Alcoholism Recovery: Organizational Factors

By: Gary J. Salton, Ph.D.
Chief: Research & Development
Professional Communications, Inc.


INTRODUCTION
This analysis looks at the environment within which the 12-steps of the Alcoholics Anonymous process are executed. Sponsorship, the 12-Traditions, and the established processes of the AA organization form a core of this recovery framework. Without this framework, it is likely that the 12-step effectiveness will be seriously compromised.

This study is part of a three research blog series. The statistical
foundation for the series can be found in the Evidence-Based research listing on www.iopt.com. A study of the 12-Steps is available in the Applied Research listing on www.iopt.com. A video summary of all three research blogs in this series can be found in the "Coffee Break Videos" section of www.iopt.com or by clicking
the icon on the right.


THE PROCESS
There are a host of processes that are brought into play within the AA organizational framework. Cultural conventions on how to behave, meeting rituals and even humor play a role. However, in terms of altering a person’s information processing profile (i.e., worldview) several things stand out.


Public Disclosure
The AA process carries an implied encouragement to publicly disclose past wrongs. This begins with the ritual salutation of “My name is X and I am an alcoholic.” Disclosure proceeds in the informal interactions with others attending the meeting. It can culminate in broadcasting past transgressions in explicit detail from a speaker’s podium. The anonymity mandated by the AA steps and traditions protects the person. These revelations will not return to haunt the recovered alcoholic. Disclosure is made relatively safe.

Disclosure reduces the binding force of their current worldview. The alcoholic's initial input>process>output pattern protects the alcoholic from the full force of any pangs of guilt. For example, the Reactive Stimulator (RS) “I Opt” strategy can create a protective field. The RS’ inattention to detail helps mask the impact of the consequences of negative behavior. The RS’ tendency to focus on transient variables (e.g., situations, events, issues, relationships, etc.) continually divert attention. Without disclosure it is likely that people relying on an RS strategy will maintain their protective worldview. With disclosure there is less to protect.

Public disclosure clearly has other psychological effects. However, the above is sufficient for illustrative purposes. The net effect of disclosure is to lower the risk associated with change regardless of the dominant style. A lowered risk translates into improved odds of recovery. It is an important organizational component of the recovery process.

Meeting Attendance
At its core the AA relies on a variant of the “wisdom of the crowd” approach. The 12-steps can be seen as direction that is devoid of content. This makes sense. Pre-specifying exactly what to do and when to do it could help some and destroy others. However, the process of direction without content puts a premium on guidance. Without it the odds of success would greatly diminish. The “crowd” attending the meeting helps provide that guidance and support.

First, the people attending the meeting are at all phases of recovery. The probability of encountering someone at roughly the same stage of recovery is high. This means that relevant advice and counsel is always readily at hand. In addition, it is likely that multiple perspectives will be available. Options and ideas can be mixed, matched and melted to help meet immediate needs.

The meetings also offer a supportive social control element. The relationships established during the meetings carry with them mutual expectations. Positive behavior can expect to be rewarded with approval. Negative behavior is likely to be met with sympathetic corrective counsel. This support further strengthens the odds of success.

The meeting format itself is serves to aid recovery. Typical formats include open discussion, Big Book study and 12-step study. Speaker meetings are also offered. Each format gives insight into another dimension of recovery. The active participation of “crowd” members (i.e., the attendees) insures that the framework will not become stultified. The insights can help evolve a positive “worldview.”

The average AA member attends 2.4 meetings per week(1). In early stages much greater frequency is recommended. The often quoted “90-90” or attending 90 meetings in the first 90 days of recovery suggests the importance of the meeting. Frequent attendance maximizes the opportunity for the processes embedded in the meeting to take hold.

The meeting effects are probabilistic in nature. Just as in Las Vegas, the outcome of a particular encounter or event is unpredictable. But the outcome of a series of events becomes a virtual certainty. But however frequent, meetings are brief and interrelationships of personal issues can escape attention. Sponsorship addresses this element of recovery.


SPONSORSHIP
Dr. Bob and Bill W. (the creators of AA) discovered that helping others is a central element to one’s own recovery. The number of members involved in direct support activities testifies to the validity of their finding. The AA reports that 79% of AA members have a sponsor. 73% of the members acquired a sponsor in the first 90 days(1). This kind of penetration could not be achieved without mutual benefit. The sponsorship role is simply too taxing and lengthy to rely on pure altruism to support it.

The sponsor’s task is broad and intrusive. It extends from providing emotional support in the wee hours of the morning through helping to interpret the AA steps and traditions. It involves guiding the new entrant through the customs and practices of the AA. It can even involve arranging ways for the new member to get to the meeting itself. Altruism alone is unlikely to support this kind of sponsor commitment. There must be something “in it” for them. That thing is the sponsor’s own long-term sobriety.

So there is a motive for both the sponsor and sponsee to participate in the relationship. Now the question is why does a particular new entrant and a specific potential sponsor both agree to enter into an actual relationship? At least part of the answer can be found in their ability to “connect.”

The concept of “connect” is not well defined. In general terms it means that the people involved use a similar frame of reference. This allows them to communicate without the need to analyze, assess, define or otherwise scrutinize the meaning of each others words. Applied to the sponsor/sponsee relationship “connecting” means that both people can focus on recovery. The transaction cost is minimized for both parties.

GRAPHIC 1
THE INFORMATION PROCESSING PROCESS

At its core the “frame of reference” reflects a similarity in information processing strategies. The fit is defined by the basic “input > process > output” model. For example, one person might need great detail so they unambiguously understand “input.” The other might favor understanding using only the central situation elements. The detail oriented person wants “facts” while the other is content with analogies and metaphors. A “disconnect” at this level yields built-in frustration for all concerned.

