The impact of COVID-19 has shown that mutual aid groups like AA may be even more beneficial than we realised, say Lisa Ogilvie and Jerome Carson.
Admitting to being an alcoholic is hard. It means conceding that your actions and decisions have led to a point of failure, and fear of humiliation and public stigma places a major obstacle to those seeking help. Science may yet prove that alcohol problems are inextricably linked to dysfunctional brain processes rather than character flaws, but until then this perceived failure – and associated shame – is a driver for people to seek solace in mutual support groups like Alcoholics Anonymous (AA).
AA groups understand the plight of the alcoholic through their own lived experience. An AA group has compassionate goals, and an altruistic motivation toward supporting its members to achieve a better life in recovery. Iztvan et al (2016) identified in Second wave positive psychology: Embracing the Dark Side of Life that having a shared compassion can bring about a positive and transformative adjustment in wellbeing, and it was this that led to the idea of investigating how AA membership affects its members’ wellbeing and self-definition.
It was anticipated that having a high level of cohesion with AA would improve wellbeing, and that AA members would have weathered the general decline in wellbeing during the COVID-19 pandemic – as reported by the Office for National Statistics (ONS) in its Annual personal well-being estimates – better than people not engaging with mutual support. The study included more than 200 members of AA from 12 different countries, including the UK, USA, Australia, South Africa and Turkey, and the demographic was further varied in terms of age, gender and length of sobriety. Participants completed a survey which included questions that measured their cohesion with AA, the significance they placed on different aspects of their character, and their wellbeing. They also described what being a member of AA meant to them.
Cohesion and wellbeing
The importance of having a sense of cohesion with AA became clear, as the findings showed a strong link between cohesion and wellbeing – in fact, the level of cohesion with AA was found to be influential in predicting wellbeing. Those participants reporting higher levels of cohesion also experienced significantly better wellbeing, and this was similarly true with the personal characteristics reported by the participants. Those who reported higher levels of cohesion were more likely to be altruistically motivated in supporting others, and conveying empathy, acceptance and friendship.
This was summarised by one participant who said, ‘Before finding AA I didn’t know it was possible to connect with people that want the best for me, who I had never met before. It has opened up a world of new friends and kindness, and shown me the way to a better life’. Interestingly, this finding resonates with one of the traditions of AA – ‘Each group has but one primary purpose – to carry its message to the alcoholic who still suffers.’ This suggests cohesion is key to the success of AA in terms of both altruistic motivation and increased levels of wellbeing, a finding that was further substantiated when it was noted that the length of sobriety was also positively associated with wellbeing.
Evidence of a specific recovery identity among AA members was revealed when the findings indicated that working toward compassionate goals as a group establishes an identity that safeguards close relationships, and rejects characteristics associated with high-risk behaviours – such as binge drinking – in favour of upholding community values. As an example, one participant said that AA represents, ‘A sense of community based on shared experiences and feelings that come from knowing oneself as an addict and the particular way a mind wired that way, works. Nobody “gets” an addict like an addict’. This indicates that cohesion with AA encourages its members to adjust aspects of their identity, so they might contribute to successful inclusion in a supportive network of people living in recovery.
The significance of AA to its members’ wellbeing during the pandemic was apparent when the data in the study were compared with two independent research projects on COVID-19 and wellbeing. The participants in this study showed markedly higher levels of wellbeing than those recorded in both COVID-19 studies, and demonstrates that AA has had an important and positive impact on its members’ wellbeing – so much so that they have avoided the overall decline seen in the general population during lockdown (DDN, December/January, page 9). According to one participant, ‘The positive impact goes well beyond healing health, family life and personal recovery. It has led me to know myself, to access other help as needed. Today I have a healthy relationship with myself and others’.
Further analysis showed participant wellbeing compared favourably with data collected by ONS prior to the COVID-19 pandemic, which even exceeded the threshold for having a high level of wellbeing as designated by ONS. This indicates that cohesion with AA not only improves wellbeing but provides its members with a foundation on which to flourish. To flourish is the pinnacle of living a happy and meaningful life, and is the main focus of positive psychology (Seligman, 2011). To see such clear evidence of this in a sample of recovering alcoholics was an unexpected finding, perhaps best captured by one participant who said, ‘Belonging to AA has meant many things to me during my recovery. Inclusion, wisdom, support, guidance and spiritual growth. Above all it has given me freedom and the freedom to just be me and that is a miracle’.
This study convincingly supports the basis for the research – that being moved by a shared compassion will have a transformative effect on the wellbeing of AA members. It demonstrated that people in recovery who are members of AA have better wellbeing than that of the general population during the COVID-19 pandemic. Most remarkably, evidence of flourishing was discovered, indicating that cohesion with AA not only acted as a protective factor against the general decline in wellbeing seen during lockdown, but also improved it, with higher levels reported in this study than seen only in pre-pandemic research.
All of this introduces an exciting avenue for future study, looking at flourishing and addiction recovery and how to enhance this process. It has long been known that AA members benefit from being part of a group of recovering addicts. It has not been known that such membership actually leads to flourishing.
The Twelve Steps
The heart of the suggested programme of personal recovery is contained in Twelve Steps.
- We admitted we were powerless over alcohol – that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought 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.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practise these principles in all our affairs.
Newcomers are not asked to accept or follow these Twelve Steps in their entirety if they feel unwilling or unable to do so. They will usually be asked to keep an open mind, to attend meetings at which recovered alcoholics describe their personal experiences in achieving sobriety, and to read AA literature describing and interpreting the AA programme.
Lisa Ogilvie recently completed an MSc in counselling and positive psychology at the University of Bolton, and is a member of AA.
Jerome Carson is professor of psychology at the University of Bolton. Previously a ‘high functioning alcoholic’ he has been abstinent for more than four years.
A more detailed version of the research can be obtained by emailing Lisa on firstname.lastname@example.org