Alcoholism And Spiritual Influence Health And Social Care Essay


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Alcoholics Anonymous (AA) is an old practice, dating back to year 1935 when Bill W, experienced a reawakening in spiritual terms leading him on a path of recovery from the chains of alcoholism (AA Services, 2002). Since that time, many other people with alcoholic addictions have attributed the same kind of relief to this ideal movement. AA is referred as a spiritual fellowship by its subsequent members. However, it is new to many, and they barely understand the mechanisms, which underlie the concept of recovery (George, 2005). The spirituality validation, an enigmatic term, must seemingly be based on physiological and psychological findings. An initial element of this paper is providing a definition of spirituality in empirical terms as done by AA Services (2002) saying that it is "that which develops in people some purpose and meaning in life." This definition was amplified by pointing out that spirituality as a human aspect can be achieved "with participation in a religion (Mark & Robert, 1996). It can as well be much broader than this, for instance belief in naturalism, rationalism, God, family, humanism, and arts."

The use of such a term with this connotation is of recent origin. Anthropologists surprisingly have applied the word "spiritual" on many other concrete religious aspects and shamanic practice (Paul, Mueller, David & Teresa, 2001). The current usage of the same is understandable to have derived ideally from numerous sources, some of them specific to trends happening recently in American culture at least evident over the past century (George, 2005). Acceptance of this concept on orientation to ecumenical religion has led to an acceptance of the fact that the ritual practice formalities may be less of relevance than the values, which numerous religious denominations hold. Acceptance of these bases of practices for instance meditation and complementary medicine has brought in another dimension to the concept.

The AA emergence as a personal transformation potent vehicle has also been committed and immensely influential, as it brings in the term spirituality to the limelight of the mental health professionals as well as the general public (AA Services, 2002). All these leads to acceptance by the public of the several spiritually philosophies and practice used in supporting the recovery from an illness, which have emerged outside of the key domain of biomedicine. Most psychiatric modalities associate with a singular mechanism. Physiological research argues that spirituality may be critical to the healing of numerous disorders (Mark & Robert, 1996). Individuals scoring higher on personality traits that relate to spiritual transcendence have been seen as having characteristic activity in particular serotonergic brain sites, which suggest individual physiological differences in response to spiritual care (AA Services, 2002). The close relation between dream symbolism and symbolic thought is evident from the activation of particular brain centers and deactivation of others, suggesting an association between neural function and spiritual metaphor. Response to the social context of conversion to the spirit may also be related to neurophysiologic function (George, 2005). A person in a diverse social setting where a spiritually oriented perspective is present with intensity may be influenced and adopt that perspective (Paul, Mueller, David & Teresa, 2001).

Bill's experience at the inception of AA, where he was "caught up in the ideal ecstasy which there is lacks words to describe," cannot be researched with ease. On the same note, framing the methods to study the role of AA on recovery of alcoholism is difficult. Twelve-step fellowships need anonymity of their member (George, 2005). They are also oriented toward the members' primacy of their needs beyond research objectives, which investigators might propose. Because of such requirements, numerous outcome studies and researches on recovery through AA tie to follow-up on patients participating in professionally based treatment and attending AA meetings. Uncontrolled assessments using the Twelve-Step "Minnesota Model" for residential rehabilitation in a long-term aspect in a professionally directed setting show promising results, however, one significant study that relates to AA-based recovery stands out due to its entailment to experimental controls and randomization (AA Services, 2002).

A large-scale National Institute on Alcoholism evaluation was carried out using the long-term follow-up. It showed clearly that Twelve-Step Facilitation, a grounded modality in design to promote AA attendance, at least was as effective as cognitive, and motivational techniques (both of which in development were from empirically grounded models of research), and it was highly effective than the techniques in developing long-term abstinence (AA Services, 2002). Twelve-Step Facilitation, therefore, has been a professionally based intervention, and AA application is a peer-led fellowship. Nevertheless, this outcome highlights the relevance of further controlled research on the 12-step programs participation (George, 2005). Professional treatment of abuse of substance impaired physicians on the same note, offers an insight into AA's value, with the fact that long-term abstinence has critical public health implications for the addictive population.

