A really beautiful and serious thing

[Mark]

The most commented article of all time on Mental Help Net lives in our Alcohol and Substance Abuse topic center. It is titled, Alcoholics Anonymous (AA) is a Cult? (http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=9527&cn=14) and there are literally hundreds of responses made to this article. The article itself is rather simply about my experience coming to understand how much anger there is out there focused towards AA. It was, frankly, a shock for me to realize that there are numerous people out there who have found the AA experience to be completely toxic. Or, rather, I should say, not really so much a shock that people didn't like AA as a shock that there were people who didn't like AA who seemed to have in some cases quite legitimate reasons behind their opinions. In hindsight, it makes more sense to me, and I'm more able to accept the notion that a diversity of individuals requires a diversity of problem solutions. AA being a prominant solution to be recommended for it does benefit many, but by no means the only one recommended. I only wish that there were more secular and science-based self-help programs out there for alcoholics and other addicts.

At any rate, the debate rages on and I don't see that there is any resolution. On the one side are people who have found AA to be helpful and who come to AA's defense when it is criticized. As sobriety is literally life-saving in many cases, who can blame these people for wanting to defend something that has helped them (in their estimation). On the other side are people who have been harmed in their estimation by predators they met in AA, or who are secular in orientation and who cannot stomach the religiousity practiced in many AA settings. I don't believe that AA must be practiced in a religious context, but I do know that it frequently is. And who can blame these people who perceive themselves to have been abused for wanting to warn others about the danger? The two sides will never meet I don't think. In some cases they are talking about two different AAs which are run differently. AA is not a uniform insititution though it does have its unifying steps and traditions. In other cases, people's differing backgrounds lead them to be more or less comfortable in the same setting. One man's poison is another's dinner, that sort of thing. I do note that more than a few commenters don't realize this diversity of experience is occuring and talk as though their personal experience of Twelve Steps is the same experience everyone has or will have. Not true, but an easy mistake to make for some people.

Inasmuch as the debate will continue, I hope to shift it over to this forum simply becuase this forum system is a far better environment for having a debate than the comment system on Mental Help Net. If you wouldn't mind, perhaps you can help us accomplish this task by writing about your own AA experience (or any other experience you are having or have had with regard to alcohol and other substance abuses and addictions). This stuff is a hotbutton issue. If you write something and stake out your position, I feel rather confident that someone from the other camp will come along and take issue with what you've said. It would be funny almost if people weren't speaking from their hearts about such a serious issue as addiction. That's what makes it not funny - that the discussion is about life and death and avoiding damage. that's the part that makes the discussion rather noble from all directions. The urgency comes from people trying to help other people avoid mistakes. That's a really beautiful and serious thing.

Perhaps through further discussion, some people can begin to understand how to integrate the positions in a way that makes sense and not have to feel so polarized and urgent. That would be a benefit to all who achieved it, I believe, becuase accompanying that new understanding would be a greater sense of inner peace.

What do you think?

[xenophon]

First things first, AA is religious in nature. Three Fedral Courts of Appeal have ruled such. I agree with and accept that judgment.

There is a level of bad conduct within AA that renders it suspect. The fact that bad conduct occurs elsewhere is not relevant.

Sponsors have no qualifications and are not accountable. No adult leadership. There can be no expectation of confidentiality. The concept of the wounded healer is invalid.

AA is a dumping ground. The courts use AA as an adjunct; an alternative to incarceration. Mentally ill are sent to AA by practioners using triage. "I can't treat you unless you stop drinking." And, so it goes.

The 12 steps are an act of faith; that is, revealed truth. The 12 steps arose from the Oxford Group, run by Buchman.


I am glad, sir, that you have learned something about AA and 12 step. It is time to grow beyond AA. It is not good enough.

[John Rutledge]

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[Mark]

I didn't come up with the idea that AA could be practiced outside the context of a religious system. An anthropologist and "cyberneticist" by the name of Gregory Bateson (husband to Margaret Mead, I've read) did. I have on my desk from a while back a book called "steps to an ecology of mind" which is a collection of Bateson essays from the 60s and 70s. In one of the essays, "the cybernetics of "self": a theory of alcoholism" (published in the journal "Psychiatry", in 1971) which is worth reading, Bateson suggested that the power of AA resided primarily in the surrender and overthrow of the self-concept that thinks it is in control of things. The way I read that article, Bateson is saying that the underlying movement is correct and can be understood in an entirely secular manner by thinking of it as a philosophical conversion rather than a spiritual one. Here's a quote from the article if it helps:

"The first two steps of AA are as follow:

1. We admitted we were powerless over alcohol - that our lives had become unmanagable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.

Implicit in the combination of these two steps is an extraordinary - and I believe correct idea: the experience of defeat not only serves to convince the alcoholic that change is necessary; it is the first step in that change.
To be defeated by the bottle and to know it is the first "spiritual experience". The myth of self-power is thereby broken by the demonstration of a greater power.

in sum, I shall argue that the "sobriety" of the alcoholic is characterized by an unusually disasterous variant of the Cartesian dualism, the division between Mind and Matter, or, in this case, between conscious will or "self" and the remainder of the personality. Bill W's stroke of genius was to break up with the first "step" the structuring of this dualism.

Philosophically viewed, this first step is not a surrender; it is simply a change in epistemology, a change in how to know about the personlity-in-the-world. And, notably, the change is from an incorrect to a more correct epistemology."
I'm not saying that AA is practiced secularly; I'm just saying it could be.

[xenophon]

There are a lot of interesting questions about the social and psycho dynamics of AA/NA.

1. Who are the people who buy into the doctrine of AA and become believers/ advcates. What is the pyschodynamic of that process?

2. Who are the people who actively dislike AA? What is the dynamic which leads to that?

3. Who are the people who seem unaffected -- either way - by AA. There are people who use AA as a talking shop. Why?

4. People have quit drinking prior to attending AA. Why do they attend?

5. What goes on inside AA? What are the dynamics of the interactions that occur there?

6. Who prospers in AA? Do people with narcissistic PD do well there? Anti social PD? Depressives? Who are the gurus? What is their psycho dynamic?


Very little is actually known about the workings of AA/NA behind the closed door. Does anyone want to know?

[Mark]

Who are the people who buy into the doctrine of AA and become believers/ advcates. What is the pyschodynamic of that process?

Who are the people who actively dislike AA? What is the dynamic which leads to that?


People complain about two broad themes in my experience. The god/religious aspect, and the sociopaths/predators. I'm thinking these are unrelated complaints.

We've got atheists/agnostics or just plain non-christians who have a personal experience in AA where they feel invaded/colonized and push back against it. This is an identity thing. "I want help, but I don't want to have to compromise my core beliefs about the world and myself in order to obtain it". "I don't want to compromise my independence." Perhapse some people who benefit from AA don't feel their independence is compromised, while others do. If this is so, the interesting question is why do some people feel compromised while others don't. Would having a religious background where you are raised in an environment with a higher power have something to do with it?

We've got people who go to AA and get involved with someone who takes advantage of them. This is an abuse complaint. Seems to me most anyone might make such a complaint based on how they have been treated.

Maybe a third common complaint too, which is that people don't like the lack of a scientific program, or lack of accountability.

[xenophon]

I understand; what you are saying makes sense.


Why have a support group at all?
I would think that such a group about alcohol abuse/alcohol dependence would be mostly educational.

Tips on how to quit; the mechanics of doing that. Such as: How to replace the drinking behavior with other behaviors;
how to divert the urge to drink -- thought stopping, CBA, behaviors which rule out drink, etc.

perhaps some morale/confidence building comes in.

A support group run by and for deeply troubled people does not seem a healthful venue. Is it not much better to socialize with balanced people who behave appropriate to the circumstance? A group based upon common interest, rather than a common problem?


How could a support group based upon drinking deal appropriately with issues such as depression, anxiety, etc? That seems a difficult proposition.

[ASchwartz]

Both you and Dr. Dombeck make a very good point when you state that many people are bothered by the lack of accountability in support groups such as AA. It does seem difficult to understand how people struggling with sobriety can be helped with their emotional problems as well because that takes professional guidance.

For most of my career I had a private psychotherapy practice in New York City. One day a young man referred himself to me to help him deal with his depression. As it happened, he was a full member of an AA group in Manhattan and was sponsor for several AA members.

As a result of the help he got in psychotherapy he referred some of the other members from AA that he knew of. Before long I was doing individual psychotherapy for a small group of people who participated in that particular AA group. As it turned out, the psychotherapy became an important means for them to work out their depression, anxiety and family problems, while continuing to use AA to help them maintain sobriety.

I do not know if all AA groups around the country work in this way. I do know that AA now accepts the fact that many people must be on psychiatric medications of one type or another.

I agree that there are many misgivings that people have about AA. However, in my experience its benefits seem to out weight its weaknesses.

What do you and others think?

Allan Schwartz

[John Rutledge]

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[xenophon]

It is difficult to know what goes on AA. There is no real interest.

As for the abuse, it is unlikely that will be discussed in any venue. If it is discussed, it is unlikely that it will be taken seriously. Religious belief is a private matter. It should not be the concern of AA, nor anyone in AA.


The question is: why have a group at all? people solve the problem on their own on a regular basis. It is done on your own 100% of the time -- group or no group.

[Mark]

The question is: why have a group at all? people solve the problem on their own on a regular basis. It is done on your own 100% of the time -- group or no group.

Many people benefit from group support is why. People need to be witnessed and appreciated by other people. Not everyone, but most. So, even if group support is not something you need, there will be people out there who will do better with it than without it.

[xenophon]

Perhaps. Perhaps not.
It depends, to a large extent, upon the group; the values of the group; the pyscho and social dynamics of the group.

Neither one of which may be life affirming.

Also, there is a time to leave a group founded upon a common problem.

[Abbadun]

First let me say that I still go to AA meetings in fact I will go to a "As Bill Sees It" at Noon today. I enjoy most of the people that I meet at meetings, but I still see a lot of problems with AA and similar groups.

As a Secular person I do not mind the God Talk in AA, but I wish Secular statements were not a automatic reason for the membership to re-qualify the speaker's sobriety.

I find the Literature the biggest let down, too many negative statements about the faults of Secular people because of their lack of faith. AA Literature has too many statements about Spiritual belief that tells the reader that he/she must do this or that. I know that in other statements that the AA Founders state that they do not know everything about Alcohol, but each statement must itself be truthful to create a aggregate AA message that is consistent.

I find AA's refusal to upgrade the Literature worrisome. What other Literature or Doctrine (except that thought to be guided by some God) is unchangeable? All that I have learn in College and before is that organizations (and people) must change and react to society. It is not healthy that AA is so fixated on writings from the 1930's.

I do readings and talks with destitute men in Rehabs and I use some of Hazelden's newer Literature which is spiritual but does not need to be demeaning to Secular People. I like Hazelden's older Literature also.

I get be in AA by not attending meetings using the "Big Book", "12x12" and and similar Literature.

AB

[ASchwartz]

Thank you for your comment. To me, your approach makes sense. In other words, an individual can make use of AA without subscribing to its religious approac in a literal way and, from people I know who do attend, that is a common approach. The particular meeting makes a big difference, an since there are many meetings, one does not have to attend one that over emphasizes religion. At least, that is my thought.

Allan

[Gene S.]

Indeed interesting discussion.
Should this topic be named: The Effectiveness of Placebo Effect?
In this case should we broad this topic to 12 step placebo effect vs Pastoral counseling vs Professional counseling?
Most of the time when MentalHelp.Net makes a referral to 12 steps mutual help groups, a few reasons are given:
1. Cost effective. 12 steps are free (donation based) to attend. Pastoral counseling, some self help peer groups are also free (donation based).
2.12 steps groups are wide available. Pastoral counseling is also wide available. Self help groups have web based network which is accessible if person has a computer and Internet access. (all public libraries have computers and Internet access).

Religious aspect is not the one, that degrades the placebo effect of 12 steps. Contrary, the rest of mambo-jumbo is a determining factor of low effectiveness of 12 steps.

[John Rutledge]

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[xenophon]

AA, or 12step does not fit all. If the shoe does not fit, do not wear it. It is a spiritual [ religious] solution.

It is, basically, revealed truth.

AA and the 12 steps are a tool, which some people may find useful. It is important to to understand that 12 step is just that -- a tool. It is not a way of life, unless you want it to be a way of life.

AA can be useful as a sounding board, a place to ventilate. AA can be a place to hang out until you get better, get worse, or stay the same.

As I stated earlier joining a group focused upon a problem is a choice. People have the right NOT to join such a group, if they deem it unnecessary.

[Mark]

I get the objections to AA that our many secular contributers are talking about. No one likes to be bullied, or evangelized to. And therapists by and large don't have in mind that they are trying to convert someone to a religious point of view when they recommend AA by the way. They are trying to help someone get support to become sober.

Here's the issue I can't resolve. I have seen addicts lie to me so many times and continue lying to me even when it is clear that they are lying - they know it and so do I and yet they still lie. It's safe to say that many addicts are not in their right minds (at least initially during treatment). When someone comes to me who has a substance abuse problem, and they say, "I don't like AA becuase i don't have an interest in being converted to the AA brand of religion", how do I know when they are simply making excuses to avoid pressure to stop drinking/drugging and when they are making a legitimate and rational objection. And what if it is both at the same time? It's a dilemna.

I see lots of complaining about how AA sucks or is an ill fit, but few people talking about how they are finding alternative ways to meet their support and therapy needs (which most addicted people surely have). I hear a lot of talking about how it is important to be able to "go it alone" and some macho talk about how if you want to stop, you will and you don't need assistance to do that, but while that may work for a very few people, I know from experience that it simply doesn't work for the majority. Addicted people are often trapped in a mindset that causes them to reject the help they need.

Which brings me to a related and perhaps more fundamental issue, namely when is it ever appropriate to compel someone into treatment?

Many of the "cutting edge" treatments for borderline personality disorder have elements of cohersion built into them, although not the variety of cohersion that courts practice. For instance, a DBT therapist might say to a chronically suicidal patient, "you can call me before you have a suicidal episode and we'll talk about it, but if you call me during the episode, I will help you resolve the immeidate crisis and then remove you from therapy for X number of months". The idea is that without some leverage on the patient - without being able to threaten the patient with some consequence that he/she doesn't want to experience, it is hard to get them to take therapy seriously. One important aspect of this sort of cohersion is that it is imposed by the patient him/herself - he/she is motivated to avoid breaking the rules, and not by outside consequences like the threat of imprisonment. This same logic does apply to the treatment of addictions but I'm not sure entirely how just now.

Is anyone following me in my thinking (I hope)? Not all cohersion is a bad thing; some of it is necessary sometimes for motivating people to get better. Which isn't to justify abuses that may occur in AA, but simply to say, its not just about AA being a secret hotbed of religious fundamentalism; there may be a reason for the presure in the program that actually is useful. ??????

[John Rutledge]

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[Mark]

Hmmm. Clearly, there are situations in which coercing people into treatment may be necessary for their own good and that of others. Whether coercing people into faith-based programs that do not square with their personal convictions is perhaps another matter.


Intellectually, I understand that point very well. Emotionally, I'm resisting it. Not becuase I'm interested in converting people to any particular faith. Because if I accept that principle, (speaking as a generic therapist), then I have patients who are dictating to me what their therapy needs are. This is not so bad in itself if I have a range of options to offer the patient, but in this case I often don't. SMART/Rational Recovery, I suppose, which is more available than in the past via internet, but these groups are not widely available in face to face format. We (therapy profession) know beyond a shadow of a doubt that social support is very important for healing and recovery in general (not for all perhaps, but for the vast majority - people need to be witnessed and supported - that is a lot of what therapy and none-sick family is about) There is a hole where an important support ought to be.

Perhaps AA ought to fork (split) into orthodoxy and reform movements, the reform movements re-writing the founding book with the aid of what is now known from scientific study of addiction therapies, but still preserving what I think is a vital part of the recovery process from a philosophical point of view - the notion of surrender to a higher power - which we can simply restate as a surrender to benign social influence - the stopping thinking (privately and publically both) that you have all the answers and are self-contained and don't need other people or can operate without impacting them and involving them in your problems. This would be the birth of an ecological self of self rather than a selfish one - the birth of humbleness inside what was perhaps before a very egotistical persona.

The re-writing of the book could be done online - in wiki format perhaps. We could do it here. It would be an interesting exercise at any rate, and maybe it would prove to be useful in practice too. Would that be worth pursuing here does anyone think?

Mark

[John Rutledge]

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[Mark]

John,

Not pointless, but maybe not what you are wanting to hear either. We're all individuals here, and each of us starts from different places. My own position on AA has shifted over the past two years pretty dramatically, as a result of my being open to talk on the site. I personally am not ready to throw the entire enterprise of AA out the window at this point, however, despite my becoming more aware of the serious problems that exist there for some people. I've seen too much good come from it. You don't have to agree with me (God knows, many people don't :)).

I like the idea of rewriting the book, myself, the more I think about it. These problems so many people are having come from the religious attitudes encoded in that book. If the book was something that could be re-written to not be revealed truth, but rather rely on humanistic and scientific principles, it might influence a few meetings and make some change possible that would be harder to happen otherwise. The only people who might find a revised book appealing would be those who are dissatisfied with the original, but hey, there is no shortage of folks like that, are there. And a wiki format would help insure that all dissatisifed (online) voices had an opportunity to participate in the new shape.

Anyway, truly not trying to upset you. Just speaking out loud about a difficult issue.

Mark

[Mark]

By the way, I do not note any response to the comment that "rigorous honesty" may, in some small way, conflict with "giving oneself completely to this simple program" in many cases. Yes, Life is, indeed, too short.

I didn't respond to that quote specifically, becuase I agree with it and do see what you and others have spoken about as problematic. My wish for some alternative to offer people is for one that won't cause them to have an identity crisis they can't relate to (as occured for you in AA) but still have some of the benefits of a peer program like AA.

[John Rutledge]

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[xenophon]

I am not, in principle, against, reformulating the ideas of AA.
Doing that will be very difficult.

No two drunkards are alike. There are generalizations about the characteristics of the various sorts of drunkards that may be useful. That would involve an entirely new DSM, dedicated entirely to dunkards and drunkism.

Rather than call 'alcoholism' a disease, it is more useful to call it a behavior. A behavior that may be changed; replaced with more life affirming behaviors. It is more useful to make a list of those behaviors. As in: instead of drink, I will ____.

Making a list of priorities will help. One will see that all must be done sober.

And, so on.

[Mark]

(JR - hope your cat is feeling better today.)

You know - it may be that I'm thinking about 1) what could I do as an individual (therapist), and 2) what would be a good edition to what is out there today, whereas you maybe were thinking what would be good for you. these might be two entirely separate things. I'm not trying to force any particular program on anyone. Just to try to expand the universe of programs that might be helpful to someone. I stand by my assertion that some support program is generally better than none for the majority of people, even while I also get it that you (and many others) have felt harmed or at least an uncomfortable and ill fit with the support programs that exist. My though was, hey - maybe if we could rewrite the foundational documents of AA, someone might want to pick up on that and do a more rational support program based on them. and that sort of program might be a better fit for some percentage of the people feeling like they are harmed by being forced to consume religion with their sobriety. If you're not into a support program at all, none of this would apply. And no matter what I do or not, therapists will still push some program over none - becuase they are making statements that seem to be most helpful to the average person (which includes many people but definitely not all). It's not a perfect world, and all we can do is to try to make it better.

I went out and actually read over the big book text yesterday and it is copywritten, so any actual rewriting will have to take place offline - we could only post what we had already revised. Or outlines thereof. But in reading over the text, it seemed clear to me that the book itself is mostly motivational writing and that only a small percentage of it is active ingredient (e.g., the steps themselves). The part about athiests and agnostics needs to be excised, as prejudiced and unnecessary and the whole thing needs to be put on a rational and consistent basis - I think the best such basis I can think of right about now would be to formulate it in terms of what is known about developmental psychology and how identity forms over time. At least that is the way I see it in my head right now.

Xeno - do you think that we'd need a full typology of all the different personality varietys of alcoholic? that could be done within the framework of DSM already probably, but if we did it that way, we'd be already saying that this is a disorder/disease.

What shape would you want this revision to have?

[John Rutledge]

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[Mark]

12 step without God/supernatural being is easily possible. 12 step without transforming identity change probably isn't. That Gregory Bateson article from the 1970s I mentioned previously shows the way. Calling the first step a "surrender to a higher power" is just a religous way of talking about what could also be thought of as a developmental identity transformation from a position of self-centeredness (normally characteristic of a child, say, but often persisting into adulthood) into a position of consciousness of interrelatedness with other people. You could talk about it as a simple growth of compassion; a maturity; a loss of selfishness. It's not an either/or black or white thing; it's a process. you tiptoe into it and at some point it becomes clearer. The "higher power" is the consciousness that other people matter and will be harmed if you don't stop yourself. It's probably quite possible to get sober without undergoing this normal transformation of consciousness that occurs during maturation, but then again, it is also possible to get sober without surrendering to a higher power (as you and ohters have pointed out). Just stopping drinking works fine if you can manage it (which many can't/don't)

Glad to know your cat is a little better. That sucks - feline diabetes. At least animals are pretty adaptable.

[xenophon]

mark, reforming AA is not possible. Revealed truth of the 12 step sort and logic are a contradiction in terms.

You would be better off forming your own group.

I realize that dual diagnosis is tough. You would be better off, clinically, if you seriously looked into harm reduction and motivation training.

I very strongly suggest that you into the whys and wherefores of those who quit on their own. You may learn a great deal from those folks. They do know how and why it was done.

[Mark]

You would be better off forming your own group. You would be better off, clinically, if you seriously looked into harm reduction and motivation training.

No tall order there :) I've got five minutes uncommitted tomorrow. that should be enough time to formulate it all :)

I'm aware of most of the good work that has been done with regard to the psychological treatment of addictions. I agree that it should be more widely available. Kind of shocked that it isn't.

I'm not thinking I can convert anyone who doesn't want to be converted. I'm not interested in converting anyone. Nothing like that. There are just a lot of athiest/agnostic AA malcontents out there who feel harmed by how AA is practiced. I'm just seeing a way that the good ideas inherent in AA can work independent of religiosity or spirituality. A varient of AA would work just fine if formulated in entirely humanistic/developmental/secular terms. it would only appeal to those people who are today frustrated with their personal experience of AA, but nothing wrong with that.

Of course, it would make sense to try to build in some of what has been learned about motivational interviewing and relapse prevention, etc.

Curious: Do you all think that rational ideas about recovery are less inherently appealing to people than religious ones? What is it about a recovery paradigm that makes it sell?

[John Rutledge]

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[xenophon]

Quite seriously, I see two important selling points for AA/NA: it is very low cost. And, it is readily available.

Secular group meetings are much harder to find. These organizations are much newer than AA.

SOS and LifeRing are more practical in nature. SMART Recovery is more intellectual. More thinking.

I am not a huge fan of self help groups that are focused on a common problem. I think that there are factors at work within a group that militate against the dynamic of some individuals.

If these factors are known, they may be minimized with professional leadership.

Such a group does not solve the problem. The group is a permissive factor. It provides factual information; it provides encouragement and support; it provides a place to be instead of drink. There are others. But, I think that those are the big three.


There is no one set of ideas that apply to all. Some flexibility of treatment methods seems indicated to me.

[John Rutledge]

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[Mark]

Because one is religious, it does not follow that one can accept the Word according to Bill. True dat (as they say on The Wire). The larger 'malcontent' complaint is that people resent being forced into a mold that conflicts with their basic identity, beliefs and values

I don't know where my choice of 'malcontent' came from but I like the sound of it. I have not seen that show you refer to.

By the way, my experience of AA is not terribly extensive and almost completely external. I know it primarily through the experinces of others. I have not been shy about sharing that.

AA without its very particular religious take would not be AA.


You're all being emphatic on this point. Is that important if whatever would be created would not be AA but something else?

I think the steps could be retained without the idea of a higher power, however and still be just as transformative and useful. Instead of saying "salvation comes from the higher power", you can talk about it as the emergence from one organization of consciousness into another. more like buddhist enlightenment than christian salvation - no higher power required - (although I have something far more developmental psychological in mind than anything buddhists would come up with). I guess I'm not being very clear in my description, however. I recognize this would not be AA anymore, but that is not so important to me what it would be called. I'm really just interested here in finding a way to help people if for the moment only with words. And not having too much success just now :(


(the group) It provides factual information; it provides encouragement and support; it provides a place to be instead of drink. There are others. But, I think that those are the big three.
This is important stuff! Vital for many. Not to be trivialized (not that you are doing this). It also provides a plan and structure, and a way to think about what is happening and what the end goal looks like. It provides a place to go back to and make reports (which helps with sustaining motivation). All important.

I would have to say that I would think long and hard about trying to organise an alternative here.
Is there something to be afraid of here that I'm not comprehending? That's certainly possible. I'm thick enough to miss something completely :)
Are you suggesting that an alternative such as we have been discussing would be actively suppressed, or that it would be just ignored.

[xenophon]

Mark -- if you want to take on this onerous task, you could organize a group of your own. You do group therapy? It would be a good analogue.

Investigate the 12 steps. What do they address? If 12 step is the answer, what is the question? What is useful there?

Investigate SMART REcovery. It is largely REBT/CEBT.

Same with SOS and LifeRing [ they are similar]. And, Women for Sobriety.

What is useful in those venues?

Mix everything up, and make your own.

I think disregarding Harm Reduction and motivational interviewing would be unwise. Going from a pint of gin a day to nine ounces a week is progress.


AA has acquired the inertia of motion. It runs on momentum alone.

[ASchwartz]

I am also concerned about the amount of hostility expressed towards AA. I have known many people who have recovered from alcoholism thanks to AA. If the spiritual part is that annoying to people there is another alternative called Rational Recovery. However, I do not believe they use group meetings.

It seems to me that, despite what the Big Book says, it is the group cohesiveness that plays a large role in the recovery process. Having a place to meet, find support for the addiction issue, speak to people who are also recovering, all of this is what helps move people toward recovery.

Is AA for everyone? No. Does it work for all people? No. Is it perfect? No. Are there other alternatives? Yes, and one of them is Rational Recovery. Also, there is now very effective medication that helps the addict by blocking the craving for alcohol. I have seen some people greatly helped by this.

But, what is puzzling to me is why there is so much anger at AA?

Allan

[John Rutledge]

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[xenophon]

Why the hostility?
It is earned.

Slogans:
You best thinking got you here

Take the cotton out of your ears and put it in your mouth.

My mind is enemy territory.

There are other amusing slogans, as you may guess.

Bad conduct:
Clancy Imislund
MidTown group

Just two examples, I do not want to gild the lily.


Sponsorship: Speaks for itself.

AA has three priniciples of operation:

ego deflation

shame induction

guilt induction

hidden/deniable control

Those are most important.

[John Rutledge]

deleted ....

[xenophon]

Well John, it is sad.

It is real shame that destructive drinking is treated with a doctrine of despair and self defeat. This is 2008; not 1930. I would think that reality testing would have intervened long before this. This thread, if logic and reality meant anything, would not exist. 12 step should have been off the table years ago.

12 step is a doctrine of defeat -- ego deflation, shame induction and gulit induction. Not exactly a recipe for success. It reads as if it were written by a narcissist for narcissists. Not for depression, anxiety, bi polar, borderline. For narcissists. The rooms are full of them. The depressed, anxious, etc are kicked to the curb. Root, hog; or, die.

I hope, one day, reality testing will appear. I am a survivor and and optimist.

[Ray Smith]

I do know that AA now accepts the fact that many people must be on psychiatric medications of one type or another.

Allan Schwartz

Some people in AA may accept that people may need medications, but there is still a very vocal anti-medication, anti-therapy faction of AA.

I worked with an ACT team in upstate NY for a couple of years, all our clients were dually diagnosed, almost every one of them complained that people treated them like dirt for taking medications. Several were persuaded to quit taking their medications causing dire results.

Perhaps AA doesn't do that in some of the upper class, professional, suburban groups, I wouldn't know, but they certain do in the groups frequented by those who are mandated by the courts or by Social Services and other government agencies.

[Ray Smith]

I'm not saying that AA is practiced secularly; I'm just saying it could be.

What mental gymnastics allow you to pray to a God and expect results from that prayer and call it secular?

[Ray Smith]

... In other words, an individual can make use of AA without subscribing to its religious approac in a literal way and, from people I know who do attend, that is a common approach. The particular meeting makes a big difference, an since there are many meetings, one does not have to attend one that over emphasizes religion. At least, that is my thought.

