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Saturday, 1 November 2014

Our Great Responsibility, January, 1966, Bill W

The Fellas (Friends of Alcoholics Anonymous)

PS For AA Minority Report 2013 click here

Friday, 31 October 2014

Bill and Bob's Excellent Adventure! (contd)

A wildly imaginative dianoetic rambling concerning the the “basic text” of Alcoholics Anonymous (viz. the Big Book) (our comments in red print)

The Doctor's Opinion (pp. xxvii-xxxii)

The doctor writes:

The subject presented in this book seems to me to be of paramount importance to those afflicted with alcoholic addiction.

I say this after many years’ experience as Medical Director of one of the oldest hospitals in the country treating alcoholic and drug addiction.

There was, therefore, a sense of real satisfaction when I was asked to contribute a few words on a subject which is covered in such masterly detail in these pages.

We doctors have realized for a long time that some form of moral psychology was of urgent importance to alcoholics, but its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge.

Many years ago one of the leading contributors [Bill Wilson] to this book came under our care in this hospital and while here he acquired some ideas which he put into practical application at once.

Later, he requested the privilege of being allowed to tell his story to other patients here and with some misgiving, we consented. The cases we have followed through have been most interesting; in fact, many of them are amazing. The unselfishness of these men as we have come to know them, the entire absence of profit motive [something which some of our 'AA entrepreneurs' might care to remember – you know who you are!], and their community spirit, is indeed inspiring to one who has laboured long and wearily in this alcoholic field. They believe in themselves, and still more in the Power which pulls chronic alcoholics back from the gates of death.

Of course an alcoholic ought to be freed from his physical craving for liquor, and this often requires a definite hospital procedure, before psychological measures can be of maximum benefit. [medical treatment should remain strictly the province of those qualified to administer it, and not left to amateur diagnosticians! See our April Fools Quiz, Q. 4]

We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.

Frothy emotional appeal seldom suffices [“Frothy emotional appeal”, of course, is a cult speciality. Jumping up and down and getting all excited whilst chanting 'happy, joyous and free' and claiming “never to have had a bad day” doesn't quite constitute a message which has both “depth and weight”] The message which can interest and hold these alcoholic people must have depth and weight. In nearly all cases, their ideals must be grounded in a power greater than themselves, [ie. probably not a sponsor. See (b) of the “three pertinent ideas” ('Alcoholics Anonymous', Chapter Five, How It Works, p. 60)] if they are to re-create their lives.

If any feel that as psychiatrists directing a hospital for alcoholics we appear somewhat sentimental, let them stand with us a while on the firing line, see the tragedies, the despairing wives, the little children; let the solving of these problems become a part of their daily work, and even of their sleeping moments, and the most cynical will not wonder that we have accepted and encouraged this movement. We feel, after many years of experience, that we have found nothing which has contributed more to the rehabilitation of these men than the altruistic movement now growing up among them.

Men and women drink essentially because they like the effect produced by alcohol. The sensation is so elusive that, while they admit it is injurious, [admission does not in itself constitute acceptance or realisation] they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one. They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few drinks [ie. their restlessness etc derives from failing to satisfy their drink craving. If one is sober and feeling “restless, irritable and discontented" this is simply a by-product of normal life; to feel this way is not evidence of some kind of pathology] —drinks which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to drink again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery.

On the other hand—and strange as this may seem to those who do not understand—once a psychic change has occurred, the very same person who seemed doomed, who had so many problems he despaired of ever solving them, suddenly finds himself easily able to control his desire for alcohol, the only effort necessary being that required to follow a few simple rules [this does not imply that these “rules” should be administered by another – rather that they are adopted and undertaken by the person concerned].

Men have cried out to me in sincere and despairing appeal: “Doctor, I cannot go on like this! I have everything to live for! I must stop, but I cannot! You must help me!’’

Faced with this problem, if a doctor is honest with himself, he must sometimes feel his own inadequacy. Although he gives all that is in him, it often is not enough. One feels that something more than human power is needed to produce the essential psychic change [see Chapter Five above]. Though the aggregate of recoveries resulting from psychiatric effort is considerable [see here], we physicians must admit we have made little impression upon the problem as a whole. Many types do not respond to the ordinary psychological approach.