A sample of physicians, previously having abused substances and abstinent for at least two years, in AA-based treatment previously, reported 12-step membership as the principal reason for the long-term recovery they achieved as well as the abstinence (George, 2005). In addition, in a sample of 101 physicians randomly selected in a group of those monitored by a physicians', found that 97 percent of the one who previously had been in a 12-step program further engaged in the program in the monitoring period (AA Services, 2002). Research on the spirituality role in the recovery process separate from professional management has been empirically modeled, and the relations between AA involvement and the outcome have been a subject of concern (Mark & Robert, 1996). In any case, no doubt prevails to the fact that membership in AA; characteristically seen to associate with its spiritual grounding now has been used by millions of people suffering addictions and they all credit program for their recovery (Paul, Mueller, David & Teresa, 2001). The 12-step experience develops a sense of communality, and this is different from the running conventional institutional context. It is, therefore, the reason why this solidarity hails as critical to the program's spiritual nature (George, 2005). The fellowship's orientation ideally to mutual support facilitates a shared sense of individual renewal validating the behavioral requirement of total recovery and abstinence known as maintaining abstinence. For addicts, the orientation to mutual support also sustains the structure and integrity of AA as a movement (Mark & Robert, 1996). Substance-impaired physicians have established a strong, supportive network via AA-related Caduceus groups in AA (AA Services, 2002). The clinical benefit of AA's program has been in demonstration in the controlled researches on enhanced outcome in treatment programs, on lowered need for professional staffing in outpatient rehabilitation, and on treatment of addiction with psychiatric care for individuals with dual diagnoses (Paul, Mueller, David & Teresa, 2001).

Surveys suggest that numerous patients have a spiritual life regarding their spiritual health as well as physical health as momentous, as well. On the other hand, people may hold greater spiritual needs in times of illness. A review of published studies, systematic reviews, subject reviews and meta-analyses, examining the association between spirituality and physical, health-related life, health and religious involvement, mental health, and other health outcomes indicated that spirituality and religious involvement associate with better health outcomes, which includes coping skills, health-related life quality and greater longevity (even in the event of terminal illness) and depression, suicide and less anxiety (George, 2005). Several studies show that addressing the needs of the patient especially the spiritual ones enhance recovery from certain illnesses. Acknowledging, supporting and discerning the spiritual patients' needs can be done in a straightforward manner (AA Services, 2002).

Conversely, when people consult physicians in determining the treatment and cause of an illness, they at times may also try seeking answers to some questions that medical science do not provide an answer for example, "Why an illness happens to a particular individual?" numerous patients rely on a spiritual framework as well as religious beliefs calling on spiritual or religious care providers to give them answers to the respective questions (AA Services, 2002). Indeed, over the years in history, spirituality and religion and the medical practice have been intertwined. Because of this, many religions embrace the care of the sick as a primary mission, and numerous worlds' leading institutions of medicine have spiritual or religious roots (Mark & Robert, 1996).

Therefore, the twelve-step program has been remarkably famous and serves as one of the most supported approaches in treating alcoholism (George, 2005). The twelve-step program is a set of principles that guide a patient. The program outlines a course of action to be of use in the recovery from compulsion, abnormal behavioral problems or an addiction. The program was originally developed by Alcoholics Anonymous (AA). It was initially a method of recovery for patients suffering alcoholism. The Twelve Steps first came to be published in a book "Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism in 1939 (AA Services, 2002)". The method then came to be adopted; becoming the foundation of the ideal twelve-step programs developed later for instance Cocaine Anonymous, Narcotics Anonymous, Co-Dependents Anonymous, Debtors Anonymous and Overeaters Anonymous (AA Services, 2005). As the American Psychological Association summarizes, the process is all about:

• Admitting the fact that one cannot is not under control of his or her addiction or compulsion;

• Recognizing a power, which is greater and that can provide strength

• Examining past errors using he help of a sponsor

• Making amendments to the respective errors

• Learning how to live a new and better life with a newly developed behavior

• Helping other people suffering from the same compulsions or addictions

The Twelve-step methods ideally have been famous adopted in addressing a variety of substance abuse and other problems relating to dependency. Over 200 organizations known as fellowships with a global membership and having millions employ the twelve-step principles in their recovery process. Narcotics Anonymous formation was by addicts who did not have extensive relations to the alcohol dependency specifics. Similar preferences relating to the addicts' drug of choice also led to the start of Cocaine Anonymous, Pills Anonymous, Marijuana Anonymous and the Crystal Meth Anonymous (AA Services, 2002). Behavioral issues for instance compulsion for, and/or addiction to, sex, hoarding, gambling, food and work are also under address in numerous other fellowships for instance as Overeaters Anonymous, Workaholics Anonymous, Gamblers Anonymous, Sexual Compulsives Anonymous, Debtors Anonymous. Auxiliary groups for instance Al-Anon and Nar-Anon, for family members of addicts and alcoholics, are part of a response in use to the treatment of addiction as a disease, which is enabled by family systems (George, 2005).

The Twelve Traditions also accompany the new and practiced Twelve Steps. The Traditions give guidelines for individual, group governance (AA Services, 2005). They were started in AA in helping with the resolution of conflicts in the fields of finances, publicity, and religion. Most twelve-step fellowships adopted the developed principles for their governance (Paul, Mueller, David & Teresa, 2001). The Twelve Traditions of AA include:

• Our welfare should be first; personal recovery is dependent upon the AA unity

• For the group purpose, there is only one ultimate authority, which is a loving God. Leaders are only trusted servants and do not govern

• The only need for AA membership is a strong individual desire to stop drinking

• Each group must be autonomous except in issues that affect other groups or AA

• Each group has a single and primary purpose, which is carrying its message to the suffering alcoholic

• An AA group should never finance, lend or endorse the AA name to any enterprise, lest issues of prestige, money, and property diverts us from the main purpose

• Every AA group should be fully self-supporting, and declines outside contributions

• Alcoholics Anonymous must remain non-professional forever. However, the service centers can or may as well employ distinct workers

• AA, therefore, must never be organized; but can create committees or service boards responsible to those they serve directly

• Alcoholics Anonymous do not have an opinion on some outside issues; therefore, the AA name must never be presented in public controversy

• The public relations policy basis on attraction and not promotion; we required to maintain personal anonymity always at the level of films, press, and radio

• Anonymity is the foundation of all the traditions, ever keeping use to remind and place principles ahead of personalities (AA Services, 2005).

In the twelve-step program, the structure of humans is symbolically represented in dimensions including spiritual, physical, and mental (AA Services, 2002). The problems the individual, groups deal with are known to manifest themselves in respective dimensions. For alcoholics, the ideal physical dimension is described best by the allergy-like reaction in the body, which results in the compulsion to using substances after the preliminary use (George, 2005). For individual groups not related to abuse of substance, the physical manifestation is more varied with elements such as distractibility, compulsive hoarding, eating disorders, hyperactivity, hypomania, dysfunctional enabling, insomnia, lack of motivation, irritability, mania, panic attacks, laziness, psychosomatic illnesses, procrastination, self-injury, poor impulse control, and suicide attempts. The statement in the initial Step that the person is "powerless" over the substance-abuse that relates to behavior at issue connotes the lack of control over the individual compulsion persisting for long despite any negative consequences, which may be endured (AA Services, 2002).

The mental obsession in the description is the cognitive processes, which causes the person to repeat the behavior after some time abstaining; either knowing that the later result will be a developed inability to stop or operate under the inner delusion that the result ideally will be varying. The description in the initial Step of the life of the person suffering from alcoholism or addict as "unmanageable", connotes the lack of choice that the individual mind of the addict affords regarding whether to use again (AA Services, 2005).

