Women and AA

Broken Face

By Amy Gutman

The first time I walked into an AA meeting, I knew I was in the right place. It was a small women’s meeting on the Upper West Side of Manhattan, where I was then living, and what I found entranced me: Attractive, successful, articulate women talking – and laughing! – about the sort of things that had brought me close to hopelessness.

That was 16 years ago. Or 17. I’ve sort of lost track at this point, but one way or another, AA has kept me sober for a good many years. Since then, I’ve attended hundreds, maybe thousands, of meetings of all shapes and sizes. I’ve met homeless people and celebrities – people of diverse races, ages, sexes, and sexual orientations, and pretty much any other demographic box that you’d care to check. I’ve written (and published) two novels, drafted speeches for the dean of Harvard Law School (now a U.S. Supreme Court Justice), and accomplished many other fulfilling and challenging goals. I can’t imagine having done these things without first getting sober, and I can’t imagine having gotten sober without AA.

All of which goes to explain my profound uneasiness with the depiction of AA in Her Best-Kept Secret: Why Women Drink – and How They Can Regain Control, a new book by journalist Gabrielle Glaser that was recently excerpted in the Wall Street Journal and appears to be selling briskly. (As of this writing, it ranks #454 on Amazon.) As Glaser – a self-proclaimed non-alcoholic who attended “about 10 meetings” in the course of researching her book – portrays it, AA is a cult-like faith-based organization rife with sexism, a hotbed of misogyny that serves as a veritable playground for dangerous and sometimes violent sexual predators. In the rooms of Glaser’s AA, it is “common” for vulnerable women to be preyed upon by men “who are purporting to help them heal.” In support of such claims, she invokes a notorious Washington, D.C., AA group featured in 2007 pieces in Newsweek and the Washington Post, the infiltration of AA phone help lines in Britain by sexual predators, and the 2010 murder of a woman and her daughter by a troubled Iraqi veteran she’d dated after meeting him in AA, which he’d been court-ordered to attend.

Having set this sinister stage, Glaser urges women struggling with alcohol to seek out alternatives – to explore what she, with no small bias, calls “Twenty-First-Century Treatment.” And what does this entail? Well, for starters, you send in a deposit check of $2,500 (to be followed with an additional $8,750 for five days of therapy, a medical evaluation, and three months of follow-up through a California treatment business called Your Empowering Solutions. Glaser helpfully notes that this is “a bargain by the standards of private rehab,” never mind that most alcoholics can likely afford neither), book a plane flight, and reserve a room “at a luxurious inn near the ocean” where you’ll stay during your five full-day sessions. Once there, in addition to undergoing counseling, you’re likely to be prescribed the drug naltrexone, which reduces the pleasure of drinking – and thus its appeal – through endorphin blocking and costs about $100 monthly. (There’s also an injectable form that costs up to $1,000 a shot, Glaser notes). At least that was how things unfolded for “Joanna,” Glaser’s sole example of a woman embarked on this regime, whose treatment story occupies a good part of a 30-page chapter.

Think this could be hard to pull off for anyone besides the wealthy? Not to worry, Glaser has a plan – albeit one that seems unlikely to materialize in the foreseeable future. “Rather than entrust recovering drinkers as the first and last mechanism of support, we need to convince insurance companies and federal insurance programs to reimburse doctors for their new role, and patients for expensive medication.” Good luck with that. In the meantime, there are millions of women (and men) – many un- or under-insured – suffering, who need help. AA is free – and it is everywhere.

In fairness, I share more than a little of Glaser’s frustration with AA’s failure to move with the times in its treatment of women, as well as with some of the religious framing that so antagonizes her (and, as she observes, the two are often related). For me, this has centered on out-of-date AA literature, including the seminal text known as “the Big Book,” in which women appear primarily as the beleaguered helpmeets of alcoholic husbands, and not the alcoholics themselves. Well into the 21st century, there continues to be a Big Book chapter addressed “To Wives,” replete with exhortations of patience and compassion. “Try not to condemn your alcoholic husband no matter what he says or does,” is one such admonition.

The book’s pervasive focus on male alcoholics, a vestige of the era when AA was founded, even led one anonymous AA member to pen a “contemporary translation” that dispenses with many masculine pronouns and otherwise attempts to make the Big Book more inclusive. “Women today frequently feel excluded by the Big Book, sometimes even hurt. They are forced to rewrite it mentally in order to include themselves,” writes “J” in the introduction to A Simple Program, published by Hyperion in 1996. Similarly, where the 12 steps include the language “God, as we understand him,” I – and a growing number of people in meetings I attend (not all of them women) have taken to reading “God as we understand God.” (As to why AA doesn’t simply change this language when any number of churches have managed to update hymnals and prayer books, all I can say is that an astonishing number of women AA friends, including lesbians and self-proclaimed feminists, have looked at me blankly when I raise the issue. “It doesn’t bother me,” they say.)

