HealthCom Issue: 2

Introduction“A simple sign outside a meeting place that says ‘A.A. meeting tonight;’ listing in local phone direc-

tories; distribution of A.A. literature; and radio and television shows using sophisticated media techniques. Whatever the form, it comes down to one drunk carrying the message to another

drunk.”- Bill W., co-founder of Alcoholics Anonymous

The message of media could not be construed better than that of Bill Wilson, formally known as Bill W., co-founder of Alcoholics Anonymous. Since its development in the mid-1930s, Alcoholics Anonymous has been the fastest growing and most successful nonprofessional mutual aid group in the world. With global capitalization and widespread knowledge of the program, including a member base of over 2,000,000 recovering alcoholics, Alcoholics Anonymous has faced many challenges which have come with growth. Due to its tremendous impact on society, Alcoholics Anonymous has attracted the media spotlight several times throughout the past seventy years in both negative and positive frames. The goal of the A.A. program is not only to guide “personal recovery and continued sobriety of individual alcoholics,” but they strive maintain a positive public image of its members and the organization as a whole. Alcoholics Anonymous’ reputation in society is the driving force behind its member retention and recruitment, thus it is a very vital asset for the organization to protect. The program is very sensitive to how they conduct their public relations; being aware not to affiliate with other interests, endorse outside organizations, and always maintaining anonymity. This essay explores the rapid progression of Alcoholics Anon-ymous as a self-help recovery group; how they maintain and utilize media; and the protection efforts in upholding a positive public image in order to ensure the protection of its members.

A Brief History of AAIt was not until the mid 1930s where social support groups for those with chronic addictions began to come to the surface of American society. Alcoholics Anonymous was amongst the one of the first nonprofessional mutual aid groups to develop within mainstream culture. In its infancy, the Alco-holics Anonymous group was primarily structured on the religious movement known as the Oxford Group. This group is characterized by initiating development programs in which individuals perform self-inventory, admit wrongs, make amends, use prayer and meditation, and most importantly carry the message to others (World services, 2011). Although this program was highly successful among its local cohort, Alcoholics Anonymous (then known as the Akron group) did not become a visible facet of the health community until its publications began to filter into the mainstream network in the 1970s. Founders of Alcoholics Anonymous, Bill Wilson along with Dr. Robert Smith, worked closely along one another with the ultimate and specific goal to “stay sober and help other alcoholics achieve sobriety” (World services, 1939). The framework and cultural dynamics of the Alcoholics Anonymous group were outlined in their two primary publications, Alcoholics Anonymous (traditionally known as the Big Book) and Twelve Steps and Twelve Traditions (1952). It wasn’t until the 1970s where Alcoholics Anonymous began to see national recognition for its self-help successes amongst the health commu-nity.

Goals and Culture

Steps & Traditions

Taking a minimalist approach, the Alcoholics Anonymous program insures that each mem-ber within the society maintains complete anonymity during their time as a member. This idea of complete anonymity is build into the societal skeleton of the organization as it remains one of the group’s twelve traditions. With the extensive utilization of social support groups, the Alcoholics Anonymous pro-gram focuses on mutual aid through emotional, esteem, and informational support. The group uses proactive support approach designed to validate the problems of each members through open discussion, narrative, problem-focused coping, and sponsorship programs. By retaining a strict tradition of anonymity, members are more apt to conform to group standards, engage in self-disclosure, and engage in weak-tie relationships with other fellow Alcoholics Anonymous members. In addition to operating an organization which primary functions as a social support group, the Alcoholics Anonymous program ensures that members feel validated and accepted within the community by engaging members in an active sponsorship upon their introduction to the program. “The sponsor – member relationship is a quasi-therapeutic one in which both core facilitative conditions of trust, caring, respect, nurturance, and behavioral strategies are present”(Thoreson & Budd, 1987). Sponsors of the Alcoholics Anonymous program must ensure that entering members of the program respectfully adopt the culture; inspire confidence in the program, share stories to validate the candidates problems, introduce faith, offer expert guidance, take part in reading the Big Book, and go to meetings (Snyder, 1944). When an individual recognizes that their use of alcohol or drugs has developed into a fundamental, life-affecting problem, they have many options in terms of finding treatment. Many seek the support of close friends and family, faith, professional doctors, or hospitals. In several studies across the field of health motivation, research indicates that support-seeking individuals are more than twice as likely to choose self-help approaches such as Alcoholics Anonymous over traditional alcohol treatment programs (Burton and Williamson, 1995). The motivation for indi-viduals who chose nonprofessional social support groups as opposed to the professional medical outlet can be indicated by looking at the societal perceptions of Alcoholics Anonymous.

