A.A - Anonymous, but not invisible

By Katherine Burgdorf

What do you know about Alcoholics Anonymous? You're probably familiar with the concept of AA meetings, and maybe you've heard of their '12-step programme'. But, unless you're a social worker or a member of the Fellowship, as it is called, you probably don't know much more - I certainly didn't. And so when a friend invited me to attend a seminar hosted by AA I was keen to learn more about what I think is a fascinating and engaging organisation.

The event last night was a panel of speakers at the Houses of Parliament, hosted by AA and Iain Duncan Smith, the Conservative MP. The aim of the event was to educate broad groups of professionals on what AA is, and how it might be able to assist them in their roles when working with people who have an alcohol abuse problem. The audience was diverse and included psychiatrists, social workers, doctors, magistrates, members of the clergy, parliamentarians and other odds and sods like me. The message I took away was that while instincitively we think AA has a strong brand, many people know very little about the organisation and may not know enough about it to use it effectively when engaging with people whom the organisation could help.

There were four speakers at the event last night, two professionals (a psychiatrist and a manager within the prisons network) and two members of the AA Fellowship. Iain Duncan Smith unsurprisingly opened the panel with a plug for the coalition's universal credit scheme. His message was that the Government does not believe it is morally or socially acceptable to financially maintain the illnesses of what are the country's forgotten people. I have no desire to blog about Government policy in this piece so I'll leave it there, other than to write that I did think he made an interesting point about our cagey denial to tackle alcoholism. I feel we talk about alcoholism a lot in the UK, but I suppose his point was that if they was any other disease, we would do more. So what is it about drink problems that we shy away from? Is it that we all know, in the UK, that most of us drink too much, that we're in an uncomfortable boat together? Are we avoiding a mirror? I'd be interested in people's thoughts.

It was, of course, the two members of AA, drinkers who were achieving sobriety on a daily basis, who were the panel's best speakers - both in style and content. AA goes by first names only and in any case I've already forgotten names (amnesia sets in early) so I will call them Bill and Alex. 'Bill' was a vet, and I guess in his mid-60s - still working as he'd eventually lost everything he owned, and his family, in the trough of his 40-year drinking career (he had his last drink in 1999). Bill's message was that his life was governed by insanity when he was drinking. He was completely insane, and says the person he is today is the opposite of who he was when he was drinking. He recounted with absolute clarity his first drink, and his transformation via alcohol from shy, geeky schoolboy into a confident, outgoing conversationalist at ease with everyone. His message was that he absolutely had to hit rock bottom before he could see that life as it was wasn't working, and even then, he wasn't sure. And indeed, until very near the end he never missed a day's work in his vetinary practice. His message for the lady magistrate who asked 'is it really worth sending people to AA if they're not interested' was the rather endearing fact that he had to be physically dragged, driven and hauled into his first 40 or 50 group meetings. Even at rock bottom, he didn't think AA would work, and he didn't want to be there.

His attitude was shared by Alex. Alex was about as successful looking a woman as you could get. She would have been in her late twenties or early thirties, and is now working in the medical industry. If I could have pointed to the person in the reception area last night as my idea of the least most likely person to be an alcoholic it would have been her. But women make up around 40 per cent of AA's estimated 2 million members worldwide and looking successful - or being successful - aint any cure. Her opening comment was that she hoped she wouldn't gush too much about how AA had changed her life. She was absolutely passionate about it. The way she described her drinking was to say that her alcolholism just took off, straight away. From 16 to her mid twenties she was drinking, suicidal, in and out of institutions and just hated life, and hated the world. There were times of 'white knuckle sobriety' but it never lasted. It sounded like a bushfire. When she was asked about the moment she really knew she had to do something she said when she was drinking again and again even when she didn't want to be drunk. She vaguely knew a friend of a friend who was in AA and she said 'he absolutely had his stuff together' so she called him, and he introduced her. But she was certain it wouldn't work, and she really feared her personality would 'change'. She also said she sees the world almost inversely to the way she saw it when she was drinking, but she still feels like Alex, just happy. She shared that she was currently going through a separation which back then would have been a disaster, but now, while sad, was absolutely OK, and drinking as a 'solution' wasn't anywhere near the ballpark of possibilities.

