The Social World of Alcoholics Anonymous: How It Works

Editor’s Note: This post is brought to you by Annette R. Smith, and is taken from her 2007 book The Social World of Alcoholics Anonymous: How It Works. Smith received her masters in social work from the University of California, Berkeley in 1961, and her Ph.D. from UC San Diego in 1991. She worked for several years as a psychiatric social worker at Napa State Hospital in California, where she helped develop an innovative co-educational unit for treating alcoholics, who had long been merely warehoused in those giant institutions. As one of the key elements in this new approach, she worked with the local A.A. Hospital and Institutions Committee in bringing A.A. to the inpatients in that program. This experience began her lifetime association with the fellowship. The Social World of Alcoholics Anonymous asserts the value of viewing AA as a social world, and argues that the success of AA is dependent on integration into the social world. Enjoy!

Annette R. Smith
Annette R. Smith

After several years working as a clinical social worker and program manager in the alcoholism treatment field, and being involved as an associate of Alcoholics Anonymous, I returned to school to obtain a doctorate in sociology. As I became more aware of sociological constructs, it became clear to me that although there was considerable literature on the history and philosophy of AA, its value as treatment, its bases of affiliation and the experiences of its members, AA as a social organization and the impact of that organization upon recovery, had not been widely examined.

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Alcoholism in Communist Yugoslavia

Former_Yugoslavia_Map

(Editor’s Note: This post is brought to you by contributing editor Mat Savelli, a postdoctoral fellow at McMaster University in Ontario, Canada.)

Yugoslavia had a problem with alcoholism.

Or at the very least, that’s what the country’s psychiatrists generally thought. During the Communist era (from the end of the WWII through to the country’s collapse in 1991), leading Yugoslav physicians routinely warned about the population’s rapid descent into widespread alcoholism.

Year after year, the statistics on drinking seemed to grow. Yugoslavs were consuming more and were beginning to drink heavily at a younger age. Even more problematically, excessive drinking seemed to be spreading to new populations, with women and the country’s substantial Muslim population increasingly taking to booze.

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In Memoriam: Ernie Kurtz, 1935-2015

All serious historians of alcohol and drugs will be saddened to hear of the passing, last week, of Ernest (“Ernie”) Kurtz, the first and foremost historian of Alcoholics Anonymous. Kurtz’s commanding Not-God: a History of Alcoholics Anonymous was published in 1979 by Hazelden.  Though Ernie often talked about how AA history in the decades since Not-God appeared had outstripped its claims, and in fact called from the pages of Points for a revised and updated history of AA, his book remains the definitive word on the fellowship’s founding and early growth.

Hazelden, 1979
Hazelden, 1979

Kurtz wrote Not-God as his dissertation; he earned a Phd in the American Civilization program at Harvard University (a fact that I don’t hold against him, even though I attended a different and really much better American Studies program down the road). The volume’s power arises from his ability to situate its founders and their fledgling organization within the context of American religious and cultural history.  Like two other compelling historians of AA,  Damien McElrath and Glenn Chesnutt, Kurtz was positioned well to inquire into the program’s spiritual foundations: after earning a BA in philosophy from St. Bernard’s Seminary in Rochester, New York, he entered the priesthood and served as a parish priest from 1961 to 1966.  I’ll leave it to better Catholics than myself to sort out whether it was Ernie’s seminary training or his departure from the church in the late 1970s that gave him such penetrating insight into the ways AA manifested what he came to call “the spirituality of imperfection.”Read More »

Breast or Bottle: La Leche League and Alcoholics Anonymous as Lay Health Movements

Editor’s Note: This post is from Contributing Editor Michelle McClellan.

I’ll begin with two anecdotes, the first of which is probably familiar to most Points readers. In 1935, a stockbroker named Bill Wilson found himself in Akron, Ohio for a business deal. When it fell through and Wilson felt the urge to drink again after a period of sobriety, he reached out through area ministers and was put in touch with a woman who arranged a conversation between him and Dr. Robert Smith, a local physician who also struggled with his drinking. Their conversation is now recognized as the genesis moment of Alcoholics Anonymous (AA).

bill wilson

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Contextualizing the First Annual “We Agnostics and Free Thinkers” AA Convention, Nov 6-8, 2014

Editor’s Note: This post is brought to you by the venerable Trysh Travis, former Points managing editor.

A friend with a drinking problem has been going to Alcoholics Anonymous meetings lately, and finding them not very helpful. “I can’t stand all the God talk,” she explained. She was raised in an Islamic country where God is routinely invoked—sometimes consciously, other times mechanistically—as a punitive, fearsome presence whose main purpose in the world seemed to be to limit the freedoms of women like herself. God was the last person she felt like turning to for help.

Before you go getting up on your Fox News soapbox and calling in more drone strikes in the name of an oppressed Third World Woman, let me just note that I’ve had American friends—Baptists, Catholics, and Jews—who had the same gripe with 12-Step culture. Twelve-Step recovery’s official posture may be that it is “spiritual, not religious,” but the niceties of that distinction may be lost on people for whom “God” is hot-button issue.

