The believers

Downtown Atlanta is crowded today, so crowded that the traffic is at a standstill. A long stream of people heads towards the concrete complex of the Georgia World Congress Center, ambling past a three-piece band playing jaunty New Orleans jazz. The throng includes veteran bikers with straggly beards, smartly-dressed college kids and hundreds of volunteer stewards wearing green neon vests carrying the slogan “Happy, Joyous, Free”. Almost everybody here wears both a smile and a lanyard, which carries their AA name in bold letters: Jane M, Tim B, Brandy R, Renata H.

These people are here for the 80th birthday party of an organisation many of them credit with getting their lives back on track. They’re here for the Alcoholics Anonymous International Convention.

Bill Wilson, the founder of Alcoholics Anonymous

Bill Wilson, known by Alcoholics Anonymous members as Bill W (there are no surnames in AA-land), was a stockbroker with a drinking problem. In 1933, during the dying days of prohibition, he was necking three-and-a-half pints of cheap moonshine a day and living off the meagre earnings of his wife Lois. He recognised his problem and, after his brother-in-law agreed to foot the bill, checked himself into Towns Hospital, a smart clinic catering to New York’s upper crust inebriates. There he met Dr William Silkworth, a neurologist who had become convinced that alcoholism was not rooted in a moral failing or weakness of character, but that it was a physical illness triggered by the ingestion of alcohol in any quantity, no matter how small. Wilson was captivated by Silkworth’s belief that only abstinence could arrest the progress of alcoholism, which, in the doctor’s words, was “an obsession of the mind that condemns one to drink”.

To form the basis for Alcoholics Anonymous, Wilson combined Silkworth’s insights with spiritual enlightenment from an unlikely source – his old drinking buddy Ebby Thatcher, who had “got religion” and succeeded in giving up booze. Could worship, Wilson wondered, be the key to abstinence? In 1934 he received his answer. He was recovering in Towns Hospital for a fourth time when, according to AA lore, a great miracle occurred: his “hot flash” conversion. The room lit up with a white light and he felt the presence of God. He was free. He knew right then that he would never drink again.

“The Big Book, Wilson’s original text, was named one of the ‘Books That Shaped America’ by the Library of Congress in 2012”

Silkworth and Thatcher played a large role in Wilson’s journey to sobriety, but it was not until he met surgeon Robert Smith on a business trip to Akron, Ohio, in May 1935, that the idea of the AA was born. The two men had separately attended meetings of the Oxford Group, an evangelical Christian movement, and they formed a friendship that would last until Smith’s death from colon cancer in 1950. Together they came up with the idea of starting a group for alcoholics where they could spread their message of abstinence and prayer. The very first meeting was held in an Akron school hall in July 1935, 80 years ago.

AA chapters spread rapidly – the organisation claims that 100,000 alcoholics had recovered through its programme by 1950. Today, it says, AA meetings are held in more than 170 countries around the world. The Big Book, Wilson’s original text, written in 1939, was named one of the ‘Books That Shaped America’ by the Library of Congress in 2012 and has been translated in 69 languages, the latest being Twi, for people with a drinking problem in Ghana. It has proven extraordinarily resistant to huge advances in medicine, neuroscience and psychology in the intervening years; if you attend an AA meeting anywhere in the world you’ll still be introduced to Bill W’s 12 steps, the programme’s spiritual core. It’s a programme viewed by fans as inspired genius that’s helped save millions of lives – and by some critics as unscientific quackery.

“My name is Stephanie M and I’m an alcoholic,” says a middle-aged woman standing on the stage of the Georgia Dome, part of the World Congress Centre complex. A crowd of close to 60,000 people roars its approval. It turns out that Stephanie hasn’t touched a drop in 25 years – but to this audience, even this epic dry spell doesn’t mean she has ceased to be an alcoholic. One of the organisation’s core beliefs, based on Dr Silkworth’s research, is that alcoholism is an illness without a cure, a lifelong disorder. The crowd listens attentively while Stephanie tells her story – or, in AA parlance, “shares her experience, strength and hope” – and cheers its support at key moments. Like all AA “shares” (and at this Atlanta convention we hear a whole lot of shares) Stephanie follows a tried-and-tested format: the build-up of addiction, a turning point (usually a low point AA calls “bottom”) and a new, sober life.

She’s one of many people here celebrating booze-free lives – and a shopping centre has been created especially to cater for them. At Sober Village, a plethora of mom-and-pop outfits deal in all manner of sobriety-related goods: T-shirts with the slogans “Sober Princess” and “Spiritually Intoxicated” for the girls, and “Bill W Rode a Harley” for the bikers. Diamanté sobriety medallions are on sale, as are plenty of baubles based on the AA emblem, an encircled triangle. And then there’s the perfect gift for the true AA evangelist: a presentation box made of polished wood in which to keep Bill W’s Big Book, as though it were a sacred text.

At night the Tabernacle, an ornate 19th century music hall, hosts a “Sober Comedy Slam”, a sobriety-themed Muppet Show and a set from Tom Sway, who “performs an evening of original music inspired by his recovery from alcoholism”. It also hosts a talk by Clancy I, one of the biggest names in the organisation. The 87-year-old is idolised by his disciples in the Pacific Group, one of the largest AA meetings in the country, and his charity, the Midnight Mission, has been credited with getting hundreds of homeless people off LA’s Skid Row by applying an AA-style 12-step recovery programme to help them overcome their addictions.

Sober since 1958, he’s known as a no-nonsense speaker and he regales his listeners with vignettes from his misspent youth. “You aren’t an alcoholic because alcohol is your problem,” he tells the crowd. “You’re alcoholic because alcohol is your answer.” The solution, he insists, lies in the AA’s system of fellowship, a network of people who share their experiences and help each other stay off the booze. When I speak to AA’s press officer – a man so healthy-looking it’s hard to believe he’s ever so much as glanced at a shot glass – he echoes Clancy’s views. “Bill and Dr Bob discovered that one alcoholic can’t stay sober on his own. But when they share their experience, strength and hope with one another, they can overcome their disease”.

Carol from Vancouver, sober for 14 years, talks me through Bill W’s 12-step programme. She says that the first step, admitting powerlessness over alcohol, was the hardest but the most critical. “Coming to terms with the fact that my drinking was completely out of control and my life was unmanageable was the beginning of everything,” she says. “I thought I had bad luck, that I drank because I had problems, and through the first step I had the opportunity to learn that it was my drinking that was creating these problems. The support of the fellowship, a community of people working towards the same goals and living in a similar way, has helped me stay sober.”

Of the other 11 steps, God or an unnamed higher power, is mentioned in six: step two instructs members to believe that a “power greater than ourselves could restore us to sanity” while step six asks members to “be entirely ready” for “God to remove… defects of character”. AA meetings often take place in churches and commonly end in prayer. On its UK website, the organisation states that while the programme has Christian origins it is suitable for atheist or agnostic people, although “those who believe in some form of divinity often find it useful to incorporate the programme into the religious practices and vice versa.”

“We don’t have one-size-fits-all answers for heart disease, high blood pressure, or anything else. Why should there be a one-size-fits-all solution for this?”

With AA’s growth came controversy. As early as 1963, psychologist Arthur H Cain complained that the organisation’s once flexible philosophy had narrowed into “exclusive dogma”, closed to a spirit of enquiry and the admission of new knowledge.

The spiritual element of the programme, too, became a bone of contention: in his article in Harper’s magazine, Cain went as far as saying that the movement was “becoming one of America’s most fanatical religious cults”. Secularists have long seen AA with its Steps and non-denominational “higher power” as a religion by another name, an affront to the enlightened rationalism within which any medical treatment should operate. Cain also criticised “the concept of sobriety as the ultimate goal of life”, saying that “the very word ‘sobriety’ has taken on a religious flavour and is uttered with hushed awe, rather than spoken of as a condition necessary to health and happiness… Sobriety has, indeed, become the AA’s end which justifies any means.”

Whether you view AA as cult or cure, it’s famously difficult – impossible even – to get AA to debate these questions. In fact, it is one of its articles of faith that “AA does not engage in any controversy”. Bill Wilson counselled that: “when under sharp public attack or heavy ridicule … our best defence … would be no defence whatever – namely, complete silence at the public level.”

American journalist Gabrielle Glaser has written extensively – and controversially – about what she calls AA’s “irrationality and lack of effectiveness”. While it may help some people, she says, at the moment there’s an over-reliance on one system in the US – a system that’s black and white, dividing people into alcoholics and non-alcoholics, when in reality there is a spectrum of alcohol misuse, which should be addressed with appropriately nuanced therapies. “Alcoholism is a complex condition involving your genetic vulnerabilities physically and emotionally, as well as grief, trauma, depression, anxiety – and genetics play a very important role too,” she says, suggesting that AA is more grounded in religious belief and superstition than in modern science. “We don’t have one-size-fits-all answers for heart disease, high blood pressure, or anything else. Why should there be a one-size-fits-all solution for this?” She references other treatments including the use of cognitive behavioural therapy with a clinical psychologist and prescriptions for drugs such as nalmefene, which is designed to reduce the urge to drink alcohol.

While AA may have been portrayed by some as a panacea for alcoholism, however, it was not seen as such by its founders. Bill Wilson claimed that “it would be a product of false pride to believe that Alcoholics Anonymous is a cure-all, even for alcoholism. We must be … open-minded toward every new development in the medical or psychiatric art that promises to be helpful to sick people.”

So does AA work or not? In his 2014 book The Sober Truth, Dr Lance Dodes, a retired professor of psychiatry at Harvard Medical School, claims that the best evidence available puts AA’s success rate at between five and ten percent. However, Dr John Kelly, a professor in the same Harvard department cites a new study, due to be published early next year, that shows AA is “a clinical and public health ally in addressing endemic alcohol and other drug problems. Typically what we find is that when people are engaged in a 12-step-oriented treatment and go to AA, they have about 30 percent to 50 percent higher rates of continuous abstinence.” One of its major benefits, he says, is the opportunity for members to change their social networks, which can “reduce exposure to high risk drinking or drug-using situations and help build coping and resilience to stressors.” Crucially, unlike many other programmes designed to tackle alcoholism, AA is free, so there are no barriers to long-term use of the programme. This is vital because “addiction is susceptible to relapse even after several years of continuous remission.”

Unsurprisingly, AA sceptics like Glaser are thin on the ground in Atlanta. At a gay and lesbian party in a hotel ballroom – soft drinks only, obviously – I meet Orlando P, a 34-year-old from Detroit who works in a dental office while trying to develop his modelling career. Raised by a pastor who disapproved of homosexuality, Orlando took refuge in alcohol and drugs, which helped him feel more at ease. Within a few years he had become “a slave to drink” and after he lost his driving licence for the third time, his lawyer warned him that he was a danger to himself. “He said I was going to hurt myself if I didn’t get help, and I believed him,” he says. The lawyer pointed Orlando to AA. In his case at least, it was the start of a sober life.

“I changed my behaviour patterns and my friends,” he says. “My friends are in the fellowship now and we have coffee after meetings and sometimes dinner and things like that. I have no interest in going to bars. My dreams fell by the wayside because alcohol took precedence over them, but now they’re in the forefront again.”

“This programme has given me hope and freedom,” adds Orlando, who believes that in his case abstinence was the only possible solution for his addiction problems. “AA has given me my life back,” he says. “I’m not a slave to alcohol any more”

Posted on Monday, October 16th, 2023 - Categories: #20 - Jul-Sep 2015, App Issues.