The Success of AA

In over 35 years of practice, I have seen many former patients achieve sobriety through the 12-step program of Alcoholics Anonymous (AA). There persists, though, a disconnect between AA and the behavioral health community. Most of my colleagues actually know very little about how AA works, and I hope to impart some insight. With the assistance of you, the reader, responding to this blog, we can help build a bridge between how we work and how AA works.

First, a person with alcoholism must have the realization that, even with a supportive spouse and family, he or she cannot achieve sobriety alone. Ecclesiastes 4:12 states that 2 strings together are stronger than 1 is alone, and 3 strings, even stronger. When 1 alcoholic person tells his or her story to another, both people become stronger. In an AA meeting, many strings (alcoholics) together become a powerful rope. In the admission of “powerlessness” over alcohol (Step 1), the person becomes willing to give up self-control and surrender that power to the group and to God. This is a crucial change in attitude. One then is willing to ask for help and support. Further development occurs in the relationship of the alcoholic person with his or her sponsor. The frequent, even daily, contact reinforces the power of 2 being stronger than 1. This power is further strengthened when the alcoholic person then sponsors another person with alcoholism: the strength of 3 strings.

All successful programs must have a book. Religion has its sacred books, eg, Torah, New Testament, and Koran. AA has the Big Book. Reading the book makes one think, meditate, and be mindful of its spiritual principles. Also, the alcoholic person, through reading, becomes a little less engaged in the material world and a little more engaged in the spiritual one. The spiritual principles and stories in the book are beautifully written by Bill W. The process of thinking more and more spiritually moves the alcoholic person further from alcohol and closer to God. Abraham Twerski, a rabbi, psychiatrist, and retired director of Gateway Rehabilitation Center in Pittsburgh, used the term “spiritual deficiency syndrome” for being out of touch with one’s spiritual needs. The process of recovery treats the person’s spiritual deficiency through its pragmatic spiritual focus. Getting further out of oneself and into a closer relationship with a Higher Power leads one to look at life in a more meaningful fashion. AA is largely a program for living life; only in Step 1 is alcohol emphasized.

Even with all of this spiritual growth, the desire to drink remains, and, therefore, every morning the alcoholic person asks God for 24 hours of sobriety. This constant spiritual reinforcement is necessary to keep from relapsing back to the use of alcohol. Praying, attending meetings, talking with one’s sponsor, reading the Big Book, and working through the 12 steps are the keys to recovery.

I urge my colleagues who work with alcoholic patients to obtain a copy of the Big Book and read it. Chapter 5, especially, contains material on dealing with anger, resentment, and self-centeredness. Additionally, going to a few open meetings will open your eyes to how AA operates.

Financial disclosure:Dr King had no relevant personal financial relationships to report.