A really beautiful and serious thing

[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? 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 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]

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 ....

Edited October 29, 2009 by John Rutledge

[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]

deleted ....

Edited October 29, 2009 by John Rutledge

[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.

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]

deleted ....

Edited October 29, 2009 by John Rutledge

[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".