I do not hold with those who believe that alcoholism is entirely a problem of mental control. I have had many men who had, for example, worked a period of months on some problem or business deal which was to be settled on a certain date, favourably to them. They took a drink a day or so prior to the date, and then the phenomenon of craving at once became paramount to all other interests so that the important appointment was not met. These men were not drinking to escape; they were drinking to overcome a craving beyond their mental control [mere cognition coupled with will-power is insufficient].

There are many situations which arise out of the phenomenon of craving which cause men to make the supreme sacrifice rather than continue to fight.

The classification of alcoholics seems most difficult, and in much detail is outside the scope of this book. There are, of course, the psychopaths [see Narcissism with particular reference to its predominance amongst cult types] who are emotionally unstable. We are all familiar with this type. They are always “going on the wagon for keeps.’’ They are over-remorseful and make many resolutions, but never a decision.

There is the type of man who is unwilling to admit that he cannot take a drink. He plans various ways of drinking. He changes his brand or his environment. There is the type who always believes that after being entirely free from alcohol for a period of time he can take a drink without danger. There is the manic-depressive type [now termed bipolar] , who is, perhaps, the least understood by his friends, and about whom a whole chapter could be written.

Then there are types entirely normal in every respect except in the effect alcohol has upon them. They are often able, intelligent, friendly people.

All these, and many others, have one symptom in common: they cannot start drinking without developing the phenomenon of craving. This phenomenon, as we have suggested, may be [ie. this statement should be regarded as an hypothesis rather than as accepted fact] the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity. It has never been, by any treatment with which we are familiar, permanently eradicated. The only relief we have to suggest is entire abstinence.

This immediately precipitates us into a seething cauldron of debate. Much has been written pro and con, but among physicians, the general opinion seems to be that most chronic alcoholics are doomed.

What is the solution? Perhaps I can best answer this by relating one of my experiences.

About one year prior to this experience a man was brought in to be treated for chronic alcoholism. He had but partially recovered from a gastric haemorrhage and seemed to be a case of pathological mental deterioration. He had lost everything worthwhile in life and was only living, one might say, to drink. He frankly admitted and believed that for him there was no hope. Following the elimination of alcohol, there was found to be no permanent brain injury. He accepted the plan outlined in this book [ie. the initiative remained with him – not with another]. One year later he called to see me, and I experienced a very strange sensation. I knew the man by name, and partly recognized his features, but there all resemblance ended. From a trembling, despairing, nervous wreck, had emerged a man brimming over with self-reliance and contentment. I talked with him for some time, but was not able to bring myself to feel that I had known him before. To me he was a stranger, and so he left me. A long time has passed with no return to alcohol.

When I need a mental uplift, I often think of another case brought in by a physician prominent in New York. The patient had made his own diagnosis [not a good idea!], and deciding [incorrectly] his situation hopeless, had hidden in a deserted barn determined to die. He was rescued by a searching party, and, in desperate condition, brought to me. Following his physical rehabilitation, he had a talk with me in which he frankly stated he thought the treatment a waste of effort, unless I could assure him, which no one ever had, that in the future he would have the “will power’’ to resist the impulse to drink.

His alcoholic problem was so complex, and his depression so great, that we felt his only hope would be through what we then called “moral psychology,’’ [see above] and we doubted if even that would have any effect.

However, he did become “sold’’ on the ideas contained in this book. He has not had a drink for a great many years. I see him now and then and he is as fine a specimen of manhood as one could wish to meet.

I earnestly advise every alcoholic to read this book through, and though perhaps he came to scoff, he may remain to pray.

William D. Silkworth, M.D.”