Allan

One could conceivably go to a church and sit there without joining that faith, but for what purpose?

Look at the steps, read the Big Book, read the history of the group, AA is a religious organization, its main purpose it to get right with God; getting sober is a byproduct, not the goal.

[Ray Smith]

Intellectually, I understand that point very well. Emotionally, I'm resisting it. Not becuase I'm interested in converting people to any particular faith. Because if I accept that principle, (speaking as a generic therapist), then I have patients who are dictating to me what their therapy needs are.....people need to be witnessed and supported - that is a lot of what therapy and none-sick family is about) There is a hole where an important support ought to be.

Perhaps AA ought to fork (split) into orthodoxy and reform movements, the reform movements re-writing the founding book with the aid of what is now known from scientific study of addiction therapies, but still preserving what I think is a vital part of the recovery process from a philosophical point of view - the notion of surrender to a higher power - which we can simply restate as a surrender to benign social influence - the stopping thinking (privately and publically both) that you have all the answers and are self-contained and don't need other people or can operate without impacting them and involving them in your problems. This would be the birth of an ecological self of self rather than a selfish one - the birth of humbleness inside what was perhaps before a very egotistical persona.

The re-writing of the book could be done online - in wiki format perhaps. We could do it here. It would be an interesting exercise at any rate, and maybe it would prove to be useful in practice too. Would that be worth pursuing here does anyone think?

Mark

I see so many things wrong with this post I barely know where to begin:

You have a problem with clients "dictating what their therapy needs are"? Since when is AA "therapy" and what makes you think your clients are completely clueless? Do you listen to your clients, how do you know what they need?

I had therapists tell me that if I quit drinking, my depression would magically go away. I explained that depression was a pre-existing condition, that I am an atheist and had tried AA on several occasions and each time gotten suicidal, yet I kept getting pushed into AA in order to receive mental health treatment.

Support?! What kind of support do you think an atheist gets in the rooms? Ask any atheist you find in the rooms and I'll bet he or she staed in the closet about their non-beliefs until they had a few years under their belts, faking it until they were making it in this "honest program". After the treatment I received in the rooms, someone claiming that AA offers support can set me off. I've attended hundreds of meetings in five states over a 20 year period and I haven't seen any more difference than I find differences in McDonalds from one location to the next.

Rewriting the Big Book? Don't make me laugh...suggest it at a meeting, you may get lynched. They haven't changed a word of the first 164 pages since it was written. The Big Book isn't a text book that gets updated, it is a holy text.

[Ray Smith]

I went out and actually read over the big book text yesterday and it is copywritten, so any actual rewriting will have to take place offline

AA lost the US copyright some time ago.

[Ray Smith]

12 step without God/supernatural being is easily possible.

Only if you ignore half of the steps. It's about the same as trying to be Roman Catholic without a belief in God.

It's a RELIGIOUS program. Every time the question has come before a higher court, the final outcome has been at least that AA "is religious in nature".

AA is an offshoot of the Oxford Group, a Christian sect. It defines God, tells you what God will and will not do for you. Meetings open and close with Christian prayers.

People who claim "spiritual not religious" need to look up the definitions of those words; the best one might be able to claim is non-denominational, not non-religious.

[Ray Smith]

There are just a lot of athiest/agnostic AA malcontents out there who feel harmed by how AA is practiced.

You paint a pretty picture of those who are dissatisfied with AA. They're not all atheist/agnostics, you know. Many that have an understanding of the concept of Free Will also have problems with AA. And then there's that pesky "miracles on demand" that most Christian religions denounce. And then there's the more fundamentalist Christian that object to Bill and Dr. Bob's experimentations into the occult. Did you know that Bill claims to have "channeled" the steps from a 15th century monk named Boniface?

AA appeals to lapsed Christians, not people of firm Christian faith, other faiths, or no faith. AA is a religion unto itself, a person unwilling to replace whatever beliefs they hold with those of AA is not going to be made welcome in the rooms.

[Ray Smith]

I think disregarding Harm Reduction and motivational interviewing would be unwise. Going from a pint of gin a day to nine ounces a week is progress.

I'm a firm believer in Motivational Interviewing; not only does it work, it appears to work best for those who are dually diagnosed.

Study after study shows that AA works for about 5% of people, the same as no treatment at all, and that people exposed to AA tend to fail more spectacularly than those who attempt sobriety on their own.

I believe one of the things that is being overlooked here is that dual diagnosis people do not even achieve the 5% abstinence rate that others do. Kathleen Sciacca claims that their success rate in traditional 12step treatment is "too small to be accurately measured". Sciacca achieved a double digit abstinence rate at the end of a two-tear period using MI, impressive for any group of people, but especially impressive for dually diagnosed clients. And the majority of her clients who chose to moderate reported an increase in their quality of life.

More people CHOOSE abstinence and achieve abstinence using harm reduction methods that achieve abstinence through 12step methods. This is evidence-based practices; where are the studies that prove that AA works? There are none, why is this debate still going on?

[Ray Smith]

I have known many people who have recovered from alcoholism thanks to AA...But, what is puzzling to me is why there is so much anger at AA?

How many people failed in order for you to see those successes? It's like looking at a professional sports team, how many people didn't make it in order for you to see the successes? I get very frustrated when I see intelligent people make such foolish remarks based on testimonials by a few true believers.

You will hear the same things from those who got sober while in Narconon (Scientology) or in the Moonies, or in VA programs. People rarely get sober on their first try, but if they keep trying, almost all will eventually get sober. Wherever they were at the time gets the credit.

I can tell you why I get angry, I know what I went through in the rooms, and I see clients going though the same things. Professionals who ought to know better are telling desperate people the same things I was told a quarter of a century ago, telling them to go to a program based on faith healing.

I do not understand where you get the idea that AA is some wonderful support group. People with mental health issues are snubbed, shunned, and often taken advantage of. It is a minefield for those who are mentally fit and how many are when they get to the rooms? Have the abuses in the Midtown Group shown us nothing?

From the Orange Papers:
"Dr. Brandsma found that A.A. increased the rate of binge drinking, and
Dr. Ditman found that A.A. increased the rate of rearrests for public drunkenness, and
Dr. Walsh found that "free A.A." made later hospitalization more expensive, and
Doctors Orford and Edwards found that having a doctor talk to the patient for just one hour was just as effective as a whole year of A.A.-based treatment.
Dr. George E. Vaillant, the A.A. Trustee, found that A.A. treatment was completely ineffective, and raised the death rate in alcoholics. No other way of treating alcoholics produced such a high death rate as did Alcoholics Anonymous."

[John Rutledge]

deleted ....

[bltu56]

The most commented article of all time on Mental Help Net lives in our Alcohol and Substance Abuse topic center. It is titled, Alcoholics Anonymous (AA) is a Cult? (http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=9527&cn=14) and there are literally hundreds of responses made to this article. The article itself is rather simply about my experience coming to understand how much anger there is out there focused towards AA. It was, frankly, a shock for me to realize that there are numerous people out there who have found the AA experience to be completely toxic. Or, rather, I should say, not really so much a shock that people didn't like AA as a shock that there were people who didn't like AA who seemed to have in some cases quite legitimate reasons behind their opinions. In hindsight, it makes more sense to me, and I'm more able to accept the notion that a diversity of individuals requires a diversity of problem solutions. AA being a prominant solution to be recommended for it does benefit many, but by no means the only one recommended. I only wish that there were more secular and science-based self-help programs out there for alcoholics and other addicts.

At any rate, the debate rages on and I don't see that there is any resolution. On the one side are people who have found AA to be helpful and who come to AA's defense when it is criticized. As sobriety is literally life-saving in many cases, who can blame these people for wanting to defend something that has helped them (in their estimation). On the other side are people who have been harmed in their estimation by predators they met in AA, or who are secular in orientation and who cannot stomach the religiousity practiced in many AA settings. I don't believe that AA must be practiced in a religious context, but I do know that it frequently is. And who can blame these people who perceive themselves to have been abused for wanting to warn others about the danger? The two sides will never meet I don't think. In some cases they are talking about two different AAs which are run differently. AA is not a uniform insititution though it does have its unifying steps and traditions. In other cases, people's differing backgrounds lead them to be more or less comfortable in the same setting. One man's poison is another's dinner, that sort of thing. I do note that more than a few commenters don't realize this diversity of experience is occuring and talk as though their personal experience of Twelve Steps is the same experience everyone has or will have. Not true, but an easy mistake to make for some people.

Inasmuch as the debate will continue, I hope to shift it over to this forum simply becuase this forum system is a far better environment for having a debate than the comment system on Mental Help Net. If you wouldn't mind, perhaps you can help us accomplish this task by writing about your own AA experience (or any other experience you are having or have had with regard to alcohol and other substance abuses and addictions). This stuff is a hotbutton issue. If you write something and stake out your position, I feel rather confident that someone from the other camp will come along and take issue with what you've said. It would be funny almost if people weren't speaking from their hearts about such a serious issue as addiction. That's what makes it not funny - that the discussion is about life and death and avoiding damage. that's the part that makes the discussion rather noble from all directions. The urgency comes from people trying to help other people avoid mistakes. That's a really beautiful and serious thing.

Perhaps through further discussion, some people can begin to understand how to integrate the positions in a way that makes sense and not have to feel so polarized and urgent. That would be a benefit to all who achieved it, I believe, becuase accompanying that new understanding would be a greater sense of inner peace.

What do you think?

I first attended AA in 1982. Been off alcohol and drugs since 1984. I was a true believer for my first 4 years. The next four I was on the edge. Still in AA but not as fervent. After 8 years I did not buy the miracle thing anymore. I did not buy "The Chosen Few" BS anymore. I believed I was clean because I was taken away from the life long enough to be able to see past it. I saw that it was possible to live without booze.
I have since atended meetings sporadicly. For the most part keeping to myself my thoughts about god and aa. I did not feel that my agtheistic leanings where appropriate in AA. I did not want to pollute the stream. New people and all people deserved the right to practice as they saw fit.
I was also afraid of rejection and the looks that would come from someone who dared to not buy the hype.
I am still not comfortable sharing my disbelief with old friends who are still true believers.

[JohnD]

At any rate, the debate rages on and I don't see that there is any resolution. On the one side are people who have found AA to be helpful and who come to AA's defense when it is criticized. As sobriety is literally life-saving in many cases, who can blame these people for wanting to defend something that has helped them (in their estimation). On the other side are people who have been harmed in their estimation by predators they met in AA, or who are secular in orientation and who cannot stomach the religiousity practiced in many AA settings.
I've been an active member of AA for some years and am committed to the AA 12 step program. It saved my life, showed me how to deal with the problems in my life, and has given me a contented sobriety. I'm happier now than I've ever been.

However, within weeks of joining AA I became aware that I was being given different advice by different people, and it appeared something of a minefield to negotiate. I found a sponsor, who had shared on Step 4 at a meeting and had impressed me with the thoughtful way in which he approached it. As my sponsor, he never told me what to do. He led by example. If I had a problem with the steps, or with life, we would discuss it and he would allow me to make up my own mind what to do. I use the same approach with my sponsees these days. Over the years I've become increasingly unhappy with some of the advice that is prevalent in the fellowship but which is clearly in conflict with the program, as it appears in the Big Book and 12 x 12. I hope to write about these in the near future but let me give a trivial example now.

I heard recently at a meeting that we were not supposed to do work for other AAs. I'd never heard this before, it's clearly nothing to do with the program, but it's easy to see how it developed. Joe Blow is a plumber and one day at a meeting Hugh Phoo asks him if he will replace the wash hand basin in his bathroom. Joe Blow doesn't like Hugh Phoo and doesn't want to do any work for him so he makes up the excuse that AAs shouldn't do work for each other. Hugh Phoo hasn't heard this before but he tells Ray Fey, who passes it on, and before long a new AA myth is born. These things hardly ever get shared at meetings so they're never subjected to peer review, and they continue with a life of their own. There are other much more dangerous sayings of this type, mostly having come from outside the fellowship, that I really do want to address both here and within the fellowship.

Now, on a different tack, I have to admit when I joined I found the concept of some benevolent higher power hard to take. I had denied the existence of God at the age of nine and had considered myself an atheist since then. I looked down on Christians, considering them weak. They had to have some imaginary crutch to lean on when they were in trouble. I, of course, was able to stand on my own two feet. It was only when I recognized that whenever I had been in trouble I had turned to alcohol I realized that for all those drinking years I had adopted alcohol as my higher power, my God, but it was a God that had wrecked my life and was going to kill me. All I had to do was find something to replace it. It may have been a simple concept but it was hard for me to put into practise. Eventually I managed it and though I don't know what it is, my higher power does give me a belief that whatever life throws at me I will be able to cope with it. It may be horrible and I may not like it, but I have the tools to deal with it. I hope this helps someone.

[Mark]

I've been away attending to family matters for a few weeks so sorry I've not been participating more actively. I'm back now. I see I've certainly staked out a lonely position.

JR's sideways comment suggests I've been making claims to being a "savant" with regard to AA and that is not really the case. For the record, I'm trying to figure things out; not make pronoucements (about AA or copyright law)

Ray's intense anger is baffling to me. Ray, it's as though you believe you are in possession of all the answers here and anyone else who doesn't agree with you must be thick. It's coming across (to me anyway) as intolerant when intolerance is not called for. Maybe I'm just being defensive here. I'm not trying to pick a fight.

Let me be clear that I'm not trying to deny empirically derived techniques their due, and I'm not fool enough to think that someone who was comfortable with (or otherwise emmeshed) in AA as it has been described and is practiced would be at all interested in a secular rewrite of the steps except perhaps to condem it. If that rewrite were to be created, it would appeal to some and perhaps those folks could/would make use of it. I've gotten one email to that effect, actually, and if one person has bothered to write in support, then several others probably feel the same way but have less interest in communicating.

At worst rewriting steps is a fools errand, and at best it becomes a valuable tool for a few people. This would not be a zero-sum game either. It would not be the case that rewritten steps would conflict with other empirically derived recovery techniques. in fact, I would think such techniques would be encouraged. Where is the harm?

Many systems of thinking (like AA) proceed from core metaphors. As many here have pointed out, the core metaphor for AA is a christian religious one; a variation on being born again. In the case of being born again into a church context, a person is originally sinful, then submits to a higher power (God/Jesus), and is absolved of sin. By submitting to the will of God, the person becomes free from sin. This line of thinking is more or less what AA seems to suggest, only watered down. The literal Jesus is substituted for "god as you understand him", and sin is reduced to being out of control with your drinking and being too proud to recognize that weakness (e.g., alcoholic behavior is seen as a moral or psychological failing more primarily than it is a biological one). The whole thing is heirarchical - the power you submit to is "higher" than you. This has potential for abuse, becuase anyone who is in the position of being the interpreter for God, gains that superior heirarchical position and gets to boss people around. If they are not themselves decent benevolent people, there is potential for abuse.

The way I'm seeing it, the heirarchical-submission model could be put aside in favor of a horizontal-appreciation model based on developmental principles. In developmental psychology, people start out with a limited perspective and gradually grow in the complexity of their appreciation of the world. So for instance, babies do not understand the nature of the social world, they just demand to be fed and changed and think that these things just appear. Later they grow to understand that other people are separate from them but still retain the idea that other people are there to either serve them or to get in their way. Still later, people can grow to understand that other people have feelings just like they do and that forms the basis for an understanding of reciprocity and compassion. it is harder to hurt or use other people when you understand that they have the same status as you do.

Instead of submitting to a higher power, it could be alternatively possible to awaken into a broader, more accurate and compassionate appreciation of the nature of your impact on others and others impact on yourself.

In place of
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.we could have something like
We came to understand that our habitual use of alcohol had resulted in our behavior becoming self-centered, and that our emotional lives were empty and that we were lonely, as a consequence of that self-centered-ness.
Came to understand that if we wanted the lonelyness to stop and to have more fulfilling emotional lives, that we would have to become less self-centered, and that if we wanted to become less self-centered, we'd have to give up drinking.
Made a decision to stop drinking, so as to pursue a deeper, more fulfilling, less hollow and lonely emotional life.this above is a weak first draft - poorly stated and absolutely overreaching at present (its certainly possible to be addicted to alcohol and not be a selfish person, for one thing). What I've got above doesn't handle situations of self-medication or really biologically driven addictions very well either. Maybe it can't, I don't know yet. Please keep that in mind. But it does perhaps provide a way for some people for whom the above does apply to have a transformative experience without the need for submission to a higher power.

I'm thinking, again based on the Gregory Bateson article i've referenced in the past, that part of what makes AA work when it does work is its demand for a transformation of self-concept (that born again thing again), and so if we abandon the idea that we are transforming through submission and the taking on of a paradoxical powerless persona, then we still need something to transform into, which in my developing view here ought to be a person who is more compassionate and emotionally available than before and more defined in terms of relatedness to other people, someone who is less narcissistic than before (See my essay about Robert Kegan's work (http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=11433&cn=28) for more on this line of thinking). Someone with a broader more mature interpersonal understanding. Someone who recognizes and accepts that you need other people to be happy and fulfilled and that it is hollow to have a primary relationship with the bottle (just as it is with porn or other people substitutes). So hopefully people will think about this in the direction I'm going and not in terms of the words I'm using now. Something like this can help with motivation without any particular reference to a diety or higher power. There is instead of a literal higher power, a higher understanding or appreciation of the social reality that people need one another (in most cases). An athiest can swallow this and believe it. And none of this conflicts with teaching relapse prevention or that sort of thing, and neither does it alter the utility of doing the moral inventory sorts of things described in later steps which, it seems to me, may have some utility.

I'd appreciate some constructive criticism of the above if anyone has something they want to contribute.

[Mark]

After 8 years I did not buy the miracle thing anymore. I did not buy "The Chosen Few" BS anymore. I believed I was clean because I was taken away from the life long enough to be able to see past it. I saw that it was possible to live without booze.

One of my early feelings of discomfort with AA had to do with there not seeming to be any regular and sanctioned way to mature out of it. When I've stated this before, people have written in to suggest to me that for many there is no need or desire to "mature out" - that the idea is a bad one. But your comment quoted above, bltu56, reminded me of my original concern. A good therapist tries to put him or herself out of business (e.g., by making their client or patient well enough to not need him or her). AA doesn't seem to work that way, and while that might be okay for some, it is clearly not okay for others.

[Abbadun]

Hi Mark

What is worse is that there are so many Rehabs that are centered around 12 Step teachings that have a customer-base (males) that never graduate from the vicious circle of Rehabs. Sometimes those that do become sober come back as employees further establishing this culture.

AB




One of my early feelings of discomfort with AA had to do with there not seeming to be any regular and sanctioned way to mature out of it. When I've stated this before, people have written in to suggest to me that for many there is no need or desire to "mature out" - that the idea is a bad one. But your comment quoted above, bltu56, reminded me of my original concern. A good therapist tries to put him or herself out of business (e.g., by making their client or patient well enough to not need him or her). AA doesn't seem to work that way, and while that might be okay for some, it is clearly not okay for others.

[xenophon]

mark, your guidelines are a good start toward effective guidelines. I would suggest: leave god and religion out of it; always have professional leadership in the meetings; deal with people where they are; treat like any other group therapy.

There are several imporatant issues with AA: The religious aspect; many do not buy it.

There is no adult or professional leadership in AA. The blind leading the blind.

There is no code of ethics. If there were, there are no means to enforce them. People may say or do anything with impunity.

There is no basis for leaving. people, simply, leave.

AA is, basically, a diversion from incarceration. Offenders, as part of sentence by the court, are mandated to attend AA for a period of time. AA has become an adjunct of the criminal justice system. As to whether the offenders do need help, is for them to decide. But this benefits the court and AA. The offender does avoid jail.


There are alternatives to AA.

[Ray Smith]

[QUOTE=Mark;634]Ray's intense anger is baffling to me. Ray, it's as though you believe you are in possession of all the answers here and anyone else who doesn't agree with you must be thick. It's coming across (to me anyway) as intolerant when intolerance is not called for. Maybe I'm just being defensive here. I'm not trying to pick a fight. QUOTE]

My anger comes from having been misled by people in AA and therapists who were either two-hatters or had bought into 12step treatment. When I first got involved with AA, there wasn't any alternative groups or information. I was told over and over by people either did not understand the program or purposely lied to get me in the door, that atheists were welcome and could find help in the rooms.

It has been reinforced by seeing so many dual diagnosis clients who have gone through experiences that mirror my own. I believe the concept of "powerlessness" is the exact opposite of what people need; I believe they need to be EMPOWERED in order to make healthy choices. Some will say I do not understand their definition of powerlessness, and maybe I don't, but I sure understand the way it is used in the rooms, and it's unhealthy.

And it angers me that so many people buy into the hype without examining the statistics. A lot of them smart people who should know better.

5% of people how go to AA get sober and 3% die.
5% of people who try to quit on their own get sober and 0.5% die.
These numbers come from George Vaillant, a member of AA's Board of Trustees who set out to prove that AA works. For a treatment method to be successful, it must cure more people than would get better without treatment. AA not only does not cure more people than no treatment, it has a MORTALITY rate six times higher! To make matters worse, people who have co-morbid disorders do not achieve the 5% success rate of the general public, and since we're discussing this at mentalhealth.net, I'm assuming that we're talking about a dual diagnosis clientele. Kathleen Sciacca states that the success rate or people with a dual diagnosis in traditional 12step treatment is "too small to be accurately measured". She achieved a double digit abstinence rate at the end of a two year period using Motivational Interviewing; the majority of the clients who chose to moderate reported an increase in their quality of life.

I get frustrated when I see people go off of medication because the folks in the rooms tell them they're not really sober if they take medication. I see people who were love-bombed when they first came to the rooms, but as soon as their mental illness became apparent, either through self disclosure or by their actions, are suddenly ignored or snubbed. The dually diagnosed person then will do anything in order to please the AA members to regain their "friendship".

And that's not even getting into the predators that inhabit the rooms, looking for the weakest members.

[John Rutledge]

deleted ....

[mike-lee]

I am a qualified psychodynamic counsellor and thought that perhaps this following article might be useful in the course of this discussion. I also spent over 5 years in AA. My experiences have been both positive and negative. I do believe that the following article reflects my views. AA certainly has the potential to damage people. The whole article cannot be posted here in full, but can be found on-

http://www.unhooked.com/sep/aacouns.htm
- where it examines each of the 12 steps and its conflicts with a range of theoretical principles inherent in various counselling and psychoanalytic orientations.



Alcoholics Anonymous and the Counseling Profession:

Philosophies in conflict

By Christine Le, Erik P. Ingvarson, and Richard C. Page

From: Journal of Counseling & Development, 07-01-1995, p. 603.

This article describes the contribution of Alcoholics Anonymous (AA) to drug and alcohol treatment. The potential for AA 's steps to encourage growth is discussed, and their consistency with counseling philosophy examined. To stimulate constructive discussion, 12 new steps based on counseling theory are proposed and contrasted with AA 's steps. The need for counselors to be aware of these differences is emphasized and the move toward more solid boundaries between AA and the counseling profession is advocated.


AA has also been instrumental in bringing about the acceptance of the disease model of alcoholism (Kurtz, 1988). It supports the idea that some people may be "allergic" to alcohol and unable to use it in any form (AAWS, 1976a), and presents alcoholism as a progressive illness that can be arrested but not cured (AAWS, 1984). Although AA's explanation of alcoholism as a disease is supported by the American Medical Association, its validity continues to be debated in the literature (Erickson, 1992; Miller, 1991; Peele, 1990, 1992). Some of the controversy concerning the disease model has arisen due to a lack of scientific evidence, and from differing definitions of disease (Fingarette, 1988). It is beyond the scope of this article to discuss this debate in detail; however, it should be noted that for many individuals AA's view has reduced feelings of guilt and shame, clarified the cause of their desire to drink, and removed much of the stigma associated with treatment.


As research has failed to assess the effectiveness of AA, counseling theory may be a more appropriate standard of measurement. Through a comparison of AA and counseling philosophy, counselors can have the opportunity to decide for themselves if the AA program is consistent with their counseling values and potentially helpful for their clients. This decision is similar to the numerous choices that counselors must make concerning the use of different treatment methods, models, techniques, and schools of thought. Becoming well acquainted with the AA program will help to make this choice easier and will allow counselors to be clearer on the extent to which they wish to integrate AA into their work.

AA's 12 steps are especially relevant as they represent the AA program and are the member's main guide to sobriety. Because the counseling profession advocates the use of these steps with a wide variety of clients (Chappel, 1992; Polcin, 1992; Ratner, 1988), it is desirable that counselors be knowledgeable about the steps and aware of any differences between them and their own counseling philosophy. AA's 12 steps are therefore examined and their consistency with counseling philosophy discussed.

Because of the diversity of philosophies that exist within the counseling field, the AA steps will be looked at in relation to the theories of selected writers including Rogers (1961, 1980); Maslow (1968); Jung (1933); Homey (1950); Frankl (1959); Perls, Hefferline, and Goodman (1951); Ellis (1989); and Bandura (1982). This selection represents a variety of counseling theories and includes the person-centered, humanistic, analytical, neo-Freudian, existential, Gestalt, rational-emotive, and cognitive approaches to counseling. As there is no single inclusive theory of counseling, our choice will necessarily be both subjective and limited. Nevertheless, as the theories chosen place emphasis on change, growth, and the development of the individual, they are representative of the values held by many professionals in the field, and are consistent with what is taught in most graduate programs in counseling.

To help stimulate constructive thought and discussion, 12 new steps will be proposed. AA's steps have been rewritten by several professionals, including B. F. Skinner (1987), who wished to provide an alternative program for the nonreligious. The goal of this article is not to provide an alternative program, but to offer the reader the chance to compare AA's steps with steps containing principles drawn from counseling theory. Inconsistencies between AA philosophies and counseling values will be clarified and the possible consequences for the client examined.

THE 12 STEPS

Step 1

AA Step 1: We admitted that we were powerless over alcohol, that our lives had become unmanageable.

Proposed Step 1: I realize that I am not in control of my use of alcohol.

AA views the admission of powerlessness as the first step toward sobriety. Here, individuals learn that they are passive victims, resting at the mercy of the greater power of alcohol. Admitting powerlessness has the potential of guiding the individual in one of two directions. The first leads toward the AA program and Step 2. The second, and more dangerous, encourages the individual to view himself or herself as a helpless alcoholic who accepts the futility of trying to stop drinking.

In a profession where empowerment is a widely accepted goal, it seems strange that powerlessness should be the primary focus of the most referred-to substance abuse treatment program. Stensrud and Stensrud (1981) wrote that the helping process can even be dangerous if feelings of powerlessness are increased. It is therefore advisable that, although the first step recognizes that the individual is not in control of his or her use of alcohol, it also has as an underlying rationale the belief that people are capable of self-direction and self-responsibility regardless of their level of alcohol dependence. Egan (1990) pointed out that "if clients are not urged to explore and assume self-responsibility, they may not do the things needed to manage their lives better, or they may do things that aggravate the problem they have" (p. 73). This belief in self-direction and self, responsibility is echoed in the writings of Rogers (1961), Maslow (1968), and Peris et al. (1951).

The AA steps all begin with the plural "we," which may cause individuals to simply identify with the group as a whole without internalizing the steps for themselves, thus further reducing the need for self- responsibility. Having the steps in the first person (using "I" as opposed to "we") helps to emphasize the need for individual decision making and responsibility within the group atmosphere. According to Jung, the need to separate oneself from the collective and find one' s own way is essential for self-realization (Kaufmann, 1989). Because the AA steps are written in the past tense, they tend to imply that once a step has been achieved work in that area has been completed. The use of the present tense in the proposed steps may encourage continuous work on the steps and self in the here and now.

Step 2

AA Step 2: We came to believe that a Power greater than ourselves could restore us to sanity.

Proposed Step 2: I acknowledge that a spiritual awakening can help me to find a new direction.

Having accepted powerlessness, AA's Step 2 reinforces the idea that change is only possible if a power outside of oneself can come to the rescue. The theme of greater forces saving powerless individuals reminds one more of ancient myths than modern day realities, and for many the promised happy ending never arrives. The goal of being restored to sanity also raises concerns. Even though some individuals in the AA community might have unique interpretations for certain words, for many clients and counselors it is unacceptable to label all problem drinkers as insane. Bufe (1991) pointed out that this step promotes the idea of individual helplessness and encourages dependency, which is directly contrary to the usual therapeutic goals of self-direction and independence. Although individuals in crisis may need direction from outside forces to help restore equilibrium, too much reliance on external powers may prevent the development of internal resources (Gorton & Partridge, 1982). Theorists like Rogers (1961, 1980), along with many professional counselors, place faith in the individual's ability to grow.

