I think the difference between your gym analysis and AA is as **Evil Joe ** mentioned earlier. The gym encourages you to do things that are directly related to weight loss and fitness. Talking (and I do not consider AA’s version to be “therapy”) can make no such claim.
My other problem is that AA contradicts the “disease” model by continually harping on moral failures of alcoholics. They say that your very make-up needs fixing, when removing the booze from the equation will usually remove the bad behavior, as well. Are there exceptions? Certainly, but generally, a drunken asshole will not behave like an asshole if he’s not drunk. They send a very confusing message.
I think the harm lies when people believe they can hand something over to a higher power. Then when it doesn’t work, the psychological damage to the poor guy who does everything “right” (as if that could even be measured) pushes them even deeper into the failure mindset.
An alcoholic has to quit drinking to get sober. If that is accomplished through self-delusion, well, at least they’re not drinking. But what do you say to the person who make an earnest effort and still can’t beat it? Keep beating that dead horse (Keep coming back…it works if you work it)? “It” doesn’t “work” for the vast majority of people. We need to stop saying that AA is the best game in town, because by their own admission, it isn’t.
Of the people who do stay sober (which is, granted, a small percentage - addiction is a horrible thing with horrible relapse rates) most people I’ve met and talked to credit AA (or a similar group support system) with helping them stay sober.
I wish that there was something that did work more consistantly than AA. Most people involved in an addicts life do. But I wouldn’t remove one of the few things that seems to help some because it doesn’t help everyone.
“There are those less fortunates who are constitutionally incapable of being honest with themselves.”
This is a part of AA I do not like, and am completly against, as I have seen the most down and out person morph into a functioning member of society.
There is a misconception I must clear up…There are quite a few good people in AA who were good before they got sober. If you are an asshole before you get sober, you could be one after…just giving up the booze isn’t always going to clear up personality traits fostered for years and years. I know quite a few sober assholes. And quite a few sober frienly people…
Just taking the booze away doesn’t clear up ones life miraculasly (sp?)
Good points Kalhoun, and by and large I agree with the various objections to AA that have been brought up in this thread. I believe that a large part of the AA program may be superfluous ritual and verbiage that adds nothing to the results, but to some degree it comes as a package.
As regards the mechanism by which AA produces (putative) results, well, I don’t know. Not a very satisfying rejoinder, but there it is. I’m basically a soft-atheist, and agree that ‘god-dependence’ is problematic. May work for some, may not for others - a large number of 12-step devotees are atheists of one stripe or another, so it would be hard to point to ‘higher-power’ as a mechanism for success.
If I had to come up with a theory, I’d say that AA’s success relies on the group. Not necessarily the talk per se, but seeing others stay sober, the knowledge that others are staying sober, having someplace to go other than a bar, friendships with ‘good influences’, maybe even the desire to compete with other AA members. From my POV the only substantial differences between an AA group and a therapy group are
sharp focus on addiction
no authority figure, so maybe attendees have a stronger feeling of ownership and autonomy / personal responsibility for success
people really attend. For some reason I’ve found that therapy groups tend to peter out. Maybe they’re typically too small, and everybody ends up hating each other.
I’m not sure I agree with this (as per Philosopher). I only have first-hand knowledge, but what I’ve seen is that when you take away the drink or drugs, you get a cowed addict who behaves differently for a few months, but then slips back into the same patterns of behavior. I’ve seen several addicts stay clean, but still end up back in jail after a year or two. I’d say that once you take away the drink / drugs, there’s still a steep learning curve, depending on how far and how long the addiction went.
This is your most troubling point. It would be difficult to determine whether somebody left a 12-step program more demoralized than when they arrived. AA is made up of human beings, and there are some assholes in the bunch who might try to push somebody down. There are also plenty of good people who I hope would balance out the effect. Unfortunately I can’t guarantee that this never happens. There does also seem to be a phenomenon where addicts stay clean for 3 or 4 months, and get all pumped-up on euphoria and delusions that everything’s going to be easy. Then there’s a severe backlash when reality sets in, be it dissapointment when the people they’ve met in meetings turn out to be regular humans, or plain old real-life blues.
I’ll agree that the 12-step program is deeply flawed, but In the balance, I’d encourage those with a serious problem with addiction to attend.
By in large this is my experience. Your points are well outlined. The 3-4 months of feeling good is called a pink cloud. The addict/alcoholic thinks they are on top of the world, and this does in fact end. That is when living sober and attending regular meetings helps by hearing how others did it and using the anecdotes from them in your daily life…Then someone new comes in and the down and out alcoholic may have a chance to help another human being…and the cycle continues.
That’s one of the interesting things I’ve found (completely anecdotally) about addicts who get benefit from AA. They’ll use all sorts of things as their “higher power” if they aren’t comfortable with God. Simple physics and biology are a “higher power” - i.e. if I drink, I’ll destroy my liver, there is no getting around biology in this case - its a higher power. The weather is a higher power - I can’t control it, I have to learn to live with it.
To some extent, addicts have gotten quite good at rationalizing - its a survival mechanism for most of them. So rationalizing “higher power” from “God” to “forces outside me” seems to be pretty simple for lots of them.
