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Scant attention has been paid to the American alcoholic mutual aid societies that preceded AA. This article seeks to stir interest in lost chapters of the history of alcoholism recovery in America by cataloguing and comparing pre-AA. alcoholic mutual aid societies with AA. and post-AA. mutual aid groups, and by describing those characteristics that pre-AA. alcoholic mutual aid societies shared in common. In addition, it will identify the factors that led to the demise of pre-AA. alcoholic mutual aid societies, discuss what the collective histories of these groups reveal about the sources of A.A.'s resilience and the potential fate of post-AA. alcoholic mutual aid societies, and provide valuable insights into the process of recovery.
Published in revised form in: White, W. (2001) Pre-AA Alcoholic Mutual Aid
Societies. Alcoholism Treatment Quarterly 19(1):1-21.
Pre-A.A. Alcoholic Mutual Aid Societies
William L. White
It would be hard to imagine picking up a late 20th century text on alcoholism that did not
detail or debate the value of Alcoholics Anonymous (A.A.) as a framework for long term
recovery from alcoholism. Based on its size, geographical dispersion and endurance,
A.A. has rightfully earned its place as the standard by which all other sobriety-based
support structures are judged. Given the more than 3,000 books and articles that have
been written about A.A. (Bishop and Pittman, 1994), it is surprising that only scant
attention has been paid to the American alcoholic mutual aid societies that preceded A.A.
Modern understanding and even acknowledgment of these groups is quite rare. This
paper seeks to stir interest in these lost chapters in the history of alcoholism recovery in
America by:
cataloguing and comparing pre-A.A. alcoholic mutual aid societies with A.A. and
post-A.A. mutual aid groups,
describing those characteristics that pre-A.A. alcoholic mutual aid societies
shared in common,
identifying the factors that led to the demise of pre-A.A. alcoholic mutual aid
societies, and
discussing what the collective histories of these groups reveal about the sources of
A.A.’s resilience and the potential fate of post-A.A. alcoholic mutual aid
The Boundaries of Mutual Aid
Alcoholics have a long history of reaching out to others for help, and they have for more
than 200 years been involved in organizing support structures to help themselves and each other.
To explore the latter, we must determine which efforts deserve inclusion in the present study.
First, our discussion will focus on group-supported recovery rather than the many varieties of
“solo” recovery from alcoholism. Linda Kurtz has described such groups and classified them by
their degree of focus on personal change, their degree of inclusion or exclusion of professionals,
and their degree of organizational autonomy (L. Kurtz, 1997). For our discussion, we will
operationally define “pre-A.A. alcoholic mutual aid societies” by limiting our scrutiny to groups
that meet the following six criteria:
1. They were founded before 1935.
2. Alcoholics played leadership roles in their founding and/or operation.
3. Their goal, in whole or in part, focused on the resolution of drinking problems at a
personal level.
4. They specifically (but not necessarily exclusively) recruited alcoholics as
1. They were member-directed as opposed to professionally-directed.
6. Their existence can be verified from multiple historical sources.
These criteria exclude from our discussion many 19th and early 20th century temperance
and religious groups, including the Oxford Group, that were used by alcoholics as an aid to
sobriety but were not organized by alcoholics and whose goals did not explicitly include the
reclamation of the alcoholic. The requirement that groups be member-directed eliminates from
our discussion the entire spectrum of 19th and early 20th century professionally-directed
treatments for alcoholism. And by restricting ourselves to groups whose existence can be
validated from multiple sources, we eliminate (at least pending further historical investigation)
groups such as the Harlem Club of Former Alcoholic Degenerates whose fictional depictions
may or may not have had a real counterpart (Cullen, 1899). At the same time, the above criteria
include several Native American cultural revitalization movements and 19th century urban
missions even though these groups had goals that included, but transcended, recovery from
alcoholism. These criteria also embrace the mid-19th century moderation societies organized by
and for those with drinking problems but whose goal was not total abstinence.
Having set the boundaries for our discussion, we will introduce the pre-A.A. alcoholic
mutual aid societies in the order in which they appeared.
Native American Temperance Societies
The first abstinence-based mutual aid societies in America were organized by Native
Americans whose own sobriety often followed near-death experiences with alcohol. The vision
experiences of these messianic leaders vividly revealed the role alcohol (the “Water of Death”)
was playing in the destruction of Native Peoples. As early as the 1750s–nearly a century before
the Washingtonian Revival–Wagomend, an Assinsink Munsee, and Papoonan, a Unami
Delaware, exhorted their tribes to denounce rum and return to their cultural traditions.
Wagomend hosted quarterly meetings where walking, singing, dancing and cathartic weeping
were used to support the personal and cultural rejection of alcohol (Francis, 1996, P. 121).
In the late 18th and early 19th centuries, Samsom Occom, Handsome Lake, Tenskwatawa
(The Prophet), The Kickapoo Prophet Kenekuk, Kah-ge-ga-gah-bowh (George Copway), and
William Apess turned their own rebirths into broader temperance and cultural revitalization
movements. The local “circles” organized by Handsome Lake were led by a “holder” who
served as a teacher of the “Code of Handsome Lake,” the first principle of which was complete
rejection of alcohol. To the best of this author’s researches, these circles constitute the first
geographically de-centralized alcoholism recovery framework in America (Cherrington, 1926;
Mancall, 1995; Edmunds, 1983, 1984; Schultz, 1980; Apess, 1992; White, 1999).
The personal recoveries of these Native American leaders generated the first alcoholic
confessional literature in America, the first anti-alcohol tracts written by and for alcoholics, and
the first group experiences whose goals included personal and cultural sobriety. The extent and
nature of Native American alcohol problems have often been misportrayed in the form of what
Leland has christened “firewater myths” (See MacAndrew and Edgerton, 1969, and Leland,
1976), just as the contributions of Native Americans within the history of alcoholism recovery in
America have been almost universally ignored. These contributions constitute an area of much
needed study.
