What I find most troubling is that when a person attends AA for a bit, and then leaves and starts drinking again, the AA folks don’t see that as a failure of their system, but as a failure of the individual to follow their system.
Say you want to do X. I tell you, in order to do X, do A through V and without fail you’ll be able to do X. If someone does A, B, and C, then can’t do D, is my program to blame, or is the person who fails to blame? If there’s 10% failure at each step, very few people will succeed, yet if at each step the person is to blame for not completing the task, my method as a whole has no failure rate. Does this mean that my method is a good way of learning to do X?
Then there’s the issue of whether the steps are actually helpful. Back in the previous situation, what if A through V have absolutely nothing to do with actually being able to do X, but those able to do X already will have no problem doing A through V and very few that are able to complete them are not able to do X. Is it fair to call A through V a useful program for learning to do X?
Those who “fail” AA are precisely those who aren’t willing (yet?) to put in the actual effort needed to conquer their addiction. And that’s exactly the problem. Shouldn’t we be focusing on trying to help people who don’t have the ability to climb out by themselves? There’s not necessarily anything specific about the 12 steps that causes one to overcome their illness, it’s possible only those strong enough to follow that path will be able to remain sober.
Just being in a group setting, facing one’s addiction, and being willing to go through a lengthy process to fight it are likely what’s needed; while some of the 12 steps are probably helpful, there’s nothing specific about them that makes the process a cure. Having someone unable to do those things is as much a failure of the process not being applicable to all cases as it is a failure in the individual.
Everyone is “so sure” that AA/12-step works there are very few other options. Pann was in Houston so hardly some rural backwater with few resources. Houston is easily big enough to expect a variety of options yet none existed for this.
Would Pann have avoided some of the hell had another option been available rather than wait longer before choosing AA because no other choice existed? Not sure anyone can say but would have been nice for options to exist for this.
I think it is self evident that AA is not for everyone. To think otherwise is to say AA is the only route to lasting sobriety and is absolutely the only right answer for everyone. Absurd on the face of it.
So, what are we left with?
A program started some 70+ years ago that was the brainchild of a guy who got the idea while tripping balls on drugs so powerful I don’t think anyone today uses them (and that is saying something). He sees God while tripping and from that we get AA.
Gets better. In 70+ years the program has not changed in any meaningful way. Most therapies are studied and outcomes measured and therapies refined. Conveniently you cannot study AA very well due to its nature so everyone just supposes it works and points to “those guys/gals” who were saved as all the proof they need that it is a good program. I’m sure some snakeoil was sold in the past where you could find someone who swore by its efficacy because it worked for them. Doesn’t mean you should buy that stuff.
What studies have been conducted to date show AA to be no better than any other method and possibly worse.
Add to that AA groups can be hit or miss. Some groups sound great, some awful (plenty of anecdotes for both out on the web). There is no rigor in the method such that AA is normalized across groups. Better hope you get a good one in your area. If not you’re screwed.
Now look at what the steps required to “fix” the alcoholic are. Turn your will and life over to God (3), have God remove all defects (6), have God fix your shortcomings (7). AA has some great steps for taking personal responsibility…steps that I think are a good idea for most people in most circumstances and not just alcoholism. In the end though magic will fix you. At this point you may as well go to a witch-doctor and have them kill a chicken for your recovery. For all the science those two methods share one is as good as the other.
The damage AA does is that it has become the defacto treatment for alcoholism in the US. So much so the State may mandate some people enter the program which, as noted, becomes State endorsement of religion. Money and efforts for other treatments have been stymied as a result. Cities as big as Houston have no other alternatives.
So Pann got fixed by attending AA. Great! (really)
What we do not and cannot know is how Pann (and others) might have fared if we had 70 years of study and effort into treating alcohol addiction under our belts that resulted in several different programs for treatment.
All we got is AA…don’t like it die an alcoholic. You have no other choice. Everyone just “knows” it works so therefore it must work for you (no matter who “you” are).
Having worked with drunks who were having a very hard time staying sober, I gotta call B.S. on this, at least in the A.A. groups in my area. I have personally assisted active alkies in finding places to stay (half way houses), donated money, held people while they puked, and all kinds if other stuff. While dealing with the active drunks, the response to those drunks has always been ‘What can you do to stay sober? How can we help?’. Some people wanted to go to a halfway house. Some wanted to go to a church and ask for assistance there. Others wanted to go to a meeting. (Oddly, no one so far has asked for family) In every case, we assisted the person with what they wanted and offered advice. No one I know in the program gives a damned how anyone gets sober, only that they get and stay sober.
On the steps, I believe that there is a very valid reason for the steps though I do not believe the guys who wrote them really understood why they work for some people when they were written. I went to one of the best treatment centers in the country (though I didn’t get and stay sober at that time. It took going to a halfway house and lot of A.A. meetings to finally get it) Two of the main issues they dealt with at the treatment center were shame and guilt. In a nutshell, the theory is that the shame and guilt the alkie feels (usually brought on by actions done when they were drunk) is a huge problem and needs to be handled before they will have a good chance at sobriety.