Many of them choose not to bother with the higher power concept at all. And that’s part of my problem with it. The texts make it quite obvious that they believe you need to be “saved” but this is obviously false if you can achieve sobriety without it. Looking at liver disease, for instance, isn’t making illness a higher power; it’s a consequence of drinking. They are two very different things and I do not see how one can be mistaken for the other.
Addiction is a disease like depression is a disease. I choose “depression” for the comparison because they have a lot in common.
There’s genetic factors (accepted, although not yet completely known).
And environmental factors.
And the labels are really umbrellas. Not every depressed person needs the same treatment. We accept this (ok, not everybody does, but that’s another thread), and I believe that the same is true for addiction.
Some people’s depression is treated better with a pill; some need a different pill; some need individual therapy; someone need the support of a group.
We don’t have a pill to treat addiction. We have nicotine patches; we have people who do better quitting cold turkey. We have methadone; we have people who quit cold turkey (and who often become chain smokers). We have people who do better quitting on their own, because for them talking with others in the same situation is a negative feedback loop. We have people who do better quitting in a group, because for them talking with others in the same situation is a positive feedback loop.
It’s human nature and sorry, last I looked it didn’t come in black and white.
(Do we have to list our credentials or can I leave my family out of this?)
One can’t be mistaken for the other. But people are not going to AA to be saved by some miraculous force either…They need to put effort into it. You can take or leave the faith in God. Personally, I go for the support in knowing others went through what I did, and I’ve made some good friends. There are no other groups in this area which can give me that.
That is like you can be a Catholic and go to church every Sunday, get all the sacraments, get comfort and friendship from the priests and parishioners but take or leave the whole Jesus and God part. Its possible yes, but it doesn’t make any sense.
Its not as simple as it seems unless the person is simple-minded. How do you pray to biology or physics? Substitute some non God in these steps and see if it makes any sense. My italics below.
We admitted we were powerless over alcohol—that our lives had become unmanageable.
Came to believe that a *Power greater than ourselves *could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
You are quite right that people quit by themselves all the time.
AA is, by definition, an organization for people who are convinced that they cannot stop by themselves. It is not, and has never been, an organization that says that nobody who feels they drink too much can ever control it by themselves.
The first step says “We (i.e., the people who chose to join with other alcoholics in AA) admitted we were powerless over alcohol. . . .”
It does NOT say “We believe that no human being who drinks alcohol can control their drinking.” Nobody in AA has ever said that.
As an AA member, I am aware that many people stop drinking on their own resources. I am also aware that some cannot. Do you in fact know that everyone who drinks too much suffers from exactly the same condition?
If three people are coughing, one of them may have a normal viral cold that the body will get rid of by itself in a few days. Another may have an infection that needs antibiotics. Another may have a serious lung condition that needs hospitalization. They are all coughing, but can the first person turn to the others and say, “I overcame it by myself, why can’t you?”
I would never generalize and say that everyone who drinks is powerless to stop without the help of other alcoholics. Nor can we generalize that all people who drink too much should be able to control it by themselves.
I don’t remember the phrase “we’re all in this together” being used in AA as such (I could be wrong) but to whom would the word “we” refer in that case? Presumably to people like me, who have tried for years and years to lick the problem alone and failed.
Is it possible that some persons drink too much because they just got into a bad habit? And that they can quit on their own with a little help and support from family, maybe? Sure it is possible. I fully agree that such people exist. And I have never heard anyone in AA deny this.
By the same token, is it not possible that others have a problem that runs deeper and needs the power of others who have the same problem to stay sober?
I am not a weak or stupid person. I have a university degree and have done post-gradutate work. I was able to stop smoking by myself 12 years ago. But 20 years of trying to control my drinking ended in nothing but failure. Thanks to AA, where I work with other people who have my problem, I have stayed completely sober for 16 years.
So once again, if you will excuse me for screaming at you in bold and large letters, tthe simple fact is this:
[**SIZE=1]AA is NOT an organization that says that nobody should drink alcohol. It does not say that nobody can control alcohol abuse by themsleves. It is an organization for people who have come into the organization voluntarily convinced by bitter experience that they cannot lick it alone, and found that they have a chance of beating it by working with other people who are in the same boat, by participating in a lifelone program of character transformation and improvement.[/SIZE]
Or to put it into one sentence: AA is not an organizxation of people who say nobody can control tgheir drinking. It is an organization for people who feel THEY cannot control THEIR drinking without help.**
But that’s not how it’s presented by medical professionals or most members of AA. They don’t say, “Hey! If you want to quit with other people, come on by and quit with us!” AA is regularly presented as “the only effective way” or as an island in a sea of moral decay. Some people are joiners by nature and I think the hand-holding could be beneficial to them. But it should not be presented as The Best Game (or The Only Game) In Town when clearly it’s not.
Or perhaps instead of simple minded, able to visualize a God that doesn’t fit in the box you’ve defined.
(I’m a Deist - I don’t believe in a God that answers prayers, I don’t pray, but I do believe in a higher power).
(I also wish AA would drop the dependance on the “G” word - I think it turns off a lot of people who are distrustful of God but could be helped by the other elements of AA. A lot of (but certainly not all) alcoholics seem to have had abusive pasts, and occationally that abuse was justified with religion, its a bad mix for some of them - and not just those that reject religion whole cloth).