Alcoholics Anonymous

Η ιδέα της αυτοβοήθειας και αλληλοβοήθειας, που εμφανίστηκε τα τελευταία 150 χρόνια, αρχίζει να συζητείται ευρύτατα τις τελευταίες δεκαετίες τόσο στους ακαδημαϊκούς κύκλους όσο και στους κύκλους των Εθνικών Συστημάτων Υγείας. Στην αύξηση του ενδιαφέροντος της επιστημονικής κοινότητας για την ιδέα της αυτοβοήθειας/αλληλοβοήθειας συνέβαλαν αποφασιστικά δύο γεγονότα. Το πρώτο είναι η αδυναμία αντιμετώπισης των σύγχρονων ψυχοκοινωνικών προβλημάτων από τις παραδοσιακές δομές και τις επαγγελματικές προσεγγίσεις • Albee, 1985• Gartner and Riessman, 1984. Το δεύτερο είναι η μεγάλη ανάπτυξη των ομάδων αυτοβοήθειας στην αντιμετώπιση προβλημάτων ψυχικής και σωματικής Υγείας

Multiple studies have shown social network variables to mediate and predict drinking outcome, but, because of self-selection biases, these studies cannot reliably determine whether the influence is causal or correlational. The goal of this study was to evaluate evidence for a causal role for social network characteristics in determining long-term outcomes using state-of-the-art statistical methods. Outpatient and aftercare clients enrolled in Project MATCH (N = 1,726) were assessed at intake and at 3, 6, 9, 12, and 15 months; the outpatient sample was also followed to 39 months. Generalized linear modeling with propensity stratification tested whether changes in social network ties (i.e., number of pro-abstainers and pro-drinkers) at Month 9 predicted percentage of days abstinent and drinks per drinking day at 15 and 39 months, covarying for Alcoholics Anonymous (AA) attendance at Month 9. An increase in the number of pro-drinkers predicted worse drinking outcomes, measured by perce...

Several pilot studies have provided evidence supporting the potential of classic psychedelics like psilocybin in the treatment of substance use disorders (SUDs). If larger trials confirm efficacy, classic psychedelic-assisted psy- chotherapy may eventually be integrated into existing addiction treatments such as cognitive behavioral therapy, contingency management, and medication-assisted therapies. Many individuals seeking treatment for SUDs also join twelve-step facilitation (TSF) programs like Alcoholics Anonymous (AA), which are among the most widely available and accessed treatments for alcohol use disorder worldwide. For such individuals, engaging in clas- sic psychedelic-assisted psychotherapy could be seen as controversial, as members of AA/TSF programs have historically rejected medication-assisted treatments in favor of a pharmacotherapy-free approach. We argue that classic psychedelics and the subjective experiences they elicit may represent a special, more compatible case than conventional medications. In support of this claim, we describe Bill Wilson’s (the founder of AA) little known experiences with psychedelics and on this basis, we argue that aspects of classic psychedelic treatments could complement AA/TSF programs. We provide a review of clinical trials evaluating psychedelics in the context of SUDs and discuss their potential large-scale impact should they be ultimately integrated into AA/TSF.

An experience in developing a treatment program of addiction in an Arabic Muslim Society. The three major waves of knowledge and methodology are reviewed in historical perspective. General description of Al Amal Hospital, Dammam, KSA, and the three phases which the hospital ...

An essay about the impact of the religious right and the "Recovered" movement upon Alcoholics Anonymous and the inherently reactionary nature of the Fellowship.
https://www.poeticdiversity.org/main/prose-fea.php?nameCode=LarissaShmailo&date=2019-04-01

Background: Most formal treatment programs recommend Alcoholics Anonymous (AA) attendance during treatment and as a form of aftercare, but we know very little about treatment seekers' patterns of AA involvement over time and how these relate to abstinence.

Although the Minnesota Model of treatment for alcohol and drug addiction is a common treatment approach, there are few published reports of its effectiveness. This study describes the Minnesota Model treatment approach as practiced at Hazelden, a private residential alcohol and drug abuse treatment center located in Center City, Minnesota (a founding program of the Minnesota Model) and presents recent outcome results from this program. This study includes 1,083 male and female clients admitted to Hazelden for treatment of a psychoactive substance-use disorder between 1989 and 1991. The outcome study is a one group pretest/posttest design. Data collection occurred at admission to treatment and at 1-month, 6-month, and 12-month posttreatment. At 1-year follow-up, 53% reported that they remained abstinent during the year following treatment and an additional 35% had reduced their alcohol and drug use. These results are similar to those reported by other private treatment programs. The Minnesota Model has consistently yielded satisfactory outcome results, and future research needs to focus on the therapeutic process of this common treatment approach.