Since its institution in 1935, the Alcoholics Anonymous program has driven to maintain a specific set of norms, standards, and guidelines in terms how its members and the organization as a whole is represented in society. The initial point of exposure the American populous has been heavily controlled by the outlines within the Twelve Steps and Twelve Traditions guide book. This book is the most respected media which entails how the society functions, and “outlines the means by which A.A. maintains its unity and relates itself to the world about it, the way it lives and grows” (World services, 1952). The primary traditions that this essay will focus on are Tradi-tions Six, Eight, Eleven and Twelve in that they are directly related to driving methodology behind Alcoholics Anonymous’ approach to publicity, media, and communications. The “Twelve Traditions” are the framework in which all Alcoholics Anonymous literature, media materials, committee guides, pamphlets, brochures, periodicals, and educational materials offspring from. The Alcoholics Anonymous ‘Big Book’ was the first publication of the program, and set many milestones in regard to the A.A. cultural norms, history, and culture. It was not until the “Twelve Traditions” were established in 1953 where the organization began to institute legal, societal, and ethical standards in response to public perception. This was a pivotal point in the

Attraction vs. Promotion

historical development of the Alcoholics Anonymous program in that it was the first time an A.A. publication focused not only on the members of the program but non-A.A.s as well. As a supple-ment to the Big Book, the “Twelve Traditions” provide members with a clear definition of A.A. principles, attempted to eradicate common delusions of the organization, and gave A.A. members an educational reference tool when speaking will non-A.A. members. Included within the Alcohol-ics Anonymous Public Information Workbook, they note:

The subject of alcoholism and drug addiction is a very sensitive and highly debated topic within American society. Individuals who often struggle with complications in regard to alcohol and drugs feel stigmatized by mainstream culture. Before the 1970, individuals with alcohol problems were given very little attention by members of the professional community including doctors, therapists, and research scientists. In addition, alcoholism has been characteristically stigmatized as a problem associated with lower social classes, moral weakness, and low self-efficacy (Cox, 1987). It is due to a long history of societal neglect that members of the alcoholic community often disregard and overlook self-help recovery programs. It has been the challenging task of the Alcoholics Anonymous program to tackle the stigmas held in society, and attempt to gain trust of the alcoholic community. By taking a nontraditional approach to public awareness and recovery, the Alcoholics Anonymous program has made great strides in penetrating what has been a cultural roadblock for over seventy years. Alcoholics Anonymous is very aware of the sensitivity of not only its members, but the orga-nization as a whole. In order to ensure a high degree of integrity, A.A. has made exemplary efforts to outline specific rules in which to govern the organization. It is delineated heavily through the A.A.’s eleventh tradition where the organization states their opinion on how promotional approaches should be maintained. As tradition eleven explicitly states, “Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films” (World services, 1953). The Alcoholics Anonymous view of both promotion and attraction is starkly different and their ideals can be vividly seen in how they conduct a public presence. Because the reputation of the Alcoholics Anonymous program is very sensitive and potentially destructive to the organization, directors within A.A. make it aware that no one person can represent the program as a whole. While many members of the program express their opinions about the culture, principles, and their personal experiences with the Alcoholics Anonymous program, it is highly stressed that these members cannot represent the organization. This strict guideline is linked to the importance of main-taining a valid and respected public image. One individual could single handedly stigmatize the reputa-tion of A.A., and it is for that reason why Alcoholics Anonymous operates as a unified group. Using the systems theory to analyze the public relations approach would suggests that program prefers the totality of the system verses its individual entities when reflecting the public perception of organization.

A.A. is not a secret society, and we carry the message to whomever we can. If a suffering alcoholic never meets an A.A. member, how is he or she going to find us? We must however, be ever aware of the need to remain anonymous at the public level; we must try to give the media an accurate picture of the A.A. fellowship as a whole.

