Mechanisms of change in AA

Addiction Research and Theory published a review of mechanisms of behavior change in AA.

Here’s an excerpt from their conclusions:

Why have spiritually-oriented organizations, like AA, become so popular among alcohol and other drug addicted individuals and not as popular among those suffering from other kinds of mental disorders? One reason perhaps is that the disinhibiting effects from heavy alcohol and drug use frequently generate deviations from one’s own moral code or set of values. Repeated over and over this “Jekyll and Hyde” scenario can lead to a sense of profound moral failing, self-blame and self-loathing. As structural and functional brain alterations caused by continued alcohol use exacerbate impairment over the regulation of drinking behavior negative feelings may intensify and be deepened and reinforced further by the reproach of affected onlookers and significant others. For many, the sense of “salvation”, historically and implicitly embedded within AA philosophy and in many other recovery mutual-help societies throughout US history (White 1998), may feel cleansing and self-soothing, providing a framework for self-forgiveness. This may account for the rather odd AA mix of spirituality and, “alcoholism as a medical disease” (see the Doctors’ Opinion, xxv; AA 1939, 2001), which may have been initially a purely pragmatic hybrid constructed to alleviate common feelings of guilt, shame, and self-loathing that serve as barriers to salutary change. The attenuation of these feelings and self-perceptions as a function of AA exposure may be more specific to the spiritual/disease framework of AA and worthy of future mechanisms research.

I cringe a little at the uncritical use of disinhibition and I consider the word “salvation” to be laden with a kind of religiosity that I don’t find in 12 step groups. However, the article did a pretty good job of examining the program and placed a great deal of emphasis on the growth fostering relationships within the fellowship. It’s worth noting that all 12 step meetings are not created equal and that there would probably be significant variance of these mechanisms between groups.

Farm staff who would like a copy can email me.