America’s crazy for support groups. Or maybe
support groups keep America from going crazy.
All of a sudden, people are pouring back into churches and synagogues with a fervor that hasn’t been seen since the ‘50s. It appears that a great religious revival is sweeping the land – until you examine the situation a little more closely. Then you’ll notice the biggest crowds today often arrive in midweek. And instead of filing into the pews, these people head for the basement, where they immediately sit down and begin talking about their deepest secrets, darkest fears and strangest cravings.
Alcoholics? Third door to the right.
Sex addicts? They meet on Tuesday.
Overweight men who have a problem with compulsive shopping? Pull up a folding chair buddy. You’re in the right place.
Where are you, specifically, is at a support-group meeting-one of about 500,000 that will be attended by some 15 million Americans this week. In the last 10 years, the number of these self-help organizations has quadrupled, and the topics they cover have been expanded to include everything from abused wives of doctors to zoologists who love too much. Alcoholics Anonymous, once heavily male and middle class, has experienced a huge influx of female and low-income members. Men, meanwhile, are streaming into the self-help movement at what is-considering the usual male reluctance to discuss intimate feelings-an absolutely astonishing rate.
Why is this happening? Because people have discovered that talking and listening to their fellow sufferers has a soothing effect on the psyche, sometimes more so than doing the same thing in the presence of a therapist. Support groups-a rather high-falutin name foe what’s usually nothing more than loosely structured gab sessions-salve psychological wounds, help destroy addictions and even extend the lives of other people suffering from cancer and other physical afflictions.
And how do they do all this? Well, let us first acknowledge that there are some doctors, psychiatrists and others who say that support groups do nothing of the sort-that they in fact represent a dangerous do-it-yourself approach to problems of the mind, body and spirit. Yet most professionals and, of course, support-group members themselves, see the meetings as an amazingly effective antidote to aloneness- something that, apart from being a problem in its own right, compounds every known condition brought on by late 20th century living, from compulsive hand-washing to AIDS. Though no academicians or researchers have yet studied the self-help movement, there seems to be something at once common-sensical and utterly mysterious about how the meetings work. “Just the sight of your fellow sufferers,” says one self-help group organizer, “tends to make your pain a little more bearable.”
And so there is a group for every season. Got the midwinter blues? (Call Depressives Anonymous.) Are you obese? (Overeaters Anonymous or the National Association to Aid Fat Americans.) A gay Episcopalian? (Integrity.) Consider yourself assexual? )Finding Our Own Way.) Feel certain that aliens are trying to transform you into George Jessel? (National Organization of Rare Disorders.) Wish that aliens would transform you into George Jessel? (True Potential Toastmasters.)
Cultural Upheaval: You could call this a trend of course, of course. But when there is a group for women whose daughters won’t talk to them meeting weekly in Westchester County, N.Y.-and when the New York City Self-Help Clearinghouse has had several callers ask if there were meetings for people who, to quote a spokesperson, “drink a little too much but not way too much Coca-Cola”-then what you have, really, is a sea change, the kind of cultural upheaval that makes the fax machine look like mood rings, break-dancing or some other fleeting fad. Through it all, though-as the national registry of support groups has grown to include Compulsive Shoppers, Pedestrians First, the Trichotillomania Support Network (for people who pull their hair out, strand by strand), Hot Flashes (“support for women with menopausal problems”) and numerous bereavement groups-two basic conditions have endured. The first is that participation in a true self-help meeting is limited to peers. That means there is no professional moderator to make Wise Pronouncements based on a purely academic understanding of the subject matter, to sell books or to collect fees. While some groups designate a leader who might be charged with making announcements or recognizing members who want to “share” an experience or observation, no true self-help organization can have a hierarchy, especially one headed by someone who doesn’t share the members problems. To include such a person transforms the support-group meeting into group therapy, a standard psychiatric technique which tends, the self-help people say, to take the burden of recovery off the group member. “As soon as you have a therapist or someone like that running the meeting,” says Marilyn Ng-A-Qui, director of the New York City Self-Help Clearinghouse, “the group members tend to dump their problems on the so-called expert. Their attitude becomes ‘Here I am-fix me.’ In a support group, though, the members know they can’t be lazy. The responsibility for getting better is in each member’s hands.