I’m also wholeheartedly on board with Glaser’s claim that there are real and important differences between male and female alcoholics. For one thing, as she writes, women are simply more vulnerable to the physical effects of alcohol, both because of their higher percentage of body fat and lower percentage of alcohol-absorbing water and because their bodies contain less of a key enzyme that breaks down alcohol before it enters the bloodstream.

Beyond these physical realities, women often arrive in recovery awash in feelings of hopelessness and shame stemming from sexual abuse and other forms of victimization, an issue explored at length in psychologist Charlotte Davis Kasl’s ground-breaking Many Roads, One Journey: Moving Beyond the 12 Steps, published by Harper Collins in 1992. While the professional men who founded AA devised the 12 steps with an eye to reigning in egotistical selfishness and resentment, for female alcoholics, the challenge is often just the opposite one. “Reminding people of their faults and reinforcing humility hardly seems the remedy for a person who has little sense of self, feels ashamed of being alive, and self-blames for just about everything that goes wrong,” Kasl writes, an insight that fueled her development of an alternative to AA’s 12 steps – “16 steps for empowerment and discovery” designed to encourage people to tap into their internal wisdom and cultivate personal strengths, either along with or apart from AA.

But it’s one thing to say that men and women alcoholics are different. It’s quite another to make the global claim, as Glaser does, that AA “is particularly ill-suited to women.” Perhaps I wouldn’t be so disturbed by such assertions if I didn’t know from first-hand experience the crucial role books can play in opening – or blocking – routes to sobriety. I got sober when I did only because I was fortunate enough to happen upon the late Caroline Knapp’s life-changing AA memoir Drinking: A Love Story, a 1996 New York Times bestseller responsible for getting untold numbers of women to stop drinking. She was smart! She was confused! She was just like us. I hate to think how different my life might be had I stumbled on a book with a message like Glaser’s instead of Knapp’s. And I worry for all the problem drinkers out there who may now be in this position.

I have only the haziest ideas of how AA goes about revising literature or making other changes–just enough to know that the grassroots process moves with glacial speed–and no reason to think that changes I’d like to see will happen anytime soon. What keeps me in the AA rooms despite this is, first and always, the people – a community whose impact is hard to grasp unless you are part of it (which the self-proclaimed non-alcoholic Glaser most definitely is not). At the end of Drinking a Love Story, the one-year-sober Knapp looks out at a sea of faces in a meeting she’s attending, filled with a mix of emotions–admiration, affection, appreciation, along with a bit of sadness for all the pain endured. “I didn’t realize until hours later that there was a name for that feeling. It’s called love,” she writes.

———-

This article is re-posted with permission. It was first published as “No, Alcoholics Anonymous Is Not ‘Ill-suited’ to Women” on July 12, 2013, on The Atlantic.com. Amy is a senior writer at the Harvard School of Public Health. Her work has appeared in Salon, the Chicago Tribune, and Psychology Today. She writes regularly at Plan B Nation.

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Comments

Women and AA — 23 Comments

  1. I am not sure why I missed this one on the first go-round, but am thankful for the “Related Posts” feature that directed me here today. This is a brilliant piece of work.

    While I am very much in agreement with the insights regarding differences in the alcoholism-related problems of the sexes, I appreciated the reviewer’s general positivity respecting AA.

    AA is indeed both ubiquitous and FREE. Sometimes in our complaining about what is wrong, we neglect what is right. I thought the piece struck that balance about perfectly.

  2. Out of the church closet….

    As I near my 66th birthday, I consider my spiritual path and try to discern where I am on it. This was the year that I finally shared, in several meetings, that I am an agnostic. It was more difficult to make that admission than it was to share that I am an alcoholic! How curious…

    While there are definitely negative repercussions to the admission of one’s alcoholism, the reactions to one’s declaration of agnosticism are even more dramatic.

    Non-alcoholics generally think of alcoholics as a group of folks who “can’t handle their booze”, “don’t have willpower”, “don’t care about their families”. They think that alcoholism is a problem that can be “fixed” with the putting down of the drink. Alcoholism can be “cured” if the alcoholic just has the willpower to “get over it” or “stay away from it”. We who sincerely adopt and live the 12-step approach to life would argue against those simplistic prescriptions.