The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities. D

This article examines the roles of gender and sexuality in the public and private debate over medicalizing inebriety in the United States from 1930-50. During this period various interest groups wrestled with two competing visions of how to frame chronic drinking, which came to be labelled alcoholism following the repeal of Prohibition. Mainstream doctors and psychiatrists agreed that the underlying cause of alcoholism was in the mind of the individual. A number of psychiatrists went further, suggesting a connection between alcoholism and latent homosexuality. In contrast, laypeople identifying themselves as alcoholics advanced a second, competing vision of alcoholism that framed it as a blameless physiological illness. This second understanding of alcoholism, particularly as promoted by members of Alcoholics Anonymous (AA), emphasized the need for restoring heteronormative gender roles for alcoholics (who were generally men) and their spouses (who were generally women) as an important step to recovery.

Indigenous people in Australia and in North America have been creating innovative interventions in the addictions field for several years now-incorporating traditional healing practices and cultural values into otherwise western programs-although this process is more developed in Canada and the U.S. than it is in Australia. Through a process of cultural diffusion, Australian Aborigines have incorporated many ideas from Native Canadian treatment models. As a result, residential treatment utilizing adapted forms of the 12 steps of Alcoholics Anonymous is being promoted by indigenous Australians. This paper examines comparative material on the uses of culture as a form of healing and traces the rationale for the argument that cultural wholeness can serve as a preventive, or even curing agent in drug and alcohol abuse. This is a qualitative leap from the now universally accepted notion that treatment and rehabilitation for native people should be culturally appropriate. There are, however, certain dilemmas confronting native treatment directors attempting these syncretic approaches, given aspects of cultural contexts which can serve to foster drug and alcohol use rather than discourage it. Additionally, North American Indians have at their disposal a rich heritage of communal healing techniques: some (such as the sweat lodge) have been adapted and incorporated into the treatment both of solvent abuse by adolescents, and alcohol abuse by adults. In Australia on the other hand, traditional healing techniques have been less amenable to adaptation. On neither continent are indigenous people attempting to adapt recent mainstream models of intervention to suit their needs (such as Brief Intervention) which is currently receiving international attention in addictions research and treatment.

Since self-efficacy is a positive predictor of substance use treatment outcome, we investigated whether it is associated with spirituality within a religious 12-step program. This was a cross-sectional survey (N = 91) of 10 different Celebrate Recovery sites held at community churches. The mean spirituality score for those with high confidence was significantly greater than those with low confidence. Spirituality associated with greater confidence to resist substance use (OR = 1.09, 95% CI 1.02-1.17, P \ 0.05). So every unit increase of measured spirituality increased the odds of being above the median in self-efficacy by 9%. We conclude that spirituality may be an important explanatory variable in outcomes of a faith-based 12-step recovery program.

The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities. D

What’s best for someone’s well-being – to be spiritual OR to be religious OR both… OR neither?
This seminar is aimed at provoking thought and generating discussion concerning the role of spirituality in our lives, with a view to sculpting a coherent and empirically-based understanding of how spiritual development and well-being could be connected.
I will present findings from several empirical projects that set out to examine what it means to be more spiritually focused so that we can then craft a sense of purpose and meaning.  This process may come through the adoption of a religious set of beliefs or it may emerge through the adoption of spiritually based traditions; alternatively, it may also come through the negation of religion or spiritual teachings and instead a process of ‘deconversion’ away from the religious/spiritual teachings of one’s childhood/adolescence.  Regardless of what belief system is adopted, the embracing of a new set of beliefs (and, at times, a new spiritual/religious/secular community) could help to effect a sense of belonging and connectedness with others.
Drawing from: (1) a qualitative study of spirituality in recovery from addiction and (2) through examination of an in-depth mixed methods analyses of identity development among those who convert to a religion and (3) through qualitative enquiry about how a sample of women who convert to Islam are able to cope, I hope to be able to thread together these potentially disparate studies to show how spiritual meaning and purpose can emerge through community connectivity. 
Overall, I would like to propose (by turning to findings from another allied collaborative study into the psychology of purpose) that one’s well-being can be enhanced by turning to transpersonal purpose as a motivator.  In so doing, a spiritual awakening of being more transpersonal in one’s orientation could aid in moving away from habitual modes of thinking of ‘self’ and ‘other’ but rather could benefit from moving towards ways of having ‘we’ and ‘us’ at its very heart.

