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ANNALS Vol: 5:3, MARCH, 1975
ANONYMOUS AND RELIGION
by Margaret Bean, M.D.
solves certain knotty problems of working with
alcoholics by following a religious rather than a medical
some particulars. If we consider what A.A. has borrowed
religion and how this operates, it may enrich our understanding
how and why A.A. functions as it does, what it offers, and
solves some problems and gives rise to others.
is such a broad term that it may help for us to
isolate a few points and show how these are germane to the
at hand. Man's religious experience probably developed from
primitive form whereby magic was used to deal with the "emotional
play between hope and fear" and ritual was used to
As the concept of a single God - considerably removed from
related to him - developed, the question arose concerning
means whereby the gap could be closed. Three modes, contrasting
and interacting, seem to operate in all major religions:
individual's gradual sublimation of his physical nature
spiritual, his identification with a community that stands
private relationship to God, and his continuing rejection
or qualities perceived as "bad" in favor of those
"good." These various processes give rise to techniques
accomplishment: worship, ritual, symbol, ceremony, and an
system that relates the individual to the community.
have observed that many of these are used in A.A., and it
appears a little puzzling when A.A. states specifically
that it is
not a religion. Apparently what is meant here is that A.A.
not undertake to determine a member's relationship with
God or the
structures whereby he achieves this relationship. It is
cult that borrows strength from religious experience and
existing religious structures.
only aspect of God thought to be important in A.A. is
help in staying sober. What it offers is a way of life to
stop drinking, not to save one's soul or grow into a relationship
A.A. does incorporate another major aspect of religious
thought: the struggle against evil. This is played in modern
religious thinking to the point where we may not appreciate
force it has exerted in developing man's religious experience.
A.A. is a distinctly Manichean system, with two powerful
contending for possession of every member's life - alcohol
(powerful, beautiful, and evil) and A.A. (powerful, noble,
good). In society, alcohol is regarded as a social good
moderate importance or as a nuisance to be managed by social
control. In A.A. it is regarded as an evil of tremendous
One of the qualities of an A.A. member that sets him apart
awareness that he and others like him serve as the battleground
for epic conflicts waged between elemental forces.
borrows a number of religious elements to manage this
conflict between good and evil. There are historical figures
resembling saints and prophets, such as Bill W., who is
canonized in A.A. There are ritual roles for leaders and
converts. There is a "bible" and a body of writing
sometimes read aloud at meetings, like liturgy. The meetings
resemble religious services, with prayers, confessions,
collection. There is a feeling, sometimes explicit, of borrowing
strength from conventional religion. Development of religious
feeling is considered a safeguard against damaging narcissism,
resentment, and self-pity. Each member is specifically instructed
to invoke his Higher Power, since he alone cannot exorcise
demon of alcohol. The precise nature of the Higher Power
person's relationship to it are deliberately not spelled
phrase "As we understood Him" occurs twice in
the Twelve Steps.
This vagueness has presented a problem in some religions
the main point is man's relationship to God, but it does
any difficulty in A.A. because the focus there is not on
on the struggle between alcohol and the A.A. way of life.
A.A. system, based on a dualistic world view, has a
valuable consequence in the relation between the helper
helped. A.A. members trying to help an alcoholic achieve
do not experience it as personal failure when the alcoholic
relapses. In A.A., when the member drinks it is considered
loss of one battle in the war with the powerful and beautiful
satanic force. It is quite comprehensible and does not diminish
the intrinsic value of the drinker or the validity of the
effort. It is a sin against doctrine, not against one's
man; the defect is defined as not enough A.A. The forces
ultimately will triumph over the alcohol, but it is expected
often a nearly even struggle. This brilliantly sidesteps
weakness of the medical model, in which drinking is seen
disgusting rather than compelling, so the chronicity of
drinking is blamed on the weakness of the drinker and
the failure of the helper.
analogies to religion roles occur in A.A. The role of
the priest is traditionally that of mediator between God
people. Both the people and the priest's own standard demand
he live a holy life as defined by the goals of the system.
