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Alcoholics Anonymous (AA) is a Cult ?

Mark Dombeck, Ph.D. Updated: Jun 1st 2006

We've got a comment system on Mental Help Net, and lately we've been getting a lot of comments regarding an old essay I wrote concerning Alcoholics Anonymous. The essay, titled "AA is to shame as a hot knife is to butter", presents a generally positive view of the Alcoholic's Anonymous fellowship and twelve step programs in general. The positive view expressed in that essay came out of my experience working for a year (during my postdoctoral fellowship) in a partial hospital program (otherwise known as an IOP or Intensive Outpatient Program) for dually diagnosed people. Dual diagnosis means that you have two diagnoses: one is an addiction, and the other a serious mental disorder. So, we dealt with people who were schizophrenic, and alcoholic, or bipolar and using cocaine. That sort of thing. Many of our clients' lives were complicated by severe poverty and homelessness. The sicker you get, the further down the socio-economic scale you tend to fall.

beer bottle viewed from above Our partial hospital program dealt with addiction issues and mental health issues simultaneously, but always prioritized the addictions, on the theory that you cannot benefit much from psychiatric or psychological attention when you are intoxicated. We did drug screenings every day using breath tests, urine, and occasionally blood. Patients found to be intoxicated were sent home for the day. Patients who had recently relapsed into using their drug(s) of choice were asked to talk about it in a group therapy session in which the therapists (sometimes myself) helped the group to identify the behaviors and triggers and thought patterns that had led up to the relapse. There were other forms of therapy, and lots of psychiatric medication, and lots of attention in general. There was also AA, a process deemed so important by my clinical superiors that they had integrated it directly into their program, actually having meetings occur within the hospital, and us bringing our patients there during scheduled time periods.

My positive impression of AA came out of that year of experience; watching the patients rise and fall and noting when people were able to keep it together and when they weren't. You could pretty much tell who was going to use after a little while. The folks most likely to use (or never stop using) were those most deeply in denial about their drug problem; who could not submit to the idea that their drug use was actually a problem. The ones who could never settle on a sponsor; who would lie to you saying that they had not used recently, when you had their positive urine test results in your hand.

My experience with AA was never very much first hand. I have been to exactly two AA meetings in my life. Both were observational in nature, a "field trip" if you will, so that I could see what I was recommending to my patients. What I saw during those two meetings was non-remarkable. People speaking about their drinking issues and receiving support from the group; pretty much what you'd expect. These experiences took the novelty of the thing away from me, but hardly qualify as a good sample of what AA is about. More to the point, my impression of AA's usefulness came from our patients, and from our staff, a few of whom were in recovery themselves. The point was made in my head that addicts are unable at first to control their own behavior, and thus need and benefit from programs like AA that help to set limits on them.

The rub is that AA asks its participants to submit to a higher power, God as you understand him, or "good orderly direction". And many people, addicts and non-addicts alike, deeply dislike the idea of needing to submit to a higher power. They rightly distrust and dislike even more the idea that the higher power they are submitting to might be selfish in nature, or twisted, or power-hungry and looking to dominate. They dislike what they see to be the cultist aspects of AA, as is readily apparent in this comment (which I declined to append to the essay itself because there are already a number of comments there expressing this very point), but which I will reproduce here):

The author is trying real hard to rationalize AA. Being accessible and free means nothing...so are alcohol and drugs and Christ, etc., etc. The "peer support" is not support...it is peer indoctrination. I tried AA for 14 years...I believed it, I "worked it", and it almost killed me.
I believe thatn any professional that reccomends AA or any twelve-step treatment should have their license revoked. It is no different than recommending Scientology to someone with a broken arm, or Islam to someone with cancer, or Catholocism to someone with herpes.
AA is definitely NOT the "feel good peer-driven support group" that everyone touts. It is completely unregulated, and 95% of the people that walk in the door leave...how many of them die? How many recover on their own (like I have now)? How many continue to drink and become burdens on them selves and society (for years...like I did)?
Would you get on an airplane that had only a 5% chance of safely getting you where you wanted to go?
Until you directly answer the question, from all angles: "Does AA do more harm than good?"....then it is a CRIME AGAINST HUMANITY to recommend it or coerce anyone to attend. It is a very pervasive and dangerous cult, so much so that M.D.'s and PhD's recommend it in the absence of ANY valid scientific research showing that it does more good than harm. They should really have their licenses revoked.

It's a bit hard for me to read this sort of thing, because the person who wrote it obviously has felt very damaged by AA, a group that someone recommended to him or her, because they thought it would help. I don't doubt that this person has had a bad experience, has felt abused, perhaps was abused. It's sad.

Its no secret that AA's focus on submission to a higher power has broad potential for abuse. That focus on submission and making ammends is there for a very important reason - it encourages the growth of empathy and social solidarity in participant addicts; qualities which help them resist the lure of their drugs. And yet, that very submission also comes with a terrible vulnerability. it is important that anyone teaching submission as a way of life also be a kind and loving person, because otherwise, that submission becomes the basis for cult-like cohesion, as the commenter points out. Sociopathic types who also tend to be addicts are very likely to get themselves into AA and then use it for their selfish purposes. At any given moment within AA, there are going to be people who are honestly struggling with remaining sober and people who are using and not admitting it, or not taking the steps necessary to end it; people who understand hurt and who want to help others stop hurting and people who are all too willing to use other people for selfish purposes.