Of particular historical importance is the way in which the earliest Native American
abstinence-based movements viewed personal recovery from alcoholism as inseparable from the
physical survival and the economic, political and cultural revitalization of Native American tribal
life. As we shall see, the degree to which alcoholic mutual aid societies address broader
political, economic and social concerns will vary widely and constitute a subject of considerable
on-going controversy.
The Washingtonians
Recovered alcoholics served as temperance missionaries in the 1830s, but it was not until
April 2, 1840, that a mutual aid society was organized by and for Euro-American alcoholics.
The Washingtonian Temperance Society was birthed out of the failure of the existing temperance
movement to focus any significant and sustained energy on the reclamation of the drunkard. It
was only a matter of time before a group of “sots” would organize their own temperance group–
one whose membership would invite others like themselves into sober fellowship. The
Washingtonians grew to a collective membership of more than 500,000 within three years,
distinguishing it as one of the fastest growing social movements in American history. Their
membership, which at first was made up almost exclusively of “hard cases,” grew in the face of
its public recognition to include members who had not suffered from alcoholism. In most places,
the latter quickly outnumbered the former.
The Washingtonians pioneered a program of alcoholism recovery based on: 1) a public
commitment to total abstinence (signing the pledge), 2) public confession, 3) continued
participation in weekly “experience sharing” meetings, 4) service work (“Let every man be
present, and every man bring a man.”), 5) mentorship (older members visiting newer members),
6) personal assistance (provision of food, clothing, shelter, work), and 7) sober fellowship (social
activities). The Washingtonians also created special support branches for women, young people,
and “free colored” (Anonymous, 1842; Baker, 1844; Maxwell, 1950; Blumberg and Pittman,
1991; Alexander, 1988). The Washingtonians are the most widely know of pre-A.A. alcoholic
mutual aid societies. They were the only alcoholic mutual aid society before A.A. to achieve
that unique and often fatal American phenomenon, “super-success.”
The Fraternal Temperance Societies
A new sobriety-based support structure–the fraternal temperance society–rose from the
ashes of the collapsing Washingtonian groups in the mid-1940s. These societies–groups like the
Sons of Temperance, Order of Good Templars, Order of Good Samaritans, and Order of
Rechabites, to name just a few–used group cohesion, mutual surveillance, financial assistance,
and elaborate meeting rituals to bolster one’s pledge of abstinence. The centerpiece of the
recovery approach of the fraternal temperance society was regular sober fellowship. The
transition from the Washingtonians to the fraternal temperance societies was marked by a shift in
emphasis from signing the pledge (initiating sobriety) to developing a new sobriety-based
lifestyle(sustaining sobriety). This shift was also marked by a movement from a highly public to
a more private (“secret”) venue of alcoholism recovery–a venue within which one’s identity as a
former drunkard could be protected (Temple, 1886).
Fraternal temperance societies grew prolifically in the middle decades of the 19th century.
Membership in the Sons of Temperance grew to more than 250,000, and membership in the
Good Templars exceeded 2.9 million. Since the membership of most of these societies was not
exclusively alcoholics, the number of alcoholics using these societies as frameworks for personal
recovery is not precisely known, but some indication is the estimate that 400,000 of the 2.9
million Good Templars were former drunkards. Smaller groups, such as the Independent Order
of Good Samaritans, were organized by alcoholics and sustained an exclusive membership of
those seeking recovery. Amidst great controversy, some of the fraternal temperance societies
included women and African Americans (Fahey, 1996, p. 20). While some of these local
fraternal temperance societies meet our criteria of being organized by and for alcoholics, this
focus was often lost over time.
The Reform Clubs
As fraternal temperance societies became less focused on the reclamation of the
drunkard, reform clubs emerged as a new sobriety-based support structure in America. The roots
of the whole movement can be traced to events in Maine during the early 1870s. It was here that
newly recovering alcoholics J.K. Osgood, Dr. Henry Reynolds, and Francis Murphy organized
their Royal Purple Reform Clubs, Red Ribbon Reform Clubs, and Blue Ribbon Reform Clubs.
The “ribbon” in the reform club names reflected the practice of reform club members wearing a
colored ribbon as a public sign of membership and as a personal reminder of their commitment
to total abstinence. The reform club movement spread throughout the East and Midwest in the
closing decades of the 19th century. Because of its highly de-centralized structure, the total
membership in the reform clubs is unknown, but the state membership of some reform clubs in
the 1870s exceeded 40,000 (Ferris, 1878; Hiatt, 1878).
The recovery framework of the reform clubs consisted of public commitment (pledge
signing and carrying a signed pledge card), weekly experience sharing meetings in the
Washingtonian tradition, active recruitment of new members, and regular sober fellowship. The
reforms clubs were more religious in their orientation than the Washingtonians or fraternal
temperance societies, but strictly prohibited political discussions within their meetings. Most of
the reform clubs were organized geographically, but some were organized within particular
professional groups, e.g., railroad employees and police and fire department employees
(Vandersloot, 1878).
The Moderation Societies
Not all of the 19th century alcoholic mutual aid societies were founded upon the principle
of abstinence. Early 19th century temperance workers had tried (unsuccessfully) to coach
alcoholics to moderate their drinking, but it wasn’t until the second half of the 19th century that
moderation-based mutual aid societies were organized. One of the better-known of these groups
was the Business Men’s Moderation Society founded in 1879. The moderation societies relied
on a unique type of pledge and mutual support to ameliorate their drinking-related problems.
They pledged not abstinence, but that they would not drink during working hours, would not
participate in “treating,” and would limit the amount they drank to certain predetermined levels
(Cherrington, 1926).
Institutional Aftercare Associations
Between 1860 and the early 1900s, an elaborate network of inebriate asylums, inebriate
homes, and addiction cures institutes appeared on the American landscape. Some of these
institutions grew out of alcoholic mutual aid societies. The Washingtonian Home in Boston
grew out of the Boston Washingtonian Temperance Society while the San Francisco Home for
the Cure of the Inebriate was founded by the Dashaway Association, a mutual aid group
originally formed for alcoholic firemen (Baumohl, 1986).