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Recent News Roundup: The Sobriety Coach Edition

Twelve-step sponsorship is so twentieth century—or so The New York Times would have us believe. In an article published last month in the newspaper’s Fashion and Style section, author Marisa Fox made the case that “recovery coaches,” “once consigned to Hollywood entourages to keep celebrities on the straight and narrow,” are currently trending among upper-class women “from the Upper East Side to the beachfront homes of Boca Raton.”

Last weekend, NPR’s All Things Considered followed the trend, offering a more inclusive description of recovery coaches’ clientele (the stock image that accompanied the report was still a view from the beach).

heroinrecovery_wide-2a6fc5fa05e9de7f53966c3853b923f2d5c80a73-s4-c85
Diane Diederich/iStockphoto featured on NPR.com

The historical angle adopted by both news outlets was obvious. The old-fashioned practice of sponsorship—defined by Alcoholics Anonymous as the process by which a person “who has made some progress in the recovery program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety”— presents shortcomings in today’s treatment marketplace. The women featured in the Times have the ability to buy their way out of the social awkwardness and fear of exposure that twelve-step meeting attendance invites. The NPR piece notes that people in early recovery don’t always gravitate toward the most adept supporters— coaches, who are trained to provide practical as well as spiritual guidance, can help solve this long-standing problem.

Clipping from Hazelden's MORE program pamphlet. The program offers coaching for clients in early recovery.
Clipping from Hazelden’s MORE program pamphlet. The program offers coaching for clients in early recovery.

As historian and clinician Bill White explained, coaches are not sponsors (they don’t do voluntary twelve-step work on “paid time”) and they’re not quite counselors (they don’t diagnose or probe underlying psychological issues). They occupy a new niche in the service economy that employs more than 75 percent of today’s American workers. They are “the new Pilates instructors,” one coach told the Times. They are compensated to be both “cheerleaders” and “beacons of hope,” another told NPR.

Like NPR reporter Martha Bebinger, I think coaches can produce tremendous benefits, both for people in recovery and for the treatment system as a whole. But the proper role of recovery coaches in today’s health service sector also deserves a systemic critique—and not the trolling, “New York Times Style Suction” sort.

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Fiction Points: Dan Barden

Dan Barden is a professor in the Creative Writing Program at Butler University in Indiana. His essays have appeared in Esquire, GQ, Details, and Poets and Writers, among other journals and anthologies. He is the author of the novels John Wayne: A Novel (Doubleday, 1997) and The Next Right Thing (Dial Press, 2012). The latter is a crime mystery set inside a recovery story, told by a hardboiled ex-cop for the ages. Check out the novel’s Amazon.com page for a glimpse of the rave reviews it received in all the right places, from The Atlantic to TheFix.com. He speaks to us today about the human beings who inspired it. 

Two nuns and a penguin approach you at a bar, and you tell them that you’re a writer. When they ask you what your last book was about, how do you answer?

I’d like to think I’d have a different answer for the nuns than I did for the penguin. To the nuns, I would say that I was trying to justify the ways of God to man insofar as the book — The Next Right Thing, which is a literary crime novel set among a community of AA members — is about what I find beautiful and honorable and appealing in the lives of men and women who are recovering from addiction to alcohol and drugs.

Dan Barden (© Liz Pinnick)
Dan Barden (© Liz Pinnick)

Why would God do this to these folks? Why would He vex them so much with these intractable emotional and spiritual problems? And then make them so charming and wonderful on top of all those vexing and intractable problems? To the penguin, I would say that the book is about how strangely human beings are to love each other in the strange ways that they love each other.

Points is a blog primarily for drug and alcohol historians. What do you think this audience would find most interesting about The Next Right Thing?

I hope that The Next Right Thing is a novel about the beauty of codependence, if such a thing is even possible. I guess I wasn’t kidding when I just said that thing about “justifying the ways of God to man.” It really bewilders me that I have spent so much of my life loving alcoholics and addicts. Read More »

Thoughts on the “Geographical Cure”: Where would Alcoholics Anonymous be without it?

In Alcoholics Anonymous lore, twelve-steppers are taught to beware the “geographical cure.” The AA program imparts a common-sense lesson: when you move, your problems often come with you. The warning that changing locations doesn’t necessarily have the desired influence on habits runs contrary to the grand American ideal of re-invention. The maxim also harkens back to a historical tradition of vacation-like therapies—the sorts of escapist cures that it pithily dismisses.

Even so, AA’s own cure, in its early years, was geographic in other ways. Like any historical phenomenon, it was rooted in a time and place. And before the movement generated national press attention in the early 1940s, its spread relied on the mobility of members—mostly salesmen— who “carried the message” on their travels. The initial dissemination of AA’s solution to the problem of substance dependence reflected regional differences. As the first Detroit member claimed, “Psychiatry had not penetrated the Middle West.”