For some counselors, the emphasis on outside forces and greater powers may be attributed to the recognition that a sense of spirituality is one of the factors that correlates with positive treatment outcomes (Ludwig, 1985; Rogers, 1980). Carl Jung expressed his belief in spirituality as an aid to recovery from alcoholism when writing to Bill Wilson (Adler & Jaffe, 1963). Wilson placed less emphasis, however, on recognizing the spirituality that lies within the individual and on helping people to awaken their own spiritual strength.

Although some clients are comfortable with the idea of a "power greater than ourselves" coming to rescue them, others might feel this aspect of spirituality is foreign and alienating. Thus, rather than prescribing the type of spiritual assistance needed for the client, the focus could be changed to developing an individual spiritual awakening. This awakening could lead the client in a new, personal direction developed from within.

[John Rutledge]

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[jennifer]

To me, spirituallity is not something that can be forced into one's life. Introduced...yes, but many people that come to A.A ,N.A. etc. try too hard to get the spirituallity part and end up frustrated and upset with themselve's when they can't get it. Addicts want a quick fix and a greater power does not usually work that way. A.A. should welcome anyone for what they believe in and some groups have problems with people who don't want to totally work the program in the way Bill W. did it. The twelve steps make sense for everyone's life, alcoholic or not. Spirituality comes when there is no choice but to deal with your pain and the need to feel a purpose in life. We are here to make mistakes,to feel pain, and to find spirituallity in our own ways, at our own times,and at our own pace. If the meetings help you in any way, than keep going, because there will alway's be other people there who rely on you for coming!

[Mark]

Mike-Lee,

That is a great short article that I was not aware of. Thank you so much for posting it here. It's a good feeling to learn about others who were or are thinking the way you're thinking. I'd probably formulate a few of Le, Ingvarson, and Page's proposed alternative steps a little differently, but we are definitely on the same page, or I am rapidly approaching their page at any rate. The written down values that form the core of the twelve steps are not humanistic (person-centered) values but rather Christian ones. As JR and others have pointed out, these values will work for some but definitely not for all.

There's been some talk above in this thread as I've talked about rewriting things that this would be a useless thing to do becuase it would not impact the way AA does business. That perception, it has seemed to me, is a misperception. I never thought that AA could be 'reformed' from within by outsiders. Rather, a revised set of steps could form the basis for other people wanting to form an AA like group (or at least a group based on steps) which was not AA; which fit their values better and therefore would be more supportive for them.

The article reinforces this point:

It is not with AA that changes need to occur, but with the relationship the counseling profession has formed with AA. Numerous treatment centers use the 12-step program without considering whether the principles of AA are consistent with their counseling values and acceptable for their clients.

Counselors and therapists and other people like judges have an important triage/recommendation and social approval role to play. Frequently, people are referred to see such people and AA referals are made by those people. So - if there is a change that needs to be made, it would be to help such people think through the value any given program offers people and the values that it promotes.

Even if there is a real problem with the values promoted by AA, therapists, who are a conservative bunch in terms of how they practice in many cases, will not promote a "healthier" alternative unless it is widespread, and easy for people to connect with. Even better if such an alternative could promote itself as the "empirically validated" choice, meaning that it was open for study and was shown to be useful for some people. This would require a generational shift in the making, just as cognitive behavioral approaches gradually supplanted the non-empirical psychodynamic formulations during the 80s and 90s.

What I'm saying is that if you want to affect how therapists and other influential public figures think of AA, and if you want to have them recommend an alternative, I think your efforts would best be directed towards *growing the presence and footprint* of a sound and scientifically based alternative to AA.

On a different note, I don't speak Latin, but apparently JR does (or is at least better read than I am in such matters). I googled for "Pax tibi Marce, evangelista meus" and got this page (http://www.macalester.edu/courses/geog61/ataff/History%20of%20%20Venice.htm).

St. Mark’s body is stolen from Alexandria by two Venetian sailors and brought to Venice. Legend says that while visiting Venice, the saint had a vision of an angel who told him, "Pax tibi Marce, evangelista meus. Hic requiescet corpus tuum." (Peace to thee, Mark, my evangelist. Here your body shall rest.) The winged Lion of St. Mark, holding a book engraved with the angels word, will adorn almost every building in Venice.


So - here JR is again suggesting that I'm an uncritical promoter of AA. To which I will admit to being a few years ago, but to slap that label on me today produces an ill fit. JR, Ray and others probabably won't be happy until I have gone through the site and scrubbed away all the words they don't agree with. I don't intend to do that, however, prefering the other alternative which is to show that people's attitudes and knowledge can change over time, and that is okay.

[xenophon]

mark, I am in favor of your group forming an alcohol abuse group, and writing a program.

But, I have several suggestions:

It must have professional leadership. God and religion must be left out of it. That is, no opinion on god and religion. It has to be based upon personal dignity, autonomy and self empowerment. None of this shame and guilt. It must be kept confidential. No place for gossip. No gurus.

It would, basically, be a mutual aid society. The professional would be there to stay on task, prevent predation. And, people do graduate.

People who drink too much frequently have issues of mental suffering [ in DSM or not]. Others may not. Sometimes drinking too much is just that. That has be taken into account.


I think it necessary to develp good programs to deal with this matter. As a society, we have to do better than AA. I am glad that you are working on this. As we both know, there are no miracles.

[Gene S.]

So - here JR is again suggesting that I'm an uncritical promoter of AA. To which I will admit to being a few years ago, but to slap that label on me today produces an ill fit. JR, Ray and others probabably won't be happy until I have gone through the site and scrubbed away all the words they don't agree with. I don't intend to do that, however, prefering the other alternative which is to show that people's attitudes and knowledge can change over time, and that is okay.



This is unfortunate that you see anybody critics toward the 12 steps as an intend to change your opinion about 12 steps.
As a professional guidance in 12 steps: idea is not new. You may look at 12-step facilitation (12SF) groups --broadly populated by Hazelden. However, why you want apply the principles that treated an addictions as a spiritual disease, it is beyond my understanding.

[John Rutledge]

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[Abbadun]

Hi Jennifer

You said.............The twelve steps make sense for everyone's life, alcoholic or not. Spirituality comes when there is no choice but to deal with your pain and the need to feel a purpose in life.

It is absolute thinking in 12 Step programs which is the root of the problems that people have with AA.

1. The Steps do not make sense for everyone
2. Spirituality is not infallible, it comes to many alcoholics and addicts that never become sober.

Until AA doctrine stops its absolute mind frame that created a dogma that says that one must do this or that to become sober the program will continue to not work for most people. Until AA doctrine does not judge people who think differently because the founders of AA said those groups were no good, AA will always be offensive to many.

AB



To me, spirituality is not something that can be forced into one's life. Introduced...yes, but many people that come to A.A ,N.A. etc. try too hard to get the spirituallity part and end up frustrated and upset with themselve's when they can't get it. Addicts want a quick fix and a greater power does not usually work that way. A.A. should welcome anyone for what they believe in and some groups have problems with people who don't want to totally work the program in the way Bill W. did it. The twelve steps make sense for everyone's life, alcoholic or not. Spirituality comes when there is no choice but to deal with your pain and the need to feel a purpose in life. We are here to make mistakes,to feel pain, and to find spirituallity in our own ways, at our own times,and at our own pace. If the meetings help you in any way, than keep going, because there will alway's be other people there who rely on you for coming!

[xenophon]

Quite, Abbadun.

What is called 'recovery' is unique to an individual. Some people may want what AA offers: a 'spiritual' program; structure; discipline; a simple guide for living [ 12 steps may typed on one sheet of paper]; ego deflation; shame induction.

Others may not want any of that. The issue turns upon the individual -- the wants, needs, beliefs, thoughts, feelings, experience, etc -- of a discrete individual. Human beings are not paper dolls.

It is important to point out that most people solve the problem on their own or a minimal involvement with a group. How and why people do that is largely unknown. Knowing the how and why of those people who quit on their own is important. There are costs involved in ignoring them.

[jennifer]

Why do people find A.A. so offensive? I,like others, go back and forth on this issue. Why the problem with finding a "higher power?" I understand that no one needs rules and regulations to have spirituallity, but as an addict of any sorts, chaos is huge factor in one's life. The twelve steps try to break that down, so there can be structure and clarity.
I,myself, have found out what I believe in on my own.When I read the twelve steps, it just made sense to me, because I was already practising that to be a better,sane person.
I know a person who has been with his group for 3 years now, and he struggles with spirituallity too. He cannot accept his year medallion because he has gone back to the occasional drink. It may bother some from his group, but most are accepting for he is living his life for himself and believes he can handle it. But his behaviour is not really changing. The steps never got done, and change seems to have halted to a stop.
I don't believe the answer is changing A.A.,N.A.,etc, way of life,because it has worked for millions for so long. The choice to go back and use is ones own fault. Either, find your own way or like what has been stated in other posts, start a new kind of group.
In Brantford here, there is a group that has no religion whatsoever used, has moderation as the key,and even subsitution of another drug is accepted. How about dealing with life without using something that alters ones perception? I don't know what the success rate is in on the group, but many get seen going back to A.A. or not coming back at all! It is hard to stay clean and sober,when the guy next to you is still smoking weed but not doing crack, or staying off prescription pills and drinking. Anyway it is done, it needs to be done by getting help with dealing with life, instead of avoiding it.Many people go into meetings feeling ashamed,guilty,and with an attitude with authority, for they have thought of themselves for so long.How else do you break that down? Like stated before, it is about the individual, and what they are looking for in life.

[Mark]

Jennifer,

Mostly, where this thread has gone (at least for me) is to point out the need for a more widespread alternative, secular and hopefully scientifically based group system that runs parallel to conventional AA. I don't think it useful possible or practical to try to pry people out of something that is working for them (or not working but in which they are enmeshed). I do think that there are many people (a minority but a bunch of them) who find AA to be toxic and would benefit from an alternative fitting the above characteristics. The need for it to be widespread is so that average people can make use of it and not just those who are technologically elite (to participate in online discussion) or those who live in big, more progressive cities. In my opinion, it won't be until such an alternative group has a large presence that it will be taken seriously by therapists who work with addicts so that referals will be made. I do think that many therapists have an uncritical stance towards AA. Critical doesn't necessarily mean negative - it just means aware. recovery will work out best when people are matched to a workable program that makes sense to them.

Mark

[JohnD]

I've been in AA for some years and the only rules I've identified are to do with anonymity, confidentiality, and avoiding bringing AA into disrepute. We have guidelines for how groups are run, but these are not rules. They are disregarded when it is seen fit by the group's conscience. There are no rules regarding recovery. Some people choose to study and follow the 12 step program. Some do not. In the book "Alcoholics Anonymous" it says "These are the steps we (the early members) took which are suggested as a program of recovery". It is just a suggestion. In my experience those who do the steps live more contented lives than those who don't. No one tried to force me to do the 12 steps, that was my own choice.

The 12 step program is "spiritual". What does that mean? According to one of my dictionaries spiritual means "highly refined in thought and feeling". I think of it as "pertaining to the higher emotions". Some find this through religion but in my experience most do not. They find it, as I did, through practising the 12 steps. There are good things and bad things going on in my life. I deal with the bad things when I need to but I cherish the good things. Before I came to AA I dwelt on the bad things and forgot about the good. Now I do the opposite. That has taken away one very powerful excuse to drink.

Most drinking alcoholics feel an enormous amount of guilt and shame when they've not consumed enough alcohol to anaesthetise themselves. When we get sober that doesn't go away, at first it may intensify. AA does not make us do this. It happens naturally. We need to deal with these feelings or they will never go away. People who practise the 12 steps find out how to deal with these feelings. In step four, our voyage of self-discovery, we find out what is good and what is bad about ourselves. It is the only opportunity most AA members get to see themselves as others see them. Being aware of our faults may help us to eradicate them, or we hand them over to our "higher powers" or even our subconscious if we can not. It allows us to come to terms with ourselves as we really are. Later steps deal with making amends to people we have wronged. Whether they forgive us or not it does free us from this burden of guilt, and it leaves us with a free conscience. We no longer need to look over our shoulders as we walk down the street. The skeletons in the cupboard have gone. Far from making us feel shame and guilt, AA program frees us from it.

John D.

[mike-lee]

Mark, thank you for the response. I came accross this article when researching for my research proposal which was focused on the experiences of people who are committed to the twelve steps approach and being in counselling at the same time. It is a qualitative research proposal and ties in somewhat with what you said regarding AA and any possible change that might occur regarding the nature of the programme, in that perhaps the research will be useful in playing a part in discovering if there could be adaptations to the current AA setting which may be more therapeutic for some people.
I believe that AA currently contradicts itself in some important areas, in that although it is often said that the 12 steps are suggestions only, further reading of the AA literature will reveal strong, dire warnings regarding those who do not thoroughly follow the suggestsions, thus raising serious questions over the degree to which individuality and questioning of the programme is allowed or encouraged.I found this aspect of AA very difficult to accept when I was in the midst of my existential module whilst training! Indeed the conflict between the two was a motivation in my ending my association with AA.
Personal experience in addressing my own defenses and exploring myself in the transference relationship yielded far more benefits and transformational experiences than AA ever did for me, however, it did support me in my decision to address my alcholism, when I had made a decision to do so, and I am grateful to AA for that.

[swolf154]

Why do people like to debate an organization that has been around for over 50 years, Helped millions recover from alcoholism and Basic Text is published in 52 Languages? I don't see them going out of business real soon. I've been in recovery for 18 years and use all the tools people have to offer. When my thinking and mental illness is off I see my Doctor and therapist more. When my spirituality is off I attend more AA meetings and do more step work. The only time I get confused is when people bring their therapy into AA and AA members bring AA into my group therapy.

Steve W :)

[JohnD]

I got sober in London. London was one of only two places I ever wanted to live. It is one of the world's cultural centres and I had a choice of concerts, movies, exhibitions etc. that I could get nowhere else in the UK. I also had a very well paid job, earning over twice the national average wage. The other place was a wild countryside area which I valued for it's scenic beauty and the long walks I could do there. It had for a long time been my wish to sell up in London when I retired from work and move to that countryside where property and the cost of living are much cheaper. When I came into AA I had been out of work for six years and had been forced to sell my home nine months earlier as I could no longer borrow money to pay the mortgage. I moved into a rented flat. After paying my debts I still had a substantial sum in the bank.

Two months into sobriety I found a job as a sales assistant. It was the best I could do at the time, I'd never be able to get a job in my old career again. I was, in fact, very grateful to get any job at all. Four/five months later I got fired and simultaneously got notice to quit my flat. Over those months I had come to realise that I could no longer afford to enjoy those concerts, movies, etc. If I stayed in London I was going to have to work long hours just to pay the cost of living. Any entertainment was going to have to be paid for out of my savings. That future, with my savings haemorrhaging away did not appeal to me. I thought if I moved to the countryside as planned I could buy somewhere to live with what I had in the bank, live very cheaply and survive on whatever work I could find. I talked about this with my sponsor and went off to check property prices, job availability, AA meetings etc. in my chosen place (a small town which I'll call X). The UK was deep in recession at the time, property prices were low and there were millions unemployed. I found that there was more work available in X than in my part of London, the AA meetings there seemed to suit me and I could just afford a comfortable flat leaving me with a prudent reserve. I put in a very low offer for the flat, it was a buyer's market, and we agreed terms. I got back to London feeling jubilant. My sponsor, a hard-headed businessman, knew my plans were sound. Then I told other friends in AA. "Oh, you can't make a major decision till you're a year sober." they chorused. Well, I'd been to over 200 AA meetings by then and I'd never heard that. I heard it from so many that I started to doubt my plan and it caused me a great deal of distress. However, my sponsor, bless him, didn't agree with them. I continued with my plan and moved into my flat in X in the December of that year. In the new year property prices started to rise and by March I would not have had the money to buy property here. Had I followed the advice and waited till I was a year sober before putting my plan into action I could no longer have afforded it. My dream to live in X would have been lost for ever. It would have been a disastrous mistake.

So where does this rule come from? Nowhere in AA literature does it consider a year's sobriety to be significant. Why should it? It's just an anniversary. It's not a qualification. Some people come into AA, get involved in the fellowship and the program and make rapid recoveries. Others drift in and out and struggle to stay sober for years. How could a one year rule apply to both? Age limits and time limits are beloved of our legislators. That's not because they are right; it's because the are convenient. In AA we don't need to do what's convenient. We can try to do what's right. Add to that the warnings in AA literature about procrastination and we can see the one year rules aren't even compatible with the AA program. Add also that the 12 x 12 tells us only to give advice that we are competent to give, nobody in AA should be spreading this garbage. We've spent years using alcohol to hide from reality, when we get sober that has to stop. We can't live in a vacuum for a year just because we got sober. We need to learn, or relearn, how to make considered decisions. A good sponsor will help sort out the pros and cons, but the decisions must be ours.

In fact the one year rules come from treatment centres, according to people who have been to such places. Why they are told this I don't know, but as there is a constant influx of new AA members coming from treatments centres it's hard to get rid of in AA. It may save some from making bad decisions but missing out on good decisions can be just as disastrous. There are disaffected former AA members out there as a result of having fallen foul of this. But don't blame the AA program. The blame lies elsewhere.

John D.

[jennifer]

From what I hear, the first year is supposibly the hardest year,if you are totally clean and sober, but I still think that is about the individual themselves. The addict is up and down, and not really clear headed. And sometimes, making decisions can be impulsive ones, without thinking them through first. And adding change and stress to ones life, might cause unnecessary feelings of being overwhelmed. For example, my spouse is about a year clean, and all of a sudden, a couple of weeks ago, he decided that we need a new car. He had drove up in an Acura that he was test driving and had already been to the bank to talk about finances. Even though I did not agree, for money is already tight as it is,and we only have had our other car for 3 years, he wanted it and he was going to bug me until I agreed. This is how he use to get when he wanted out of the house, or money, during his active addiction. He would be really nice and than that would change into acting like a child and throwing tantrums, until he got what he wanted. Well, now we are picking the car up on Monday.I still think it is an impulsive decision that he thinks is going to make him happy,but only for a bit.
So, is it usually smart to wait things out until the head is clear to make big decisions that effect everyone?I think so, for it was the thrill of being "spontaneus",and the boredom of everyday life, as to why we have a new car. He is unable to see his behaviour and to think in realistic and unselfish terms to see what he has just done. Do I think that A.A. members were trying to run your life,no, ...just giving advice like anyone else in this world and it will always be up to you to make the choices in your life without blaming others for what might of happened "if" you took what they said to heart. A.A. is a support group, no need to take it further than that. Take what you can out of it and leave the rest.

[xenophon]

I think it quite likely that a person brings to the table their own personality and state of mind. If a narcissist abuses, he remains a narcissist, and so on.
In vino, veritas.

Human beings are discrete individuals. There is no more a typical or "real" alcoholic than there is a typical or "real" cancer patient. Putting people into categories obviates the need to treat human beings as individuals with dignity and respect. When a mortal human being is consigned to a category, all is permitted.

All that has a greal deal to do with what is called "substance abuse treatment".

[Ray Smith]

There's been some talk above in this thread as I've talked about rewriting things that this would be a useless thing to do becuase it would not impact the way AA does business. That perception, it has seemed to me, is a misperception. I never thought that AA could be 'reformed' from within by outsiders. Rather, a revised set of steps could form the basis for other people wanting to form an AA like group (or at least a group based on steps) which was not AA; which fit their values better and therefore would be more supportive for them.



People on the inside couldn't change it even if they wanted to, the first 164 pages are holy text.

And why would you want to attempt to fix something that never worked in the first place?

[jennifer]

I understand exactly what you mean,for it is like a generalization, which many in society do. If you call a child no good all there lives, than that is going to affect them. There should be no labels on anyone person. Children that are born hyper and unable to function at the "normal" level, are considered to have Attention deficit disorder, and put on medication. We need to accept people for who they are. That is where I don't agree with A.A., for I, myself, who used alcohol as a way to self medicate,but steered myself away from that for it was affecting my life negatively. I know I wouldn't want to call myself an alcolohlic my whole life because I am more than that, and I feel that even though I can't handle alcohol anymore, I would like to think that I am in control over that aspect of my life and that is not who I am. Respect and honesty is definitely the answer.

[John Rutledge]

deleted ....

[xenophon]

Alternatives do exist.

The first, and best, method is the most common. Do it yourself. Happens every day. People quit entirely or successfully cut back every day. And, little is known of people who solve the problem on their own. With good reason.

The alternatives are small because all are fairly new and a person is supposed to leave when finished with the job. AA wants to be huge -- empire building -- and does not want people to leave.

I am in favor of mentalhelpnet setting up a face to face group for their clients. It would be like any other therapy group that mentalhelpnet has. Science and common sense.


AA lives by coercion. Coercion is the prime recruitment tool for AA. never forget that.

[Abbadun]

Hi Jennifer

I find AA lacking because too many times its literature states that one must find a Higher Power to get sober. I dislike that AA Doctrine always portrays secular people as bad people. I am sorry but ideas like this do not belong in a program that is supposed to be about helping people.

AA Literature mentions the respect and tolerance that the program has for the beliefs of others, well in practice the Literature never shows the least bit of common decency toward Secular people.

AA does not have to get rid of Higher Power, but it can no longer say that it is the only way, there are too many sober secular people out there for such a lie to continue in AA.

Another problem is that the literature intentionally or unintentionally contradicts itself many times. It is problems like these that attracts objections toward AA.

This is not about Higher Power, but is about the teachings of AA showing at least a lowest level of common decency towards people of all types of spiritual beliefs.

AB

[QUOTE=jennifer;776]Why do people find A.A. so offensive? I,like others, go back and forth on this issue. Why the problem with finding a "higher power?" I understand that no one needs rules and regulations to have spirituallity, but as an addict of any sorts, chaos is huge factor in one's life. The twelve steps try to break that down, so there can be structure and clarity.

Snip

[JohnD]

I share my story of the advice given to me about moving from London occasionally at meetings. On one occasion a woman came up to me afterwards and said she had got into a relationship when six months sober and it was a disaster. The matter of AAs making relationships and marrying/living together is covered in the 12 x 12. Bill W. compares two different cases. One is where the couple are long-established AAs with a secure sobriety which he writes have a better than average success rate. "It is only where boy meets girl on AA campus and love follows at first sight that difficulties may develop." The long-established members will know that passage and need no warning but what do we do with the newcomers?

I once attended a meeting where two newcomers who didn't know each other, both without a drink that day, arrived together early at the meeting. There was only one other person there, and as he was setting up the meeting the two newcomers got chatting. They returned the next week together and on the third week it was clear that there was more than just friendship between them. One of the older members (a female) decided to have a word with them and, taking them aside, suggested that it wasn't a good idea for them to start a relationship just at present, that they should wait till they had longer sobriety. In another case a man who had been sober three months, who was attending meetings regularly, had a sponsor and had started studying the 12 steps, met a woman outside the fellowship and they started a relationship. Other AAs went to his sponsor and said the recent AA shouldn't start a relationship until he was a year sober and that the sponsor should put a stop to it. The sponsor thought about it, decided he didn't know whether this relationship would work out well or badly and that on that basis he didn't have the right to break up the relationship. He contented himself that if things went wrong he would be there to help pick up the pieces and so did nothing. Which of the two, the female advisor or the male sponsor, if either, got it right, and which got it wrong?

[JohnD]

The couple who met at their first meeting never returned after their third. They believed that AA members would try to split them up and they felt they had to choose between AA and each other. They got a flat and moved in together. After a few months he started drinking again and she threw him out. After that I lost track of them. So what did our intrepid AA member achieve with her advice? She may well have signed someone's death warrant. How much better it would have been if we had all been able to welcome them into the fellowship as a couple and support them if all went wrong. In the second case the relationship proved to be very supportive and the couple have been together now for over 15 years. I know them well. I was his sponsor. I think that for me to have given in to the coercion of others and to have attempted to break up that relationship would have been downright wicked.

The "rule" that AAs should not start relationships until they are a year sober is another that comes from treatment centres. It is easy to see why. Treatment centres are full of desperately distressed and confused individuals and some seek comfort in the arms of others. This gets the centres very bad publicity and it can be even worse when someone like Elizabeth Taylor marries someone she met at a Betty Ford clinic, a match that so many felt inappropriate. Given that he ended in jail for beating up a subsequent girlfriend the many may have been right. The "rule" has more to do with public relations than recovery. Having treatment centres telling people when they can start relationships and having AAs do so are different matters. If it happens in AA then there are people outside, academics, doctors, researchers for governments etc. equating AA with sects like the Moonies. This inevitably brings AA into disrepute. It should never happen, as it is not part of the AA program, but some mistakenly think it is. For people who drift in and out of relationships at the drop of a hat it may be a good idea for them to restrain themselves. For those who are more circumspect and choosy about their potential partners finding one is a big deal. For a sponsor to fob them off by telling them to wait till they are a year sober is a dereliction of duty. The sponsee needs help in deciding if they are getting into it just to make them feel better, in which case they are better off out of it, or whether this is a potentially good relationship which deserves further investigation. By the way, the woman who told me she got into a bad relationship at six months sober got into another one several years into sobriety. That was a disaster as well.

I indicated in my last post what Bill W. had written about it in the 12 x 12. He suggests strong AAs have a GOOD chance of making a good relationship and newcomers MAY be in trouble. He doesn't say they are. You may think he is sitting on the fence. He is - of course he is. He has the humility to recognise that he doesn't know, and that he can't legislate on the matter. It is unfortunate that some in the fellowship think they know better.

[xenophon]

The last two posts have laid it out clearly.

Do not go visiting in another man's life.

The issue is: adult leadership.

[Ray Smith]

So - here JR is again suggesting that I'm an uncritical promoter of AA. To which I will admit to being a few years ago, but to slap that label on me today produces an ill fit. JR, Ray and others probabably won't be happy until I have gone through the site and scrubbed away all the words they don't agree with. I don't intend to do that, however, prefering the other alternative which is to show that people's attitudes and knowledge can change over time, and that is okay.

Just because you're a professional, I don't expect you to instinctively know everything, but be able to change and adapt when faced with new information; a real professional doesn't stop learning. You'd be amazed at how many people won't listen to any negativity about AA at all.

And BTW, I've listened to several of your podcasts in order to learn more. I never finished my degree in Human Services, but was hired by an ACT team a while back for my substance abuse and alternative treatment knowledge.

[Abbadun]

It is common knowledge that most people fail at Sobriety a few times. AA Doctrine (customs) is quick to point out to a person that relapsed what AA suggestion that they have ignored.

If one stays in AA with open eyes you will see people who know how to "talk the talk" quietly relapse over and over without other members seeing the need to dissect their behaviors or lack of behavior. All they get is a "welcome back, keep coming"

AB



[QUOTE=JohnD;851]The couple who met at their first meeting never returned after their third. They believed that AA members would try to split them up and they felt they had to choose between AA and each other. They got a flat and moved in together. After a few months he started drinking again and she threw him out. After that I lost track of them. So what did our intrepid AA member achieve with her advice

Snip

[xenophon]

It is clear that opinions regarding AA are polarized. A useful and verifiable truth may lie somewhere in the center. AA is useful to some people. AA is not useful to others. AA is such that actual psychic harm may insue.

It is not impossible that the clientele of AA are such that a solution is very difficult to implement. That is, for some who are very dependent upon alcohol, the prognosis is poor. I accept that. That may be a reason for the low success rate of AA.

For many, the drinking is the tip of the iceburg. They also suffer from mental disorders. The drinking is a serious obstacle; the drinking really compicates matters.

The key, I think, is getting a grip early in the process. I think that the professionals here may agree with that. A possible approach is motivational interviewing and helping people find reality based options to drinking to assuage mental suffering. Many people do drink for that reason -- assuage mental suffering.


There are viable options to AA. All are much smaller than AA.

They include: SMART Recovery; SOS; LifeRing; Women for Sobriety; Moderation Mangement and HAMS. The last two are harm reduction.

[Abbadun]

Hi

Lifeline meetings are just starting to come into my area, still too far away to visit often. Even if Secular meetings were in my area I think that is would still be important to point out the gross ethical problems in AA because too many addiction workers are far too embedded in AA to be fair and of any help to Secular people coming to them for help.

