AA Quietly Marks 60 Years of Deep Impact on Society : Addiction: Alcoholics Anonymous, low-profile even at its biggest convention ever, spawned the self-help industry.

On a fateful day in 1935, a stockbroker from New York and a surgeon from Akron, Ohio--both mired in lifelong alcoholism--decided to find a way for alcoholics to help other alcoholics get sober, one day at a time.

This weekend, on the 60th anniversary of the improbable meeting between Bill Wilson and Dr. Bob Smith, the organization they founded is holding its international convention here, the biggest convention this convention city has ever seen, the biggest gathering Alcoholics Anonymous has ever organized.

An estimated 70,000 to 80,000 AA members and guests are in the midst of four days of celebrating a movement that has changed the attitude of Americans toward alcoholism and radically altered the way the culture approaches myriad ills and afflictions.

It is hard to exaggerate the impact of AA and its founders, known to members as Bill W. and Dr. Bob.

“AA gave birth to the modern [self-help] treatment industry,” said Michael Neatherton, administrator of the Betty Ford Center in Rancho Mirage for drug and alcohol addiction, and an enthusiastic booster of AA.

Thanks to the influence of AA, modern America is replete with self-help groups, often with the term anonymous in their titles, for all manner of physical and behavioral maladies and obsessions. Many of these AA progeny use the 12-step approach contained in AA’s “Big Book” or a close variant.

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From its humble, do-it-yourself beginning, AA pioneered a problem-solving technique that has become firmly rooted in the American psychosocial soil: that people with similar problems can improve their plight by sharing their experiences in a group, offering sympathy, encouragement and tough love to one another. Underlying the technique is a simple principle: Nobody understands an addiction or an affliction as well as those who suffer from it.

There had been other efforts to fight alcoholism--Wilson and Smith were both reluctant participants in the moralistic, temperance-based Oxford Group--but AA spread like no prior movement. It was championed by the usually skeptical mass media, starting with radio commentator Gabriel Heatter and the Saturday Evening Post.

The American imagination was seized by the term anonymous , by the offer of supportive fellowship, by the unlikely tale of Bill W. and Dr. Bob, and mostly by their 12-step approach. The steps start with admitting a problem, proceed to turning to God and making a “fearless moral inventory,” and end with making amends for past transgressions and attaining a spiritual awakening.

AA has its critics and its rivals but after 60 years, its supremacy as the best-known program to help the nation’s 20 million alcoholics shows no signs of serious challenge.

William DeJong, a social psychologist and lecturer in alcohol addiction at the Harvard School of Public Health, said the success of AA can be measured by the number of other self-help groups that have imitated it.

“Among professionals in the field, AA is almost universally acclaimed,” DeJong said.

Surprisingly, given its size-- 1.8 million members in 145 countries--and cultural dominance, little is known about Alcoholics Anonymous outside the enthusiastic fellowship of its members, many of whom continue going to weekly or even daily AA meetings even decades after taking their last drink. AA holds international conventions only once every five years, lest planning for annual conventions should detract from the work of local chapters.

“It’s not like we’re trying to keep AA a secret,” said Roy, a teacher and AA member. “It’s just that we’re too busy trying to stay sober and keep others sober to spend much time talking about AA to outsiders.”

AA is certainly no secret to San Diego this weekend.

The size and diversity of the AA movement is on full display, with conventioneers crowding local tourist attractions and restaurants (which are ready with special nonalcoholic fruit drinks and copious amounts of coffee and ice cream). A fleet of 500 buses has been assembled to shuttle AA members from 115 hotels, motels and dormitories at several colleges.

Members from 72 countries are in attendance, in keeping with the convention’s motto, “AA--Everywhere, Anywhere.” Translation at major sessions is available in Finnish, Spanish, Italian, German, Japanese and American Sign Language.

An old-fashioned block party was held outside the city’s waterfront convention center Thursday night. Conventioneers packed San Diego Jack Murphy Stadium on Friday night for an opening session with hoopla befitting the Olympic Games. Tonight, a rally is set for the stadium to honor AA members who have been sober 40 years or longer.

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Alcoholics Anonymous is a uniquely American organization, with its underpinnings in Protestant religiosity and American optimism about the power of the individual to conquer all obstacles. Its philosophy holds that alcoholism is a disease, not a moral failing, and that resisting alcohol involves constant struggle.