The spiritual dimension illness, relatively known as "spiritual malady," is considered in the respective twelve-step individual groups to be self-centeredness. The model is not intended to be explained scientifically, it is only an individual perspective that twelve-step program find useful (George, 2005). The process of working the program steps is intended to totally replace self-centeredness with a growing willingness for self-sacrifice, moral consciousness and unselfish constructive action (AA Services, 2002). In twelve-step groups, it is referred to as a religious experience or relatively, spiritual awakening (AA Services, 2005). This should not be mistaken with abreaction, producing dramatic changes. In twelve-step fellowships, the concept of "spiritual awakening" is inferred as developing, most frequently over a long period.

It is suggested that individual members regularly attend meetings joined by other members who share their recovery problem. In accordance with the initial Step, twelve-step groups make emphasis on self-admission by individual members of the problem they intend to recover from (AA Services, 2005). It is in this spirit that individual members identify themselves often along with their problem admission for instance "Hi, I'm Mike and I'm an addict." Such catchphrases widely associate with such support groups normally. Some meetings are popular as dual-identity groups encouraging attendance from particular demographics (George, 2005). Some areas have, for instance, men's groups; gay, lesbian, women's groups; and transgendered groups. There are also in some, beginner's groups and "old-timer" groups limiting who shares, or speaks in these meeting, by the length of time each member has in that fellowship (AA Services, 2002).

Alcoholics Anonymous is, therefore, ranked high in its effectiveness. It is known to be one of the largest of the established twelve-step programs (Mark & Robert, 1996). The Narcotics Anonymous comes second with the twelve-step members who recover from addiction coming from drugs or alcohol (AA Services, 2005). The majority of programs, however, combat the illnesses and not the addiction. For instance, the third twelve-step program, known as Al-Anon, assists members of a family of addicts and alcoholics (George, 2005). About twenty percent of programs engage in addiction recovery, the remaining eighty percent address several of problems stretching from debt to depression (Mark & Robert, 1996). It would be an enormous error assuming the effectiveness of twelve-step approaches at treating problems because they are surely effective. From its critics, Alcoholics Anonymous (AA) is only a placebo, not even able to compete with more effective treatments. They also refer it as a dangerous cult. For its supporters AA receiving the Lasker Award (America's highest prize in the medical field for progress) is enough to justify the process.

George (2005) argues that because detoxified alcoholic individuals relapse frequently, the psychological professions as well those from medical do not have an outstanding record in the handling of alcoholism. Over the long-term, many of what has been in practice to treat alcoholism professionally is what can be termed as a placebo (AA Services, 2005). On the first note, cure from addiction of all kind does not come via psychodynamic insight. In a study of Harvard men done recently, 26 alcoholics received 5000 hours of psychotherapy, with an average of 200 hours per man. Only a single man recovered from alcoholism. Life-saving detoxification is also not effective for long in handling alcoholism (AA Services, 2002). As Mark Twain quipped, 'I found quitting smoking so easy after doing it twenty times'. This is the same for alcoholism. Indeed, long-term researches show that waiting for treatment (a placebo therapy form) is as effective as the detoxification approach. Additionally, cognitive behaviour therapy is not particularly efficient since it works less well. Linda and Mark's studies of training alcoholics and helping them return to controlled drinking [8] became famous globally for years until patients in their study were followed after a 10-year mark and found as still fared no better than the research controls. In the last twenty years, there are two drugs having made clinicians in the field of alcoholism hopeful including naltrexone and acamprosate (Mark & Robert, 1996). However, many studies indicate that they are only successful in the short term basis.

