Aa history Lovers 2010 moderators Nancy Olson and Glenn F. Chesnut page

Hemsley, that

joining the organization had done wonders for his game. Wilson and the

founding members were not quite prepared for the sudden success. "You had

really crazy things going on," says William L. White, author of Slaying the

Dragon: The History of Addiction Treatment and Recovery in America. "Some AA

groups were preparing to run AA hospitals, and there was this whole question

of whether they should have paid AA missionaries. You even had some reports

of AA groups drinking beers at their meetings."

The growing pains spurred Wilson to write AA's governing principles, known

as the 12 traditions. At a time when fraternal orders and churches with

strict hierarchies dominated American social life, Wilson opted for

something revolutionary: deliberate organizational chaos. He permitted each

group to set its own rules, as long as they didn't conflict with the

traditions or the steps. Charging a fee was forbidden, as was the use of the

AA brand to endorse anything that might generate revenue. "If you look at

this on paper, it seems like it could never work," White says. "It's

basically anarchy." But this loose structure actually helped AA flourish.

Not only could anyone start an AA group at any time, but they could tailor

each meeting to suit regional or local tastes. And by condemning itself to

poverty, AA maintained a posture of moral legitimacy.

Despite the decision to forbid members from receiving pay for AA-related

activity, it had no problem letting professional institutions integrate the

12 steps into their treatment programs. AA did not object when Hazelden, a

Minnesota facility founded in 1947 as "a sanatorium for curable alcoholics

of the professional class," made the steps the foundation of its treatment

model. Nor did AA try to stop the proliferation of steps-centered addiction

groups from adopting the Anonymous name: Narcotics Anonymous, Gamblers

Anonymous, Overeaters Anonymous. No money ever changed hands-the steps

essentially served as open source code that anyone was free to build upon,

adding whatever features they wished. (Food Addicts Anonymous, for example,

requires its members to weigh their meals.)
By the early 1950s, as AA membership reached 100,000, Wilson began to step

back from his invention. Deeply depressed and an incorrigible chain smoker,

he would go on to experiment with LSD before dying from emphysema in 1971.

By that point, AA had become ingrained in American culture; even people

who'd never touched a drop of liquor could name at least a few of the steps.
"For nearly 30 years, I have been saying Alcoholics Anonymous is the most

effective self-help group in the world," advice columnist Ann Landers wrote

in 1986. "The good accomplished by this fellowship is inestimable . God

bless AA."

There's no doubt that when AA works, it can be transformative. But what

aspect of the program deserves most of the credit? Is it the act of

surrendering to a higher power? The making of amends to people a drinker has

wronged? The simple admission that you have a problem? Stunningly, even the

most highly regarded AA experts have no idea. "These are questions we've

been trying to answer for, golly, 30 or 40 years now," says Lee Ann

Kaskutas, senior scientist at the Alcohol

.htm> Research Group in Emeryville, California. "We can't find anything that

completely holds water."
The problem is so vexing, in fact, that addiction professionals have largely

accepted that AA itself will always be an enigma. But research in other

fields-primarily behavior change and neurology-offers some insight into what

exactly is happening in those church basements.

To begin with, there is evidence that a big part of AA's effectiveness may

have nothing to do with the actual steps. It may derive from something more

fundamental: the power of the group. Psychologists have long known that one

of the best ways to change human behavior is to gather people with similar

problems into groups, rather than treat them individually. The first to note

this phenomenon was Joseph

[17]

att+physician&source=bl&ots=gc6zfxK_oF&sig=dsQJBlk91ptVWmOw3H74N3gfXPo&hl=en

&ei=v9UbTMPmE8Wblgfds8GjDQ&sa=X&oi=book_result&ct=result&resnum=6&ved=0CCwQ6

AEwBQ#v=onepage&q&f=false> Pratt, a Boston physician who started organizing

weekly meetings of tubercular patients in 1905. These groups were intended

to teach members better health habits, but Pratt quickly realized they were

also effective at lifting emotional spirits, by giving patients the chance

to share their tales of hardship. ("In a common disease, they have a bond,"

he would later observe.) More than 70 years later, after a review of nearly

200 articles on group therapy, a pair of Stanford University researchers

pinpointed why the approach works so well: "Members find the group to be a

compelling emotional experience; they develop close bonds with the other

members and are deeply influenced by their acceptance and feedback."

Researchers continue to be surprised by just how powerful this effect is.

For example, a study published last year in the journal Behavior Therapy

concluded that group therapy is highly effective in treating post-traumatic

stress disorder: 88.3 percent of the study's subjects who underwent group

therapy no longer exhibited PTSD symptoms after completing their sessions,

versus just 31.3 percent of those who received minimal one-on-one

interaction.
The importance of this is reflected by the fact that the more deeply AA

members commit to the group, rather than just the program, the better they

fare. According to J. Scott Tonigan, a research professor at the University

of New Mexico's Center on Alcoholism, Substance Abuse, and Addictions,

numerous studies show that AA members who become involved in activities like

sponsorship-becoming a mentor to someone just starting out-are more likely

to stay sober than those who simply attend meetings.
Addiction-medicine specialists often raise the concern that AA meetings

aren't led by professionals. But there is evidence that this may actually

help foster a sense of intimacy between members, since the fundamental AA

relationship is between fellow alcoholics rather than between alcoholics and

the therapist. These close social bonds allow members to slowly learn how to

connect to others without the lubricating effects of alcohol. In a study

published last year in Alcoholism Treatment Quarterly, Tonigan found that

"participation in AA is associated with an increased sense of security,

comfort, and mutuality in close relationships."
And close relationships, it turns out, have an even more profound effect on

us than previously thought. A 2007 study of a Boston-area community, for

example, found that a person's odds of becoming obese increase by 71 percent

if they have a same-sex friend who is also obese. (Wired covered the study

in more detail in "The