Recent Developments in Alcoholism

Volume 7 of the series Recent Developments in Alcoholism pp 91-104

Al-Anon and Recovery

  • Timmen L. CermakAffiliated withGenesis, Department of Psychiatry, University of California-San Francisco Medical Center

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The history of Al-Anon and its current demographics are reviewed. In order to understand 12-step recovery and psychotherapy for family members of alcoholics, the concept of codependence is defined with a set of diagnostic criteria consistent with the DSM-III-R definition of personality traits and disorders. At the core of codependence are denial and an unrealistic relationship to willpower. The therapeutic implications of considering codependence as a personality disorder are explored, as are the characteristics that make codependence unique among personality disorders: the central role of denial and the existence of a self-help organization to facilitate recovery. The dynamics of working the 12 steps on codependent characteristics are outlined. A synergistic relationship between psychotherapy and the 12 steps is described. Special attention is given the emergence of Al-Anon adult children of alcoholic meetings, and the future of codependence is discussed.

While the preceding chapters have explored the history and effectiveness of Alcoholics Anonymous, an intriguing question remains: Why do the principles of AA generalize successfully to the family members of alcoholics? This chapter explores the fellowship of Al-Anon Family Groups in an effort to understand why the Twelve Steps of AA have retained their healing power in this arena as well.