The second common trait among support groups is that they engender a near-religious fervor. Listen to a member of Schizophrenics Anonymous in Southfield, Mich.: “If I don’t come to a meeting and I’m by myself for three or four days, I’ll start getting weirder than I am now. I have to realize that I can’t do it alone.” Many members of Alcoholics Anonymous-the oldest and by far the largest support group, with an estimated membership of 1.73 million worldwide-strongly suggest that newcomers attend 90 meetings in as many days in order to break their bonds with the past.
Swirling blizzard: But many support-group members don’t need encouragement to attend. “If people are feeling needy or going through a crisis,” says a New York woman from Al-Anon, a group for relatives and friends of alcoholics, “they’ll build their whole lives around the meeting schedule. They’ll go 15 times a week.” Fran Dory, now executive director of the California Self-Help Center, recalls that when she was organizing groups in New York, a bunch of senior citizens trudged through a swirling blizzard and then, when an elevator failed to function, climbed 14 flights rather than miss their weekly meeting.
There’s nothing irrational, or spookily New Age, about this kind of devotion, which is usually born of sweet relief from years of suffering and isolation. Support groupies say their meetings tend to serve as much stronger mind medicine than an equal number of hours with the most expensive shrink. Regular attendance, they claim, allows them to sleep more soundly, eat heartier and, in the case of recovering sexaholics, finally have the time to read the collected works of Will and Ariel Durant and mow the lawn.
Lately there has even been some scientific data to support the continual stream of anecdotal evidence-put forth by members of such diverse groups as Cocaine Anonymous, stroke victims and Incest Survivors-that the meetings don’t just improve life but prolong it as well. A 10 year study by researchers at Stanford University showed that terminally ill cancer patients who participated in weekly support group meetings in addition to receiving treatment lived nearly twice as long as those receiving only medical care.
Even if support groups didn’t work, they would provide a very wit-it way to stay miserable. It’s hard to open a local newspaper without seeing, on the once bland community-activities calendar, notices for child molesters, former convicts or gambling junkies. Likewise, every suburban supermarket bulletin board seems to have-push-pinned among the pleas for babysitters and promises of cheap firewood-announcements pertaining to cocaine addicts, teenage insomniacs and women who love too much. The settings vary-the folding chairs might be chintz-covered at a meeting of a short-lived group called Rich Kids Anonymous. But a quick flip through the Self-Help Sourcebook-Older Women In Relationships with Younger Men…The International Intractable Hiccups Organization…Prostitutes Anonymous….only proves that human problems know no geographic boundaries. And that Donahue, Oprah and Geraldo will probably never run out of topics.
Fashionable recovery: Indeed, steely-eyed guest hunters from some of those shows haunt the hallways outside support-group meetings, aware that transsexuals must be out by 9 because the bulimics have the room booked. “There’s so much happening so quickly in this movement,” says Frank Riessman, executive director of the National Self-Help Clearinghouse in New York, “that sometimes you just have to sit back and smile at it all.” Of course, intense suffering is what brought every support group into existence-and every member, quaking, to his or her first meeting. In one sense, nothing about this movement is funny. Yet, if you look at it the other way, why not laugh a little? We the People have embraced this notion with a bit of a vengeance, no? Today, in fact, “the social climate is such,” says Riessman, “that it has actually become fashionable to be ‘in recover’ from everything from drug addiction to spouse abuse.”
In big cities especially, many people now treat AA and organization like the Manic and Depressives Support Group as an extension of the singles scene. “There are women at my meeting who don’t really have a problem with alcohol,” says Belinda L., a New Yorker in A.A. “They’re looking to latch onto some guy who got divorced, or never got married in the first place, because of his drinking.”