AA is also unique in its structure and its relentlessly modest public persona. In a modern culture obsessed with celebrity, AA is hopelessly retrograde.

Wilson and Smith knew that other anti-alcoholism movements had been damaged by leadership struggles, involvement in politics, or by insisting on a rigid religious message. AA invokes God but lets members decide for themselves what or who God is.

Members are required to use only their first names when dealing with the media. As a condition of gaining access to the convention, reporters have been instructed not to use last names of AA members or show their faces, even if an AA member gives permission.

The no-last-names rule is part of a philosophy of keeping a low profile. AA does not recruit members, attempt to proselytize, or engage in public debate about alcohol or alcoholism.

“Maybe the only way to sell this thing is to stop trying to sell it,” says Dr. Bob in the docudrama play “Bill W. & Dr. Bob” by psychiatrist Dr. Steve Bergman (pen name Samuel Shem) and psychologist Janet Surrey, both of whom are AA members and teach at Harvard.

AA does not lobby in favor of legal restrictions on alcohol or increased funding for alcoholism research and does not collect dues from members or ask the government for money. No member is allowed to contribute more than $1,000 a year; a good hunk of its annual budget of $12 million to $14 million comes from the sales of periodicals as well as books written by the two founders, both of whom are long dead.

AA endorses neither politicians nor products (several coffee companies would have loved to be the designated coffee supplier for this weekend’s gathering, according to the San Diego Convention and Visitors Bureau). It does not engage in public fund raising or seek big-name endorsements.

“AA has only one goal: alcoholics helping other alcoholics,” said Adelle, a psychiatrist and AA member. “That’s the beauty of it. It does one thing and does it well.”

To AA, an alcoholic is someone who has lost control to alcohol and cannot take a single drink without risking a relapse, hence the continual need to attend AA meetings. AA rejects the concept of “social drinking” for alcoholics.

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The idea that all alcoholics, even after decades of sobriety, are but one drink away from ruination is deeply embedded in AA philosophy. Bill W. and Dr. Bob were strangers when the former, stranded in Akron after a disastrous business trip, was tempted to start drinking and went searching instead for a fellow alcoholic to dissuade him.

Many on its headquarters staff in New York are alcoholics; all rotate jobs every two years, with the proviso that only nonalcoholics can be in charge of the money. The board of trustees of AA consists of 21 members, 14 of whom are alcoholics.

The goal is for Alcoholics Anonymous to be non-hierarchical, for the power and emphasis to reside in individual chapters, not with a centralized staff, national spokesman or a panoply of experts. “ We are the experts,” said Howard, an aerospace engineer.

At last count, there were 49,443 chapters of Alcoholics Anonymous in the United States, 5,133 in Canada, 2,085 in Canadian and American prisons, and 32,578 in other foreign countries. AA does not keep membership lists, but the official estimate of members is 1.8 million, including 250,000 in Southern California and Baja California.

A 1992 AA survey showed that 51% of members are 40 years old or younger, 63% of members have undergone medical, psychological or spiritual treatment besides AA, and the average member attends 2 1/2 AA meetings a week. Men outnumber women 2 to 1, with representation tilted toward professional and white-collar jobs.

Nan Robertson, a Pulitzer Prize-winning reporter for the New York Times who authored a book about her successful fight against alcoholism titled “Getting Better: Inside Alcoholics Anonymous,” has written that AA “is less an organization than an organism that keeps splitting amoeba-like into ever more groups.”

AA sees itself as a continuation, not an alternative or a competitor, of the care afforded alcoholics in the alcoholism treatment centers that have sprung up in recent decades.

“A treatment center for alcoholism is a protected environment,” said Bob, a journalist. “But when you’re back in the world where there is a bar on every block and your colleagues are drinking, you have to have help in finding a place where you can stay sober. That place is AA.”

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There are mountains of anecdotal evidence that AA works--indeed, much of the convention, including the gatherings at Jack Murphy Stadium, is given over to AA members offering such testimony. But there is barely a molehill of scientific evidence to back up those claims.

