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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