I have sat in meeting with Addiction Counselors paid by the state and listen to them state that clients have to get a higher power, but not to say this in front of Case Workers from the Dept. of Social services.

Abbadun



It is clear that opinions regarding AA are polarized. A useful and verifiable truth may lie somewhere in the center. AA is useful to some people. AA is not useful to others. AA is such that actual psychic harm may insue.

It is not impossible that the clientele of AA are such that a solution is very difficult to implement. That is, for some who are very dependent upon alcohol, the prognosis is poor. I accept that. That may be a reason for the low success rate of AA.

For many, the drinking is the tip of the iceburg. They also suffer from mental disorders. The drinking is a serious obstacle; the drinking really compicates matters.

The key, I think, is getting a grip early in the process. I think that the professionals here may agree with that. A possible approach is motivational interviewing and helping people find reality based options to drinking to assuage mental suffering. Many people do drink for that reason -- assuage mental suffering.


There are viable options to AA. All are much smaller than AA.

They include: SMART Recovery; SOS; LifeRing; Women for Sobriety; Moderation Mangement and HAMS. The last two are harm reduction.

[xenophon]

AA does greatly benefit from the inertia of unconsidered good opinion. It is the automatic option. Chosen by many, owing to that inertia.

That opinion will not change quickly or soon. But, people vote with their feet every day. 95% are gone within one year. And, there are no exit polls. Denial does not answer the question of why do these people leave? The concept of denial is an evasion of the question of why do people leave in such numbers.

Denial is a convenient idea. It allows the avoidance of the difficult matter of: Am I doing something wrong?

Something is wrong here. If alcohol dependence and alcohol abuse are to be taken seriously, changes in the methods have to be revisited.

In this life, one is either the hammer or the anvil.

[Abbadun]

Hi

Does anyone think that many Churches other than the Unitarian Universalist would house a Secular Recovery Group? The Secular Groups on the fringes of my area all seems to be housed in Hospitals, Community Centers or Foundations.

Marketing place (store location) is just as important as price and advertising to the success of a product. Well AA has a monopoly on the greatest locations for Self-Help Recovery Groups

AB



AA does greatly benefit from the inertia of unconsidered good opinion. It is the automatic option. Chosen by many, owing to that inertia.

That opinion will not change quickly or soon. But, people vote with their feet every day. 95% are gone within one year. And, there are no exit polls. Denial does not answer the question of why do these people leave? The concept of denial is an evasion of the question of why do people leave in such numbers.

Denial is a convenient idea. It allows the avoidance of the difficult matter of: Am I doing something wrong?

Something is wrong here. If alcohol dependence and alcohol abuse are to be taken seriously, changes in the methods have to be revisited.

In this life, one is either the hammer or the anvil.

[John Rutledge]

deleted ....

[xenophon]

No one really wants to associate very closely with drunkards. Just as no one really wants to associate with the "mentally ill". There is real stigma attached to both. I do not expect that to change.

Maybe both hit pretty close to home. No one is really immune from either.

I do not know about those who have mental suffering and want help. I expect that most are pretty much on their own. I know that I was.

Same with those who drink too much. A person in that situation is not going to get competent aid. What they will get is 12 step. That is worse than nothing.

Better to do it on your own; accept it. Read and learn all you can about how to get a grip. And, do it on your own. There really is no good option.

[Mark]

Better to do it on your own

That may work for you, but I know that is not the best method for all. Many people really need social support and guidence as to methods for not relapsing, etc. it's not as simple as you make it out to be.

[Ray Smith]

That may work for you, but I know that is not the best method for all. Many people really need social support and guidence as to methods for not relapsing, etc. it's not as simple as you make it out to be.

Bad treatment is worse than no treatment.

Why is the mortality rate in AA so high? (Vaillant) Why does being in AA result in more binge drinking? (Brandsma) Or increase the rate of rearrests for public drunkenness? (Ditman)

AA has a 5% success rate* so does quitting on your own. If a treatment method is to be considered successful, shouldn't it cure more people than no treatment?

*Rand Corp; the Sobells; Vaillant; "During Bill's stay in Akron, he and Bob calculated their success rate to be about 5 percent..." Bill W. A Biography of Alcoholics Anonymous Cofounder Bill Wilson, Francis Hartigan, pages 91-92

[xenophon]

I have come to the conclusion that AA does not really do very much of anything -- good or bad.

At best, AA is a variety of replacement therapy: go to meetings, do the steps, etc., instead of drink.

It does give people a place to hang out -- go to a meeting, instead of the bar.

The 12 steps are basically busy work.

Getting a sponsor does not accompish a lot. It can help for people who want to be told what to think, feel and do.

If a person is going to get better, they are going to get better. AA has very little to do with either getting worse or getting better.

[SuziQ]

My goodness--such carrying on about AA. I guess someone was sentenced to meetings or they would not be so upset. I just went because I had a problem and because of that I stayed and worked the steps. I saw no harm in them and they helped me look at myself and change. Should people be sentenced to AA? Just dump them on the group and let AA deal with their anger and ridiculous behavior? Probably not.

I have no clue how many stay or go or get sober or stay sober. AA doesn't keep track. And that was precisely why AA worked for me. AA doesn't have rules, it has suggestions. There were structured groups and non-structured groups. Some were religious and some weren't. I am sure it would not have worked for me in a small town so not only does AA not work for everyone, but it doesn't work everywhere. I got sober in the LA area in the sixties. What a wild time we had---all us undisciplined AA members. We went on picnics--to the beach--sat in coffee shops 'til 2am and worked to support ourselves. At first, sobriety was almost as much fun as drinking---then as time wore on---it became more fun than drinking. I unabashedly love sobriety and having control of my behavior. If I decide to be outrageous today, it is with my full knowledge and knowledge of possible consequences. Did I believe everything about AA? Of course not. And I didn't have to. No one ever asked me to leave a meeting or told me not to come back. If I followed the steps and wrote down what I did wrong (according to my own principles) told some one else and then had to make amends---then I thought about what I did. And writing down what you did wrong is a great practice. It is just too much trouble to write a bunch of lies and excuses to yourself and it is very tedious. Being helpful to others is nice and causes pleasant sensations.. I always knew that I was not the center of the universe--so a higher power was not difficult to accept. As a child I had wondered if we were like an ant colony in a universe too big to even see or understand.

Did AA keep me sober? No, but it gave me tools to use to keep myself sober. And it gave me examples of what those tools could do and how to use them. I got to choose which people I picked to watch and learn from---based on my own observation. I was assigned to no one nor told I had to be like anyone. For me, AA was a gate to freedom.

So after all these years Don't knock it until you have truly tried it and and if you don't like it---then just walk away. Do I attend AA today? No. My drinking and using was for about a five year period. I would not define my life by a five year period---and stay stuck there. I'll be 74 this summer. I loved my years in AA and it was not a bunch of drunks. There were many very bright, sober people I still love and miss. AA is about a bunch of sober people. Bars are about a bunch of drunk people.

I could go on and on, but that's enough for now.

SuziQ

[John Rutledge]

deleted .....

[SuziQ]

Hi John,

Sorry you had a bad experience in AA. And there are many who do. As with any approach to addiction, it does not work for everyone. And, I went many years ago. I also had been to psychological therapy and some doctors were great and some were nuts. I read many books and some helped and some didn't. For whatever reasons, I am not very worried about the opinion of others and wasn't back then either. So, the group was never my conscience and I was single and no one pressured me to do any thing. I feel the same way today.

I don't think that I am unique. I was fortunate to be in a well educated group of people who were critical --maybe skeptical--of the program and we spent many hours discussing the nuances of the program. And the general climate was different---it was the sixties--and rebellion abounded. There were cults and saffron robes, gurus and chanting, sex therapy, nude therapy, scream therapy and hippies. I lived at Venice Beach in So Calif.

Turning one's "life and will" over to the care of anyone or any group is dangerous and AA does not suggest that. It says turn your life and will over to the care of God as you understand him. I took it a step further. If I planned a picnic and the day turned out to have severe storms, then I turned my life and will over to the care of nature that day and didn't go. AA is made up of individuals and some are pretty sick and some aren't. I would never push any specific type of therapy on anyone. No one said that reasoning and logical thinking could not be my higher power. And that is generally my higher power, but that, of course, fails me at times. I do love that alcohol and/or drugs are not my higher power today and that they do not govern my behavior.

As I stated, I am not sure AA in a small town would have worked for me. Actually, that is when I stopped attending meetings--when I moved to a small town. I simply was not interested in anyone else's opinion of my sobriety or my lifestyle. And I am not a very "free actor", just a free thinker. No one would ever say I live some outrageous lifestyle---but some days I would like to. I'm too old now.

I don't have the "Big Book " around anymore so I can't debate specific passages. And, no, I am not on a dry drunk---thanks for the positive observation-- I am just living life as it presents itself on a day by day basis.

Also, thanks for your comments. I wish I had printed them so I could reference them as I write this---I blame my age for my forgetfulness--and even that is open to discussion--

SuziQ

[SuziQ]

Hi John,

One thing I did miss in my response. I did work the steps and in many ways continue to do so. Those are the tools that I talked about. And, of course, I am the one who stayed sober and I will take credit for my sobriety. If I were a mechanic and repaired a car with the help of a diagram, schooling, and certainly tools, I would say I repaired the car. I use many tools for sober living, but AA was the first tool and I am glad it was there for me. Actually, it was the first time I linked my crazy behavior to drinking. I thought there was something wrong with me. What a relief to find that most of the stuff I pulled on myself and others stopped as soon as I stopped drinking.

Have a good day. Do you live in Europe?

SuziQ

[John Rutledge]

deleted .....

[xenophon]

It is important to be the driver. AA may be useful to some as replacement therapy or a social group. A place to hang out until you get your act together. Then, walk away.

[John Rutledge]

deleted .....

[SuziQ]

Hmmmm Are you, who wants to be the driver, ordering other people to walk away from AA ? What exactly do you wish to be the driver of---everyone's life? I wish you a pleasant trip and lovely scenery on your personal trip through life. I plan to have the same---even though we take different routes. There are many roads to chose from and they ALL end at some point, so I will simply make my journey as I choose and wish you the same.

[xenophon]

chill out.

Every mortal human, at the end of the day, drives his own life.

Some people choose 12 step. Some people do not. That is the point.

Human beings are moral agents who make choices.

[SuziQ]

I think what has bothered me so much is the bashing of AA. Did anyone get sober on their own? I mean did they NOT go to AA ? If they did not, what did they do? What are the steps they took to stay sober? How is it working for them now? Did they have a problem beyond drinking--like drugs?

AA is about the only game in town for many people and it is there 24/7 and free. It is not perfect, but lots of people get sober there. If someone is looking for help to get sober, is what is being said here going to help or just make them feel as if there is nothing to help them? Maybe there ought to be a subject called "After AA". The plain unvarnished truth is that if I were drinking today and I wanted help today---the ONLY place I could go TODAY is AA. I could call to see if there is a rehab center, but I would wait until insurance is approved, if I had insurance. I could go to a therapist, if I had money and could get an appointment---but most therapists don't treat drunks who are still drinking. So somehow, I would need to get sober to go there.

Actually, I get re involved ( mentally) now an then when I help someone.My neighbor and I met a woman living in her storage shed selling everything off. I got her off on the plane Sunday to her mom's house at her request. She is 48 and her life is a mess. I did not take her to an AA meeting. Her daughter has about 6 mo sobriety and I'll let her handle that. I had her SSI check so I had the money to cover her ticket. She cashed it her last day here and paid me. She could have stayed with me, but I told her no alcohol, so she slept in the storage unit except the last night. She still took a walk to the local VFW and drank that night. She will get sober or she will stay miserable or she will die. Some crazy doctor has given her a script for oxycodone and she is using those as well. I hope this woman goes to AA. I hope that she gets sober and gets her life together. I hope she selects someone who is not a nut for a sponsor. And, if she decides not to stay in AA, I hope she continues to stay sober. And, I totally ignored her talk of God and that He sent her angels to rescue her and I was one.

I have not been to a formal meeting in years. Last week I met another woman near my house and we got into a conversation about the the drunk woman and our own personal experience in AA. She is sober and fine---just sort of outgrew AA, like me.

So with all the reminders of those years so long ago, I just visited this website to see what is new. Not much different from then, some sober people arguing that AA is not for them and that it doesn't work. I will readily admit that AA will be very difficult for home drinkers. Someone needs to
want the social aspects of AA to attend and like it.

So whatever floats your boat--but don't keep shooting torpedos at mine.

[SuziQ]

I noticed in Post 38 that Xenophen talks of Clancy. What exactly do you know about Clancy ? I , who have known him personally, am curious about your perception and personal experience with him. We do butt heads, don't we ? Still haven't read all the posts, but I will.

[Ray Smith]

[QUOTE=SuziQ;1508]I think what has bothered me so much is the bashing of AA. Did anyone get sober on their own? [QUOTE]

I've answered this question time and time again. Read it on the DangerThinIce website or IndyMedia or Yahoo! Answers. Google "Why do people bash Alcoholics Anonymous?"

It ends with:
"Why should AA be immune to valid criticism? Where are the studies, the facts and figures that prove AA works? All you have are the testimonials of people who claim AA worked for them, what about the testimonials of those who say it didn’t and those who say it harmed them?"

Seriously, I'm getting tired of giving out the stats from the Brandsma study, the Vaillant study, Walsh, Ditman, Orford and Edwards, what have you got to show that AA works? The Moos study? All that showed was the longer someone was in AA, the more likely they were sober.

People got sober on their own for thousands of years before Bill and Dr. Bob told the world it couldn't be done.

Alcoholics Anonymous is of particular disservice to people who are diagnosed with mental illnesses, the idea that this is even a debate on a mental health board is a shock to me.

[SuziQ]

Actually, you could post them everyday--and I would not care. I did not know that AA said that it was the only way to recover. The lady across the street used to be one drunken hell raiser---she is sober today and has not attended AA. Her drunken husband died and she quit drinking.I also was not aware that AA was supposed to help with mental illness--

And so it goes. Those who want to believe AA helps will believe that and those who don't will believe it does not help. If I am tired of AA bashing---well, then that is something I am tired of. If you are tired of trying to post statistics that show it only helps 5%, well that is what you are tired of. They are each personal positions. Those it did not help are just as correct as those it did help. I just hope that those who feel the need to get sober are able to get sober by whatever means they can and that their lives are better than they were before.

If you are shocked by this topic on this website---I suggest you email the administrator.

[John Rutledge]

deleted ....

[SuziQ]

Hi John,

You are one beautiful man !!! I probably, as I do with most things, just took what I needed and left the rest. In fact, in the meetings I attended that was one of the mottos. I remember sitting in church as a child staring at a stained glass window with God is Love printed at the bottom and hearing "hell and damnation" from the pulpit. We had a family in our church who had been missionaries in China and they talked about that. I decided that God would not create the world and people so different from us and then comdemn them to hell just because they didn't believe my particular concept of religion. And if that is what He did, then he wasn't a fair God. I, also, believe that the Bible was a book written by men, translated by men and edited by men. So, maybe, I have no religion at all. I do hope that my God is the one who judges me, if there is an afterlife. So, I guess that in AA, as in politics and religion, concepts are best left unsaid---if one wants to "get along". So, if I am not sober, please don't tell my family. They have enjoyed the fact that I don't drink or use drugs for many years. I am somewhat aware, on some level, that I often don't think like a lot of people I know.

I still will encourage people to go to AA. They will maybe stop drinking and never know that they are not following the "true program" as it was written. I have never been great with directions and can't imagine how I passed phlosophy in college. If something works, I use it and if it doesn't, I move on. I probably don't embrace anything wholeheartedly--always have some reservations. So, here's to our years of not drinking and many more !!

[Abbadun]

Hi John

As a Secular person I find that a Secular person is first faced with the out right derogatory statements by AA Literature toward Secular people. Then there is the smaller passive-aggressive AA Literature anti Secular Statements.

For example the Literature makes blanket statements about Secular people such as we are doing things alone or do not believe in anything bigger than we are.

Then there is the AA Promise that we can use a God of our understanding. Now if AA Literature was a legal contract I would sue for the right to use anything or nothing as the God of my understanding.

I would love for the image of AA to finally degrade to the point where the membership will finally be moved to fix all the mistakes in AA that hurt and even kill some people.

That being said I do go to meetings for the goodness of the AA members, not that the Literature or Foundation merit attendance. AA is like a necessary evil for me.

Abbadun


Er... actually, if you add up all the "points of attachment" of AA dogma (as Revealed in the Big Book and "Twelve and Twelve") with alcoholic reality, it does really suggest that the only road to Recovery (as defined by AA) is through taking Step One, and then working through the Twelve Steps, without interruption, to your dying day. This is the only option allowed to those "driven to AA by the lash of alcoholism" (Bill really loved alcoholics, didn't he ?) - unless one counts miserable alcoholic death. Of course, "Recovery" per AA means something other than merely not drinking, and the simple benefits accruing from that course. To be blunt, it means conversion at some level to the religion of the "God of the Preachers" - to the religion of Dr. Frank Buchman's "Oxford Groups" of the early 20th century. Before someone objects - Bill Wilson said as much. According to AA, the happiest mere ex-drinker is still a denying, suffering dry drunk. In itself a sort of death, perhaps ? To attain true AA "Sobriety", one must do (and perpetually do) the Steps, "prayer and meditation" (Eleventh Step - read Buchmanite "Quiet Time" seances) and all.

Of course, this does beg a question - does what most people mean by "recovery" equate with AA's "Recovery", and does what most people mean by "sobriety" equate with AA's "Sobriety"? I think that the answer must be, "No". It surely requires a huge leap of faith (and I use the term advisedly) to accept that in order to attain the benefits of a simple recovery from the plagues of the Evil Spirit, one must subscribe to the bargain-basement Buchmanism propagated by Bill W. and Dr. Bob. Simple release from addictive practice and its associated ills are all that most entering the Rooms for the first time want. Self-denigration, self-abnigation and a "God-controlled" life guided by "God" through a spiritualistic program severely at odds even with the mainstream Christian faiths and with their emphasis on scripturally-based revealed truth is all too often what is actually "suggested" to the newbee. By the way - I am a Buddhist/Stoic (or perhaps a Stoic Buddhist), and I am not hung up on the Bible or the Qu'ran, but I still feel the point is worth bearing in mind.

Again I echo Dr. Stanton Peele - if people find AA helpful, and can accept Bill W's version of Buchmanism or, in the alternative, cod themselves into believing that they accept it for the particular purpose sufficient to their personal recovery, well, fine. I would not decry this positive aspect of AA, for the people concerned, for a minute. Perhaps the more fundamental question is, whether there should be more of a challenge to AA's proposition that "Recovery" means just one thing, and that all would-be ex-alcoholics (although AA would reject the concept of an "ex-alcoholic"") should want that one thing that AA members "have got", in the form in which they "understand it".

For all I know, there are as many roads to true recovery as there are to God (however one may understand "Him"). This, however, is a perspective that is denied by AA, and is in consequence effectively denied to a huge number of suffering alcoholics hemmed in by the effective Twelve Step monopoly of recovery options over large parts of the world, and by the uninformed complicity with and approval of the AA model on the part of the therapeutic community, mainstream religious institutions (which, if they examined the matter, should really know better) and the public at large which - even without ridiculous phenomena like the US "court mandate" - soul-massage the sufferer into a program unsuitable to many, but viewed by the community in general as a safe containment zone for a problem that few have the clarity and courage to face up to, even in their own lives and families.

Maybe it should just be easier to recover without being forced to "want, specifically, what (AA members, they claim they) have got". Maybe it would be better if, when this dubious "medicine" fails, it were more practicable to try an alternative, rather than being forced by theraputic fashion and legal or social pressure to return to drink from the same bitter well. Maybe - but the prospects for this in the context of current fashion in the addiction treatment sector seem, for the time being, remote. I stand apart, and live in Hope.

Live Long and Prosper,

[xenophon]

To say that AA does little-- either to help or hinder -- is not "bashing". That does not make me a man of stones either; anyone who calls himself xenophon cannot be. I am not alone in that life is, frequently, an anabasis.

AA is, I think, basically, a permissive. It is not, really, dynamic. It is driven; it does not drive. AA may be thought of, by some, as a driver. That error may be problematic at times.

What does AA actually do? Not what it 'wants' to do. What does it actually do? I submit that it does very little. basically, it gives permission to quit destructive drinking.

It is not easy talking people into and out of things; destructive drinking is little different from any other behavior.

[John Rutledge]

deleted .....

[SuziQ]

You know, guys,

I used bash in the context of the definition of "to hurl harsh words at" and so that is what I perceived. This is all so much nonsense. It is the same thing that led me to quit attending meetings---just on the opposite side of the coin. I listened to the podcast and don't really disagree with much said. If I had plenty of money and was seeking relief from an alcohol problem today, I could go to him and pay him. But it has been 42 years since I started AA---and that is a long time ago and much has changed and alcohol is really not a part of my life anymore. I haven't attended meetings in probably 30 years. I just have a look-see now and then when I cross paths with someone who is having trouble. There ain't no therapists in this little ole town in Texas--and not many big towns nearby. So for them ignorant and uninformed people with little or no money who are struggling with an alcohol problem---what exactly would you suggest? Many of the people with alcohol problems around here will never see this anyway---they don't have computers.They have pickup trucks and fishing poles and guns and are sitting down by the lake with their ice chest full of beer getting drunk. And their family is sittin' home wishing they'd attend AA. Any way, have a nice night all

SuziQ

[Mark]

One lesson I've taken from all of this discussion is that i'm glad to know there is a diversity of approaches for people who want to do something about their drinking. If AA works for someone, that is fine. I've been educated by this discussion to realize that more people than I ever thought have had problems with AA, and I'm glad to know that there are alternatives to it, although as I've pointed out before, not in the smaller towns and cities. The internet goes a long way towards helping that situation, but not everyone has access (or wants it). It's also hard to get quality treatment for not-everyday-seen medical events in a small town - that's just the nature of a small town environment. not a lot of specialization in such settings.

[John Rutledge]

deleted ....

[SuziQ]

Hi John and All,

Problem is----I have no answer !! The even more bizarre thing is that I did not even know about AA/NA until I came home to detox from heroin. My mother found them in a newspaper article. At that time, it was illegal for anyone to treat a person addicted to heroin. I had not used long, but I was physically addicted. I, frankly, found the first relief in my life in that drug. I call it "the granddaddy of all tranquilizers". Problem was, it caused more problems than it cured. I had my first use because I was very physically ill and someone who used it gave me a very small amount in the muscle to kill the severe pain until they could get me to the hospital. It, also, killed the emotional pain and I was on my way to that addition.
My drinking was totally out of hand at the time--sometimes 30 days binges. The alcohol had led me to "lower companions" so I knew people on drugs. I did not stop drinking when I used. I did both.

AA/NA did save my life in many ways. That I chose to leave for many of the same reasons others talk about does not mean that it did not work. I did not get drunk or use when I left---I just moved into a different phase of my life. And many I knew who left AA did not leave to drink---they stayed sober---but after they were sober a while, did not like the rhetoric. So, in my mind, it worked to get me to a spot where I could find something that suited me better. And, nothing else had worked. I had therapy, 2 stays in psychiatric units (the only thing available then) and really never connected my behavior to alcohol. AA is so adament that I could not fail to see the connection. I did a fourth and fifth step and saw a lot about how I operated in my life. It was very helpful.

Do I believe that it is necessary to stay in AA forever? Absolutely not--unless it fits your mindset. I see it as the ONLY starting point available for many people. For many people, if they don't fix up that old Toyota (no matter how faulty)---they will never have a car. They must use what is available. I defend AA because it defended me until I could defend myself.

And, guys, I forgot to mention the female alcoholics run down to the local VFW and embarass the heck out of their families. Don't want to be sexist about this.

And, yes, John, my kitties are fine. Thanks for asking. A three legged kitty-- I know you must love him/her.

To all--have a great day and don't drink---no matter what method you use.

SuziQ

[SuziQ]

I was 31 years old. I had really screwed up my life. I was 3 days into detoxing from heroin. I had started college at 15 with a 93 out of 100 percentile ranking on my admissions test. I had three kids. I was sooo ashamed. I wanted to change. The only people I knew by then were the people I used and drank with. A member of NA drove to my house and took me to a meeting. He said he understood. He said I would be ok. He said I was welcome and they would help and I would never have to go back where I had been unless I wanted to. At that meeting there was Charlotte, George, Rick, Hank, Bob, Wally, Julie and myself. Wally went back out after a few years, Julie was in and out and has a serious personality disorder, but did function for a number of years. Hank died a couple of years ago sober. Bob died sober and the rest of us are still fine.

Those people gave me hope--those people gave me understanding--they gave me love when I was unlovable--They listened to me--they taught me to live and laugh again. In our small group of eight--all made it for a while and 6 of us made it permanently. Later, some came and some went. One came in who knew me, but I had no recollection of him. He said I was always drunk when he saw me. I was a little embarassed, but we all laughed.

And so I changed and grew and finally left to move on out into a different place. They were right--I did not have to go back to where I came from that night. To this day, I have no idea what the concept of God was to any of them. We didn't discuss it--we discussed how to find work, how to become better human beings, how to avoid pitfalls that could lead us backwards instead of forward.

We went to the Pacific Group on Tuesday night (Clancy's group). I never had sex with Clancy. Occasionally, he'd get lucky---but not very often. I, occasionally, told him I thought he was an ass, but it did not affect my sobriety or his.

So, does AA work? Hell, I don't know. If I am a therapist and my patient gets drunk, is it that I am not good or that alcohol was simply more attractive? Just as I loved my husband who couldn't stay sober, I loved AA with all its faults. And. just because a life preserver saves my life, I don't carry one around with me, but I will throw one to a drowning person.

So keep coming back--life is so much more interesting without alcohol.

Night, John. How many kitties do you have ? Take good care of your three legged one--it is a reminder that one does not have to be perfect to be loved.

SuziQ

[xenophon]

I suppose that we are getting to the point of defining the problem. And, the realization that AA is only one route. That is an accomplishment.

I just have the small thought that it is difficult for many to understand obsession with drinking alcohol. perhaps it may be useful -- clinically -- to associate it with other obsessive compulsive behaviors.

Also, people are unique. The severity -- time and amount - varies; the reasons for abuse vary; etc.

[Abbadun]

Hi

One of the reasons that I like to speak out about the many major problems in AA is that in my area AA has a strangle-hold on the self-help addiction groups. Too many Addiction Counselors and Rehabs herd people in AA and other groups simply do not have a chance. One way to fight this is to constantly highlight the many problems with AA and like programs.

AB


I suppose that we are getting to the point of defining the problem. And, the realization that AA is only one route. That is an accomplishment.

I just have the small thought that it is difficult for many to understand obsession with drinking alcohol. perhaps it may be useful -- clinically -- to associate it with other obsessive compulsive behaviors.

Also, people are unique. The severity -- time and amount - varies; the reasons for abuse vary; etc.

[SuziQ]

Hi Abbadun

I wonder if explaining all the other programs and all the things they do that AA does not do would not be a better way. You cannot ask a person to let go of the only lifeline available to them until you can present a better one. And although I have not read all the posts, where are the ones about how I got sober in program X or Y ? Even the podcast---the guy started with AA. And most of the people so unhappy with AA got sober there originally.

Here in the US, we live in a Judeo-Christian society. Those men who founded AA lived here and wrote what worked for them---based on their upbringing and values at that time. And like it or not, I live in a community based on and governed by mostly "God-fearing" people.

I have asked "what do you suggest?" and I get answers about how AA does not work.

I agree with Xenophon, AA is only one route---so ---let's move on and talk about some other routes. If AA is NOT the route for you, why keep focusing on it? Just let the people who get sober in AA be happy with their sobriety and you be happy with yours---however you got it. Share with us what you are doing. I know I would be open to hearing new things.

By the way, someone posted to me in private email a most wonderful definition of Buddhism written by Albert Einstein--no other comment, just the definition. I wrote back asking why she sent it to me, but have not received an answer. ( It wasn't John, it was a woman and I have not seen her name on any posts) That definition opens up new avenues to explore--even at my old age. And I was so grateful to get it.

SuziQ

[SuziQ]

Here ya go---some new treatment ideas and a BOOK to go with them. Don't know that I could pay the cost, but it does appear to address a lot of the concerns some have. Go to passagesmalibu.com For some different religious ideas---try--- spaceand motion.com/theology-AlbertEinstein

I have just sort of looked over the sites, but there they are anyway.