Some mutual aid societies were birthed within pre-existing alcoholism treatment
institutions. The first of these–the Ollapod Club–appeared in the 1860s within the New York
State Inebriate Asylum (Parton, 1868). Over time, these groups designed to support alcoholics
while they were undergoing treatment were extended beyond the walls of treatment facilities to
also support alcoholics after they had left treatment. These usually took the form of local
alcoholic temperance societies such as the one organized for current and former residents of the
Appleton Temporary Home in Boston. It was a powerful experience for a man who had just
entered such a home to sit between men who had themselves entered that home months or years
earlier but today were sober, productive and respected (McKenzie, 1874).
In 1872, “inmates” of the Franklin Reformatory Home for Inebriates in Philadelphia
organized a “practical, mutual-benefit association” that was named after its first president,
Samuel P. Godwin. The Godwin Association conducted weekly support meetings, sought out
delinquent members, served as an “ambulance corps” to find and bring the intemperate to the
Home, and provided financial support to care for the indigent at the Home. The Association also
held special meetings and dinners on election nights, the Fourth of July, Thanksgiving,
Christmas Eve, and other “days of general excitement, when temptations incident to them are
better guarded against” (Twelfth Annual Report..., 1884). The meetings themselves were very
much in the experience sharing style of the earlier Washingtonian meetings. The presentations at
the Tuesday night Total Abstinence Conversational Meetings were described as follows:
These brief addresses, free from display and personal vanity, but teaching a manly, self-
reliant spirit, chastened and controlled by a humble trust in God, make their impress
upon the heart and soul, so recently prey to all anguish of remorse and despair. (Twelfth
Annual Report..., 1884)
The most highly organized and geographically dispersed of all the mutual aid societies
linked to treatment institutions were the Keeley Leagues. The first Keeley League was founded
on April 8, 1891 at the original Keeley Institute in Dwight, Illinois. (The Keeley Institute was
the largest and best known of the private addiction cure institutes.) The Keeley Leagues grew in
tandem with the expanding Keeley Institute franchises. The 370 Keeley League chapters
embraced a membership of more than 30,000 former Keeley patients by the mid-1890s. Keeley
League meetings were held daily at the Keeley Institutes, run by officers who were continually
replaced from the arriving pools of new patients. Keeley meetings were then held back in local
communities where former Keeley patients met for support and fellowship. Keeley League
meetings were a mix of welcome to new patients, speeches from departing patients, reading
communications from former patients bearing news and encouragement, and social and religious
activities. Keeley League members were expected to prominently display their club pin on their
person, write their local newspapers proclaiming their cure, and contribute financial support to
subsidize the treatment of indigent alcoholics within the Keeley Institutes (Barclay, 1964).
The Mission Support Groups
When Jerry McAuley opened the doors of the Water Street Mission in October of 1872,
he birthed the urban mission that would open its door and its heart to the indigent alcoholics.
McAuley also marked the beginning of the leadership role that the recovered, or in their
language, redeemed, alcoholic came to play within such institutions (Offord, 1885; Bonner,
1967). McAuley’s work was replicated within independent urban missions throughout the
country, the best known of which would be the Salvation Army service centers. What is
noteworthy for us in this current study is the fact that the daily meetings at urban missions served
as alcoholic mutual aid structures and birthed even more formal mutual aid societies. Among the
latter was the United Order of Ex-Boozers founded in 1914 as a “fraternal group devoted to the
reclamation of other drunkards.” Such groups hosted gospel meetings, planned or participated in
“Boozer’s parades,” and provided personal testimony within the urban missions (White, 1998, p.
The Emmanuel Movement and the Jacoby Club
In 1906, two clergy, Elwood Worcester and Samuel McComb, and a physician, Isador
Coriat, created a clinic within the Emmanuel Church of Boston that for several decades
integrated religion, medicine, and psychology in the treatment of disorders ranging from
tuberculosis to alcoholism. The clinic’s work with alcoholics birthed a “lay therapy” movement
that exerted a profound influence on the treatment of alcoholism in the 20th century (McCarthy,
1984). It is noted here because of a unique adjunct to the Emmanuel Clinic: the Jacoby Club.
The Jacoby Club was started by Ernest Jacoby in 1910 to provide a place for fellowship
and support for those undergoing treatment for alcoholism at the Emmanuel Clinic. Although
Ernest Jacoby was not an alcoholic, the Jacoby Club is included here because its mission so
specifically focused on support for the newly recovering alcoholic. It functioned much like the
earlier noted Appleton Temperance Society, Godwin Association, or Keeley Leagues. Its motto
was “A club for men to help themselves by helping others.” Sometimes referred to as a
“Drunkard’s Club,” the Jacoby Club blended sober fellowship, recreation, and service to “men
and women who are struggling to escape the slavery of drunkenness,” all within an informal
atmosphere of “sympathy and encouragement” (Purrington, 1909; Dubiel, 1999). Also
interesting was the expectation that “every man who is cured shall undertake the reformation of
one other person.” This other person was known in the language of the Jacoby Club as a
“Special Brother.” Ernest Jacoby referred to the process of how men changed in the Jacoby Club
as one of “regeneration” (Dubiel, 1999).
Early Counterparts to Later Groups
Before closing this review of pre-A.A. mutual aid societies, it is appropriate to pause and
place such groups within the context of subsequent developments. There are historical
counterparts to many of the alcoholic mutual aid societies that emerged as adjuncts and
alternatives to A.A. following its founding in 1935. Alcoholics Victorious, which was founded
in 1948 to provide an explicitly Christian framework of alcoholism recovery has its counterparts
in groups such as the United Order of Ex-Boozers that rose within the late 19th and early 20th
century urban mission movement in the U.S. Women for Sobriety, founded in 1975 by Dr. Jean
Kirkpatrick (1978, 1986) to provide an alcoholic mutual aid society organized by and for
alcoholic women, mirrors concerns about the special needs of inebriate women that were present
in the 19th century and that led to the founding of the Martha Washington Society and the Keeley
Leagues for Women.