Conversely, with 15 years having passed, the long-term researches that could prove the efficacy of the respective treatments are still undone (George, 2005). The reasons for the professional therapy failure in preventing the eventual relapse, and, therefore, altering the natural alcoholism history, are twofold. First, there is a hold that drug addiction in human beings never rest in our cortex. The hold of addiction of any kind on the human minds lies in the reptile brain. The hold emanates from regular, cellular changes in midbrain nuclei for instance the superior tegmentum and nucleus accumbens (George, 2005). Eventually, the plasticity loss of neuronal response in the two centers renders abstinence unattainable and holds down the willpower. Therefore, you can understand why the drug does not help and why AA comes in as a better substitute (AA Services, 2002). The second reason that often professional treatment fails in preventing the relapse in alcoholism is similar to the relapse in diabetes. Change in the clinical course in diabetes and alcoholism is only achievable by relapse prevention (Paul, Mueller, David & Teresa, 2001). Lady Macbeth's a long serving physician quotes 'Therein the individual patient is responsible in ministering to herself'. There are several factors commonly present in preventing relapse for most addictions (George, 2005). The factors, which aid in the prevention of relapse, are ritual dependency on a new love relationships, competing behaviour, and deepened spirituality (Mark & Robert, 1996).

Normally, two factors must be present for the prevention of a relapse to occur. The reason that the factors are effective is that probably unlike many of the professional treatments, these factors do not work in the creation of reduced drinking or temporary abstinence. They work to effect the prevention of relapse; and, therefore, like the self-administered insulin in patients suffering diabetics, they should be used for a prolonged duration. This holds all to the concept of using AA in the treatment other depending on the medical substances (AA Services, 2002).

Alcoholics Anonymous, just like many personal trainers, facilitates motivation from without, therefore, suggesting that clients return again to the same program routine. In AA, members are advised to find a sponsor to visit and telephone often. They are advised to 'work the steps' and always engage in the provision of the service (George, 2005). Each of the activities is dedicated in providing a daily involuntary reminder with everything hitting the mind that alcohol is an enemy, and never will be a friend. The activities provide supervision from the external supervisors, or in the language of AA 'always keeping the memory green'.

However, AA also comprehends that compulsory supervision is enormous and works best when it is by individual choice. George (2005) adds to this fact by saying that people suffer under the strict rules of a coach, but they always evade prohibitions of which they do not approve (Paul, Mueller, David & Teresa, 2001). Second, it is critical to find a substitute dependency or relatively known as a competing behaviour for any kind of addiction (AA Services, 2002). One cannot easily give up a habit especially without having another thing to do and evade practicing the same behavior (Mark & Robert, 1996). For instance, disulfiram, prescribed often because it makes the alcohol ingestion sickening, fails mostly to cure the addiction because though it may be taking alcohol away, disulfiram has no replacement and eventually the addict stops the medicine and it does not, therefore, help (George, 2005). Nevertheless, competing dependencies for instance, methadone maintenance in abuse of heroin facilitate prevention of relapse because they offer a substitute (a carrot or a stick).

AA also was initiated on the concept that, in contrast, imprisonment as a method of reducing relapse to heroin abuse has never worked (Richard, 2001). This is because punishment alone does not change ingrained habits. Alcoholics Anonymous acknowledges what all behaviorists know, and it understands what many parents and doctors forget that such dastardly habits leading to addictions need substitutes (George, 2005). Alcoholics Anonymous on this note provides supervision as well as a gratifying schedule of service activities as well as social preferences in the presence of now-healed alcoholics, particularly at times of high risk given an example of holidays (Paul, Mueller, David & Teresa, 2001).

On the same argument, AA operates on the idea that new love relationships are critical to full recovery. It seems critical for ex-addicts to bond with other persons who they have never met or hurt in the past and to who they do not have deep emotionally relations or in debt (AA Services, 2002). Indeed, it is supportive of individuals helping them bond with other persons who they can help and receive help. Alcoholic Anonymous meetings relatively are full of sober former pub-crawlers that the addicts befriend but persons who one does not owe (George, 2005). On the same note, an AA sponsor, similar to a new spouse, promotes the prevention of a relapse better than many other long-suffering members whom they torture for years.

