"The Irrationality of Alcoholics Anonymous" -Article- March 18, 2015

[MeJustMe]

I just read that article - very interesting.
What I think is this: AA is very useful for some, but it is not for everyone. If those not willing to do the steps are 'constituionally uncapable to be honest with themselves" then what happens to them?
The tenets of the AA programme are also very different to what goes on in meetings. It's a bit like Lord of the Flys in meetings - mad (dry or not) drunks taking centre stage.
With my last visit to meetings - five years ago - I was amazed by how old world the whole thing felt. Things have moved on since telexes and bakalite phones. That's how AA seems today.

[Spiritfree]

I just read that article - very interesting.
What I think is this: AA is very useful for some, but it is not for everyone. If those not willing to do the steps are 'constituionally uncapable to be honest with themselves" then what happens to them?
The tenets of the AA programme are also very different to what goes on in meetings. It's a bit like Lord of the Flys in meetings - mad (dry or not) drunks taking centre stage.
With my last visit to meetings - five years ago - I was amazed by how old world the whole thing felt. Things have moved on since telexes and bakalite phones. That's how AA seems today.

Hi Me -you make some very good points:
(1) "AA is useful to some -but is not for everyone": For me AA was a life saver in the beginning but then became a liability to my health as time moved on in my AA membership. Many of the original ideals of AA have become lost or ignored; for instance: "The only requirement for membership is a desire to quit drinking." None of the groups that I ever went to 'really' accepted this concept -although it was read at the start of every meeting. If you/me were still drinking -after a week or two and belonging to AA, you would, for the most part, be ignored (or worse) by the other members. Typically, if you were still drinking, your best bet was to not say anything about your drinking (or say anything -really). At best, when I was in AA and still drinking, I felt as though I was a fraud and really not a member.

(2) "If those not willing to do the steps are 'constitutionally incapable to be honest with themselves" then what happens to them?" Great question. What does happen to 'them'? Well, if I chose this statement to apply to me, then I would have just accepted that I am drunk until I die. However, for me, I chose to start researching alternatives to AA and medications for alcoholism. This thought "start researching for alternatives" has ended up saving my life from an alcoholic death because I was a stubborn drunk who did not want to die from the results of alcohol.

(3) "I was amazed by how old world the whole thing felt -AA" (3) : As I stated earlier, it is my opinion that AA will soon begin its journey into non-meaning and loss of its life if it does change its ways and words. With the advent of medications for AUD (alcoholism), AA -with its religious tones and true lack of medication support/acknowledgement, will soon become an institution of the past. Right now, AA is primarily the only game in town and this is now beginning to change -thankfully- all as a result of medications, insurance, and access to knowledge (information).

Medications really are beginning to take precedent with sufferers and doctors. Each are becoming more fed up with the talk therapy solution -that really, in all reality does not work. The brain has to change in order to function in a sober kind of way. Medications offer the only real solution. Of course, I do believe that the brain eventually does rebuild itself over a course of years -with no alcohol, but it is my experience, and that of many other alcoholics, that we are just not patient enough type of folk to wait around long enough for the talk therapy "switch" to occur.

Thank you for your post.
SF

[Seagirl1]

AA did not help me at all. In fact, I think it damaged me more then I choose to remember. I lost my other and real identity and began to think 24/7 that I was "just" an alcoholic. I watched so many people fail and leave because of the strict regime. People who then committed suicide because they could not follow or believe the doctrine. To think that this cult is still being used as a mainstream treatment for alcoholism is absolutely abhorrent and dangerous. FFS ! Given the long term success of abstinence has a success rate of between 5% and 8% in AA surely has to mean something. I, personally, think it does far more harm then good and seriously messes with people's heads. I also have a family member who has attended these 12 step groups since he was 19yrs old and is now 37yrs old and still drinking/drugging. He talks the talk but still has to walk the walk. Heaven help us. AA seriously scares me. I think it is responsible for far more suicides then the drinking/drugs will ever be. Sorry.............just had to vent!

