Introduction

A drinking problem is in its essence a feeling and behaviour towards oneself and other people, which is embedded in the drinker's personal history and situated within the nexus of a total, complex, personal present. Recovery, when it begins to arrive, will be based on the individual's own sense of possibilities for change and movement within that subjective and objective, constraining and enabling, historically and contemporarily determined reality. Recovery can be assisted by the therapist, but cannot be dictated by any professional outsider. The role of therapy is best considered as that of supporting a natural potential for recovery by perhaps a timely nudge, lending some hope, explaining techniques for self-management, or given a warning of blind alleys.

That perspective was articulated by Orford and Edwards (1977) in the following terms:

That is not a denigratory, nihilistic view of treatment, but it differs radically from the concept of any single favoured intervention as sovereign and specific remedy, a master stroke to be prescribed for the patient who is the passive recipient of a powerful medicine.

The argument that sees the understanding of ‘natural healing processes’ as the best foundation for treatment of drinking problems has been further developed by Vaillant (1980), with empirical support from his own longitudinal research (Vaillant, 1983). Of particular relevance to the concerns of the present chapter is the suggestion made by Vaillant (1980) that AA may contain within it important elements of what studies of the drinker's career reveal as being the possible levers or processes that effect change in drinking and life course over the longer term: