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12-Step Program: History and Process

history of the aa

The Oxford Group: Early Beginnings of AA

The alcohol support and recovery group known as AA, or Alcoholics Anonymous, appreciates a history spanning over 75 years. Its beginnings are as grassroots as one can imagine. In 1934, a former Wall Street banker, Bill Wilson, found himself in a state of seemingly hopeless, irreversible alcoholism. A friend, and former alcoholic, sought Wilson out to offer him a piece of advice – join the faith-based Oxford Group.[1] The advice would prove to be a watershed in Wilson’s personal history of addiction and recovery. Around 1921, an evangelical Christian missionary by the name of Frank Buchman founded a movement named the First Century Christian Fellowship. By 1932, the fellowship became known as the Oxford Group. A main tenet of the Oxford Group was that in order to lead a Christian life, one’s existence must be faith-based and God-controlled.[2] The Oxford Group did not specifically intend to be a resource for alcoholics; the group’s Christian beliefs, teachings and supportive community atmosphere helped its congregants to experience spiritual conversions. The sheer power of the Oxford Group’s observance of the teachings of Jesus Christ helped some alcoholic members to voluntarily quit drinking, and from there alone, the message began to spread that this group could help people recover from alcoholism.[3]

Bill Wilson, taking his friend’s fateful advice, not only addressed his addiction to alcohol, but also thereafter committed his life to helping treat the disease in other alcoholics. Although Wilson did attend Oxford Group meetings, he credited his vision of a bright white light during a hospital stay with his miraculous recovery (he never drank again after the epiphany).[4] Post-recovery, Wilson found that a key to staying sober was helping others to overcome their addiction to alcohol, which included application of Oxford Group’s Christian principles.

Dr. Bob Smith was the first alcoholic who Wilson helped to recovery. Together, Wilson and Dr. Smith founded AA in 1935. Both AA and the Oxford Group drew attention not only from alcoholics, but also from world-famous psychoanalyst Carl Jung.

“When a member of the Oxford Group comes to me in order to get treatment, I say, ‘You are in the Oxford Group; so long as you are there, you settle your affair with the Oxford Group. I can’t do it better than Jesus.” Carl Jung

AA’s Early Success and Development

Alcoholism, unfortunately, has long been stigmatized, even being considered a sin in some religions, and there was no exception to this public opinion in the 1930s. For instance, the American Medical Association did not deem alcoholism an illness until 1956.[5] When viewed in its historical context, Wilson and Smith’s feats with AA are even more laudable. The first AA book, Alcoholics Anonymous, became known as The Big Book and is the seminal text on AA. According to The Big Book, 50 percent of alcoholics who joined AA and stayed with the program got sober, 25 percent got sober after some relapses, and the rest of the participants all showed improvement.[6]

Alcoholics Who Joined AA and Stay with It

alcoholics who join AA and stay with it

alcoholics who join aa and stay in

Written in 1939, this seminal text on faith-based alcohol treatment has sold over 30 million copies in 70 languages.

The 12-Step Program

The 12-step program, which is a regimen for recovery, was the brainchild of Bill Wilson and an outgrowth of three influences: the Oxford Group, the expertise of Dr. William D. Silkworth (Wilson’s attending doctor during his stay at the hospital where he had his fateful epiphany), and the teachings of the famed psychologist William James.

One night, while suffering with an ulcer, Wilson was working on the fifth chapter of The Big Book when in a fit of inspiration (based in great part on the above insights), he drafted the 12 steps in 30 minutes.[8]

The following insights proved to be Wilson’s main guidance for the creation of the 12-step program.[7]

  • The Oxford Group’s unwavering commitment to:
    • Absolute honesty
    • Absolute purity
    • Absolute unselfishness
    • Absolute love
    • The practice of sharing one’s life challenges with the group
    • Making amends for wrongs committed
    • Meditation, or self-reflection

Dr. Silkworth’s belief that alcoholism is a disease but purification of one’s moral life could organically lead to recovery. Further, Dr. Silkworth thought that alcoholics should be aggressively told the disastrous effects of the disease on the body and the increased likelihood of mortality. Further, compared to a doctor without any history of alcoholism, a hopeless alcoholic who had become sober would be more effective at delivering warnings to alcoholics about the ill health effects and increased risk of mortality.

William James’s book, The Varieties of Religious Experience, helped Wilson to validate his epiphany and experience of the white light while he was hospitalized. According to James, miraculous conversions to faith in God could happen over time, but also suddenly, as it had for Wilson.

