Books: Review/Commentary: Circles of Recovery: Self-Help Organizations for Addictions

Abstract

Circles of Recovery: Self-Help Organizations for Addictions, by Keith Humphreys (Cambridge, UK: Cambridge University Press, 2004), 228 pp., $85 hardcover.It is nearly impossible to discuss self-help/mutual-aid societies without reference to Alcoholics Anonymous (AA). With its more than two million members, international growth, organizational longevity, and adaptation to nearly every conceivable human problem, AA has become the standard with which all other mutual-aid groups are compared. AA's dominance obscures awareness of the large number of mutual-aid societies that preceded it (White, 2001) and the growing number of adjuncts and alternatives to AA.There are four significant trends within the recent literature on addiction recovery mutual-aid societies: 1) the emergence of backlash literature attacking the principles and practices of AA and other Twelve Step programs from both ideological perspectives (Bufe, 1991; Ragge, 1998; Peek & Bufe, 2000) and personal perspectives (Gilliam, 1998; Fransway, 2001); 2) a new body of literature detailing alternatives to AA (Kirkpatrick, 1978, 1981, 1986; Christopher, 1988, 1989, 1992; Trimpey, 1989; Kishline, 1994; Volpicelli & Szalavitz, 2000); 3) growing interest in addiction recovery mutual-aid groups as an international phenomenon (Makela et al., 1996; Special Issue, Contemporary Drug Problems, Volume 23, 1996; Room, 1998; White, in press); and 4) scientific studies evaluating the effectiveness of AA and its alternatives (e.g., Emrick, 1989; Ruzek, 1987; Kaskutas, 1992; Galanter, Egelko & Edwards, 1993; Connors & Dermen, 1996; Humphreys & Klaw, 2001). Two noteworthy texts detail the inner workings of self-help/mutual-aid societies, document what is known of their effectiveness, and outline how helping professionals and government bodies can best work with such groups. The first is Linda Farris Kurtz's Self-Help and Support Groups: A Handbook for Practitioners, and the second, the subject of this review, is Keith Humphreys' just-released Circles of Recovery: Self-Help Organizations for Addictions. Where Kurtz's text focuses on a broad spectrum of self-help societies in the United States, Humphreys' book is international in scope and focused on peer-based addiction recovery support groups.Circles of Recovery opens with a discussion of five conditions that contributed to the rise of modern self-help movements: 1) the growing need to manage chronic health problems; 2) weakened family and kinship networks; 3) recognition of the limitations of professional care; 4) rising consumerism in health and human services; and 5) the immediate benefits many people experience through participation in mutual-aid groups. Although this discussion details important contextual influences, it leaves unanswered the question of why addiction recovery mutual-aid groups catalyzed and continue to remain at the center of the international self-help movement. There are several possible answers. Mutual-aid groups are particularly well suited to respond to stigmatized conditions that have been inadequately addressed through professional interventions, and few groups have been subjected to more sustained contempt and have been less welcomed in traditional service settings than those experiencing chronic alcohol and other drug-related problems. AA provided a means of healing stigma-induced shame while using anonymity as a protective shield against the continued effects of such stigma. The Twelve Steps of AA marked a technological breakthrough in the management of chronic health problems that was easily adapted to numerous other conditions and cultures, and the Twelve Traditions of AA underscored the difficulties of sustaining self-help groups and provided a framework (e.g., singleness of purpose, a decentralized cell structure, avoidance of public controversy) to enhance the resilience of mutual-aid organizations.Humphreys catalogues the rise of addiction recovery mutual-aid groups around the world. …