function is to transmit and interpret God to the people,
back to the ethical life, and perform rituals and acts of
sanctification. In A.A. there are priestly or prophetlike
the A.A. veterans and sponsors, who are felt to be mediators
between the A.A. method and the members. They are under
to express in their lives the highest realization of the
ethical system, so it is logical that the leadership emerges
those who have both charismatic qualities and long periods
sobriety without relapse.
and veterans serve some priestly function but abjure
others. They interpret the A.A. word as embodied in the
writings. They urge members back to the Traditions and Steps.
do not perform sacraments, and they do not decide who is
related to the group and the doctrine. Confession, absolution,
penance are transacted not between a sinner and a priest
between the member and the group. The sponsors and veterans
collectively and socially only to define the ethical system,
do not in individual cases pass judgment on any member.
think there are good empirical reasons for this. In A.A.
constant struggle has occured to keep individuals out of
protect the structure of the organization against ambition,
ensure an analogue to our current concern for a government
and not men. Alcoholics have felt social opprobrium so often
they are acutely sensitive to the danger of giving any member
power to censure another. Guilt is handled not by explicit
individual absolution but by implicit collective acceptance
person's confession. A model that includes punishment by
excommunication would be dangerous to A.A., for there is
to tell an ex-alcoholic that drinking will bring hellish
punishment. He knows. For a group of extremely self-destructive
people who have primitive and cruel superegos, an organization
that controls by attraction and persuasion rather than punishment
is a thoughtful way to avoid many problems, and is more
by virtue of its humaneness.
shares other external supports and controls with
religious systems. One is the use of forgiveness to restore
continuity between a transgressor and the social context
the individual moves towards his ideal. In those religions
which concepts of sin are emphasized, the sinner comes to
absolver; God grants absolution through the priest, and
usually performs a restorative act. The person's attachment
and the community is renewed, his relationships are restored,
he is freed from guilt. If we were to consider one aspect
psychotherapy as the freeing from limitations and growth
an ideal, it would include similar mechanisms of identification
acts of feelings perceived as dysfunctional, giving these
the therapeutic encounter, reinforcing allegiance to the
and consequent freeing of energy for growth.
A.A., people confess their past transgressions first to
themselves, secondly to another person, and thirdly to a
gathering. This ritual act functions in a complex way to
anxiety and improve felt competence. Admitting the behavior
defuse the affect associated with it, assuaging guilt and
stigma more bearable. Confessional speeches are cathartic
with social conventions about alcohol by simultaneously
confirming, flouting, and working to change them. The needs
punishment and for admiration are both met by the not-very-secret
meeting where the speaker degrades himself by public confession
and description of his alcoholism before an audience that
hold him culpable and whose members relish with him the
details of his drinking experience.
persons are familiar with the confession/penance
mechanism only as it functions in the Catholic branch of
Christianity, with the requisite participation of a priest.
modes of religious expression incorporate the same mechanism
without a priest; the individual may do it himself or through
action of the community. A closer parallel to the A.A. experience
occurs within Fundamentalist Protestant experience. "Typically,
after having been crushed by guilt and despair they describe
within a supportive group, a radical turning point is experienced,
in which they deeply feel the acceptance and grace of God,
whereupon a rich flow of gratitude and freedom motivated
reshape their behavior." In A.A. all these elements
with hope substituted for grace. The cause of the despair
alcohol, equated with sin, and the behavior to be changed
drinking. These testimonial confessions serve several purposes:
they corroborate the ethical system, free the individual
affirm his status as a member of the community, and provide
examples and encouragement in the form of identification
role models, and instruction by example in how sobriety
in A.A. has a number of psychological functions,
such as expressing self-destructiveness in a manner less
destructive than drinking, accomplishing universalization
experience so that the person does not feel alone in his
providing a frame for making identifications leading to
object relationships, dramatizing as entertainment, and
is the state in which a person, once in a
positive relationship with a dogma or ethical life, is removed
from it. It may be either an official action or a felt state.
