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An Examination of Alcoholics Anonymous:

The Open Speaker Meeting and Yalom’s 11 Curative Factors

Adrian Restivo-Levitt

 

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This paper is a review of the open speaker meeting of Alcoholics Anonymous in the light of Yalom’s 11 curative factors. Counselors, educators, students, and mental health professionals may benefit from this perspective when considering referrals to Alcoholics Anonymous.

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Regardless of the setting of their practice, mental health and social service professionals will encounter clients with drinking problems. Mental health professionals value the role of self-help groups. Self-help groups offer a special type of support and information. Alcoholics Anonymous (AA), founded in 1935, was the first self-help group for alcoholics. Although AA should not be conceptualized as a form of treatment, it does exist to help recovering alcoholics.    This article offers a view of the open speaker meeting of AA (Lewis, Dana, & Blevins, 2002). With the proliferation of various self-help groups intended to help those with alcohol problems the time is right to re-examine AA in the light of theory. The more existential aspects of the AA program may be of interest to counselors and other mental health professionals. Mental health professionals need to find their own areas of comfort with self-help approaches (Van Wormer & Davis, 2003), and this paper is an attempt to familiarize professionals with one such program. According to McCrady and Miller (1993), since the 1950s professionals have called for more scientific research on AA. Attending an open speaker meeting of AA avoids the issue of anonymity. Anyone may attend and all are welcome.

The purpose of this paper is twofold: (a) to demonstrate the theoretical soundness of the recovery program of AA as demonstrated in the open speaker meeting, and (b) to encourage counselors and other mental health professionals to attend an open speaker meeting of AA by explaining the format. In this way counselors and other mental health professionals will have first hand information to share with someone seeking help with a drinking problem. Information about meeting times and location can be obtained from the AA Web site (http://www.alcoholics-anonymous.org/), or in the phone book under Alcoholics Anonymous.

Graduate student counselors and student assistance counselors enrolled in substance abuse courses are sometimes required to attend an open speaker meeting of AA as part of their coursework. The information in this paper may facilitate their approach to their first meeting. Counseling professionals who are involved in teaching graduate students should acknowledge the students’ apprehension. This may help students to understand empathetically the apprehension an alcoholic may experience when the suggestion to attend such a meeting is made by a counselor or other mental health professional. The experience of attending an open speaker meeting of AA will be qualitatively different for the student or counselor because they are not in dire need of help but on an information gathering expedition (McCrady & Miller, 1993).

 

 

Alcoholics Anonymous (AA)

AA is a worldwide organization dedicated to helping alcoholics to achieve sobriety. After its founding in 1935 by two alcoholics, one a New York stockbroker, the other a physician from Ohio, they developed a 12-step program intended to help those coping with alcoholism. It includes psychological principles that have long been associated with Cognitive Behavioral Theory and Practice. Techniques include cognitive restructuring, thought stopping, and meditation, and new behaviors such as not drinking, going to meetings, reading literature from AA, and talking with a sponsor form the core of the recovery program.

The organization functions through local groups that have no constitutions, officers, or dues. Anyone who has a desire to stop drinking may become a member. Presently more than 99,000 local groups meet in the United States; worldwide membership is approximately 2 million (AA, 1976). Other groups patterned on AA include Narcotics Anonymous, Overeaters Anonymous, and Gamblers Anonymous (McCrady & Miller, 1993)

            AA is cost-effective, widely available, and consistent with the transtheoretical model of change (Prochaska & DiClemente, 1986). Open speaker meetings of AA are available to all for an introduction to this 65-year-old recovery program. AA may not be appropriate for every person who suffers from alcoholism but it is for some. Counselors and other mental health professionals have an opportunity to learn about a program that works for many individuals.

Although meetings take several forms, this paper is an examination of the open speaker’s meeting format. Anyone who has an interest in learning more about AA may attend an open speaker meeting of AA. Other meeting formats may be closed, which means attendance is limited to those who have a desire to stop drinking. Meetings such as Step Meetings, Discussion Meetings, or Big Book Meetings may be closed.