The common feature in recovery from any form of addiction is the discovery of spirituality. This is intensely controversial and surges a heated debate. Inspirational, altruistic individual, group membership as well as belief in a greater power than 'me' seem critical to recovery from all kinds of addiction. In the Religious Experience, William first articulated the relationship between a recovery from alcoholism and religious conversions. As Carl Jung directed the AA cofounder Bill Wilson: The universal model that Frank describes in his works, Healing and Persuasion, for effective psychotherapy resembles spiritual healing closely (AA Services, 2002). In Frank's model, the healer should have the ideal status (for example a few years of abstinence), be equipped with numerous unambiguous conceptual models of the problematic issues (for example, AA's Big Book) and must create in the patient cure expectancy (Richard, 2001). Alcoholics' Anonymous assemblies, after all, are the places across the globe, which are populated densely by alcoholics with sobriety (Paul, Mueller, David & Teresa, 2001). Finally, Frank argues that in group therapy complete healing came from people caring for one another, not oneself. The Twelfth Step of AA delivers a message of healing. But there are other reasons that in the ideal addictions spirituality is critical for prevention of relapse (Mark & Robert, 1996). First, there is a sizeable difference between a connection of healing in spiritual communities and with a hierarchical psychotherapist or religious leader (George, 2005).

In authoritarian religion as well as in medicine, the wise priest or doctor asks the sinful, unenlightened patients or sick to wallow in dependency relieving their past losses and angers. In contrast AA and other ideal democratic spiritual communities have a level playing ground. One of the Akron drunks in the early days, to whom Dr. Bob brought their message of recovering from alcoholic, expressed the reciprocity well that people talking to him wanted to help him, and his pride prevented him from listening to them (AA Services, 2002). Second, spirituality influences individual behaviors, not through reason but by its emotion appeal. Four cardinal studies have provided proof that, after control of variables like alcohol consumption prohibition, religious involvement when the younger generation reduces cigarette consumption and alcohol when at adult generation (Mark & Robert, 1996).

Religious prohibition of use of alcohol (for instance Mormons in Islam in Saudi Arabia and Utah) has been all along successful (George, 2005). In contrast, prohibition against alcohol consumption by the government has been less effective (for example, prohibition in America in the 1920s and in the 1990s in Soviet Union). Third, alcoholics and addicts unlike most sinners are not annoying (Monica & Scott, 2000). Alcoholics have inflicted enormous pain often as well as injury on others. Therefore, when sober, the addict may experience guilt from the torture, which they inflict on others (AA Services, 2002). Even though a poor tranquilizer and an antidepressant, alcohol are probably the most powerful solvent ideally for a guilty conscience, which modern pharmacology has devised. Thus, absolution from guilt arbitrated by a 'power more than ourselves' generates an alternative to alcohol becoming a critical part of the alcoholic's process in healing (George, 2005). Finally, spirituality, for instance human attachment - both arbitrated by the temporal lobe and limbic circuitry may be a worthy replacement for drugs (Mark & Robert, 1996). In other words, religion and spirituality present a substitute to the high facilitated by drugs. Religion, Marx's 'the people's opiate' and Jung's spiritus, possibly will be an indirect way, which we have of motivating our limbic brain as well as its endorphins.

Nevertheless, efficacy of AA and information on the AA efficacy is hard to get. First, as an institution, AA is uninterested in the field of research (Richard, 2001). Second, because of unconscious rivalry and differences, medical researchers from respective scholars sometimes have hard times in the assessment of AA without bias (AA Services, 2002). Finally, in the process of their chronic disorder, addicts and alcoholics come across many, diverse interventions, simultaneously. Thus, unlike the case with most drug trials, there is no absolute way that one can conduct a controlled study (Mark & Robert, 1996). Until recent times, it was not clear whether AA attendance resulted to abstinence or whether attending AA was just a manifestation of greater compliance with therapy or abstinence. The overall evidence, nevertheless that AA works as a better 'cure' is convincing (George, 2005). First, multiple studies, which collectively involved more individuals, suggest that absolute and effectual clinical outcomes are correlated significantly with frequency of attending AA, with having a sponsor, with chairing meetings, and with engagement in a Twelve-Step work. Second, for 35 years I have been Director of the Study of Adult Development.