(our emphases)

Coming next – Chapter 2 There Is A Solution (as already indicated Bill's Story will not be included in our discussion)


The Fellas (Friends of Alcoholics Anonymous)

Thursday, 30 October 2014

Alcohol research

Project Summary

The Behavioral Health Recovery Management (BHRM) project seeks to apply the principles of disease management to assist individuals with chemical dependency and/or serious mental illness to engage in a process of recovery from these illnesses.
The major components include the application of evidence based treatments coupled with longitudinal recovery support as an alternative to the acute interventions that characterize traditional behavioral health approaches. In addition, the project emphasizes a consumer-centered, strengths-based service delivery model.

The project is a partnership of Fayette Companies located in Peoria, Illinois and Chestnut Health Systems headquartered in Bloomington, Illinois and the University of Chicago, Center for Psychiatric Rehabilitation in Chicago, Illinois. Funding is provided by the Illinois Department of Human Service’s Office of Alcoholism and Substance Abuse.

A full description of the project is contained in the BHRM Project Description”  
The Fellas (Friends of Alcoholics Anonymous)

PS For AA Minority Report 2013 click here

Wednesday, 29 October 2014

A small matter of honesty!

Extracts from the aacultwatch forum (old)

Thanks ….... I regard myself as a Christian, like Joe McQ and yourself, but I also try to be honest enough to admit that what I aspire to be in my thoughts and religious beliefs doesn’t always match my behaviour. Chapter Five of the Big Book starts with the matter of honesty. It gives the reason why some alcoholics fail to achieve sobriety; they may be constitutionally incapable of being honest with themselves. It is possible for someone to be a very dishonest Christian. It is also possible for an honest person to practice another religion or to be an honest agnostic or atheist. When it comes to being honest or dishonest it matters little what religion of philosophy a person aspires to follow. In terms of the alcoholic in Step Two, (Twelve Steps and Twelve Traditions) it describes the alcoholic who is“ full of faith” in his religious belief, but with no real communication with a power greater than himself; his faith superficial, or wallowing  in emotionalism, mistaking this for true religious feeling. An atheist or agnostic alcoholic can go through the process of ego deflation and acquire the humility to be honest with himself and others, and to understand that there is a power or powers greater than himself. Conversely, an alcoholic who has his own idea of faith in God and Jesus can still be an alcoholic with an inflated ego; unable to comprehend this concept of God as a power greater than himself; and unable to acquire the humility of being honest. In such a case the exercise of prayer can simply be the alcoholic's time spent communicating to himself, rationalising his own self deceit into the will of God as imagined by him.  Honesty, ego deflation, are the most important things for an alcoholic to acquire and hold on to in order for him to maintain lasting emotional sobriety. His religious beliefs become irrelevant without these.

The Big Book is only the basic text of Alcoholics Anonymous written in 1938, published in 1939; the first A.A. book to be published in what was a developing program of recovery, based on only four years or so of experience. It was written at a time when most of the fellowship was under four year’s sobriety. Dr. Bob and Bill W. counted 40 alcoholics dry in 1937, so the remaining 60 of the first one hundred members at the time of writing the book in 1938 and publishing it in 1939, were under a year or two in continuous sobriety. Most were in the honeymoon period, yet to meet the acid test of their sobriety in living life’s successes and failures. The editor of the Big Book was drunk by the time it was published and others later fell off the wagon as well. For a brief period around 1939-1941 the fellowship was largely under direct leadership from Dr. Bob, Bill W. and the founding members. However, after large scale publicity such as the Jack Alexander article in 1941, the New York office mailed out big books all over the USA and new groups started without direct guidance from the rest of A.A.  It was soon found that the Big Book alone was not enough to sustain an alcoholic’s ego deflation in many cases, or to sustain unity in the fellowship. Egos ran riot, groups became dictatorships; local public relations went haywire. There were times which brought the fellowship close to collapse.