This article is a compilation of the information presented at a symposium at the 2001 RSA Meeting in Montreal, Canada. The presentations were: (1) Maintaining change after conjoint behavioral alcohol treatment for men: the role of involvement with Alcoholics Anonymous, by Barbara S. McCrady and Elizabeth E. Epstein; (2) Changing AA practices and outcomes: Project MATCH 3-year follow-up, by J. Scott Tonigan; (3) Life events and patterns of recovery of AA-exposed adults and adolescents, by Patricia L. Owen and Valerie Slaymaker; (4) Social networks and AA involvement as mediators of change, by Lee Ann Kaskutas and Keith Humphreys; and (5) What do we know about Alcoholics Anonymous? by William R. Miller, discussant.

The notion of rock-bottom is widely used in the treatment of addiction and can be described in existential terms as an event of truth. Addiction is described as an attempt to technocratically alter the lived-texture of being while recovery is being open, while acknowledging the finitude that is humanity’s essential nature.

Claims of impressive outcome figures for the Minnesota Model find some support in published studies, with as many as two thirds of admissions apparently achieving a genuinely good outcome at 1-year follow-up. However, methodological criticisms of these studies indicate the need for further research incorporating control or comparison treatment groups, longer follow-up, more rigorous assessment procedures, and clearly defined diagnostic/outcome criteria. The powerful ideology of the programme provokes criticism but is apparently central to its success. It incorporates a number of therapeutic elements known or suspected to be of value in the management of drug/alcohol dependence. While some clients or patients and professionals alike may react against this treatment model we all have much to learn from it, and many are undoubtedly helped by it.

This review synthesizes the philosophy, development, history, and current status of the philosophy of social or community model of recovery and of Social Model Programs (SMPs) based on an analysis of the available literature, much of it outside traditional sources. The social-community model of recovery evolved out of Alcoholics Anonymous (AA), and has a distinctive program philosophy with different assumptions, knowledge, and practice than professionally based treatment models. SMPs began in the 1940s in California, evolving by the 1980s into a continuum of recovery services that are publicly funded, legally incorporated nonprofit organizations. The characteristics of SMPs are described and the range of services are presented, including social setting detoxification, residential recovery homes, nonresidential neighborhood recovery centers and sober living houses. SMPs are staffed exclusively by recovering alcoholics and their structure is based on the 12 traditions of AA, which emphasize democratic group processes with shared and rotated leadership and a minimal hierarchy. Cost effectiveness data suggest that residential social model programs average approximately $2,700 per stay versus $4,400 for other residential approaches, yet may offer similar outcomes in terms of substance use and improvement employment or family function.

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En el campo académico que aborda el tratamiento del alcoholismo y la
drogadicción en México, muchas investigaciones asumen que educadores
avalados por el gobierno están haciendo frente a la brecha de conocimiento
científico que afecta a operadores de centros de tratamiento “mixtos”, organizaciones
que combinan el trabajo profesional de la salud con planteamientos
de grupos de ayuda mutua como los establecidos en Alcohólicos
Anónimos. En contraste, este artículo argumenta que si bien los operadores
carecen de conocimientos científicos especializados y acreditados, al
mismo tiempo poseen fluidez y un entendimiento propio de conceptos
científicos que juegan un papel central para la definición de la ciencia de las
adicciones. Adicionalmente, su uso del discurso científico es sólo una de
las muchas herramientas empleadas en el servicio de atención a las adicciones
y en el reclamo de jurisdicción técnica entre expertos más tradicionales
como los profesionales médicos. Para concluir, este artículo argumenta que
la manera en que se distribuyen los conocimientos especializados entre expertos
acreditados y no acreditados en la actualidad probablemente continuará
favoreciendo las explicaciones científicas que sean compatibles con
el paradigma planteado por grupos de ayuda mutua.
Palabras claves: drogadicción y alcoholismo, tratamiento de la adicción,
alcohólicos anónimos, comprensión pública de la ciencia, normatividad
de servicios de salud, estudios sociales de la ciencia y la tecnología, conocimientos
especializados.

