Alcoholics Anonymous Describes Itself as

Alcoholics Anonymous describes itself as a "fellowship," rather than a club and does not charge any dues or fees ("Alcoholics Anonymous"). Moreover, members never officially join or register, preserving full anonymity. The lack of strict rules or regulations in Alcoholics Anonymous makes the group difficult to comprehend for outsiders expecting to analyze its structure or methods.

Although meetings are often held in the public rooms of houses of worship and community centers, Alcoholics Anonymous states that the fellowship is "not allied with any sect, denomination, politics, organization or institution." The methods by which Alcoholics Anonymous helps its community seem rather vague and intriguing. A attended a ninety-minute meeting of Alcoholics Anonymous, held in a large room of a local church. The meeting was selected because I have the acquaintance of two members who have been attending Alcoholics Anonymous meetings for over two decades.

These veterans are unusual among Alcoholics Anonymous members because of their willingness to talk freely about themselves, their battle with alcoholism, and their association with the organization. However, both individuals emphasized the anonymous nature of membership. The organization derives its name from a staunch dedication to the protection of names and the absence of personality or power struggles. Members do not have to reveal anything about themselves they choose not to when at a group meeting.

Only those willing to share stories contribute to the meetings, and usually those with seniority lead the meetings. The meeting started on time, at 8 PM with twenty-one people in attendance. I was told that a few members were regulars, including the two individuals with whom I spoke. The members ranged in age from early twenties to seniors. Ethnicity of participants varied as well, and the ratio of males to females was balanced. No one took attendance.

However, one of the people I was with and another individual had volunteered to lead the meeting. At Alcoholics Anonymous meetings, individuals volunteer for leadership positions. Their ability to serve depends largely on their level of sobriety. Members who have not yet been able to remain sober for any length of time generally do not fulfill any position of leadership. Strict sobriety is a theme of Alcoholics Anonymous. The Alcoholics Anonymous approach to healing is total and complete abstinence, not moderation.

Moreover, Alcoholics Anonymous, like many established medical organizations like the Mayo Clinic, describes alcoholism as a "chronic disease," (Mayo Clinic 2008). The disease model is integral to the philosophy of Alcoholics Anonymous. Alcoholism is not viewed as a bad habit. Without intending to offer any medical advice or information, the group and its literature present alcoholism as a disease but do not suggest whether it is congenital or not. However, Alcoholics Anonymous literature does suggest that the disease is progressive.

One person speaking at the meeting stated that even after fifteen years of sobriety, a person was still an alcoholic. The disease apparently remains dormant and is triggered by just one sip of alcohol. One person noted that taking one drink would affect an alcoholic the same way as if he or she had never stopped drinking in the first place. Alcoholics Anonymous has no membership criteria, and there really is no clear line between members and non-members.

A member is basically any person who chooses to attend meetings and who wishes to stop drinking. Alcoholics Anonymous does not help people to drink moderately, and any member who attends a meeting without desiring to quit entirely is either encouraged to reexamine their lives with brutal honesty or to consider another mode of intervention. The origin of the Twelve Step program, Alcoholics Anonymous started in the 1930s by two men. Both are viewed as humble forefathers of the Twelve Step program and every veteran member speaks about Bill W.

And Dr. Bob as if they were old friends. Some of the Alcoholics Anonymous books, including the ubiquitous "Blue Book" are authored by one or the other. A long table lined with literature for sale -- none of which brings in profit to the organization -- accompanied the meeting. Members are encouraged to read the Alcoholics Anonymous literature for support when they are not at meetings, but the literature is not intended to substitute for meetings.

Meetings are touted as the most important feature of the Alcoholics Anonymous group and the Twelve Step method. Most of the members who spoke at the meeting mentioned their being helped by the meetings they attend regularly. Members seem to gain much from camaraderie, from being together in the same room with people who have suffered similar problems as they have and who are all dedicated to healing and recovery. Members do not normally associate socially after the meeting, and most are only known on a first name basis.

In spite of this, members attending the meeting shared intimate secrets about their lives when speaking. Speakers took turn, each standing up in their place and sharing an anecdote or life story. Like a confessional, the meeting consisted mainly of these testimonial tales. Members related how they started drinking, when they first blacked out, what trouble they had gotten into because of alcohol, including any trouble with the law or with domestic violence.

The stories were heart wrenching and most if not all of the speakers can easily be said to have reached the "rock bottom" they refer to. Reaching "rock bottom" seems to be the key motivator for individuals seeking help through Alcoholics Anonymous. Somehow, walking through the doors of a meeting hall is like admitting one has a problem. Incidentally, the first of the Twelve Steps is an admission that one has the disease.

The first step also includes the weighted term "powerless," as the person is expected to admit being "powerless over alcohol." Consistent with the disease theory of alcoholism, the first step essentially presents the person with a conundrum: "On the one hand, I will always be an alcoholic and there is nothing I can do about it. I can never again enjoy a glass of wine, because it would kill me," said one member.

On the other hand, members are expected to take responsibility for their lives by attending meetings and following the Twelve Steps. The Twelve Steps are not exact rules. Some suggest specific behaviors such as making "direct amends" to anyone harmed by the disease such as loved ones (Step 9 of the Twelve Steps of Alcoholics Anonymous). For the most part the steps seem abstract, such as "Came to believe that a Power greater than ourselves could restore us to sanity," which is Step 2.

Believing in a "higher power" as it is referred to in the meeting is a central tenet of the Alcoholics Anonymous program. The higher power is generally construed as God but one member in the meeting declared, "The group is my higher power, because I am an atheist." Atheists may be in the minority in Alcoholics Anonymous, but their presence reminds critics that the group is not as religious as it may seem based on the inclusion of spiritual references in the Twelve Steps and related literature.

As a visitor, I did not at any time feel like the meeting was preachy except for the continual reference to the disease model. The notion that individuals are powerless over a substance is a difficult one to stomach for those who have never struggled with addiction. However, nurses and especially psychiatric nurses, can easily understand why Alcoholics Anonymous works as it does. Alcoholics seem like Mr. Hydes and Dr. Jeckylls.

They are two persons in one: the diseased individual clambering for self-esteem and seeking it through alcohol and the healthy individual who is capable of so much more. The program of Alcoholics Anonymous helps those who are struggling.