“Process” interprets the input. One person may rely on rigorous logic. The other might use “gut feel” or some other form of spontaneous assessment. What one person sees as adequate evidence the other could see as speculation. If the parties differ, it is likely that neither will “make sense” to the other.

Finally, targeted “output” must mesh. One party might focus on action—getting something done about the immediate situation. The other might be thought oriented—attempting to plan, assess or otherwise establish some kind of path. What one party sees as a necessary investment of time and effort that other might view as useless and wasteful dawdling.

The variables of “input > process > output” permeate a person’s worldview. They evidence themselves in ordinary conversation on even trivial matters. Characteristic combinations of these variables have even entered the language. “Nit picker”, “space cadet” and “egghead” are only a few of the thousands informal categorizations commonly used to recognize these different frameworks.

“I Opt” technology has well-articulated, quantitative methods of assessing the “worldview” fit between people. It involves measuring the overlap of the profiles of two people. The degree of variance can be measured and interaction outcomes predicted.

GRAPHIC 2
MEASURING STRATEGIC PROFILE COMPATIBILITY

The AA program handles the challenge of meshing people in a different way. They use an iterative process. Casual conversations and intermittent meetings provide enough information for each party to judge their “fit” with each other. The ability of either party to withdraw from the relationship is a built-in corrective mechanism for errors in judgment.

The above is sufficient to show how sponsorship works into the basic “I Opt” model. “Connecting” is a matter of aligning strategic style profiles. And while AA has a process that automatically aligns profiles, alternative recovery programs are not equally endowed. They use counselors in place of sponsors. The “fit” between a particular counselor and specific client is a matter of chance. Professional methods and techniques can help compensate for disjoints. However, on average these are likely to be inferior to the natural affinity of the AA’s mutually selected sponsor/sponsee relationship. These alternative programs would do well to consider using “I Opt” technology in pairing counselors with clients.


THE 12-TRADITIONS
Table 1 lists the 12-Traditions as published in 1949. Organizationally they can be seen as a system of firewalls that protect the recovery mechanisms that are built into AA. In other words, they do not directly affect information-processing transactions. Rather, they assure that those processes will continue to operate so long as the scourge of alcoholism persists.

TABLE 1
The Twelve Traditions of Alcoholics Anonymous

It is beyond the scope of this paper to cover in detail how these traditions work together to protect the AA as an entity. However, it may be worth outlining them in general.

Traditions 1 (common welfare), 2 (no temporal authority) and 5 (single purpose focused on an individual) protect AA from being redirected towards other or additional ends. They keep the focus on the single goal of helping individual alcoholics.

Tradition 3 (no admission standards) prevents anyone from “stacking the deck” by admitting certain kinds of people and excluding others. Traditions 4 (local group autonomy), 6 (no endorsements), 7 (self-support) and 10 (no opinions) bar the establishment of relationships which could be used as channels to redirect or control AA by outside forces. Without a channel, no force can be exerted.

Traditions 8 (non-professional), 9 (no hierarchy), 11 (no promotion) and 12 (absolute autonomy) act to prevent the emergence of individuals who might gather enough power to change organizational direction. These traditions limit the ability to “take over” AA from the inside.

These traditions give a sense of the extent of the effort needed to keep an organization focused on a single objective. These same forces will operate on any organization of any type. Periodic redirection may be a good thing for some. For example, it could allow a firm to change to meet new environmental challenges.

In AA’s case, this is not needed. The 12-Steps themselves are without content on exactly “what to do.” Their content can flex to meet individual, local and general conditions. The processes outlined in this paper are themselves not fixed and can similarly flex. The ability to adjust is built into the very fabric of the AA. There is no need to build an organizational guidance or enforcement mechanism. Automatic adjustment is literally interwoven into the very fabric of AA.


SUMMARY
This applied research blog has outlined the processes that are integral to the success of the 12-steps. Disclosure weakens the bond that ties an individual to a particular worldview. Meetings provide both information and supportive control mechanisms that help an individual maintain sobriety.

Sponsorship is a mutually beneficial relationship. It provides the guidance and support needed establish new worldviews for the sponsee and helps the sponsor refine and extend their own worldview. The Traditions act like a shield to protect and preserve the AA as an entity within which these tools of recovery can operate.

Looked at in information processing terms, the AA is a masterpiece of organizational engineering. It proceeds to systematically alter the way the world is perceived, evaluated and acted upon in a predictable manner. It has a “wisdom of crowds” foundation. It contains tools (i.e., steps) that are directional but without content. This gives the “wisdom of the crowd” a channel within which to work.

The AA provides processes that systematically weaken the hold of dysfunctional worldviews (e.g., disclosure), provide immediate support (e.g., meetings) and guidance for creating long-term positive worldviews (e.g., sponsorship). Finally, it contains a system that protects these processes and insures that they will persist.

It is difficult to see how “experts” sitting at a desk could devise an AA type system. From the perspective of this writer it could only be done by iteration. Identifying needs, trying out options, adopting successful methods and correcting failed ones appears to be the ideal strategy for addressing seemingly intractable issues. That is what Dr. Bob and Bill W. confronted in the 1930’s. Over 75 years later their work still stands.

Those working to improve the functioning of organizations would do well to study the why and how of the AA organization. This paper is an attempt to contribute to this effort. Defining what is happening and why gives insights into a unique organizational structure whose success is demonstrated by its longevity. Lessons have been learned and there are undoubtedly many more yet to be discovered.


REFERENCES

(1) Alcoholics Anonymous 2007 Membership Survey. Alcoholics Anonymous World Services' General Service Office. 2008. http://www.aa.org/pdf/products/p-48_07survey.pdf. Retrieved 8-7-2010.