Abstract
Many accounts of Mexico’s alcoholism and drug addiction treatment field
assume that government sanctioned educators are working to fill a scientific knowledge gap among the operators of “mixed” treatment centers, treatment
organizations that combine the work of health professionals with
mutual aid group approaches such as that found in Alcoholics Anonymous.
I argue, however, that while operators lack credentialed forms of expertise,
they possess their own type of fluency in scientific concepts and play a
central role in defining what addiction science is. Furthermore, operators’
use of scientific discourse is one of many tools they apply in service of
treating addictions and claiming technical jurisdiction among more traditional
types of experts, such as medical professionals. In conclusion I argue
that the current way that expertise is distributed between both credentialed
and non-credentialed experts in the field will likely continue to favor
scientific explanations that are compatible with the mutual aid paradigm.
Keywords: addiction and alcoholism; addiction treatment, alcoholics
anonymous, public understanding of science, health service regulation,
science and technology studies, expertise.

AIMS – In Russia the paradigm of alcoholism as a disease is still in contrast to the general perception of alcoholics as weak-willed. This article studies alcoholism and recovery in Russia through the case study of the Russian Alcoholics Anonymous online group. It studies how people who are seeking help for their drinking problems in this online community come to incorporate a new self-understanding of being ill with alcoholism. DESIGN – The data were collected from a Rus-sian online support group for people struggling with alcoholism. The source material consists of 617 posts by more than 35 individuals. The data was analysed with qualitative content analysis using the RQDA software. RESULTS – The online group acts as a virtual space where people can anonymously talk about alcoholism and engage with AA's 12-Step program. Typically, a new forum member goes through a process of admitting one's problem with alcohol and coming to a new understanding of oneself as a person suffering from a chronic disease. This process includes creating a new relation to alcohol, a new understanding of one's reasons for drinking and a commitment to stay sober and to help others to recover. CONCLUSIONS – The online community creates a space for engagement with AA's 12-Step program and service work of supporting other alcoholics in recovery in the context of Russia, where face-to-face AA groups and other recovery programmes are scarce. When the state cannot deliver the services for problem drinkers or recovering alcoholics, people may turn to the Internet to find alternative information and social support.

"This paper will attempt to examine the interface between the contribution made by medical treatment of addiction and recovery ministries by various Churches and Christian agencies. Four contemporary models will be examined. Alcoholics Anonymous grew out of the Oxford Movement and Rev. Sam Shoemaker’s Calvary Episcopal Church about seventy years ago. Over the years, churches and clergymen such as Dr. Calvin Chambers and Dr. Robert Claytor have endeavored to work cooperatively with this program. However, as the program has grown, it has drifted from some of its earlier Biblical roots, as described by Dick. B., making this cooperation increasingly challenging.  Secondly, the Book the Cross and the Switchblade  told the inspiring story of how a simple country preacher established Teen Challenge as a rehabilitative program for drug addicts 51 years ago. This has now grown to a worldwide network of over 1000 Teen Challenge treatment centers. Thirdly, Alistair Jappy, an experienced and licensed drug and alcohol counselor compared the results of a Christian group and a spiritually eclectic group in a publicly funded alcohol and drug community clinic. Finally, I will examine Celebrate Recovery: Kevin Nieman conducted a unique “hermeneutic interpretation” of cohesiveness and its effects on a large Celebrate Recovery program in a large Church of Christ in Louisiana. Although each program is unique, it adds to and improves on the A.A. 12 Step model.
Insights from each of these programs will be used along with models presented by Drs. Earley and Roberts from the Talbott Recovery campus in Atlanta Georgia to suggest how medical and spiritual modes of treatment can work collaboratively to address the needs of a person suffering from addiction.
"

This study investigates the 10-year course and impact of AA-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post-treatment. Alcohol consumption, AA participation, and otheroriented behavior were assessed at baseline, end of the 3-month treatment period, and one year, three years, and 10 years post-treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved otheroriented interest.

En esta investigación, analizo las retóricas y las prácticas del exceso y la moderación en el proceso de patologización de la adicción —un fenómeno que, en antropología, suele atribuirse a la medicalización/psicologización de la vida social, propias de la modernidad temprana y tardía—. Defino la adicción como sufrimiento social y propongo una indagación de mayor hondura cronológica para identificar las fuerzas histórico-culturales del fenómeno, que han servido como condiciones de posibilidad en su tránsito a convertirse en enfermedad y, simultáneamente, en pathos que demanda ser curado.
Para lograr este objetivo, opté por una perspectiva multisituada, tanto a escala espacio-temporal como en mi interacción con diversos sujetos y fuentes. En primera instancia, me valí de una extensa revisión crítica de fuentes secundarias, que me condujo a la reconstrucción genealógica e histórica de tres dominios conceptuales: el melodrama como retórica del exceso, la imaginería en torno a hýbris vs. sôphrosynê, y la emergencia de la adicción como patología moderna. En segundo lugar, elegí el recurso a la etnografía como método de aproximación a la escena contemporánea de la adicción: adelanté el trabajo de campo en un centro privado de tratamiento de adicciones y en diversos grupos de apoyo del Programa de Doce Pasos en Bogotá, Colombia; así mismo, realicé entrevistas a usuarios y terapeutas y analicé documentos oficiales, literatura de autoayuda y algunos espacios virtuales.

