DRAFT July 10, 1994

Common Goal <<>> Distinct Means

by : Dennis Bauer

Recovery from alcoholism was a true miracle in 1939 when Alcoholics Anonymous entered the scene. Quite unlike todayUs world in which the recovery process, which has come to be identified with A.A., finds broad acceptance and is seen as common-place. Alcoholics Anonymous is most often described as a Rself-helpS program, even among the members of the Fellowship itself. This description, along with the Rgroup therapyS nomenclature, has led to much confusion among professionals of all kinds, members of the media, writers in general, and the public at large. So much so that it has begun to displace the original concept in the minds of AA members, many who received their first description of AA through these Rthird party care-givers.S In order to retain its own concept of its purpose and function, the time is upon the members of Alcoholics Anonymous to clarify their place in the alcoholism recovery experience.

RSelf help,S while an easily used description of AA is in actuality a misrepresentation of the recovery experience as provided by the Twelve Steps of Alcoholics Anonymous. A far more accurate description would be to present AAUs program as a Rspiritual helpS or Rself responsibilityS program. While those using the self-help term do so with the very best of intentions, the common usage of that term implies a return to the age old idea of Rwill power.S

It is at this early juncture that a difficulty begins for the potential recovering alcoholic who is headed, or being guided, in the direction of membership in Alcoholics Anonymous. Whole societies have sprung up due to this simple miscue. The alcoholic, who has sought a lifetime to exercise his or her own power, comes to Alcoholics Anonymous with the misconception that they must exercise this power. Self-empowerment appears to the newcomer to be the proper approach to the problem at hand.

In the professional setting this may well be the correct approach. There exists a contained environment, a vehicle to exert peer pressure, and professionals trained in determining whether the power exerted by the individual is focused in a reasonable direction. Behavior modification requires effort on the part of the patient and the medical/treatment approach places a great store on treating the symptoms first in order to stabilize the patient. This to good effect and purpose.

This approach, however, does not transfer well into the AA environment. Here the accurate description would be self responsibility. The responsibility falls to the individual to seek out the methods and actions which might be used to remain sober. While this takes every bit as much personal exertion as previously noted in the professional environment, its focus is quite different.

In the professional setting a standard is set and the person must exert their will in order to reach this agreed upon goal. The intended end-point predicts the direction and the effort. Working within the framework of the Twelve Steps the goal is unattainable in its complete form QRIto fit ourselves to be of maximum service to God and our fellows.S Therefore the small actions which constitute the attempt to reach maximum usefulness are what are paramount. Working with a focus which is less definitive in its end-point, self determination becomes virtually impossible. Only by placing oneself in a environment whereby ones progress can be viewed through the eyes and experience of others is it possible to make progress in any substantial way. The full responsibility falls upon the individual to seek rather than decide, to make the effort toward the goal rather than accomplishing it.

One of the unfortunate side-effects of the aforementioned misunderstanding has been an erosion of the level of responsibility with the AA fellowship. With large numbers of AA members focused on Rhelping themselvesS the natural sense of purpose and responsibility for survival of the whole has fadedQalmost out of view. The impact has been to create more self-centeredness rather than other-centeredness.

To underscore this misconception, the term Rgroup therapyS has provided additional impetus. The RgroupS in a professional setting fulfills a considerably different role than it does within Alcoholics Anonymous. In the professional world the group shoulders the burden of setting standards, judging performance, and communication of the demand that performance meet the standards set. In the near past this was often where the practice of confrontation took place. Today one will find more of a negotiation approach being used. None-the-less, this differs greatly from the AA approach.

As is noted in the book, Alcoholics Anonymous, Rdefiance is the outstanding character of the alcoholic. The Twelve Steps and Twelve Traditions take this central fact into account in presenting a program of recovery to the potential member. They place the responsibility squarely on the individual for becoming aware of and modifying their behavior. Life, in general, and active alcoholism, in particular, become the disciplinarians. For most it takes little time to come to the realization that their battle is with, and within, themselves. With great wisdom, born out of tragic experiences, Alcoholics Anonymous refuses to offer the alcoholic an opportunity to create the illusion that the problem lies anywhere other than with, and within, themselves.

Confrontation and Rgroup therapy,S on the other hand, provide excellent distractions unless carefully managed in a professional manner. Since AA has made it a policy to remain free of professional services, these two endeavors are beyond its scope.

Another difficulty felt by Alcoholics Anonymous, also tied to the Rself-help/group therapyS misconception is the perception that Ra drug is a drug.S The inference is that the common denominator need only be an illness from which the person wishes to recover. In its severest cases this extrapolates to emotional restlessness as the core factor. Many a battle has raged before, during, and after group meetings over this attempt at global inclusiveness.