While the Washingtonian Society is often referred to as A.A.’s predecessor, it might be
more aptly described as the predecessor of Secular Organization for Sobriety founded by James
Christopher in 1985 and Rational Recovery founded by Jack Trimpey in 1986 (Christopher,
1988; Trimpey, 1989). While there are similarities between A.A. and the Washingtonians, the
Washingtonians were so distinctly non-religious and non-spiritual in orientation that they were
charged by their religious critics with the heresy of humanism (placing their own power above
the power of God) (Blumberg and Pittman, 1991, p. 152). Contemporary groups like Moderation
Management, DrinkWise and Drink Watchers similarly have their counterparts in such 19th
century groups as the Business Man’s Moderation Society.
America has also witnessed the emergence of Afrocentric mutual support models for
addiction recovery in the late 20th century (Williams, 1992). This author has been unable to
discover mutual aid societies of the 19th century organized exclusively by and for African
American alcoholics, but the earliest efforts to frame sobriety within an African American
cultural context can be traced to the 19th century writings of Frederick Douglas and the practices
of groups like the Black Templars (Douglas, 1855, pp. 252-256; Crowley, 1997, p. 126-128).
Before exploring what influence, if any, these early alcoholic mutual aid societies had on
the history and structure of A.A., we will examine what these societies shared in common as well
as their collective fate.
Shared Characteristics
There are several similarities in the history and structure of the groups reviewed in this
paper. Most were founded by and primarily for white, adult, working class men. They emerged
during or immediately following a period of economic depression or cultural crisis, and most
emerged out of the messianic vision of a charismatic leader who was himself in the earliest days
or months of his own recovery from alcoholism. Most of these leaders had achieved sobriety in
the wake of a profound experience akin to religious conversion. The organizational life of these
groups tended to be dominated by these charismatic leaders.
Most of the groups profiled in this paper share what Linda Kurtz has described as the
“self-help ethos”: a set of core values that place a high premium on the personal, the democratic,
and on experiential as opposed to expert knowledge. They also relied on the mechanisms of
change that Linda Kurtz notes as typical in self-help groups: identity transformation,
empowerment, insight, reframing, and the formation of a new way of life (Kurtz, 1997). Most of
the pre-A.A. societies relied on a public commitment to abstinence (pledge signing), emphasized
the importance of experience sharing, relished symbols and rituals, and immersed their members
in sober fellowship and rescue work with the intemperate.
Pre-A.A. alcoholic mutual aid societies managed the “spoiled identity” of their members
through a mechanism that Blumberg and Pittman have christened “status reversal.” These
groups turned the social stigma of the drunkard on its head by creating a milieu within which
“having been a drunkard brought high prestige and not having been a drunkard led to low
prestige” (Blumberg and Pittman, 1991, p. 148). Group members qualified themselves through
the vehicle of an almost archetypal three-part story style: the extent and general consequences of
their drinking, the specific events and experiences that led to their sobriety decision, and what
their life was like after they signed and kept the pledge. Identity reconstruction through the ritual
of storytelling was the centerpiece of recovery within these mutual aid societies.
The Fate of the Pre-A.A. Societies
The influence of most of the abstinence-based cultural revitalization movements faded
under the continued physical and cultural assault on Native American tribes, but their shadow
extends to later movements such as the “Peyote Way” of the Native American Church (Albaugh
and Anderson, 1974) and even to contemporary abstinence-based intertribal support structures,
e.g., the Red Road, Circles of Recovery, and Firestarters (Bordewich, 1996; A Report..., 1998).
While the explosive growth of the Washingtonian Movement breathed new life into a
waning temperance movement in 1840-1842, most of the Washingtonian groups had disbanded
by the mid-1840s. The demise of the Washingtonian Societies has been attributed to many
factors: conflict with mainstream religious and temperance groups, controversies surrounding
religious and political issues, lack of a defined program of long term recovery, a lost focus on the
personal recovery of the alcoholic, professionalization (leaders seeking careers as temperance
lecturers), the relapse of prominent leaders and members, and a weak organizational structure
that left the Washingtonians vulnerable for co-optation by mainstream temperance organizations
(White, 1998).
The fraternal temperance societies that evolved out of the collapse of the Washingtonians
declined and became less hospitable to alcoholics as they developed restrictive membership
criteria, got caught up in the political debates surrounding the drive for legal prohibition of
alcohol, or fell victim to authoritarian leadership. These organizations, many founded for the
specific purpose of providing safe haven for reforming men, became more and more focused on
the personal, social and political agendas of their leaders. As this occurred, recruitment and
service to alcoholics precipitously declined.
The fate of the reform clubs in the 1870s and 1880s was often tied to the fate of their
charismatic founders. Many of these groups faded into oblivion when their leaders died or
otherwise disengaged from their positions. The reform clubs never rose above their local level of
organization, and never established a collective identity that linked local groups into a strong
national organization. They also lacked a formal program of recovery, believing that religious
faith, experienced sharing, and sober fellowship were sufficient to sustain sobriety.
We know very little about the fate of the 19th century moderation societies other than the
attacks upon them by temperance advocates who charged that these groups ceased to exist
because their members died of drunkenness. While some of these groups were the subject of
attack and ridicule for pledges that allowed as much as 14 glasses of wine per day, the more
responsible of such groups provided a medium of moderation for excessive, but non-addicted,
drinkers (Dorchester, 1884).