 

The Open Speaker Meeting of AA

            The open speaker meeting is sometimes referred to as a home group meeting. Recovering individuals who are members of the group may celebrate accumulated sober time at the open speaker meeting of AA. The meeting follows a consistent format. The opening may be composed of reciting the Serenity Prayer, reading announcements, a call for any announcements related to AA from the floor, a secretary’s report, a treasurer’s report, and passing a basket for contributions. Members from a visiting group of AA then share their stories from a lectern or podium with the members and guests of the home group. Their stories tend to follow a consistent pattern. Although the contents of the stories vary, the story of the progression of the disease of alcoholism is similar (Keller, 1993). Speakers tend to include the experience of feelings such as going from hopelessness to hopefulness, and from feeling isolated and unique to active membership and a feeling of belonging. Without using the terminology of Yalom (1995) each of the curative factors can be heard in the collective experiences of the speakers.

Perhaps one reason AA has been so successful in helping individuals to recover from alcoholism is that it incorporates all of Yalom’s (1995) 11 curative factors. Irwin Yalom is considered to be one of the primary contributors to the field of group counseling In his seminal work, Yalom identified 11 curative factors present in group work: instillation of hope, universality, imparting of information, altruism, corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, interpersonal learning, cohesiveness, catharsis, existential factors. At an open speaker meeting of AA one can see how each of these factors comes into play.

 

Instillation of Hope

            Hope is considered by some to be the hallmark of mental health. According to Yalom (1995) “many self-help groups…place heavy emphasis on the instillation of hope and a major part of…Alcoholics Anonymous meetings is dedicated to testimonials…” (p. 5). The epithet of a “hopeless alcoholic” was used for late-stage alcoholics for whom there seemed to be no possibility for recovery. Entering a room full of people, many of whom are laughing and smiling, smelling coffee brewing, being welcomed at the door with a handshake or a hug, could fill one with hope for better days to come. Realizing that the people in the room are people who are recovering from alcoholism can be interpreted as reason to feel hopeful oneself. Because attendance at the open speaker meeting of AA is open and ongoing, the members are in different stages of recovery. The recovering members demonstrate the possibility of abstinence or sobriety. Their modeling serves to uplift and give hope to the newcomers who may be feeling hopeless.

Cognitive techniques work by helping people to reframe their thoughts and take actions to directly fight the condition. Some of the slogans in AA such as, "One day at a time," and "Make a gratitude list," which helps the recovering alcoholic focus on the positive events in his or her life, actually refer to cognitive techniques that help fight depression as well as alcoholism (Szalavitz, 1999). Another slogan heard at meetings is, “It gets better.” Simple and pithy, these slogans might increase hope for someone whose life has been getting worse in a downward spiral of alcoholism (Jellinek, 1960).

The open speaker meeting of AA may end with the saying, “Keep coming back, it works if you work it.” The slogans used in AA appear to be simple statements that can be used either in crisis situations or to avoid crisis situations from arising so that members have some basic guidelines to employ on their own.

Vaillant (1983) has consistently emphasized the role of hope in recovery from alcoholism, but with a caveat: “Hope is not something we can simply hand to another,” he affirms. “We can share only our own hope, just as AA’s can share only their own strength and experience in sobriety. “ No one can be guaranteed success in AA. Each person’s story is different, each person’s story of recovery is different, yet there are common themes shared among the fellowship’s members.

 

Universality

Many alcoholics report feelings of isolation and uniqueness (The AA Grapevine, Inc., 1985). Walking into an open speaker meeting of AA may allow the individual to recognize that he or she is not alone in their struggle. The pamphlets and literature of AA share experiences that can also lift the mantle of wretched uniqueness (Corey & Corey, 2002). Joining an organization like AA, which has approximately 2 million members, could give one a sense of universality. American members of AA who have traveled abroad report feeling comfortable, understanding the feelings of others at meetings, even when English is not spoken.

At the open speaker meeting of AA newcomers are encouraged to identify with the speakers and not to compare their experiences to those of the speakers. Instead of formulating the thought, "That hasn't happened to me,” members are urged to identify with, or relate to, the person’s feeling.