[Lostinspace]

I hear ya, Seagirl. I don’t want to bash AA, because it does help many people, and for those that it helps, they turn their whole lives around. But for most people, it doesn’t work that way. I, too, felt that it did more harm than good. First of all, I think the idea that if you give in a little, that you’re doomed to spiral into a total relapse, wore off on me. There were times when I only had maybe four or five drinks after a particularly stressful day, after going though a period of a month or two without drinking. But because it was so drilled into my head that having even ONE drink meant total despair, I followed suit without even realizing I was doing that. I gave up on myself when there was no reason to. I could have bounced back from a single day of light drinking, but instead, I thought the world was over. It’s a very harmful mindset. At least it was for me. I’m very thankful that I saw the light, so to speak, and that I no longer think that way.

And honestly, I’m not even sure that it’s just a matter of needing to update their approach to accepting people taking medications that would make them more relevant. The whole idea that if you take one drink that you’re doomed needs to go. (I won’t get into the other aspects of AA that I disagree with, because that’s a topic for a whole other thread, and it may be more personal to me). I think it harms people to drill it into their heads that one drink means the end. People who would otherwise come back from a brief interlude with alcohol all of a sudden think “oh my god! This means I’m back to square one. I’ll never get better.”

Never mind the fact that the other AA members will no longer talk to you because they’re instructed to “stick with the winners.” And as someone who’s still drinking, you are by definition, one of the losers. You keep going to meetings, hoping for some help, but all of a sudden, you realize that even fellow alcoholics want nothing to do with you. You’re poison to them. That sh*t hurts. I understand completely that there’s a great social aspect in AA for those who abide by the rules. But for those of us who couldn’t, we end up feeling even more alienated.

Sorry for the long rant. Suffice it to say, I’m glad that I’ve seen beyond that way of thinking and beyond such narrow rules. I’m finally getting better, slowly, but surely.

[Spiritfree]

I hear ya, Seagirl. I don’t want to bash AA, because it does help many people, and for those that it helps, they turn their whole lives around. But for most people, it doesn’t work that way. I, too, felt that it did more harm than good. First of all, I think the idea that if you give in a little, that you’re doomed to spiral into a total relapse, wore off on me. There were times when I only had maybe four or five drinks after a particularly stressful day, after going though a period of a month or two without drinking. But because it was so drilled into my head that having even ONE drink meant total despair, I followed suit without even realizing I was doing that. I gave up on myself when there was no reason to. I could have bounced back from a single day of light drinking, but instead, I thought the world was over. It’s a very harmful mindset. At least it was for me. I’m very thankful that I saw the light, so to speak, and that I no longer think that way.

And honestly, I’m not even sure that it’s just a matter of needing to update their approach to accepting people taking medications that would make them more relevant. The whole idea that if you take one drink that you’re doomed needs to go. (I won’t get into the other aspects of AA that I disagree with, because that’s a topic for a whole other thread, and it may be more personal to me). I think it harms people to drill it into their heads that one drink means the end. People who would otherwise come back from a brief interlude with alcohol all of a sudden think “oh my god! This means I’m back to square one. I’ll never get better.”

Never mind the fact that the other AA members will no longer talk to you because they’re instructed to “stick with the winners.” And as someone who’s still drinking, you are by definition, one of the losers. You keep going to meetings, hoping for some help, but all of a sudden, you realize that even fellow alcoholics want nothing to do with you. You’re poison to them. That sh*t hurts. I understand completely that there’s a great social aspect in AA for those who abide by the rules. But for those of us who couldn’t, we end up feeling even more alienated.

Lost -thanks for the post and thoughts.

