Alcoholics Anonymous grew out of the temperance and Protestant revival traditions in America. The first installment of the Ken Burns documentary, Prohibition, described the Washingtonians, a group of what we would now called recovered alcoholics (who regarded themselves as sinners who had been saved) within the temperance movement. In nineteenth-century America, the Washingtonians—whose meetings closely resembled contemporary AA ones—had a proportionally larger membership than AA does today.
AA-ers think their movement was uniquely created by God in heaven (if not by Nora Volkow in the laboratory) speaking through Bob and Bill in 1935, and that it is thus the most successful treatment for alcoholism (and whatever else ails you) of, and for, all time. Their thinking is an example of America's belief in our "exceptionalism." This is a mantra among right-wing politicians that implies that we aren't subject to the cultural determinism other, lesser societies are prey to.
The philosophy and the spirit of AA reflect a specifically American theme—idealistic, on the one hand, perfectionist on the next. These are the sources for AA's abstinence fixation. If you used to drink two bottles of vodka nightly, and you quit entirely for ten years, and then you had a sip of a cocktail at a wedding—BOOM—back to ground zero. For AA, a miss is as good as a mile as a decade of alcoholism.
We could say that this makes little difference, since the goal of treatment is to maintain—or return immediately to—abstinence. We could say that—but we'd be wrong. The abstinence fixation has the following drawbacks:
Imagine Amy Winehouse's feelings when, after leaving her abstinence-always rehab, she drank herself to death. "I shouldn't do this; I'm horrible; I might as well drink myself to..." Then consider AA's philosophy as applied by a sex addict. Suppose he or she is at a stage where they are tempted by sexual thoughts or options. How should they regard this? As a normal part of life? Or as a sign of a deep dark, malevolent urge which proves that they are diseased.
Thus, when treating people recovering from and fighting with their AA learning, the first thing a helper must do is to get the person to acknowledge the progress they have made.
But an even more basic thing a helper must strive to accomplish with the addicted individual is for them to recognize that they are a whole human being capable of thriving like all other human beings.
Because, you see, as with other types of perfectionism, AA's irrational demandingness makes people far less "perfect" than they are actually able to be.
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*Billy Sunday, who left professional baseball to become an evangelical minister (a job at which he ultimately made much more money) was America's most popular temperance preacher in the lead-up to Prohibition. Sunday himself was a moderate drinking ballplayer, unlike most of his teammates. Two of his sons, however, were alcoholics, both of whom died in their forties. According to the Wikipedia, Sunday "criticized such popular middle-class amusements as dancing,playing cards, attending the theater, and reading novels...[but] his three sons engaged in many of the activities he preached against, and the Sundays paid blackmail to several women to keep the scandals relatively quiet" (I guess this means they violated more than Sunday's prohibitions against dancing, cards, theater, and novels).
Wikipedia also notes, "his three sons disappointed him." Yes, as so many Americans did.
Leonard Cohen's Billy Sunday
My name is Billy Sunday
I speak in the name of God.
They call me Billy Sunday
I speak in the name of God
And God is always angry
Just in case you think He's not
He's angry at your body
For reasons that are His
He doesn't like your body
According to reasons that are only His
I'd like you to know He's very very angry
But that's just the way He is
He's angry at the spirit
That is turned away from Him
He's angry at the spirit
That's turned away from Him
If He ever gets His Hands on it
He's gonna tear it limb from limb