"Stick With The Winners" was the slogan I liked the best. Some meetings are better than others, because there is more beneficial order and kindness available there, and less sociopathy and sickness. If you are an addict in a twelve step situation, and you find that situation abusive (and not simply limiting of your urges), it seems to me that you need to find a better meeting; not quit entirely.

What are your thoughts? There must be some people out there who feel they have benefited from AA and twelve step. There must be other people who feel abused or put off by the process too. Do you have any advice or comments for the person who wrote the above comment? For me (grin!), as a doctor (like so many doctors) willing to write about and recommend things he has not lived or experienced first hand himself? Can there be submission to a higher power without abuse taking place? How do you handle abusive attitudes and individuals within AA and other twelve step programs? What are the merits of twelve step. And if you can't think of any merits, what are the better alternatives?

Mark Dombeck, Ph.D. is Director of Mental Help Net (a public service of CenterSite.Net - a provider of website and internet services and educational content to employee assistance and behavioral health organizations), and a licensed Psychologist in the state of Ohio (License #5698).

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Marlboro Disease, Projection, Etc?? - Allan N. Schwartz, PhD - Feb 9th 2010

MJR, ML, and All,

The fact is that people do not simply "quit" the addiction of smoking or drinking or drugging. It is a battle, just as fighting cancer is a battle and the bottom line, all too often, is that life is at stake. So, MJR, I don't know what point you are trying to make.

As to all of this other "stuff" about projection, my interests in this issue, personal or otherwise, is all beside the point and meant to cloud the issue.

The issue, from my perspective, is simply and only that addiction, like other diseases, is a disease. My purpose here is to educate and not make a philosophical statement, personal statement or even a statement about AA, Smart Recovery, Twelve Step Programs, etc.

At present, under the Obama administration, there is a proposal to give parity to both mental health and addiction treatment. The implications for this is that those needing mental health or addiction treatment services will have money available to get that treatment. That does not exist at the moment. Too often, people seeking treatment in either area are faced with the harsh facts that very limited funds are available through insurance the way healh insurance is now set up. This is why the disease concept of addiction is so important: It means that this is a disease that can be helped with medical intervention.

ML, you are quite correct, "I could pull my hair out," if I had any hair to pull out (smile), because I am now being accused of being anti AA whereas for the longest time I was accused of being pro AA!!!!!! I am neither.

The disease model of addiction has nothing to do with pro or anti AA sentiments. In fact, it has nothing to do with the philosophy of any organization. The disease model does NOT imply that one is helpless over the addiction. Quite the contrary, diseases are treated and the active participation of the patient is always vital to treatment success.

Perhaps somone of you could explain why you are so very resistant to the disease concept of addiction? For all the sarcasms and silly analogies, I do not grasp why this should be a problem for anyone, especially when the stakes are so high.

Allan

Junk science, meet lazy theology - Mike - Feb 9th 2010

Mr. AA writes:

There is a solution to this Catch-22: pieces of the puzzle have been surfacing in spiritual technologies (-theistic, non-theistic, and a-theistic) for several thousand years and I have been, for two decades, looking for a responsible way to bring this tested knowledge out of Esoteric AA and into the public. Home alone, I feel the joy of a new revolution. Log onto this site, and I retire back to my financial comfort and wonder why I even care.

I may not be a well published, patented, financially independent former monk, but I know snake oil when I see it. What are you selling, Mr. AA? You mentioned in an earlier post that you have yet unpublished research that you have been doing with some rehabs. We on this forum have some experience with those guys. I especially like the link that got pasted here last year to a rehab in Panama that claims a 677% increase on returns, whatever that means.

As Dr. Schwartz's grandma would say, "oy weh". As my wife's would have said: "Quatsch!".

two main conclusions - - Feb 9th 2010

I have come to two main conclusions: there is a congruence between mental illness and substance abuse. This congruence is frequent enough to notice; one should take effective action when they do.

The several substance abuse groups are support groups; they are not a dynamic change agent. The character of the group and the person should be compatible.

For the question: Is AA a cult? No. But, there people within AA who want to bethe leaders of a cult.

Let's be mindful of mindfulness - Mike - Feb 9th 2010

Meditative practices are being extensively incorporated into modern forms of psychotherapy. Currently, this is largely (formally) confined to mood disorders and personality disorders treatments (such as DBT and ACT), but in no time at all you will find people talking about mindfulness with regard to addictions if this has not happened already.

Dr. Dombeck,

I completed Zin's mindfulness course a few years ago and attended mindfulness meditation practices on and off thereafter. I'd be a little careful about promoting this technique. As with AA, there is a little more to it than meets the eye. Mindfulness purports to help people who have anxiety issues. For a few hundred dollars one is introduced to meditation, yoga, and mindful practices (such as breathing and body scanning). After graduating from the program the participant is invited to take part in weekly mediation practices at a local church. One of the mindfulness teachers in my program was a leader of these practices. She was also a Buddhist priest. There’s the catch. Many of the people coming from the mindfulness program are introduced to the Buddhist religion. Every couple of weeks there is a call for people to take some kind of vows. Those who do have to wear this funny little vest thing.

