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The proof of the validity of any idea has to be in whether or not it works in practice. The worlds of politics and religion are full to overflowing with ideas - but do they work in practice? The worlds of psychology and psychiatry are also full to overflowing with ideas. But do they work in practice? The history of the ideas of the Twelve Step programme is fascinating and is outlined in Not-God by Ernest Kurtz (Hazelden, 1991). This book is well worth reading for its historical account but it occurs to me that one factor is supremely important: the ideas took root because they worked in practice. In the UK, even today, these ideas are largely ignored in university courses in psychology and psychiatry. The British National Health Service has no Minnesota Method treatment centres of any stature.

It is often suggested that patients should go to Alcoholics Anonymous when no other clinical approach has worked, but those who make this suggestion have very rarely attended an open meeting of Alcoholics Anonymous or even have any idea of the basics of the Twelve Step programme other than that it has something to do with God. This erroneous connection between a spiritual programme and religious belief is the cause not only of a great deal of confusion but of some hostile rejection. Yet, as emphasised in Not- God, the founders of Alcoholics Anonymous went to great pains to emphasise that theirs was not a religious programme even though the Twelve Steps were a development of the Five Steps of the Oxford Movement headed by Buchman. The spiritual concepts of the Anonymous Fellowships are not those of religion. They refer to the human spirit, the God within each one of us.

In the Big Book of Alcoholics Anonymous there is a whole chapter devoted to atheists and agnostics, showing how these rejections of standard theist belief should be no bar to attendance at meetings of Alcoholics Anonymous or to working the Twelve Step programme. The repeated emphasis on God as youunderstand Him could not be more clear in specifying that an orthodox religious belief is compatible with working a Twelve Step programme but it is not essential for it. I myself have no religious belief whatever yet I work a Twelve Step programme on a day-to-day basis in complete comfort alongside others who may have specific religious beliefs of one kind or another. My "God" is "other people". I learnt from years of isolation that I run my own life extremely badly when I do not take account of other people. I have learnt from personal experience the truth of John Donne's saying, "No man is an island". I learnt for myself my interdependence with other people. I learnt the hard way - ultimately in isolation in a side ward in a mental nursing home to which I had been admitted on diagnosis of "depression". Paradoxically I am grateful for that experience because it taught me that I cannot survive in isolation. I need other people to keep me sane.

That same discovery is the essential "entrance fee" paid by every new member of the Anonymous Fellowships. We learn that we are powerless over our addiction - of any kind - and that our lives have become unmanageable while we ourselves run them. This comprises the first Step. In the second Step we learn to believe that a higher power than self is what we need to help us move forward. Progressively we work

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