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The AA talking cure

Eighty years ago in the summer of 1935, Bill Wilson, a stockbroker from New York City, and Dr. Bob Smith, a surgeon from Akron Ohio, both formerly hopeless alcoholics, shared their “experience, strength, and hope” with each other in Dr. Bob’s living room, and Alcoholic’s Anonymous was born. Today, 2 million people in 170 countries continue to do exactly what Bill W. and Dr. Bob did.  Formerly hopeless drunks sit in church basements and in clubhouses, and share their stories with each other, not with ministers, addiction experts or psychiatrists, but with fellow alcoholics. We speak with each other about “what it was like, what happened, and what it is like now.” The meetings are called the fellowship and consist almost entirely of being together with fellow alcoholics and sharing our “experience, strength, and hope.” Insofar as A.A. works, this is how it works. It is a talking cure.

A fair number of people get and stay sober through the fellowship alone. There is also the well-known 12 steps which is the program. The program consists of doing the 12 steps with a sponsor (someone who has already done them with his or her sponsor). The steps involve focused, deliberate work on one’s self, one’s character, one’s weaknesses and strengths, stressors, and triggers, as well as on strategies and practices to help one heal and maintain sobriety. The steps, like the fellowship, consist almost entirely in thinking and talking with another alcoholic (when one reaches the stage of making amends to those one has harmed, this requires action, but often this too is largely verbal). The 12 step program starts with a declaration of powerlessness over alcohol and culminates with a vow to help any and all other suffering alcoholics. In between, there are steps that involve “a searching and fearless moral inventory,” admitting to God and another human being the exact nature of our wrongs, as well as “turning our will and our lives over to the care of God as we understood Him,” which make some wonder about whether AA is a religious program.

Insofar as AA works, this is how it works. It is a talking cure.

There is no doubt that AA was developed by Christians and directly inspired by the Oxford Group, a 19th-century American Christian men’s group that both Bill W. and Dr. Bob had independently gone to for help with their alcoholism, and which emphasized confession and spiritual perfection. The fact that AA embeds Christian practices of self-examination, confession, and making amends does not entail that these are not wise practices. That said, in the southeastern USA, where I live, The “Lord’s Prayer” (the Protestant version “kingdom, power, and glory”, not the Catholic version) is said at the close of many meetings. But in my experience even very religious people will insist that AA is a spiritual program, not a religious one, and that agnostics and atheists are entirely welcome. Whether members speak about God is largely a matter of local culture. God-talk is fairly common where I live in Durham NC, and even more so in Nashville, Tennessee, closer to the buckle of the American Bible Belt. In NYC, and Connecticut, and in the UK, Hong Kong, Thailand, God or Higher Power talk is rarer and functions more as common code for such things as one’s home group; the 80 years’ worth of AA wisdom, something that is beyond my own individual will-power, which try as I might, was not enough to get and keep me sober.

In the first decades of AA, Bill Wilson was asked by some Buddhist alcoholics, atheists by Abrahamic standards, whether they could revise the steps, replacing “God” with “Good.” In 1957 Wilson wrote “To some of us, the idea of substituting ‘good’ for ‘God’ in the Twelve Steps will seem like a watering down of A.A.’s message. But here we must remember that A.A.’s Steps are suggestions only. A belief in them, as they stand, is not at all a requirement for membership among us. This liberty has made A.A. available to thousands who never would have tried at all had we insisted on the Twelve Steps just as written.” (Alcoholics Anonymous Comes of Age pg. 81). This suggests that AA is first and foremost a communal solution to a problem that many alcoholics tried to solve of their own but couldn’t.

One piece of genius of AA is the 12 traditions. The 12 traditions were not fully formulated and published until 1946, and provide the only structure for what is otherwise a model of an egalitarian anarchist commune. The traditions include such principles as, “The only requirement for A.A. membership is a desire to stop drinking,” that “there are no dues or fees for AA membership,” and “Alcoholics Anonymous should remain forever nonprofessional.”

These traditions mean that there is no financial obstacle to attending AA. At the end of a meeting, if one has a dollar, then one puts it in a basket to buy coffee and cookies and pay rent; otherwise not. This also means that people who would not normally meet, people of every profession, economic status, ethnicity, sex, gender, sexual orientation, and age gather together to “solve our common problem.” There is a great beauty in choosing to heal among people of every kind, to love and be loved across every boundary that typically separates people and grounds disdain and prejudice.

There is a great beauty in choosing to heal among people of every kind

In the 1880’s, when Freud and Breuer discovered the “talking cure” while treating their hysteric patient Anna O, the psychoanalytic talking cure was entirely professional and asymmetric. Freud and Breuer were psychiatrists and Anna O. was a mentally ill patient. In AA, the patients treat their fellow patients. The AA talking cure is entirely unprofessional and symmetric.

One might wonder about the wisdom of non-professionals treating their fellows for what even AA says is a serious disease. There is at present a large controversy over whether and how much control an alcoholic has. The phenomenology of addiction almost always involves experiences of craving, obsessive thinking, and a bewildering disconnect between resolutions to stop drinking and then getting drunk. There is some evidence that long-term alcohol use harms midbrain pleasure centers. The alcoholic wants or needs what they no longer like, what they no longer get any pleasure or relief from. Suppose this is true, the question remains how does the alcoholic get healthy, where and how do they regain leverage over their life and live as they intend? There is abundant evidence that alcoholics have some control over their lives. Knowing that one needs help, that one cannot do this on one’s own is an expression of agency (see Peg O’Connor). For many of us, especially for those of us for whom drinking is embedded in a whole life style, a way of being our self, the AA talking cure is an excellent, time tested way of regaining self-respect, and developing tools to sustain a sober life, often a happy sober life. Thanks to Bill W. and Dr. Bob for sharing your “experience, strength, and hope” eight decades ago, and gifting us with the AA talking cure.

Feature image: AA Hood Ornament by Mark Engelbrecht. CC-BY 2.0 via Flickr.

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