This discussion has taken place before around here, but with the push toward faith-based social services, I thought it might be worth having again.
Earlier this week, as part of my psychiatry rotation, I attended an AA meeting. The people there were very nice, and were very open to medical students coming in to observe. I have no doubt that this program has helped a lot of people, and the studies seem to back that up.
However, I have some reservations, two in particular:
–The meeting I attended was, essentially, a religious service. Sure, they go through some careful semantic gymnastics to refer to God “as He reveals himself to the individual”, and they try to de-emphasize their basis in Christianity.
However, they opened with a “moment of silence” and closed with the Lord’s Prayer. The speaker talked about how he was able to quit drinking only after he found God. (He started by talking about how he wasn’t a believer when he first started, and I thought I was going to hear about how a nonbeliever would get through AA, but he instead changed his evil ways.)
I’m sure not every AA meeting is quite the church service this one was, but the whole idea is still fairly confined to Yahweh. The idea of “asking God every morning to help you stay sober today and thanking Him at night” implies a God that takes a personal interest in people’s lives, a concept that Deists, among others, would disagree with. Atheists and agnostics (which I fall somewhere in between) have trouble with the idea of a “higher power” altogether.
I don’t consider this a problem in itself. However, I consider religious witnessing by physicians to be the height of unprofessionalism, and I could never envision telling a patient that he needs to go to church. Yet we tell them to go to AA or NA meetings all the time. Is that wrong? I feel uncomfortable sending a patient to such a religious environment, yet I know it’s one of the most effective ways to stay sober.
–On a similar note, I have a real problem with that first step. It seems to me that admitting you’re powerless over something is exactly the wrong thing to do. My inclination would be to help the patient realize that he does have the power to stop drinking, and to have an organization such as AA for social support and “positive peer pressure”. Then again, like I said, it’s hard to argue with AA’s success.
In short, sending a patient to AA or NA seems to me like saying, “You can’t solve this problem yourself. You need to turn it over to God.” I don’t like that attitude, for a variety of reasons. Am I incorrect in my assessment? And should a physician let such hangups prevent him from recommending a program with such demonstrable success?