Alkies do lots of dumb and evil shit when they are drinking. A lot of alkies, or so goes the theory which I happen to agree with, do not know how to deal with the guilt and shame that these actions produce. To deal with the feelings they turn to alcohol or another drug. It turns into a vicious cycle. The 12 steps deal with these emotions in a positive way. To sum up the 12 steps:
Admit that you have a drinking problem
Admit that what you have done to try and fix the problem hasn’t worked
Admit that you do not have the answer to the problem and someone else may Look at what you have done wrong
Talk to someone about what you have done wrong
Make amends (where possible) for what you have done wrong
Repeat the previous three actions
Help others do the same
Some people are not ready, for whatever reason, to do these things. Having been through it, I can tell you it is a **really **unpleasant process. At the same time, as unpleasant as the process was, finally doing it was freeing in a way that is hard to describe.
Now, a question for you. How, exactly, do you go about helping someone who does not want to be helped? That is a huge problem. My family and friends tried for years to help me and I didn’t accept the help. I didn’t want it. Everything they did was irrelevant until I was willing to accept the help offered. Are my friends and family failures because I would not accept help that they offered? If someone goes to a dietitian, listens to the dietitian and then proceeds to eat themselves to death anyway, is it the dietitians failure?
Addiction is bitch. At this point no one knows of a cure. A.A. isn’t a cure and has never claimed to be one. A.A. claims that if you can follow the program it can help you stay sober.
Czarcasm,
Here is the summary of a study from the NIH website.
So, according to that study*, rates for sobriety at 16 years are doubled by A.A. attendance. Does this settle the argument about A.A.? Nope, but it does point to A.A. having a reasonable effect. There are more studies out there, some pointing to A.A. being effective, some not. However, in almost every study I have read the authors point to a huge problem in studying A.A. and that is the anonymity problem. Since it is voluntary (for the most part**) and anonymous, it is hard to follow.
Are there better options than A.A.? None that I have heard of and I want there to be better options. Having lived as an alkie I don’t want anyone else to have to go through that.
Slee
*There are more that I posted somewhere around here. I really don’t feel like digging them up right now…
** I am not a believer in court ordered A.A. attendance. I think, in many cases, it can hurt more than it helps. Forcing someone into any kind of treatment can easily backfire because the person may feel resentment about the whole thing.
I noted Pann’s assertion that he tried to find alternatives to AA in Houston and couldn’t. You can call him a liar if you want but I am not prepared to do that.
I recently had a friend choose to go to AA. I worked to find alternatives in Chicago and found precious few that were not a 12-step program. One I did find (http://www.smartrecovery.org/) had too few meetings and locations (there are two in Chicago…that’s it).
In general I would dissuade someone from going to AA. That said it can become the difference between a bad choice and a worse choice and if their alcoholism is causing major damage to the person even a bad alternative can be better than the status quo.
True, Thirty years ago there were no other programs and god dammit I’ve learned to not argue with success.
Fact is, it was really hard for me in the beginning, because by just attending AA made me feel like a loser. If there was a professional program funded by the government , (I live in Canada), I would have most assurdly have tried that route first.
Why must everyone, when bringing up the steps, drop the phrase ‘as we understand him’ from the god part? I am in A.A. I understand that god does not exist. See how simple that was?
I find it interesting that you admit some of the steps have value and then in the very next sentence ignore the steps that have value and claim that A.A. is ‘magic’.
So, do the steps have value or not? If you believe that some of the steps have value then discounting the whole program because of the word god seems very short sighted and totally based on your militant atheism* instead of a problem with the whole program itself.
Because as “you understand him” is meaningless in this regard.
You can think God is the Flying Spaghetti Monster. In the end you are appealing to an outside, supernatural source to intervene on your behalf and cure you.
I do not see that as anything like a rational, science based approach to mental health therapy.
And there is nothing inconsistent with looking at a list and thinking some items have value and others are bullshit.
However, when the whole list must be accomplished to achieve the goal and half the list is based on bullshit it throws the whole thing into serious doubt. I see nothing wrong with cherry-picking the good stuff however.
I would see what programs are in the area, get the basics on each, and ask him which one he is most comfortable with, while continuing to get background information and studies on each when and where possible.
He died in my house, not knowing where or who he was. Until he forgot how to drink, he would occasionally get drunk, but never felt he was as bad off as “those losers over at AA.” I remember him complaining about his third meeting, saying that each member would stand and give his pathetic story to show how low he or she had sunk before getting help, and the next member would stand up and tell an even more pathetic story to show how far he or she had fallen, and so on. He said he wasn’t going back unless he could have a good belt or two first.
Oh please, that last comment is completely underhanded.
There’s the Betty Ford clinic, but I don’t know how availabe it is to average people.
Its only in the last year that someone has pushed his book on national tv claiming a “cure” for alcoholism.
If I personally know hundreds of people telling me that it works, or scientifically vetted, only then would I give it credence.
BTW if you think a lot of alcoholics will have the patience to research alternatives, you are sadly mistaken. A decision to quit could be “in the moment” and you could start “treatment” within a matter of hours even minutes in AA. You are not going to get that in any other program.
I had noted in my post that Pann could not find alternatives in Houston. You asserted there are other options available which, while true, is misleading.
And Betty Ford Clinic, IIRC, costs around $1,000/day and insurance usually won’t cover much, if any, of that at all. I think it is safe to say most people cannot afford that leaving it just for the very wealthy.
Again this is my point. There are not other alternatives (or rather precious few). Maybe if we had spent the last 70 years properly researching alcoholism and treatments for it there might be other (and better) options today.
If only the people involved in AA had spent the last 70 years reviewing the process, researching what worked and what didn’t, instead of treating it like a direct message from God On High that Must Be Kept Whole And Never Questioned, we might have the answers that people have been recently looking for.
