Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Summer 2015 Women In Alcoholics Anonymous: A Qualitative Research Study Ariel Larson Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Larson, A. (2015). Women In Alcoholics Anonymous: A Qualitative Research Study (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/799 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. WOMEN IN ALCOHOLICS ANONYMOUS: A QUALITATIVE RESEARCH STUDY A Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Ariel Larson May 2015 Copyright by Ariel Larson 2015 WOMEN IN ALCOHOLICS ANONYMOUS: A QUALITATIVE RESEARCH STUDY By Ariel Larson Approved May 1, 2015 ________________________________ ________________________________ Russell Walsh, Ph.D. Jessie Goicoechea, Ph.D. Professor of Psychology Assistant Professor of Psychology (Committee Chair) (Committee Member) ________________________________ Michael Flaherty, Ph.D. Guest Reader (Committee Member) ________________________________ ________________________________ James Swindal, Ph.D. Leswin Laubscher, Ph.D. Dean, McAnulty College Chair, Psychology Department Professor of Psychology iii ABSTRACT WOMEN IN ALCOHOLICS ANONYMOUS: A QUALITATIVE RESEARCH STUDY By Ariel Larson August 2015 Dissertation supervised by Russ Walsh, PhD This research looks at how women in particular navigate the complicated power dynamics of twelve-step programs, specifically AA, to achieve long-term sobriety. This study attempts to understand how women in AA are appropriating and shaping AA and its reliance on the twelve-steps in unique and resourceful ways to make recovery their own. The methodological approach of this study is empirical-phenomenological. Interviews with five female members of Alcoholics Anonymous were conducted, transcribed and analyzed in an attempt to identify and understand how women approach and adapt recovery strategies and technologies that evolved during the twentieth century to meet the needs of alcoholic men. Discussion of findings is structured as a comparison and dialogue with Metaphors of Transformation: Feminine and Masculine (White and iv Chaney, 1993), which also looks at the experience and language of women in recovery, applying a meta-analysis of theory, science, practice and experience. White and Chaney’s approach is not grounded in a specific phenomenological analysis, but is perhaps the most definitive work to date examining the need for gender specific understanding in AA and recovery. Results of the current study suggest that themes of empowerment, resolution of shame, and connection with other women are particularly important for gender-specific treatment. v TABLE OF CONTENTS 1. Abstract………………………………………………………………………………………….iv 2. Introduction…………………………………………………………………………………...1 3. Method ……………………………………………………………………………….............14 4. Results ………………………………………………………………………………..............20 Table 1……………………………………………………………………...............21 5. Discussion…………………………………………………………………………………….41 Table 2……………………………………………………………………...............42 6. References …………………………………………………………………………..............87 7. Appendix A: Consent Form…………………………………………………...............91 8. Appendix B: Recruitment Flier ……………………………………………..............94 9. Appendix C: Participant Transcripts……………………………………...............95 vi Introduction The following study will explore women’s experiences of Alcoholics Anonymous, and their ways of navigating through its predominantly male-oriented treatment paradigm. Consistent with a growing literature concerned with minority access to treatment services and mechanisms of recovery in a variety of cultural contexts this project will employ a phenomenological method to delineate the unique and common features of women who achieved sobriety through participation in AA. Prevalence Epidemiological data suggests substance use disorders and the accompanying difficulties are pervasive, touching the lives of most, if not all, Americans in some form. According to The Journal of the American Medical Association, rates of alcohol abuse and dependence are “highly prevalent and disabling” (Hasin, 2007, p. 830). JAMA reported a lifetime prevalence of alcohol abuse at 17.8%, and reported that 4.7% of individuals interviewed said they abused alcohol within twelve months of the survey. Alcohol dependence was reported at a lifetime rate of 12.5% with 3.8% reporting dependence within twelve months of the survey. Dependence rates were higher among men, whites, Native Americans and respondents who were middle-aged, younger, had lower incomes and were single adults. As a group, middle-aged Americans had the highest prevalence of lifetime dependence, which is associated with significant disability and a number of substance and alcohol use disorders. In addition to increased risks for automobile accidents and fetal alcohol effects, alcohol dependent individuals are more likely to have financial and legal difficulties, mood, anxiety and personality disorders, 1 neuropsychological impairment and problems taking medication as prescribed (Hasin, et al, 2007). The Origins of Alcoholics Anonymous Understanding of alcohol addiction as an illness has increased since the 1930’s, when the successful lobbying efforts of Alcoholics Anonymous made the disease model relatively common, whereas before it was almost universally considered a moral failing (Conrad and Schneider, 1992). The first notable proponent of the alcoholism as disease argument was Benjamin Rush, a prominent physician, signer of the Declaration of Independence and influential American colonist. But Rush was before his time. During the late 18th and the 19th centuries, temperance efforts and reform clubs came and went as “inebriates” (White, 1998) were housed in any institution that would take them, from charitable homes and jails to workhouses or even lunatic asylums. These alcoholics, almost exclusively male, were not treated for their alcoholism until professional treatment began to emerge in the late 1800’s. Early efforts were highly ineffective and alcoholics were usually considered hopeless cases until mutual aid groups began to take hold. It wasn’t until 1935 and the birth of AA, that alcoholics began to band together to find hope and fellowship (White, 1998) and to garner the attention and support that would carry their organization forward until it became the internationally represented, household name that it is today. Ultimately AA, with its emphasis on a modified disease or allergy model and addiction as a chronic, irreversible condition, would change the national and even international understanding of the chronic drunk, urging us toward the medicalization of a formerly moral condition. 2 After 75 years of growth, membership estimated at well over two million, meetings on every continent, four editions of the Big Book of Alcoholics Anonymous available in 58 languages, and vigorous outreach programs aimed at physicians and other healthcare professionals (aa.org), AA has helped to destigmatize alcoholism. For a number of reasons— ranging from social and economic forces colliding at the right time and place (aided by AA founder Bill Wilson’s vision and charisma) to the effectiveness of AA’s program for many alcoholics who previously had little hope—AA spread far and wide, followed by Al-anon/Al-Ateen for families of alcoholics, and Narcotics Anonymous. Later there was a veritable explosion of twelve-step groups styled after AA, including Sex Addicts Anonymous, Overeaters Anonymous, Gamblers Anonymous and many more. But just because twelve-step recovery dominates the field doesn’t mean it is a good fit for everyone. Women in Alcoholics Anonymous Women have had a presence in AA from the very beginning and as far back as 1945 AA literature acknowledged “attitudinal barriers” that women faced in the AA recovery community (White, 1998, p. 158). While the wives of the founders, Lois Wilson and Anne Smith as well as others, deserve credit for their support of the early AA community, the women trying to get sober during that time deserve credit for fighting addiction along with the sexist stereotypes of the fifties and sixties. Some men didn’t believe women could be alcoholics and others didn’t believe women belonged in AA since they would be a “distraction,” but they struggled on and their stories are told alongside those of pioneering male AA’s. Florence R.’s story appeared in the first edition 3 of the Big Book, though she eventually died of alcoholism, and Marty Mann was not only one of the pioneering women of AA, but achieved lasting sobriety and her story, “Women Suffer Too,” is still being reprinted in current editions of the Big Book (White, 1998, p. 158). Some of AA’s most cherished traditions, including free coffee and birthday tokens or chips given out for sober time, are credited to Sister Mary Ignatia, whose remarkable efforts on behalf of alcoholics at St. Thomas hospital in Akron laid the groundwork for a pathway to recovery that is still recognizable today (White, 1998, p. 166). Many of the stereotypes highlighted by those early AA articles regarding women in AA