AA NA meetingIs there an alternative to Alcoholics Anonymous? Do the 12 steps really work? These are questions that most alcoholics will ask when they decide that they want to change.

Alcoholics Anonymous (AA) originated in Akron, Ohio in the 1930’s from religious individuals grouping together to solve their alcoholism. The 12 steps soon emerged as a formula for all addicts to follow if they were to stay sober.

From the very beginning, complete abstinence was seen as the only answer. Of course this does work for some people, but clearly not for everyone.

Figures for how effective the 12 step recovery process is are impossible to find. Estimates suggest only about 5% of people who attend meetings regularly stay sober for more than a year. Not much more than the placebo effect really.

However, AA and NA (Narcotics Anonymous) do develop networks of community support, which is undoubtedly very positive. The support given is from other addicts or alcoholics of course, not trained professionals. And by their very nature the meetings are public access, anyone can attend.

The main objection many people have to the philosophy is its rigidity, so anyone who hasn’t seen them before must be wondering, what are these 12 steps then? Here you are –

  1. “We… admitted we were powerless over alcohol, that our lives had become unmanageable.”
  2. “Came to believe that a Power greater than ourselves could restore us to sanity.”
  3. “Made a decision to turn our will and our lives over to the care of God as we understood Him.”
  4. “Made a searching and fearless moral inventory of ourselves.”
  5. “Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.”
  6. “Were entirely ready to have God remove all these defects of character.”
  7. “Humbly asked Him to remove our shortcomings.”
  8. “Made a list of all persons we had harmed, and became willing to make amends to them all.”
  9. “Made direct amends to such people whenever possible, except when to do so would injure them or others.”
  10. “Continued to take a personal inventory and when we were wrong promptly admitted it.”
  11. “Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.”
  12. “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles.”

Any of you who are not particularly religious might be squirming a little right now.

The Higher Power issue is the biggest problem that people seem to have with Alcoholics Anonymous or NA.

Handing over responsibility for your problems and the solution of them, it doesn’t sit well with modern approaches to psychological self-help does it? SELF responsibility and empowerment are essential to good mental health.

“One of the things they (AA) tell you is you are powerless – you must submit, that’s stupid. Once you become sober, you realize you do have the power to quit.”

Strangely there’s not many references to alcohol in those 12 steps. Or indeed how to prevent yourself giving in to cravings. It seems like will-power, determination and faith are supposed to get you sober. That and some apologies of course.

Of course, there are different interpretations of these 12 steps, and many AA groups do advocate a more liberal approach, with the meetings themselves being seen as the higher power.

In my experience, people appreciate a more personalised view of their addiction and recovery, one in which each person’s background and personality are taken into account. The cognitive approach to addiction encourages the person to look at themselves and discover what they need to change, then helps them to make those changes in any sequence they choose. It provides strategies to understand the psychological mechanisms of your addiction.

The AA idea is to work through each of the steps with various written tasks. Should anyone relapse or have a drink at any point, they have to go back to step one and start again.

The alternative view suggests that abstinence is not the only option, for many people a healthier level of consumption is possible. We can help you to become the expert, so you are not dependent on either a group, or on your counsellor. You learn the skills to take control of your alcoholism.

The AA view is there is no cure for alcoholism or addiction, it is seen as a disease, which again slightly removes any personal responsibility from the equation – “I can’t help it, I’ve got a disease”. We view it more as a set of habitual patterns, cognitive and emotional automatic behaviours that can easily be un-learnt and replaced with something healthier.

So maybe there are alternatives to AA for alcoholics, ones with more flexibility and a more personal approach.