What’s equally remarkable, perhaps, is that the self-help movement has managed, despite its phenomenal growth, to avoid becoming a big business, or really any kind of business at all. “There’s this explosion of interest,” says Riessman, with a sly cackle, “and no one has figured out a way to make a dime off the whole deal.”
The best news, though, is that group members usually make measurable progress-a seemingly unknown concept in many forms of psychotherapy-if they stick with the meetings. Cambodian refugees who attend a group in San Francisco often say during meetings that they have nightmares about the atrocities they themselves endured at the hands of Pol Pot. But when they arrive, neatly dressed and with children in tow, at the Tenderloin Self-Help Center each week, the group members are often engaged in animated conversation, playing with their children and otherwise showing signs of recovery. As with other support-group members, relief, for the Cambodians, has come with a willingness to express intimate thoughts and experiences to one’s fellow sufferers. “When I eat,” said an older woman at a recent meeting,” I think of starving relatives and I cry.” Hearing that, another woman tried to commiserate. “I know what you’re thinking. Most of my family was executed and it is still too overwhelming for me. Yesterday I lost my way home. I forgot I was in San Francisco.” A 39-year-old male refugee then spoke up, saying, “I feel happy in this group because I know the faces. It’s been very helpful to realize I am not the only one who has trouble in my new life.”
Marcia Colone, the director of social services at the University of Chicago’s Hospitals, sees something uniquely American in the self-help movement’s emphasis on tangible results (though other countries are now getting involved as well, most notably in Europe and the Mideast, where groups for victims of terrorist attacks have recently sprung up). “This supports America’s values of marshaling resources, taking charge and solving the problem,” she says. “There’s no doubt that these groups help people make real changes in their lives.”
Yes, power to the people, so the people may help themselves. The support-group movement may be the only advance in the area of social services that was possible in the era of Reaganomics. “At a time when we are faced with drastic government cutbacks,” says Ng-A-Qui, of the New York City Self-Help Clearinghouse,”a lot of poor people and people of color have had to fall back on their tradition of banding together to help each other.” Most people in poor areas, she says, prefer the relatively unstructured groups, which usually don’t bother with such formalities as guest speakers and would never think of limiting the conversation to any one topic. Instead, says Ng-A-Qui, “people just get together and share experiences or exchange practical information.”
Formal presentation: At the other end of the spectrum there are the 12-step “anonymous” groups. These stop short of employing parliamentary procedures, but they do usually begin with a formal opening statement defining the group and its goals and then proceed to announcements about schedule changes, new chapters and upcoming events such as lectures, films or picnics. After that, the leader often turns over the meeting to a group member who has prepared a 10-to 20-minute talk, either on one of the steps or a personally chosen topic. These groups usually round out their hour long meeting by allowing any of the other members to share a thought, feeling or experience that in some way relates to the speaker’s presentation.
In both the more and less structured groups, cross talk and the giving of well-meaning but potentially dangerous advice such as “get a divorce,” “tell that boss of yours to go to hell” and “send firetrucks and pizzas to her house” is usually discourages. Members who do get too controlling are usually reminded by the group leader that it is the principles of the organ-ization, and not one person’s opinion of what another should do in a specific situation, that really matter.
Support groups are obviously based on the ancient concept of community, as strangers gather to help one another by telling stories. But in another sense they also represent a holdover from the Me Decade, since no one comes to a meeting for purely altruistic reasons. “The person who’s sharing gets as much out of the experience as the listener, frequently more,” says Riessman. Or as one Al-Anon member says, “This is a very selfish program. But what we’ve found is that the best way to feel better about ourselves is to help each other.”
