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The Philosophies and Practices of Alcoholics Anonymous From a Psychodynamic Perspective

Although predominantly ignored in the existing literature, psychodynamic perspectives on addiction are relevant to understanding the twelve-step program known as Alcoholics Anonymous (AA). This dissertation analyzes specific psychodynamic perspectives on addiction including ego psychology, object relations theory, self-psychology, and attachment theory, as well as their derivations and the philosophies and practices of AA outlined in AA literature. These literatures are integrated to inform the findings and recommendations section, justifying certain AA practices while offering recommendations to improve the overall effectiveness of AA. Findings concentrate on AA helping members transition from utilizing primitive to mature defense mechanisms; manage volatile emotions in early recovery; increase humility in addressing alcoholism; establish consistency in the recovery program; participate in a nurturing holding environment; strengthen object permanence; establish transitional objects and address unmet selfobject needs, including helping members feel valued (mirroring); merge with an admirable object (idealizing); and experience alikeness with others. Recommendations are made to AA leaders and include pronouncing the value of joining a home group in AA literature and having members state whether they attend a home group during meeting introductions, stressing respect for boundaries members should not cross, and maintaining consistency in where and when meetings take place and how they function. Newcomers are suggested to attend 90 meetings in their first 90 days of AA; have family and friends attend open anniversary meetings; choose sponsors whom they have the potential to emulate; receive treatment from mental health professionals when necessary; and discuss with their sponsors and peers regarding decreasing weekly meeting attendance. Members are encouraged to receive treatment from mental health professionals when warranted and promote collaboration between their sponsors and treatment providers. Mental health/addiction treatment professionals are advised to recommend AA meetings to their clients where they are most likely to form attachments with those in attendance. Degree Type Dissertation Degree Name Doctor of Social Work (DSW) Department Counseling and Human Services First Advisor Ram A. Cnaan, Ph.D. Second Advisor Marni Rosner, DSW This dissertation is available at ScholarlyCommons: http://repository.upenn.edu/edissertations_sp2/73