If you're unaware of AA and are considering learning more about it, you may desire to read this paper. It is a review of two meetings that I attended per requirement of my medical school's Addictions course.
Alcoholics Anonymous, 12 Step Meetings
The room was large, beautiful in an old building located in a large park surroundings. The mix of men to women was about equal and age ranges were mainly middle and upper but there were a couple young early 30’s folks there as well. I was surprised by the number of seniors in the group. I’m not sure of the exact number but I would say about 50 people. The arrangement was well done in a horseshoe shape with the emphasis on the front speaker’s table. The front speaker seemed to organize the meetings structure and was in charge of choosing who spoke.
The seats were simple fold out chairs. There was a ton of light in the room from numerous windows. Being there at 7 AM was interesting as I saw most people had a large cup of coffee and refilling often and donuts were provided. Substituting one addiction for another?
People seemed to know each other quite well. I could tell the newcomers were a bit more shy compared to the people who gathered around afterwards and hung out to talk. A lot of thanking and praising each other went on.
The morning routine was reading from the AA principles, 12 steps, code and saying their prayer. People elected to participate in doing the readings some meetings prior so it wasn’t only the head speaker in the front doing all the talking. The head speaker would provide the day’s topic at large and tell a bit about themselves. Then they would open the floor up to whoever wanted to speak. If no one spoke, then they had the right to ask if X wanted to speak today. I never saw anyone deny a turn in speaking. They all accepted which was actually surprising to me.
The meeting was one hour long and most people lingered longer drinking coffee, eating donuts, smoking outside and talking with their buddies.
The meeting place was well located in a park setting which I immediately thought was cool and refreshing. Alcoholics tend to be depressed, angry or sad and a park setting is perfect to help recovery. The building was also a beautiful old Victorian with large bay windows all around and warm wood flooring. It seemed as if we were all sitting in someone’s living room which also added to the comfort. I understand the need for folded chairs but they tended to ‘scatter’ the group too much. If the seating was more with long tables or couches, I believe the support and unity would be stronger for those who are newcomers. The newcomers, or so they seemed anyhow, sat in the back or sides of the room away from everything and everyone. Perhaps the AA meeting staff wanted it this way so people could feel more secure at a distance and then participate when they were ready.
It was cool seeing the moderator at the front as one of the fellow members – no higher status no special treatment – just a moderator who signed up to be so. I must say I disagree with the requirement to attend two meetings in two different areas. I did not realize that until I began writing this paper and I believe I am fortunate for that. I now know the morning’s events are exactly the same read by different people who signed up from a prior meeting. If I had not gone to two of the same meetings in the same location, I would have not known that the morning events are repeated just as if they were brand new. The only difference is that they were read by different folks. My first meeting I believed that the moderator was an outsider. Although an alcoholic, she seemed to capture the room and present herself with authority. The gentleman today was not near her presence; in fact, he seemed quite distant and bored with the whole thing.
The topic that the first moderator chose was LYING. When she asked the room if there were any visitors, I simply stood up, announced my name, why I was there and thanked them for sharing their stories. It was after I introduced myself that she called the theme for the day. An awesome topic for a medical student to hear and I almost thought she picked it just for me to know how much addicts lie.
The moderator took the AA pamphlet – Do you have a drinking problem? – and went question by question. This was very interesting as it showed me the perspective of an alcoholic. I wish I could have recorded her statements by what is said, stays and I honor that. She took every single question in that pamphlet and denied the presence of a problem until the last two questions. It sucks that I don’t recall her answers to them but I do remember that it was those last two questions which made her think. I will have to go back at some point and get a pamphlet.
Basically all the speakers for the LYING topic all simply said that the only people they listened to was someone else who had been in their same situation or damn close to it. They also lied to the doctors on the intake form – not only the questions the docs asked but also the intake form. That is spooky to me – and it is reality. I am glad I heard that.
That topic also pounded home: people must be prepared to change – move out of the denial phase. If in denial, nothing will get them to budge a millimeter as they have a lie or reason to drink for every question. So it is not worth it. The only thing a doctor can do at that point is say, “My door is open and I am here to support you when you think you may be ready to stop drinking.”