These days nothing is too personal, it seems, to share with a group of strangers. The sexually dysfunctional gather at Impotents Anonymous. Those who subsist unhappily among stacks of old Vogues and Ladies’ Home Journals can call Messies anonymous-or maybe Crossroads, a group for male transvestites. As for women who continually fall in love with priests: Good Tidings. It doesn’t matter if you’re a member of Bereaved (a group of parents of children who died during autoerotic asphyxiation) or if you suffer from AIDS or from such strange-sounding afflictions as prune-belly syndrome, male breast cancer and maple-syrup urine disease. “The only thing you won’t find in this whole movement,” says Riessman, “Is someone waiting to judge you.” “Why, there’s even a Kleptomaniacs Anonymous. They meet….well, the list was here a minute ago.
Anyone who explores the self-help movement eventually winds up on a road heading towards Akron, Ohio. It was there, in 1935, that Dr. Robert Smith and a New York stockbroker named Bill Wilson-both heavy drinkers-held a historic discussion that led to the founding of A.A. Wilson and Smith made no breakthrough on the causes and cure of alcoholism; the world awaits that news. What they did discover that evening was that there was something about the presence of a fellow sufferer that was more powerful, as an aid to recovery, than any of the spouse-inflicted punishment, public humiliation or solitary pain they had previously endured.
Never mind that “something” was-the way to stop drinking was to get together and then, tomorrow, get together again. Wilson eventually took the notion of camaraderie and refined it into a program based on his now famous 12 steps. These emphasize such concepts as acceptance of one’s addiction and the acknowledgment of a “power” in the universe greater than oneself. A.A. grew rapidly in the 1930s,’40s and ‘50s, though near as fast as it would grow in the ‘80s, when it doubled in size as women and minorities started joining in large numbers. The one thing it didn’t do for a long time was inspire many offshoots or imitators. With the exception of Al-Anon, a program begun by Wilson’s wife, Lois, in 1951, AA for all practical purposes was the support-group movement for many years. Which meant that if you didn’t happen to be male, white, middle class and a drinker, there were no meetings at which you could feel comfortable.
That wasn’t a big problem. In those days, many people had something that took the place of meetings: intact, functioning, extended families. You wanted some brotherly advice? You called-egad, how positively “Nick at Nite”-ish!-an actual brother. For a maternal perspective on things…right there in the kitchen, she’s all yours. And so on, down to street-wise Aunt Sophie and just-plain-wise Uncle John. Women who had problems too delicate to discuss with any of the faces around the dinner table could always turn to their coffee klatches or, as Leslie Borck Jameson, the executive director of the Westchester Self-Help Clearinghouse says, with a sweeping gesture toward her window, to “all those other mothers you always saw pushing baby strollers through the park.”
Kiddie books: But of course that world now seems as distant as Freud’s Vienna-or Donna Reed’s Hillsdale. The traditional family started to come apart at the seams in the mid-‘60s, as boomers began graduating from college and moving far away from home to find jobs. Divorce, drugs and the doomed Yuppie quest for perfection have sped along a process of deterioration that had been going on since the late 19th century. By the early ‘80s, there was a flourishing cottage industry of kiddie books and records that dealt in the “OK-ness” of having no dad, two moms, a step-this, a half that, a mysterious “uncle” and a grandma who’s not talking to any of you lowlifes at the moment. But in fact there were problems, even more than before, and, for many people, only two places to bring them-the therapist’s office and/or a self-help meeting.
Traditional “couch” therapy has certainly helped a lot of people, offering as it does the advantage of a professional caregiver and a greater focus on the individual patient. But even those who can afford the high cost of psychotherapy have sometimes grown dissatisfied with the open-ended nature of the process, and suspicious of advice that comes from someone who has never sparred with their particular demons. For those people, the only viable option is frequent support-group sessions.
It was the women’s consciousness-raising movement that first extended the self-help concept, beyond alcoholism. For the most part, these oh-so-‘60s “organizations” engaged in unstructured discussions that were as likely to concern drinking or drugs as they were sexual harassment, the military-industrial complex, lower back pain, Vietnam or anything else that wasn’t groovy. What the get-togethers were mostly about, though, was getting together. The consciousness-raising groups set the tone for the self-help revolution of today, by giving people a chance to come out and see others who-despite having some very recognizable flaws and problems-were surviving, thriving and even smiling.
