There is some evidence for the pessimistic view. ‘Old-timers’, as they are affectionately called, observe that in most groups newcomers outnumber them. If, as they like to say, ‘It works!’, the population of the long-term sober in AA should grow year by year into a majority. It doesn’t. Is it because members graduate from the fellowship into truant sobriety? Or, horrible thought, do most of those who pass through the meetings ‘lapse’?
AA, one concludes, is either the only nationwide, affordable alcoholism treatment that truly works, or it is a gigantic con: the drinker’s grandest illusion. No one knows for sure. My own view (based on two decades of intermittent attendance in the US and the UK) is that AA rescues three kinds of alcoholic. ‘Low-bottom’ drunks who have lost everything else can creep into the fellowship and live an institutionalised existence. Like Poor Tom’s hovel, AA is their shelter from the storm of the real world.
The second kind to derive help from AA is the ‘high-bottom’ alcoholic on the brink. Someone, that is, who still has a job, a family, a place in society – but who is in imminent risk of drinking all that away. For such drunks (I was one of them), AA supplies a breathing space and a springboard back to a sober, or at least more controlled, way of life.
The third, and most interesting of those who thrive in AA, are the virtuosos of the fellowship: mystics of sobriety and gurus of recovery. My guess is that the majority of those who come to meetings eventually go out to continue their drinking careers as unsaved by AA as by all the other remedies: atropine aversion therapy, antabuse, ECT, acupuncture, snake-pits – and, doubtless, in a year or two, gene-replacement therapy.
Authorities in the US take a very upbeat view of AA; it is, after all, as American as its airline namesake. The Program is integrated into court-sentencing practice in many states. Convicted DUIs (intoxicated drivers) are routinely obliged, in addition to other humiliations (handcuffing, a night in the drunk tank), to attend a course of AA or NA (Narcotics Anonymous). Typically, this means attendance at a dozen meetings.
In large conurbations these pressed men can nowadays make up a sizable part of the AA congregation. They tend to be a surly crew; not least because they have had to come to the meeting by public transport. Baffled by the proceedings and frequently pissed in both the American and British senses of the term, they can’t wait to get their court cards signed and reclaim their driving privileges.
Whether attendance is conceived by American judges as condign punishment (like Volpone being confined with the incurabili), as rehabilitation, or as moral tagging is unclear. It’s likely the courts do it as a sop to the immensely powerful pressure group, MADD (who would really rather drunk drivers were strung up on piano wire). Court-coerced drunks benefit little from AA – but they give the organisation a valued seal of official approval.
AA has similarly come to serve as an approved outpatient facility for the American health industry. Medical-benefit policies are specific about what treatment they will provide for addiction – typically a chronic and intractable condition. Coverage tends, in most plans, to be limited to a month per year, per family member.
Residential care for alcoholics – in what used to be called sanatoriums – is costly: the cheapest institutions run at around $5,000 to $10,000 a week; the most fashionable (such as the Betty Ford Clinic, at the delightfully named Rancho Mirage) cost much more. They are strange institutions, with something of the penitentiary about them. Their anthem should be Amy Winehouse’s ‘Rehab’ (she, tragically, died of drink aged 27).
The health management organisations (HMOs), which were set up in the US in the 1980s specifically to keep medical costs under control, take a similarly dim view of alcohol rehabilitation. If you are hospitalised for a drinking problem in the US, what routinely happens is a crash-course of ‘detox and counselling’, after which (within a few weeks at most) the still trembling patient is released into AA on a fire-and-forget basis. The prospect for these unfortunates is poor.
In its totality, AA resembles nothing so much as a terrorist network. There is no central organisation as such – just a honeycomb of cells on the ground, none of which directly communicate with each other, with HQ, or with the outside world. The Tenth Tradition is fundamental to the operation of these bodies: ‘AA has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.’ The fellowship has no views on politics or on anything (even alcoholism). It is pure praxis. On the ideological level, it remains faithful to its founder Dr Bob’s dying injunction to the faithful: ‘Keep it simple.’ Empty, that is, of complicating doctrine or confusing theory.