At the core of all Alcoholics Anonymous traditions is the goal of maintaining an accurate public per-ception. By explicitly outlaying the principles and expectations of the A.A. program, they stride to carry the message; maintain unity, faith, and independence; focus on attraction verses promotion; remain non-professional; and forever preserve anonymity (World services, 1952).

“In the beginning, the press did not understand our refusal of all personal publicity. They were genially baffled by our insistence upon anonymity. Then they got it – a society which wanted to publicize its principles and its work, but not its individual members” (World services, 1953). The reasons for this approach can be traced to tradition number four of anonymity. It is perfectly clear that an institution founded on the principles of unity and anonymity would sanction the ideas of personal promotion through the media. This could result in serious social consequences for Alco-holics Anonymous in jeopardizing their reputation. While many high profile celebrities and public personal have expounded their personal experiences with Alcoholics Anonymous in the past, A.A. has worked relentlessly to put an end to this type of publicity. One might see that promotion from celebrities would benefit the organization, attracting members who can relate to the public per-sonalities. While this idea is true for traditional advertising and promotion, it strictly violates the fundamental public relation ideals of Alcoholics Anonymous. Disseminating a full name of an A.A. member to the public, even a household name, violates Tradition Four. In addition, international fame is not a goal of the program in that doing so would dismantle their ideology of attraction over promotion. The idea of not using “promotion” can be confusing in a traditional sense of linguistics. Under a strictly Alcoholics Anonymous context, the term promotion means not to promote indi-vidual members but the totality of the organization. This is not to mention that the General Ser-vices Office, the organizational affiliate which represents Alcoholics Anonymous in all publication and media, does in fact utilize mainstream facets of public exposure (R. Gabriela, 2010). Aiming to reach potential members, Alcoholics Anonymous utilizes modern media advertising such as television, radio, internet, and print. When maintaining the image of A.A., their primary goal is to education the public of the Alcoholics Anonymous way of life. In addition, they stress the idea that the A.A. program will not affiliate with any other organization due to the fact that it may give the impression of a partnership. A perception of organizational merge or partnership could potential-ly create a discrepancy between ideals and interests. Any negative or poorly directed campaign or opinion on behalf of a partner could transform itself onto the image of Alcoholics Anonymous. It is for this reason why A.A. chooses to cooperate with other organizations, but refuses to affiliate. As stated in the Public Information Workbook, “A.A. is concerned solely with the personal recov-ery and continued sobriety of individual alcoholics” and “Alcoholics Anonymous does not engage in the fields of alcoholism research, medical or psychiatric treatment, or propaganda of any form, although members may participate in such activities as individuals.”

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Remaining “Non” professional Alcoholics Anonymous’ primary method for public relations and awareness is word of mouth through social networks. Due to the very high success rate within the program and its continually growing member base, it is no surprise that most of Alcoholics Anonymous’ member-ship grows through association. It was Bill Wilson’s original intent upon the foundation of the A.A. program to carry the information from one person to the next, either through personal contact or media. One facet which Alcoholics Anonymous has found success in is the idea of remain-ing “nonprofessional” and unaffiliated with physicians, therapists, and professional recovery programs. Doing so has allowed Alcoholics Anonymous to be viewed as a community of similar people sharing similar problems, thus cultivating the effectiveness of A.A. as a mutual social sup-port group. Friendship and social ties are an important aspect of the A.A. culture which has been driven by their emphasis on remaining a “Fellowship of peers.” The idea of establishing relational connections with members of a mutual society eliminates the stigma of professional recovery. The Fellowship, coped with social support has allowed Alcoholics Anonymous to become a highly successful and adaptive self-help program. Of course, not all individuals who struggle with alcoholism seek immediate help by attend-ing a local meeting. Many potential members alike seek information prior to actively participating in a meeting. Due to the high degree of response efficacy required when facing an issue such as alcoholism, Alcoholics Anonymous must not only be sensitive to their target audience but be able to effectively tailor messages in order to elicit a behavioral response. There is no a set formula to reaching out to those with maladaptive behaviors. For this reason, Alcoholics Anonymous’ prima-ry goal in utilizing external media outlets is to “carry the message of recovery to the still-suffering alcoholic by informing the general public about the A.A. program” (World services, 1994). The publications released by Alcoholics Anonymous offer clear, direct exposure to the A.A. program of recovery without introducing the ambiguities and complexities of the disease as described in the vast array of publications available elsewhere (Thoreson & Budd, 1987). Alcoholics Anonymous publications including the Big Book and the Twelve Steps and Twelve Traditions, are written in very simple, precise, and concrete language. With the absence of medical nomenclature, individu-als with low to moderate literary levels can understand the message of A.A. with limited compli-cations. This is merited to the fact that the authors of Alcoholics Anonymous publications focus on reaching a wide target audience by which limited medical understanding is required to benefit from the material. In addition, unlike traditional medicine which attempts to reach at the core cause and solutions of alcoholism, the literature materials made available by A.A. are designed to help individuals create a new sober life rather than to search for the medical etymology (Thore-son & Budd, 1987).

