Alcoholics Anonymous (AA) is a voluntary program that arose from the experiences of recovering alcoholics and does not involve professional direction or input. AA is well known for its 12 Steps and 12 Traditions. In a drinking society, abstinence is not an easy task and many recovering alcoholics do best by following AA precepts and attending AA meetings. Many alcoholics in recovery experience a slow, difficult change in identity and lifestyle and need the support and tolerance that AA groups tend to provide. The AA strategy is based on:
An unconditional acceptance of the label "alcoholic"
A belief in the concept of alcoholism as a disease and
A commitment to support others in the AA program.
AA was founded as a fellowship by William Wilson ("Bill W.") and "Dr. Bob" in 1935 "to help the sick alcoholic recover if he wishes." The creed is to refuse the first drink since alcoholic beverages trigger compulsive drinking and all the hard work of recovery can unravel in a momentary slip. Complete abstinence is considered the only feasible goal and an AA fellow will describe his or her success in terms of the days, months or years of sobriety. Sobriety is strongly linked to merit and virtue. There are an estimated 12500 groups worldwide holding regular meetings.
The recovery of an alcoholic involves an initial stage of denial that is gradually replaced by a more realistic assessment of alcohol addiction and its consequences. Alcoholics in recovery experience a slow, unstable and sometimes painful identity change. Many alcoholics have remorse for the harm they have done to themselves and others and their guilt must be fully expressed and acknowledged before the new identity can emerge and flourish. AA members invoke a "higher power' in their quest for purpose and identity. In a truly ecumenical spirit, the higher power is open to any individual definition. The AA step 11 suggests prayer and meditation and Step 12 suggests the assistance of other alcoholics. A sense of purpose in life increases success with continuing sobriety as does some form of spiritual practice.
In an appreciative review of AA benefits, Khantzian and Mack stated: "Alcoholism is associated with tremendous suffering, psychological denial, and physical and emotional debilitation. Much of the suffering that plagues alcoholics is rooted in core problems with self-regulation involving self-governance, feeling life (affects), and self-care. Alcoholics Anonymous is effective because it is a sophisticated group psychology that effectively accesses, corrects, or repairs these core vulnerabilities. The traditions of storytelling, honesty, openness, and willingness to examine ("take inventory") character defects allow people to express themselves who otherwise do not feel or speak and help those who otherwise are deceitful (to self and others) and would deny vulnerability and limitation to openly admit to it."