Η αντιμετώπιση του προβλήματος της εξάρτησης αποτελεί ένα από τα πλέον σύνθετα ζητήματα στο πεδίο της κοινωνικών επιστημών και των επιστημών υγείας. Η διόγκωση του προβλήματος και αδυναμία εξεύρεσης αποτελεσματικών τρόπων αντιμετώπισης του οδηγεί στην αναγκαιότητα αναζήτησης νέων παραδειγμάτων παρέμβασης. Η πλαισίωση των πρωτοβουλιών των άμεσα ενδιαφερομένων πολιτών είναι ένα από τα βασικά ζητούμενα στην συγκρότηση νέων προσεγγίσεων. Το συγκεκριμένο κείμενο συνιστά μια επισκόπηση της πρώτης προσπάθειας προαγωγής της ιδέας της αυτοβοήθειας στο πεδίο της εξάρτησης στην Ελλάδα. Μέσα από την παρουσίαση του Προγράμματος Προαγωγής Αυτοβοήθειας και πιο συγκεκριμένα των βασικών αξόνων της φιλοσοφίας του, του τρόπου λειτουργίας, της πορείας εξέλιξης και της δυναμικής του αναδεικνύονται οι συγκεκριμένες διαστάσεις του εγχειρήματος. Η έμφαση δίνεται στην ανάδειξη των συγκεκριμένων χαρακτηριστικών της πρότασης, που μπορούν να συμβάλλουν στη συζήτηση δημιουργίας νέων παραδειγμάτων και όχι στην περιγραφή ενός νέου «απόλυτου» εργαλείου παρέμβασης

My dissertation frames the evolution of David Foster Wallace’s writing ethic as a function of addiction recovery. Wallace completed only two novels—the first of which is generally dismissed as the work of a young author enamored of his talent, and the second of which is not uncommonly hailed as “the voice of a generation.” Between these novels, he weaned himself off an addiction to the conspicuous narrative foregrounding of poststructuralist theory, progressing into a writer capable of bringing theory to life through narrative engagement with its application. This reformed Wallace repurposed these sterile, theoretical paradoxes as models for understanding not just the crises of individual experience, but also of American culture more broadly.

Wallace’s life and work invite us to use the institutional language of addiction and the inherent narrative structure of twelve-step programs to read his novels as a progression toward an open-ended and always-contingent recovery from literary theory. Wallace was a chronic substance abuser during his teens and twenties and became a devoted member of twelve-step groups in the second half of his life. I use the three-part narrative schema of recovery—“what we were like, what happened, and what we are like now”— to account for the differences between Wallace’s two novels. Wallace understood himself as an addict; failure to read him as one means neglecting the crucial ways 12-step recovery informs his larger fictional project.

Yet Wallace’s writing complicates a purely twelve-step notion of theory recovery by rejecting certain edicts of Alcoholics and Narcotics Anonymous. Whereas Wallace’s substance-abuse recovery depended on adhering to twelve-step doctrine, his theory addiction required fashioning his own hermeneutic recovery process: a pragmatic appraisal of theory’s narrative value for his readers. The result of this process is a writing style that foregrounds the mental route Wallace took to arrive at his conclusions. By importing the classic math teacher injunction to “show your work,” Wallace imbued his writing with a transparency that rendered it capable of meaningful engagement with readers.