Xenophon---Passages seems to address a lot of the issues you brought up in your last post. It just showed up in my spam mail and I decided to look it over before deleting it. It really looks interesting. See what you think.

John---you might like the space and motion website.

Enjoy--I'll be out of town for several days.

SuziQ

[Claire Saenz]

Hi all, I'm new here, but I'm not new to the debate about AA.

By way of introduction, my name is Claire, and I'm a 48 year old lawyer from Pittsburgh who has been sober for 10 years. I went to AA for 9 years, happily for the first 5--but the last 4 were hell. It was as if, once I finally got beyond my addiction to alcohol and brought some emotional health on board (mostly through therapy) the people who once helped me started trying to bring me down. My therapist told me I was emotionally healthy and we discontinued therapy, but in AA it was: "Remember, Claire, your best thinking got you here." "You suffer from the disease of 'first thought wrong.'" "Claire, when you're in your own head, you're in a bad neighborhood." "Remember, Claire, you only have a daily reprieve, contingent on the maintenance of your spiritual condition."

The story of how I finally decided to leave, despite the warnings of inevitable relapse if I did, is far too long to repeat here. But suffice it to say that I am glad I left.

I do credit AA for giving me some helpful things at the start of my recovery, group support and acceptance most of all, although certainly such things can occur outside the AA format which, as someone accurately noted, has no exit plan.

Now to comment on the following:

Hi Abbadun

I wonder if explaining all the other programs and all the things they do that AA does not do would not be a better way. You cannot ask a person to let go of the only lifeline available to them until you can present a better one. And although I have not read all the posts, where are the ones about how I got sober in program X or Y ? Even the podcast---the guy started with AA. And most of the people so unhappy with AA got sober there originally.

SuziQ

There are several alternatives to AA available right now, including SMART Recovery (which is based on REBT), LifeRing Recovery, Rational Recovery, and Women for Sobriety. Indeed, they are all much smaller groups than AA, but it is hard to see how they could be otherwise when nearly every treatment center (at least in the states) is based on the 12 step model. In short, it seems to me that one reason alternatives "don't exist" (even though they do) is that people who might prefer them are sent to AA and kept there whether they like it or not. It is not as if someone who doesn't like AA goes back to their 12 step rehab counselor, says "you know, AA doesn't seem like my style" and is given a referral to SMART Recovery. No, such a person is told they need to "go to any lengths" and to work on steps 1-3 (at the end of which the person is asked to make a decision to turn his will over to the care of God).

In short, we'll only have other real alternatives when we stop taking the position that AA is the only, or the best, choice.

[SuziQ]

Hi Claire,

Welcome. If you read my posts you will know that I have not gone to AA in years. Also, none of those programs existed when I got sober. I do not know how I missed the problems with the rhetoric--but I did. I don't mean it wasn't there--I just didn't care. Still don't. I just plain got tired of the focus on what was no longer a problem for me.

So, what type of tools are used in the programs you mentioned ? That is what I mean about other programs. Have you been ? How has it helped? What is different? I know the names--I just don't know what they offer. I know Rational Emotive Therapy because I took a course in it and all the counselors used it when doing counseling, but AA was the only actual program available to refer them to back then. And there were no treatment programs My therapist did not suggest I go to AA. But I was already sober.

Maybe I just think differently from other people. And if that is the case, then it has little to do with AA or any other program. If something doesn't make sense to me---I just ignore it. I, and I alone, am responsible for maintaining my sobriety. When I was a counselor, years ago, my groups were based on individual responsibility--for your sobriety--for your actions--for your reactions--for your happiness. NO program will keep you sober unless you wish to stay sober. NO program can dictate how to live your life or what to believe in and if you let it ---then that is your choice---not theirs. If you do not like what is available in one program---go look for another. It is your responsibility to determine the course of your life. I got sober and I started reading books about alcohol and about therapy and how to books and some were great and some were nonsense. Going to AA did not stop me from doing anything I wanted to do, but it did remind me that drinking was not a good idea. Dogma was not popular in LA in the 60's and politically correct was not even heard of--so maybe AA is different today. I know what the "book" says but most of us just ignored a lot of it and it was ok. Guess I'm just out of tune--but I kinda know that. Getting old is a bitch.

SuziQ

[Claire Saenz]

Hi Susie,

I appreciate everything you are saying and I know a number of people like you, folks who were able to do the proverbial "take what you like and leave the rest" thing. And that's fine. The important thing is that you are sober.

But others, like me, don't have your temperament. Hand me a book that says "AA does not demand that you believe anything" on page 26 and "We saw that we had to reconsider [belief in God] or die" on page 30 (this is in the 12 & 12) and I'm going have trouble with it. And I don't want to be told "more will be revealed" or "your mind is a bad neighborhood" when I question it.

Also, the question of "what do those other programs offer?" can easily be answered by a google search. They all have websites that clearly spell out their methodology, and they all have chatrooms and online meetings. Here's the one for SMART Recovery, which happens to be the one I gravitate towards:

http://www.smartrecovery.org/

I must admit though that, probably like you, I don't particularly NEED a program anymore--another great AA myth is that one needs a program forever. I like SMART recovery because it makes sense to me, but I don't need it, because I never struggle with drinking anymore. It isn't an issue!

[SuziQ]

Hi Claire,

Didn't mean my response specifically for you---just was sort of rambling. Think I'd take the posh Passages program (20 hrs of one-on one therapy each week)---if I'd had the choice back then--or maybe not. My self esteem was at such a low point that I might have decided they wouldn't want to accept me. Still, I had a great stay at Cedars Sinai just before I got sober. Lots of celebrities--spent the afternoon at Dinah Shore's house--her daughter was at Cedars and she asked me to go home with her. Her dad was such an a** and she didn't want to deal with him by herself.

Self esteem has always been an issue for me, but being old helps a lot. I get my Soc Sec check no matter who likes me or approves of me. It just got in the way of earning a living. I was always worried I'd get fired and have no money to support the kids. Went to law school for a year when I was about 3 yrs sober. Somehow, raising teenagers, earning a living, going to meetings, dating and all the reading and writing briefs was more than I could handle. I couldn't type and that didn't help. I never had issues about my ability to do things--just about my ability to be acceptable. AA accepted everybody--I desperately needed that.

So, like you, alcohol is not an issue with me today, and when it is no longer an issue---AA is a drag. And, no, there is no exit plan, but I don't think the founders planned to exit. I'm glad you are here.

SuziQ

[xenophon]

People do exit. Not very many people stay in AA.

There are competent alternatives to AA: LifeRing; SOS; SMART Recovery; WFS. Those are goups for those who wish to be involved in a group. One need not be involved in a formal group.

There is Rational Recovery for those who do not wish to join a group. RR is a variant of quit on your own.

Some folks, for their own good reasons, decide that participation in a group is the correct way for them.

A problem is that for people in distress, making informed choices is unlikely and/or difficult.

[Abbadun]

Hi Suzi

Threr is a lot wrong in AA Doctrine and some of it can not and should not be ignored. Each of those "errors" in AA Doctrine takes away from the overall merit of the program. At some point you have to stop and accept that there are a lot of mistakes, contradictions and lies in the Foundations of AA.

AB




Hi Claire,

Welcome. If you read my posts you will know that I have not gone to AA in years. Also, none of those programs existed when I got sober. I do not know how I missed the problems with the rhetoric--but I did. I don't mean it wasn't there--I just didn't care. Still don't. I just plain got tired of the focus on what was no longer a problem for me.

So, what type of tools are used in the programs you mentioned ? That is what I mean about other programs. Have you been ? How has it helped? What is different? I know the names--I just don't know what they offer. I know Rational Emotive Therapy because I took a course in it and all the counselors used it when doing counseling, but AA was the only actual program available to refer them to back then. And there were no treatment programs My therapist did not suggest I go to AA. But I was already sober.

Maybe I just think differently from other people. And if that is the case, then it has little to do with AA or any other program. If something doesn't make sense to me---I just ignore it. I, and I alone, am responsible for maintaining my sobriety. When I was a counselor, years ago, my groups were based on individual responsibility--for your sobriety--for your actions--for your reactions--for your happiness. NO program will keep you sober unless you wish to stay sober. NO program can dictate how to live your life or what to believe in and if you let it ---then that is your choice---not theirs. If you do not like what is available in one program---go look for another. It is your responsibility to determine the course of your life. I got sober and I started reading books about alcohol and about therapy and how to books and some were great and some were nonsense. Going to AA did not stop me from doing anything I wanted to do, but it did remind me that drinking was not a good idea. Dogma was not popular in LA in the 60's and politically correct was not even heard of--so maybe AA is different today. I know what the "book" says but most of us just ignored a lot of it and it was ok. Guess I'm just out of tune--but I kinda know that. Getting old is a bitch.

SuziQ

[SuziQ]

Hi Abbadun

I, frankly, do not see that I EVER said that AA or any other program was perfect.

So, if you feel that you will win some sort of debate by my saying it is not perfect---fine. You won---now what?

I am not and will not be in some sort of contest to see who is right and who is wrong. I cannot say for sure and will not research it---but, most, if not all, literature has inconsistancies and contradictions. So What?

I have stated my personal beliefs and my personal experiences and, even there, there may be inconsistancies. So I am not perfect either. Big deal. I knew that a long time ago.

SuziQ

[Claire Saenz]

To me, the critical point is that whatever the merits may be of AA, it is clearly not for everyone. It does not have an impressive success rate, and it appears to lack the institutional capability of addressing (or even acknowledging) the variety of abuses that exist within the program.

Yet, despite these deficiencies, nearly all treatment in the US is 12 step based. Why? AA and its progeny (NA, CA, Al-Anon, etc.) get almost universally favorable press, so much so that the general public genuinely believes that the answer to everyone's addiction lies in some 12 step group. Why?

If alcoholism, or addiction in general, is indeed a "disease", then why isn't it treated like other diseases? Why do we send the diseased person to a "treatment center" that is little more than a conduit to a faith healing group, and tell him that if he fails to improve, the problem lies with him, rather than with the treatment?

These questions, to my mind, need to be addressed...but instead of addressing them it seems like we often get wrapped up in a debate about whether AA has any merit at all. Can't we agree that it DOES, for some, but not for enough that it should be the only game in town?

[SuziQ]

Claire,

AA started back in the 30's. I have no idea how it became so popular, but suspect it was by word of mouth. People are strange. Some like one TV show, some like another. As a disease, treatment can be covered by insurance. As for treatment centers, they were not, as such, known much when I got sober. Abuses cannot be addressed as the whole thing is set up as individual groups with no one in charge. I think TV and the internet have a lot to do with the hype of almost anything. Therapy is very popular today. Some therapists are great, some are lousy and some are abusive. Religion can be abusive and many don't agree with it, but it still persists. It can be healing for some, destructive for others.

Write a book about the abuses of AA, get it published, hope it becomes a bestseller and MAYBE then there will be a shift in public perception. ( This is not meant for you, specifically, just as a suggestion)

There is so much out there that I do not agree with--a pill if you are unhappy, a war I personally did not believe in, outpatient treatment for people with extreme mental illnesses, and on and on. Disagreement on idealogies has gone on for centuries, even before mass media.
Nothing said on this entire post shocks me, surprises me, or is contrary to things I saw when I got sober.

Alcohol gets people drunk and it is popular and legal. And people will abuse it. Prohibition didn't work so it remains popular and legal today.

AA is "the treatment of choice" today, but it will one day lose it's status and another equally controversial program will take its place.

Because my experience in AA is different from your (collectively meant) experience in AA does not not negate or validate anything. We all respond differently to stimuli.

How many angels dance can dance on the head of a pin? First, are there angels?

SuziQ

[Claire Saenz]

Suzi,

My comment was not directed to you, but since you have responded to it, I have to say that you appear to be missing my point entirely.

It appears that you had a good experience with AA, and that is fine. Some people do, some people don't.

The point is that the good experience of a few should not qualify AA as the "treatment of choice" for all, particularly in light of the genuinely bad things that also go on.

Bottom line: this isn't about you (or me). It's a larger issue, an issue of choice.

[SuziQ]

Hi Claire,

My point was exactly what yours was---you did talk about how AA became popular and what to do that could change the perception that it should be the treatment of choice.

Those were serious ideas about anything that is popular and considered the "in thing"---not because I had a positive experience in AA.

Unless I misunderstood your post, I thought it was about how to change a perception that AA is best or should be the only available treatment. I was not being facetious about writing a bestseller---doing that, getting on talk shows, getting people to try something different, and letting the public somehow know--- is at least one route to changing a collective perception.

I was responding to the WHY that you asked. The answer is that it is a public perception and I was merely responding to how public perception might be changed.

I, too, believe that people should have choices. I, too, believe that one method does not work for everyone. And my response was NOT about you or me. I just had a difference of opinion by phone with someone in a treatment center concerning a different addiction because they started spouting the 12 step theory. I, actually, do not even see why there is an inpatient center concerning that addiction. I was only looking for information about someone else and how that addiction manifests itself in behaviors.

Since this last post was to me, I am responding to it. Frankly, I have NO CLUE how to change public perception and I have NO objection to anyone changing it--at least about AA. I do wish there were other alternatives--my last husband could not get sober with AA or treatment centers. He was a wonderful, bright, funny, caring man. I NEVER (although I was sober) demanded he go to AA or any other treatment--he tried his best because he wanted to be sober. It did not happen.

SuziQ

[Gene S.]

Hi Claire,
it should be the treatment of choice.



how to change a perception that AA is best or should be the only available treatment.

SuziQ

Sorry if I am interrupting your dialogs, but since when are 12 step peer support groups consider to be a treatment?

Second if you want to consider it a successful treatment, the results of such treatment should be run against the placebo effect. In case of 12 steps group it can not be done, because the effect of 12 steps participation is a "Placebo Effect" and obviously we can't compare placebo effects.

[Claire Saenz]

since when are 12 step peer support groups consider to be a treatment?


Answer: When you to to a "treatment center" and find the 12 steps up on the wall, are told to do 90 meetings in 90 days, and to get a sponsor and start doing steps, I'd say that's a "treatment."

[John Rutledge]

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[xenophon]

I am not a mind reader. I do not know the motivation for acting as if 12 were the only method. I doubt that a honest answer from those dispensing the "medicine" will be forthcoming.

I suspect; but, cannot prove, that the best answer would be: "When your only tool you have is a hammer, everything looks like a nail".

[John Rutledge]

deleted .....

[Claire Saenz]

Indeed. In fact, in the "recovery community" where I live, treatment is absolutely considered to be synonymous with AA. Sure, there are some AA oldtimers who complain about this, even going so far as to blame the treatment centers for causing the high relapse rate (I guess the treatment programs aren't "pure" enough), but the community at large takes it for granted that people going to rehab are eventually going to end up at the meetings. Meetings are held at treatment centers, and treatment centers bus people to the church-basement meetings. It is not unusual for treatment center folks to seek sponsors at these meetings because they have been ordered to do so by their counselor.

I did outpatient rehab myself but in a rather unusual way. Instead of being in a group program, I simply talked to a counselor at the rehab center for an hour every week for about 9 months. The counselor was an AA longtimer who told me to go to meetings, get a sponsor, work steps, read the Big Book, etc. When I mentioned the idea of Rational Recovery, he did not run screaming but he did raise his eyebrows and strongly suggest that this was a bad idea. "I only know the AA way myself" he said, "although I do work with one guy who is using RR, and I guess he's doing okay."

I guess that is what passes for an alternative!

[xenophon]

Treatment centers, etc, are doing what they know. Perhaps it is unfair to say that they should know better and do better. But, inertia is a problem.

I have thought for a while now that severity of the problem has lot to do with whether there is a solution. Not a profound thing to say; but, I think that severity has a lot to do with it. Also important are the processes driving the abuse. Sometimes, the drinking arises from peer pressure and youth. Sometimes, it is situational, such as job loss or grief. Sometimes, it arises from serious conditions, such as a personality disorder.

I think that these processes are important -- and, everyone has his own process. That complicates matters -- real people tend to refute stereotypes.

Whatever methods are used, the first thing that needs to be done is: stop using.

[peaceful1]

I've been to my share of meetings. It's easy to see how someone could fear that it is a cult. Salvation (from drinking) is offered and granted to those who are willing to surrender what they believe to be their "self." I am not an alcoholic, but have gone through a spiritual transformation that is similar to what members of AA experience, and what anyone who truly stops drinking must accomplish. I am not religious. What I have experienced can be communicated to another person in a philosophical way, or a religious way, and it truly matters not the path a person takes as long as the end result is the same. I have written to Christians about this transition into a new and joyful life, using the teachings of Jesus. I have talked about this topic with Atheists and Agnostics in a scientific language and a philosophical language. Like I said, it doesn't matter. So, I believe that AA can point a person toward the direction of Enlightenment, or the end of suffering, but can't take them there. Alcoholism itself can be seen as a path to enlightenment if someone can overcome it.
"Hitting rock bottom" is a point where someone can say, "I just can't live with myself anymore." At that point, it may strike the person that there is more than one "self" inside them, that in order to be fed up with yourself, there must be a part that loves itself enough to be fed up with misery. There is a great amount of fear associated with this. The false (miserable) self wants to keep existing, wants to go on suffering. Suffering is what it eats, and alcohol (for many) is how it cultivates that food. The alcoholic will always be an alcoholic, unless he becomes like the few enlightened people that have walked the earth and shed's his/her identity completely (people often think of buddha and Jesus, but there are others that have known this bliss). Forgetting the past, not worrying about the future and living in the only moment that truly exists--right now--is part of shedding the self. AA teaches "just for today" Surrender is extremely powerful. Who we think we are becomes transparent and the REAL being comes into view. The REAL being is connected and constantly showered in the lightness of peace and tranquility and bliss. Through surrender, it is possible to see that loneliness is an illusion. All suffering, including Alcoholism is an illusion. Some, who have been through AA have discovered this. The AA old timers have not shed the self, in my opinion, but modified it into a preacher, a helper, an encyclopedia of psychological struggle, and a condescending parent, and yes, a non-drinker. Those who have used AA as enlightenment don't drink because they no longer identify with the self that was an alcoholic, thus they have transcended AA and the rest of the manifested world. I think that fairly soon, we will all shed our identities during life (as opposed to the moment of our deaths) and transcend the suffering. Many are doing it right now. At this very moment. The moment your eyes glance at these words.
In conclusion, AA can be the start of looking at oneself in spiritual/metaphysical terms, not as a diseased body and mind, but a living force that is NOT sick, and needs no cure other than to wake up from a nightmare. And of course we can all see haw it can fall drastically short of the goal.

[Ray Smith]

"I'm not saying that AA is practiced secularly; I'm just saying it could be."

But then it wouldn't be AA. AA requires turning your will over to God. If a person attempts to work AA as a secular program, they are met with open hostility. Of course some people do it and don't say anything, but that defeats the concept of rigorous honesty, or at least it does in my mind.

Many, if not most of the people do not work the program as presented in the Big Book and the 12 & 12. Most never bother reading the second book. (Some groups tell newcomers not to read the 12 & 12 until they've been in the program for awhile.) It details the bait and switch methods they use, how to soft pedal the religious aspects of the program until the convert is ready. It reads like an indoctrination handbook. Most rely on others interpreting the literature for them, the way that most Christians allow their priests and preachers to tell them what the Bible says. Some people find peer support in the rooms without getting to involved what the program is or does. They often leave after they've gotten what they've needed, but that is also contrary to the program.

Most of the people in the rooms relapse and each time they are told they didn't "work the program hard enough"; they are shamed. Some redouble their efforts, some give up. For people that used alcohol to cover up mental health symptoms such as anxiety or depression, do they really need ego deflation?

I was diagnosed with depression in the early 70s, before I started drinking. Ten years later I had a severe addiction to alcohol and went to detox where I was told I must go to AA or I would drink again. So I went.

When I told people I wanted to know how I, as an atheist, could work the program, I was told I needed to got out and do some more "research" (drinking) and come back when I was "teachable" (broken down bad enough to convert). I left several times, did lots of "research", but it never proved anything about God to me.

During my times in the rooms, whenever I talked about being diagnosed with depression, it was dismissed as "being on the pity pot". I was told that if I took medication, I wasn't really sober and that if I worked the steps properly, God would restore me to sanity, I didn't need therapy. I was taught that I had a disease, that I was powerless, that it wasn't my fault: all great excuses to continue drinking. After all, if only God could help me, and I didn't believe in God, I was helpless.

One of the things that soured me on AA was the way people in the rooms talked about the suicides that occurred. "At least he died sober", or if he drank first, "He just couldn't get this simple program". Now wait one minute! Since when is the program more important that the individual they claim to exist for? "Some must die so that others might live" may be fine on a battlefield, but since when is that appropriate in suburbia? They claim these deaths as some sort of proof that the program works!

After bouncing in and out of the rooms for years, never achieving more than a few months of sobriety at a time, in 2001, I finally got a decent therapist who listened and didn't look at my objections towards AA as me wanting to go back to drinking. He helped me to empower myself, and I was able to stay stopped.

Because of my trials and tribulations in the rooms, I was asked by a local ACT program to tell my story to a group of dual diagnosis clients, all of whom had experienced problems in AA. That evolved in my co-chairing a weekly group, and them my becoming a peer advocate. I saw many people who were not alcoholics forced into 12step treatment where their mental health needs were not met. They invariably got worse in the rooms.

I now work for an ACT program in a different state and own or moderate several recovery and recovery from AA groups.

It doesn't matter if AA is a cult or whether it's religious, what really matters is whether AA works or not. AA has fared poorly in study after study, where are all the studies that live up to AA's claims? There aren't any. (OK, the laughable Moos study that showed the longer a person is in AA, the more likely it is that they are sober, but has nothing to do with cause and effect.)

Kathleen Scaicca claims that the success rate for people with a dual diagnosis in traditional 12step groups is "too small to be accurately measured". That has certainly been my personal experience, and now it's my professional experience as well.

[xenophon]

What did I see in AA? Not very much.
It is a place that an offender is sent. The offender gets his attendance sheet signed. A significant number of attendees may be mandated. Their demeanor and behavior was all over the map.
I saw old timers. Most of these old timers spoke a few cliches -- What they said was predictable.
There were those who were -- clearly -- struggling; struggling with drink and/or state of mind. And, making no progress.

There were those who came as a form of insurance -- an amulet if you will -- against drinking. None of those had much to say Perhaps many of those had no good way of explaining why they left to friends and family. Perhaps, they had neither. That does happen to heavy drinkers.

I did not see: practical advice; real support which builds confidence; straight talk about living a regular life [ with all that entails]; real active listening.

AA is not, really, very much of anything. I have come to think that AA exists because it exists. It has little to do with drinking; it has little to do with anything at all.

People do quit or cut back on their own. It does not matter whether that is believed or not. No one actually needs to believe that, at the end of the day, everyone quits or cuts back on their own.

[Ray Smith]

[QUOTE=SuziQ;1513]I also was not aware that AA was supposed to help with mental illness--QUOTE]

It doesn't, they're not a mental health service so they should quit pretending that they are a cure-all for everything.

About half of all alcoholics have a mental illness according the NIMH. The anti-medication/anti-therapy faction of AA does a lot of harm. Some folks in the rooms interpret "restore us to sanity" as meaning if you do the steps properly, God will fix your mental health while He's at it.

If I brought up that I suffered from clinical depression, I was accused of being on the 'pity pot'. In what way is that the least bit helpful to someone who is suicidal? "Take the cotton out of your ears and stuff it in your mouth" is another fine thing to tell people when they come in desperate for help and have questions.

Many with mental health issues are fooled by the 'love-bombing' that occurs when they are new. At the first hint of mental illness, whether through self-disclosure or by their actions, the good folks who will 'love you until you can love yourself' withdraw. It can be very confusing for those in early recovery. They end up hanging out with the only folks in the rooms who will talk to them, the chronic relapsers and the predators.

In the rooms people are told that as long as they do not drink, they are fine. Some believe it and ignore their mental health. They see the people in the rooms on a weekly, maybe daily basis. A therapist who see them for a 50-minute hour once or twice a month doesn't have the kind of influence the people in the rooms have. A hundred of your 'friends' telling you that you are powerless and a therapist trying to empower you, who are you going to believe?

[xenophon]

The blind leading the blind.
Practising medicine without a licence is a felony. And, this anti medication cabal in aa is doing just that.

The best reason to go to AA is to get out of the house. It offers nothing on how to actually stop drinking. It offers no practical advice on doing that. IT offers little "moral support" ; it does offer puerile bromides such as "let go and get god". Etc.

The best reason to attend aa is to get out of the house. That is about all the good that aa does: it gets you out of the house.

[Claire Saenz]

Indeed, the saddest part of my experience with AA had to do with what happened to members who were mentally ill. Ray is absolutely right. It's a travesty.

The lucky ones are the ones who are shunned and ignored, actually. It's far worse when they are told that their mental illness will be removed if they "work a program". I've even known people to be told they don't have a mental illness at all...seriously, people with bi-polar disorder and major depression were often told they weren't mentally ill, that the problem was that they weren't working the program right.

The mental health system is complicit in this, though. Dually diagnosed people are SENT to AA by their health care professionals. I wonder what it is going to take before people wake up to this. Maybe the truth is that nobody cares what happens to addicts and people with mental illnesses...it sure seems that way sometimes.

[xenophon]

Claire, I agree.

Very little is really devoted to mental illness and substance abuse. And, they are linked. It is a matter of "charisma". Neither one has any glamor; and, "crazies" and "drunkards" are not respected. Nor, are either really worthty of help. Compare "lunacy" and "alcoholism" with cancer or heart disease.

[Abbadun]

Hi

Thinking about my sobriety I realize that the AA reading material after the "honeymoon" period of Sobriety has had more of a negative effect on my Sobriety than anything else.

I do like talking to other people with my problem, so I go to topic, speaker meetings and sometimes a "As Bill Sees It" meeting. Mostly it is the defeat and success of other addicted people that teachs me.

At this point I get much more reading benefit from books like:

"Don't Sweat the Hard Stuff"
"Seven Secrets of Highly Effective People"
"Taming the Monkey Mind" and other Buddhist Writings

Text Books for School

Human Resources, Team Management and Change Management

AA Literature tries to do some of the stuff the above Literature does, but AA Literature is tainted with the Authors' narrow-minded (zero diversity) mindset.

Anyone who think a slogan contains the solution to the diversity of addiction is crazy :)

Abbadun

[effectivehelp]

"I only wish that there were more secular and science-based self-help programs out there for alcoholics and other addicts. "

There is a completely secular rehab out there, it's called Narconon. It teaches life skills and gives power back to the addict.

I've never been to AA or NA but I have heard about the steps, the religious nature of it, and proclaiming yourself powerless. This never seemed right for me and never made sense.

Narconon teaches being responsible and accountable for your own actions and makes you aware of what you are doing and of your environment. It's amazing.

I hate to sound like an advertisement but the program works...
(http://www.drugrehab.net)

[effectivehelp]

In further reading the messages in this discussion I have quite a few things to say. I agree that AA does not work for MOST people for the reasons mentioned above. It doesn't give you any solutions, it tells you that you are a victim to yourself and that you should succumb to that, learn to cope with it, and be miserably sober. This kind of lifestyle does not work for most people, then again it does work for some. The statistics are so low that they are not publicized however I would say it's less than 10%.

Furthermore, when it comes to bipolar disorder and other mental illnesses, these are grossly over diagnosed. Most people are just sad or stressed out and have absolutely no solution on how to deal with their problems, hence the moodiness and acting out in strange ways. Teach them some skills, give them constructive ways of dealing with their emotions. They will stop.

Again, I truly believe in the validity and strength of the Narconon Program and believe one day it will replace AA in our judicial system. It works.

[John Rutledge]

deleted ....

[JustTrying]

I personally have nothing against AA.... however i do not need the STEPS.. the steps to me teach you how to be a good human... OK>> FINE>> maybe some need that .. but I was raised to be a good, kind, caring person.....

so no the last time I tried the 12 steps someone pushed me down them......


RAY I see your posts all over the internet.. can't say I do not agree with them.. i think I got this site from one of your post.....

JT

[Mark]

I'm seconding what JR has to say about the Narconon posts above. I want to caution people that Narconon is an arm of the Church of Scientology, and as far as I can tell, is a "program" that seems to be more capable of harming vulnerable people looking for addictions help than actually helping them. I have edited the above posts to remove the live links back to the Narconon website, but do not want to censor overly. It is useful to allow expression of the program if only to be able to point out that it is something to avoid, IMHO.