The 12 Steps

step1We admitted we were powerless over alcohol and that our lives had become unmanageable.
step1Came to believe that a power greater than ourselves could restore us to sanity.
step1Made a decision to turn our will and our lives over to the care of God as we understood Him.
step1Made a searching and fearless moral inventory of ourselves.
step1Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
step1Were entirely ready to have God remove all these defects of character.
step1Humbly asked Him to remove our shortcomings.
step1Made a list of all persons we had harmed, and became willing to make amends to them all.
step1Made direct amends to such people wherever possible, except when to do so would injure them or others.
step1Continued to take personal inventory, and when we were wrong, promptly admitted it.
step1Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
step1Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Source: http://www.aa.org/assets/en_US/smf-121_en.pdf

The 12 Traditions

To provide guidance beyond the 12 steps, Wilson also devised the 12 traditions, which are tantamount to an AA constitution. The 12 traditions set forth the necessity to preserve the unity of the group, the primacy of God as a force of personal inner direction, and a commitment for the fellowship to be run by members and to maintain its self-sufficiency and organizational independence. Read the 12 traditions: http://www.aa.org/assets/en_US/smf-122_en.pdf

AA Today

Bill Wilson and Dr. Smith’s efforts to help alcoholics have grown into an organization today with approximately 114,000 groups and 2 million members across 170 countries.[9] Although AA has grown into an international fellowship and the experience from one group to another may vary, AA meetings are a common denominator. AA Around The World

Anyone with alcohol addiction issues is welcome to attend a meeting and per AA official literature[10] can expect the following:

  • A no-pressure environment; all membership is voluntary and walk-ins are welcome
  • A non-denominational setting dedicated to spirituality based recovery process and not proselytizing for any particular religion
  • No mandatory fees; AA is a self-funded, self-sustaining organization
  • An invitation to share personal stories about alcohol addiction and its impact on life
  • A guest can be brought to a meeting for added support
  • A discussion of the 12 steps

What to Expect at AA

Success of AA

Gauging the Success of AA

There is some difficulty in gauging the success of AA because overcoming alcohol addiction is not a process that can be easily quantified. Further, it is often difficult to pinpoint exactly which influence in an alcoholic’s life compels him or her to sobriety (and recall, Bill Wilson himself mainly credits a white light and an epiphany with his recovery). The early success rates of AA may have been owed, in part, to the relative smallness of the groups and the ability of the founders and local organizers to have firsthand knowledge of the individual progress of members.

In modern times, approximately 40 percent of persons who join AA exit the program within one year.[11] However, in 2006, two psychologists affiliated with the Department of Veteran’s Affairs and Stanford University concluded a 16-year-long study which found that of those study participants who stayed in AA for at least 27 weeks, 67 percent were sober as of the 16th year, compared to only a 34 percent sobriety rate among those who did join AA.[12] Again, it cannot be known with certainty that the AA program was dispositive to the sobriety success data, but it was a contributing factor. A 2010 study of the relationship between perceived stigma associated with alcoholism and the probability of accessing treatment found that negative perceptions of alcoholism directly impacted an alcoholic’s willingness to seek help.[13] For this reason, the study concluded with the recommendation that efforts to reduce public stigma be incorporated into public health programs to treat alcoholism. The study illustrates that many alcoholics continue to internalize shame about the disease, which may cause them to avoid much needed treatment.

shame and stigma of alcoholism

Perceptions of AA

In a two-year research study of medical students’ attitudes towards AA, researchers found that the students had a more favorable perception of AA’s spirituality based treatment before they began training in psychiatry compared to after.[14] The study concluded with a recommendation that medical students be instructed on spirituality based alcoholism treatment during their medical education and training. The findings of the study are reminiscent of Dr. Silkworth’s early insight that while alcoholism is a disease, recovery cannot be purely biologically based and spirituality can be instrumental in treatment. Media has capitalized on an AA phenomenon: “Hello, my name is… and I am an alcoholic.” David Colman, writing for The New York Times, and an AA member himself, points out that while it is a tradition within AA for members to maintain anonymity vis-à-vis the press, radio and film, AA’s existence in the mainstream of American culture is working to break down the anonymity that was once coveted.[15] Colman points out that when AA began in the 1930s, alcoholism was seen as disgraceful, whereas today there is a proliferation of best-selling memoirs with authors confessing their alcoholism, and further, many celebrities and public persons are open in the media about their alcoholism and battle with the disease. In short, alcoholics are no longer viewed as the social pariahs they were earlier in the 20th century, and these days anonymity may not be as needed.

