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I felt this book centered around four areas - Knapp's personal history and relationships, her growing relationship with alcohol, the nature of alcohol, and her experiences as a member of AA.

With regard to the first, she gives an excellent description of what it's like to have problems in a middle class family that ostensibly look squeaky clean. Her father was a psychoanalyst, and life at home seemed very civilized. Then we learn that her father's first marriage was to an alcoholic, and that she had a half brother, called Wicky, whose chaotic life was the result of fetal alcohol syndrome. Wiky lived with them for a while, his behaviour causing extreme disruption. Later on in the book, her father admits to a friend that he has serious problems with drinking too, albeit that "he drank in a Ivy League, genteel way". The squeaky clean family exterior was masking some major cracks.

With regard to her commenting on the nature of alcohol, I found the following of interest. It goes a long way to explaining why people sometimes feel depressed for some time after they stop drinking....

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Drinking artificially "activates" the brain's reward system....increasing the release of the neurotransmitter dopamine which is central to feelings of pleasure and reward. Over time...the brain develops what are known as "compensatory adaptations"to all the artificial revving up: in an effort to bring its own chemistry back into its natural equilibrium, it works overtime to decrease dopamine, ultimately leaving those same pleasure/reward circuits depleted. A vicious cycle ensues: by drinking too much, you basically diminish your brain's ability to manufacture feelings of well-being and calm on its own, and you come to depend increasingly on the artificial stimulus - alcohol - to produce those feelings.

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I was also interested in her descriptions of AA, and the people she met there. She obviously wrote the book when still a relative newbie, going to 4 or 5 meetings a week, and her enthusiasm is palpable. And why not? This organisation has managed to inspire her to stop what was an extremely destructive habit. The thing that impressed me most was her description of the comaraderie and community that is found in AA. As Johann Hari is famous for saying "the opposite of addiction is connection".....and AA seems to provide that in spadefuls.

She is vehemently against the idea of moderating or harm reduction, which is also very much an AA stance. (view spoiler)[

"One of the most commonly cited statistics on recidivism comes from the Course of Alcoholism: Four Years after Treatment, a January 1980 report by the Rand Corporation and the most extensive and comprehensive study of its kind today. This study tracked a group of 900 alcoholic men over a period of 4 years. Of those, only 28% remained free of alcohol problems both at 18 months and at 4 years after entering treatment; only 15% were in continuous remission for the entire 4 years. Once you've crossed the line into alcoholism, the percentages are not in your favour; there appears to be no safe way to drink again, no way to return to normal, socially controlled drinking."

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She also talks about the frequency of cross addictions. In her experience with men this often involves alcohol with drugs or gambling, and for women it is frequently alcohol and food issues. (At one point in her life Knapps developed anorexia, and her weight went down from 120 lbs to 83 lbs. Thankfully she recovered.)

All in all I found this an interesting read - and I was sorry to hear that Knapps had died since writing the book (she died of cancer.) I'm sure it has been an inspiring read for many people.