[JustTrying]

Not trying to be mean... aa has helpled many... but they are a cult.... read the orange pages if you have not.....


GABS/ JT

Who is to say allcults are bad....

[WinterSky]

Furthermore, when it comes to bipolar disorder and other mental illnesses, these are grossly over diagnosed. Most people are just sad or stressed out and have absolutely no solution on how to deal with their problems, hence the moodiness and acting out in strange ways. Teach them some skills, give them constructive ways of dealing with their emotions. They will stop.

I think you need to do some homework before stating the above. You know absolutely nothing about mental illness, obviously.

This message is coming from someone who has been there, worked the "program" (psychotherapy), and still has instability in moods. Mental illness begins in the brain and are diseases of the brain, just like diabetes is a disease having to do with the pancreas.

Next we'll hear that schizophrenia isn't a real disease either. Oh and what about Parkinson's Disease. That is a disease in the brain as well. :rolleyes:

[WinterSky]

Scientology is a "religion" based on one man's viewpoint. It is based on his own exploration of the world. How bogus is that! I agree, I'd steer clear of it as well.

[xenophon]

Actually, getting shut of alcohol abuse is not impossible. It was not impossible for me, owing to the fact that I did just that. I see no reason to be pessimistic. I was not.

[ASchwartz]

I did not realize, myself, that Narconon is an arm of the scientology group. Perhaps I am mixing the groups on my mind? There are so many "anons," like Ala-non and etc. Anyway, I will second and third Mark and John. Scientology is dangerous. They are a cult, have been accused of spying on members, never letting people leave the group and doing other very unsavory things. Caution: watch out and keep away.

Allan:(

[John Rutledge]

deleted .....

[JustTrying]

Actually I have started going to NA ( Narcotics Anonymous) Although I am not hooked on drugs per say. They accept me because they believe alcohol is a drug. Too me it seems to be based on AA but it is newer and is not as old fashioned. In their literature they speak of your emotions, feelings, past hurts etc being the reason you are hooked on "drugs". AA goes more with the disease theory only. NA also says disease but also realizes that you need to get help with the underlying cause. Whether it be from a doctor or from talking to people with similar things in their life.

They had a discussion about how AA treated addicts. We have small towns around here and AA is the only thing available. They were told not to say they were an addict etc. I won't get into it all. Made me mad because My AA group mostly welcomed addicts ... except for the older men. But I tried to explain , me being an alcoholic only... we alcoholics really do not understand drugs. I have never stolen to drink, or killed to drink, or not fed my kids... etc. Not saying all addicts have done that ... or that there are not alcoholics that have not done that.

I personally do not understand METH.. which is popular around here.... I am not putting any DRANO in my body... or Embalming fluid etc. And yeah alcohol may be just as poisonous but, in my mind it is more natural... like Pot. If Pot were legal i would smoke it... I am too scared to buy it.

The way they describe a METH high... it is fantastic... But coming off of it is hell.

BUT back to NA. The people in it around here are closer to my age and there are alot more women. I do not know if I will ever "Work" the steps. But I feel good going, I can relate alot to these people. It is a good place to go and talk some if need be......


JT

[xenophon]

AA is attractive to some people. There are several reasons for that attraction.
a need for structure
a need for authority
loneliness
a need for an answer.

[Ray Smith]

I do know that AA now accepts the fact that many people must be on psychiatric medications of one type or another.

What do you and others think?

Allan Schwartz

I think you're wrong.

A 2000 study by Robert G. Rychtarik, Gerard J. Connors, Kurt H. Dermen, Paul R. Stasiewicz showed:
"Over half the sample believed the use of relapse-preventing medication either was a good idea or might be a good idea.

Only 17% believed an individual should not take it and only 12% would tell another member to stop taking it. Members attending relatively more meetings in the past 3 months had less favorable attitudes toward the medication. Almost a third (29%) reported personally experiencing some pressure to stop a medication (of any type)...

Conclusions: The study did not find strong, widespread negative attitudes toward medication for preventing relapse among AA members. Nevertheless, some discouragement of medication use does occur in AA. Though most AA members apparently resist pressure to stop a medication, when medication is prescribed a need exists to integrate it within the philosophy of 12-step treatment programs." (J. Stud. Alcohol 61: 134-138, 2000)
http://www.jsad. com/jsad/ article/Alcoholi cs_Anonymous_ and_the_Use_ of_Medications_ to_Prevent_ Relapse_An_ Anon/730. html

Only 17%? And the ones with more meetings being more likely to object to medication? This is a serious problem. The new people listen to what the 'older, wiser' members tell them, they are desperate, grasping at straws. They do not know what to pick and choose to listen to, if they did, they wouldn't be there.

From 2004-2006, I worked for a dual diagnosis program in upstate NY; all had been through 12step treatment and meetings unsuccessfully. Each and every one of them had been told at some point by AA members that they weren't "really sober" if they took psych meds.

[Ray Smith]

I'm seconding what JR has to say about the Narconon posts above. I want to caution people that Narconon is an arm of the Church of Scientology, and as far as I can tell, is a "program" that seems to be more capable of harming vulnerable people looking for addictions help than actually helping them. I have edited the above posts to remove the live links back to the Narconon website, but do not want to censor overly. It is useful to allow expression of the program if only to be able to point out that it is something to avoid, IMHO.

I find it amazing that you see something is wrong with Narconon, yet are still ambivalent about AA.

Have you ever been to a real AA meeting? Not one in hospital setting or tucked away in some suburb where the buses don't run, a downtown meeting or one in a clubhouse? Try doing one of those, anonymously, and see if you don't feel differently.

[Mark]

Ray,

I do listen to/read your posts and the posts by similarly voiced peers of yours who post here (Claire, JR, AB, etc.). I take what you have to say seriously. The sheer repetition of the same message over and over again gets old though - starts to focus me less on your message and more on a feeling of sympathy for whatever happened to you to kick you into this mode where you can never rest until everyone sees the "true nature" of AA

I get it that you find nothing of value in AA. You are not alone in this opinion by any means, and my sense is that we will see more critical evaluation of AA in the coming years within the mental health professions anyway.

Why does it have to be the case, however, that any ideas about AA which are out of sync with your own have to be broken? Why are you so intolerant about this?

I know you are a well meaning man. I know you want to help others. I know you want to root out things that will harm others. I know you are right that in your experience of AA, there are predators who harm people there, etc. I'm not saying you are wrong. But can there be no other face to the thing? Are you incapable of recognizing the gray that exists in-between the black and the white?

Your extremity here is the main message I'm hearing lately - not just you - I'm getting this from many sides so my comment here to you is not just a comment to you but to Claire, etc. I find it troubling that you have to be right so much so that a moderate voice like myself has to be challenged relentlessly until final conversion occurs, I suppose. It starts to have an evangelical quality that is disturbing.

Mark

[JulianP]

..........

[John Rutledge]

deleted....

[Mark]

JR,

AA may indeed be helpful to some people, whether in helping them to give up drinking or otherwise in enhancing their lives. If somebody can accept the AA program, or otherwise accommodate themselves to it in order to obtain social benefit from participation, that is great. I would never wish to dissuade anybody who can benefit from participating in the Fellowship from doing so.

Equally, I am convinced that there are many who are unable to accept or accommodate themselves to the program, whether for reasons of conscience, of conviction, of personality, or for other reasons. For such people, the program may be useless, or even harmful.


I very much agree with the quote you've written above. I'm not arguing for the merits of AA these days, so much as I'm trying to suggest that some people like it and benefit from it. There are a lot of voices who will seemingly never be happy until the entire edifice is torn down, however. I just don't get this, and am prone to understand it as a reaction to people having been very unfortunately victimized by predators within AA (who are certainly there along with non-predators) and who have generalized the negative experience to the *entire* thing as though their own experience is the same thing as everyone else's experience. It comes across as one of those "The Lady Doth Protest too Much" Hamlet-esque sorts of things.

Being a psychologist, I'm prone to want to know what the history is, but I also want to respect people's privacy. I also want to raise people's awareness that they are coming across as over-zealous, but I suspect that people don't see it that way at all, and rather understand me as an *enabler* of some sort. Someone to be converted, because their base position is harmful. It is wearying, but also understandable in a way, and I feel some sympathy because I gather there is a reservoir of pain under the surface. The sustained and self-renewing energy behind the attack is as much a message as the contents of the attack.

Bottom line is that I have listened and I have learned, and I'm not going to move much beyond where I'm at today I don't think, which is pretty much what you've described in the quote (reserving the right to refine the position further). I'm open to further movement, but I'm not seeing new arguments which are compelling. I'm seeing anger, outrage and repetition.

Mark

[JulianP]

..........

[Ray Smith]

I find it troubling that you have to be right so much so that a moderate voice like myself has to be challenged relentlessly...

You may be more of a "moderate" now, but hasn't that come from people like myself voicing valid objections to the program? And if there is to be a change coming, isn't because people like me have been demanding that our complaints are no longer swept under the rug?

"Moderates" give AA an air of legitimacy, it is still faith healing pure and simple. You and Dr. Schwartz are quick to denounce Narconon, yet its members give the same sort of glassy-eyed reports of how that program saved their lives. (Narconon may actually have a better success rate.) Why so quick to condemn one and not the other?

I am bothered by the idea of mental health professionals green lighting a program that runs contrary to most therapeutic methods. People are taught that they are powerless to change, only God can grant daily reprieves. AA calls for "ego-deflation", that may be of help to a select few, but what about the people who already have problems with self-esteem or depression who make up the majority of people with substance abuse issues? A fear based program that teaches people to distrust their every thought and to turn their will and their lives over to some Higher Power? To focus on the 5% of people who stay sober in AA while willfully ignoring those that are not heped and those that are actually harmed does not make sense.

People with coexisting mental health problems fare poorly in program. A recent study (J. Stud. Alcohol 61: 134-138, 2000) showed 12% of AA members (higher with those who attend more meetings) tell people to stop taking medications of any sort. This is the vocal anti-medication faction that I have spoken about before. A mental health professional who sends a dually diagnosed individual to a group where he is told to throw away his medication is sending a seriously confused message.

In my mind, a mental health professional (who is not a two-hatter) that sends a client to AA is passing the buck, hoping that the client will get help without wasting the professional's time. Tossing folks into the AA pool to sink or swim is not in keeping with being a "helping professional". It is quite the opposite of "first do no harm".

[Ray Smith]

I very much agree with the quote you've written above. I'm not arguing for the merits of AA these days, so much as I'm trying to suggest that some people like it and benefit from it. There are a lot of voices who will seemingly never be happy until the entire edifice is torn down, however. I just don't get this, and am prone to understand it as a reaction to people having been very unfortunately victimized by predators within AA (who are certainly there along with non-predators) and who have generalized the negative experience to the *entire* thing as though their own experience is the same thing as everyone else's experience. It comes across as one of those "The Lady Doth Protest too Much" Hamlet-esque sorts of things.

Many would be happy if us uppity people would just shut up and let the professionals continue to do what they've been doing. You'll get around to listening and treating us with a little respect eventually, right?

It's only been through assertiveness that changes are made.

It's not just the predators in the rooms, or the anti-medication faction, or the religious nature of the program, but the very core of the program that is harmful, it is accepting powerlessness. It is anti-therapeutic. People should be empowered in order to make healthy changes in their lives, not beaten into submission.

[Claire Saenz]

"The sheer repetition of the same message over and over again gets old though - starts to focus me less on your message and more on a feeling of sympathy for whatever happened to you to kick you into this mode where you can never rest until everyone sees the "true nature" of AA."

The reason I continue to repeat myself is simply that I feel I am not being heard on one, very, very basic point, which is that AA absolutely must be evaluated on its empirical merits just as a treatment for any other condition would be. This evaluation, like all others, should involve its efficacy (treatment should produce a statistically significant improvement over no treatment) and its side-effects (i.e. potential risks of treatment).

I simply cannot imagine another context in which this simple and logical point would be continually turned aside, or where my perseverance would be dismissed as an indication of--what?--PTSD?

Claire Saenz, JD

[JulianP]

..............

[ASchwartz]

Hi JP,

I do not agree with you about twelve step programs. However, I do agree that any knee jerk reaction to helping people is wrong, whether its AA or anything else.

Outside of that, AA and other programs have been helfpful to many people. I know, professionally and personally, many who have been helped by AA. This is separate and apart from so called "studies." In fact, outslde of the postings on the Internet, I have never been aware of such anger at AA. Nothing works for everyone and nothing is perfect. However, before AA there was noting to help those with addiction of any kind. There are many who owe their lives to AA and have expressed this to me in no uncertain terms.

By the way, my comments are in no way meant to dismiss those of you who had bad experiences and who do not like AA. Its just that your experiences (those who had bad experiences) are not the whole story.

Allan :)

[JulianP]

............

[John Rutledge]

deleted....

[ASchwartz]

Dear JP,

You and I are going to disagree with each other on this issue of AA. The people I know and have know are more than a handful. They are very many. I do not know if you fully understand how down and out some people become. Perhaps you do and I do not mean to sound demeaning of you and your experience. I do not know your personal experience and I hope you never had to be homeless and living in the streets. Perhaps that did happen to you. I do know that the people I am speaking of were on the verge of death. There was nothing left for them. Disowned by their families and disowning their families, lost in a haze of alcohol and other drugs, they were in the streets, at the mercy of the elements, street predators, rats, cops, hungry and hopeless. They were at the end of the road. Many of these people die. They never come in for help and just perish, nameless and forever lost. A few manage to summon their last bit of energy and go to an AA meeting, dirty, smelly, hopeless, and there, they find a beginning. Those of us who are aware of this through our professional and personal lives remain mystified by the hostility to AA.

Let me be clear about my position:

I do not see AA as a cult or a religion.

I do not see AA as the permanent or only answer. For many it is a start. Lots of people move on to other forms of help, especially psychotherapy.

Mine is not a "knee jerk" reaction to AA and I in no way reject other forms of help.

But, you need to realize is that, other than being arrested for public drunkeness or disturbing the peace, there is nothing else but AA at that point for this particular type of person who is also known as a "skid row bum." I do not like the term but it does seem descriptive for a certain type of person.

What I wish for is more of a respectful dialogue on this topic rather than the type of all out war that the issue seems to raise for some people on the Internet. I am not implying that that is true of you or everyone but it is true of some.

I await your thoughts and the thoughts of others, as well.

Allan

[JulianP]

..........

[JulianP]

..........

[Claire Saenz]

Dr. Schwartz:

Now I am really confused. You claim that you support other forms of help, but only yesterday, in the question and answer portion of this website, you were asked for advice by a woman whose husband had been drinking for 30 years. After telling her to talk to him, mentioning the anti-craving drugs that are now available, and recommending therapy, you say:

"Lastly, you could ask him to start attending Alcoholics Anonymous meetings. If he will not, you could and should begin attending Alanon meetings so you can learn how to cope with him, especially if he refuses to listen to your concerns about his drinking."

Not a single mention of any other support group. Just 12 step groups. Rather odd from a person who claims to hope that support groups that use other approaches become more readily available.

Even more confusing, your current posting here suggests that you think AA has value for the "skid row bum" sort of alcoholic, who has nothing else left. Why then did you write this, back in October of 2008, to a another woman who wrote in to ask what to do about her husband's alcohol problem:

"If his is not yet an extremely serious case, he can begin attending Alcoholics Anonymous (AA) meetings."

Surely you perceive the irony here. You told this woman to send her husband to AA if he isn't too bad, but you're telling us you see the value of AA for people who are really bad.

There is no logic here, any more than there is logic in continuing to cling to anecdotal evidence in the absence of the scientific variety.

Claire

[Ray Smith]

Outside of that, AA and other programs have been helfpful to many people. I know, professionally and personally, many who have been helped by AA. This is separate and apart from so called "studies."

So called "studies"? Please look at this and get back to me.

http://www.orange-papers.org/orange-letters26.html#RLCS

[Ray Smith]

But, you need to realize is that, other than being arrested for public drunkeness or disturbing the peace, there is nothing else but AA at that point for this particular type of person who is also known as a "skid row bum."

If that were the case, why am I not dead?

I was homeless, abandoned by my family. (Folks in AA told my mother she needed to practice "tough love", that I wasn't serious about sobriety because I refused AA, after getting progressively worse each time I attended.)

As I mentioned before, I was diagnosed with depression before I started drinking. AA managed to add to that depression.

I'm an atheist. I accepted that I was powerless, that I had a disease, and then I had no Higher Power to rescue me. I came to believe my two options were suicide or drinking myself to death. I drank more destructively after having been exposed to AA.

When I told people that I objected to the religious nature of AA, they all told me that I was mistaken, many atheists and agnostics have found sobriety through the program of AA. So I started believing it must be me, so I'd give it another shot. And each time I asked how an atheist could work the program, I was attacked by those who thought they could convert me. I was told repeatedly, by different members, in different meeting that unless I started believing in God, I would end up "dead, drunk in a gutter".

I felt that if I could get help for the depression, I could quit and stay stopped. But that went against the sensibilities of everyone, including the mental health professionals who said they would be happy to treat my depression after I had been sober for 3 or 6 months. I'd go back, worse than ever and they would insist I stick it out a bit longer. They were certain that drinking caused my depression, that I was lying or misremembering because I was an alcoholic. One even went so far as to suggest that alcoholism came first because I was an alcoholic before I ever took that first drink by virtue of genetics.

Only by manipulating the system was I finally able to get the mental health help I needed. Lo and behold, once I talked with a therapist who listened and did not pass me off to some 12step group, I stayed sober. I have maintained my abstinence for almost eight years now.

At two years sober, I was asked to help facilitate a dual diagnosis group for a new ACT program in town. People with mental health and substance abuse issues rarely get better in traditional 12step groups (according to Kathleen Scaicca, a pioneer in the treatment of dual diagnosis), this ACT program was for people who had repeatedly failed at 12step treatment. That led to a position as a Peer Advocate. Part of my job was keeping our clients OUT of ineffective and potentially damaging treatment.

Each and everyone of our clients had been told to throw away their psych medications, if they took them they weren't "really sober". Some did and attempted suicide, that's how we ended up with them in our program.

I now work for an ACT team in another state, I am a Peer Specialist (awaiting certification). I run Motivational Interviewing-based dual diagnosis groups and work with dually diagnosed clients every day. I rarely run into 12step promoting mental health professionals anymore, most have gone to Evidence Based Practices, AA doesn't qualify.

[finding my way]

Hello. Thanks to all who have put so much thought into these posts for us to read; clearly this is a very important issue to visit for the sake of sufferers, families, and professionals involved. I hope I am welcome to participate. It’s not easy putting this into words, but I am going to try.

Back in school, my prof said that religion is the number one alienator and the number one dealienator both at the same time. That certainly seems to be true. At the risk of stepping into the fire here unwelcomed, I’d like to view this paradox from a psychological perspective. Saying that, even, is controversial. Let’s just say I’d like to air my thoughts.

The phenomenon of having thoughts and having feelings is somewhere at the core of having a mind. We have to form an identity somehow, a working ego to function in the world, to make decisions, to act. Most of us experience ourselves as our thoughts and feelings… that is who we are. It is absolutely foreign and nonsensical, if not terrifying, to pry “who we are” apart from our thoughts and feelings. However, that is exactly what we are required to do in both the counseling session with a psychologist, and in a religious encounter, whatever the setting.

In a religious encounter, you pry yourself from what you’ve known of your ego functioning and give yourself over to the better judgment of God, resulting in an improvement in your ego functioning.

In a counseling session, you pry yourself from the thoughts and feelings you’ve been having long enough to examine them. Sometimes this very act results in realizations and a change, which results in an improvement in ego functioning.

There are other ways to achieve this dynamic (Buddhism, military training, music lessons –personal joke, sorry). The dynamic is prying a space between “you” and the thoughts and feelings you are having long enough to achieve a positive change in your perspective that leads to a positive change in your functioning.

The bare-bones fact is that most of us have to have help in order to do it. We cling with complete and utter stubborn loyalty to what we have known of ourselves. Trust is a major issue. When you have been abused, why would you ever want to accept outside help for anything? People abuse each other as much as they help each other it seems. Yet when we have gone astray with our behavior, there are thoughts and feelings behind, and fierce loyalty to those so prolongs the suffering. My therapist’s term was “unblending,” and he taught me some very creative ways to respectfully unblend just enough to take a look at what was happening and the thoughts and feelings behind it. The resulting shift would be quite profound, and I have been able to crawl out from under quite a bit of mental suffering and change around many behaviors. In my case, I required a spiritual context to summon the trust to even have the experience, and that is what we did in session. Others require a spiritual context to be no where near in order to summon the trust to have the experience. But the experience of unblending can occur either way.

A “spiritual” type myself, I am comfortable with calling this process religious. I am very aware, however, that calling it that is deeply alienating for others. Do we lose or gain anything if we call this process “psychological”? From what I read when I participated in al-anon, Carl Jung was a strong influence when AA was created. His career was deeply controversial for the way he “psychologised” religion, perhaps similar to what I’ve just done. I guess all I want to attempt is to highlight that “unblending” phenomenon. It is at the root of both religious and psychological experiences that result in changed behavior, and most of us have to have help from someone to learn how to do it.

[ASchwartz]

To Claire and others,

Simply put, referring to AA is the easiest way to get people started toward recovery. A couple of years ago, there was no viable drug treatment available for alcohol problems. I am not sure why you are looking for contradictions in what I write. From my point of view there are many ways out of alcohol addiction. What I object to is the outright rejection of AA that I hear from so many of you and so much contradicts the very real experiences I have had with people over decades in the field and in my family.

JP, it appears to me, but I am not certain, that you were in some type of program that used twelve steps. That is something else. I am referring only to the AA twelve step process.

As for depression, I am aware of the fact that there are those therapists, be they social workers, psychologists and psychiatrists, who will not start therapy with a person until they are free of abuse for a few months. However, there are many who do NOT work this way and start treatment with a person while they are still using. In my experience, I worked with people in therapy while they were attending AA meetings. In fact, they came to me after they had started, primarily because I had built a really good reputation. In that experience, it was the combination of therapy and AA that worked best.

Understand, please, that I am NOT suggesting that AA or twelve steps are for everyone. I have my own family experiences with programs and know how awful they can be. I am just saying: Don't throw out the baby with the bath water."

Laslty, what some of you see as failures on your way to recovery I see as valuable experiences that, one after the other, set you on the course to recovery and I congratulate all of you for that recovery.

Please do not assume that my personal experiences with programs through family member problems, were good ones because they were not.

I encourage more and more dialogue.

Allan :)

[Claire Saenz]

deleted by poster

[JulianP]

..........

[JulianP]

...........

[finding my way]

JP, thank you for your words and thoughtfulness with us:)

[ASchwartz]

Hi JP,

That was a beautiful statement you posted to Fingingmyway. In fact, this time you did NOT come across as a "hard ass" but as a real human being. I also agree totally with what you say about having to meet and remove the underlying obstacles to a fulfilling life. Obstacles that led to addiction in the first place because, after sobriety there needs to be a lot more work done. Actually, you stated it much better than I.

Congratulations and thanks,

Allan:)

[JulianP]

............

[Mark]

Ray, This is ultimately a matter of social skills, I think. You seem unable to recognize when it is time to stop, and that makes it hard for me to like you. I'd like to like you, but listening to you repeat yourself is wearing. Interpret it how you will - I'm fairly sure it will not be flattering, because it does seem that you need me more as something to resist against than as a person who could be a friend - but - it's time to stop at least as far as I'm concerned.

Claire, I'll say more or less the same to you. It's great that you are a lawyer and all but save the cross-examination stuff for the courtroom please. Allan and I are not the enemy unless you need, for your own reasons, to make us take on that shape.

Mark

---Quote (Originally by Mark)---
I find it troubling that you have to be right so much so that a moderate voice like myself has to be challenged relentlessly...
---End Quote---


You may be more of a "moderate" now, but hasn't that come from people like myself voicing valid objections to the program? And if there is to be a change coming, isn't because people like me have been demanding that our complaints are no longer swept under the rug?

[Claire Saenz]

Allan, Mark, like many others, I get a bit prickly when I'm not listened to or taken seriously. I apologize for the tenor of my previous post. I hope you will do me the courtesy of answering my question, though. It is a very simple one.

Why, when asked a direct question about alcoholism, do you (Allan) continue to recommend AA alone without mentioning any of the other peer support groups available?

Claire

[Mark]

Claire,

Inasmuch as the topic comes up, I typically do recommend the range of self-help programs these days, including SMART, Rational Recovery, etc. It's important to me that people appreciate the range of options they have available. If one thing doesn't work out, or cannot be accessed for one reason or another (and here we are not talking about what should be available but rather what is and what is affordable), I want people to know about the other options, so that they don't fall through cracks unnecessarily.

I certainly would (given the time) talk about the best available treatment techniques I'm aware of, which include relapse prevention, motivational interviewing, the harm prevention approach, etc.

If the person I was talking with seemed like a good candidate for AA classic (religious flavoring and all) I would not hesitate to point them there. There are quite a few people who do not find the concept of submission to a higher power to be disempowering. I would however, given the chance, caution people that some trends within AA - which I do not believe are universal by any means but which clearly are present in many places - such as telling someone who is taking medications as prescribed by a responsible physician that they are not sober or otherwise sabotaging psychiatric health on the alter of ideology - are not useful and that if they encounter that, this would be a clue to find a better meeting or leave the program altogether if that is not possible and a better alternative can be located.

My first impression of AA was that while it did seemed to help people get sober, that it also held them too tightly after they had managed to become sober. My early complaint was that it did not offer people a path to graduate and rejoin the world. When I actually did addictions work for a year back some time ago, I absorbed many of the opinions of my mentors, and my opinion of AA shifted towards a more positive direction. At that time I was working with people who were really really ill - dual diagnosis and actively using very heavily. Honestly, whatever worked with those people and AA worked for some of them. The horizon there at the partial hospital was very short term - a few weeks of treatment, so these longer term philosophical incompatibilities that are discussed here were not immediately relevant there and indeed live at a different level of the heirarchy of needs. That work was "any or all ports in a storm", while the discussion here is more often not taking place in the midst of absolute crisis.

Hard as it might be to believe, I'm actually happy that people are speaking up about how AA doesn't work for them and why when that is the case. It is important that people who have not thought this through and find themselves in a similar predicament can find such discussion and recognize that they are not alone. It is equally important that they find recommendations for what to do if AA doesn't fit them and I'm glad to help promote that awareness.

To summarize, it's not one size fits all, and neither is it one epistemology (theory of knowledge/method for determining truth) fits all. Some people are baseline secular and AA is perhaps going to lodge in their throats. Some others are faith-based and it's going to work for them. Who are we to say that we have better knowledge than a person who finds something that fits them and knows it?

I don't know if this is entirely coherent, but hopefully it is. Gotta go make dinner now.

[John Rutledge]

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[JulianP]

............

[Claire Saenz]

Mark, JR,

Thanks to both of you for your thoughtful posts.

JR, like you, my path to abstinence began with 12 step based rehab. I had been drinking for 25 years (since age 13). I could no longer work, I was having nightly blackouts, my days were filled with constant panic attacks...I was not living on the street by any means but was internally crushed, utterly desperate and desolate. I presented for treatment knowing absolutely nothing other than the simple fact that I wanted to quit drinking, and I trusted the medical community to do right by me.

Looking back, my level of innocence and vulnerability astonishes me. When my rehab counselor told me I had a deadly disease that required a spiritual solution, I simply accepted it and went off to AA fully prepared for a lifetime of meetings if that was what it was going to take to stop the pain.

I can't say that everything that happened in my early years of sobriety, when I was in AA, were horrible. I had a kind sponsor (who is my friend to this day, although I've had to set some clear boundaries) and it was great to have social support and a place to go at night. I think the friendships and the place to go were helpful to me.

But AA's ideological framework meant that the help I got came at a very high price. As I got better, and particularly as I underwent individual therapy, my process of self-discovery was often at odds with AA doctrine, and I was faced with confusing internal conflicts. In AA I was told I'd drink if I didn't believe and do certain things (accept my powerlessness, put AA before everything else in my life, etc.)...but in therapy I was learning to empower myself, deal with my feelings without drinking, and set appropriate and balanced priorities.

For example, I had a huge issue with my mother when I got sober (long story) that was very painful for me and I had a lot of anger over it. My therapist was carefully leading me through the process of experiencing and then releasing these feelings before finally accepting my mother as she is--a process that was ultimately successful.

