2013, she published a book, Her Best Kept Secret: Why Women Drink–And How They Can Regain Control. More recently, in the summer of 2015, she penned an article for The Atlantic entitled, “The Irrationality of Alcoholics Anonymous.” In particular, Glaser often feigns concern for the women alcoholics who enter this program that’s so “ill-suited” to them.
Let’s step into the halls of Glaser’s Alcoholics Anonymous for a minute. Glaser told Jezebel that she attended “about 10 meetings” of AA before writing her book. But as Tamara O., an AA from New Hampshire, tells me over the phone, “I can’t go to anything 10 times and be an expert on it.”
Of the women and femme folks I spoke to for this piece, none of them believe that AA is above criticism. Nor do they claim that the program works for everyone. What all of them do believe, however, is that criticism of the program needs to be informed. And it’s hard to be fully informed if, like Glaser and many other critics of AA, you’ve never been an alcoholic yourself.
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This fundamental lack of understanding has enabled many inaccurate myths about AA to take root; if the critics are to be believed, the program is nothing more than a cult and a sham that also happens to actively harm the women who pass through its doors.
As someone who’s been involved in AA myself, I decided to provide a look at the program using the insights not of its outsider critics . . . but of those who have actually worked it.
Getting The Facts Straight
Glaser spends a lot of time citing research that debunks “the program” of AA, but it’s important to define exactly what that program is. And despite what Glaser says (and popular lore would have you believe), meetings are not the program of Alcoholics Anonymous.
The “program” actually involves the Big Book of AA’s Twelve Steps, none of which involve attending meetings. Meetings have always been a way of carrying the message of the solution to alcoholism, first through the Oxford Group, which was a precursor to Alcoholics Anonymous and whose program the Steps are based on, and then through AA itself. This is well-documented in Ernest Kurtz’s incredibly thorough book Not God: A History of Alcoholics Anonymous.
Meetings are not the program of Alcoholics Anonymous.
This misunderstanding has helped foster the myth that AA has a shockingly low success rate. Lance Dodes, a retired psychiatry professor from Harvard Medical School, recently wrote The Sober Truth, Debunking The Bad Science Behind 12-Step Programs and the Rehab Industry, which Glaser cites in The Atlantic. In his book, Dodes claims that AA’s success rate is between 5–10%.
But this doesn’t account for a simple fact: for better or worse, many people are court-ordered to attend meetings. And many of these people do not meet the only requirement for membership, which is “a desire to stop drinking.”
Not only that, but if we go back to the definition of AA, it’s clear that attending a few meetings over the course of a year isn’t actually “working the program” as is laid out in the literature. This may seem like a minor distinction, but in terms of how the program is viewed by those who haven’t been in it, it’s proven to be a critical one.
Science Vs. Spirituality
Another criticism of AA is that it’s founded on spiritual and peer-based counseling rather than medicine and science. In The Atlantic, Glaser writes that experts discredit AA’s view that “counseling could be delivered by people who had struggled with addiction, rather than by highly trained doctors and mental professionals.” In revealing how alcoholics and addicts can help each other, Glaser adds, AA “may be heartening, but it’s not science.”
Yet many alcoholics I spoke to pointed out that doctors and mental health professionals had been unable to help them. “I’ve been in therapy pretty much my entire life. Since I was 14,” says Arianna T., an AA member from California. “And therapists would tell me that I had a problem drinking and I would not listen to them.”
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Conversely, being counseled by fellow alcoholics has proven to be effective for many I spoke with. “Peer counseling is used very successfully in many fields,” says Tamara. “The peculiarity about addiction is that those who do not have it cannot understand it. That inability to fully grasp what it feels like and what it is to have this disease makes a non-alcoholic underprepared and under-qualified to service another alcoholic.”
Clementine M, an AA from Ontario, Canada, agrees:
“In a culture where most medical care is an industry in the hands of professionals, a very successful treatment program run by drunks themselves seems strange. And yet, it is demonstrated time and again that alcoholics can get through to each other when no one else can.”
