Alcohol misuse is a global health risk, and Alcoholics Anonymous (AA) is the largest and most popular mutual-help program for individuals with alcohol-related problems. In recent years, researchers and clinicians have become increasingly interested in specific mechanisms of action that may contribute to positive outcomes through involvement with this 12-step program for recovery, yet few have applied a theoretical framework to these efforts. We examined the phenomena of alcoholism and recovery in AA, using the nursing Theory of Human Relatedness (THR). THR addresses a pervasive human concern: “establishing and maintaining relatedness to others, objects, environments, society and self.” The theory describes four states of relatedness (connectedness, disconnectedness, parallelism, and enmeshment) and four relatedness competencies (sense of belonging, reciprocity, mutuality, and synchrony). Both alcoholism and recovery in AA can be viewed primarily in terms of relatedness. In active alcoholism, an individual’s involvement with alcohol (enmeshment) can limit, impair, or preclude healthy or adaptive relatedness toward virtually all other referents, including self. As a program of recovery, each of the 12 Steps of Alcoholics Anonymous addresses an individual’s relatedness to one or more identified referents while simultaneously enhancing and expanding each of the four relatedness competencies. THR provides a theoretical framework to help direct patient care, research, and education and has the potential to serve as a unifying theory in the study of alcoholism and recovery in AA.
Stephen Strobbe, PhD, RN, NP, PMNCNS-BC, CARN-AP, University of Michigan School of Nursing, Ann Arbor.
Bonnie Hagerty, PhD, RN, University of Michigan School of Nursing, Ann Arbor.
Carol Boyd, PhD, RN, FAAN, University of Michigan School of Nursing, Ann Arbor.
This work was supported by a research grant from the International Nurses Society on Addictions, a New Investigator Award from the University of Michigan School of Nursing, and a research grant from Sigma Theta Tau International Honor Society of Nursing, Rho Chapter.
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.
Correspondence related to content to: Dr. Stephen Strobbe, University of Michigan School of Nursing, 400 North Ingalls Street, Ann Arbor, MI 48109-5842. E-mail: firstname.lastname@example.org