From 1940 to 1950, we were beset by group problems of every sort, frightening beyond description. Out of these experiences the Twelve Traditions of AA were forged - Traditions that now protect us against ourselves and the world outside. This effort, requiring immense office correspondence and experience, finally resulted in a whole new literature dealing with AA's unity and services. Under these influences we grew solid.” (Bill W. “Guardian of AA: Our General Service Conference” AA Grapevine April 1958. The Language of the Heart pp 167- 168)
Therefore, in good time, I hope you don't mind me suggesting that you gently nudge …....... to read the Twelve Steps in the “Twelve Steps and Twelve Traditions” as well as the Big Book. They go a little deeper into the understanding of ego deflation and the ways in which an alcoholic rationalises truth into deceit than does the Big Book.  I also suggest “As Bill Sees It” and “The Language of the Heart.” There are some good readings for personal recovery in “The Language of the Heart,” like “This Matter of Honesty” “This Matter of Fear” “What is Acceptance?” “The Next Frontier: Emotional Sobriety” “Take Step Eleven.” You might find he’ll be a much easier person to live with in the long run, than if he just bobs along with Joe McQ and the Big Book. 

There’s a good example of how an alcoholic rationalises his own idea of the truth into deceit on the acknowledgments page of “Carry This Message” by Joe McQ.  Some people might call it dishonest, others might call it fraud.
The author and editors are grateful to the following for their contributions to this book: …. Alcoholics Anonymous World Services, Inc., for permission to use the Steps.” (Extract from Acknowledgments. “Carry This Message” by Joe McQ. published 1990 by August House Inc.)
Extracts from “Big Book Study Guides Reviewing a Position Paper” (A.A. World Services Inc):“In 1977, faced with a rising number of requests from non-AA sources and some AA members to reprint portions of the Big Book and other material in study guides, the directors of AA World Services, Inc. took a hard look at the subject and appointed a committee to explore the question. Members of the committee unanimously recommended that the board not grant permission to outside entities to use excerpts from our literature in study guides, and that AA itself should not publish study guides… … … … … … … The AA World Services Board of Directors feels strongly that permission should not be granted to outside publishers or other parties to reprint AA literature for the purpose of study guides or interpretive or explanatory texts, etc. If such interpretive or study guides are to be prepared, they should be published by AA World Services, Inc.” (Box 459, Vol. 51, No. 6, December 2005.) (AA Service News 127, Summer 2006)
In my experience, alcoholic Christians seem to have just as much trouble in being honest with themselves as do non Christian alcoholics. And when an alcoholic tries to wear the halo of “Teacher or “Preacher” it sooner or later works its way down to his ankles. I keep my Christian religious beliefs out of AA meetings and sponsorship, because I understand the reasons why Bill W. wrote the following:
If we recognize that religion is the province of the clergy and the practice of medicine is for doctors, then we can helpfully cooperate with both.” (Extract from Concept 12, warranty five)
Nothing however, could be so unfortunate for A.A.’s future as an attempt to incorporate any of our personal theological views into A.A. teaching, practice or tradition.” (Bill W. footnote, Alcoholics Anonymous Comes of Age p 232)
Beyond a Higher Power, as each of us may vision him, A.A. must never, as a society, enter the field of dogma or theology. We can never become a religion in that sense, lest we kill our usefulness by being bogged down in theological contention” (Bill W. Letter 1954, As Bill sees It p 116)
Our Traditions are set down on paper. But they were written first in our hearts. For each of us knows, instinctively I think, that AA is not ours to do with as we please. We are but caretakers to preserve the spiritual quality of our fellowship; keep it whole for those who will come after us and have need of what has so generously been given to us.” (Bill W. “AA Is Not Big Business” AA Grapevine November 1950 The Language of the Heart p 124)
Like you say …...., all most newcomers want to do at first, is stay sober, nothing else; they can't cope with much else until their minds defog from alcohol. AA needs to be kept dead simple for the sake of the newcomer. The changes in the fellowship due to the influence of outside published literature which incorporates the authors’ personal religious beliefs are making it confusing and exclusive to some newcomers. I hope this newcomer on the AA Grapevine forum makes it. I have a feeling many just walk away never to return. They are being denied the traditional and gentle “Easy Does It,” “I came; I came to; I came to believe.” approach; and therefore denied their chance to defog from alcohol first before coming to their own understanding of the steps and a power greater than themselves; according to their own agnostic, atheist or other religious beliefs.
AA Grapevine I Say forum: New to AA?: “God, Booze and Food”: Anonymous, Fri, 2012-04-27 15:57 http://www.aagrapevine.org/forum/331
I stopped drinking ten days ago, attended a couple of meetings, and now I'm feeling depressed and frustrated. I'm attending a meeting tonight, but at this point, I'm just listening and trying to get my bearings and the right kind of meeting. I realize that more than one group can help, but I'm reluctant to embrace a strong religious approach. I understand the idea of a higher power and I know I'm powerless over alcohol, but falling on my knees and praying to Jesus (and I'm sorry if I'm insulting some of you) isn't for me. Any advice? And,unfortunately, I've been replacing booze with food, but that's just adding to my plummeting self esteem. Please advise and many thanks.”
God Bless,
P.S. Since this is not an AA website, I’ll incorporate a few more of my Christian beliefs into this post. I think these quotes from the Bible are good ones for any alcoholic Christian in recovery to remember. I have a sneaky feeling from Christian alcoholics in the fellowship that I know, that some of them spend about as much time reading the Bible as they do reading the Twelve Concepts for World Service. As the saying goes along with being “happy, joyous and free!” sometimes “Ignorance is bliss.”
Not every one that says unto me, Lord, Lord, shall enter into the kingdom of heaven; but he that does the will of my Father who is in heaven.” Matthew 7:21 (King James version 2003)