From results in a community study, half of the sample abused alcohol until they died or until present. There were few clear differences distinguishing the men achieving stable abstinence from the ones who remained alcoholics in a chronic state (Monica & Scott, 2000). Poor education, multi-problem, low IQ did not identify the sample population that would fail in achieving stable abstinence. Nor did risk factors abundance for alcoholism, for instance alcoholic heredity, youth hyperactivity and sociopathic behaviour, endure in predicting the chronic state (George, 2005). However, it was remarkable that the sample population in the satisfactory outcome groups indicated attending at least 20 times as many meetings of AA as the men in the poor outcome participating groups (AA Services, 2002). Another multimillion-dollar study, referred to as Project Match compared the diverse effects of treatments upon alcoholic patients arriving at several conclusions (George, 2005). Project Match indicated that in the event of the first year AA as a treatment approach was as effective as the professional alternatives including motivational enhancement therapies and cognitive behavioral therapies. Certainly, AA in some levels was better than the cognitive, behavioral therapy. On the other hand, the Match follow-up also indicated that in spite of the original treatment arm (motivational, Twelve Steps or cognitive behavioral) the more meetings held by AA and individual attendance, the better the outcome (Richard, 2001).

However, there is a 'scientific' question relating to AA efficacy. Even with proof that AA cures alcoholism, what is the level of its safety? The question aims at addressing the AA side effects. Indeed, AA has its ideal detractors and critics regarding its operations. Designed to influence the reptile brain, the emotional language and the rhetoric of the spirituality of AA guide, journalists as well as other social scientists fear that AA is a cult (George, 2005). Cults can lead to exploitation as well as cases of demagoguery, and this is one big shot used in criticizing AA. They argue that religion can result in exclusion, war and bigotry. Individual alcoholics who attend incompatible AA individual groups or ally themselves with inopportune sponsors sometimes are witnesses of horror stories regarding the fellowship (AA Services, 2002). Many of the beliefs that members in AA express regarding alcoholism, are similar to the tenets of any tradition not related to science. For instance, if men are followed for 40 years it is clear that alcoholism is not as normally expressed as a 'progressive disease'.

Something restoring the safety of AA is that as an institution, it is not a religion. The institution has incorporated principles deliberately in an attempt to avoid cultic abuse. Religions for instance nationalism draw circles, which draw some, people out and, therefore, not excellent when it comes to matters of recovery. On the other hand, Alcoholics Anonymous draws circles, which draw others in and, therefore a favorite. The AA spiritual foundation came from the intellectual experience of men who were deeply mistrustful of all religions. These men, William with his Religious Experience Varieties, Carl Jung handing his prescription ideally known as 'Spiritus contra spiritus' and cofounder of AA, Dr. Robert Smith, of whom each students of what was healing between the prevailing religions (George, 2005). This kind of spirituality usually develops to love, humility, tolerance and awe toward the global universe.