The fate of mutual aid societies tied to treatment institutions was, not unsurprisingly,
closely tied to the fate of these institutions. The Dashaway Association disappeared by 1890 and
the San Francisco Home for the Cure of the Inebriate with which it was so closely linked was
turned into a “private prison.” The collapse occurred amidst growing conflict between the
Association and the Home–conflict that sparked charges of patient maltreatment, financial
improprieties, and even murder and suicide attempts by key figures in the dispute (Baumohl,
1986). The Keeley Leagues similarly fell into decline in the late 1890s. A major factor in this
demise was the growing conflict between League officers and Dr. Leslie Keeley. The officers
charged that Dr. Keeley was trying to transform the Leagues from a vehicle of mutual support
into a “great advertising medium” for the Keeley Institutes. There were also charges of financial
impropriety in the operation of some of the Leagues. The last Keeley League National
Convention was held in 1897 (Account of...., ND; Barclay, 1964).
Mutual aid societies born within the religious missions rarely sustained themselves. This
was due to both the difficulty creating and sustaining an identity and autonomy separate from the
authority of the missions in which they were born and the fact that the strongest of the
indigenous leadership either took full time positions in the mission or returned to sober
productivity far from the physical and social world of Skid Row.
The Jacoby Club eventually split from the Emmanuel Church and broadened its mission
beyond that of serving alcoholics to the broader goal of helping the “down and out.” There was
considerable conflict during this transition over the question of whether the Club should keep its
mission focused on service to the alcoholic. In the end, that mission was lost, but in an
interesting touch of historical continuity, an A.A. group in Boston used the facilities of the
waning Jacoby Club to hold its regular meetings.
What this review reveals is the large number of factors that can contribute to the demise
of an alcoholic mutual aid society. Some of these movements were enmeshed within larger
movements and collapsed in tandem with the demise of the larger movement or were smothered
within this larger movement. This might well have been the fate of A.A. if its earliest members
had remained within the Oxford Group.
Mutual aid societies are vulnerable for cult-like isolation and implosion if they are too
closed but are also vulnerable for co-optation by more powerful organizations within their
environment if they become too involved in outside interactions. The former typified many of
the local reform clubs while the latter process clearly contributed to the demise of the
Washingtonian Society.
Mutual aid societies are at risk of being hijacked from within for personal or financial
gain, and are at risk of being exploited or consumed by more powerful organizations. Alcoholic
mutual aid societies are at risk with both weak leadership and charismatic leadership, and they
are at risk when their program of recovery is either ill-defined or too rigidly defined. Mutual aid
societies, like any social institution, are vulnerable for dissipation in the face of competition from
more viable structures. This may have occurred in Boston as the Jacoby Club’s mission of
serving alcoholics weakened in tandem with A.A.’s growth in Boston.
Mutual aid societies are vulnerable to lose the evangelical zeal that marks their founding
and developmental years. When this zeal is lost, the organization is vulnerable for distractions,
diversions, and even a fundamental redefinition of its mission. This seems to have happened
with many of the fraternal temperance societies, where the focus shifted more from reaching the
still suffering alcoholic to providing comfortable social fellowship for those who were already
members while supporting the political agenda of alcohol prohibition.
A.A. and the Lessons of History
Having briefly catalogued the history of the major pre-A.A. alcoholic mutual aid
societies, we are left with the question of how A.A. differed from these earlier mutual aid efforts
and with the question of what lessons might be drawn from this history that could benefit current
and future alcoholic mutual aid societies. These questions take on added significance in light of:
the continued growth of A.A.,
the emergence of what E. Kurtz (1999) has called the “varieties of the Alcoholics
Anonymous experience,”
the virtual explosion in other Twelve Step programs,
the recent intensification of criticisms of A.A., and
the proliferation of organizational alternatives to A.A.
There are many unique elements within the history, structure, and processes of A.A. that
have been the basis of both praise and criticism. The focus of the present discussion will be
primarily upon those aspects of A.A. that have contributed to its survival, the integrity of its
mission, and its growth.
A.A. did not draw upon the experience of earlier alcoholic mutual aid societies when its
program of recovery (the Twelve Steps) was retrospectively formulated in 1938. A.A.’s co-
founders weren’t even aware of the existence of such groups until a July 1945 A.A. Grapevine
article brought the history of the Washingtonians to Bill Wilson’s attention, and there is no
awareness reflected in A.A. literature (even today) of pre-A.A. groups other than the
Washingtonians (Wilson, 1945). But discovery of the Washingtonians may have played another
significant role in A.A.’s history.
Wilson’s new knowledge of the Washingtonians occurred in the middle of a decade in
which A.A. was undergoing experiences–growth, conflict–not unlike those that had unfolded a
century earlier. Wilson’s discovery of the dramatic rise and then rapid dissipation of the
Washingtonians must have sparked serious reflection regarding A.A.’s future. It may be more
than coincidence that within a year of learning of the Washingtonians, Wilson formulated,
published, and began promoting what became the Twelve Traditions of A.A.
The Twelve Traditions, whose purpose was to guide A.A.’s organizational life in the
same way that the Twelve Steps guided the personal recovery of A.A. members, provided unique
answers to the most critical problems that had mortally wounded the alcoholic mutual aid
societies that preceded A.A. Whether one looks at A.A. through the eyes of a grateful and
adoring member or through the eyes of the most rabid A.A. critic, one fact is unarguable:
Alcoholics Anonymous is the only widely available alcoholic mutual aid society in American
history that has outlived its founding generation.
When we examine A.A.’s resilience in light of the demise of its predecessors, eight
distinguishing characteristics stand out.
1. Program Codification. In contrast to the Washingtonians and other early mutual aid
societies, A.A. refined its program through the trials and errors of its early members and then
described its program of recovery in writing before experiencing the trials of public acclamation
and rapid growth. This minimized dilution and distortion of the Twelve Steps and the group
rituals that surrounded them during A.A.’s explosive growth in the early 1940s. That A.A. was
able to capture its program in writing within its basic text was as important to A.A.’s early
survival as what was included in that text.
