I cannot fully answer that question. Many A.A. techniques have been adopted after a ten-year period of trial and error, which has led to some interesting results. But, as laymen, we doubt our own ability to explain them. We can only tell you what we do, and what seems, from our point of view, to happen to us.
At the very outset we should like it made ever so clear that A.A. is a synthetic gadget, as it were, drawing upon the resources of medicine, psychiatry, religion, and our own experience of drinking and recovery. You will search in vain for a single new fundamental. We have merely streamlined old and proven principles of psychiatry and religion into such forms that the alcoholic will accept them. And then we have created a society of his own kind where he can enthusiastically put these very principles to work on himself and other sufferers.
Then too, we have tried hard to capitalize on our one great natural advantage. That advantage is, of course, our personal experience as drinkers who have recovered. How often the doctors and clergymen throw up their hands when, after exhaustive treatment or exhortation, the alcoholic still insists, "But you don't understand me. You never did any serious drinking yourself, so how can you? Neither can you show me many who have recovered."
Now, when one alcoholic who has got well talks to another who hasn't, such objections seldom arise, for the new man sees in a few minutes that he is talking to a kindred spirit, one who understands. Neither can the recovered A.A. member be deceived, for he knows every trick, every rationalization of the drinking game. So the usual barriers go down with a crash. Mutual confidence, that indispensable of all therapy, follows as surely as day does night. And if this absolutely necessary rapport is not forthcoming at once it is almost certain to develop when the new man has met other A. A.s. Someone will, as we say, "click with him."
As soon as that happens we have a good chance of selling our prospect those very essentials which you doctors have so long advocated, and the problem drinker finds our society a congenial place to work them out for himself and his fellow alcoholic. For the first time in years he thinks himself understood and he feels useful; uniquely useful, indeed, as he takes his own turn promoting the recovery of others. No matter what the outer world thinks of him, he knows he can get well, for he stands in the midst of scores of cases worse than his own who have attained the goal. And there are other cases precisely like his own - a pressure of testimony which usually overwhelms him. If he doesn't succumb at once, he will almost surely do so later when Barleycorn builds a still hotter fire under him, thus blocking off all his other carefully planned exits from dilemma. The speaker recalls seventy-five failures during the first three years of A.A. - people we utterly gave up on. During the past seven years sixty-two of these people have returned to us, most of them making good. They tell us they returned because they knew they would die or go mad if they didn't. Having tried everything else within their means and having exhausted their pet rationalizations, they came back and took their medicine. That is why we never need to evangelize alcoholics. If still in their right minds they come back, once they have been well exposed to A.A.
Now to recapitulate, Alcoholics Anonymous has made two major contributions to the programs of psychiatry and religion. These are, it seems to us, the long missing links in the chain of recovery:
1. Our ability, as ex-drinkers, to secure the confidence of the new man - to "build a transmission line into him."
2. The provision of an understanding society of ex-drinkers in which the newcomer can successfully apply the principles of medicine and religion to himself and others.
So far as we A.A.s are concerned, these principles, now used by us every day, seem to be in surprising agreement. (N.Y. State J. Med.,Vol.44, Aug. 15, 1944).
On the surface A.A. is a thing of great simplicity, yet at its core a profound mystery. Great forces surely must have been marshaled to expel obsessions from all these thousands, an obsession which lies at the root of our fourth largest medical problem and which, time out of mind, has claimed its hapless millions. (N.Y. State J. Med., Vol. 50, July 1950).