Some Alcoholics Anonymous (AA) members conceive of the fundamental problem they share as a “spiritual malady.” Based on fieldwork among three AA groups in Nova Scotia, Canada, this article advances an ethnographic description of the concept. Through a close examination of how the spiritual malady was interpreted by my interlocutors, I propose that the concept creates a cultural framework for the articulation of subjectivities and the interpretation of psychologies. I argue that it exists through a reciprocity of private and public meanings that are more the product of interactions between AA members than the learning and repetition of a formal ideology. This analysis becomes a means of exploring the agency of AA members as producers of meaningful representations of the challenges they feel they hold in common.