How to Respond: “AA is Not For Me”

What is the most effective treatment for alcoholism? After 25 years of practice of psychiatry and direct or indirect involvement with well over 30,000 patients with alcoholism and/or chemical dependency, I feel that by far the most effective and successful long-term therapy for alcoholism is Alcoholics Anonymous. 

I have observed and read about other treatments, and these remind me of Aesop’s fables that I learned as a child. A fox and a cat were discussing what to do when chased by dogs. “I run up a tree,” said the cat. “What else do you know to do?” asked the fox. “Nothing,” said the cat. “You poor stupid animal,” said the fox. “Why, I have a thousand different ways of outsmarting those dogs.” Just then, they heard the barking of hunters’ dogs that were approaching. The cat quickly scampered up a tree. The fox tried to figure out which of his many ways to use, and soon the dogs had him by the ear. 

One proven method is worth more than a thousand maybes. Alcoholics Anonymous has been around for 50 years, and it has proven its efficacy over the long duration.  Why then do many people still resist A.A.? If A.A. is so effective, (and it is also free of charge), why would the person who seeks help with a drinking problem be hesitant to join A.A.? 

The person who has finally come around to realize that alcohol is destructive for him, nevertheless, often retains the hope that someday, somehow, he will be able to return to safe, “social” drinking. A.A. punctures this dream bubble. Although A.A. advocates “taking one day at a time” and not worrying about what will be the next month, next year, or 10 years hence, the unspoken position is quite clear. No alcohol in any amount, not now, not later, not ever. This is a message the alcoholic does not want to hear. 

There is a strange logic in alcoholism. Even the person who is aware that he can no longer drink, and actually commits himself to total abstinence, may nevertheless wish to have the option to drink. Giving up alcohol is somewhat akin to accepting the death of a loved one; the person may know the fact, but is unable to accept it. To a person who feels this way, going to A.A. means accepting that one is indeed an alcoholic. This is difficult not so much because of the stigma of the term, but more so because it means giving up the option to drink. 

Although the above reasons are invariably the true reasons for the resistance to A.A., they are not the ones given. The reasons usually cited are rationalizations or excuses, although the person may convince himself that they are indeed his true reasons. There may be various ways to counter these rationalizations. Here is how I have responded to some of them. 

Objection: “A.A. is not for me. I tried it a few times. I can’t stand those meetings. They bore me”

Response: Let’s assume for the moment that what you say is true. Actually, the overwhelming number of meetings are not enjoyable, but let’s just suppose that they are not. The condition you have is a malignant one. You have already seen what alcohol has done to you. You are in the process of losing your family, your liver function tests show physical damage, and your work performance has been affected. Continued drinking will make everything much worse. Alcoholism is like cancer; if untreated, it is progressive, and will take from you everything you hold precious. A.A. is lifesaving treatment. No one refuses lifesaving treatment for cancer because “I don’t enjoy it”. You are not going to A.A. for enjoyment, but for life saving treatment. 

Objection: “I went to those meetings a few times, and you know what? I felt like having a drink more than ever.” 

Response: That’s interesting.  You seem to have done pretty well in your consumption of alcohol before you ever went to an A.A. meeting. Seems to me you never needed much outside urging to drink. Furthermore, even if it were true that an A.A. meeting makes you want to drink, it is not the desire that is going to cost you your family, job, and health, but the drinking. Those people who were at the meeting know all about overcoming those urges. They were able to salvage important parts of their lives. You ought to ask them how they did it. 

Objection: “I don’t need anyone to tell me how to stop drinking. I can do it alone.” 

Response: Of course you can. And that’s why you’re here in the hospital detoxifying, right? (Sometimes the urge to be sarcastic can’t be resisted.) 

Objection: “I was at some meetings. You hear the same damn thing over and over again. I’m bored to death.”

Response: What was so different everyday drinking at the bar? The same guys were sitting around drinking. The only reason you were not bored by the monotony at the bar is that you were too blitzed to remember what went on the night before. If the A.A. speaker bores you because you feel he is repeating what another speaker said the night before, congratulate yourself on being able to remember the night before. 

Objection: “A.A. is not for me. They talk about God and I am an atheist. I don’t believe in God.” 
Response: You’re way ahead of yourself. The part about God doesn’t come until the second step. Take the first step first. It has nothing to do with God, but you just have to admit that you are powerless over alcohol. You see, your problem is not that you don’t believe there is a God. I think you do believe in God, but you think you are Him. All the evidence shows that you’ve lost control, but you still keep on insisting that you have control. Why don’t you take the first step, admit that you are not omnipotent, and that you have lost control. Once you have accepted the fact that you are not your own God, then you can think about whether there is one out there. 

Objection: “I saw a couple of guys go out of a meeting and head straight for a bar.” 

Response: That can happen. A.A. doesn’t cure anyone the first time they set foot at a meeting. But how come you didn’t focus on the seventy-eight people who did not drink after the meeting. They have been sober anywhere from several weeks to forty years. Didn't you ever hear of a person who had a checkup at his doctor’s office, and two days later died of a heart attack? Does that mean that if you get some chest pain you will go to the gas station for treatment because doctors are not effective?

Objection: “A.A. is not for me because I’m Jewish and A.A. is all Christian.” 

Response: Nothing in A.A. relates to any particular religion. Most A.A. meetings are held in churches because until recently people believed, as you did, that Jews are immune to alcoholism. There are now an increasing number of meetings being held in synagogues. (If you are in a belligerent mood you might just ask, “When is the last time you saw the inside of a synagogue?”) 

Objection: “I can’t go to A.A. because I might meet someone I know.” 

Response: You might meet someone you know? You're bound to meet someone you know. It may be a neighbor, your doctor, a lawyer, or even your boss. So what! What do you think they are doing there? They have the same problem you have, and they’ll be more than happy to share their recovery with you. Furthermore, we have this strange notion that our drinking problem has been the world’s best kept secret. No way! We're the last ones to discover anyone thinks we have a drinking problem. 

Objection: “I went to a few meetings and the speakers I heard turned me off. I have never done any of those things. I’m not that bad.” 

Response: Alcoholism much like pregnancy, is a progressive condition. Just like there is early stage pregnancy and late stage pregnancy, so there is early alcoholism and advanced alcoholism, but it’s all the same condition. Those people who described some of the terrible consequences of alcohol have the same disease that you have, but did not get help until it reached an advanced stage. If your problem remains unchecked, you will get to where they did. They were all at one time where you are now, and like yourself, thought that those things would never happen to them. If you stay around A.A. you will come in contact with many people who came for help at an earlier stage like yourself. You will not have trouble identifying with them. 

Objection: “I can’t go to all those meetings. I have a family, and my wife and children need me at home.” 

Response: If you go to meetings four nights a week, that will give you three nights with your family. And if you will only be honest with yourself, you will admit that that will be three nights more per week than you have been with them now. Not much point in being with your family if you’re in a condition where they’d rather you not be there. 

Objection: “A.A. meetings are not for me. I don’t have a car and I can’t get around.” 

Response: Lack of transportation didn’t seem to be a problem when you had to get alcohol did it? There’s probably an A.A. meeting about as close to you as the liquor store or bar. And you’ll find many people at A.A. more than happy to take you to meetings. 

Objection: “I don’t understand how listening to other people's stories is going to help me.”

Response: I’m sure that you have taken aspirin for headache or a fever, even though you don’t know how aspirin works. The simple fact is that people who go to A.A. and stay with A.A. stay sober, and right now, that is what you are after. 

Objection: “I went to a few A.A. meetings and they don’t do anything for me.” 

Response: That sounds like a child who came home from his first day at school and his mother asked, “Did you learn anything today?” “I guess not,” the child answered, “they said I have to go back again tomorrow.” we come into A.A. after twenty years of drinking, and expect instant sobriety. That's not the way it works. It may be a long while before the meetings reach you. Just bring your body to the meetings. Your head will get there eventually. 

Rationalizations are good reasons which are given in place of true reasons. Even when they sound good, they are still only excuses. The true reason for resisting A.A. is invariably that the idea of total abstinence forever is very frightening. 

As you refute the various objections, remember that the person you are talking to is very frightened. As destructive as it is, alcohol has been the only reliable method he had for dealing with what were to him, overwhelming life situations. While giving up the toxic alcohol is essential, have some compassion for the person whose only crutch you are removing. You might even skip the urge to make biting, sarcastic remarks, and respond in a more benign manner. 

Do not just give the person a list of A.A. meetings with instructions to get there. You can greatly facilitate entrance to A.A. by calling someone in the program to accompany the neophyte to his first few meetings. Choose someone whom he can readily identify; someone close to his own age, in a similar occupation, and perhaps living in the same neighborhood. Seeing someone similar to oneself, who has continued to live and even thrive after giving up alcohol is most reassuring. It helps one believe that there is a life after sobriety. 

Throughout this article, I have used the male pronoun. Extra sensitivity must be used with the woman alcoholic. The double standard still prevails, and the resistance on the part of the woman to accept herself as an alcoholic and join the fellowship usually exceeds that of her male counterpart. The firmness of your own conviction of the value of A.A. will carry the message. If the desired results are not immediately forthcoming, be patient. Remember, it is impatience and the quest for immediate results that contributes so greatly to alcoholism. The path to recovery must be different.