Nothing is emptier than the AA purse. The organisation accumulates no cash, capital or material assets. There are good reasons for this austerity. Alcoholics (whether practising or recovering) are hopeless with money. As well give them whisky. Those groups which collect funds to set up their own premises or accumulate treasuries for good works inevitably collapse in a welter of recrimination and relapse.
AA survives by virtue of its peculiar brand of communism. There are no dues. It will not accept bequests. Meetings are self-supporting (usually with a dollar in the basket – the Seventh Tradition). Any money surplus to immediate requirements (typically the hire of a dusty church hall, an urnful of acrid coffee and some cookies) is given away before it can do any harm.
The ritual of the AA meeting is familiar even to lifelong teetotallers from (usually melodramatic) depictions on film and TV. The alcoholic enters the meeting denuded of his or her identity, with only a forename between them and the similarly nameless group. The speaker ‘qualifies’ by confession: ‘My name is [Nicholas or Mary] and I am an alcoholic.’ If the speaker is a newcomer, a hearty round of applause will follow this bald proclamation. After that, beans are spilled. It is not merely identity that is blanked out by the anonymity gimmick – but social rank and hierarchical status. It is conceivable that a judge and the criminal he has sentenced can meet in a meeting. I once, to our mutual embarrassment, came face to face with a junior colleague.
There are two main varieties of AA meeting: ‘Speaker’ and ‘Participation’. As the names suggest, in one you will listen, in the other you may talk. The discourse in the Participation groups is distinctive. Dialogue (in AA-speak, ‘cross-talk’) is proscribed. One does not address one’s fellow-alcoholics, one ‘shares’. It looks to the outsider like seminar discussion but isn’t. It’s a bunch of people musing aloud; a kind of self-willed collective autism; pure Samuel Beckett. The ban on cross-talk is, like much else in AA’s procedure, prophylactic. Bad things happen when alcoholics communicate too directly with each other, as any bartender knows. Tempers are lost, fists are raised, nails brandished, knives and guns come out.
The disciplines and practices of AA are paradoxical in the highest degree – but not crazier than drinking, as its members never tire of pointing out. Warmth is overpowering within the group. But outside the group members shun each other’s company. There are no Masonic handshakes or codewords. This, too, is motivated by prudence.
Alcoholics are typically dysfunctional individuals – particularly with each other. The first informal advice newcomers tend to be given is: (1) never borrow money or lend it to a fellow-alcoholic; (2) never buy a car from a fellow-alcoholic; (3) above all, never fuck a fellow-alcoholic. Outside the cloying intimacy of the group, it is a fellowship of strangers.
An exception is made for the ‘sponsoring’ relationship – something universally encouraged but not formalised by the Program. Newcomers are always told to immerse themselves in AA – 90 meetings in 90 days is the standard prescription. At its simplest, this is a weaning process; something to fill the huge socket left in the former drinker’s life where booze used to be. It is also, as any psychologist will recognise, standard induction routine – especially when associated with physical exhaustion (few detoxing drunks sleep well). But, however many meetings he dutifully attends, the newcomer will probably need day-round support: a babysitter, that is, to call wh
en a ‘slip’ is imminent – perhaps at some grossly anti-social hour of the night. This is where the sponsor comes in.
Necessarily, the sponsor-sponsee relationship flouts the non-hierarchical conventions, the prohibition on cross-talk and the anonymity principle. It can lead to emotional dependency and exploitation. There are suggested safeguards. Cross-gender sponsorship is strongly discouraged. Ideally, the sponsor should be the elder of the pair (in years and sobriety) – allowing a mellowly avuncular relationship to develop. But sponsoring is fraught with difficulty and is a component of the AA machine that often goes wrong. It is abuse of the sponsoring relationship that led, most recently, to accusations that AA is a cult – scientology for drunks.
Bill W. and Dr Bob’s organisation is, of course, much nobler than L. Ron Hubbard’s bunco scheme. AA meetings are, with baseball games, the only truly democratic events in America. The typical AA group is an omnium gatherum in which all sectors of American life and society are represented in conditions of genuine social equality. Alcoholism is no respecter of class.
Clustered around the big meetings are myriad self-selecting grouplets (usually Participation meetings) of a more homogeneous kind: tinkers, tailors, soldiers, sailors, rich men, poor men, beggar-men, thieves all have their own AA sessions. These tend to be closed occasions, unadvertised in the fellowship’s ‘blue book’ or websites. They can be hard to find unless you doubly ‘qualify’. Many Hollywood stars, for example, attend AA. But you won’t find yourself sitting next to Christian Slater or Robert Downey Jr– unless you happen to be in the industry and making seven-figure alimony payments. There is no copyright on the 12-step Program and any number of imitative therapies have borrowed it: Al-Anon, Al-Ateen, Chocanon, MA (Marijuana Anonymous), Weightwatchers. Most are pallid imitations.
AA’s theology and medical science are primitive but serviceable. The movement was largely inspired by Frank Buchman’s Oxford Movement (the same movement that gave us Moral Rearmament and Mrs Whitehouse). True to its enthusiastic origins, AA believes in the regenerating effect of ‘total’ confession of sin and human inadequacy: ‘We admitted we were powerless over alcohol [but] came to believe that a Power greater than ourselves could restore us to sanity’ (in the original 1939 formulation, the salvationary word was ‘God’, not ‘Power’). Evangelical Christianity remains the dominant flavour in AA’s ideological mix. There are few more culturally perplexing sights than seeing a group in, say Beverly Hills, composed largely of alcoholic Jews having to finish a meeting with a choric recitation of the Lord’s Prayer.
The ‘higher power’ to which AA members are obliged to surrender themselves as their second step to sobriety is manifestly the deity of Billy Graham, Lord Longford and Jeanette Winterson’s mother. AA has always been an aggressively evangelical movement. The twelfth and final step – that of carrying the AA message to the ‘alcoholic who still suffers’ – imposes the role of proselyte on every active member of the fellowship (if I were conscientious, I would insert a website address here).
Medically, AA cleaves to the disease concept of alcoholism. Those ‘alcoholics who still suffer’ are conceived to be in the grip of an illness that is ‘cunning, baffling and powerful’. The recovering alcoholic is never cured – but must imagine himself in a kind of protracted remission; as with the diabetic, relapse is always imminent (particularly if you stop going to meetings – the insulin analogy is often made). AA holds to the superstition that the alcoholism progresses inexorably, even when you are not drinking. Should you fall off the wagon, after 20 years of sobriety, your disease will be two decades more terminal. ‘Rust’, as Neil Young (the alcoholic’s favourite balladeer) puts it, ‘never sleeps.’
The belief that they are victims of an illness allows recovering alcoholics to forgive themselves for the awful things done in drink. Few alcoholics, by the end of their drinking careers, have not committed offences that the sober mind shudders at. But, although AA subscribes to the disease of alcoholism, it despises the medical establishment whose business disease is. Routinely at meetings, scorn is poured on the ‘ignorant professionals’. As a favourite joke puts it: ‘There are those who say doctors don’t know everything. And there are those who say doctors don’t know nothing.’ AA is firmly of the second party.
Alcoholics have good reason for disliking doctors and psychiatrists and for jeering at their ignorance (despite the fact that doctors themselves are notoriously prone to alcoholism). Traditionally, the medical schools and teaching hospitals of America and Europe have given their students abysmally inadequate instruction on the nature of the ailment.
Many alcoholics who apply for treatment find the conventional health services too busy to mollycoddle sots like them. There are patients with real illnesses to treat: broken bones, cancer and acne. Sitting two hours after appointment time in the waiting room at the Maudsley hospital in south London (Bedlam, as it once was), with a splitting hangover, in the company of the stark staring mad is a foretaste of hell. AA bases its good works on the shrewd analysis that drunks know better how to deal with fellow-drunks than doctors for whom drunks are a job of work or raw material for a career-advancing research project. AA places special stress on welcoming rituals, designed to allay the newcomer’s crippling shame and make him feel at home. And genuinely wanted.
