An expert in addiction medicine explains how Alcoholics Anonymous works, from the perspectives of personal experiences and scientific research.

Galanter (Spirituality and the Healthy Mind, 2005, etc.) is a professor of psychiatry, director of the Division of Alcoholism and Drug Abuse at the New York University School of Medicine, and past president of the American Society of Addiction Medicine and the American Academy of Addiction Psychiatry. Not an addict himself, Galanter has written previous books on addiction and treatment as well as on cults, faith healing, and spirituality. This background makes him especially well-suited to examine AA, the Twelve Steps program of recovery that centers on turning one’s will over to a higher power. This scholarly but approachable work is written for three audiences: people with substance abuse problems who wonder whether AA can help; family and friends of addicts; and health professionals who want a clear explanation of the AA fellowship. Part I discusses AA’s origin and evolution, controversies—particularly about the role of God or a higher power—and whether alcoholism is a disease. Part II examines the AA experience, including the steps, sponsorship, and spiritual awakenings (for some an awakening “is sudden and dramatic, and for others it comes on more gradually”). In Part III, Galanter considers AA as part of addiction treatment, the role of rehabs, and the overall question of the program’s effectiveness. Throughout, the author includes personal accounts by people in and out of recovery, a diverse set of experiences that sheds light on how AA works in practice. Well-informed and engaging, this volume backs up its observations and anecdotal accounts with evidence from research. This can yield surprising results: for example, patients in a study ranked spiritually oriented items as most important to their recovery, while their health professionals ranked these elements the lowest. Galanter is particularly insightful on spiritual awakening, showing the diversity of this experience, its importance to recovering addicts, and how it can be understood psychologically. His fair-minded approach also contrasts AA with other recovery methods and discusses AA’s limitations, such as treatment issues with addicts who are mentally ill.

An accessible, well-written, and authoritative account that should help demystify AA for a broad range of readers.