 

 

Imparting Information

            A good portion of the one-hour open speaker meeting of AA format is spent on imparting information. The 12 steps might be read, the meeting format discussed, newcomers might be encouraged to identify themselves so they can be helped after the regular meeting. Announcements might include the times and locations of other meetings, the availability of temporary sponsors and the opportunity to be of service to the group by making coffee or helping to set up or clear up after the meeting. Members are urged, “Don’t drink, go to meetings, and read your Big Book,” and encouraged to collect and use phone numbers of other members.

Imparting information is helps the newcomer understand what has happened to him or her and what he or she can do to apply the 12 steps to recover from addiction (Yalom, 1995). The open speaker meeting of AA uses an indirect form of advice. Direct advice is replaced with alternatives presented in the speakers’ stories. Those in attendance then have the opportunity to identify what will serve them the best in their situations (Yalom, 1995).

 

Altruism

            Everyone in AA is a volunteer. The leader has simply been elected by the group to conduct the open speaker meetings and may not have any particular status in the structure of AA. A collection basket is passed to cover the cost of the room, the literature that is available, and the coffee. Members greet newcomers, encourage them to attend regularly, offer them rides to meetings if they cannot drive, and give them their phone numbers. Sponsors are members of AA who help other members. Sponsors report that they get more out of helping newcomers than the newcomers get from them, which practically defines altruism. A slogan suggests that, “You cannot keep it if you do not give it away.” This reminds members of the importance of altruism.

 

Corrective Recapitulation of the Primary Family Group

An understandable way to determine the rightful role of the well-functioning family is to use Maslow’s Hierarchy of Needs as a heuristic model. Families strive to meet basic needs, safety needs, belonging needs, love needs, achievement needs, and self-actualization needs. For the alcoholic, using alcohol is unsafe. It can usurp financial and physical resources, making it difficult or impossible to meet all of the needs listed above. The group helps recovering individuals meet these needs by offering a program for living a rich and full life, free of fear.

In families where alcoholism is present, children may grow up in dysfunctional households where their emotional needs might not be met. As adults, these children tend to feel isolated and uneasy. Some adults who have grown up in alcoholic homes take any criticism as a personal threat. Some become alcoholics. Alcoholism is referred to as the family disease.

Observing men and women of different ages and at different stages of recovery from alcoholism can be helpful in healing these childhood wounds. Seeing members at an open speaker meeting express appropriate emotions, report new behaviors, make amends for wrongs they have done to others, and observing improved family relationships are forms of corrective recapitulation exercised by the primary family group. Speakers at these meetings have been heard to say members and sponsors often function as helpful friends, or even like healthy family members, as they face life in recovery.

For the alcoholic, the experience of regular attendance at meetings, starting on time, ending on time, and a predictable meeting format may be comforting, and can reinforce stability in a life that had once been unmanageable as articulated in Step 1 of AA. “We admitted we were powerless over alcohol—that our lives had become unmanageable.”  Each person showing respect for others while he or she is speaking, being encouraged to refrain from profanity, and being appreciated for taking on commitments by being thanked by name by the leader of the meeting can be seen as a corrective recapitulation of the family of origin. Commitment is the term used for accepting responsibilities such as going to another group to speak, making coffee, setting up or cleaning up, or serving as treasurer or secretary for the group. These tasks are similar to family chores. A feeling of ownership, membership, and belonging can emerge from these activities.

 

Development of Socializing Techniques

Socializing techniques are addressed by individual speakers telling their stories of how they were as active alcoholics, what happened that caused them to consider joining AA, and how their lives are today. As the newcomers identify with the speakers, the newcomers may recognize and eventually incorporate the social skills and coping strategies used by the speakers in dealing with life without alcohol. The subtle agenda is listening, greeting and having appropriate manners, refraining from the use of profanity, and dealing with life in general. All of this can be considered under the next two curative factors: imitative behavior and interpersonal learning.

Giving feedback on maladaptive behavior, and embracing healthy behaviors are two ways in which development of socializing techniques are employed in AA. The more experienced members easily identify maladaptive behaviors. In the personal testimonials, the speakers at open speaker meetings of AA describe destructive thinking or behaviors when disclosing parts of their lives or the lives of unnamed others. They help members to see where those types of thoughts or actions lead, and leave it there for the individual to partake of as they will (Yalom, 1995).