What bothered me is that the mindfulness program is run in a clinical setting (much like a rehab) but then segues to a religious one. I also should note that the woman running the program had her husband stand in for her a few times as she jetted around the globe attending mindful/Buddhist seminars. We were asked for donations after every meditation session. Another thing I’d like to mention is that while AA seems to be more aligned with the Christian right (thanks, Buchman), the mindfulness folks are unequivocally left wing in their views. The meeting after the meeting is a lesson in modern socialism and not so modern pacifism.

Ironically, it was mindfulness that was the straw that broke my groupthink thought. In both cases I went into programs that seemingly treated one disorder, but actually had a hidden religious, quasi-cultish agenda. The bait and switch technique, as Orange would say. Do not label me anti-religious. I am a practicing Christian. At least an out-and-out religion as one finds in my church is straightforward about its motives. These other programs are not.

Dr. Dombeck's Note: The meditative techniques are seperable from the religons that have spawned them, but often times, the people who are most interested and avaialble in promoting those techniques happen to be religous. Yoga for instance started as a religous technology. the name comes from the same root as "yoke" and "union" I understand, and the intent was to condition the body and mind so as to yoke it to the divine. But yoga is also a kick-ass physical conditioning system, a marvelous method for self-soothing, a good social outlet (in some cases), and a way to remove physical posture problems that present themselves as mood issues (I don't know how to talk about this directly, but in my experience, when there are body posture problems, these affect your mood. I expect that meditation techniques, which also derive from the yogic tradition (I understand) have similar pros and cons. So - there is a "baby" here and some "bathwater" too. It's important in life to be able to identify where the baby ends and the bathwater starts and to choose the baby, discarding the bathwater. I expect that everyone's definition of where this boundary is found will be slightly different. I don't claim to have a perfect answer, but I do believe (based on reading and discussion with colleagues; not on personal experience) that meditation techniques can be very helpful for getting people who are cognitively stuck to become unstuck, and this will apply across a great range of human suffering problems.

marlboro disease - mjr - Feb 9th 2010

its interesting how smoking and drinking are disease.s you can quit. How do you quit stomach cancer?

therapists are not exempt from tendency to project - - Feb 9th 2010

Dr. Dombeck's Note: Dynamically trained therapists like Dr. Schwartz are used to people projecting onto them what they need to see. It's part of what they've been trained to do; a method through which they are able to gain a little bit of insight into the needs, wishes and desires of their clients. In this situation, Dr. Schwartz is an essayist and not a therapist, and the people doing the projecting are not clients, but instead readers and commenters. However, the tendency to project is still there just because that is what people tend to do in emotionally charged interpersonal circumstances. See my essay on Transference for a more thorough explaination.

I entirely agree that the tendency to project exists when in emotionally charged interpersonal circumstances. That applies to everybody – including Dr. Schwartz – and Dr. Dombeck for that matter. Therapists may be trained to recognize projection in clients – however that training does not prevent them from engaging in projection of their own. Clearly this is an emotionally charged topic for Dr. Schwartz. I don’t think anyone has any doubt about that.

clear as mud - - Feb 9th 2010

I am glad that I quit drinking, without all the toing and froing described here. I still felt puny mentally, for several reasons, so I went to talk to a CEBT therapist. Mind you, I had quit drinking - so that complication was missing from the equation. After about six or eight sessions, we decided that I was OK. I was, and am OK. After all that, I have been trying to learn about this substance abuse/addiction matter. I have read books and articles; it remains clear as mud. It seems that I am not alone - no disrepect intended.

Am I supposed to be confused; or, am I just thick?

Mr. AA on Choice - - Feb 9th 2010

As a former Buddhist Monk (Sorry, Mike—you can't make this stuff up) I was taught the idea of karma as the momentum of one's choice's. Applying this to alcoholism: we begin making free choices about alcohol but, as the intimate memories surrounding each experience of being drunk accumulate, each subsequent choice becomes increasingly conditioned by those memories and, therefore, less free as a result of the conditioning.

My contribution to the mix, acquired through deep meditative practice, is this: when we move past the point of drinking to change how we experience the world (a technology of feeling-states) to drinking to change the way we experience ourselves (a technology of being-states), we move from problem drinking to alcoholism.

Please listen to this Drs. Allan and Mark: treating alcoholism as a disease trivializes the problem—it is SO MUCH WORSE than a disease. If it were a disease we could describe it, isolate its cause, and treat it; as a Scientist of some repute, I know that road is a dead end.

Because alcoholism is so intimately tied to what it means to be a human being who makes choices we cannot, under the current paradigm, excise the alcoholism without destroying a part of us that makes us who we are—our survival instinct will not allow this.

Dr. Dombeck's Note: Meditative practices are being extensively incorporated into modern forms of psychotherapy. Currently, this is largely (formally) confined to mood disorders and personality disorders treatments (such as DBT and ACT), but in no time at all you will find people talking about mindfulness with regard to addictions if this has not happened already.

The way I see it, the main problem with mindfulness meditation as a treatment technology is that it is difficult for the average person to benefit from. A lot of people try it out and then find it difficult to do and abandon it. It has amazing potential, but requires considerable dedication and ability to persevere through aversive subjective states (e.g., it's uncomfortable and boring for a long time before it gets good).

