drew on the procedures of the evangelical Oxford Group - giving in to God, listening to God's direction, checking guidance, making restitution, and sharing. Within this framework, a life that was confused and chaotic takes on a human shape. At AA, when a woman tells her story and communicates it to others, she gives meaning to her life, and she can begin to heal.

Yet this particular story reflects many assumptions that do not apply equally to everyone struggling with addiction - not surprisingly, since Bill Wilson, the cofounder of AA, based the all-important Big Book on the experiences of a hundred white, Protestant, mostly upper-middle-class men and one woman. Unlike these people, there are woman (and men) who walk into the halls of AA without ever having known a life they would like to recover. The AA approach, which confronts the false pride of the alcoholic, may not be helpful to a woman who needs to build her self-esteem from the ground up. Many alcoholic women have histories of childhood trauma that AA is not meant to address. New research has established that sexual problems are frequently interwoven with women's alcohol problems - they usually begin before the addiction and continue after it - but AA is not the place the bring these up. Many alcoholic women are dependent on men, and many start drinking in response to depression. Taking responsiblity for their lives may require them to look at how they have been socialised to relinquish their power to men, and to recognise the role that alcohol has played in these dymnamics. AA discourages discussion of social and political factors contributing to alcoholism. A single, needy woman may also meet with male "assistance" that amounts to sexual harassment (what's known as 13th stepping").

In many places, AA is adapting to women and minorities - particularly in cities, there are same-sex groups that avoid some of these problems - and women currently make up 40 percent of its membership. Some have made good using AA by remembering the slogan "Take what you need and leave the rest." But where is a woman to turn to with issues that AA cannot address? In today's climate of managed care, substance abuse treatment is likely to be brief. There is often no time to address the life issues bound up with a women's drinking, and in any case, these require ongoing support. My point here is that the dominant images of alcoholism and recovery are based on men's experience. For woman - and many men - the reality is often quite different. We need to know more about this group of people who do not fit the mold, and we must acknowledge and act on information we already have about specific aspects of women's alcohol problems...