The many groups that have copied Alcoholics Anonymous
Alcoholics Anonymous was founded 80 years ago. It has spawned a host of other groups dealing with every manner of compulsion, writes Chris Stokel-Walker.
"My name is Peter and I'm an alcoholic."
It's a familiar phrase even to those who have never attended a meeting of Alcoholics Anonymous. When Peter introduces himself to 40 others in a small room just off Newcastle's main shopping thoroughfare, on a sunny Saturday morning, he receives a warm welcome back in unison.
Everyone here shares a drink dependency, though they come from hugely different walks of life. The format of the meeting is simple - an introduction, a reading, one member explaining their story, then a free-for-all discussion for others to share their concerns, their triumphs, and their thoughts.
Peter began to drink at the age of 11. "By the age of legal drinking in the UK I was being admitted to local alcoholic units; in and out of doctors; in and out of police cells. Everything in my life really deteriorated." But Peter hasn't tasted alcohol in 34 years, and he attributes his sobriety to Alcoholics Anonymous.
All members talk about "working through the 12 steps" that form the cornerstone of the programme. The first of the steps, published four years after AA began, reads: "We admitted we were powerless over alcohol - that our lives had become unmanageable."
The 12 steps outline a plan of recovery to overcome addiction, which involves submitting to a higher spiritual power and admitting that alcoholism is an ongoing problem. Founded by Bill Wilson and Bob Smith in Akron, Ohio, AA grew out of a Christian organisation - the Oxford Group.
The group is marking 80 years from the moment Wilson helped Smith - 10 June 1935 was the latter's last drink. That social element of AA, the importance of "sponsors" in the process, is as well known as any of the steps.
Today, there are 115,326 Alcoholics Anonymous groups in 175 different countries, according to the group's latest estimates, with more than two million members. There are 60,143 groups in the United States alone.
According to a study in 1998, 90% of private substance abuse treatment centres based in the US model their treatment on the 12 steps. The principles have provided a basis for other 12-steps groups with no affiliation to mainstream AA.
THE 12 STEPS
- We admitted we were powerless over alcohol - that our lives had become unmanageable
- Came to believe that a Power greater than ourselves could restore us to sanity
- Made a decision to turn our will and our lives over to the care of God as we understood Him
- Made a searching and fearless moral inventory of ourselves
- Admitted to God, to ourselves and to another human being the exact nature of our wrongs
- Were entirely ready to have God remove all these defects of character
- Humbly asked Him to remove our shortcomings
- Made a list of all persons we had harmed, and became willing to make amends to them all
- Made direct amends to such people wherever possible, except when to do so would injure them or others
- Continued to take personal inventory and when we were wrong promptly admitted it
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs
These include Narcotics Anonymous, the more specific Marijuana Anonymous, Gamblers Anonymous, Workaholics Anonymous and Sexaholics Anonymous.
Clutterers Anonymous deals with those with hoarding problems. Underearners Anonymous offers support for those suffering an "inability to provide for one's needs". Support for loved ones of those going through addiction is on offer at Families Anonymous.
On Monday alone there were four Narcotics Anonymous meetings in Manchester, a Marijuana Anonymous meeting in Fitzrovia, central London, and an Overeaters Anonymous session in Cannock. For some of the smaller groups, if there's no dedicated meeting available, addicts are advised to go to AA as a substitute.
Across England, Wales and Scotland, 687 different Alcoholics Anonymous meetings took place on Monday, with 113 chapters coming together in London alone.
"If you look at any 12-step programme, the only significant difference really is the first part of the first step," says Peter, who attends AA meetings and organises Emotions Anonymous meetings in the North East of England.
The latter group deals with issues as diverse as low self-esteem, resentment, fear, anger, indecision, perfectionism, forgiveness, depression, grief, shame and anxiety.
"I think there's a fellowship for every particular human condition," Peter jokes. "But I can understand that, because apart from the first part of the first step, the rest of the programme is a programme for living."
Most fellowships offer Skype sessions, where you'll be greeted in the same way, any hour of the day by welcoming peers always happy to listen, and you'll say the same words: "My name is… and I'm addicted to …"
"The 12 steps are very applicable to any other addiction," says Amy Krentzman of the University of Minnesota's School of Social Work, who has conducted research into Alcoholics Anonymous and other 12-step programmes.
"They modify the language, but it's the same basic programme, the same basic steps, and other people have got well from following them."
The "helper" theory, first coined in the 1960s, helps explain AA's efficacy, says Krentzman. The helper ends up feeling better too. Most, if not all, of those running 12-step groups are themselves undergoing treatment for addiction.
In countless movies and TV shows - from the Sopranos to Mad Men to House of Cards to the West Wing - the sponsor-addict relationship crops up. Sponsors act as a spiritual, emotional and practical guide.
Treatment is always ongoing in AA, unlike some other traditional rehabilitation programmes which offer short programmes followed by the addict coping largely alone.
Marijuana Anonymous has "exactly the same format", explains Thomas, a member. "It has the 12 steps, and various stories that illustrate the practical application of those steps, and stories from people who have gone through the experience and gone sober."
These spin-off groups are not explicitly endorsed by Alcoholics Anonymous World Services (AAWS), which oversees the organisation's copyrights. But AAWS does grant permission for groups to use the 12 steps.
And AA's principles are still regularly criticised. Some dislike the quasi-religious element, others the emphasis on complete abstinence rather than the possibility of moderate consumption. There's also a new film - The 13th Step - about sexual assaults carried out by AA members on other members.
But perhaps the greatest criticism is from those who want concrete evidence that this widely accepted programme actually produces results.
"The evidence is that it works very well for some people," says Krentzman. A review of scientific studies of Alcoholics Anonymous' success in aiding sobriety in 2006 found that "no experimental studies unequivocally demonstrated the effectiveness of AA".
Dr Lance Dodes, a former substance abuse treatment specialist, wrote in a book about 12-step programmes that: "Alcoholics Anonymous was proclaimed the correct treatment for alcoholism over 75 years ago despite the absence of any scientific evidence of the approach's efficacy, and we have been on the wrong path ever since."
Another bone of contention is that porting across the 12-step programme to other areas offers cultural legitimacy to the idea of a wide range of compulsions as addictive diseases.
Scientists continue to be divided over whether food addiction really exists. They are torn as to whether sex addiction is real or not. It does not, for example, appear in the American Psychiatric Association's list of mental disorders.
But for many, the programme is effective. Krentzman notes: "It works because of a psychological process, a social process, a spiritual process. Because of the way it gives people a sense of community and knowing other people who have the same problem."
That's something Jennifer, who attends Overeaters Anonymous, agrees with. She joined the group in 2008, when she was 37 years old and 17-and-a-half stone. Today, she is at a more manageable weight, and attributes that to her ongoing relationship with the fellowship of overeaters.
"When I'd been to therapists and they were telling me to try things, they had no experience of it themselves," she says. "There's something about one addict helping another addict. There was an authenticity to what they were saying."
"It's a very simple programme for complicated people," Thomas says, "and it seems to withstand a lot of questioning from outside and within, which can't be said for a lot of rehab philosophies."
In the AA meeting in Newcastle, 40 people sit and share stories of addiction. Aftewards, there are firm handshakes and friendly conversations - smiles and shared jokes.
One by one, they file out the door into the crowds toting shopping bags, looking like anyone else. But in their mind, they carry an extra weight with them throughout the week.
Some names have been changed
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