There has been much recent debate about whether a person has to hit rock bottom in under to surrender and start recovering, whether one has to go to the bitter end before surrendering to the recover process.

My own experience shows  that we have to concede to our inner selves that we are alcoholic and that we need help from others.

For me it was a “last gasper” rock bottom for many it was a low bottom, I had lost practically everything and for some they had lost little compared to me but they had seen the road ahead and realised it was not going to get any better without accepting help.

This shows there is more to alcoholism than alcohol, that these people realised their negative behaviours and their consequences were causing them as much distress as their drinking. They did not like who they were becoming or the effect it was having on others around them , their loved ones, families and friends and employers.

I maintain also that there are also many different variables that contribute not only to one’s alcoholism and it s severity but also in one’s chances of getting into recovery sooner rather than later. Environmental factors such  as ethnicity, income, place in society, class can often play a role and social and therapeutic support networks. One of the most startling parts of this study was the lingering question that given that 85.1% of AA members in the US are White shouldn’t AA members be reaching out to non-white communities? 

Environment  is a factor in the progression of addiction but should it play such a huge role in the starting and progression of recovery too!? I have also noticed that many AAs in the groups I have intended are White and middle class. It always bugs me that there is not more non white and working class or blue collar alcoholics in recovery,  in my part of the world anyway.

In fact, the working class, and sometimes non-white alcoholics I know have come to AA via Treatment facilities.  Do cultural issues get in the way of access to recovery? The other startling point is that many more alcoholics who seem to have stopped drinking before losing what was important to them are motivated to pursue recovery than those who lost nearly everything, including health, family, friends, and jobs.

Individuals are accessing treatment via support networks much earlier in their drinking and may not have to experience the multitude of physiological, mental, emotional, financial, legal relationship and other problems low bottom alcoholics frequently do. This for me begs the question of whether AA is doing enough for the low bottom alcoholic who still suffers?

Anyway check this study (1) out – it signals the start of many blogs on why and how AA and other 12 works. Also this study shows a very interesting statistic which is that a majority of recovering alcoholics in this study have sought additional professional help. This shows that Bill Wilson’s “Lets be friendly with our friends” appears to be becoming a reality for many. It is our intention, via our research blogs, to continue this desire, to demonstrate how 12 step and other recovery models can work together and even compliment each other.

“The concept of hitting bottom persists within Alcoholics Anonymous (AA) even though the backgrounds, addiction experiences, and therapeutic options of AA members are now radically different than they were at the group’s founding. Understanding what AA members now mean by hitting bottom is important because the experience describes the point at which they become willing to seek help—professional treatment, AA, or both.

The concept of the alcoholic bottom evolved from the illness model of addiction. By popularizing the illness model (later reconceptualized as a disease model), AA revolutionized addiction treatment, and its 12-step approach remains the most popular and accessible route to recovery (Gross, 2010; Kurtz, 2002).

Among the most controversial aspects of AA is the idea that alcoholics will seek help only when their “illness” has led to “pitiful and incomprehensible demoralization” (AA, 2001, p. 30). Those words originally appeared in the 1939 first edition of Alcoholics Anonymous, but by the time of the publication of the 1953 commentary, Twelve Steps and Twelve Traditions (AA, 1953), the idea had changed in contradictory ways. The instance of help seeking received a name (“hitting bottom”) that suggested an objectively fixed point.

On the other hand, the experiences of those entering AA demonstrated that such a point is relative, and not fixed. AA was helping “people who were scarcely more than potential alcoholics” so it was “necessary to raise the bottom” (AA, 1953, p. 23). The meaning of “hitting bottom” remains problematic (for some). Denzin (1987) provided the succinct definition used in this article: “Bottom: Confronting one’s alcoholic situation, finding it intolerable and surrendering to alcoholism. Accompanied by collapse and sincerely reaching out for help; may be high or low” (p. 134).

The hitting bottom concept originally reflected the experience and outlook of AA’s founders and pioneers in the 1930s. They shared a common background (professional White men), the common “low-bottom” experience of institutionalization for their alcoholism, and commitment to peer-facilitated spiritual growth (Kurtz, 1988). In refining the disease concept of alcoholism,Jellinek (1946) surveyed these early AA members and identified the bottoming-out phenomenon, which he subsequently developed into the Jellinek curve (Jellinek, 1960).   Since the founding of AA, the membership has become much more diverse and the rise of professional treatment has provided multiple alternatives to institutionalization of alcoholics (Robertson, 1988; Stolberg, 2006). Yet despite the variable backgrounds and experiences of AA members today, they continue to rely on the hitting bottom concept and terminology. Although hitting bottom entails the crucial decision to seek help, no research has been conducted to determine any commonality among AA members regarding the meaning and implications of the term. The purpose of this exploratory study, therefore, is to determine how AA members perceive their alcoholic bottom (high, middle, or low)…

The study found that Whites, religious people, and episodic drinkers were less likely to be low bottoms when they began recovering. Alcohol-related problems were most clearly associated with level of bottom, supporting recent findings that problems increase the odds that an alcoholic will perceive the need for help and will seek help (Grella et al., 2009). Findings were – high bottom (36.1%), middle bottom (44.5%), and low bottom (19.4%).

A fundamental tenet of AA is that alcoholism is progressive, so that alcoholics “get worse, never better” (AA, 2001, p. 30). Supportive of this progressive framework is the finding that problems distinguish high bottoms from low bottoms. The difference was most clear in the categories of social and physical problems, indicating that early identification of these problems could signal a need for intervention, particularly if the individual drinks constantly or uses drugs other than alcohol.

The finding that hitting bottom remains salient for AA members holds implications for addiction professionals treating those members. Professionals have struggled with the idea that addiction must render an individual demoralized before treatment can be initiated. Some reject the bottom concept outright, whereas others have attempted to integrate hitting bottom into standard practice.

Nearly 50 years ago, the family intervention was developed to “raise the bottom” by confronting alcoholics with ultimatums to guide them into treatment (Jay & Jay, 2000; Johnson, 1986; Liepman, Nirenberg, & Begin, 1989). In recent decades, the legal system likewise has coerced offenders into treatment initiation and compliance (Sullivan et al., 2008). Although such confrontational and coercive strategies ostensibly are in the alcoholic’s best interest, they have drawn criticism for their manipulative tactics and for inconclusive reports of effectiveness (Broadstock, Brinson, & Weston, 2008;Loneck, Garrett, & Banks, 1996; W. R. Miller, Meyers, & Tonigan, 1999; Perry et al., 2006).