" For in much wisdom is much grief: and he that increases knowledge increases sorrow.” Ecclesiastes 1:18 (King James version 2003)”

The Fellas (Friends of Alcoholics Anonymous)

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Tuesday, 28 October 2014

Again at the Crossroads, November, 1961, Bill W

The Fellas (Friends of Alcoholics Anonymous)

PS For AA Minority Report 2013 click here

Monday, 27 October 2014

European Commission – Public Health – Alcohol Policy

Alcohol related harm is a major public health concern in the EU accountable for over 7% of all ill health and early deaths. Even moderate alcohol consumption increases the long term risk of certain heart conditions, liver diseases and cancers and frequent consumption of large amounts can lead to dependence. Any amount of alcohol can be dangerous during pregnancy and when driving. Young people are particularly at risk of short term effects of drunkenness, including accidents and violence, with alcohol-related deaths accounting for around 25% of all deaths in young men aged between 15 and 29.”


The Fellas (Friends of Alcoholics Anonymous)

PS For AA Minority Report 2013 click here

Sunday, 26 October 2014

Twelve Steps and Twelve Traditions (contd)

aacultwatch's perspective on:

(an almost as wildly discursive commentary as our 'take' on the Big Book)

This tome is much reviled in cult circles (especially amongst the Big Book nutters who regard it as almost heretical! (A point of interest – if you're looking for meetings largely free of the aforementioned 'fruitcakes' – and for that matter sundry other screwballs – then a Twelve Step meeting following the format of the above text is usually a safe bet). The text we will be using is as indicated above. And now we come to the:

Step One

We admitted we were powerless over alcohol—that our lives had become unmanageable.”

Who cares to admit complete defeat? Practically no one, of course. Every natural instinct cries out against the idea of personal powerlessness. It is truly awful to admit that, glass in hand, we have warped our minds into such an obsession for destructive drinking that only an act of Providence can remove it from us.

No other kind of bankruptcy is like this one. Alcohol, now become the rapacious creditor, bleeds us of all self-sufficiency and all will to resist its demands. Once this stark fact is accepted, our bankruptcy as going human concerns is complete.

But upon entering A.A [or before – such an admission is not purely contingent upon attending AA] we soon take quite another view of this absolute humiliation. We perceive that only through utter [“absolute”, “complete”, “utter”- these superlatives serve to emphasise the point] defeat are we able to take our first steps toward liberation and strength. Our admissions of personal powerlessness finally turn out to be firm bedrock upon which happy and purposeful lives may be built.

We know that little good can come to any alcoholic who joins A.A. unless he has first accepted his devastating weakness and all its consequences. Until he so humbles himself, his sobriety—if any—will be precarious. Of real happiness he will find none at all. Proved beyond doubt by an immense experience, this is one of the facts of A.A. life. The principle that we shall find no enduring strength until we first admit complete defeat is the main taproot from which our whole Society has sprung and flowered.