Alcoholics Anonymous ant the Treatment Industry - Ron - Feb 9th 2010

Alcoholics Anonymous has hijacked the treatment industry (or is it the other way around?)

1. The treatment industry gets cheap labor in the form of "para-counselors" whose only credential is sobriety in the AA program.

2. The treatment industry gets a free dumping ground for their patients (aftercare???) and absolves them of any responsibility if the patient fails to remain sober.

3. "Spiritual not Religious" is a ploy that allows AA to fly under the radar of the establishment clause and allows judges to coerce people to attend AA meetings.

4. AA's near total lack of governance allows all sorts of abuse to occur without consequences.

5. Until the Internet came along, AA and the treatment industry have been able to suppress un-favorable information. There is a HUGE anti-AA movement growing that will eventually dislodge AA from its un-deserved position of dominance.

Poor Dr. Schwartz! - Mona Lisa - Feb 8th 2010

Mr. AA, you directed the following comment to Allan:

Perhaps you should disclose your anti-AA bias here: you have stated in the forums that you would rather not treat people who come from 12-Step Programs. Your rationalization is that they carry too much baggage (paraphrase); the truth is that you may simply have not been taught the skills (why should you? those skills only exist in Esoteric AA) to speak their language and, consequently, treat them.

Allan must be ripping out his hair in frustration by now! The poor man has been fending off accusations of harboring a hidden pro-AA stance for months now, and now you're accusing him of having a hidden anti-AA stance?

Are you being sarcastic? I've never known Allan to espouse an opinion that was even remotely negative towards AA.

Dr. Dombeck's Note: Dynamically trained therapists like Dr. Schwartz are used to people projecting onto them what they need to see. It's part of what they've been trained to do; a method through which they are able to gain a little bit of insight into the needs, wishes and desires of their clients. In this situation, Dr. Schwartz is an essayist and not a therapist, and the people doing the projecting are not clients, but instead readers and commenters. However, the tendency to project is still there just because that is what people tend to do in emotionally charged interpersonal circumstances. See my essay on Transference for a more thorough explaination.

agree - - Feb 8th 2010

Disease concept, by Dr. Schwartz: I agree with Dr Schwartz. I have two cooments: I think that the several groups are all support groups and should be treated as such.

Second, I think that many people have sustance abuse addiction or lesser problem, should have therapy.

Maxwell House - Mike - Feb 8th 2010

Perhaps Coffee treatment centers can be set up next to Starbucks across the country. Imagine the potential cash flow in that?

LOL, I want first dibs on setting up a caffeine rehab - I'll call it Maxwell House (there's actually an old SNL skit that pokes fun at this concept, I think).

I think that many addicts end up using coffee as a substitute for the more dangerous stuff. The lesser of two evils, I suppose. I blogged on this a few weeks ago.

http://www.outofsteps.net/blog_2010_01.htm#Jan202010

Mike

The History of The Disease Theory of Alcoholism - MeMay - Feb 8th 2010

Can we take a look back at the history of the disease theory of alcoholism? I think it is important to look at WHEN this came about, WHY it came about, WHERE it came about, and the MAJOR SUPPORTERS of this theory (ex: Christian groups, Pro-Prohibition groups,Temperance groups, AA etc) I am sure some of you are very informed regarding this subject. I am not but I am willing to read up on it. Any recommended books to read on this subject? Can we have a short discussion on these forums about it or can Mr. Dombeck start another blog topic on this?

Dr. Dombeck's Note: We have forums for this sort of extended discussion MeMay. You'll find our "addictions and impulse control problems" forum at http://community.mentalhelp.net/forumdisplay.php?f=12. Feel free to create a community account, start up a thread there for this purpose and then come back here to recruit discussion participants. For whatever reasons, this is where everyone congregates.

What's next caffeine? - - Feb 8th 2010

"You have missed the point. Smoking is listed in the DSM IV because it is a disease."

No, you have missed the point. The fact that it is listed in the DSM IV as a disease does not change the absurdity of it being considered a disease. Again, the only one who benefits from smoking being considered a disease is he who stands to profit from the treatment of that pretend disease. The same is true for alcohol. The only people who benefit from it being considered a disease are those who stand to profit from the treatment of that pretend disease - such as treatment centers who complicate and exacerbate the issues of addiction. Many treatment centers impose false concepts which induces relapse - which of course, provides them with repeat business and more profits.

Caffeine is addictive, too. I wonder when addiction to caffeine will be considered a disease? I am sure there is some visionary businessman who is working on figuring out how to get the DSM IV to list caffeine addiction as a disease. Perhaps Coffee treatment centers can be set up next to Starbucks across the country. Imagine the potential cash flow in that?

It is no wonder why doctor's opinions are no longer revered as they once were - and rightfully so.

Disease Concept - Allan N. Schwartz, PhD - Feb 8th 2010

“Actually, smoking or addiction to nicotene is listed in the DSM IV as a disorder. It has all the necessary characteristics for a disease by bringing with it an altered physical state, withdrawal symptoms, etc”

"That is the point. Smoking is no more of a disease than someone biting their nails."

You have missed the point. Smoking is listed in the DSM IV because it is a disease.

As I wrote in my essay posted yesterday about "words and meanings," that words can be easily misinterpreted and misunderstood. The assumption that addiction is not a disease runs the risk of taking us back to the bad old days, it does not predict that will happen.