Films with themes of alcoholism and/or featuring AA provide key insights into changing societal views of alcoholism as well as artistic treatment of the subject in the different epochs of America cinema. For instance, the Oscar-nomination-laden film Days of Wine and Roses (1962) plays out like a cautionary tale against drinking, whereas Crazy Heart (2009) delves further into the heart of an alcoholic and invites compassion for the disease. Flight (2012), one of the most recent films in the addiction genre, is effective at drawing the audience directly into the central conflict that revolves around the alcoholic pilot (Denzel Washington) managing to avert an air disaster while drunk. Film treatment of alcoholism shows the many dimensions of the disease and is not only a product of public opinion but can also actively work to improve the public view on alcoholism.

The following movies include alcoholism as a central theme and are entertaining without undermining the seriousness of the subject:

  • 28 Days (2000)
  • Leaving Las Vegas (1995)
  • When a Man Loves a Woman (1994)
  • Barfly (1987)
  • Under the Volcano (1984)
  • A Star Is Born (1954)
  • The Lost Weekend (1945)

The Future of AA

Since 1730, more than 100 mutual aid fellowships have existed, but AA has managed to dominate and succeed in the field of alcohol addiction recovery.[16] But past success is not itself a guarantee of future success. According to one scholar and counselor writing on the future of AA, continued success in the 21st century depends on a variety of factors, including the degree to which AA members identify with the group, society’s changing perceptions of recovery, the emergence of new government and private groups dedicated to alcohol recovery, and the role of technology in recovery including whether mutual aid fellowships will increasingly exist in the virtual space of the Internet.[17] These theoretical points, and other academic literature on alcohol addiction and AA, provide guidance to AA as an organization to help formulate next steps and best ensure future success.

Future Success of AA AA, like any organization, must at once maintain its traditions while at the same time remaining flexible to changing times and needs of its members. Although the future of AA cannot be certain, it is clear from its past successes that its mission meets an ongoing personal and public need and the continuation of its work can help many more people struggling with alcohol addiction.

If you’d like more information on recovery, or how the 12-step movement can factor into your recovery, contact us today here at Futures.


[1] Alcoholics Anonymous World Services. Alcoholics Anonymous. 4th ed. New York: A.A. World Services Inc. (2001). Accessed 10 June 2014. [2] See Buchman, F, Remaking the World. London: Blandord Press (1961). Print. [3] See Alcoholics Anonymous World Services. Alcoholics Anonymous Comes of Age: A Brief History of A. A. New York: A.A. World Services, Inc. (1957). Print. 4 See Pittman, B, AA The Way it Began. Seattle, WA: Glenn Abby Books (1988). Print. [4] See Pittman, B, AA The Way it Began. Seattle, WA: Glenn Abby Books (1988). Print. [5] Alcoholics Anonymous Worldwide Services, Carrying the Message of Hope and Recovery for 75 Years: A.A.’s ‘Basic Text,’ Alcoholics Anonymous, Reaches Another Milestone” (2014). Accessed 10 June 2014. [6] Alcoholics Anonymous, p. 174. [7] Wilson, Bill. “Where Did the 12 Steps Come From?” AAgrapevine (1957). Accessed 10 June 2014. [8] Ibid. [9] AA Worldwide Services. A.A. at a Glance. New York: AA Worldwide Services Inc., (2013). Accessed 10 June 2014. [10]AA Worldwide Services. “A Newcomer Asks…” New York: AA Worldwide Services, Inc, (2013). Accessed 10 June 2014. [11] Liliefeld, S. & Arkowitz, H Does Alcoholics Anonymous Work? Scientific American (2011). Accessed 10 June 2014. [12] AA Worldwide Services. “A Newcomer Asks…” New York: AA Worldwide Services, Inc. (2013). Accessed 10 June 2014. [13] Keyes, K.M., et al. “Stigma and Treatment for Alcoholic Disorders in the United States” American Journal of Epidemiology (2010): http://aje.oxfordjournals.org/content/early/2010/11/01/aje.kwq304 Web. 10 June 2014. [14] Fazzio, L, et. al. “Evaluation of Medical Student Attitudes Toward Alcoholics Anonymous” (2003): Accessed 10 June 2014. [15] Colman, D. “Challenging the Second ‘A’ in AA” The New York Times (2011). Accessed 10 June 2014. [16] Krentzman, A.R., et al. “How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives” National Center for Biotechnology Information (2011) Accessed 10 June 2014. [17] White, W. “The Future of AA, NA and Other Recovery Mutual Aid Organizations” (2010) Accessed 10 June 2014.