I think that you make a good summation of AA for many people who have tried AA:
(1) A person first makes a choice to go to AA (although many are forced to -I myself volunteered)
(2) A person feels some relief just by being around others who share the same experience and disease. Some sobriety often occurs at this point.
(3) One eventually chooses to drink (most all members eventually do -IMO)
(4) Fear-Guilt-Shame result (not just because this is natural for many alcoholics, but because of cult impregnation AA plants in the minds of its members)
(5) Eventually, one elects not to pick up anymore white chips and just hide the 'fact'
(6) A person eventually gets fed up with the routine, lack of acceptance/tolerance by AA, and possibly feels the need to be free. Also, this person possibly feels the need to just go drink and not feel the AA guilt machine.

At the end of my tenure with AA, I was sick and tired of being sick and tired of AA. I once again felt that there was really no one that I could speak to about my situation without that member preaching the AA gospel. Shortly after quitting AA, I started back drinking -full force and then some. At that point, I truly was out of answers -though I was still not willing to throw in the towel -of the few thoughts that I could think, I knew that I wanted to somehow live.

As a result of my self-imposed removal from AA, and my continued desire to try and live, I began researching -and I mean I dug deep into the web trenches. I had come to the conclusion that I was not ever going to live my life in accordance with AA. I somehow KNEW that there had to be a real answer for me -and I believed that science had to have an answer -and it did; Baclofen (although Baclofen did work, it seemed liked hell getting to the freedom mark)

I really have AA to thank -twice: first, for saving my life when I first started AA. Second, for causing me to seek answers (real) outside of AA. I am just not interested (most days) in "bashing" AA.

[guapo]

Two years ago, it was suggested that I start a treatment program, and then twelve-step programs, and all that. I read up on things, and thought about it, and thought NO WAY. Instead, I use naltrexone judiciously, worked on other ways to deal with the urges and cravings, and reeducated myself about alcohol, and have done so very successfully.

To see all angles of the problem, I did attend an AA meeting, and read the big book. Good Lord! At the meeting, I almost mentioned naltrexone. I was definitely on the other side of the dichotomy there.

Anyhow, as I understand it, with the AA philosophy I am perpetually addicted, diseased, forever in danger of relapse, and tiptoeing through life. Interestingly, I have none of those issues, I feel like a million bucks, I'm doing great, and I know I'll never return to drinking insanely, because I see how ridiculous it is.

I still drink on occasion in the right circumstances, but it's become a complete nonissue. That in my book is success.

[Spiritfree]

It is my opinion that AA would be much-much less of a factor these days if so many people were not mandated to attend. In most every meeting place that I attended, the majority of attendees were court ordered. Unfortunately, as of now, there are just no no other options to courts (and others) other than AA. Alcoholics Anonymous is the only formalized entity to which the court system can turn to -to send the mentally ill (or unlucky first timers) to.

As Cass points out, the new insurance regulations may help to change all of this nonsense.

The courts keep AA in business -like it or not.

[Spiritfree]

Interesting article on the website MindVox:

Resisting Twelve-Step Coercion


Copyright © 1996-2004, Stanton Peele, Ph.D.

http://ibogaine.mindvox.com/keeping-clean/resisting-twelve-step-coercion/

[Seagirl1]

I still think this is a most important thread. Given the fact, that still, this antiquated "treatment" is still being proposed by the medical and justice system ad infinitum is so ,so wrong. I am not an AA "basher" , I am seriously concerned for the people, vulnerable as they are, are being exposed to brainwashing. It is brainwashing people, believe it. I just cant believe that in this day and age that it is treated as a bona fide "treatment". My God, it doesn't cost the Government anything to send off people to this religious based, insidious "treatment". That is why it is so popular to the "system". It costs them nothing. It is still based upon moral weakness. Until people actually do start "AA Bashing" then nothing will change. There are far more effective ways to "save people's lives" then sending them off to an AA room to confess their weakness. AA still has an amazing stronghold where people can "belong" and "be accepted". Psychologically , these two premises are a basic need for humans but without the judgement and "rules". We need something different peeps. We need for the medical establishment and the justice system to wake up to the very different ways addiction can be treated. Ugh it still really bothers me no end. It will cost money to establish such and, in my opinion, that is what is really stopping proper treatment being a relevant and viable alternative.
As we prob all know there is still a stigma attached to "addicts" and they are prob not going to count in the voting system. Just sayin....

