TO THE CASUAL observer, Alcoholics Anonymous is an absolute good. It is tacitly accepted that it's beyond reproach and must do nothing but good, probably because we have all at least heard of someone who swears by it. But AA (and the 12 Step approach to addiction recovery it pioneered and patented) is currently very much in the dock. A number of ex-members and addiction treatment professionals have accused it of having cult-like qualities and using brainwashing and bullying methods that weak and vulnerable people are particularly susceptible to. In the US, the anti-AA lobby has been further fuelled by the recent publication of two books; Alcoholics Anonymous: Cult or Cure? by Charles Bufe and The Real AA by Ken Ragge.* There is also a support group on the Internet called Recovery From 12 Steps**.
In Britain, another side to the 12 Step/AA story is also emerging. Which is good to know when you consider that there are currently 3,350 AA groups in the UK, and counting. Addiction Counselling World magazine also lists 23 UK 12 Step fellowship groups in its current issue (including Survivors of Incest Anonymous, Workaholics Anonymous and Sex Addicts Anonymous). The ever-expanding world of 12 Step Recovery is hugely successful for a lot of people - according to research by Dr Bryan Hore at the University Hospital of South Manchester, 12 Step has a success rate of as high as 70 per cent. But, given its omnipotence, it's worth knowing when and why it's not.
AA started in the Thirties in the US but, despite 60 years of expansion, its core programme has remained unchanged. Anyone who wants to stop drinking can go to one of hundreds of meetings held every night across the country and will be introduced to the 12 Steps and the Big Book (of guidance and member stories) as well as a sponsor for one-to-one support. They will listen to other members' stories and tell their own. AA members can use this support system for life, and clinical psychologist Oliver James feels that this is a large part of AA's problem - people are encouraged to stay in AA for life. Once you are an alcoholic you are always an alcoholic. In AA you can never move on.
"After a year with AA, you're like a Moonie and you're probably in a relationship with another AA member," says James. "By the end of your second year, you are definitely cured of your physical addiction, but not the underlying causes - and AA does nothing about this. It merely replaces one dependency with another. The AA approach is authoritarian and fascistic, which is very effective when it's getting you to stop taking your drug of choice. With any addiction, that is the most urgent need initially; you have to stop killing yourself. But then, at some stage, you have to break away. Once you've been clean for, say, two years, you should move on to therapy. You have to get away from the AA paternal structure that may have been missing in your childhood. People use addiction as a substitute for intimate relations and AA cleverly provides an intimate relationship."
Caroline (not her real name), 39, took four years to break away from AA and looks back with loathing at what she now sees as its self-serving and coercive methods. "I had doubts from the start but I carried on because, at the time, I had very low self-esteem and no confidence. AA only works if you're prepared to take it on as a religion. I should know, I was brought up a Jehovah's Witness until I was 18 and the similarities are astounding."
Indeed some of the AA steps make no bones about this. Step Two talks of believing "in a power greater than ourselves", three of turning "our lives and wills over to the care of God" albeit "as we understand him", while 11 encourages prayer and meditation. This aspect of AA rhetoric is supposed to be negotiable nowadays, but Caroline disagrees: "As with any religion, you have to play by their rules or you're out. They have a Big Book which is their equivalent of the Bible. Your sponsor encourages you to pray and refers you to the Big Book at times of stress. I'd done all that sort of stuff before with the Jehovah's Witnesses. It's about control, and AA controls you by telling you that alcoholism is for life; they offer no hope of recovery. Members feed off each other in a very unhealthy way; it's like a dating agency. Opposition is not encouraged; I once made the mistake of mentioning to another member that I was in contact with a woman who had dropped out. He was very critical that I would still speak to someone who had `fallen away'. I went for it all at first. I wanted friends and I wanted to be liked but now I've detached. It's sold to you as if you're part of a special order. You're not. You just can't have a drink. I've been emotionally damaged by their mind games to keep you a member, to keep you needing them. It's a bullying environment."
David Oddy, 43, went to AA for eight years on and off before leaving to cure himself through therapy. He agrees: "I did an undercover story about the Moonies for a local radio station once and the approach is the same. AA is bondage of another form. It is evangelical and rabid in outlook. It doesn't empower or encourage independence."
Oliver James and other professionals also have problems with the AA identification of alcoholism as a disease. "It places an unhelpful emphasis on genes," James says. "Scientific evidence does not support this theory. The majority of addicts become so because of something that happened in their childhood." Dr Richard Hammersley at Sheffield University also agrees that the Disease Model approach can be a problem but feels that AA meetings nowadays would be tolerant of non-subscribers. Still, some ex-members found the thought that they could never recover disempowering.
There is also a view that AA is only of real use to people who are very far down the line. Sue Baker, who is the Assistant Director of Alcohol Concern, doesn't feel that AA's line on complete abstinence is always appropriate. "For some people the disease/abstinence method works," she admits, "but it is entirely possible that others could return to drinking in a safe and moderate way."
"AA," James continues, "doesn't touch on the use of other drugs either. Obviously this is vital and clearly sensible when you're coming off one drug already and that is your most urgent need, but later on this approach blocks progress when say, antidepressants and therapy would help."
Nigel Walsh, 37, attended various AA meetings over a three-month period and found the approach wilfully inward looking. "Ridiculous though it sounds, they focus far too heavily on alcohol and its effects. For me it was obvious what it had done - buggered up my life. Eventually I gave AA up and went into rehab of a totally different type, where the emphasis was on feelings and emotions. That worked for me. The thing is that the principles were put in place years ago and society has moved on."
David Oddy's memories are similar. "Fourteen people would sit around a table and discuss alcohol. All they ever discussed was booze. What practical use is that for moving on? My advice to anyone who feels they have a problem with alcohol would be to go into detox initially and then find a trained and accredited therapist."
AA themselves are not in the business of defending their position. A spokesperson was happy to provide facts and figures but felt unable to officially comment on the issues raised here. "Our policy is not to get into dialogue about outside issues." She was pleasant and not remotely defensive and it is worth mentioning again that AA and the 12 Step approach to curing addiction does work for huge numbers of people. But if it doesn't work for you it seems there are good reasons, and being in denial isn't necessarily one of them. Other treatments are available. Start with your GP.
* These books are both published by See Sharp Press, PO Box 1731, Tucson, AZ 85702, USA. ** Internet newsgroup address is alt.recovery.from-12-stepsReuse content