Alcoholics in A..A. who have had a lapse see themselves
disturbed relationship with their ethical and social frame,
they know the ritual, symbolic, and social acts whereby
restore the relationship. In A.A. a slip does not result
action of excommunication, though in an organization where
requirement for membership is a desire to stop drinking,
continuing to drink brings members status into question.
triggers not official condemnation but, rather, heavy caring
pressure to restore the person's attachment to the community.
religious aspect of A.A. is Twelfth Step work:
"Having had a spiritual awakening as the result of
these steps, we
tried to carry this message to alcoholics, and to practice
principles in all our affairs."
is the correlate of evangelization and conversion of
nonbelievers. Many observers have pointed out the importance
Twelfth Step work in A.A. It maintains the group, provides
with status, reinforces aversion to drinking, safeguards
idealization of drinking, and acts as a therapy for the
functions as an ego defense in which the alcoholic can safely
out rescue fantasies and master conflict by projective
identification and fullfillment of his own wish to be rescued,
it is a means of assuming a prestigious role as a missionary
the point of view of the organization's continuance,
Twelfth Step work is adaptive. If there were no mechanism
recruitment of new members, A.A. would shrink and all the
processes that rely on large numbers, wide geographic spread,
numerous role models, and the doctrine that "nothing
A.A." and "A.A. always works" would grind
to a halt. It is
psychologically vital to permit development of individual
defenses: first reaction formation, counterphobia, and undoing
and, as the person matures, sublimination and altruism.
Twelfth Step worker in A.A. is the analogue of the
missionary and healer in religion. He spreads the good news,
achieves conversion of the uninitiated, ministers to the
distressed and needy, and serves as an ethical model for
community and living proof of the efficacy of the system.
existence shows not only that the struggle against alcohol
won but also that it can result in a meaningful and satisfying
life. Twelfth Step activity bolsters his self-esteem, secures
defenses, and, by symbolic reminder of the wreckage of life
devastation of personality that can be wrought by alcohol,
heightens his motivation to stay sober.
many in A.A. it seems to work. One disadvantage of the
limitation of the ethical system to the relation with alcohol
that missionary or priestly status seems to be the only
maturity can be conceived of in A.A. The person who gives
drinking and achieves mature functioning must express this
A.A. formula, or he will have no role in A.A. The same thing
occurs in religious systems that see maturity only in terms
involvement in their system. I think there are many people
recover from alcoholism in A.A. and find they no longer
much reaction formation and focus on the fearfulness of
They have internalized their defenses (at least partially)
have other important commitments and sources of meaning
lives. A.A. does not provide very well for these people.
not encourage their achievements elsewhere, and finds the
that they can stay sober outside A.A. threatening. Such
never mentioned to newcomers.
leads to a basic difficulty that A.A. shares with
religion: the question of authority and autonomy. Many religions
have experienced the problem that arises when the individual
internalizes the system and can function autonomously, no
needing the community to maintain his proper relation to
A.A. there are people in whom the same maturation has
taken place. They no longer need the world view that divides
experience into evil and good, nor do they need the external
supports, controls, and community reaction formation. A.A.
this possibility, and in doing so betrays its limited respect
man's capacity to change. A.A.'s fundamental strength, the
dependence that works so well to facilitate the early
establishment of sobriety, becomes a weakness or constraint
someone in the later stages of recovery. The same problem
for our patients who wish to maintain affiliation with a
system that conflicts with their growth in personal maturity.
may well be that the patient for whom A.A. was useful,
aiding him to mourn alcohol and reinvest in controlled sobriety,
must come to the point where he has to mourn A.A. and reinvest
further life goals. These are problems for which no solution
exists. Professionals outside A.A. can at least be aware
if they find themselves working with a mature, recovering
alcoholic, they can encourage him to understand what is
and develop according to his own strengths and capabilities.
need not accept A.A.'s dictum that such capacities are limited.