Here again we see practices used within the treatment community which are significantly different from those within AA. In the treatment setting there is a significant need to educate and, as noted earlier, treat the immediate symptoms. There occurs a sharing of definitions, discussions concerning life styles, a comparison of experiences looking for the common pattern, and a fueling of the resolve to change. The exchange is primarily intellectual and educational.

The process within Alcoholics Anonymous is significantly different. Here the exchange must occur across a bridge built of shared experiences. The luxury of appealing to the intellect is, at best, a dubious one for the AA who wishes to assist someone in getting or staying sober. When on the firing line of daily living the newcomer is faced with the temptation to drink, or take an action which would result in drinking, time is of the essence. There is simply not enough time to achieve common definitions or provide attractive scenarios as alternatives. There must be a link established over which virtually absolute trust flows easily. Often it is only that link which means the difference between sobriety and drunkenness. Time and time again it has been across this connection that the Rhand of AAS has truly been extended with maximum meaning and effectiveness.

It will be the most devastating of errors for the person who suffers from an affliction other than alcoholism to think that they, too, can rely upon this safeguard. What a terrible shock it must be to reach that moment of despair only to slip slowly back to the horror of the past. To do so as the result of incorrect information given by those one has trusted must be an entirely disheartening experience. What works well in a closed environment fares poorly in the open world.

It comes as no real surprise, when the concept of Rself helpS is used, that the next step would be to bolster a persons sense of themselves. Self-esteem is vital to self-help. Again, what works under one set of conditions suffers badly under another. In a carefully monitored setting it is possible to affect a new self-concept in a person. This can occur after much examination and reassurance by others. Essentially the experience is Rif they can believe this of me, then I can too.S Thus the professional friends of Alcoholics Anonymous attempt to prepare their charges for AA. Theirs is the hope of convincing the person of their inherent value or goodness. In the professional setting there is time to turn illusion into reality, but as noted earlier, this is a luxury not attainable in the open world.

The program of Alcoholics Anonymous provides this element of spiritual growth through another means. AA recognizes the fact that the alcoholic is always aware, within themselves, when they are facing the truth and when an illusion is being created. A positive sense of self is therefore reached by Rclearing away the wreckage of the past.S In this way the new sense of self is not a cosmetic one, but an actual rebuilding of the psyche. There is no attempt to convince the person of their valueQthey are set upon a path by which that discovery is made along the way. Being a discovery, it becomes fact far more easily that through any other means. The alcoholic, being essentially of an all or nothing mind, must live entirely with fact or they begin to opt for the ultimate illusion. Since there are no external controls in the AA environment there is little time to move from illusion to reality. It must be reality, or its closest possible facsimile, that is the order of the day for the alcoholic in AA.

Finally, there is one liability AAUs professional friends suffer from that Alcoholics Anonymous easily avoids. In the medical/treatment world much of the information upon which decisions are based is arrived at by the self-reporting of the patient/client. Even with the most diligent attempts at ferreting out the truth, the professional is always at a disadvantage. For them it is a matter of carrying out a responsibility to the individual and the professionals own calling. For the alcoholic the battle over truth or illusion is a matter of life and death. Any realistic appraisal of a patient/clients records must allow for a factor of falsehood. Bearing this in mind, the care provider will always be basing their treatment plan on some greater or lesser degree of fictional information. There will always be matters unresolved or unattended.

The Fellowship of Alcoholics Anonymous cannot suffer from this quirk of the alcoholic. Since it does not offer advice to the individual, it need not rely on the reporting done by the person. Again, the responsibility falls directly on the alcoholic trying to get sober. This frees AA from attempting to provide anything other than a place whereby examples can be seen of its program of recovery in action. There is nobody to fight, nobody to please, and nobody to make decisions for the person wanting sobriety. The example and the opportunity are clearly present. As is noted in the book, Alcoholics Anonymous, RIthe kit of spiritual tools is laid at the feetS (of the newcomer).

And so it is that the ultimate goal of sobriety is met by considerably different means by Alcoholics Anonymous and by those treating the illness professionally. Clearly each method has its place. There are those who require only one of the two methods, and legions of others who will take advantage of both. Each also has a responsibility to the other in this common endeavor. Both the professional and the AA member must work diligently to retain the integrity of their respective approaches while ensuring the autonomy of the other. For only through each being able to offer their particular approach can we be sure, with any degree of comfort, that all has been made available to those who suffer. It is not ours to determine where the doorways to sobriety ought to be, for we know not from which direction our fellows suffers will come. Ours is but to ensure that the doorway entrusted to our care is in its place, open to the next alcoholic wanting to gain entrance to our world of the spirit.