As fascinated as I am over the founders of Alcoholics Anonymous—a physician and stockbroker who created a mass movement because they couldn’t stop drinking—I would not be much of a freethinker if I didn’t offer a more candid analysis. The Big Book, despite containing some obvious truths, is a muddled piece of work that seems to only intrigue its members but not the experts.
Although it contains many pithy statements to give it its appeal, the book is far away from a scientific understanding of alcoholism and substance abuse. Even though it is wrong in its details, the approach works for many (iii) by creating a group consciousness that their pseudo-selfish (i) behavior is destructive to them and to others. The group acts to reinforce the new social norms created.
Too Smart For Own Good
Now we come to another problem, the intellectually self-sufficient man or woman… far too smart for own good… blow ourselves into prideful balloons… 
The theme throughout the book is that the ego, self-will, or willpower is something to be smashed and looked down upon. The ego is the part of us that we feel when we self-indulge—I want, and I need—and helps us to differentiate ourselves—I am better than he, she, or they—as well as engages in self-appraisals—I did this and everyone needs to know. The ego is the ugly part in all of us.
But the ego is also the part of us that helps us to advance in life since it drives us to compete with others. The problem with the Big Book is that it generalizes the ego and equates it to sin. This isn’t surprising given the Protestant background of the founders, and the same fear tactics are used from religion concerning over-indulgence. But a big ego in itself doesn’t cause addiction (ii).
The book contradicts itself often and one noteworthy paradox is that the same will and self that is condemned is the same will and self that helps the member to learn new habits and stay clean and sober. Maybe the founders anticipated members to be critical—”far too smart for own good”—of the newly learned beliefs and hence they decided to denigrate the concept of the ego altogether.
The Self-Centered Man (iv)
Selfishness, self-centeredness! That, we think, is the root of our troubles. Driven by a hundred forms of fear, self-delusion, self-seeking, and self-pity, we step on the toes of our fellows and they retaliate. 
Selfishness can’t be the cause of addiction. We usually stand to benefit when we are being selfish and alcoholics and addicts are beyond the stage of pleasure. They are driven by an obsession to use the substance and can act compulsively on that impulse. Selfishness is just not an accurate description especially since their willpower has been hijacked by a very strong desire to use.
Even in the beginning stages of addiction, a member that drinks occasionally would be no more selfish (ii) than someone that indulges in chocolate. From an outsider, it looks like a selfish act since the attention is on them, but in the long run, there is no net benefit for them, and they end up harming themselves. At best, we have to settle for a label of quasi or pseudo selfish .
The Big Book of course gets it right when it says that arrogance and over-indulgence usually backfire on us, but that does not mean that these qualities cause addiction. Furthermore, there is no shortage of grandiose personalities who are not addicts or alcoholics, and there has to be the right situational and genetic factors that lend hand to creating what we would call an alcoholic or addict.
A Harmless Delusion
We will suddenly realize that God is doing for us what we could not do for ourselves. 
During the course of the day, many of us will think and feel that we are better than average in capabilities, appearance, and intelligence. This can’t be true if these traits have a bell-shaped curve. But we operate best when we delude ourselves into thinking that we are slightly better than others. So is there anything wrong with members believing that God is helping them stay sober?
We should be careful to not dismiss members out of hand because there are well-understood benefits to surrendering ourselves to something greater than ourselves. This concept is endorsed by Western psychology and even evolutionary psychology as a way to deescalate the defense system (involuntary defeat system) which is what is activated in periods of failure, rejection, and stressors.
The founders wanted members to be demoralized, hence the humiliation of “My name is __, and I am an alcoholic”, so that they realized the severity of their problem. Members often are in denial to protect their egos, so perhaps this method works in combination with surrendering their willpower to something greater than them so that they open up and address the problem.
But if we want an analysis of what is really going on, then members need to realize that believing in something that feels good doesn’t mean it’s grounded in reality. A belief in God is optional but is probably harmless.
i) The best analysis that I have seen on AA was brought to my attention by Dr. David Allen. Please see the references section .
ii) Two personality traits that are related to what we would think of as egotistical would be narcissistic and self-centeredness. Addiction is correlated with these two traits but that does not mean that they cause addiction.
iii) An analysis of over 27 randomized controlled studies concludes that 42% of 10,565 participants of a 12-step approach will remain abstinent for a period of 1-year or more whereas only 35% would remain abstinent through other approaches.
iv) When I use the word man, I am implying the pronouns he, she, or they.
v) The group’s “serenity prayer”—”. …accept the things we can’t change, the courage to change what we can, and the wisdom to know the difference.”— is powerful and although we may not know it in words, we intuitively do it all the time by letting go of concerns that are out of our control.
 Allen, Dr. David. “The 12 Steps of AA: A Translation.” Psychology Today
 12 Steps and 12 Traditions. Alcoholics Anonymous World Services Inc.
 The Big Book. Alcoholics Anonymous World Services Inc.