Both of them talked about the pleasure they now have in helping others, and I left the event with a clear picture that for alcoholics who reach sobriety, a day at a time, it's a life's work to stay that way, and also to help sufferers reach that point too. Several times the speakers said if you take alcohol away you have to replace it with something, and that was very clearly service to others.

I am drawn to the simplicity and self-sustainability of this organisation. It began in 1935 at Akron, Ohio, as the outcome of a meeting between Bill W., a New York stockbroker, and Dr. Bob S., an Akron surgeon. Both had been 'hopeless alcoholics', according to the website's historic literature. In meeting each other, they found a unified way to reach sobriety together. In 1939 the Fellowship published its basic textbook, Alcoholics Anonymous. The text, written by Bill, explained A.A.'s philosophy and methods, the core of which was the now well-known Twelve Steps of recovery.

The concept of unity is core to the AA group, as is self-sufficiency. The organisation does not accept outside funding, and is instead funded by dues from its own members. It is, therefore, sufficient on itself for money, time, ideas, management and daily operation. While there is a General Service Office (GSO), and Board, in York in the UK, it is individual groups which are at the top of an inverted pyramid and which are the 'front line' of the organisation, to be supported by the GSO.

Anyone who works in marketing or business management would be drawn to the simplicity of the structure. The local groups, of which there are about 4,400 in the UK, have one single goal, which is to take its message to the 'still suffering' drinker. There is also only one requirement for membership to AA, which is a desire to stop drinking. As far as an organisational objective, it doesn't get much more straightforward than that. There are 'traditions' which are concepts broadly followed around the world, but they are not binding, and I would think take on a different flavour country to country (worth reading, http://www.alcoholics-anonymous.org.uk/?PageID=57).

So what makes the AA particularly interesting to me is that it doesn't seem to follow the general pattern of a 'cause-based' charitable group. It is a charity, but it doesn't lobby, it doesn't seek publicity, the group is more imporant than the individual (indeed, the group is how the individual is helped), it doesn't fundraise externally and it states it 'does not wish to engage in any controversy; (and) neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.' In the 2010 members' survey 91% of respondents said the aspect of AA which had a significant influence on recovery was attending regular group meetings.

I gather it sometimes (often?) attracts suspicion as a would be cult. Not being a member it's hard to know. The 12-steps and the traditions do reference God, and the panel last night addressed the question of spirituality and how that can be off-putting to people considering the group, but in typical British fashion the message was rather more like 'Spirituality? Make of it what you will.' With its foundations in 1930s America I would be shocked if it didn't have a strong religious framework. But, other than that, it doesn't seem to me to tick the usual cult boxes. For one, it doesn't seem to actively recruit members (or money), and secondly, it doesn't seem to promote a particular personality, such as the founders, other than for historical note. The trustees of the General Service Board have tenure of only four years, and they rotate at different times so there are always new faces coming through on the Board - something local councils of Britain might like to consider adopting for their committees. I may be wrong, of course, but listening to three members speak last night I didn't pick up any alarming vibes.

In this 'age of austerity' the concept of a 'free service' for a huge social issue is an attractive proposition. One of the professional panel speakers last night, a psychiatrist, said he was struck by the notion of infinity. If you take the number of people helped by AA in any given society, let's say it was 50,000 people, and called that 'achievement' or 'hope' and you placed that number over the cost of the service itself which is 'zero', the answer mathematically can be argued to be infinity. Infinite hope, or achievement. A very interesting thought and a very good reason why anonymity might be important for the Fellowship but it certainly shouldn't be invisible.


Resources

There seem to be several websites, even in the UK, but these were some useful links.

http://www.alcoholics-anonymous.org.uk/_static/Who_Me.pdf

http://www.alcoholics-anonymous.org.uk/?PageID=64