[Spiritfree]

Guapo -congrats to you on successfully finding your own way out. Hopefully, others may read your post and try a version of your method. I really wished that you had mentioned naltrexone at the meeting -just to hear what type of feedback you may have received. Lol.

The lack of knowledge in the AA community is the problem. It is not the people -per se. There really are many-many good hearted people in AA. The few that have stuck around for years are not really interested in learning about new or improved ways to stop drinking. I think that society at large operates in this same way about many things. All in all Guapo, AA will just not survive much longer unless they get on board with medications for alcoholism -imo.

[Spiritfree]

[QUOTE=Seagirl1;1605884]I still think this is a most important thread. Given the fact, that still, this antiquated "treatment" is still being proposed by the medical and justice system ad infinitum is so ,so wrong. I am not an AA "basher" , I am seriously concerned for the people, vulnerable as they are, are being exposed to brainwashing. It is brainwashing people, believe it. I just cant believe that in this day and age that it is treated as a bona fide "treatment". QUOTE]

Seagirl -You make a valuable point. When someone who is desperately hurting from their addiction to alcohol and first enter the rooms of AA, they are very vulnerable. Full of fear combined with a lack of knowledge about the disease provides one person an easy way to manipulate another person. For the most part, I don't think that the real intent of most AA ole timers is to take advantage of others in a harmful way. I do however believe that it can become an ego booster to an ole timer to help someone else in alcohol trouble -if the newbie will let them be their mentor -and of course, the ole timer was never allowed the opportunity to try medications.

The medical community and the judicial system have to become more educated -period. This will just continue to take more time -unfortunately. The 'new' insurance laws will probably help to finally speed up this educating process immensely, or so at least this is my hope.

[Spiritfree]

A new article in Scientific American offers a slightly different -more positive view point of AA.
Perhaps it only through our own personal experiences that we can each relate to the pro-s and con-s of AA? But as we can easily see, this writer jumped quickly to the AA support wagon.

"Does Alcoholics Anonymous Beat Rival Treatments?"
By John Horgan | April 4, 2015 |

Alcoholics Anonymous, the 80-year-old self-help program, has always had critics, who fault it for being too religious and unscientific. Journalist Gabrielle Glaser revives both these charges in her April Atlantic article, “The False Gospel of Alcoholics Anonymous.” She claims that “researchers have debunked central tenets of A.A. doctrine and found dozens of other treatments more effective.”

Research suggests that A.A. (logo pictured) is about as effective as other approaches to alcoholism, contrary to an article by journalist Gabrielle Glaser in this month's Atlantic.

The addiction-treatment industry is a racket, which cries out for critical investigation. But Glaser’s article is embarrassingly shallow and one-sided. She cherry-picks data and anecdotes to make A.A. look bad and alternatives look good. Her article has already provoked some blowback, including this critique in New York Magazine, but I’d like to add my own complaints.

Here’s an example of how Glaser misrepresents sources: She quotes a 2006 report by the Cochrane Collaboration on A.A. and other twelve-step programs (so-called because they are based on A.A.’s recommendations for maintaining sobriety). Cochrane Collaboration is a terrific source of independent analyses of health-related issues, but for the most part its work does not support Glaser’s thesis.

She quotes Cochrane’s conclusion that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.” She neglects to mention that the 2006 report also examined studies comparing twelve-step programs to other treatment methods. The result? “Severity of addiction and drinking consequence did not seem to be differentially influenced by [twelve-step programs] versus comparison treatment interventions,” Cochrane states, “and no conclusive differences in treatment drop out rates were reported.”