In AA, though, the level of anger I felt is referred to as "a resentment", and the remedy for it is supposed to be that you go to the person you resent and make an "amends". My sponsor ordered me to make an amends to my mother very early in my sobriety. My therapist was horrified, very concerned that this would simply force me to stuff my anger instead of dealing with it. My sponsor read me passages from the Big Book and 12&12 suggesting that I'd drink over my anger and that my anger automatically meant that I was in the wrong.

Thus began several years of mental pretzel twisting. Common sense on the one hand, AA on the other. Therapy that was obviously helping me on the one hand, AA pushing in the other direction with threats of relapse. (I consider myself fortunate that I usually ended up following my therapist's advice rather than my sponsor's.)

All of this to say that on balance the help I got from AA was not worth the price. Social support and a place to go are great, but they didn't get me sober and they didn't make up for the years of cognitive dissonance I had to endure (or the unpleasantness of walking away...those folks are not very nice when you leave the fold).

I understand that another person might have a different experience with AA, but my deep concern is that those of us who have these negative experiences are dismissed as crackpots or extremists while the "go to AA" drumbeat continues unabated.

Claire

Now I've got to go to work....more about cooking another time, it's one of my favorite pastimes...next to eating.

[JulianP]

............deleted

[Claire Saenz]

JP,

I can tell that you get it. Integrity is essential to emotional health, but integrity is impossible to achieve when one is told that one must permanently adopt a repellent value system in order to live.

In my own case, I was so desperate at the start of my sobriety that I would have (to use a borrowed AA phrase) pushed a peanut with my nose all the way to Florida if my sponsor told me to. I was unable at that time to discern between what made sense and what didn't. I just wanted to stop hurting. And all that AA love was wonderful at first. It was so much better to be with those nice AA people than it was to be at home, where my husband was furious and my kids were scared. It was wonderful to think that the answers to all my problems were to be found in AA...prepackaged and approved (so I was told) by medical science.

When the conflicts between common sense and observed reality on the one side, and AA on the other started to become evident, my first assumption was that something was wrong with me, and AA was right there to reinforce that assumption via slogans such as "your best thinking got you here" and "nobody is too stupid for this program but some people are too smart" and "when you're in your own head, you're in a bad neighborhood".

I kept thinking that right around the corner, the apparent contradictions would resolve themselves. But as time went on and they did not, I became increasingly uncomfortable, increasingly unable to reconcile what my own intelligence told me with the "wisdom" of AA.

When I brought up these concerns with AA friends, I was told that the answer was to work another step. To pray harder. To work with another alcoholic. To go to different meetings. The notion of actually questioning the fundamental truth of AA was simply not an option. One could NOT do this. The program was perfect. If I had doubts, well, more would be revealed.

I struggled with this for nine years. It's hard to pin down one single event that broke the deadlock; ultimately I suppose it was the sheer volume of inconsistencies that forced me to come out of the fog and acknowledge that I'd been essentially brainwashed. "Rarely have we seen a person fail"...a lie. "Anger is the dubious luxury of normal men"...utter baloney. "What we have is a daily reprieve contingent on the maintenance of our spiritual condition"...absolute, unmitigated malarkey.

People can agree or disagree about whether AA is or is not a cult, and that point is arguably a mere distraction from the real issue, which is the efficacy of the program. But I think it's a cult, simply because of how I felt when the blinders came off. My brain was completely full of contradictory information. I knew at some level what I really thought about things, but at another level, I was scared of those thoughts because I'd been told that to "do it my way" was to "sign my own death warrant."

When I put in my first internet search, to see if there were others out there, like me, who felt brainwashed by AA, I was trembling with fear. I knew, but I was afraid to know. I thank God that I was easily able to find others like me, to find resources (such as the Orange Papers) that enabled me to begin deprogramming. I have found deprogramming very difficult. I have had to reexamine everything I was taught over a nine year period.

Some things have been easy to evaluate (i.e. those guys in AA were right, I can't have even one drink!) but others have been a real challenge. Still, after two years of deprogramming, I'm quite comfortable saying this:

1. I am not powerless over alcohol. I can't drink safely, but I'm perfectly capable of deciding not to drink and to openly state that this is a lifetime commitment.

2. I am completely responsible for my own sobriety (not God, although I do believe in God).

3. Other than my inability to handle booze, I am not fundamentally different from other people. "Normies" can understand me just fine. I do not need to spend all my time with "recovering" alcoholics.

4. I am intelligent and entirely capable of making decisions for myself, based on whatever input I may find reasonable. I do not need a sponsor to oversee my existence, nor is my own brain a "bad neighborhood".

5. I am not an "alcoholic", "recovering" or otherwise. I am a person who used to drink too much and there is nothing to be gained by a lifetime identification with a problem I left behind over a decade ago.

These may seem like simple and obvious concepts to the average person who has never been exposed to AA, but to someone who spent so many years inside the "fellowship" the mere statement of them feels like a declaration of freedom.

Claire

[JulianP]

............deleted

[Mark]

can I ask a stupid question? what is a "two-hatter"? :confused:

[JulianP]

............deleted

[Claire Saenz]

There are even training programs for "two hatter" addiction counselors.

http://www.hazelden.org/web/public/certificate.page

[ASchwartz]

Hi Claire and JP and everyone,

I never heard of "two hatter" either and thank you for the clarification. I also agree that there is no such thing as a stupid question.

I guess you all know that addiction in the medical field is rampant and there are books and articles on this topic. Medical Doctors have all the drugs available to them and so do nurses. However, psychologists, social workers and other health professionals are not immune. Now, there are programs available for doctors and nurses to get help without losing their licenses. I am not sure about psychologists and social workers and other health professionals.

Allan:)

[John Rutledge]

deleted....

[Claire Saenz]

JR,

I'd say the "two hatter" rehab counselor who sent me to AA in the first place is indeed a "Mad Hatter".

I found out, years after I got sober, that this counselor 13th stepped my sponsor--slept with her--when she was brand new and vulnerable (also married, and this is the same spiritual fellow who still sends me Christmas cards each year signed "In Jesus' holy name".)

He has grey hair dyed pink. I think he's trying to achieve a delicate shade of red, but no, it's pink.

So here's this sponsor screwing, pink haired fellow "counseling" people and sending them to AA. Oh my God, when I think about it I don't know whether to laugh or cry.

"It would be so nice if something made sense for a change.”--Alice

Claire

[JulianP]

............deleted

[Claire Saenz]

JP,

Thank you so much for your post. Those are my own thoughts, exactly, but expressed better than I could have ever done.

It's so true that I've interpreted the doctors' responses in this debate as being dismissive and hurtful. I feel somewhat like Joseph Merrick in the movie "Elephant Man", curled in the corner crying "I am not an animal!"

Claire

[ASchwartz]

Hi JP and Claire,

Inadvertently, and I do believe it is 100% inadvertent, those responses are being interpreted by some of us in a way that is quite similar to being told, "The people who have reported positive benefits of AA are more valid to me than you or others who have had negative experiences" and I am therefore discounting your claims and continuing to refer patients and not include any consideration for possible abuse,...

Excellent post. You "hit the nail on its proverbial head." Speaking for myself ( I cannot speak for Mark but suspect he would agree), I do not invalidate your experiences. I do not even think of them as "claims" because I know they are accurate. I know you read my article about communication and its problems and that is just what I was trying to point out, how, in a debate, it is very easy to feel dimissed and invalidated.

Just to clarify, I do not refer people to AA. In fact, I am retired from active private practice and no longer work for any agencies. Except for this, I am retired. However, it is true that I did suggest AA to a few people over the years. Among those I suggested it to, most refused and a few did not have such good experiences, either. Most of my experience was with AA people who found their way to me. That was when I was in New York City and one person found me on the Internet and then started to suggest me to other AA members. Most came to see me, stayed in psychotherapy and we worked together for years. They have moved on to their full lives and I am retired. By the way, I saw these people at extremely very low fees. That was my choice and no regrets. It worked out well.

Claire, what a great way to put it: Feeling something like the "Elephant Man." Sorry, I never intended for your, JP, JR, Mike or all the others, to feel that way. I am sure Mark would agree.

Could some of you explain, in some detail and without violating anyone's privacy, some specific incidents of the types of abuse you witnessed or suffered at AA? If not, I understand.

Allan

[John Rutledge]

deleted.....

[JulianP]

............deleted

[Claire Saenz]

Could some of you explain, in some detail and without violating anyone's privacy, some specific incidents of the types of abuse you witnessed or suffered at AA? If not, I understand.



Allan, I have posted my experiences with AA abuses numerous times in various places throughout this website, as have others. If you want to get the full flavor of these abuses, you could do no better than to read through the postings one more time.

But as JR has pointed out, the issue of abuse is, by far, not the only one. If I had never been subjected to or witnessed a single abuse in AA, that would not change the fact that the philosophy of the program completely contradicts everything I believe but was presented by the "treatment" community as being the only way for me to avoid death. Nor would it change the fact that there is no scientifically valid evidence that the program works.

Claire

[JulianP]

............deleted

[Mark]

This thread moves too quickly for me to keep up :)

Julian - your post about misunderstandings was right on, as others have pointed out. Allan and I are not trying to judge or dismiss, but it is easy to see us as judging, dismissive figures, I think, in part because of our professions and the various transferences that go with that.

Claire's image of the Elephant Man is very vivid and painful. It suggests to me the great difficulty - the wounds that have been sustained in the process of "graduation" from AA which those active here in this thread have experienced. In order to break away (after whatever early support's beneficial aspect was done), it was necessary to become very lonely and to go against the prevaling wind. Many people telling you that you were wrong, and only yourself to trust that you were doing right. And - this coming from people who have had reason to not feel confident in trusting their instincts, coming out of a program which makes no bones about its rejection of trusting instincts. So it is a kind of bloody bruising victory that has been achieved, and a lonely one. I get that - or at least that is how I think it must be - not having experienced it directly (in this format - I've had to do my own breaking away in my own life in different circumstances and can relate a little bit).

I see this as a kind of development of identity - an assertion of identity in the face of pressure to not do that. This kind of thing always reminds me of my favorite developmental theorist - Robert Kegan. I recommend that those of you here who are active please read my essay about Kegan's book "the evolving self" (http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=11433) - and pay careful attention to the transitions he describes between stages of identity and how the process of emerging from one consciousness into another works - a process of disembedding yourself and becoming more objective about it - and the blowback you get from others around you who can't understand what is happening.

[JulianP]

............deleted

[Claire Saenz]

In order to break away (after whatever early support's beneficial aspect was done), it was necessary to become very lonely and to go against the prevaling wind. Many people telling you that you were wrong, and only yourself to trust that you were doing right. And - this coming from people who have had reason to not feel confident in trusting their instincts, coming out of a program which makes no bones about its rejection of trusting instincts.
...
I see this as a kind of development of identity - an assertion of identity in the face of pressure to not do that. This kind of thing always reminds me of my favorite developmental theorist - Robert Kegan.

Mark,

Thank you for your thoughtful comments. First, I want to echo the statements made by JP regarding the lack of beneficial support I found in AA in the first place. As I wrote here a few days ago, on balance whatever support I received was not worth the emotional and intellectual price I paid for it. Nor was it necessary for whatever support I did receive to be packaged within a sick ideology. One can certainly learn strategies for staying sober and have contact with others who have had similar problems without being required to abandon one's values and common sense in the process.

Second, I want to point out that it is not merely the people inside AA giving us "blowback" for leaving. It's a much larger problem than that, because the "common wisdom" of AA has so permeated society that people who've never set foot inside a meeting or read a paragraph of the Big Book have absorbed a lot misinformation. So, it's not just that your former AA friends are calling you to beg you to come back before your inevitable relapse...it's your real friends and family who believe that you're forever "recovering" and just as likely to relapse after ten years as you were at ten days. "So what are you going to do to stay sober NOW?" they'll cry upon being told you've quit going to meetings, and they won't be satisfied when you say you've just moved on from the problem and consider yourself a nondrinker now.

Third, regarding the idea of stages of maturity and the courage it takes to progress (particularly beyond the level of those around you) I agree wholeheartedly. But isn't it ironic, then, that our addiction treatment system, which almost always sends people into 12 step groups, is essentially placing people in an environment that makes this already challenging process more difficult? Isn't the point of treatment supposed to be to help people get healthy, not refer them to a group where signs of increasing maturity are viewed as Red Flags for relapse ("trying to do it yourself, now, are you, Claire? Remember that your best thinking got you here!!!!!"......ARRGGGHHHH).

Finally, I wasn't sure from your comments whether you are suggesting that the passion some of us have for this issue is somehow pathological. I do know that some folks think it is! I wonder if people who feel this way would feel the same we had gone for cancer treatment and had been shunted by our doctors into a faith healing program that not only didn't help us but actively undermined our efforts to get better. I think a bit of honest ire would be viewed as understandable and even healthy under those circumstances! Somehow, though, alternate rules of logic appear to apply to the "disease" of alcoholism.

Claire

[Mark]

Isn't the point of treatment supposed to be to help people get healthy

That depends on the stage where the person is at re: their problem. Sometimes healthy is defined as "still alive", and other times it is defined as "independent". When someone is in dire trouble, and cannot self-regulate, it is good to put them into an environment where others will help regulate them. Then later on, when external regulation is not as necessary, that same regulation environment may get in the way of progress and maturity if it does not get out of the way.

In my view, AA seems to be best at the former task (of providing external guidance and containment when it is needed), and worst at the latter (getting out of the way when no longer needed).

I feel compelled to say that I had no early support or benefits of treatment or AA.That's fair, but I know that other people here have reported that it was helpful initially. Individual experiences will vary.

I wasn't sure from your comments whether you are suggesting that the passion some of us have for this issue is somehow pathological.I do think that there is a level of mild paranoia-esque overgeneralization happening here inasmuch as a number of commenters here have painted Allan and I with a fairly broad brush - representing us as being hostile/dismissive when we are not. It is widely sensed, I believe, that we are looking to judge/condem and we are not. I do think that the level of anger on display here is frequently counterproductive. I do not think that the criticisms are unfounded though or inappropriate (except in as much as they get to be overly repetitious).

[Ray Smith]

Ray, This is ultimately a matter of social skills, I think. You seem unable to recognize when it is time to stop, and that makes it hard for me to like you. I'd like to like you, but listening to you repeat yourself is wearing. Interpret it how you will - I'm fairly sure it will not be flattering, because it does seem that you need me more as something to resist against than as a person who could be a friend - but - it's time to stop at least as far as I'm concerned.

Mark,

Over the years that I've been reading & posting here, your views on AA appear to have softened, and I've commented on that here and elsewhere. You've gone from thinking there was one extremely angry poster using several names to understanding that there are many people with legitimate gripes, but you still don't seem to have an understanding of what AA can do to people with mental illness.

Your comment on my social skills was tactless, and I got the distinct impression that you were talking down to me.

Like the others that have been posting here, I often don't think I'm being heard. When I am not being heard, I repeat myself and when people still don't hear what I saying, I raise my voice. That has nothing to do with social skills, it has more to do with years of frustration with professionals dismissing what I have to say, or more importantly, dismissing me as some sort of crank. I had to learn to be assertive with people that pushed and prodded me towards ineffective and damaging treatment, and now I do the same for this generation of dually diagnosed people. I hammer out posts filled with facts & figures, stats & studies that go by largely ignored here.

I'm not here to fight you, I've been posting here to try to get you (and now Dr. Schwartz) to examine what you are telling vulnerable people. That's sort of what I do in my job as a Peer Specialist, I act as a bridge between the clients and the professionals, I have a foot in both worlds. The professionals I work with value what I have to say and my ability to reach clients.

Perhaps you still don't understand what I and many others had to go through to find any type of help that was not 12step. Casually mentioning that there are other groups out there doesn't help unless there are meetings in the area. People quit drugs and alcohol only when they find the motivation to quit. Sending people to AA is essentially a crap shoot, helping a person find his or her own motivation is not only statistically best alcohol/drug treatment option available today, it does not have the level of potential harm of 12step programs. Why would anyone send someone with anxiety, depression, or self esteem issues to a fear based program that demands ego deflation?

The AA meetings held outside hospitals and suburbia, the kind of meetings that most people with coexisting mental health and substance abuse disorders are nothing like the the AA you and Dr. Schwartz describe.

I work with clients who are diagnosed with moderate to severe mental illness. The "external guidance" that they get in the rooms is that doctors and mental heal professionals don't know anything about being an alcoholic and that they need to throw their medications away, if they work the program properly and do not drink, they won't need therapy and medication. They are pushed into believing that they are alcoholics or addicts despite not meeting the DSM-IV standards of dependence. Few of my clients do, almost all are either self medicating or attempting to fit in with their limited social circle.

Dr. Schwartz's experience with AA members seeking psychoanalysis sounds like it must have been an upscale meeting, my clients live on Medicare and Medicaid, they cannot afford to seek outside help. And the people Dr. Schwartz describes seeing were part of the small percentage of people who were successful in AA.

The clients I have go to AA and respond to the love-bombing that newcomers experience. ("We'll love you until you can love yourself!") When their mental illness become known though self disclosure or when they become symptomatic, they are shunned by most and become targets for others. Even if dually diagnosed people are warned about predators in the rooms, most do not have the social awareness to differentiate. Most are socially isolated and have never developed the type of skills necessary to navigate dangerous situations. They are easily swayed by those they believe to be friends and by those who represent authority, but when push comes to shove, which will they believe?

You wanted a testimonial?:
One of my former clients was mandated by the court to attend AA. Three or four times a year, the voices would get so bad he would drink in order to pass out. His neighbors would complain about him yelling in night, the police would show up and because he had been drinking every time the police showed up, it was assumed he was an alcoholic. He was a big, scary man in the middle of a psychotic episode, the police were never gentle.

He gravitated towards the other mandated outcasts in the rooms. Because he had a monthly disability check, he was a popular man with the chronic relapsers. He was told he was an alcoholic and believed it, he started really drinking. He stopped showing up regularly for mental health services. It's difficult to compete when a person's "friends" see him all through the week and we were lucky if we could find him for an hour or two.

He met a woman who was also mandated. She had been a prostitute but she never charged him, he thought that proved she loved him, he called her his girlfriend. She quickly introduced him to crack. The two of them would smoke his disability check and she would disappear until he was due for the next one. No drugs or money were found in the room he died in, but the autopsy showed a massive amount of cocaine in his system. He was younger and healthier than me.

Thank goodness that in the real world the mental health field is moving away from the 12step model, to find professionals on a mental health website still unaware of the problems with it is disheartening.

[JulianP]

............deleted

[Claire Saenz]

Thanks Ray and Julian for your most recent posts. Ditto to everything both of you have written.

I'd like to add another testimonial, this one personal, which speaks to the following point made by Julian:

[I]When someone is in dire trouble and cannot self-regulate, it is good to put them into an environment where others will help them learn to self-regulate. That is the only way external regulation will not be necessary later on. In 12 step treatment and in AA, self-regulating is not just discouraged. It is forbidden. Self-regulating (or any signs of wanting to self-regulate) is the equivalent of "stinkin thinkin". It is a symptom of one's disease/insanity, It is expected that a member/client will turn to his sponsor and/or his higher power for any and all direction, solutions, answers. It is the polar opposite of what someone, for example, who has already had the otherwise inherent ability to self-regulate beaten out of him, needs.

There are many sufferers who, for valid reasons - reasons outside of drugs and alcohol (or which pre-existed alcohol/drugs) - such as abuse, neglect, abandonment (keeping it simple, here) have learned and have been trained, to doubt themselves, to view themselves as worthless, incapable, "bad", and the list goes on. Demanding the acceptance of aa and 12 step philosophy by people such as this is the equivalent of saying to them, "You know all of those feelings of self-disgust, self-hate, and worthlessness you feel? Those feelings are right. You have nothing within your pathetic, diseased self to rely on - including your insane mind which, only if you "work the program" will be restored back to sanity." I won't even go into the potential horror and tragedy for this "client" when she is told that the only alternative to this program is death.


I've previously written that the support I got from AA in my early days of sobriety was not worth the emotional and intellectual price I paid for it. Julian's words express exactly why I say this. At precisely the point where I was ready and willing to do the work necessary to heal, AA's ideology stood directly in my path. I had to fight for my right to truly get better.

Following is an excerpt from the journal I kept during my first few years of abstinence. This particular excerpt was written in the summer of 1999, when I had been sober for approximately ten months and was beginning to confront some significant childhood abandonment issues. I had just entered therapy the previous week and was being told by various AA oldtimers that instead of therapy, I should simply "let it go", "turn it over to God", "make amends" and move on. I recall crying in frustration and anger as I wrote this, upset that my recovery friends were insisting that I take a path I KNEW was wrong for me.

It struck me yesterday that if there has been anything worse in my life than being abandoned and betrayed as a child, it is being told that I am not even entitled to have feelings about it. It’s as if I’m so incredibly unworthy that not only was it okay for my mother to take away her love, but that it was not okay for me to be hurt and angry about it. All my life, every time I have expressed these feelings I have been told that it is not okay for me even to have them.... And even since I’ve gotten sober and been trying to work on this, so that I can get past it, for God’s sake, I’ve continued to hear that I have to let go of my anger. That if I’m upset it’s because of my character defects--because I’m a spoiled brat, because I haven’t gotten my own way--again all my pain has been thrown right back in my face and I’ve been told to get rid of it already or I’m sure to relapse.

Well guess what. I’m done with this shit, right now. I know that I can’t sit in this pain forever, if for no other reason than I’ve BEEN sitting in it all along and all it ever did for me was make me into a crazy addict. I know it’s my job to work on this and get over it and that that process isn’t going to involve changing my mother or my father or my past or anyone or anything other than me. But I will not be told, not ever again, that I am not entitled to my feelings about this. If I am not entitled to have them then I can never deal with them, and if I can never deal with them I am destined to relive them again and again.

I went on, continued in therapy for another 5 years or so, successfully processed my issues and have a relatively calm, if not particularly close, relationship with my family of origin. But I had to ride into the wind--against AA--to do it. In order to improve the state of my mental health, I had to fight the program that the mental health community sent me to.

Claire

[ASchwartz]

Hi Claire, Ray Smith and JP,

Claire:

I know that I have written that some AA members referred one another to me quite a few years ago. In that situation, they and their sponsors ended up in my office. All of them recognized the fact that they needed psychological help above and beyond what AA could provide.

It has made me wonder if the problem is that the AA chapters vary widely across the nation. I know very well that there are old timers in AA who are extremely conservative, like the very rigid orthodox priests and rabbis found in the various religions. Despite the fact that I have been told that meetings do not vary, my sense is that the sub groups, outside of the meetings, and the various sponsors, vary a great deal. It seems that you and many others were stuck with the very orthodox guys instead of more enlightened and psychological "savvy" people.

This may be a partial explanation for the wide divergence of views and experiences with regard to AA. Even outside of the particular chapter that sort of connected itself to me, there were other people, from very different chapters, who found me because they were seeking psychotherapy. One of them was a thirty year veteran of AA.

My point is that, again, this may explain some of our divergent views. I certainly appreciate and am even angered by the fact that some "Jerk" in AA attempted to discourage psychotherapy. Ridiculous.


Ray Smith and JP:

Sorry, but I do not see psychotherapists moving away from AA or from 12 step programs. I also cannot imagine any Competent psychotherapists dismissing patient complaints about AA or complaints about anything. In fact, I would advise anyone who sees a therapist who discounts their complaints about anything to go and find a new therapist.

Sorry, Ray, but I did not do psychoanalysis with the AA people I have discussed. I charge and received amazingly low fees, I really mean a few dollars because they were down and out and it was all they could afford. These were people who had, during their addiction, become homeless, some had been in prison for a long time, etc. No, these were not "wealthy people" they just wanted to put their lives together again. Perhaps it is New York City, where people are more knowledgeable about psychotherapy than elsewhere. I have lived all across this nation of ours and I believe i am right about that.

So, sorry Ray, no, this was not psychoanalysis, not even remotely. It was supportive psychodynamic therapy and they got a lot out of it.

JP, no one is telling to give up "your story." At the end of your last post you wrote "That is my story and I'm sticking to it." Fine, no one is asking you not to and neither Mark nor myself seem to be able to make any of you undestand that we are NOT dismissing your complaints, observations or experiences. However, this goes both ways: Whether it is Ray, Claire, JP, JR or anyone else, stop trying to minimze, reduce and ridicule my very real experiences and observations. I do not mind dialogue but I am muchly bothered by the defensiveness.

Allan

[JulianP]

............deleted

[xenophon]

Well, if there is to be any progress in the matter of substance abuse treatment, there must be movement away from 12 step. I realize that inertia is a problem. But, someone has to get moving. Otherwise, we will continue to get more of the same.

"If you are satisfied with the results you have been getting, keep doing what you have been doing."

Under present day conditions, I cannot, with honor, recommend what passes for substance abuse 'treatment'. I must, as a matter of calculated risk, counsel do it yourself. I am not a luddite.

I do not expect substantive change in the present day conditions of substance abuse 'treatment'. Perhaps, one day, it may. But, I doubt that I will live to see any improvement. That is my view of it.

[Claire Saenz]

Thanks once again Julian for your kind thoughts and words, and for once again stating my own views quite clearly.

Allan, I am not dismissing your very real experiences with AA members who are happy with AA and what it has done for them. I know you have had those conversations. I have had them too; in fact, if you'd caught me a few years ago, before I freed myself, I'd have sung AA's praises myself. You'd have held me up as example of an AA success! I couldn't admit that my membership was a mistake for a very long time...leaving cost me nearly all my friends and my social life, so it was kind of hard to walk away.

But I have to disagree with the notion that my problems with AA were the result of falling in with some fundamentalist outliers. I was in mainstream AA. I went to meetings primarily in an affluent area of a large city in the Midwest, and everything I heard at those meetings was 100% in line with the things I read in the Grapevine and heard at the many retreats and conventions I went to, including International Conventions with AAs from around the world. Plain vanilla AA...powerlessness and the need for an outside power to recover. Anger "the dubious luxury of normal men". The "daily reprieve". This isn't stuff that some wingnut preaches, it's the lifeblood of AA, it's what's in the literature, it's what they talk about at meetings, it's FUNDAMENTAL, and for some of us, fundamentally harmful.

Claire

[Ray Smith]

Whether it is Ray, Claire, JP, JR or anyone else, stop trying to minimze, reduce and ridicule my very real experiences and observations. I do not mind dialogue but I am muchly bothered by the defensiveness.

Allan

Don't you think we feel the same way? I have been shouted down, ridiculed, deserted by family, and suffered many threats of physical violence for questioning AA since 1983. And I do mean questioning, I wasn't a hard line, AA critical person until a few years ago.

Now I'm involved with several 'alternative' recovery and AA-critical email groups, totaling thousands of members. A person wanting to join one today said, "I am sick of having my self-esteem trampled on by AA." That after 16 years of on and off attendance.

But anecdotal evidence proves little for either side, they are testimonials and not necessarily representative of a typical experience.

Over 60% of new AA members arrive under some sort of mandate, 95% of all new members leave within the first year. What does that say about a program that claims to be founded on "attraction rather than promotion"? The system as it now stands is cranking out a vast number of disgruntled ex-members for every member it manages to keep.

I, too, know people who swear that AA has kept them sober, but when you look at the numbers, the dropout rate, the relapses, the mortality rate, at what point do you question? You can't judge a flawed program by its handful of successes. People deserve better than being told they have a life long disease that they are powerless over. Instead of praying to God to remove the symptoms of their disease one fearful day at a time, they should be encouraged and motivated to make healthier choices. And that is happening in the mental health field more and more each day.

When a treatment method fails scientific scrutiny, new treatment methods need to be explored, evidence-based methods.

[xenophon]

I just think that it is unfortunate that people get caught up in all that. AA is full of drama, defeatism, one downmanship, etc etc. The AA that I saw was a can't do attitude, velied death threats, condescension and arrogance.
No thank you. I am better off doing it myself. And, I was. I did do it myself and I am proud that I had the strength, courage and determination to remake my life after a lot of adversity. It is no fun for everyone you cared about die. And, to have your wife die at 630 am on a sunday morning, and to be the only witness. And, AA tried to tell me what I could not do? ha.
Thanks -- but no thanks aa.

It is far past time to do better. I am 63 -- I am sure that I will not live to see any improvement.

[John Rutledge]

deleted....