En el presente trabajo, me propongo registrar un coyuntural hecho histórico: los intercambios entre Carl G. Jung y la confraternidad de Alcohólicos Anónimos (AA), fundada en 1935, en Akron, Ohio, EE. UU. La ponencia tomará como material de referencia algunas conversaciones y cartas cruzadas entre el psicoanalista y Rowland H. y Bill Wilson, miembros fundadores de AA, así como diversas fuentes históricas secundarias (documentos oficiales de la confraternidad y estudios historiográficos, sociológicos y antropológicos sobre esta). En una de sus últimas misivas a Bill Wilson, en enero de 1961, Jung escribe: “You see, Alcohol in Latin is "spiritus" and you use the same word for the highest religious experience as well as for the most depraving poison. The helpful formula therefore is: spiritus contra spiritum”. Seis meses después, Jung muere a sus 86 años. Tales palabras atestiguan la afinidad entre la conocida inquietud del psicoanalista por lo espiritual y el rasgo teoterapéutico del popular programa de Doce Pasos para la recuperación del alcoholismo y otras adicciones. Desde el punto de vista antropológico, estos intercambios epistolares adquieren gran valor en la comprensión de la influencia del conocimiento experto “psi” tanto en la elaboración y consolidación del programa de Doce Pasos, como en la particular espiritualidad que en él subyace y que ha distinguido a los Alcohólicos Anónimos durante sus 78 años de existencia. Así mismo, documentan esa relación siempre ambigua entre psicoanálisis y espiritualidad que, en sí misma, le costó a Jung su famosa ruptura con Sigmund Freud y el exilio del psicoanálisis ortodoxo.

Alcohólicos Anónimos es una comunidad que propone un programa de recuperación de Doce Pasos. En el Doceavo Paso se establece que es necesario ayudar a otros alcohólicos, como parte de la recuperación personal. A esta actividad se le conoce como llevar el mensaje. A través de la teoría de la actividad y desde una aproximación etnográfica se analizan los significados que median el llevar el mensaje: regresar la dádiva y puente de comprensión. Se considera que el resultado de este análisis contribuye a una mayor comprensión de la relación entre la abstinencia y el acto de ayudar a otros que otros autores han venido señalando.

Esta tesis busca reconstruir el proceso de consolidación de Alcohólicos Anónimos (AA) en México, proceso que comenzó desde 1956 cuando se crearon los primeros dos grupos hispanohablantes, hasta 1985 cuando la actual Secretaría de Salud diseñó el Consejo Nacional Antialcohólico, el cual incluyó como integrante a AA, quienes entonces ya sumaban 8761 grupos en el país. Con base en informes de la Organización Mundial de la Salud, documentos de la Secretaría de Salud, revistas médicas, tesis académicas del periodo, así como fuentes hemerográficas y documentos del Archivo Histórico de la Central Mexicana de Servicios Generales de AA, sostengo que la consolidación e incorporación de AA como herramienta terapéutica fue resultado de diversos factores: la descentralización y desvanecimiento de la lucha antialcohólica desde 1940; el bajo costo, la efectividad y la labor constante de sus miembros para crear nuevos grupos y establecer relaciones con religiosos y médicos; la transformación del modelo para entender y atender el alcoholismo en la segunda mitad del siglo XX, el cual retomó planteamientos de la salud mental y promovió un tratamiento multidisciplinar que incluyó la creación de grupos de AA.

La tesis está dividida en cuatro capítulos. En el primero estudio las propuestas promovidas por la OMS a partir de 1950 acerca del alcohol disease concept y el modelo multidisciplinar del alcoholismo, así como sus repercusiones a nivel internacional y en México. En el segundo analizo el origen, creencias y la expansión del modelo híbrido para el tratamiento del alcoholismo propuesto por AA, quienes emplean una noción de enfermedad triple (física, psíquica y espiritual) y centran su tratamiento hacia la dimensión espiritual del alcohólico. El tercer capítulo se centra en la consolidación de AA en México. Allí planteo que a partir de 1940 el combate al alcoholismo no fue una prioridad del gobierno mexicano, y que en ese contexto es cuando la sociedad civil reasumió la lucha contra el alcohol y comenzaron los intentos por establecer AA en el país. Analizo entonces las particularidades de su expansión y los mecanismos de difusión y legitimación, tales como la acción de “pasar el mensaje” de forma individual o a través de comités, la distribución de impresos y la creación de redes con médicos y religiosos. El último capítulo estudio la incorporación de este movimiento en las instituciones de salud mexicanas, a través de la creación de “grupos institucionales” y comités destinados al contacto con profesionales de la salud y con alcohólicos internados. En este contexto ubiqué dos perspectivas de los profesionales: primero, la de incorporarlos con el condicionamiento de que adaptaran su modelo a las necesidades institucionales; segundo, la postura que finalmente imperó en el país, la cual fue de adopción sin modificación del modelo de Doce Pasos, es decir, permitir que los grupos de AA mantuvieran su autonomía y funcionaran al interior de las instituciones sin modificar su programa de recuperación. En el caso mexicano, tanto en el contacto con instituciones de salud como en la creación de una campaña oficial, la postura de AA fue de “cooperación sí, afiliación no”, lo que les ha permitido mantener su independencia con respecto a instituciones externas.