Glaser faults the zero-tolerance tenet of A.A. and touts programs that seek reduction rather than elimination of drinking. But a 2012 Cochrane evaluation found no rigorous studies of so-called “managed alcohol programs.” The report states: “The lack of evidence does not allow for a conclusion regarding the efficacy of [managed alcohol programs] on their own, or as compared to brief intervention, moderate drinking, no intervention or 12-step variants.”

Glaser is also keen on pharmaceutical treatments, particularly those involving naltrexone, which blocks opioid receptors and is more commonly used to counter opioid addiction. Glaser reports that after taking naltrexone herself for ten days, she “no longer looked forward to a glass of wine with dinner,” and she lost two pounds to boot.

Glaser cites other personal testimonials and studies that supposedly demonstrate naltrexone’s effectiveness. Actually, the evidence is, at best, mixed. A 2010 Cochrane analysis of 50 studies involving 7,793 subjects concluded that “more patients who took naltrexone were able to reduce the amount and frequency of drinking than those who took an identical appearing, but inert substance.” The effect was hardly overwhelming. “On average,” the Cochrane report noted, “one out of nine patients was helped by naltrexone.” Even that modest effect was not supported by a double-blind study reported in the New England Journal of Medicine in 2001. Those authors found no difference between naltrexone and placebos for treating “chronic, severe alcohol dependence.”

I know many people who have tried to overcome addictions with Alcoholics Anonymous and other twelve-step programs, meditation, psychotherapies, medications and various combinations of the above. Some people have mastered their compulsions, others haven’t. I wish I could recommend a particular treatment, but I suspect that all are subject to the notorious “dodo bird verdict.” Psychologist Saul Rosenzweig coined the phrase in the 1930s to describe the possibility that all psychotherapies are roughly as effective, or ineffective, as each other.

The phrase refers to an episode in Lewis Carroll’s fable Alice’s Adventures in Wonderland in which a dodo persuades Alice and other characters to race around an island. The dodo eventually proclaims, “Everyone has won, and all must have prizes!” The dodo bird verdict has been repeatedly borne out by modern research, including this 2013 comparison of cognitive-behavioral therapy to other psychotherapies. Divergences from the dodo verdict often display the allegiance effect, researchers’ tendency to find evidence for the therapy they favor.

The dodo verdict applies to most Cochrane studies of treatments for addiction, including this 2014 analysis, which offers a weirdly double-negative conclusion: “There is low-quality evidence to suggest that there is no difference in effectiveness between different types of interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users.”

Evidence that treatments are equivalent in effectiveness flies in the face of Glaser’s claim that “researchers have debunked central tenets of A.A. doctrine and found dozens of other treatments more effective.”

And that brings me to my final complaint. Glaser unfairly conflates A.A. with for-profit rehabilitation centers, such as Hazelden, that employ twelve-step programs. Glaser estimates that Americans spend $35 billion annually on alcohol and substance-abuse treatments, including twelve-step programs. She is justly outraged that “some bare-bones facilities charge as much as $40,000″ a month for treatment. She expresses the hope that the Affordable Care Act, which expands coverage of substance-abuse treatments, will lead to better evaluations of and hence advances in such treatments. I share this hope.

But as psychologists Hal Arkowitz and Scott Lilienfeld noted in Scientific American in 2011, given “the wide availability of meetings and the lack of expense, A.A. is worth considering for many problem drinkers.” [Italics added.] If all treatments are as effective as each other, cost should be the determining factor. Judged by that criterion, no treatment beats A.A., because A.A. is free.

*The above headline replaced and is vastly superior to the original: “Alcoholics Anonymous Ain’t Perfect, But At Least It’s Free.”