For one thing, AA does not study its effectiveness nor does it encourage outside researchers. A limited study done in 1993 for the National Institute on Alcohol Abuse and Alcoholism said that acceptance of the AA philosophy and its 12-step process “may have important implications for the alcoholism recovery process” but suggested that AA “warrants further careful study” before any conclusions could be reached.

Still, many professionals in the study and treatment of alcoholism praise the group based on first-hand observation of patients who have used AA as part of a recovery program.

“The more you know about AA, the more you can admire it,” said Dr. Peter Banys, chief of psychiatry at the Veterans Affairs Hospital in San Francisco and a professor at the UC San Francisco medical school. “It is a powerful tool for people to try to stay in recovery. Some people are going to need more than AA can give, but for thousands it is enough to help them stay sober.”

Based on her two decades attending AA meetings, Adelle estimates that only about a third of members succeed in staying sober. “It’s the people who not only need to change but want to change,” she said.

The Betty Ford Center’s Neatherton said he believes AA is a “divinely inspired organization.” “The 12 steps are absolutely brilliant,” he said. “I don’t believe any human being was smart enough to lay all that out.”

Some have a less enthusiastic evaluation of AA.

Dr. James Milam, in his book “Under the Influence: A Guide to the Myths and Realities of Alcoholism,” said AA’s powers are “formidable” but added, “The recovering alcoholic should beware of the AA belief that character flaws or personality defects cause alcoholics to get into trouble with alcohol, a belief which simply has no basis in fact.”

Although AA does regard alcoholism as a disease, it also believes sufferers have the power to fight it.

Milam and others are critical that AA seemingly encourages members to switch their fixation from alcohol to smoking cigarettes, drinking coffee and eating high-calorie desserts. By all accounts, many AA members are heavy smokers.

Dr. Barbara McCrady, clinical director of the Center of Alcohol Studies at Rutgers University, said AA has proved its worth, but she sees a downside in the widespread cultural belief that AA is the only way for alcoholics to recover.

She notes that AA is the only alcohol recovery program that Hollywood presents as successful, from movies such as “Come Back Little Sheba” through television shows such as “Hill Street Blues.”

“Our cultural perceptions of alcohol have been largely shaped by AA, and those include the perceptions that an alcoholic is someone who has lost control to alcohol and that the only road to recovery is through lifelong abstinence and lifelong involvement with AA,” McCrady said. “The problem is that AA is not for everyone.”

Numerous alternative programs for alcoholics have sprung up in recent years and several have specifically marketed themselves as offering assistance to people who are turned off by the spirituality of Alcoholics Anonymous, its insistence that one drink can lead to a return to drunkenness, or, until recently, its reputation as an organization primarily for white males.

Jim Estelle, a retired prison director from Texas and California, and one of the seven nonalcoholics on the AA board, said he is unbothered by such groups, even when they criticize AA.

“You ask what AA’s reaction is to these groups?” Estelle said. “AA has no reaction. We wish them well. Dr. Bob said we should not take sides in controversies or engage in personalities.”

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Even in a city that depends on conventions and tourism, the Alcoholics Anonymous meeting has presented special challenges for the Convention and Visitors Bureau in terms of transportation, crowd control and food. Until now, the largest convention the city had ever hosted was a 40,000-plus gathering of Baptists.

Lest anyone think of AA as a gathering of dour teetotalers unable to loosen up or enjoy life, a full slate of dances, sightseeing outings and receptions is planned.

“You’re going to see some of the happiest people of your life,” said Estelle. “If I’ve ever seen anyone who is truly born-again, it’s someone who’s gained sobriety through AA. They’re walking miracles.”

Sensing a receptive audience, the Cambridge Theatre Company from Cambridge, Mass., brought its critically acclaimed production of “Bill W. & Dr. Bob” to the Lyceum Theatre in downtown San Diego for a run that lasts until July 9.

Near the end of Act I, the mordant-tongued Dr. Bob asks incredulously, “Are you telling me that what I’ve needed all along is to come clean to another nose-in-the-gutter drunk like myself?”

Bill W., usually quite talky, answers simply, “Yes.”

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AA’s 12 Steps

The 12 Steps of Alcoholics Anonymous, based on experience of the founders.

1. We admitted we were powerless over alcohol--that our lives had become unmanageable.

2. Came to believe that a power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked him to remove all our shortcomings.

8. Made a list of all people we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of his will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.