Alcoholics Anonymous
Alcoholics Anonymous is a global, peer-led mutual aid fellowship dedicated to abstinence-based recovery from alcoholism through its spiritually inclined Twelve Steps. AA's Twelve Traditions, besides emphasizing anonymity and recovery from alcoholism as its only purpose, aim to keep AA free to all, with no governing hierarchy while avoiding public controversy. In 2021 AA estimated it was active in 180 countries with nearly two million members, 73% located in the United States and Canada.
AA dates its origin to a 1935 Ohio meeting between Bill Wilson and Bob Smith. Having met through the Christian revivalist Oxford Group, they continued under its aegis to fellowship with other alcoholics until forming what became AA. In 1939 the fellowship introduced its Twelve Steps with the publication of Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism''.'' Informally called "the Big Book", later editions amended the subtitle with "Thousands of Men and Women".
The Twelve Steps are a suggested, ongoing self-improvement program to abstain from alcohol through the aid of personally defined, but not required, "God as we understood Him". The steps begin with an acknowledgment of powerlessness over alcohol and the unmanageability of life due to alcoholism. Subsequent steps emphasize rigorous honesty, including the completion of a "searching and fearless moral inventory", acknowledgment of "character defects", sharing the inventory with a trusted person, making amends to individuals harmed, and engaging in regular prayer or meditation to seek "conscious contact with God" and guidance in following divine will. The final step, the 12th, focuses on maintaining the principles of recovery, sharing the message with other alcoholics, and participating in "12th Step work," such as peer sponsorship, organizing meetings, and outreach to institutions like hospitals and prisons.
AA meetings differ in format, with variations including personal storytelling, readings from the Big Book, and open discussions. While certain meetings may cater to specific demographic groups, attendance is generally open to anyone with a desire to stop drinking alcohol. The organization is self-supporting through member donations and literature sales. Its operations follow an "inverted pyramid" structure, allowing local groups significant autonomy. AA does not accept external funding or contributions.
In regards to AA’s effectiveness, a 2020 Cochrane review found that manualized AA and Twelve-Step Facilitation therapy demonstrated higher rates of continuous abstinence, and compared to other treatments, including cognitive-behavioral therapy, AA attendance over time resulted in better healthcare cost savings.
History
Hazard's search for treatment, spiritual conversion, & involvement with the Oxford Group
's journey from Carl Jung's psychiatric treatment to spiritual conversion through the Oxford Group played a pivotal role in shaping the foundations of Alcoholics Anonymous, influencing its principles of recovery. In 1926, Hazard went to Zurich, Switzerland, to seek treatment for alcoholism with psychiatrist Carl Jung. When Hazard ended treatment with Jung after about a year, and came back to the US, he soon resumed drinking, and returned to Jung in Zurich for further treatment. Jung told Hazard that his case was nearly hopeless and that his only hope might be a "spiritual conversion" with a "religious group".Back in America, Hazard went to the Oxford Group, whose teachings were eventually the source of such AA concepts as "meetings" and "sharing", making "restitution", "rigorous honesty" and "surrendering one's will and life to God's care". He became converted to a lifetime of sobriety while on a train ride from New York to Detroit after reading For Sinners Only, by Oxford Group member AJ Russell. Hazard underwent a "spiritual conversion" with the help of the Group and began to experience the liberation from drink that he was seeking. Members of the group introduced Hazard to Ebby Thacher, whom Hazard brought to the Calvary Rescue Mission, directed by Oxford Group leader Sam Shoemaker.
Bill Wilson and his spiritual awakening
In keeping with the Oxford Group teaching that a new convert must win other converts to preserve his own conversion experience, Thacher contacted his old friend Bill Wilson, whom he knew had a drinking problem. Thacher approached Wilson, saying that he had "got religion", was sober, and that Wilson could do the same if he set aside objections and instead formed a personal idea of God, "another power" or "higher power".File:AA - Medalj.jpg|thumb|upright=1.15|right|Sobriety token or "chip", given for specified lengths of sobriety. On the back is the Serenity Prayer. Here green is for six months of sobriety; purple is for nine months.
Feeling a "kinship of common suffering", Wilson attended his first group gathering, although he was drunk. Within days, Wilson admitted himself to the Charles B. Towns Hospital after drinking four beers on the way—the last alcohol he ever drank. Under the care of William Duncan Silkworth, an early benefactor of AA, Wilson's detox included the deliriant belladonna. At the hospital, a despairing Wilson experienced a bright flash of light, which he felt to be God revealing himself.