The AA literature acknowledges that the psychological approach does work for many people, while noting that the program is a sound option for those it does not work for. Tamara cites the first chapter of AA’s Big Book, called “The Doctor’s Opinion,” written by Dr. William Silkworth, the medical director of Townes Hospital and one of the leading physicians treating alcoholism and drug addiction in the country. According to him:
“We doctors have realized for a long time that some sort of moral psychology was of urgent importance to alcoholics, but its application presented difficulties beyond our conception. What with our . . . scientific approach to everything, we are perhaps not well-equipped to apply the powers of good that lie outside our synthetic knowledge.”
Dr. Silkworth points out that the spiritual fellowship that AA cultivates has been shown repeatedly to work. The Big Book goes on to cite William James’ Varieties of Religious Experience, which explains that “spiritual experiences” have the potential to change people in such a way that they can do, feel, and believe things that had previously been impossible for them.
Criticism about AA’s non-scientific approach has prompted Glaser, Darlena Cunha (writing for The Guardian), and many of the experts they each spoke to for their respective pieces to suggest evidence-based treatment models as alternatives to AA. In particular, SMART Recovery, another peer-led recovery model, is often touted as a superior option. But despite being rooted in a distinctive approach, SMART Recovery is not actually that different from AA.
The AA literature acknowledges that the psychological approach does work for many people.
SMART Recovery is based on cognitive-behavioral therapy (CBT) and rational-emotive behavioral therapy (REBT) models. These focus on how thoughts impact emotions and emotions impact behavior, and on the value of changing negative thoughts and challenging irrational core beliefs about oneself.
AA’s Fourth Step, often called a “moral inventory,” is similarly oriented. This moral inventory requires members to do what are called “turnarounds,” where they identify how their own thoughts and beliefs are causing their feelings of depression, anger, or anxiety.
And for many involved in AA, this step has proven effective. “As you hear in the rooms, if AA is brainwashing, then my brain needed washing,” Laura M., an AA from North Carolina, says. “I needed to think differently. AA taught me how to do that.”
Is AA Like A Cult?
Another pervasive and insidious stereotype about AA is that it’s a cult. In The Guardian, Cunha calls the program “cult-like,” and Glaser has drawn similar parallels in her book.
But everyone I spoke with scoffed at the notion that AA was anything like a cult. Clementine argues that “the stereotype of AA as a cult is pretty ridiculous and actually harmful. It may prevent people from seeking out something that could help them.”
Tamara says that “cults don’t let people make their own decisions, or leave if they want to,” as AA does. “What separates Twelve Step recovery from a cult is that on an idealistic level, we are a democracy; we are self-governed,” she explains. Not only that, but the Twelve Steps are simply “suggestions,” as the book makes clear, as are all other parts of AA’s program. No one has to follow any rules in order to attend AA meetings or call themselves a member.
According to Dr. Stephanie S. Covington’s book, A Woman’s Way Through The Twelve Steps, it is this non-hierarchical structure that may appeal to women, “many of whom have experienced the abuses of traditional top-down power structures.” Though Clementine admits that this may be off-putting to people who are used to more traditional treatment models, “I think what people find strange, and maybe even threatening, about AA is that there are no experts, no leaders, no one in charge.”
People who write about Alcoholics Anonymous also claim that the program believes it is the only way to recover from alcoholism. Yet the AA literature is incredibly clear that that’s not the case. Multiple times in the Big Book, it says that if you can find something else that works for you, you should do it. The literature acknowledges that living the Twelve Steps is a lot of work, and the only people willing to do it are probably hopeless.
For many alcoholics, AA is the last house on the left — they’ve tried everything else before they’re willing to give it a chance.
Is AA Bad For Women?
Another oft-repeated fallacy about AA? That it’s specifically harmful to women.
The first step in Alcoholics Anonymous reads: Admitted we were powerless over alcohol, that our lives had become unmanageable. As Glaser writes in Her Best Kept Secret, researchers say that AA may prove less effective for women because “the idea of being powerless can underscore a woman’s sense of vulnerability.”
A Woman’s Way Through The Twelve Steps acknowledges that the word “powerless” may be difficult for some women. “It can be difficult to acknowledge powerlessness over our addictions because we already feel powerless in so many other areas of our lives.”
Arianna, the AA from California, concedes that “for those of us that get it, [powerlessness] is a freeing term. For those that don’t, it’s the most abhorrent thing they’ve ever heard.”