In addition, present day drugs being used for addictions may not be fully effective for everyone but they are headed in the right direction. It is clear that medications are helping many and that they hold great promise for the very near future.

As for church basements and etc: so what? What has any of that to do with addiction as disease? Again, my point is that it is important to talk about addiction as disease separate and apart from AA. Also, AA, Smart Recovery and etc are not treatments, they are support groups and I don't care what they call themselves. Also, people may engage in lots of practices with regard to illnesses but those practices do not render the illnesses any less diseases.

No one chooses to become an addict. Lots of people choose to drink alcohol. Yesterday, watching the Super Bowl, lots of people probably drank beer. Mostly, they are not and will not become alcohol dependent. However, a few of them will. Why? There is a difference there. Those who will become alcohol dependent have a combination of genetic or inherited and bio chemical components and life circumstances that will lead them directly to addiction while that will not happen for the others. Those who become addicted choose to while the others do not? I do not think so.

However, having become addicted, do these people have a responsibility to go for help and get better? Yes, they do. Its the same with cancer. Of course, I have seen cancer patients choose to die.

Will people recover from addiction without treatment? Some will and do while others do not. Some die as a result of the addiction before they can recover and others never recover. Yes, there are those who do. This is the same with many of the mental illnesses.

Allan

medical profession - - Feb 8th 2010

If it is a disease, and you need to quit, you quit. If it is not a disease, and you need to quit, you quit.

Calling it a disease involves the profession assigned, by society, to treat a disease. The Medical Profession. The medical Profession becomes part of the solution. What does the profession have on offer for this disease?

Goethe redux - Mike - Feb 8th 2010

Mr. AA,

Forgive my skepticism, but I have never met a synthetic organic chemist who quotes the Bible, is a stickler for grammar and spelling, and is a 12 step true believer. Maybe I should get out more.

Where did you get your PhD?

the disease concept - - Feb 7th 2010

That is the point. Smoking is no more of a disease than someone biting their nails. In terms of stopping, the only difference is that when someone stops smoking, since it is addictive, there are physical cravings and withdrawals included, whereas with biting your nails, those are not included. The only people who truly benefit from smoking being considered a disease are those who stand to profit from the treatment of that pretend disease. For smokers, it serves no positive purpose except to present one more obstacle which stands in the way of quitting.

“I believe all of you are very well meaning when you insist that addiction is not a disease. What you do not realize, I suspect, is that there are very serious risks that go with dismissing addiction as a disease. The risks are that we return to the days when, in the minds of most people, addicts, whether of the alcoholic or any other type, were seen as degenerates who deliberately decided to abuse substances and had low morals and poor character. Mental illness was seen in exactly the same way.”

Your position assumes that the only alternative to recognizing it as a disease is for it to revert to being considered how it was considered long ago. There are other alternatives to “diseasing” bad habits, outside of labeling it as some moral issue. People are allowed to have struggles without being morally defective.

“AA and its stance on addiction as a disease is totally immaterial to me. This should have nothing at all to do with the arguments for and against AA,”

It is very clear that from your perspective, since you recognize AA and 12 steps as a healthy support for all addicts, that the disease concept is totally immaterial to you. However, for those of us who do not recognize AA or 12 steps as a healthy support for all addicts, the disease concept is very relevant. There are many who do not accept the disease concept as valid. That does not change nor does the relevance of it to this discussion change simply because you say that it is totally immaterial to you. Part of what makes the 12 step movement so dangerous is the insistence that addiction is some all powerful disease – leaving its victim powerless. You say that people are not “accused” of being diseased. Clearly you have not been to 12 step treatment programs where they not only “accuse” clients of it, but they repeatedly accuse them of it and threaten them with it throughout their 28 day stay. What people have to endure if they express a discomfort with AA or 12 steps while at a 12 step treatment center is often abusive and cruel. I have also witnessed doctors and therapists who support the disease concept and AA and 12 step “accuse” patients as being diseased and use fear tactics to urge them to submit to 12 step philosophy. It is common for doctors and other health professionals to insist that there is something wrong with a patient if they do not agree to attend and follow AA and its 12 step program. That is far more common than people realize. It is is something I have witnessed far too many times to count.

There are many who believe that AA and 12 step programs have done some damage – not only to addicts – but to the entire list of “X anonymous” they claim to have the answers for. I suppose it is unrealistic to expect AA or 12 step treatment centers to take responsibility for the damage they have caused over the years or even consider that the damage is valid or real. On the other hand, it is not only realistic, but necessary to expect doctors, therapists, and other health professionals to stop defending AA and 12 steps and start working in the best interest of the patient. If the patient is not a fit with AA or 12 step – any loyalty or defense of AA should stop in that very moment and the professional’s efforts from that moment forward should be to help the patient.

I personally do not take offense when an AA member defends AA. It is a natural thing to do, provided they have no expectation for others to do the same. I think people, to some extent and with some flexibility, should be proud of their OWN CHOICES. However, I do find it offensive when a doctor defends AA or 12 step because if the doctor’s goal is to first do no harm, it is entirely unnatural to place the defense of a program above the care and loyalty to a suffering patient.

“I do not wish to "win a debate here." What I am really attempting is to educate.”