[xenophon]

As someone who solved the problem on his own, I do not matter. If I can do it on my own, I did not really have a problem. So, this is from someone who cannot be taken seriously -- substance abuse treatment is a disaster. And, I doubt very many people actually care.
I, for one, think that all that is unfortunate. But, I do not matter.

[Claire Saenz]

As someone who solved the problem on his own, I do not matter. If I can do it on my own, I did not really have a problem. So, this is from someone who cannot be taken seriously -- substance abuse treatment is a disaster. And, I doubt very many people actually care.
I, for one, think that all that is unfortunate. But, I do not matter.

Sad but true--the voices of the xenophons of this world are entirely disregarded. MOST people who get sober do so on their own (I believe 80% was the statistic Ray quoted, from the Harvard Mental Health Letter), so you'd think their thoughts and experiences would be considered quite valuable, but instead they are typically ignored. In AA they'd be subtly sneered at..."Oh, he's not a 'real' alcoholic, what does he know?"

Claire

[xenophon]

We must be ignored and disregarded. We are a living refutation.
Substance abuse treatment is a disaster; an enormous black joke. "For what we are about to receive, oh Lord, let us be truly thankful". I do not expect change in my lifetime. We await a Lister or Pasteur.


But, it is what are supposed to do, as adults: Recognize that a mistake has been made; a bad habit has been fallen into. Then, recognizing that, take effective steps on our own to get shut of it.

My user name has meaning: Xenophon wrote a book, entitled "Anabasis". Anabasis means an expedition from the sea to the interior. Which is what Xenophon did; and, what I did.

[JulianP]

............deleted

[xenophon]

JP, thank you sir.
I reflect that god is just. "The mills of god grind slowly; but, they do grind, exceedingly small."

The real world is full of people who drew a line under all sorts of 'bad habits'. With varying degrees of help. I had 'anti help'; people trying to tell me what I could not do. I left them where I found them. And, some real help - in the form of books for the most part.
I have little interest in those who preach the dogma of 'can't do'.
Very simply, I determined what I needed/wanted to do. And, set about making it so. There were significant changes to be made; which took time and adjustment and effort. In that, I am not unusual. Let no one think that I am. Shame on those who think that I am.

[Mark]

At this point, it seems safe to say that we all feel we are being not heard properly, and all involved here actively are upset about that.

I personally believe that I'm being asked, implicitly and explicitly, to become the exemplar of the aspirations of this group - the "fully enlightened" mental health professional who has learned to see the error of his ways and now actively un-promotes AA for all the many valid reasons presented here. That I am open to reexamining my views is appreciated, but not enough for you all to like me as a person. I will not receive your true accolades until I fully capitulate to your vision and your hard won views.

I think it is fair to say that you do not really want to influence professionals so much as you want professionals to accept your views as gospel. There is a dominance element in play between two sides which is preventing us from being able to recognize each other as people. From my own perspective, it feels as though I am being asked to submit, not so much to the people carrying the message but to the rightness of the message itself.

I do not see myself as trying to dominate the very intelligent anti-aa group participating here. I see myself as trying to hold my own counsel in the face of what is frequently aggressive speech. I'm not talking about the content of the speech, but rather the posture of it.

It seems to me that the anti-aa group views my unwillingness to capitulate as something aggressive in itself, as though by attempting to say, "I reserve my own counsel", I am actually saying, "you're all a bunch of losers", who as Xenophon so explicitly expressed "don't matter". Let me clarify that I'm not saying the latter at all. I hope that it is clear that I think you all do matter, Xenophon included and do take your positions seriously. This does not mean that I share them all or value them in the same way. I can respect and honor without seeing things the same way.

Where I am trying to respect and honor but not capitulate (essentially trying to maintain an assertive posture) I seem to be being responded to as though I'm being aggressive - dominant - suggesting to me that 1) I have perhaps become a proxy onto which is being projected past experience with mental health professionals, and 2) that many if not all of you have felt incredibily dominanted - by aa certainly, and that some of you are very sensitized to the feeling of being dominated, perhaps into the mild paranoid range where even people who are working hard to try to be neutral in the midst of a heated discussion can come across as aggressive (yes Ray, I'm thinking of you here, but not only of you).

I'm not immune myself by any means. I'm certainly needing to chose my words carefully because I'm feeling angry reading this stuff. I am feeling attacked too. I share this because this is not an interaction between a therapist doing therapy and group therapy participants, but rather a discussion between people from various backgrounds who want to talk about AA. I'm not here to help the anti-aa contingent as a therapist; I'm here becuase I have a personal interest in better understanding the issues being talked about here. Some of these issues are about aa itself and how it is run, and some of these issues are about us here talking about aa and the dynamics that are occurring. It occurs to me that these two levels may be related.

Would it not be funny or ironic or whatever the right term is, if the very people who were so trampled upon and wounded by aa's insistence on dominating them turned around later and became people who felt a need to dominate others - not out of a sense of wanting to dominate in an antisocial fashion, but rather out of a sense of wanting to overcome a feeling of helplessness. In other words, aa perhaps impressed the dominance/subbordination dynamic into people's heads, and in escaping aa, it has not yet been possible to escape the either/or of dominant or be dominated. Since no one wants to be dominated, the alternative is to find someone else to dominate.... Not that this is all that is going on, but it seems to me that it is maybe some of what is going on.

In closing I want to say to JP that your restatement of my point about people sometimes need external regulation is a good one. It is a better thing if external regulation can be arranged in the manner of a good parent who will help to teach self-regulation, rather than in the manner of a bad parent who will teach domination.

[xenophon]

Mark, as a layman, I appreciate the difficulties of the therapeutic process, which may be complicated by substance abuse. As I understand it, the process is, frequently, complicated by it. Rightly or wrongly, I have come to the opinion that destructive drinking/drugging is linked to 'mental suffering'/mental illness. In other words, there are reasons for it. I think that makes both more difficult to handle. It is not, 'merely', drinking too much.
Although, sometimes drinking too much is simply drinking too much. Current methods do not appear to deal effectively with 'dual diagnosis'. That is my main 'beef'.
Fervently held opinions, fervently expressed do tend to generate a lot of heat.

My own view is that there are two big factors: first is severity of the problem. Someone like me -- who drank too much for a year -- is much different from someone who drank a pint of vodka a day for 20 years.
And, state of mind is important and/or life circumstance. An alcohol dependent person with borderline PD is not the same as someone with OCD or depression.

Quite frankly, I do not see how AA is equipped to deal with that.


For me, I take umbrage at AA that insults my experience. But, I will get over that. I just want professionals to pay attention. I know it is a difficult problem.

[JulianP]

............deleted

[xenophon]

I am, basically, done here. I just want to say that I am glad that got through what I got through in one piece. It was a 'great adventure". And, I have my life back; and, an entirely different one: new wife; new family; new home; new state. Back in Feb 2004, I would have never thought it. Drinking too much was, simply, my own [ineffective] way of living through what I had to live through.

I have not changed my view that someone who quits on their own is not taken seriously by aa and the SAT business. They are not. Perhaps, some individuals do; but, not those entities. I will go about my business now.

I hope that one day substance abuse treatment improves.

[John Rutledge]

deleted....

[Claire Saenz]

Well, there really is very little to say that hasn't already been said, so I guess it's time to stop. I have found this exchange valuable and I appreciate having been given the opportunity to express myself and to read the views of others.

For what it's worth, I do think that things will change and are changing. AA is shrinking in size and would be shrinking even more quickly if people weren't being forced to attend. The voices of those of us who were not helped or who were actually harmed in AA are now being heard, thanks to the internet and forums just like this one. Horrific situations like Midtown aren't flying under the radar anymore, and it is only a matter of time before legal action (civil, criminal or both) is brought against the program and/or its members. And more and more clinicians are realizing that while AA may be an easy referral, it isn't necessarily a responsible one.

I wish you all well.

Claire

[JustTrying]

I want to join in!!!!:)

Let me just tell you what I have been up to... no bashing either way.

Earlier this month I called and made an apointment at the CDC ( Chemical Dependancy Complex) for outpatient treatment. I went on what was to be a last hurah and ended up with DUI #2.... Now mind you, I already made the apointment. As some of you know I have been struggling with this for years. I have been in and out of AA for 15 yrs and just recently started NA which I found more to my liking ( More people and more women and more folks close to my age)

After many years of therapy ( with a man that does not like or approve of AA ---- Even though I went) I believe I have finally found a therapist that understands. It is like she can read my mind. Our goal is to take a brief look at the past and see what causes the pain and feelings that I try to drink away. She also does 12 step , we are working on a Step 1 worksheet and then we will discuss it. For once I feel like things are going to be explained.

I also have had a medication added for depresion.... Symbylax... I love it!

Will I totally work the 12 steps? That remains to be seen, but it is nice to have someone explain them to me and not just say "do this".

Even though I had cut way back on the drinking.... as of today I have 5 days and I feel great. I think the meds help. I see the new therapist once a week.

I do know personally several people that after 15 -25 yrs sober still attend AA. I do not think I want to feel like I have to attend AA or I will relapse. I am looking forward with the help of my therapist and my doctors and MYSELF and yes perhaps GOD to find happiness. And in order to be happy alcohol has to go because me an alcohol are a deadly combination.

Sorry I don't now how to use all of ya'lls fancy words and all.... I can only talk the way I talk but maybe someone will get the point.

JustTrying

OH YEAH>>> I wanted to mention I got 5 days in Jail - 2 this wk.. 2 next .. 1 next... Sitting in that cell talking to women addicted to Meth, Crack and alcohol ( You name it) was the best eye opener for me... one was going away for 22 yrs... she has to leave her beloved grandson behind. Another facing a year.... just got a call that her son tried to commit suicide because he couldn't be with his Mommy... Another just got her back pay and bonded out and was headed right to the meth house. The young un (28) said she couldn't wait to do her year and get out and get a beer and some pills.

I listened to their stories and I could see that in my future.... a future I do not want. I only got 5 days in jail and 1 yr suspension and of course a heafty fine ( which my husband will pay). Normally I would have said it was just dumb luck I got caught... but I am thankful for my 5 days in jail.... I hope to see more horror stories and see the afterresults of addiction.

Whatever it takes, AA or NA or NOT..... going with my husband a few days a week or anything. I will beat this.... Oh yeah I also for 24 weeks need to attend a class called ACTS.... They are suppose to help with lifes problems and addiction. I start Monday.

Didn't mean to ramble! :o

JT

Adding>>>> one more thing. A Dear friend of mine that is only 7 yrs older than me is dying of Heptorenal Syndrome .... that is when your kidneys fail because of liver failure. He has been sober 5 months.... but it is too late for him, all we can do is keep him comfortable and in good spirits... we all know it is a matter of time...... ANOTHER REASON TO GET SOBER......

[Abbadun]

Hi JT

I agree with what you said below and I go to AA meetings once in a while. What the AA Culture has created is a system where if you goto AA, you do not criticize AA. It is like a recovery "Fight Club" :)

What the internet as done is given a outlet for all the non-addressed issues in AA. On a side note, what kind of organization does not address its errors and mistakes? What does that say of the "culture" of this organization?

I work in the recovery field and I have heard counselors and clinical supervisors discuss things like speaking one way to the clients and speaking more secular to Mental Health Dept and Social Services. I am sure that they think that the end justifies the means.

I think that the biggest problem with the "AA Organizational Culture" is that it does not understand that the end does not justify the means.

AB


[QUOTE=JustTrying;12729]I want to join in!!!!:)


Whatever it takes, AA or NA or NOT..... going with my husband a few days a week or anything. I will beat this.... Oh yeah I also for 24 weeks need to attend a class called ACTS.... They are suppose to help with lifes problems and addiction. I start Monday.

Didn't mean to ramble! :o

JT

[JulianP]

............deleted

[Abbadun]

I find it hard to believe that there people out there that argue that there nothing major wrong with AA.

We are almost halfway through 2009 and funding sources such as NIDA, HHS & SAMHSA are taking the stance that there are "Many Paths to Recovery". Yet if you go to a AA Meeting there is a good chance that you will spend 60-90 minutes taking about how the Alcoholic must have a HP or face a Alcoholic death or How no human power can keep a person sober.

AB

[Abbadun]

Hi Ray

I would add to this the anti Atheist and Agnostic nature of AA that prevents many members from freely stating their religious beliefs. Most AA groups in my area would automatically discount the sobriety of any member that freely stated zero reliance on a HP.

Sobriety in AA would be so much easier for these members if they could share all of what is going on in their lives.

Abbadun

Many would be happy if us uppity people would just shut up and let the professionals continue to do what they've been doing. You'll get around to listening and treating us with a little respect eventually, right?

It's only been through assertiveness that changes are made.

It's not just the predators in the rooms, or the anti-medication faction, or the religious nature of the program, but the very core of the program that is harmful, it is accepting powerlessness. It is anti-therapeutic. People should be empowered in order to make healthy changes in their lives, not beaten into submission.

[Claire Saenz]

I would add to this the anti Atheist and Agnostic nature of AA that prevents many members from freely stating their religious beliefs. Most AA groups in my area would automatically discount the sobriety of any member that freely stated zero reliance on a HP.

Abbadun

Quite true. There were very few admitted Atheists in the meetings I went to, and those few were treated horribly, gossiped about, their sobriety discounted, etc.

I recall a meeting when I was fairly new. We were going around the room and when this one fellow spoke, noses wrinkled and eyes rolled even though he wasn't saying anything particularly unusual. I whispered to the woman next to me, asking what was going on and she whispered back: "Oh, that's John. He's an Atheist. Everybody hates him."

[John Rutledge]

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[Abbadun]

Hi Claire

When I do go to a AA meeting it is either in support of someone who still believes in the foundations and doctrine of AA. I also go to gain some benefit from all the people that relapse, I can never forget where I came from.

While I am sitting in a AA meeting listening to all the people announce their new sobriety dates (overwhelmingly people with a HP), I feel no need to attack their religious/spiritual beliefs even-though it has not helped some of them find a consistent sobriety in over 5 years of attending AA.

For me quality sobriety equals the longest sustained sobriety by a person who attends the least number of of AA meetings possible. It is no different from any product or service you use.

Abbadun




Quite true. There were very few admitted Atheists in the meetings I went to, and those few were treated horribly, gossiped about, their sobriety discounted, etc.

I recall a meeting when I was fairly new. We were going around the room and when this one fellow spoke, noses wrinkled and eyes rolled even though he wasn't saying anything particularly unusual. I whispered to the woman next to me, asking what was going on and she whispered back: "Oh, that's John. He's an Atheist. Everybody hates him."

[Ray Smith]

Since I am unable to post over on "Is AA a Cult?", I'll post it here:

Thanks David O/my views

Thank you for sharing you thoughts on AA. I work for an ACT program and also would never suggest AA for any of our clients.

While the success rate for Alcoholics Anonymous is about the same as no treatment at all, for those with coexisting disorders it is almost nonexistent. (Sciacca, Dual Diagnosis of Major Mental Illness and Substance Disorders, 1991)

For decades, mental health professionals have pushed clients into ineffective and potentially damaging 12step treatment. Parallel treatment for mental health and substance abuse was, at one time, the best or only, option that was offered. 12step treatment, which demands the acceptance of powerlessness in the first step, is at odds with most traditional therapy which attempts to empower the individual in order to make healthy choices and changes. Consumers can become overwhelmed and confused by the differences in approaches. (Minkoff, 1989; Evans and Sullivan 2001)

Integrated dual diagnosis programs were introduced twenty-five years ago in NY in response to consumer needs, yet is still ignored by many in the field. Although developed in the US, it wasn't until the rest of the English-speaking world adopted integrated treatment that it began to become available in the US.

The mounting evidence for psychosocial interventions such as Motivational Interviewing and CBT in the treatment of coexisting disorders is disregarded by those who have a vested interest in treatment as usual (TAU) and those they have convinced of 12step's worthiness as a treatment method.

Some mental health professionals prefer to only deal with traditional mental health issues and leave substance abuse to others. No matter what methods are employed, the success rates for substance abuse are low; many find working with such people depressing and frustrating, finding it easier to point them in another direction regardless of whether it works or not. I find this unacceptable.

A mental health professional or social worker who recommends any treatment method has a responsibility to the consumer to base those recommendations on more than testimonials.

Testimonials have their place, and it is not in place of evidence. It would be nice if we could all get rich stuffing envelopes at home but most of us realize that extraordinary claims require extraordinary proof; with AA there is none. Unfortunately, many people with moderate to severe mental illness do not have the same sort of defenses against these claims, especially those who have been socially isolated and are more interested in having new friends than the truth of what these new friends are telling them.

It is irresponsible to send vulnerable people to a fear and shame based program that tells them they must identify as alcoholics, are powerless over their addiction, and that if they obtain a conscious contact with God, they can be healed. What happens when a person prays for God to remove their desire to drink as hard as they know how and God does not respond?

Over and over I hear, "Well, it works for some people...", perhaps I should remind them that my clientele are not "some people". They can be trusting souls who become targets for predators and swindlers. I have a duty, an obligation not to place them in situations with such a potential for harm and I certainly wouldn't send them to a program where 17% of the members believe that people shouldn't take psychiatric medications. (Rychtarik, Connors, Dermen, Stasiewicz; Alcoholics Anonymous and the Use of Medications to Prevent Relapse: An Anonymous Survey of Member Attitudes, 2000)

The Handbook of alcoholism treatment approaches: Effective alternatives lists 12step facilitation and Alcoholics Anonymous as 37 & 38 out of 48 alcohol treatment modalities examined. And this is for the treatment of alcoholism, not cooccurring disorders.

Evidence-based practices requires evidence of statistically significant evidence as treatment and the absence of evidence of harm; AA fails this requirement in the Brandsma, the Ditman, the Walsh, and the Vaillant studies.

I'm sorry if the doctors here feel I am repeating myself, but I do not know how else to make myself heard.

[John Rutledge]

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[ASchwartz]

Hi Ray,

and welcome to our forum. I do not understand why you cannot post over on the the "comments" part of the website in reaction to "is AA a cult." Is it a tech problem???

Ray, with all due respect to you and your right to your opinions and experiences, I see things differently as JR, JP and many others know.

As someone who has worked in mental health for thirty years I can assure you that no one in mental health has a "vested interest" in AA. The only interest we have is helping people recover. It is true that some therapists do not want to work with someone with addiction problems. But, that is also true with regard to the psychotic illnesses, and other types that some professionals do not feel comfortable with. I am not defending them, just explaining.

I have become aware that some among you seem to think that mental health professional "refer" clients to AA. There is no such thing as a "referral" to AA. Yes, we can suggest and we do suggest, but, we suggest many treatment options, including in patient treatment and others. I found that when I did suggest someone in my practice was having an alcohol problem, that they give AA a try. You know what happened? They did not go. In fact, the only patients I had in my private practice who were AA were people who were in a
AA long before they came to me. Of those people, I can honestly report that All of them were pleased with the help they got from AA whether they were still attending or not.

I can only report this, and from my point of view, my experience, and my discussions with other therapists and clients, that are pleased with AA. In fact, it is only here, on the Internet, where I have run into such an anti AA attitude.

I have said other times, that I have visited AA meetings and in other countries as well as here and the people were very pro AA.

From my point of view, there seems to be a gap between what is appearing on the Internet and what is going on "out there in the world" with regard to AA.

I would like to hear your responses, all of you, but, I really want a respectful discussion and without the bitterness and acusations that seem to characterize some of these interchanges of views.

Allan

[JulianP]

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[JustTrying]

IMHO.... You won't hear many people say anything against AA in the "real" world because AA is seen as the only and best way to get sober... You don't go against popular opinion. People who have never had an addiction problem have heard the praises of AA/NA sung so often that they think it is the only way to get sober.

I personally know several people with years of sobriety that still attend AA and have made it a way of life. What ever works for them.

I have been going to AA on and off for years and recently started going to some NA meetings. I do enjoy the people sometimes and having somewhere to go, but I do not think I will ever buy the whole deal.

I am in therapy now ( with a new therapist) that specializes in Chemical Dependency. We are on the real problems. IMHO again, Addiction is only a symptom.

I say what ever works works. I have suggested myself that people might want to give AA/NA a chance. It may be for them. I am a member, but I just go for the FREE group therapy. However, early on , listening to the WAR stories would make me want to drink and I usually stopped and got me a 12 pack on the way home.

Even watching my good friend lay there all swoll up because his liver and kidneys are failing him at the ripe old age of almost 47. Still has not made me make the decision to choose total abstinence. The DUI #2 and the 5 days in jail haven't made me choose TOTAL abstinence. I have decided to make some major changes, to not drink as often and to stay at home if I do, and off the CB and the phone. I am sure that will make a lot of people happy!:)

Gone are the angry days.... the days of getting drunk and using all those fancy 4 letter words.

I don't understand my thinking, I don't mind the black outs, the falling and the bruises. I seldom get sick and hardly ever have a hangover. The only thing that bothers me about my drinking is that..... People, Parents, sisters, brothers, husband, friends and yes AA... have made me feel that I am doing something Naughty when I drink, that I am Bad, Weak, and Powerless. That I am diseased and I cannot help myself. That I can not possibly drink at all and be sane.

The result of all that talk???? When I get drunk, I get depressed, I feel like I am a bad person, even when I have bothered no one. When I am sitting in my house alone having a few beers , I feel like I am bad. I even feel guilty buying it and I am 40 yrs old.

I am also as part of my DUI#2 having to attend an ACTS class. I too think that is BS. Last week I learned the proper way to sniff paint, the week before we learned abut "designer " drugs and which ones were stronger than Morphine.... Things that I don't need to know. Not to mention the 45 minutes of preaching that goes with it. However , If I become a member of the church I can get away with only 12 wks instead of 24.....

I have been sober for almost 2 wks now.... and yes I feel good, but I have also been busy living life. I haven't had time for AA or NA. I do enjoy going on occasion and have made a few lifelong friends there, but I do not want my life to be controlled by alcohol... either by drinking it to excess or by running to MEETINGS 2 times a day to stay sober.... To me that is allowing alcohol to control you in another way. By running from it.

I know some people who will not even eat a chocolate chip cookie or use mouthwash because after 18 or more years "sober" they are afraid it will cause cravings. I use mouthwash every day and I eat what I please. I do not think I am Powerless over anything. I make the choice to drink and I know that when I drink I am going to drink a lot, but I have never seen the point in drinking 1 .... If you don't want to get drunk, then why drink at all?

I guess I am more into Harm Reduction. To drink in as safe place and stay off the road. And to not let alcohol or drugs interfere in me living a real life. And drinking everyday, passing out and doing it all over again, is not a life....

Sorry for the rant!!!!

JT

[John Rutledge]

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[Ray Smith]

Hi Ray,

and welcome to our forum. I do not understand why you cannot post over on the the "comments" part of the website in reaction to "is AA a cult." Is it a tech problem???

Ray, with all due respect to you and your right to your opinions and experiences, I see things differently as JR, JP and many others know.

As someone who has worked in mental health for thirty years I can assure you that no one in mental health has a "vested interest" in AA. The only interest we have is helping people recover. Allan

It does appear to have been a tech problem that has been taken care of. I've been coming here to this forum for some time, but thanks for the welcome anyway.

When I talk about a "vested interest", I'm talking of "two-hatters", professional people who are quietly 12step members and use their authority to push people into 12step treatment in the belief they are doing 12th step work.

There's also the matter of kickbacks to social workers and therapists for referrals to treatment centers and rehabs. While it may not be as common as the two-hatter scenario, the treatment center I attended was closed because of kickbacks and I've run across news stories of it happening several times since. Treatment centers, rehabs, and certain programs require referrals, not suggestions.

As a mental health para-professional and vocal critic of 12step treatment, I have been made quite aware of the two-hatters in the mental health field locally and in upstate NY when I was starting out. Twenty years ago there would have been no room in mental health for an outspoken critic of Alcoholics Anonymous. Both my current and former positions with ACT programs has been because I have been successful without AA and that I understand the objections that many clients have with the program.

When I was attempting to do something about my depression through the insurance I had from work, I had little choice in who I saw. Three separate times, therapists refused to work with me unless I attended AA and had several months clean time. That comes more under the heading of "demand" than suggestion or referral. I imagine that if one of your clients responded negatively to your suggestion that he or she attend AA, you wouldn't have refused to treat them, so that's not what I'm talking about. Others in your field may not hold the same standards.

When I went to Social Services in upstate NY I had to agree to a 12step rehab followed by a 12step halfway house and 6 months of 12step treatment in order to receive help for depression, even though I explained that I had been to four other rehabs and was an atheist who repeatedly got worse during my involvements with AA. I later found out that there was an excellent dual diagnosis outpatient program within walking distance from where I had been living. It would have been a much better option in my case; so am I to believe it was incompetence or a vested interest? From the brow beating I received for stating that I didn't do well in AA or 12step treatment, I lean towards vested interest.

If this were a pro-AA site, I'd leave it alone, but this is a mental health site; when people talk about substance abuse on a mental health site, we're talking dual diagnosis. Facts do not support 12step treatment for people with mental health disorders.

Evidence-based treatment for alcohol and drug abuse By Paul M. G. Emmelkamp, Ellen Vedel lists several studies that show CBT superior to 12step facilitation, especially in the treatment of dual diagnosis.

Handbook of alcoholism treatment approaches: Effective alternatives, Allyn & Bacon, shows 37 out of 48 methods tested to be superior to Alcoholics Anonymous, and that's not dual diagnosis specific.

Kathleen Sciacca, a pioneer in the treatment of dual diagnosis has stated that the success rate of traditional 12step treatment on people with coexisting disorders is "too small to be accurately measured" and that she found Motivational Interviewing to have the best results for her clients.

Alcoholics Anonymous does not work as well as its public relations work, and it rarely works for people with significant mental illness at all. These are not opinions, these are the results of all of the non-biased studies and a few of the pro-AA studies.

Throwing someone with mental illness into a program where 12% of the members tell everyone not to take medication isn't a good idea; these are the ones who have been around, the elders, the oldtimers giving bad medical advice to a vulnerable population. You've got a person who wants to people please confronted by a person who represents authority telling him to throw away his medication, he doesn't really need it, he isn't really sick, he just needs God. You're going to chance that everyone he meets in AA is a kind-hearted person who has his best interest in mind?
http://www.jsad.com/jsad/article/Alcoholics_Anonymous_and_the_Use_of_Medications_to _Prevent_Relapse_An_Anon/730.html

A serious question for you Allan. If a sober member of Narconon told you what a wonderful program it is, how it keeps him clean and clear-headed, who you accept his story? Why or why not and what is difference between what he says and what AA members say?

And why do you continue to dismiss those of us who have had first hand experience in the rooms? You may be a mental health professional and I'm only a para, but as far as understanding Alcoholics Anonymous, I'm the professional between the two of us, unless of course you're hiding something. Curious, do you talk to other non-professionals like this, say, your auto mechanic?

The people in the rooms are pro-AA....that's your proof? The people in Klan meetings are certain they're right too.

The results of the Triennial Surveys held by Alcoholics Anonymous show that 95% of all new members drop out in the first year. Do you think all of them were angry, bitter people who wanted to get drunk and are now all dead? Or do you think the might be some valid reasons that people leave?

Not only have I attended hundreds of AA meetings in 5 states (including chairing a meeting in Bill Wilson's childhood home in VT), and attended 5 rehabs, I have made a serious study of Alcoholics Anonymous for the past seven years. I didn't have my feelings hurt by some random member and go ballistic on the program because of it.

I want to make sure that my clients don't have to experience the things that I did in the rooms or in "treatment".

You've attended meetings and didn't see anything wrong with them? Were you looking? Did you ever attend a meeting anonymously?

I have been posting facts which you dismissed as "so called studies". Nothing so-called about what I have posted. Did you bother to look at them? Why did you call them "so-called"? How do you know what you say you know, Allan?

You dismiss me as "angry" and "bitter". Having a strong opinion based on facts and personal experiences is somehow wrong in your eyes?

There is plenty of room for us to disagree, but to have a conversation requires that both of us listen, Doctor. When I give facts and figures, those are not my opinions, but the facts I base my opinions on.

If you want respect, you have to offer some, Allan; you have yet to do so. I have gone out of my way not to respond in kind, not to talk to you or Dr. Dombeck with the distain you two have shown me. Dr. Dombeck does seem to listen some, but I'm not sure I can say the same of you. Perhaps you're used to treating paras like that where you are, thank goodness it's not the case where I work.

And I'll stop repeating myself when you all chose to start listening and quit trying to project your nonsense on me. This is not me being angry or bitter, Allan, this is me calling you on your %*$#.