    Not so with agnosticism! The response I have experienced is more along the lines of “how could you?” and “how sad that you feel that way”. While they consider alcoholism to be a pattern of behavior to be remediated, agnosticism is unthinkable, even repulsive. The agnostic is to be pitied as a “lost soul”.

    Despite this perceived judgement by some of my peers, I am feeling more honest, more sincere and less hypocritical than ever.

    During my many, many years of church attendance and participation I enjoyed the fellowship, camaraderie and music of the Sunday morning activity. There was definitely a personal benefit derived from my involvement. And I like to think that my participation was supportive and valuable to the organization as well. But hypocrisy always gnawed at my psyche. I remember explaining to my astonished pastor that “no, even though I’ve been faithful in attendance for over 15 years, even though I’ve sung in the choir, raised my children here, served on myriad committees, I have never felt “qualified” to participate in the ceremony of membership”. When he assured me that I was welcome, wherever I was on my spiritual path, I took the membership pledge. And, looking back, that’s all it was. A pledge to pledge. Nothing else changed during that ceremony.

    The societal expectation that one must, of course, believe in a God of everyone’s understanding, or as the more liberated might say, a God of my own understanding is pervasive and challenging to those of us who are fledgling “outed” agnostics!

    Thankfully, I discovered the AA Agnostica website and have found the fellowship, camaraderie and acceptance I’ve been missing for a long time. Thanks to each of you for participating in this exchange of ideas and ideals.

  3. I cannot say enough times how grateful I am for this article. I’ve been involved in traditional 12 step meetings since 1985 & have seen the male recovery cripplers, women as less than, shutting people out for nohave to be an alcoholic to attend AA, and have struggled consistently w/the religious verbage that has gotten in the way of my own recovery program.

  4. The book you’re describing sounds like a thinly-veiled ad for whatever this $10K naltrexone treatment approach is and nothing more. I’m surprised people are not seeing through that. The anti-women trope is always a good one to get a reaction, though, whether from feminists or from anti-feminists, which I guess is a good way to sell a book. Throwing in the naltrexone treatment just seems disjointed…unless there is some commercial motivation.

    Anyway I am a 27-year-old woman in NYC who has been in recovery for 5 years and sober with no relapses for the past two, and AA is a big part of my life. I can easily get sucked into inflammatory suggestions that something is anti-female, but I don’t have that experience with AA. I have had some men who have made me feel uncomfortable but they never did anything identifiable, and I am never alone with them or anything. Women are the core of my sober network.

    Anyway I actually found this page because I am going to be on the West Side a lot more (59th St) and I was trying to find information about good meetings on the UWS or Hell’s Kitchen, so if anyone has any recommendations, that’d be great.

  5. Thanks for the review. Although I’m quite content with a Group in the Toronto Area – Richmond Hill – Widening Our Gateway, it has taken me a long time, almost 16 years, to join such a group and I joined only after someone else started the Group – so I’m either a very frightened alcoholic or a slow learner or maybe just a very thoughtful, reflective person.

  6. Thanks for the great article. The Big Book seemed heavy handed, misogynistic and completely out of date when I came in forty years ago. “To Wives” should have been edited out decades ago. Today, some members’ fundamentalist refusal to change with the times makes AA an easy target for critics.

  7. From the perspective of an Alanon/ACOA woman who has a terrible time with the 12 steps, this quote from Charlotte Davis Kasl is particularly insightful:

    Reminding people of their faults and reinforcing humility hardly seems the remedy for a person who has little sense of self, feels ashamed of being alive, and self-blames for just about everything that goes wrong…

    Thanks very much for including it in your very interesting piece, Amy.

    I go to Alanon because I meet lovely people there who have a clue what growing up in a drunken household does to you, but I go late enough to avoid reading/hearing the 12 Steps and 12 Traditions.

    I’m currently writing a book about addiction, particularly alcoholism. I believe that the Steps miss some basic truths. I may not even mention AA.

    • You might want to check out Charlotte Kasl’s books on addiction — both the one I mention & another: Women, Sex & Addiction. She is a true pioneer, and to my mind, her work deserves to be far more widely known than it is.

      • Thanks, Amy. I’ve ordered Kasl’s books. I don’t know how I missed Women, Sex, and Addiction when I was in SLAA. It looks wonderful.

        My SLAA friends and I went through the program in a couple of years and that was enough to change our lives. Twenty years and counting. Got the message, hung up the phone. Of course, we all had therapists, were going to other workshops, reading Pia Mellody, Patrick Carnes, Keith Miller. I look forward to reading Charlotte Kasl.