Introduction: ‘Clubs of Alcoholics in Treatment’ (CATs) are mutual-help groups of family communities following the socio-ecological method directed towards the correction of malfunction within the familial environment, involving the whole family of the alcoholic subjects in the treatment program. Most of the Alcohol Outpatient Clinic are referred to
CATs, but many choose not to attend. We tried to investigate if
there are any demographic or medical characteristics that could differentiate these groups.
Methods: We selected 339 with available information whether they
were attending CATs meetings or not. Sample was divided to CAT Attenders and CAT non-Attenders. In addition, we selected 177 patients
that had complete information on days of abstinence, presence of psychiatric or physical comorbidity and whether they were attending
CATs meetings or not.
Results: there was not any significant deference between groups regarding sex, nationality, social class and educational level or initial
AUDIT score. Attenders are slightly younger. Patients with psychiatric
comorbidity (dual diagnosis) are more prone to attend CAT than those
without. On the contrary, patients with physical comorbidity are more
likely not to attend CAT.
Discussion: The socio-ecological method followed by CATs seems to
be more attractive to alcoholics that seek help due to alcohol related
social problems and psychiatric comorbidity.

AUTHORS: E. Grinakis, M. Koulentaki, A. Sfakianaki, N. Liodaki, R.
Aggouraki, and I. Mouzas

This essay couples David Foster Wallace’s works (Infinite Jest, This Is Water, and non-fiction essays) with contemporary research on shame and addiction and explores how literature anticipates science as a means of understanding the human condition.  Wallace's personal knowledge of addiction and how the individual struggles with addiction’s causes and consequences reflects what social workers and M.D.s are beginning to understand as an issue of society at large, not simply an isolated problem of the addict.  As much of the U.S. and other countries struggle with disconnection, isolation, and the overwhelming sense of hopelessness—manifested in burgeoning debt, obesity, medication dependence, etc.—we find ourselves confronted with the realization that the addict depicts our own inner turmoil that is easily ignored or pacified in our materialistic, consumer-driven culture.  Gabor Maté’s In The Realm of Hungry Ghosts: Close Encounters with Addiction (2011) and the work of Brené Brown, Ph.D., LMSW, present claims for how the individual is a reflection of the community and vice-versa, thereby arguing for a greater commitment to understanding and aiding those plagued by addiction.  Wallace recognized, “Everybody is identical in their secret unspoken belief that way deep down they are different from everyone else” (my emphasis Infinite Jest 205).  Yet his fiction and scholars’ research suggests that human beings share more identical attributes than dissimilar ones, and that the addict—whether it be Lenz, Hal, or even Gately as he struggles with sobriety—is not so different from the community who ostracizes him/her (my emphasis Infinite Jest 205).  Wallace, Maté, and Brown encourage authenticity, sincerity, and vulnerability, which are all traits that help addicts overcome their struggle with substances, and almost ironically, it is these traits that also push the literary community out of the post-modern refrain of disillusionment, deconstruction, and irony, which Wallace admittedly strove to overcome.

El apoyo de pares, así como la recuperación, son dos pilares fundamentales en una institución que puede considerarse señera de importantísimos desarrollos en el campo de la Salud Mental. Alcohólicos Anónimos (AA) nace en 1935 de la ayuda mutua entre dos personas que han perdido toda posibilidad de gobernar sus vidas a causa del alcohol y, gracias a su eficacia y a la ausencia de profesionales -al menos en tanto tales-, se transforma con el tiempo en un ejemplo de organización basada en la ayuda de pares.

My dissertation frames the evolution of David Foster Wallace’s writing ethic as a function of addiction recovery. Wallace completed only two novels—the first of which is generally dismissed as the work of a young author enamored of his talent, and the second of which is not uncommonly hailed as “the voice of a generation.” Between these novels, he weaned himself off an addiction to the conspicuous narrative foregrounding of poststructuralist theory, progressing into a writer capable of bringing theory to life through narrative engagement with its application. This reformed Wallace repurposed these sterile, theoretical paradoxes as models for understanding not just the crises of individual experience, but also of American culture more broadly.

Wallace’s life and work invite us to use the institutional language of addiction and the inherent narrative structure of twelve-step programs to read his novels as a progression toward an open-ended and always-contingent recovery from literary theory. Wallace was a chronic substance abuser during his teens and twenties and became a devoted member of twelve-step groups in the second half of his life. I use the three-part narrative schema of recovery—“what we were like, what happened, and what we are like now”— to account for the differences between Wallace’s two novels. Wallace understood himself as an addict; failure to read him as one means neglecting the crucial ways 12-step recovery informs his larger fictional project.