The trickiest aspect of the AA Program is its moral prescriptions. While accepting that the alcoholic is sick, AA enjoins them none the less to ‘make direct amends’ for past misdeeds committed under the influence. From a purely practical point of view, this Ninth Step is a vital part of the Program. It requires the penitent husband and father, for example, to go back to his injured family, to square things with his cheated partner, and settle up with his creditors as best he can. ‘Cleaning house’ is the homely metaphor AA applies to this phase of recovery. AA, originating as it did in small-town America, is strenuously opposed to what it scornfully calls ‘geographical’ cures: that is, making a new start in a new place. You get sober where you got drunk.
The ‘amends business’ is, however, deeply contradictory. The alcoholic is reassured he is the victim of disease – no more responsible for his misdeeds than a tubercular is for coughing. Yet, at the same time, he should regard himself as a repentant sinner who must fully atone for what he has done. Recovery, as AA defines it, requires energetic doublethink to be brought to a successful conclusion.
The architecture of the AA meeting is a mixture of the rigid and the fluid. Speaker meetings are organised around a liturgy of quite stunning tedium: readings from the Big Book, prayers, the award of monthly chips and anniversary cakes (accompanied by toe-curling choruses of ‘Happy Birthday’), hand-holding, embracing, chants (‘Hi, John!’). This is evidently necessary to create a structure for the incoming drunk in freefall or those whose sobriety is fragile. The structure is always there and always the boring same; a reassuringly solid thing in a dangerously liquid world.
What is rarely boring is the drunkard’s tale, which every Speaker meeting features. It occupies the central position of the sermon in a conventional church service. ‘Our stories’, as the AA dogma puts it, ‘disclose in a general way what we used to be like, what happened, and what we are now.’ Every drunk has a story in him. AA wants to hear it. Speakers are applauded for their skill and humour in telling their stories (homily and gravity are disliked; a little pathos is OK). For large meetings, the invitation to speak is honorific and the best speakers build up a faithful following.
Participation meetings follow the Quaker pattern. They tend to be patronised by alcoholics well beyond the tremulous 90-day threshold; initiates who have learned how to talk the talk. They talk as the spirit moves. Often an abstract theme will be proposed: Faith, Hope or Charity, for example. But the subsequent ‘sharing’ quickly becomes a freewheeling affair; anecdotes, not stories, predominate. The dynamics of both kinds of meeting put a premium on eloquence and theatrical display of ego. The dominant rhetoric is a kind of Twainian vernacular. At American AA meet
ings you will find descendants of ring-tailed roarers, pork-barrel philosophers, stand-up comedy of a high order, wit, and a broad vein of red-neck shrewdness. It can be very entertaining. As much fun as drinking, as they like to say, but without the hangover and all for a dollar.
Can AA survive? It has outlasted the death of its founders (Dr Bob went in 1950, Bill W. in 1971). But the fellowship’s apparatus is clearly in need of some doctrinal overhaul – something that its lack of central organisation, or living patriarchs, renders tricky. The Big Book, the fount of AA wisdom, is – after 60 years and some ten million sales – creakingly anachronistic. A glaring example is the crucial Fourth Step, which obliges alcoholics to make ‘a searching and fearless moral inventory of ourselves’.
‘Making moral inventory’ is a figure of speech that would have made perfect sense to a 1930s white-collar clerical worker – a Dagwood Bumstead or a Babbitt – familiar with small-store stock-control. It would make sense to a grocer’s daughter from Grantham (‘Our name is Margaret, and we are not an alcoholic’). The notion of ‘making inventory’ makes less sense to multi-addicted Hispanic kids from the barrio for whom small stores are something you break into.
What is most valuable in AA and should not be lost is the set of pragmatic tools that it has evolved over the years; its working parts. It remains, as a no-cost and (probably) effective treatment for an insolubly epidemic problem, the brightest of America’s thousand points of light. But the movement desperately needs a New Testament and a Messiah for the new millennium. Jesus C. where are you?
My Story
Like The Thousand and One Nights, AA is an organisation founded on never-ending narrative. You recover by telling your story, and hearing the stories of fellow-alcoholics. It is not a ‘talking’ but a ‘tale-telling’ cure. The alcoholic’s tale is distinctively different from other verbal therapies: the Catholic’s confession, the Puritan’s cleansing ‘spiritual autobiography’, or the Freudian analysand’s grudging revelations on the solitary couch.
Last Drink to LA Page 5