When first challenged to admit defeat, most of us revolted. We had approached A.A. expecting to be taught self-confidence. Then we had been told that so far as alcohol is concerned, self-confidence was no good whatever [this suggests that self-confidence is not entirely devoid of utility]; does not necessarily in fact, it was a total liability. Our sponsors declared that we were the victims of a mental obsession so subtly powerful that no amount of human willpower could break it. There was, they said, no such thing as the personal conquest of this compulsion by the unaided will. Relentlessly deepening our dilemma, our sponsors pointed out our increasing sensitivity to alcohol—an allergy, they called it. The tyrant alcohol wielded a double-edged sword over us: first we were smitten by an insane urge [mental obsession] that condemned us to go on drinking, and then by an allergy of the body [physical compulsion] that insured we would ultimately destroy ourselves in the process. Few indeed were those who, so assailed, had ever won through in single-handed combat. It was a statistical fact that alcoholics almost never recovered on their own resources [but see Recovery/Remission from Substance Use Disorders: An Analysis of Reported Outcomes in 415 Scientific Reports, 1868-2011]. And this had been true, apparently, ever since man had first crushed grapes.

In A.A.’s pioneering time, none but the most desperate cases could swallow and digest this unpalatable truth. Even these “last-gaspers” often had difficulty in realizing how hopeless they actually were. But a few did, and when these laid hold of A.A. principles with all the fervour with which the drowning seize life preservers, they almost invariably [a qualified assurance – nothing in life is certain except, of course, death and taxes!] got well. That is why the first edition of the book “Alcoholics Anonymous[4th edn], published when our membership was small, dealt with low-bottom cases only. Many less desperate alcoholics tried A.A., but did not succeed because they could not make the admission of hopelessness.

It is a tremendous satisfaction to record that in the following years this changed. Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism. As this trend grew, they were joined by young people who were scarcely more than potential alcoholics. They were spared that last ten or fifteen years of literal hell the rest of us had gone through. Since Step One requires an admission that our lives have become unmanageable, how could people such as these take this Step?

It was obviously necessary to raise the bottom the rest of us had hit to the point where it would hit them. By going back in our own drinking histories, we could show that years before we realized it we were out of control, that our drinking even then was no mere habit, that it was indeed the beginning of a fatal progression. To the doubters we could say, “Perhaps you’re not an alcoholic after all. Why don’t you try some more controlled drinking, bearing in mind meanwhile what we have told you about alcoholism?” This attitude brought immediate and practical results. It was then discovered that when one alcoholic had planted in the mind of another the true nature of his malady, that person could never be the same again. Following every spree, he would say to himself, “Maybe those A.A.’s were right....” After a few such experiences, often years before the onset of extreme difficulties, he would return to us convinced. He had hit bottom as truly as any of us. John Barleycorn himself had become our best advocate [ie there is no better alternative to confronting active alcoholism than direct experience – reasoned argument, persuasion, education etc are insufficient substitutes].

Why all this insistence that every A.A. must hit bottom first? The answer is that few people will sincerely try to practice the A.A. program unless they have hit bottom. For practising A.A.’s remaining eleven Steps means the adoption of attitudes and actions that almost no alcoholic who is still drinking can dream of taking. Who wishes to be rigorously honest and tolerant? Who wants to confess his faults to another and make restitution for harm done? Who cares anything about a Higher Power, let alone meditation and prayer? Who wants to sacrifice time and energy in trying to carry A.A.’s message to the next sufferer? No, the average alcoholic, self-centred in the extreme, doesn’t care for this prospect—unless he has to do these things in order to stay alive himself [the bottom line!].

Under the lash of alcoholism, we are driven to A.A., and there we discover the fatal nature of our situation. Then, and only then, do we become as open-minded to conviction and as willing to listen as the dying can be. We stand ready to do anything [“willing to listen” but then act according to our own judgement – not someone else's!] which will lift the merciless obsession from us.”

(our emphases)(our observations in red print)

Coming next – Step Two


The Fellas (Friends of Alcoholics Anonymous)