However, women in the program argue that admitting this powerlessness over alcohol is actually empowering. A Woman’s Way Through The Twelve Steps states, “Yet only when we admit powerlessness and lack of control over our addiction can we truly begin to find out where we truly have power over our lives . . . For women, recovery is about empowerment — finding and using our true inner power.”
Women in the program argue that admitting this powerlessness over alcohol is actually empowering.
Laura found that when she finally understood that she was powerless over alcohol, she was able to surrender. She says, “Paradoxically, this surrender set me free to take action on the things I can control in my life.” Several of the people I spoke to emphasized that the Steps say that alcoholics are powerless over alcohol, not that they are powerless over their lives. Tamara explains that she has “remarkable willpower, determination, discernment, and scruples” when it comes to almost every area of her life — except alcohol.
By admitting powerlessness over alcohol, women and femme folks are freeing themselves to turn their attention to areas where they do have control. Clementine says that admitting powerlessness over alcohol allowed them to gain power to make their own choices and to live the life they wanted to live.
Another argument for why AA is not healthy for women is that it focuses on dismantling the ego. Glaser argues that “the steps involve surrendering your ego and self-will to God, as well as scrutinizing your character flaws . . . But most women who drink too much aren’t suffering from powerful egos, or a lack of awareness of their flaws.”
By admitting powerlessness over alcohol, women and femme folks are freeing themselves to turn their attention to areas where they do have control.
This definition of “ego,” though, shows a fundamental misunderstanding of the program literature. “Ego is not actually just about being ‘full of yourself,’ as it is commonly understood,” Clementine says. “For many people, especially some women, femmes, and queer people, ego manifests as being really hard on yourself.” This rings true for Tamara, who notes that when women arrive in AA, “We’re coming in at a low point in our lives.”
But perhaps the most sustained criticism of Alcoholics Anonymous is that it’s an unsafe space for women and feminine people. To read both Glaser and Cunha’s work, you would imagine AA to be a place where men prey on every woman who walks through the doors, and where most male members are sexual predators. Glaser says that she “found a lot of evidence that AA is not always a safe place for women.” She claims that her research found that “sexual abuse among AA old-timers toward newcomers is ongoing and systemic” and that “a study in one peer-reviewed journal shows that it happens to the majority of women who attend.”
Cunha dedicates her entire Guardian piece to the problem of predatory men in AA and a program that does nothing to protect the women who walk into its rooms. Tamara says that the piece was “offensive, one-sided, unfair,” and “took a complex issue, sexual assault, and [presented it] without understanding the psychology of an alcoholic or the psychology of AA.”
All of the people that I spoke to felt that the creepy men in the halls of AA were no more pervasive than outside of the program. “There are men who are predatory everywhere. And in a bar, there isn’t someone looking out when a creep talks to you. In AA, there are women who consider it their mission to look out for newcomers,” says Jen.
This idea of looking out for one another was cited by everyone I spoke with. They cited good sponsorship as something that can help promote the safety of newcomers. Clementine feels strongly that, “part of being in AA means working to create as safe a space as possible to help people get sober.”
A Better Call To Action
Is this all to say that AA is perfect? Of course not. The people I spoke with offered up plenty of potential improvements the program can make in order to create a safe, more relevant program for women and feminine people.
Both Tamara and Clementine, for instance, would like to see men and masculine people stepping up more often to be allies. Clementine adds that they “would like to see more meetings which emphasize the inclusion of trans people, including pronoun go-arounds at meetings.”
Tamara sees change coming from more women getting involved in service positions and the governing of groups in their area. “Our voices are valuable, but no one is going to invite us to the table,” she says. “We must insert ourselves into the governance.”
Is this all to say that AA is perfect? Of course not.
And everyone would love to see more open discussion of trauma, as so many of the women, trans, and queer folks (and even some of the men) in the halls come in with it.
Here’s the key thing all about these suggestions: they’re coming from actual AAs. And what all the people I spoke to stressed was the need to speak to women and femmes who have actually been impacted by the program. I personally find it incredibly problematic that the person being looked to to educate the public about why women drink and how we can treat them is not actually an alcoholic. Glaser has become an expert on something she doesn’t actually have any experience with, to the point of discrediting the voices of those who do.
It’s time, in other words, to let AAs speak about the program that has saved their lives — instead of allowing others to speak for them.