These are respective qualities deepening human relationships (AA Services, 2002). Certainly, AA is not all about religion but more deep into other concepts. The Alcoholics Anonymous preface flatly states: "Alcoholics Anonymous is practically not a religious institution." The only membership requirement is a desire to abstain from drinking. Alcoholics Anonymous, therefore, passes the universality test so vital in distinguishing safe spirituality and separating it from divisive religion, in the aspect that religious conviction does not have the capacity to prevent membership to AA (Richard, 2001). Over the last two decades, AA membership increased to an estimated 10-fold in Hindu India, in Catholic Spain and in Buddhist Japan. Membership has also been on the rise in atheistic Russia exponentially (Paul, Mueller, David & Teresa, 2001). Per capita, there are an estimated three times as numerous AA groups in El Salvador and Costa Rica as in the America (Monica & Scott, 2000). Today, at least one-third of members from AA are women and an estimated one-quarter are categorically less than 31 years old. Scholarly research fails in the identification of clear personality differences among the numerous alcoholics who are not attendants of AA. Neither education nor social class, neither mental health nor extroversion distinguishes the ones using AA from the one who do not (AA Services, 2002). The only variable that consistently distinguishes AA members from addicts and alcoholics who attend professional treatment centers only is that members of AA tend to have had more alcoholism symptoms.

It is of merit noting, nevertheless, some of the particular ways that AA as an institution has avoided to developing to a cult (Monica & Scott, 2000). First, from the beginning, AA has developed no clear distinction between 'the fellowship of AA' and the supreme God. There has been a tacit, if not explicit, permission always of replacing the concept of God, with the individual 'home group'. On the other hand, the AA spirituality does not have the capacity to compete with medicine (Richard, 2001). Alcoholic Anonymous work published in books is clear that it is 'absolutely wrong depriving any alcoholic of medication that are capable of alleviating or controlling other disabling emotional problems, as well as a physical problem (AA Services, 2002)' and that 'no member of AA as an institution, plays doctor (Mark & Robert, 1996)'. Additionally, some worry that the institution like cults, exerts control of the human mind and removes freedom. Mark, a New York psychiatrist, defined cults as groups of charisma with 'characteristics of a high social cohesion level, a deeply held belief system and a potent influence on its individual members' behavior (George, 2005)'. As Mark noted, this is true of AA as an alcoholic recovery institution.

Finally, another difference between all AA and cults is their governing structure. For cults, their characteristics are by charismatic leaders having infallible powers as well as an autocratic structure of governance (Mark & Robert, 1996). In AA 'leaders' trust is been held as servants; they never govern (George, 2005)'. Most of the AA positions of service are unpaid and numerous jobs are rotated frequently so that the power consolidation never occurs (AA Services, 2005). The AA organizational chart evolving is a pyramid on its head. Responsibility positions within AA are in definition, 'service as having no authority (Richard, 2001)' and the processes of AA legislation are democratic to a fault. In AA, the amusing thing is that unlike in religions and cults, they respect the minority opinions (AA Services, 2002).

A criticism of cults, as well as AA, is that they hearten dependence. And so it is critical to differentiate the dependence that is AA engendered from the dependence that is cults engendered. Dependencies in respective areas weaken or strengthen the individuals (AA Services, 2002). This is because a human being is weakened by dependence on junk food, cigarettes, or slot machines. Finally, AA's Twelve Traditions are a reflection of the founder Bill Wilson's 20-year crack to embrace spirituality protecting AA from developing into a cult (Mark & Robert, 1996). Alcoholics Anonymous, as the case with the early Christian Church, strives to stay poor successfully ad, therefore, works out appropriately (George, 2005).


In general, the role of spirituality in alcoholism recovery relates to the individuals' promotion of attaining a meaningful life. The approaches to recovery, for instance use of meditation, religious revivalism, and family therapy, exemplify the value of infusion of the individual and personal meaning into the process of recovery. All the respective approaches associate with the factors termed nonspecific often underlying the curative effects evident across diverse psychotherapy schools. It is, however, arguable that spiritual influence is one of the major concepts on recovery in Alcoholics Anonymous. It is a process involving the 12 steps as illustrated in this discussion. It is absolute that spirituality is particularly a latent construct; one inferred from numerous component dimensions, for instance social psychology, treatment outcome and neurophysiology research. Mechanisms that relate to its role in recovery promotion in AA are in discussion from diverse perspective and apply to individual differently. What is clear is that Alcoholics Anonymous (AA) being an old practice has been excellent and successful and continues to hold ground as an approach to reduce alcoholism.

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