[Spiritfree]

Having read both of these articles, this is my standing comment regarding AA:

It is only through my own personal experience that I can state that AA works and then– it does not work. As a person who suffered for many years with AUD (Alcohol Use Disorder), I believed myself to be quite fortunate years ago to have found AA. I self-admitted myself into the program because I had no other options at the time (20 years ago). AA helped immensely to dry me out for several 90 day stints, but it never was enough. In the back of my mind, I always knew that I had a brain disorder and talk therapy and meetings were never going to resolve my issue. Once that I found a medication called Baclofen, I have never looked back. I don’t ‘bash’ AA but I do support the scientific community more than ever now.

AA’s survival is now dependent on its ability to accept medications as true adjunct to reformation. With the advent of new medications (such as Baclofen) for AUD (alcoholism) and the health care reform act, AA’s ability to become “accepting” is paramount to its survival.

[Spiritfree]

Not sure why, but the AA vs. Medication (or combination thereof) is getting a lot of talk these days. And this article appears to first compare AA to using medications to treat AUD but then the article eventually just sounds like an AA promotion. Who knows?

Article title:
Alcoholics Anonymous and the Challenge of Evidence-Based Medicine

http://www.nytimes.com/2015/04/07/upshot/alcoholics-anonymous-and-the-challenge-of-evidence-based-medicine.html?_r=0&abt=0002&abg=0

"Do Alcoholics Anonymous participants do better at abstinence than nonparticipants because they are more motivated? Or is it because of something inherent in the A.A. program?

How researchers answered these questions in a recent study offers insight into challenges of evidence-based medicine and evidence-informed policy.

The study, published in the journal Alcoholism: Clinical and Experimental Research, teased apart a treatment effect (improvement due to A.A. itself) and a selection effect (driven by the type of people who seek help). The investigators found that there is a genuine A.A. treatment effect. Going to an additional two A.A. meetings per week produced at least three more days of alcohol abstinence per month.

Separating treatment from selection effects is a longstanding problem in social and medical science. Their entanglement is one of the fundamental ways in which evidence of correlation fails to be a sign of causation. For many years, researchers and clinicians have debated whether the association of A.A. with greater abstinence was caused by treatment or a correlation that arises from the type of people who seek it.

Such confounding is often addressed with an experiment in which individuals are randomly assigned to either a treatment or a nontreatment (or control) group in order to remove the possibility of self-selection. The treatment effect is calculated by comparing outcomes obtained by participants in each group. Several studies of A.A. have applied this approach. For instance, Kimberly Walitzer, Kurt Dermen and Christopher Barrick randomized alcoholics to receive treatment that strongly encouraged and supported A.A. participation or a control group. The former exhibited a greater degree of abstinence.

In an ideal randomized controlled trial (R.C.T.), everyone selected for treatment receives it and no one in the control group does. The difference in outcomes is the treatment effect, free of bias from selection.

Continued ......"

[YouKayBee]

I've been to an AA meetingrecently following success with TSM and long term AF time.

I didn't feel the need to mention TSM/Naltrexone, if someone asks specifically I'll tell them but I ain't going to go preaching about it, it's simply not a mission for me. I do know that I'd shifted hugely since my last regular stint in AA. One AAer does know how I did it, and hasn't expressed an opinion. The person does however get to see how I am on a weekly basis because our paths do cross in other ways.

Two years ago, it was suggested that I start a treatment program, and then twelve-step programs, and all that. I read up on things, and thought about it, and thought NO WAY. Instead, I use naltrexone judiciously, worked on other ways to deal with the urges and cravings, and reeducated myself about alcohol, and have done so very successfully.

To see all angles of the problem, I did attend an AA meeting, and read the big book. Good Lord! At the meeting, I almost mentioned naltrexone. I was definitely on the other side of the dichotomy there.

Anyhow, as I understand it, with the AA philosophy I am perpetually addicted, diseased, forever in danger of relapse, and tiptoeing through life. Interestingly, I have none of those issues, I feel like a million bucks, I'm doing great, and I know I'll never return to drinking insanely, because I see how ridiculous it is.

I still drink on occasion in the right circumstances, but it's become a complete nonissue. That in my book is success.