The same is true for many of us. This is not about winning a debate, but rather about making sure that people know it is perfectly acceptable to not submit to AA and 12 steps and there are recovery options for those who do not accept addiction as a disease. If either of those things stands in the way of anyone’s recovery, which I have seen that to be the case with many, it is important for them to not allow those things to stand in the way anymore, regardless of any one else’s point of view. There are plenty of other options which will better suit the type of person who doesn’t fit with AA or 12 step or other treatments based on the concept that addiction is a disease. Thankfully there are resources and much information scattered all over the internet now which will lead to support for those types of individuals.

Mr. AA addresses Mr. Schwartz - - Feb 7th 2010

I don't even know where to begin with your latest post, so I will concentrate on two points and hope that the talented contributors on this site fill in the rest of the gaps:

1. I want to make a very clear statement about my point of view on this: AA and its stance on addiction as a disease is totally immaterial to me. This should have nothing at all to do with the arguments for and against AA...One more time: this disease vs. choice debate should have nothing whatever to do with AA– Mr. Schwartz

2. Please remember, we are witnessing the introduction of new medications that effectively stop the craving for drugs and alcohol and end the addiction— Mr. Schwartz

Total nonsense: I am a synthetic organic chemist who is a heavy-hitter in this area (publications, patents, etc.) and can assure you that these medications do not end the addiction—the best research with Naltrexone and others drugs have actually demonstrated something that Esoteric AA has known for a long time: eliminating cravings does not mean eliminating the addiction. The "mental blank spot" is what most often propels relapse— not the craving. Additionally, when the craving is eliminated by Naltrexone or some other drug, the alcoholic often feels that they are able to drink normally—a feeling ironically reinforced by the absence of craving brought on by the drugs. So they drink from their sense of adventure, but the psycho-physical mechanism eventually resets itself, and the addiction—and the craving—return in an even more virulent form. (There is again, no reason for you to know this, but several rehabs for whom I am a consultant have some excellent, albeit yet unpublished, data to support my proposition.)

Mr. AA

[Disclaimer: Mr. AA does not speak for AA, but his teachings represent the very best that have come out of AA—he is the World's Greatest Expert on Twelve-Step Technology, and accepts all questions within that narrowly defined arena.]

for the sake of our discussion - Mona Lisa - Feb 7th 2010

All right, Allan. Let's assume, for the sake of our discussion, that addiction is in fact a disease.

So.....What other disease do we treat as we do drug and alcohol addiction? In the case of what other disease is "medical treatment" based on sending people to church basements, where they are expected to admit that they are powerless over the use of their substance of choice (Step 1), to believe that a power greater than themselves can restore them to sanity (Step 2), and make a decision to turn their will and their lives over to God (Step 3)?

We do not do this with other diseases--and if nicotine addiction is also a disease, that makes my point all the more clearly, since we don't treat that particular iteration of the disease with 12 step programs. We don't insist that former smokers attend meetings where they are inculcated with notions of powerlessness. After they quit smoking, we have no expectation that they continue to identify themselves as nicotine addicts, "recovering", "recovered" or otherwise.

It seems to me that defining addiction as a disease only points up the illogic of the 12 step based treatment system. I suspect that is because the term "disease" has come to mean something different in the addiction context than in other areas. When it comes to addictions, the disease concept has come to serve as a metaphor for AA's belief in personal powerlessness and the consequent necessity for God's intervention.

Brutal? - MeMay - Feb 7th 2010

Brutal you say? And you expect me to take the time and patience to try to understand your point of view? Are you kidding me? You clearly have a lot to offer as well. You seem very creative with the English language. But, and I say this respectfully, you will get no where putting people down and trying to make them feel less than. If you want to continue on in an adult manner, on the subject of morals and how it relates or doesn't relate to alcoholism, please let me know.

MeMay

The Disease Concept of Addiction - - Feb 7th 2010

ML and others,

Actually, smoking or addiction to nicotene is listed in the DSM IV as a disorder. It has all the necessary characteristics for a disease by bringing with it an altered physical state, withdrawal symptoms, etc.

As to the roles of sexual and physical abuse leading to addiction, keep in mind that people do not tell themselves that they will seek relief from their past lives by becoming addicted. Also, not all abused people become addicted and not all addicts have a history of abuse. However, there is increasing evidence that genes play an important role in whether or not someone does become addicted.

Yes, there are many other behaviors that Anonymous lists that are not considered diseases. Well, some are and some are symptoms of a disorder and some are not. Not everything is the same. Not all behaviors are the same. Also, contrary to my passionat Anonymous commentators statement, no one is "accused" of having a disease. However, they can be accused of having an addiction unless we alter our views.

I want to make a very clear statement about my point of view on this:
AA and its stance on addiction as a disease is totally immaterial to me. This should have nothing at all to do with the arguments for and against AA.

I believe all of you are very well meaning when you insist that addiction is not a disease. What you do not realize, I suspect, is that there are very serious risks that go with dismissing addiction as a disease. The risks are that we return to the days when, in the minds of most people, addicts, whether of the alcoholic or any other type, were seen as degenerates who deliberately decided to abuse substances and had low morals and poor character. Mental illness was seen in exactly the same way.