 Sigmund Freud, G. Stanley Hall, Carl Jung,  Abraham A. Brill, Ernest Jones, and Sandor Ferenczi at Clark U in 1909; Bill Wilson and fellow AA members in 1941
Sigmund Freud, G. Stanley Hall, Carl Jung, Abraham A. Brill, Ernest Jones, and Sandor Ferenczi at Clark U in Massachusetts 1909 (via Chronicle.com); Bill Wilson and fellow AA members in 1941, in the Saturday Evening Post.

Jack Alexander, the author of the Saturday Evening Post article credited with making AA a household name, contrasted the recruitment strategies in the early chapters of Alcoholics Anonymous. While AA co-founder Bill Wilson trolled the halls of New York’s Towns Hospital in search of potential converts, “in the Middle West,” Alexander wrote, “the work [was] almost exclusively among persons who have not arrived at the institutional stage.” AA co-founder Bob Smith’s Akron home was hospitable to Protestant religious traditions and functioned as a halfway house for the hardest alcoholic cases. Recovering alcoholics from Akron eventually spread AA’s gospel westward to Cleveland, Indianapolis, Detroit, Chicago, St. Louis, and Los Angeles.

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Medicine or Vacation? Selling addiction treatment, circa last century

If, like me, you’ve spent the past several years studying the history of addiction treatment, then you might know why I can’t look at beachy treatment ads—they tend to resemble the image below— without thinking about the work of William L. White, the prolific addiction professional and historian.

Addiction Ends in Malibu
Addiction Ends in Malibu?

White’s book, Slaying the Dragon, is a canonical text on the history of addiction treatment in the United States. While Slaying was written to give addiction professionals a sense of their own history, the book is also an essential starting point for any scholar who first approaches the subject. Early on, White describes the “rise and fall of inebriate homes and asylums.” At the turn of the twentieth century, White writes, “a national network of addiction treatment programs was born, was professionalized, and then disappeared—all within the span of a few decades.” In his analysis of the dissolution of the early addiction treatment industry, White finds parallels with the precarious position of treatment providers today: a motley of institutional models for addiction treatment, conflicting professional interpretations regarding the nature of addiction, and unreliable political support.

One parallel is evident in contemporary treatment ads. While a combination of forces led to the decline of treatment centers a little less than a century ago, one of the most salient factors, it seems to me, was the economics of Gilded Age addiction treatment. Despite significant changes in theories of addiction, drug policy, and treatment trends over the course of the last century, the pitch for ritzy, private treatment centers has remained remarkably faithful to its early rhetoric.

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The Points Interview — Gabrielle Glaser

Editor’s Note:  Author Gabrielle Glaser offers some quick comments about her new book, Her Best-Kept Secret: Why Women Drink — And How They Can Regain Control (Simon & Schuster, 2013).

Glaser cover1.  Describe your book in terms your bartender could understand.

A few years ago I started noticing a big shift in the way women talked about their drinking. Sometime in the early aughts it began to appear as a cultural trope — women “needing” wine. I looked into why that was, and if it could be substantiated by facts. I found some numbers that were pretty convincing. I have always been intrigued by our country’s weird relationship with alcohol. My grandfather was a Canadian bootlegger and always said he had been in the “thirst” business. He was an amazing storyteller and his tales of driving whiskey across the border in the dark of night really stayed with me. I wondered how we had gone from prohibiting booze to Real Housewife Wine, and tried to tell that story.

2.  What do you think a bunch of drug and alcohol historians might find particularly interesting about your book?

Hey, most of what I know I learned from you guys. But the marketing of wine to women in the 1950s and 60s is something I had to piece together, and that was amazing. The pamphlets urging vendors to “Market to the Housewife! Explain Why She Needs Red Wine!” and the wine industry surveys are particularly charming — a piece of the puzzle. GlaserAlso, the idea that women began making wine, and pleasing their own taste buds, was also interesting.  (Women were behind the making of Chardonnay, which was easy for women to like — it had a smooth mouthfeel and was sweet.)  Likewise, marketers helped to demystify it.  I grew up at a time when only men would get the wine list, and the cork. It was intimidating.  No more.

3.  Now that the hard part is over, what is the thing YOU find most interesting about your book?

Oh, I loved the history, but that’s my thing. I spent hours with Axel Borg, the wine librarian at UC Davis (how fabulous is that? He’s a fantastic librarian in general but he knows everything about the history of California winemaking), and learned so much about the rocky road of wine acceptance in the US. I also had a blast looking at colonial booze recipes. Who wouldn’t want to come across Martha Washington’s recipe for “Capon Ale”? Every time I got frustrated with my lack of progress, I’d look at that recipe and laugh.

DTDB_PRE_BUDGET7.jpg - wine / alcohol

4.  Every research project leaves some stones unturned. What stone are you most curious to see turned over soon?

I’m not saying this to boost Ward and Roizen’s project, but I’d love to see a biography of E.M. Jellinek.  He was a fascinating guy.  What drove him?  What were his motivations?  Did he leave private journals?  Plus, there are so many funny titles you could make use of “Bunky.”

5.  BONUS QUESTION: In an audio version of this book, who should provide the narration?

Helen Mirren or Kathleen Turner. They haven’t asked yet.