 

Imitative Behavior

            Ideally the newcomer asks someone well established in sobriety to become his or her sponsor. Those recounting their personal histories at open speaker meeting of AA often report working with a sponsor and the difference it has made in their lives. A sponsor assumes the role of big brother or big sister, mentor, teacher, and oftentimes coach. “Stick with the winners” is a popular slogan in AA that suggests imitative behavior. “When all else fails, follow the directions” is another slogan that suggests seeking guidance.

Through imitative behavior, newcomers can equate their experience with those who are working the 12 steps and are progressing in sobriety. The results achieved by acting or thinking differently are apparent in the stories of recovery.

 

Interpersonal Learning

Members have many opportunities for interpersonal learning at the open speaker meeting of AA. Newcomers soon learn that they are expected to contribute to the group maintenance by helping to set up the room before or cleaning up after the meeting because a call for volunteers may occur at the opening of the meeting. Most groups do not require members to have any particular length of sober time to participate in the various roles a group requires to maintain itself. In the early days of AA no one had years of sobriety, everyone was a newcomer.

AA members who are established in recovery model appropriate behavior at meetings. A sponsor or another role model will guide the newcomer in the fellowship and nomenclature of AA, taking new members in hand. This was done for them when they arrived in AA, and they expect to do it for the newcomer.

The slogans of AA are an example of an opportunity for interpersonal learning. At first sight or hearing of the slogans, newcomers seem to react in one of two ways to the slogans. They either think they are simplistic and stupid, or they do not understand them at all. For example, an often-heard slogan is “One day at a time.” A woman reported she could give up alcohol for 5 days and then she would drink. A member of AA suggested she just give it up one day at a time. “Oh no! I can already give it up for 5 days and then I drink,” she replied. She was not ready for the “One day at a time” slogan.

Many people with alcoholism or other addictions cannot imagine never drinking again for the rest of their lives: it seems impossible. But one could conceive of not drinking for one day at a time. Other slogans include: “AA is a school in which we are all learners and all teachers,” “Each and every alcoholic—sober or not—teaches us some valuable lessons about recovery and ourselves,” and, “The smartest thing an AA member can say is ‘help me.’”

The open speaker meeting of AA can provide members with the benefit of having people to turn to in time of need. Sometimes greeting cards are passed around the room for a member that might be in the hospital or has experienced a loss. An announcement might be made about a death of a member and all are urged to attend the wake and funeral.

Groups come into and go out of existence. More densely populated areas have more meetings. The meeting book published by AA has 45 pages for northern New Jersey, and 10 pages for the less populated southern part of the state. In either area a person can find at least one meeting any day of the week—morning, afternoon, or evening.

Some meetings are started because a member developed resentments, real or imagined, with individuals or ideas at their home group. The resentful person starts another meeting. The purpose will be the same though, to help individuals who want to stop drinking. The slogan that deals with this phenomenon is, “Principles over personalities.”

Newcomers, if they identify themselves, can experience something akin to the laying on of hands as experienced members and others with some time in the program of AA surround them after a meeting and offer phone numbers and advice. This may build cohesiveness.

 

Cohesiveness

AA has been growing for more than 60 years. The groups are autonomous, yet all of the groups have singleness of purpose: to help people who want to stop drinking. A slogan that reflects this concept is “Keep it simple.” Other recovery programs have come and gone as AA has been growing. Keeping it simple and focusing on recovery from alcoholism has built cohesion in the organization of AA as a whole and in its membership.

Cohesiveness can also mean sticking together. Yalom states that being with a group once a week may instill a capacity for cohesiveness. Regular attendance and participating in group decision-making can cultivate a sense of belonging that also can contribute to cohesiveness.