No one chooses to be an addict. No one chooses to have a mental illness. However, they can both be treated and, in some cases, cured.

Please remember, we are witnessing the introduction of new medications that effectively stop the craving for drugs and alcohol and end the addiction.

I do not wish to "win a debate here." What I am really attempting is to educate.

One more time: this disease vs. choice debate should have nothing whatever to do with AA.

Dr. Schwartz

Just what are these groups supposed to do? - - Feb 7th 2010

This is a serious question: Just what are these groups supposed to do? After all, it is the person who is abusing who has to do the stopping. No one does it for him. Do they set a good example by not drinking? Do they give him permission to quit? Is it a replacement therapy? Do they provide something missing so that he/she can live better? Are the groups a placebo?

Mr. AA thanks Mike - - Feb 6th 2010

Mike:

I logged on to deliver a brilliant, but brutal, response to MeMay when I read your supportive post. It is always good to remind ourselves that, in the words of the great comedian Bill Hicks, "It's just a ride."

And, after some trial-and-error Mr. AA has found his place in the mix. Let the games begin!

(And we now have our little semi-secret handshake now, don't we?)

Mr. AA \-;

memay, don't take it personally - Mike - Feb 6th 2010

You should of been here when Tony J was around. Anyway, welcome to Reasoning with True Believers 101. It can be an interesting journey. Mike

Response To Mr. AA - MeMay - Feb 6th 2010

Yes, I can take critisisim and I also can take an insult. When someone insulted me when I was part of the program I would have to write about it, call my sponsor, pray about it, etc. You know the drill. Now I just forget about it.

You and I are getting no where and I will not continue on with someone that gets off on putting people down. You take care.

MeMay

u say tomato... - Mike - Feb 6th 2010

Mr. AA, you’re right, it’s Buchman. I guess Buccas boomeranged on me.

I did get Himmler’s name right though, didn’t I?

\-;

role of third party? - - Feb 6th 2010

How does a third party -- be it AA, another group, a Doctor -- get the abuser to quit? Or, is that the wrong question to ask? Does the abuser actually quit on their own? If so, what role does the third party play?

Mr. AA Does Double Duty - - Feb 6th 2010

MeMay: Your passion is admirable, so it is difficult to say what I am about to say without sounding insulting; however, you said you could take respectful critique. So here goes: I would suggest that you have a literate friend review your comment thread on this site. There is a serious disconnect between what many of us are saying and what you are hearing. You clearly have a lot to offer, and your contributions would be more effective if you actually read and understood what was being said in its entirety before taking comments out of context and responding emotionally. Namaste.

Mike: Its Buchman, not Bachman, and since you made the error twice (and the "a" and "u" aren't qwerty-cozy) I thought you might like to correct yourself before you mention him again which, of course, you will. Your welcome. Having said that, I have never understood this fascination some people have with linking AA with the Buchmanites—is guilt by association still a legitimate tactic? Everything in the Big Book could have been written by anyone with a rudimentary grasp of Self, God, and Other and no knowledge of Buchmanism. Much of AA's success came from rejecting Oxford Group principles that did not work with the alcoholic—most notably the Four Absolutes.

[Disclaimer...none this time - Mr. AA knows the difference between informative shtick and hurtful sarcasm.]

Mr. AA

Sorry Mr. AA But I Disagree - MeMay - Feb 5th 2010

Mr AA. You said this;

"We lack both the knowledge and power to do that on our own."

I am proof that we do not lack the knowledge and power to stay sober and live a good life on our own. I am also proof that we do not lack the knowledge and power to have a good set of morals. But, me being proof of this will never be acknowledged by people that carry the belief system that you have. I remember when I was involved in the program, I really honestly thought I had the one and only answer. I really believed that I was healthy and all the other people that didn't agree with me were sick. Man, how wrong I really was.

MeMay

Third party - - Feb 5th 2010

In reference to those who quit on their own, it stands to reason that AA nor any professional nor other group would know anything about them. They are the 'silent majority'. People who quit on their own are not very likely to be public about it. There is no reason why they should be. perhaps a few words to close friends. That would be about it. As a practical matter, this means that 'self quitters' are not part of this conversation.

But, at the end of the day, everyone who quits, quits on their own. No one does that for them. Sad, but true.

How does a third party get someone else to quit? That is what all this posting here comes to.

Is there a logician in the house? - Mr. AA - Feb 5th 2010

MeMay:

You essentially asked this question twice:

Why are the steps about morality if a set of good morals will do alcoholics no good? MeMay

I gave you two excellent AA answers—one psychological, one theological—but both based on the idea that having morals is not enough: one must be able to act morally. We lack both the knowledge and power to do that on our own. Then you offer this:

So AA's treatment for alcoholism relates to morality, correct? Not a great way to treat a disease if you ask me. And just my point. This is not a disease!! MeMay

This is what I hear you saying: 1. AA treats alcoholism morally; 2. morality is not a good way to treat a disease; 3. therefore, alcoholism is not a disease. (Is there a logician in the house?) So I wonder if you were really asking the question you wanted ask.

Historically, AA considers whether or not alcoholism is a disease to be an outside issue, and Mr. AA has no opinion on outside issues.(Although he has corresponded with Stanton Peele on many occasions)

[Disclaimer: Mr. AA is not responsible for misinterpretations of his meticulously researched opinions. Read Mr. AA at your own risk— his opinions have been known to cause harm to those lacking a sense of humor.]