Yet Wallace’s writing complicates a purely twelve-step notion of theory recovery by rejecting certain edicts of Alcoholics and Narcotics Anonymous. Whereas Wallace’s substance-abuse recovery depended on adhering to twelve-step doctrine, his theory addiction required fashioning his own hermeneutic recovery process: a pragmatic appraisal of theory’s narrative value for his readers. The result of this process is a writing style that foregrounds the mental route Wallace took to arrive at his conclusions. By importing the classic math teacher injunction to “show your work,” Wallace imbued his writing with a transparency that rendered it capable of meaningful engagement with readers.

Although the literature on dual diagnosis has grown considerably over the last several years, reports describing inpatient treatment models are less common. We describe some of the major treatment concerns in the dual diagnosis literature, such as using 12-step self-help programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), dealing with different stages of treatment, and developing a program with integrated substance abuse and psychiatric treatment. The practical application of these treatment issues is featured by showing how they are incorporated into an innovative inpatient dual diagnosis treatment program at a public psychiatric hospital. Finally, the treatment program is described in detail regarding administrative issues, staff training, daily treatment schedules, and patient demographics.

The dominant theoretical approach to alcoholism research presumes linear, causal relationships between individual cognitions and behavioral outcomes. This approach has largely failed to account for the recovery some alcoholics achieve in Alcoholics Anonymous (AA) because AA emphasizes the transformation of identity, framed in terms of relationships rather than cognitions and behaviors. George Kelly’s personal construct theory (PCT) provides a ready means of theorizing that transformation by explaining how AA helps alcoholics resolve four identity-relevant dialectics. The basic postulate of PCT addresses changes in stigma: normal vs. deviant identity. The construction corollary illustrates changes in perspective: subjective vs. objective view of identity. The individuality corollary informs changes in affiliation: unique vs. common identity. And the organization corollary illuminates changes in stability: fluctuating vs. permanent identity. As an alternative to causal approaches focusing on cognition and behavior, PCT should facilitate further research into alcoholism as a disorder of identity transformation.

La oración de la serenidad es la oración más pronunciada y pensada por los miembros de los grupos de 12 pasos alrededor del mundo, grupos de recuperación espiritual que generalmente giran alrededor de una adicción o comportamiento obsesivo compulsivo. Los grupos más numerosos de este tipo son Alcohólicos Anónimos (AA), Al Anon (para familiares o amigos de los alcohólicos) y Comedores Compulsivos, en ese orden.  También existen otros grupos que siguen el formato de recuperación de AA: Sexoadictos Anónimos, Narcóticos Anónimos, Compradores Compulsivos, Neuróticos Anónimos, etc.

La oración de la serenidad probablemente es el momento más cercano a dios que tienen los miembros de 12 pasos que comparten el mensaje de la recuperación en los grupos, aparte de las experiencias individuales, claro está. La oración de la serenidad se reza generalmente al comienzo y/o al final de cada junta en los grupos de 12 pasos. Se llaman grupos de 12 pasos porque los miembros basan su recuperación espiritual trabajando 12 pasos que otros adictos ya trabajaron y que les funcionó para hacer a un lado su o sus adicciones, un día a la vez y sólo por hoy...

In recent decades, the considerable proliferation of the self-help groups (especially those of the Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)) has attracted the interest of those engaged in the social sciences as well as of those responsible for mapping out health policies. This article is based on the 10-year involvement of the authors in a participatory action research project for the promotion of self-help groups in Greece as well as to an extensive literature review of the AA and NA movements. Based on this methodology, the objective of this article is twofold. First, it identifies the radical perspective of self-help groups, as the main source for their effectiveness, while it attempts an assessment of their effect on traditional professional attitudes. Second, it raises concerns over the radical perspective of these initiatives in the framework of their transition from an alternative stance towards their integration in formal Health Systems. This transition process is manifested in the following developments: (1) the constantly increasing number of old members who quit the role of the volunteer sponsor and undertake the financially beneficial role of (para-) professional addiction counselor; (2) the instrumentalization of 12 steps; (3) the increasing number of members who adopt the nosological perspective of addiction 4. The various adverse effects of dominant culture on the internal working of the groups are studied. Moreover, this article attempts a comparative assessment of the produced experience with the AA and NA movements in Greece and abroad.


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