Founding of AA
Wilson's early efforts and influence of the Oxford Group
Following his hospital discharge, Wilson joined the Oxford Group and tried to recruit other alcoholics to the group. These early efforts to help others kept him sober, but were ineffective in getting anyone else to join the group. Silkworth suggested that Wilson place less stress on religion and more on the science of treating alcoholism. Bill W. would later write: "The early AA got its ideas of self-examination, acknowledgment of character defects, restitution for harm done, and working with others straight from the Oxford Group and directly from Sam Shoemaker, their former leader in America, and from nowhere else". According to Mercadante, however, the AA concept of powerlessness over alcohol departs significantly from Oxford Group belief. According to AA, alcoholism cannot be cured, whereas the Oxford Group stressed the possibility of complete victory over sin.Beginnings of AA
In 1935, AA began in Akron, Ohio, as the outcome of a meeting between Wilson—who became known as "Bill W." in AA circles—and Robert "Dr. Bob" Smith, an Akron surgeon, who would become Wilson's first recruitment success. On a business trip by Bill W. to Akron, he was introduced to the surgeon, who despite connections with the Oxford Group, was unable to stay sober. Bill W. explained that alcoholism affects the mind, emotions, and body, a concept he had learned from Silkworth at Towns Hospital in New York, where he had been a patient multiple times. Convinced by these insights, Dr. Bob took his last alcoholic drink on 10 June 1935 and never drank again. This date is regarded by AA as its inception.Bill W. and Dr. Bob started working with alcoholics at the Akron City Hospital. One patient, who soon achieved sobriety, joined them and together, the three men formed the foundation of what would later become known as Alcoholics Anonymous.
In late 1935, a new group of alcoholics began forming in New York, followed by another in Cleveland in 1939. Over the course of four years, these three initial groups helped around 100 people achieve sobriety. In early 1939, the fellowship published its foundational text, Alcoholics Anonymous, which outlined AA's philosophy; introduced the Twelve Steps; and included the case histories of 30 individuals who had achieved recovery. The Twelve Steps were influenced by the Oxford Group's six steps and various readings, including William James's The Varieties of Religious Experience. This publication marked a significant milestone in AA's development.
The first meeting outside the Oxford Group was held at Dr. Bob's house with 80 members in attendance. Dr. Bob began the meeting in his dining room by identifying himself as an alcoholic, and placing his foot on the dining room table, read the Sermon on the Mount from the Gospel of Matthew.
The first female member, Florence Rankin, joined AA in March 1937, and the first non-Protestant member, a Roman Catholic, joined in 1939. The first Black AA group commenced in 1945 in Washington, D.C., founded by Jim S., an African-American physician from Virginia.
The Alcoholic Foundation
In 1938, Dr. Bob and Bill created The Alcoholic Foundation in New York, bringing in friends of John D. Rockefeller Jr. as board members. Although they sought to raise significant funds, Rockefeller advised that large contributions might jeopardize the Fellowship. The foundation opened a small office in New York, funded primarily by AA members, to handle inquiries and distribute the Alcoholics Anonymous book. The next year, Rockefeller organized a dinner to promote AA, which further increased the number of inquiries. The office became effective. Each request received a personal reply and a pamphlet, enhancing interest in the book. Consequently, many new AA groups were established, and by the end of 1940, membership had grown to 2,000.Media coverage leads to expansion
In 1939, media coverage, particularly from The Cleveland Plain Dealer, generated a surge of interest and requests for help. The Cleveland group, although small, successfully assisted many alcoholics, quickly growing from 20 to around 500 members. A subsequent article in Liberty magazine resulted in a flood of requests for assistance, further expanding AA's reach. In 1941, The Saturday Evening Post published an article about AA, sparking a surge in inquires, and AA membership tripled over the next year. AA-related interviews on American radio and favorable articles in US magazines led to increased book sales and membership.As the growing fellowship faced disputes over structure, purpose, authority, and publicity, Bill W. began promoting the Twelve Traditions. He first introduced his ideas on these in an April 1946 article for The Grapevine, titled "Twelve Suggested Points for AA Tradition", aiming to preserve the organization's unity and purpose as AA expanded. He described the input he received as a "welter of exciting and fearsome experience" which greatly influenced the development of the Traditions. From December 1947 to November 1948, The Grapevine published the Traditions individually, and in 1950, the First International Convention in Cleveland officially adopted them.