As stated in the aforementioned sections, the primary goal of Alcoholics Anonymous is to ex-tend mutual self-help opportunities by informing the general public about the A.A. program. Behavioral changes such as those which involve addiction can be some of the most challenging to overcome. Alcoholics Anonymous must work hard to not only maintain a reputable status in society, but also to elicit motivational behaviors of potential members. As an organization, Alco-holics Anonymous uses several approaches in their publicity and media outreach programs when targeting potential members. Their primary method of behavior motivation is rational appeals, although some media such as the annual Alcoholics Anonymous public service announcement use loss frame and gain frame approaches. In example of this can been seen in their 2008 public service announcement titled, “I Thought.” The introduction of the PSA begins with a snapshot at individuals who have suffered with alcoholism by previewing what “they thought” during their struggles with alcohol. In the latter scene, images appear of the individuals under a positive light as they enjoy a new life with new opportunities. This PSA demonstrates the gain frame approach by demonstrating individuals who have performed the recommended actions (utilizing A.A.), and receive a gain of opportunities (a happy, more fulfilling life) which they would have lost if not for Alcoholics Anonymous. The public service announcement concludes as the narrator offers specif-ic action steps by stating, “You’ll find us in your phone book, your local newspaper, or on the web at aa.org.” (World services, 2008). Alcoholics Anonymous has solidified its original principles outlined in the “Twelve Tradi-tions” in order to successfully preserve the face of the organization and its members. Utilizing me-dia efforts such as written publications, television, radio, and the internet to obtain their organi-zational goals, Alcoholics Anonymous is able to retain a growing member base of over 2,000,000 individuals worldwide. Not only has A.A. been able to maintain a successful reputation within the public, but Alcoholics Anonymous is highly recognized amongst the professional community as well. Government, legal, and professional medical organizations refer individuals to Alcohol-ics Anonymous more frequently than any other self-help group. It is due to its high recovery rate, formidable reputation, and ability to maintain its strict organizational standards for over seventy years which has led to Alcoholics Anonymous’ widespread success on the global scale.

Conclusion

References

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Cox, M., (Ed.). (1987). An overview of treatment and prevention of alcohol problems. New York: Academic Press, Inc.

R., Gabriela. (2010, November). Here’s the pitch.Grapevine, 24-26.

Synder, Clarence. Alcoholics Anonymous , Cleveland Central Committee . (1944). Aa sponsorship . . . its opportunities and its responsibilities

Thoreson, R, & Budd, F. (Ed.). (1987). Self-help groups and other group procedures for treating alcohol problems. New York: Academic Press, Inc.

World services, AA. (1939). Alcoholics anonymous. New York City: Alcoholics Anonymous World Services, Inc.

World Services, AA. (1952). Twelve steps and twelve traditions. New York:

World Services, AA . (1994). Public Information Workbook. (1994). New York City.

World Services, AA. (2008). Alcoholics Anonymous: “I Thought” [Web]. Available from http:// www.youtube.com/watch?v=ur-i2C4FLkg&feature=related

World Services, AA. (2011). Alcoholics anonymous: over 70 years of growth. Origins of AA, Retrieved from http://www.aa.org/aatimeline/