Women and AA

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. Amy is a senior writer at the Harvard School of Public Health.