The 12-step format, tradition of anonymity, and democratic governance of Alcoholics Anonymous (AA) are rightly credited to Bill Wilson, whom Aldous Huxley called "the greatest social architect of the twentieth century." Bill’s life story has inspired no end of confessional autobiographies by alcohol and drug addicts, including one by Susan Cheever (1), the author of this book. She knows well the ravages of alcoholism, not only her own but those of her father, the illustrious author John Cheever, to whom she dedicates this book. Bill W’s story is also well-known to countless alcoholics from AA’s Big Book, Alcoholics Anonymous(2); the 1947 edition alone reached more than 19,000,000 people (3). Bill W has given hope to countless alcoholics who have passed the book from hand to hand as if it were a sacred document.

Bill had stayed away from alcohol until the age of 22 because of his family history of drinking problems. Having already suffered from episodes of depression, he took his first drink at 22 and experienced a glow of self-confidence and escape from dysphoria. This was followed by his descent into alcoholism and many failed attempts at detoxifications to curb his compulsive drinking. On June 10, 1935, the date affixed to the beginning of AA, Bill had been traveling on business in Akron, Ohio, and struggling to control his urge to drink. He sat down with another alcoholic, a physician, so that both could stave off their craving for alcohol, which they succeeded in doing. He later drew on his experience with the Oxford movement, which was premised on the Swedenborgian conception of steps leading to salvation, and expanded on their six-step ritual of spiritual and mutual support into the AA creed.

Cheever captures well Bill’s charisma, his talents as a raconteur, his perceptiveness as a social analyst, and, to some extent, his failings (infidelity to his long-suffering wife, for example), but she understandably cannot dig deep into the social psychology underlying the AA movement. Its remarkable ability to effect changes at the mind-body interface takes place on the basis of the highly supportive welcome from the members and the interplay of cognitive changes (the acquisition of a belief system) and social cohesiveness (engagement in an intensely bonded social group). These experiences operantly reinforce involvement, and let many members yield control of the biologically grounded pursuit of alcohol. The democratic structure of the movement and the anonymity embodied in its Twelve Traditions have served to sustain its success and hinder the emergence of self-serving leaders. Admittedly, some of the public confessionals like the one that Cheever herself published may be nibbling away at the tradition of anonymity.

Psychiatrists have a great deal to learn from AA in terms of the importance of mutual support and spiritual redemption in achieving recovery from the biologically grounded disorders that they address. This book provides a glimpse into the lives of some of the people for whom such recoveries came about. On this count, it provides a feel for what the AA experience is like and thus an opportunity to use it more effectively as an adjunct to clinical care.