Alcoholics Anonymous and other 12-step recovery programs are losing effectiveness because they have slipped their spiritual moorings, say disciples of the Episcopal priest from Pittsburgh, Pa., on whose principles the 12 steps are based.
The success rate for Alcoholics Anonymous, founded in 1935, has fallen drastically in recent years, they say."There are a lot of people for whom the 12-step program is not working because they are not in touch with the power that is going to make the difference," said the Rev. Paul Everett, who retired last year as director of The Pittsburgh Experiment, a Christian discipleship group for business people founded by the late Rev. Samuel Shoemaker.
Shoemaker, who was rector of Calvary Episcopal Church in the 1950s, developed a form of evangelism in which people with common problems met in small groups to help each other apply biblical teachings to their lives. Alcoholics Anonymous is so closely based on his work that many AA adherents consider him a co-founder of the group along with Bill Wilson and Dr. Bob Smith, who began the first chapter in Akron, Ohio.
Ironically, atheists have paid the most homage to the theological nature of the 12 steps in recent years through their rejection of AA. They have formed alternative groups, such as Rational Recovery and Secular Sobriety.
While the 12 steps have never been explicitly Christian, they are based on biblical premises. The ideas of sin, soul-searching, repentance, forgiveness and good works contained in the 12 steps are common to most faiths. But the steps assume a personal, powerful God-outside-oneself that is alien to many nonbiblical religions.
"It was assumed in the beginning that the higher power was God," said the Rev. David Else, director of the Center for Spirituality in 12 Step Recovery in Pittsburgh and an Episcopal priest.
Today's participants are often told that the higher power can be anything they imagine it to be.
AA's basic text, The Big Book, has two references to the Higher Power but about 200 references to God, he said.
The eleventh step is a vow to "improve our conscious contact with God as we understand him."
"God as we understand him" was not originally meant to imply that every concept of God was equally valid, Else said. It referred to people's limited ability to understand God. It was intended to raise the comfort level of participants who were not traditionally religious.
Many influences have eroded 12-step spirituality, Else and Everett said.
The culture no longer assumes that people are frail beings in need of God's grace. Instead, people believe they can control their lives by sheer willpower, Everett said.
"Whatever the problem is, all you need to do is look to yourself. If you can't find the answer, you go get another Ph.D. Then you will be OK," he said.
The New Age movement, a free-flowing mishmash of watered-down Eastern spirituality and Western pop psychology, has also contributed to the breakdown, Everett said. People exposed to various New Age teachings tend to see themselves as divine and therefore can't conceive of a Higher Power, he said.
The rise of treatment centers has also played a role, Else said. For decades, AA was the only hope alcoholics had apart from rudimentary detox centers, he said, and early treatment centers were staffed largely by recovering addicts who had come through the 12-step program.
But now most treatment programs are run by professionals who have never been in recovery.
"When all these programs started coming into being in the 70s, the recovery community said, `Well, they're doing it now, so we don't have to do the work we used to.' " It is Else's contention that clinicians are not as effective as recovering alcoholics in AA.
"I really think that the leadership within the addictions field must be assumed by those in recovery, by the 12-step programs."
Else no longer sees much vigorous work on the 12th step: spreading the news of spiritual awakening and recovery to other alcoholics, and practicing the 12-step principles in all aspects of daily life.
"When I first started working with people in AA, they had to carry the message after that awakening. They didn't have a choice, because the Spirit forced them to do it. If they are not carrying the message now, they must not have received the message and had that awakening. They could not keep quiet about it if they did."