75 Years Later, We Still Don't Know How AA Works

AA doesn't work for everybody, but when it does, it can be transformative. Members receive tokens to mark periods of sobriety, from 24 hours to one month to 55 years.
Photo: Todd Tankersley

In 1935, in the dark days of the Great Depression, a broken-down drunk named Bill Wilson founded Alcoholic Anonymous, an organization that would help millions of people combat alcoholism. Seventy-five years later, we still don't know how AA works.

Brendan Koerner of Wired has a fascinating look at the founding and inner working of AA, and why some alcoholics' brains may be wired to be receptive to its methods:

It’s all quite an achievement for a onetime broken-down drunk. And Wilson’s success is even more impressive when you consider that AA and its steps have become ubiquitous despite the fact that no one is quite sure how—or, for that matter, how well—they work. The organization is notoriously difficult to study, thanks to its insistence on anonymity and its fluid membership. And AA’s method, which requires “surrender” to a vaguely defined “higher power,” involves the kind of spiritual revelations that neuroscientists have only begun to explore.

What we do know, however, is that despite all we’ve learned over the past few decades about psychology, neurology, and human behavior, contemporary medicine has yet to devise anything that works markedly better. “In my 20 years of treating addicts, I’ve never seen anything else that comes close to the 12 steps,” says Drew Pinsky, the addiction-medicine specialist who hosts VH1’s Celebrity Rehab. “In my world, if someone says they don’t want to do the 12 steps, I know they aren’t going to get better.”

Wilson may have operated on intuition, but somehow he managed to tap into mechanisms that counter the complex psychological and neurological processes through which addiction wreaks havoc. And while AA’s ability to accomplish this remarkable feat is not yet understood, modern research into behavior dynamics and neuroscience is beginning to provide some tantalizing clues.


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Say 5% of alcoholics went cold turkey, successfully, in the last twelve months, and 5% of alcoholics were successful in AA in the last twelve months. AA has doubled the number of recovering alcoholics in the last twelve months.
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According to the book "Pass It On: The Story of Bill Wilson..." (1984) written by A.A. *wait for it*
Bill Wilson, the co-founder of Alcoholics Anonymous used the Ouija Board to contact spirits. Wilson claimed that he received the twelve step method directly from a spirit without the board and wrote it down. (page 196-197). That pretty much tells me everything I need to know.
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