Obvious benefits but hidden costs: A critical exploration of the impact of adopting the "master narrative" in Alcoholics Anonymous.

INTRODUCTION: New members of Alcoholics Anonymous (AA) typically acquire a distinct "alcoholic" identity, including AA-specific understandings of their "alcoholism" and what it means to be in recovery. Although much qualitative research on AA has presented the experiences of members who have embraced this identity and have been wholly praising of AA, other theorists have been strongly critical of the organization, often arguing that it emulates a cult. To contribute towards reconciling these competing bodies of research, the current study aimed to critically explore the impact of adopting AA's master narrative. METHODS: The study involved 19 prospective, in-depth semi-structured interviews with six AA members recruited from meetings across Sydney, Australia. Data were analyzed thematically using a master narrative theoretical framework. RESULTS: The study identified three core components of AA's master narrative: (1) Powerlessness over alcohol ("alcoholics" are powerless over alcohol); (2) Internalized pathologization ("alcoholics" are mentally and emotionally sick, above and beyond their problems with alcohol); and (3) AA as the only solution for wellness (involvement in AA is the necessary requirement for "alcoholics" to become and remain well). Although most participants emphasized the positive experiences from internalizing the AA narrative, our analysis also revealed potentially negative ramifications of this narrative on their self-conceptions and worldviews that were seemingly unrecognized by participants themselves. CONCLUSIONS: The master narrative framework facilitated a critical and balanced exploration of AA members' experiences. Although AA's master narrative is valuable for members, it could also carry costs that need to be mitigated by resources both inside and outside of AA.

The politics of belonging in Alcoholics Anonymous: A qualitative interview study.

A prevalent critique of Alcoholics Anonymous (AA) is that members must adopt an inflexible illness narrative, taking on an "alcoholic" identity and performing a set of practices to address this condition. Conversely, a small body of research suggests that, rather than comprising the uniform adoption of a rigid narrative, integration into AA is achieved by negotiating individual beliefs, values, and preferences with the AA model. To investigate such processes of negotiation, the current study aimed to explore the politics of belonging in AA. The study involved semi-structured interviews with 15 AA members recruited from meetings across Sydney, Australia, and data were analyzed thematically. Findings illustrated how participants navigated the politics of inclusion/exclusion within AA. While some aspects of AA were found to be negotiable by participants, a non-negotiable aspect of AA ideology that emerged was the axiom that "alcoholics" have no control over alcohol and therefore should maintain abstinence. Findings raise questions about how the politics of belonging in AA may shift over time following broader patterns of societal change.

A Critical Review of Qualitative Interview Studies with Alcoholics Anonymous Members.

Background: Alcoholics Anonymous (AA) is a community-based NGO that supports people with alcohol misuse concerns to achieve and maintain abstinence. Qualitative methods are best suited to investigate individual experiences of recovery in AA, since this typically involves not only abstinence from alcohol but also the global psychological growth of the whole person. Despite this, the growing body of qualitative research exploring individual experiences in AA has yet to be collated. Objectives: The aims of this paper were to systematically search for and critically review qualitative interview studies with AA members. Methods: A systematic database and citation search identified 21 articles published between 1977 and 2014. Two independent reviewers assessed each research report and extracted data pertaining to the findings and the methodological quality of the studies. Results: Major themes across the reviewed articles included 'rock-bottom' experiences and powerlessness, and identity and change processes in AA. Findings related to the methodological quality of the papers were both general to qualitative research and more specific to AA. Conclusions/Importance: Research in this field has been characterized by a relatively uncritical discovery of AA narratives among AA members and by a lack of methodological rigor, which is likely to perpetuate its negative standing in the context of academia, and therefore in public and political discourse. Overall, findings demonstrated a pressing need for high quality qualitative research on AA.