In the 1990s, membership in Alcoholics Anonymous (AA) and other mutual-aid, disease-specific support groups may have peaked. Yet political scientist Robert Putnam’s data from that period suggested that Americans were “bowling alone,” retreating from participation in traditional forms of civic life like bowling leagues, Rotary clubs, and college alumni fundraisers. They had less social capital and weaker emotional bonds. Critics suggested that the growth of so-called self-help support groups represented a narcissistic, responsibility-shirking substitute for deeper commitments to family, community, and faith (and Putnam partly agreed).
Both 12-step skeptics and AA purists also questioned whether corporate motives were influencing the growth of grassroots groups. Historians Ernest Kurtz and Bill White noted that, beginning in 1970, federal funding facilitated the growth of an addiction treatment industry. Dedicated treatment facilities grew from fewer than 20 in 1970 to 4,200 in 1980; by 1990, there were over 9,000 treatment centers. Many of these centers incorporated AA, and AA members often played professional roles as counselors and nurses. As a result, Kurtz and White hypothesize, AA membership outside the treatment centers also rose, more than doubling between 1970 and 1980 (from around 300,000 to over 900,000), and doubling again to over 2 million members in 1990.
Sociologist Matthew Archibald found a similar pattern in the growth of other mutual aid groups that employed variations of the AA model. By the 1970s, other groups designed to address disease status or identity issues proliferated (the chart below shows organizations that organized on a national level). The total number of nationally recognized mutual aid organizations began to drop off by the year 2000, as did AA membership.
Although bowling never made a comeback, by the 2000s Putnam’s brand of civic activism was up. Generation Xers settled down. Political and economic changes inspired a surge of populist activism. At the same time, pundits and public intellectuals have begun revising the old assessment of AA. Rather than posing a threat to American civic life, they have begun to see mutual aid as a worthy American institution with moral lessons to offer the non-addicted and not-yet ill.
In his recent neuroscientific morality play, New York Times columnist David Brooks features AA. The protagonist Harold becomes alienated—he has “no kids, no political or philanthropic cause, nothing to subjugate his own interests for,” and as a result his drinking increases. The habit “damaged the neural plasticity in his prefrontal cortex,” writes Brooks. He could not change his drinking patterns on his own.
Brooks concedes that social science can’t offer a robust conclusion about why AA ultimately works for his protagonist. But Brooks suggests that AA works for society by offering a counterpoint to an unhealthy culture of atomism and alienation. AA counters narcissism with humility, individualism with fellowship, large-scale technocratic solutions with local and adaptable ones. “Individual repair is a social effort,” he writes. Our brains don’t operate in isolation. Similarly, in the bestselling book The Power of Habit, journalist
Charles Duhigg uses AA to illustrate how changing social cues can enable individuals to alter ingrained behaviors. Socialization offers a reward that replaces addictive consumption, Duhigg claims. This lesson has been “refined into therapies that can be used to disrupt almost any pattern.” Mutual aid has something to offer everyone, and not just in terms of personal efficiency. Duhigg cites the maxim “Community creates belief.” Shared experiences and beliefs bind people together. They make it easier to make better choices. They provide ineffable but brain-based incentives for individuals to participate in collective projects.
Contemporary critics like Brooks and Duhigg use the AA analogy to support Putnam’s venerable argument about the importance of social capital. Unlike previous critics, they don’t view supposedly self-centered support groups as the antithesis of social and political engagement. They largely ignore the fact that disease- and identity-based support groups presented themselves as apolitical, even as they lobbied for research dollars and worked for public recognition. Today, the legacy of that neutral stance makes the AA group process a conveniently uncontroversial illustration of the power of social cohesion—alternatives like church cohesion and “community organizing” have perhaps become too politicized. Although AA membership is declining, editorialists like Brooks and Duhigg present the minority organization as a useful model of healthy social involvement with universal appeal. Alcohol and drugs historians have shown that AA was once quite contentious. Now, the 12-step groups make up an exemplary social institution— that most Americans will never join.