Support groups in the past few years seem to have sorted themselves into four basic categories: those that address problems of addictive behavior (Compulsive Shoppers, Workaholics and others that often follow a slight variation on A.A.’s 12 steps); those for physical and mental illness (Parkinson’s Support Group, Recovery, Inc.); those for dealing with a transition or some other crisis (Widowed Persons Service, Recently Divorced Catholics), and those for friends and relatives of people with a problem (Adult Children of Alcoholics, Parents of Agoraphobic Teenagers). Though it sounds sacrilegious, Borck Jameson and others think that a support group can be a better place to seek help than the traditional family. A dysfunctional family, after all, is often what brings people to support groups in the first place. Among strangers, people can be brutally honest. At one recent meeting of Batterers Anonymous (sometimes called Forte) in Los Angeles, a member posed the rhetorical question, “Man, what am I supposed to do when my old lady tried to block my way out of the door? There’s nothing left to do but remove her with my fist.” Moments later, another member explained that being arrested for beating his wife only fueled his anger. “The last time we had a fight, I pulled a shotgun on her and it jammed,” he said. “That’s the only reason I’m here today. If it hadn’t jammed, I’d be doing time.”
The only reason a lot of guys are at Crossroads, the male cross-dressing group, is because they need to know where to get size 14EEEE high-heeled shoes or an extra-long string of pearls. For one married member, lounging around in a wig and a dress and listening to a guest lecturer discuss the best way to apply blusher, is, he says, one way to “get away from the tension of being a husband, the breadwinner and dealing with the factory, everyday life. Here I can just be Susie.” Almost every problem left untreated can become debilitating or even life threatening. Ed Madara, the director of the New Jersey Self-Help Clearinghouse, points out, noting that at Speakeasy members tell stories of stutters whose affliction led them to suicide. At some meeting, such as those for women with endometriosis and other gynecological problems that are often mishandled by the male medical establishment, there is almost always a palpable sense of urgency-if not anger-in the air. Often, what support-group members are maddest about is the way they’ve been treated by their doctors and therapists. “The professionals are discouraging and negative toward recovery,” says Joanne Verbanic, 45, an executive at Ford Motor Credit Co, in Detroit and the founder of Schizophrenics Anonymous. They put limits on us, saying we’ll never get better. But sometimes that’s not true.”
The relationship between support groups and health care professionals is improving. There are, for example, few, if any, alcohol treatment centers in the United States that do not funnel their outpatients into A.A. At the same time, says Marion K, Jacobs, adjunct professor of psychology at UCLA and codirector of the California Self-Help Center, “there is still a huge amount of resistance in medicine to incorporating self-help as part of health care.” Though there are probably more people involved in self-help than in any other single form of therapy, psychiatrists have “scant” training in support groups, according to Dr. Frederick E. Miller, director of the Adult Inpatient Psychiatry Unit at the University of Chicago. “It’s a neglected area,” he says. Professionals don’t like the idea of self-help groups for two seemingly unassailable reasons: a little knowledge is a dangerous thing, and he who treats himself has a fool for a patient.
It’s probably time, though, to stop relying on the kind of wisdom that comes from fortune cookies. It used to be accepted without question, before A.A., that the blind couldn’t lead the blind. Of course, some people will overdo anything. Frank Riessman says he’s heard talk recently that there’s a group forming for people who go to support groups too much. Oh, well, let them come in and sit down. To find oneself in an imperfect situation is human. To learn that you are not alone, divine.
Charles Leershen with Shawn D. Lewis in Detroit and Los Angeles. Stephen Pomper in New York, Lynn Davenport in Boston and Margaret Nelson in Minneapolis
(Source: Newsweek, February 5, 1990)