        Last month, I told my bf, who is in AA, that the 12 Steps aren’t wonderful for me because “I don’t need reining in, I need furthering.”
        We’re both products of alcoholic homes. He needs to be held back from alcohol (23 years and counting) and I throw up after one drink. Chemical differences, I tend to believe. Or luck. Or grace.

        Addiction is complex.

  8. I’m glad to read Amy’s review. It is always frightening to me to hear non-alcoholics accepted as authorities on AA and how it works. I first found out about AA in 1981 from the Whole Earth Catalog, of all places. I don’t remember the woman quoted saying anything about god, but I do remember feeling just like she felt. And I heard enough to identify with other alcoholics and keep trying until I got sober in We Agnostics of Hollywood in 1988. Nothing but AA ever had an effect on me, and I’m sure glad I did not run into this lady’s book back then.

  9. Thank you so much for all the thoughtful, articulate comments everyone!! Much appreciated. I will definitely refer back to this thread as I continue to reflect on and write about recovery issues. (I just wrote “right about recovery issues” before I caught myself and corrected–clearly, it has been a long day and it is time for bed!)

  10. As usual, both the post and the commentary are thought provoking. In my own rather nerdy way I was filling my spare time with statistics. I have often wondered why, in an urban centre like Toronto, the demographics inside the AA meeting are quite different than the demographics just outside the door. AA seems older, whiter and more male that the general population.

    So I was looking at the 2011 National (USA) Survey on Drug Use and Health: Summary of National Findings and Detailed Tables to look at the statistics of people who suffer from alcoholism. According to the The Substance Abuse and Mental Health Services Administration (SAMHSA), 1.7 million Americans needed treatment for alcoholism. 37% were women. That’s almost spot-on the 35% of AA population that is women. I found remarkable variance in the age and ethnicity of people entering treatment compared to the population of AA. But on the male/female ratio, not so much.

    Having been warm to the idea that systemic discrimination inadvertently makes some people feel welcome and others feel awkward, I thought AAs patriarchal language and posture was largely responsible for the gap. But these stats show that IF the patterns, practices and policies in AA create a system that is more welcoming or more suited to one gender over the other, then this pervasiveness extends throughout the entire assessment and treatment paradigm of alcohol treatment.

    Alternatively, 2/3 of alcoholics are male. Can that be true and if it is does it mean that there is gender bias in the consumption of, or the resistance to alcohol(ism)?

    Being as I sobered up as a teenager I have a personal interest in youth in recovery. On page 34 of “More About Alcoholism” there is a footnote about AA’s under-30 population. We were reading this in a meeting where everyone had their own Big Book. The % of youth-members varied dramatically with the Edition and Printing. For instance in my 1976 printing of the Third Edition, the footnote shows 1/5 of AAs being in our teens or twenties. In the online Forth Edition, we are 1/12th (less than half the 1976 number) under the age of 30.

    Anyway, intelligent discourse like this helps keep my mind and eyes open. The personal stories of AA’s members is way more interesting than the statistics.

    • Joe,
      19 years ago while attending a Toronto meeting I commented to a couple of people that I was surprised to not to see a representation of people of communities other than the white community and furthermore very few young people.
      When questioned why I had made this observation I told them that here in Vancouver we have a great mix of whites, blacks, indo-canadians and other minorities including a healthy representation of young people under 30.
      Shoulders were shrugged and crickets were heard chirping and no one offerred an explanation other than maybe those people might have meetings of their own.
      The answer came to me when at the close of the meeting people grabbed each of my hands in spite of protestations from me and proceeded with the lords prayer.
      I suspect more people than AA members at large would care to admit are simply seeking alternative recovery methods rather than participate in these percieved revival style meetings.
      It would be interesting to learn what the demographics and growth rates are at Smart Recovery and other alternatives as a comparison to the AA model.

  11. I read Pete Hammill’s book and was moved. We dont hear the stories of those who just plain quit drinking. Being a writer he has that higher purpose. I agree the predator thing is a complication. This is more revolting when its in the guise of helping and taking advantage of women who are vulnerable. In almost 42 years in the rooms I have seen predator women too. Not in the same numbers and men tend not to object as much but its there. Stated such once in a meeting and not a popular view. If nothing else AA is a lesson in the shortcomings of human behaviour. Are the religious exempt? One would think but no. For me I avoid physical contact as to hugs or even hand holding. I just find it better. And smoke areas and car chats with the opposite sex are just better avoided. But then of late I am not there as much. Tend to be in the Hamill mode. Perhaps one day I’ll give it up. Tend to sort of miss the drama though so I deal with that. Steve.