2. Program Content. There are many elements of what came to be incorporated into
A.A. experience that are mirrored in its predecessors: sober fellowship, alcoholic-to-alcoholic
experience sharing, acts of service to other alcoholics. A.A. was unique in redefining sobriety
from the status of a single “decision” to that of “working a program” and in defining sobriety as
something qualitatively different than not drinking. The “program” that A.A. “suggested” as a
framework for recovery (the Twelve Steps) involved nothing less than a change in one’s
philosophy of living, a reconstruction of one’s identity and character, and a reformulation of
one’s interpersonal relationships. The language used to depict these Steps achieved a fine
balance. The Twelve Steps offered enough specificity to guide the newcomer while offering
sufficient ambiguity to allow stable members to continually re-interpret the Steps through the
various developmental stages of their recovery processes. This onion-like layering of meaning
within the Steps contributed to the longevity of A.A. member involvement and to the unending
adaptation of the Steps to other problems.
3. Organizational Autonomy and Singleness of Purpose. A.A. did not tie its fate to any
other organization and took the quite opposite stance of separating from its parent organization
(the Oxford Group) and subsequently refusing to align itself with any other organizations. In
contrast to nearly all of its predecessors, A.A. maintained a “singleness of purpose” behind its
painful discovery of the potential disruptiveness of outside diversions. This emerging value
prevented A.A. and its mission from being hijacked. Without this emerging value, at least three
early episodes in A.A. history might have fundamentally altered A.A.’s identity and mission: 1)
the offer to Bill Wilson to work as a lay therapist and to bring A.A. under the organizational
umbrella of Towns Hospital, 2) A.A.’s plans to operate hospitals for the treatment of alcoholism,
and 3) Bill Wilson and Dr. Robert Smith’s early involvement in the National Committee for
Education on Alcoholism. Each of these episodes might have led A.A. down a path of shared
fate with the Washingtonians or the institutional aftercare groups (See E. Kurtz, 1979; White,
4. De-decentralization of leadership. By pledging itself to a system of rotating leadership
and a minimalist approach to organizational structure, A.A. limited the ability of leaders to
manipulate an A.A. group or exploit their membership for financial or political gain. By
eliminating permanent leadership positions and pledging itself to corporate poverty, A.A.
eliminated the booty over which members of earlier groups had fought. A.A. enhanced its
resiliency by defining the source of its strength in a Higher Power expressed in the form of
“group conscience” rather than by relying on the knowledge and skills of a charismatic leader.
The open acknowledgment of the imperfection and strength of all A.A. members and the stance
of “principles before personalities” created organizational units whose fates were not tied to the
fates of any single person.
5. Cell Structure. The codification of the A.A. program, the de-centralization of
leadership, and the minimalist approach to organizational structure and membership
requirements enabled A.A. to evolve what Mäkelä (1996) has described as a highly de-
centralized cell structure. The centerpiece of the A.A. experience became not listening to the
charismatic speaker at the large temperance meeting house or marching with thousands in a
Boozer’s Day Parade, but in sharing experience, strength and hope within a small group of one’s
peers. The ease with which cell division could occur through growth, conflict, or unmet needs
contributed to A.A.’s viability and spread.
This cell structure was also particularly adept at meeting the needs of special populations
of alcoholics. Sobriety based support structures for young people, for example, have always
been inherently unstable because virtually all the members mature out of eligibility for
membership. The cell structure of A.A. allowed young people to have their own meetings while
providing a structure that could simultaneously nourish such groups and provide a larger
framework of support into which members could graduate. A.A.’s cell structure contributed in a
similar way to a wide range of alcoholics who naturally cluster around their shared
characteristics, experiences and needs.
6. Alcoholic-to-Alcoholic Identification and Mentorship. A.A. assured that the almost
archetypal image of one alcoholic sitting across the table from another sharing their experience,
strength and hope would be protected by refusing to compromise its closed meeting structure and
by evolving the practice of sponsorship. A.A. narrowly escaped developing the exclusive class
structure that plagued the fraternal temperance societies when A.A. rejected early group
membership criteria that excluded “beggars, tramps, asylum inmates, prisoners, queers, plain
crackpots, and fallen women” in favor of one criteria: “a desire to stop drinking” (Twelve Steps
and Twelve Traditions, p. 139-140). A.A. assured that no member could claim moral superiority
over another and eliminated the potential for non-alcoholic members to manipulate A.A. to serve
other needs and interests.
7. Anonymity. A.A.’s predecessors had been wounded by leaders and members who
either used visibility as a springboard for financial profit or whose public downfall brought
discredit to the organization. A.A. avoided both of these pitfalls by declaring that no one with a
name (at least a full name) could speak for A.A. Anonymity, while practiced as a spiritual
exercise, also protected A.A. as an organization and brought many individuals into recovery who
saw in anonymity a shroud of protection from the injury that can result from one’s being linked
to a socially stigmatized condition.
8. Duration of Participation. A.A. also established an expectation for continued
participation in A.A. long after sobriety was achieved. While this may have reduced the risk of
relapse, it provided two equally important organizational functions: assuring organizational
continuity and assuring the availability of members with stable sobriety and knowledge of the
A.A. program when the next suffering alcoholic reached out for help.
The creation of a sustainable alcoholic mutual aid society takes more than a workable
framework of personal recovery. As the history of the pre-A.A. mutual aid societies teaches us,
such groups must also position themselves within the larger culture, create their niche within the
broader alcohol problems arena, construct viable operating structures and procedures, and,
perhaps most importantly, find ways to transcend and manage the foibles of their leaders and
members. A.A. discovered and then institutionalized via its Twelve Traditions strategies to
manage the forces that posed the greatest threat to their existence and character: conflicts about
purpose, position, property, politics, personalities, and, of course, money.
The future of the post-A.A. alcoholic mutual aid societies may have very little to do with
their philosophy of alcoholism or the effectiveness of their framework for personal recovery.