 

Catharsis

Catharsis can be a breakdown of psychological defenses. Denial, a defense mechanism, is the greatest impediment to sobriety and indeed characterizes the disease of alcoholism; continued use of alcohol in the face of negative consequences. Catharsis can also be the release of emotional tension achieved through recalling a repressed traumatic experience. The central goal of the open speaker meeting of AA is for recovering individuals to share their stories with newcomers and others to release themselves from the bondage of addiction by remembering where alcoholism took them (Vaillant, 1983). This is sometimes referred to at the open speaker meeting of AA as keeping one’s memory green. Telling one’s story may in itself be cathartic. For a member who has had a low bottom, that is a painful descent into the progressively worse emotional, social, and physical consequences of alcoholism. Looking good, feeling good, and being able to address a roomful of people with the intention of helping others can be a cathartic experience. Many speakers are moved to tears during their recounting of experiences that led them to AA and further moved to tears of gratitude for their recovery.

 

Existential Factors

Despite encompassing a staggering range of philosophical, religious, and political ideologies, the underlying concepts of existentialism are simple: people have free will, choices are made and may create stress, and some things appear to be irrational or absurd.

According to Yalom (1995), recognition of the unfairness of life, of the inevitability of death, aloneness, and the responsibility for how authentically one lives one’s life are the existential issues ultimately addressed in group therapy. The existential factors that may be the primary concern of the recovering individual are authenticity and the concept of a higher power. These existential factors relate to the open speaker meeting of AA.

Speakers’ stories are divided into three portions: (a) how it was, (b) what happened, and (c) how it is now. This is also referred to as sharing one’s experience, strength, and hope. In the first portion of the story, often referred to as the drunk-o-log, the existential issues discussed tend to have a tone of helpless, hopeless, defeated victimization. Anxiety and meaninglessness are the underlying themes to the enlightened observer. Things appear to take on a more positive note as the testimonials continue.

People have free will. The decision to recover from alcoholism is an exercise in free will. It is very likely that an alcoholic may share about how he or she came into recovery. Many make the point that no one else, not their parents, spouses, or the judge, could mandate them into recovery. Each person must make up his or her own mind.

While attending open speaker meetings of AA, one may hear references to a belief that there are no coincidences, things happen for a reason, a higher power helps active and recovering alcoholics (Whitfield, 1985). To the uninformed observer or newcomer the higher power concept as stated in Step 2 of the 12 steps is irrational or absurd and certainly without explanation.

The unfairness of life may lead an alcoholic to the question, “Why me?” Speakers may report that alcoholism is rampant in their families, or that no one else in their families has alcoholism. Many vowed never to be like an alcoholic parent. Some had every advantage, whereas others were raised in dire conditions. There is no pat answer to the question, “Why me?” From the stories that are heard at open meetings it is possible to acknowledge the complex nature of alcoholism.

The reality of the inevitability of death may lead an alcoholic to the question, “Why bother?” Many recount instances where opportunities were lost, chances passed by, or gold was made into straw. This relates directly to the codependent notion that “if you would act correctly, I could be happy.” Many speakers tell of instances where their feelings of victimization helped them to not take responsibility for how they were living their lives. As their stories progress into their recounting of their experiences in sobriety, many report a newfound meaning in everyday life.

The issue of aloneness may be expressed as the feeling that no one cared about them, either when they were growing up or as their alcoholism progressed. As each speaker goes to the front of the room to deliver his or her message of recovery, they state their names and that they are an alcoholic, “Hello my name is …and I am an alcoholic.” The entire room answers, “Hello…” Being understood and experiencing feelings of safety and belonging are reported by many recovering individuals who participate as speakers at the open speaker meetings of AA.

            The open speaker meeting of AA can be an opportunity for counselors and other mental health professionals to learn about the program and fellowship of AA. If the meeting listing indicates it as an open speaker meeting, the attendee will not be required to identify themselves by name or reason for attending. One can expect to be greeted and made to feel welcome, and perhaps questioned individually, in an effort to determine if one is seeking help.

            Trained counselors and other mental health professionals will have ample opportunity to observe theory and practice at work at the open speaker meeting of AA. This will enable them to have a better understanding of AA and to pass this information along to those for whom they think it might be helpful. Counselors and other mental health professionals can then function from a base of specific knowledge and sensitivity.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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Author’s Note:

 

Adrian Restivo-Levitt, PhD, is an adjunct professor at Monmouth University and also maintains a private practice at Shrewsbury, NJ.