  12. What a wonderfully crafted narrative and review Amy. Thank you. I’ve read a number of interviews with Ms. Glaser as she made the book tour rounds. I too am disturbed by the lack of reportorial research performed for the book. Like you, I read Caroline Knapp’s book back in the 90’s. In fact, I read Drinking: A Love Story and Pete Hamills’ A Drinking Life in the same weekend and was profoundly moved by both.

    I know of women who have been sexually abused in AA and it is an issue not to be ignored or trivialized (and I think you did neither in your review). My hope is that the attendant publicity from this book in concert with the writings of other activists will draw attention to the issue and lead us to a solution.

    I have found a home in the world of Agnostic AA and feel very comfortable in that environment. However, I state the obvious when I say AA is not for everyone, nor is it the only way to recover from alcoholism. Indeed there are a plethora of AA alternatives out there: Smart Recovery, SOS, LifeRing, and of course, Women for Sobriety. I know nothing of the treatment course proposed by Ms. Glaser and I am hesitant to dismiss it out-of-hand as it may be helpful to some people. It seems every week I read of a new science-based approach to the treatment of addiction; Who am I to say these don’t work? Of course the longitudinal data tell us that the vast majority of problem drinkers stop on their own absent any sort of formalized treatment.

    AA has helped millions – including me. My guess is that we are stronger as a result of the criticism leveled by the likes of Ms. Glaser (spotty research and all) and if the criticism leads to some long overdue reforms – wonderful. However, I could very well be wrong. This book – and others like it – could keep some women from seeking help – and that would be tragic.

    Again, thank you Amy for a very thoughtful review.

    • Very well put, both of you! I was happy to read all your comments, but a little saddened by the fact that such a book was published (by Ms. Glaser) and still circulating out there for thousands and millions to read! It could keep women from getting help, and perhaps some agnostics such as myself :(

  13. Thanks Amy for raising this issue and treating it with such intelligence and grace. I think AA really needs to start discussing the ways in which our practices and readings affect the women in our midst. The heavily male-centred language in the Big Book makes me profoundly uncomfortable. I can only imagine the effect it might have if I was a woman. At the very least, we need more articles like this to show those who might be struggling or questioning that they aren’t alone. One day, perhaps, we will actually make the necessary changes to the program itself.

  14. Thank you, Amy, for your perceptive article on Women and AA, which as David H. noted has always created challenges for some alcoholic men since early in our history.
    I don’t know if you knew LeClair Bissell, a prominent psychiatrist in recovery in New York, but I was not too surprised to read in a 1997 interview of her by William White, Reflections Of An Addiction Treatment Pioneer, that Lois had to intervene with Bill and boys in the basement of the Clinton Street apartment to let Marty Mann, the first woman who stayed sober, attend their meetings. LeClair reports that the “boys” were concerned that Marty would mess up what they had going for them, a rather typical patriarchal stance towards women. White’s interview with LeClair gives a marvelous, very candid depiction of our history of inclusivity, which has always been somewhat threatened by the counterweight of religiosity in AA.
    I too got sober on the Upper Westside, my first meeting on October 19, 1972, being the original Renewal West meeting that met on Thursday nights in the basement of the Saints Paul and Andrew United Methodist Church at the corner of 86th Street and West End Avenue.

  15. Thanks, Amy, for the heads-up about this book by G. Glaser. Her treatment alternatives are almost laughable.
    The sexual predator, or sexual component, in AA is and always has been a real problem. It goes on here in Houston at women’s halfway houses where men are the biggest part of in house meetings. The exploitation goes both ways. Sometimes men are the founders of the halfway houses.
    And as happens everywhere, pretty women get a lot more offers for support, and a lot more tolerance for slips, than others.
    “13th stepping” was written about in the earliest times of AA. Here in Houston is the only place I’ve ever heard the term “cripple f****ers” applied to the predators, mostly men preying on women, but I don’t see why or why it wouldn’t happen in other scenarios and homosexual situations.
    The exposure of the D.C. group was an eye opener for lots of people. But AA is composed of all types of human beings, with all the shortcomings and drives of the general population, so this problem and others are naturally occurring and should be laid on the table and talked about and dealt with.
    At it’s essence, AA is one alcoholic talking to another in order to stay sober and help others to achieve sobriety.
    The fact is that other all too human drives sometimes enter into the mix.

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