For example, the expectation of several such societies that members need only attend until they
have established stable sobriety may prove quite adequate to meet the needs of many of their
current generation of members but may simultaneously doom the future of these organizations.
Without building a stable group of members out of which indigenous leaders can be developed, it
is unlikely that many of the local cells of these groups will survive over time.
Alcoholic mutual aid societies have for more than 200 years emerged from a vacuum of
unmet need. The shared elements of these societies are not derivative; most did not have
detailed knowledge of their predecessors. Instead, they are the product of a common process of
experimentation and discovery of what works to help move alcoholics into stable recovery. And
yet, even as they found things that helped particular individuals, these same societies
encountered forces that threatened and ended their organizational lives. A.A.’s endurance in the
face of the demise of all its predecessors is an anomaly worthy of serious investigation.
Alcoholics are not an homogenous group and no alcoholic mutual aid society, including
A.A., has been able to reach more than a fraction of the men and women who suffer from
alcoholism. A.A. stands out in this history for having reached more alcoholics in more places
and over a longer period of time than any alcoholic mutual aid society that came before or after.
It may take a large menu of support structures to expand the entryway to recovery for the mass of
alcoholics. As these groups emerge to seek their own niche in a growing multi-branched culture
of recovery, they would do well to study the keys to A.A.’s resilience–keys that have as much or
more to do with A.A.’s Twelve Traditions than A.A.’s Twelve Steps.
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... However, its fundamental propositions date to the temperance movement, that advocated largely moderate use of alcohol (Alexander, 2010, as cited in Alexander, 2012Koski-Jännes, 2004;White, 2004a). Such included a variety of institutional responses and support rendered to people presenting with problematic use of alcohol and other drugs (AOD), largely by mutual-aid recovery groups (White, 2001). According to White (2001), mutual-aid recovery groups existed long before the traditional AA/NA (Alcoholic Anonymous/Narcotic Anonymous) organisations' addiction treatment was largely associated with a global problem, including Africa. ...
... Such included a variety of institutional responses and support rendered to people presenting with problematic use of alcohol and other drugs (AOD), largely by mutual-aid recovery groups (White, 2001). According to White (2001), mutual-aid recovery groups existed long before the traditional AA/NA (Alcoholic Anonymous/Narcotic Anonymous) organisations' addiction treatment was largely associated with a global problem, including Africa. AA/NA organisations, the Minnesota model, resumed after the end of the prohibitionist movement, the complete clampdown on the use, mainly of alcohol, in the USA (Anderson et al., 1999;White, 2004a). ...
... Kita vertus, paieška įvairiose mokslines publikacijas skelbiančiose duomenų bazėse, neduoda vaisių bent jau nubrėžti pradinius štrichus paveiksle, vaizduojančiame tai, kaip Lietuvoje veikiančios katalikiškos religinės organizacijos prisideda padedant nuo priklausomybės kenčiantiems asmenims. Kitose šalyse atlikti tyrimai rodo, kad religingumas, dalyvavimas religinėse grupėse veikia kaip efektyvus veiksnys įveikiant priklausomybes (White, 2008;McGovern, McMahon;2008). Juoba, kad net tokiose kultūriškai skirtingose šalyse kaip Uganda ir Belgija, atliktas tyrimas parodė, kad su priklausomybe susijusios stigmos yra panašios, tačiau religiniai ir viešosios informacijos veiksniai suvokiami kaip situaciją palengvinantys (Kalema ir kt., 2017). ...
... Kita vertus, paieška įvairiose mokslines publikacijas skelbiančiose duomenų bazėse, neduoda vaisių bent jau nubrėžti pradinius štrichus paveiksle, vaizduojančiame tai, kaip Lietuvoje veikiančios katalikiškos religinės organizacijos prisideda padedant nuo priklausomybės kenčiantiems asmenims. Kitose šalyse atlikti tyrimai rodo, kad religingumas, dalyvavimas religinėse grupėse veikia kaip efektyvus veiksnys įveikiant priklausomybes (White, 2008;McGovern, McMahon;2008). Juoba, kad net tokiose kultūriškai skirtingose šalyse kaip Uganda ir Belgija, atliktas tyrimas parodė, kad su priklausomybe susijusios stigmos yra panašios, tačiau religiniai ir viešosios informacijos veiksniai suvokiami kaip situaciją palengvinantys (Kalema ir kt., 2017). ...
... Twelve Step groups began with the founding of Alcoholics Anonymous in 1935. Although there were dozens of recovery mutual aid societies that pre-dated A.A. (White, 2001), A.A. continues to be the standard by which other mutual aid groups are measured due to its size (2.1 million members in 100,766 groups), geographical growth (150 countries), and longevity (Kurtz & White, 2003). Varieties of A.A. experience were evident from its inception (e.g., differences between A.A. in Akron and New York City) and have grown throughout A.A.'s history. ...
... For fear of overstating this point, it should be noted that there are episodes in the history of addiction treatment and recovery that do exemplify a vision of long-term recovery management. Nearly all of the alcoholic mutual aid societies in American history have taken this longer view of chronic disease (recovery) management (White, 1998;White, 2001d). When Synanon, the first ex-addict directed therapeutic community, encountered a high relapse rate among its first graduates, it shifted its goal of returning rehabilitated addicts to the larger community and replaced that goal with the creation of an alternative drug free community where one could live forever (Mitchell, Mitchell and Ofshe, 1980). ...
Although characterized as a chronic disease for more than 200 years, severe and persistent alcohol and other drug (AOD) problems have been treated primarily in self-contained, acute episodes of care. Recent calls for a shift from this acute treatment model to a sustained recovery management model will require rethinking the natural history of AOD disorders; pioneering new treatment and recovery support technologies; restructuring the funding of treatment services; redefining the service relationship; and altering methods of service evaluation. Recovery-oriented systems of care could offer many advantages over the current model of serial episodes of acute care, but such systems will bring with them new pitfalls in the personal and cultural management of alcohol and other drug problems. Abstract Although characterized as a chronic disease for more than 200 years, severe and persistent alcohol and other drug (AOD) problems have been treated primarily in self-contained, acute episodes of care. Recent calls for a shift from this acute treatment model to a sustained recovery management model will require rethinking the natural history of AOD disorders; pioneering new treatment and recovery support technologies; restructuring the funding of treatment services; redefining the service relationship; and altering methods of service evaluation. Recovery-oriented systems of care could offer many advantages over the current model of serial episodes of acute care, but such systems will bring with them new pitfalls in the personal and cultural management of alcohol and other drug problems.
