Whenever I am in a meeting, sooner or later I always return to the same thought stream over and over again. That thought is, “Why isn’t AA more successful than it is?”
The Best and Only Way
I have to be cautious sharing this thought with others, as many in AA have very strong opinions about the efficacy of the program as it has been historically presented. These opinions can be summarized, “It’s the best solution there is for alcoholism!” Or, “It’s 100% effective for the people it works for!”
Then, there is the argument that ends all further discussion, “If it ain’t broke, don’t fix it!” And, it is true, that when AA is compared to all other treatments, AA is the most effective – at least according to a study by Kelly, Abry, Ferri, and Humphries, “Alcoholics Anonymous and 12-Step Facilitation Treatments for Alcohol Use Disorder: A Distillation of a 2020 Cochrane Review for Clinicians and Policy Makers.”
How Can We Help More Alcoholics?
I greatly appreciate how people whose lives have been changed working the AA program would not want to tinker with it. I get that. But, I think we all have to agree, despite all that do get sober, many don’t. Diagnosing why this is the case is difficult. Commonly heard reasons such as, “They didn’t want it bad enough!’ Or, “I guess they just weren’t ready,” are both just blaming the victim as far I’m concerned.
Rather than blame, which leads to no solution, I suggest we look at ourselves to see where AA might be wrong then try to fix it. While the AA program has many wonderful details to it, I often wonder, is there a chance our program might benefit from making some changes to it?
How About Some Simple Updating?
After spending many decades in AA, hearing people talk all across the USA, taking folks through the steps, and reading most of the AA literature, I am of the opinion that the program needs serious updating. Honestly, it’s all bit of hodgepodge. The AA materials, good as they are, are not comprehensive or part purposeful whole. Often someone seeking simple direct answers has to read many publications, talk to many members, and in the end often lands on unclear or contradictory answers.
I know changing anything in AA is an unpopular position. But, I think if the goal is to help more people get sober, some very basic changes are necessary. One example would be a companion volume to the AA Big Book that explains alcoholism in light of advances in medicine and addiction studies. A lot of material on recovery has been gathered in the past twenty years that if presented in the right way might provide some additional context to newcomers of what to expect while encouraging them to hang in there.
Evidence from the referenced study above states that the combination of AA and psychotherapy is particularly effective in driving longer-term abstinence outcomes. Better than just AA. Good to know, right?
These types of changes are both additive and relatively easy to implement. So, why not do them? More people might get sober!
What About Bigger Changes?
Far more controversial than additive changes are making more broad ones that tamper with the twelve steps or the Big Book’s first 164 pages. Suggest this and you can quickly be run out of town, so to speak. People have a very deep fondness and connection for the program they remember and want to keep it intact.
For me, recovery is not a museum preserving favorite ways of doing things, but a collection of concepts that should be dynamic, that help people get and maintain sobriety. I also think given the age we live in, parts of the Big Book could stand some revision. I say this because as it stands, to a newcomer, the Big Book is confusing – unnecessarily so.
One Such Idea
I think the Steps are too complicated and anachronistic and do more, today, to alienate newcomers than bring them into the program. They need revising.
Change the Steps? Are you out of your mind?
The Steps came from Bill and Bob, and before them, God the Almighty! Many view the steps as timeless and eternal, “a gift from God!”
Again, “if it ain’t broke….”
This feeling of the program being sacrosanct is so strong that in recent years there have been movements to roll back the clock on the Program to reset to “how it was originally done!” As if that’s the better way to it. Why is this happening? Because many come to AA and don’t get sober the way it is today. But before we return to the glory days of the AA program, with cigarettes and a total lack of diversity in the rooms, maybe we should try to get AA moving forward instead of looking in the rearview mirror.
The Five Steps
One way of modernizing the AA Program is by simplifying the Twelve Steps to Five Steps. The Five Steps are simpler, more direct, and almost all action-oriented. A sponsor could still refer to the original twelve when working with a new person doing them. In my experience, I have found these five steps, some amalgams of the original twelve and one new one, to be the most essential ones.
- Get a Sponsor.
- Inventory and Confession.
- Principled Living.
- Give Back to AA and Sponsor Others.
These five steps are the “action” part of the program, and in my experience where the power is. Most everyone I know who is sober a long time has done (or is doing) those five-steps. Because of this, I think they should be emphasized. Let me elaborate a bit.
The fact that sponsorship is not overtly discussed in the first 164 pages of the Big Big is an enormous oversight. Many, if not all, would agree that having a sponsor is THE game changer for staying sober. Yet to find a clear elaboration of sponsorship in AA literature, you need to find a pamphlet that very few read or even know of that was initially written in 1944. Because the idea of getting a sponsor is so critical to successful recovery it should be front and center in the steps – Step One.
Writing an inventory as described in the Big Book, is typically the first real “action step” one takes. Once someone starts writing this inventory in earnest, if they finish and then share with their sponsor or other AA, they are well on their way to a sober life. In addition, an inventory without “giving it away” to someone, can actually do more harm than good. Hence these two steps should be combined into one – Step Two.
Amends for many is THE personally transformative step. Clearing up broken relationships and making proper restitution will reset one’s life like nothing else. This reset is critical to staying sober. I’ve seen many an AA make great progress toward sober living, then drink again. The reason, they either never made or didn’t finish making their amends. Amends are just that important. Do them, and your life will never be the same – Step Three.
Having completed these three steps and having a desire to stay sober, it is time to live life in a new way – with principals. The selfish, self-centered, ego-driven and emotional ways of old need to recognized and tamed through the development of new approaches to life. These approaches are driven by principals that include empathy, conscientiousness, kindness, and love (to name a few). Principled Living – Step Four.
Finally, as my sponsor told me, “if you’re sober and not giving back to AA, you’re stealing!” He’s right. If AA changed your life, most likely it was changed, unbeknownst to you, by the people who were there when you go there. They were setting up and leading meetings, making coffee, and welcoming you. As someone who is transformed, now it’s your turn to give back. Most important, you need to give back directly through sponsorship, and you have to want to do this. Very few become sponsors by accident. Make it a goal and you will help transform another life. Give Back to AA and Sponsor Others – Step Five.
Some Question to Ponder?
Would a simpler, more direct, and modern approach to the steps help more people get sober? I don’t know. Nor do I know if adding some new ideas in a companion Big Book volume (not written by Bill) is even possible.
Does a book written 80 years ago full of God-talk and very little about science alienate folks? I don’t know.
Would changing what we have, in any way, make us even less effective? I don’t know that either.
What I do know is the way AA stands today, we’re not serving all those who need us. Too many are living in addiction rather than in recovery. I’d like to change this.
We all have affection for the steps and Big Book, but, the world is different today and will continue to change. Can AA change with it?
My hope is that AA can. The AA community should begin to approach the difficult job of taking a critical eye to the AA sacred cows. There are a few.
I say this because alcoholism is still killing people and making life tough for so many families and loved ones. Can’t we come together and discuss what we’ve learned? Then, we can work to create a simpler and more clear approach to recovery sober living?
I think we can. I present these thoughts as a starting point.