The people who chose to speak did a beautiful heart-felt & powerful presentation about lying and why they did it.
Person after person who spoke on Monday shared how much closer they were to their loved ones and friends. They also shared how great it is to be free from drinking and seeing the world through their eyes instead of a bottle.
The second moderator from Tuesday’s meeting chose LOVE – fitting as it is Valentine’s. This topic was not so interesting as the moderator didn’t seem to care about his presence their that day which was unfortunate. His attitude seemed to permeate the building that day – albeit a few individual speakers who made even me think about my perception of love and what it was. So I was quite impressed with one of the individuals – he spoke about what love was eloquently and more so – what it was not.
The twelve-steps seemed to be the lifeblood of the group members. Time and time again I heard that someone kept failing at giving up alcohol for good and then decided that they will try the steps in order. Once they did step 1 to step 2 and so on, they became sober and more involved in the program. One individual said that he spent the majority of the time on step 1. The other steps to him were much easier.
The advantage of the 12 steps is that it has a proven track record and people respect track records and results. Of all the speakers, not one member disagreed with the 12 steps even though he or she may have felt them lame or unnecessary at one point. In the end, they followed the step program and achieved what they needed.
Having tasks presented in a step-wise fashion is smart for difficult tasks. It allows slow change to occur; it is not overwhelming; each step gained is a positive reinforcement to obtain the next step; it is realistic to obtain a goal that requires steps. The steps also form unity and a conversation piece for support. It is like a ladder and there are people in the meetings on different levels of the twelve step process which allow members to interact in a methodical way rather than sporadic view-points of what worked and what did not.
A weakness of the twelve steps is that is God mentioned too much. This overwhelmed a number of the members from what I heard but they finally accepted it by understanding that God could be anything they want – not just the man in the sky. I also have a problem with God mentioned over and over again; especially when there are members that are already having a tough time stopping alcohol. Quitting drinking is already a tough swallow and adding on top of that the requirement to accept God or religion into their life is not easy for folks.
The fact that one must obtain twelve steps is also tough as the goal is further away than having a program with only three steps. The daunting task of quitting drinking let alone successfully obtain and live by 12 steps is not easy.
Individuals may not attend AA meetings meerly because they are not ready. They are still in denial. They may also fear the label of alcoholism and in that case they also are not ready. Walking into a room of strangers is also tough. The way the room is situated though – at least this meeting – they could ‘hide’ in the corner and listen. The pamphlets were also easily obtainable and out of the way so all could easily take some.
A requirement is for AA members to sponsor someone who has a problem and wants help. If the sponsor takes a problem drinker to a meeting or two and sits next to them during it, this could help break the ice and get them more committed to change. The pamphlets are ok but not great. It is best for a person who is in pre-contemplation to speak to a former alcoholic and hear the story this way. Any time someone has to read something, it gets interpreted differently or does not register in importance. However, if someone is considering change and they speak with someone who lived a similar lifestyle, they would likely be more attentive and responsive to change – and this is what many members stated over and over again.
My practice will benefit highly from these meetings as I know firsthand how they are, how they operate and how to access their locations. I also now realize how much addicts lie lie lie. This will always be in my head when I am talking with a suspected alcoholic and remind me to ask creative questions – well beyond CAGE as they’d deny all of those anyhow. I will have pamphlets sent out in every welcome patient packet – no matter what their condition. This will provide them with discreet information and may plant a seed. I will also include other handouts in the welcome packet such as coupons or discounts to stores so they do not feel as if I’m targeting alcoholics. This approach may get more people to open up and share with me prior to them seeking AA meetings or counseling.
I actually vote that you require more of these and drop the quizzes. Quizzes don’t mean anything to me nor do I learn from them. I learned a ton from the meetings. I would require that students attend AA, cocaine, drugs, workaholic and other meetings – say one to two a week and write about their experiences – or at least have this as an alternative to quizzes so people who like quizzes and learn from those – can have that option while the other students can benefit from attending more meetings.