Face-to-face mutual-aid meetings such as Alcoholics Anonymous shuttered with the onset of COVID-19. Research could not be conducted quickly enough to provide guidance for how to respond. However, two powerful tools could be leveraged: the research on mutual aid conducted before the pandemic and the vast number of virtual resources that proliferated with the onset of the pandemic. This article reviews the existing mutual aid research and its relevance to COVID-19, describes the diverse array of virtual resources, and provides recommendations for successful engagement with virtual mutual aid during COVID-19 and beyond.
Since Benjamin Rush first introduced the disease of wills as the cause of alcoholism, a steady and slow infiltration of the disease model has infected how the church treats those who struggle with addictions. The first organization that truly sought to remove the soul care of addicts from the church was Alcoholics Anonymous (A.A.), through their best selling The Big Book of A.A and the introduction of the 12 Steps. With the explicit approval and promotion by the clergy of the time, A.A. became a fixture as the preferred model to help those who battled addiction. A.A.’s influence on how the church confronts addiction still reverberates today with many of the ministries that address addiction foundation firmly rooted in what can be found in A.A. literature. In addition to A.A., the other prominent contributor to replacing sin with disease as the causality for addiction was the American Psychiatric Association’s seminal book the Diagnostic and Statistical Manual of Mental Disorders (DSM). While A.A pushed the disease model into the consciousness of society, the DSM solidified through its writings that substance abuse is best treated as a disease. Even amongst Southern Baptist voices on addiction, the DSM, its terminology and diagnosis of addictions is evident in their books, and lectures. Addictions were once viewed as an issue caused by sin and best addressed through faith and prayer. Currently addiction is seen through the lens of disease. Needing to be addressed either by clinical professionals or programs with foundations contrary to the Bible. The ramifications are consequential as more church members are struggling with addictions than ever before. By tracing the progression of addiction from sin to disease will reveal that the SBC and its churches have been negligent in understanding the underlying foundations of A.A. and the influence that the medicalization of substance abuse has had on the how churches approach what should be classified as a sin issue.
Studies of the long-term course of opioid use disorder (OUD) underscore how the condition is exacerbated by factors such as interactions with the criminal justice system, limited access to medications to treat OUD, chronic unemployment and conditions of poverty, physical/psychological trauma and related mental illness, social isolation, and poor social support. Developments in pharmacotherapies for OUD and innovative means of administration have yielded important advances in effective medication-based treatments, yet social and political structures remain as obstacles in some regions of the United States and other parts of the world affected by OUD. Changes in perceptions about OUD as a chronic brain disease and about the effectiveness of pharmacotherapies for OUD indicate a public health approach may slowly supersede the criminal justice approach to addressing OUD. This chapter provides an overview of OUD problems as they have emerged and as they are societally and clinically addressed, emphasizing the management and treatment of OUD with effective use of available pharmacotherapies and within environments that are supportive of recovery.
Background: The role of social work in free healthcare clinics and student-run clinics remains an understudied topic. Method: We conducted a literature review of the published studies through four online databases: Google Scholar, Social Work Abstracts, Academic Search Complete, and PsycInfo. Results: The literature review revealed 449 possibly relevant studies, but only nine met the criteria for the final review. Based on these findings, social work is not fully utilized in free healthcare clinics and student-run clinics. Conclusion: Our literature review provides evidence for the need for social work in free healthcare clinics and student-run clinics.
Drug Abuse: Etiology, Prevention, and Cessation serves as a comprehensive source of information on the topography of, causes of, and solutions to drug problems. The text covers conceptual issues regarding definitions of drug use, misuse, abuse, and dependence. Importantly, the text addresses a variety of theoretical bases currently applied to the development of prevention and cessation programs, specific program content from evidence-based programs, and program processes and modalities. Information regarding etiology, prevention, and cessation is neatly delineated into (a) neurobiological, (b) cognitive, (c) micro-social, and (d) macro-social/physical environmental units. The book is ideally suited as a primary source for students and professionals in chemical dependence programs, clinical and health psychology, public health, preventive medicine, nursing, sociology, and social work, among other fields, on the nature, causes, prevention, and cessation of the abuse of legal and illegal drugs.
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This is the first of a two-part article that outlines the history of men and women who, having recovered from addiction to alcohol and/or other drugs, went on to devote their lives to helping others similarly afflicted. This paper will describe the roles recovered people played in: (1) late 18th and early 19th century Native American cultural revitalization movements; (2) the 19th century temperance movement; (3) 19th century inebriate homes, inebriate asylums and addiction cure institutes; (4) the urban mission movement; (5) the Emmanuel Movement; (6) early alcoholism-focused hospital units, farms and retreats; (7) the Minnesota Model of chemical dependency; and in (8) the birth of industrial alcoholism and halfway house programs.
This book explores the history of America's personal and institutional responses to alcoholism and other addictions. It is the story of mutual aid societies: the Washingtonians, the Blue Ribbon Reform Clubs, the Ollapod Club, the United Order of Ex-Boozers, the Jacoby Club, Alcoholics Anonymous, and Women for Sobriety. It is a story of addiction treatment institutions from the inebriate asylums and the Keeley Institutes to Hazelden and Parkside. It is a story of evolving treatment interventions that range from water cures and mandatory sterilization to aversion therapies and methadone maintenance. (PsycINFO Database Record (c) 2012 APA, all rights reserved)