AA Pros & Cons

"Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism."
This is the A.A. preamble, read at countless meetings. Challenges to the 12-step philosophy refute that alcoholism is a disease, or that a reliance on a "higher power" can make a difference. Others insist that A.A. is a cult, and that the use of words like powerlessness excuse irresponsibility. There are those also who believe that strict exclusionary attitudes of some A.A. members harm the most vulnerable, and that the concept of anonymity is too fragile.

Powerlessness

• The first step in Alcoholics Anonymous is to admit powerlessness over alcohol. This can lead to a decision to avoid that substance, or it can lead to using powerlessness as an excuse to be a victim of circumstances. Young people may especially need to have mentors who embrace the concept of personal power in some areas of life. Many believe the A.A. program has several such paradoxes and that understanding and applying the A.A. principles takes time. Meanwhile, newcomers are advised to "take what you like and leave the rest."

Disease

• Is alcoholism a disease? It is listed in medical diagnostic books as a physical and mental disorder, with symptoms and criteria to meet the diagnosis. Certainly powerlessness over a disease is a much clearer concept--a person cannot control what happens to him when he is in the grips of a life-threatening illness. The difference is that not drinking causes remission of the disease, just as not eating wheat alleviates celiac disease, and not eating saturated fat may cure some cases of high cholesterol. The disease concept of alcoholism is a major controversy for those who believe A.A. is misleading the public--and the medical profession.

Cult

• There are many rituals to A.A., such as slogans and a book written by the founder, that some say is "scripture." It is true that the many followers of A.A. revere Bill Wilson and Dr. Bob, the two men who had the first experience of helping each other in an A.A. way. Literature is read repeatedly, and newcomers are welcomed with fervor, not unlike many churches. A.A. has traditions, however, that state "attraction rather than promotion," a clear warning against attempts to win converts. Another tradition asks members to avoid setting themselves up as spokespersons for A.A. in the media.

Spirituality

• A.A. claims not to be a religion, but the mention of God permeates the literature. The term "Higher Power" is used to qualify the assertion that God can be defined in any way, shape or form. Agnostic and atheist members are encouraged, in a chapter of the basic text dedicated to them, to try thinking of the collective consciousness of the fellowship as a power that can be relied upon to strengthen them against the insanity of taking a drink. Challengers point to the fact that meetings close with prayers, and not-so-subtle pressure is put on newcomers to "hit their knees" in privacy and ask for help. Members may reveal personal beliefs, but groups do not tolerate proselytizing.

All or Nothing

• The basic A.A. text makes allowances for medical situations, but many members do not feel comfortable sharing about the medications they take for chronic pain, anxiety or mental illness. Detractors complain that A.A. lumps all "mind-altering" substances together, although alcohol alone is mentioned in the literature. It is common to A.A. beliefs that a member does not have sobriety if she uses marijuana, recreational drugs or unnecessary prescriptions. Despite asking members to "be honest with themselves," a serious disservice may be done particularly to those who suffer from psychiatric illnesses when a misguided desire to "get off meds" is inadvertently supported.

Anonymity

• While A.A. literature suggests that members share "in a general way" when attending meetings and save details for the ear of a trusted sponsor, privacy is not legally protected. Sharing openly about unpunished crimes, infidelities or unethical business practices might land one in jail or in trouble with spouses bosses, or shareholders. Those who challenge A.A. on this basis say that anonymity is a false concept and the fellowship's principles are a "buyer beware" program. A.A. has no dues or fees for membership.