Mr. AA

Smoking and Alcoholism - MeMay - Feb 5th 2010
Mona Lisa. You are absolutely right. If you look at the number of annual deaths by smoking compared to alcohol and drugs it will blow your mind! And you are also right, smoking is not a disease. It can and will cause disease but it is not referred to as a disease. And how do many people stop smoking? Most of them just quit. I am sure some of them use support groups to help them quit but majority just stop on their own. They get sick and tired of being sick and tired and they stop. And it is the same with alcoholism. Majority of people that quit do it on their own. And I also truly believe that the majority of medical and mental health workers will continue to recommend AA to problem drinkers for a while to come. I think most of them have a hard time changing their mind about AA even though the evidence is in black and white right under their eyes. Too many of them have recommended and suggested AA to their patients and would have to take some kind of responsibility for all the people that have become statistics of the failed. Just my thoughts. MeMay

Response to Mr. AA - MeMay - Feb 5th 2010
Hi again. I read through your comment and would like to respond. I am an adult so I will not be talking in third person. I am not looking to get into a heated debate with you if that's what you think. I am totally capable of giving and receiving constructive criticism, respectively. Anyway, on to the subject at hand. We have been treating this so called "disease" with morals since the start of AA. As you and I know AA is the most popular form of treatment for alcoholism. The medical community recommends it, psychologists recommend it, families recommend it and so on. So, AA's form of treatment for alcoholism is a set of good morals, right. These are actually AA's morals but they view them as good, right? If alcoholism has nothing to do with morals and is truly a disease wouldn't you agree that this is the wrong form of treatment? And you mentioned in your response to me that it really isn't about morals but more about confession, retribution and a couple other actions. (Sorry I can't go back to the page and copy it because I am typing from my blackberry) But these are still morals. They are not moral thoughts or beliefs but they are moral actions, right? So AA's treatment for alcoholism relates to morality, correct? Not a great way to treat a disease if you ask me. And just my point. This is not a disease!! Maybe you can read Stanton Peele's "The Diseasing Of America" for some more in depth information on this topic. MeMay

Mr. AA, Bill W had a role model - Mike - Feb 5th 2010

Let Mr. AA try a more blunt approach: the Steps are about morality because Bill Wilson ultimately believed that man is a sinner and that alcoholism is a sin.

To be more succinct, Frank Bachman (who was fluent in German, knew Heinrich Himmler, and attended a Nazi rally) also believed very much that morals were what would turn this crazy world around. Bill W. was a member of the Oxford Group - Herr Bachman's Oxford group.

Ye shall know them by their fruits. (Matt 7:16)

More thoughts on the disease concept - Mona Lisa - Feb 5th 2010

It is worthy of note, too, that there are addictions that we don't characterize as diseases. Smoking, for example. Smoking is just as addictive and deadly as drinking or using drugs.

Yet we don't insist that smokers have an incurable disease. Medical and mental health practitioners don't make it a practice to refer smokers to support groups that are based on the notion that smokers are "powerless over nicotine" and must surrender to God in order to quit smoking.

When they quit, we don't expect them to continue to call themselves "smokers" or even "recovering smokers". We are completely comfortable if they call themselves "former smokers". We don't use the possibility that they might start smoking again and become re-addicted as a reason to insist that they never stop being smokers no matter how long ago they quit smoking.

No matter how you look at it, there is really no logic in portraying drug and alcohol addiction as an incurable disease.

Mr. AA Answers MeMay - - Feb 5th 2010

MeMay:

Let Mr. AA try a more blunt approach: the Steps are about morality because Bill Wilson ultimately believed that man is a sinner and that alcoholism is a sin. Having opened that door, let’s get Biblical:

“For that which I do I allow not: for what I would, that do I not; but what I hate, that do I. If then I do that which I would not, I consent unto the law that it is good. Now then it is no more I that do it, but sin that dwelleth in me. For I know that in me (that is, in my flesh,) dwelleth no good thing: for to will is present with me; but how to perform that which is good I find not. For the good that I would I do not: but the evil which I would not, that I do. Now if I do that I would not, it is no more I that do it, but sin that dwelleth in me.” Romans 7:15-20 (King James Version, of course)

As a sinner the alcoholic needs to be moral to recover, but he is incapable of being moral without God’s help, and Wilson meant GOD: the Big Kahuna, Creator of the Universe, Father of the Anointed One—not some mealy-mouthed, milquetoast, higher power of your understanding. But being a sinner, Billy Boy caved into the protestations of a couple of New York atheists and thus was born one of the truly great bait-and-switches ever perpetrated by a confidence man.

(Over the top? Check one: □ yes □ no )

[Disclaimer: The opinions expressed here do not represent the opinions of AA, nor do they represent the opinions of Mr. AA; they represent Mr. AA's opinion about what he thinks is AA's opinion]

Mr. AA

RE: Not A Disease - Allan N. Schwartz, PhD - Feb 5th 2010 - Flyover - Feb 5th 2010

"If addiction is not a disease, why is the brain altered? If addiction is not a disease why do the profiles of vast numbers of addicts include childhood sexual and physical abuse, Attention Deificit Hyperactivity Disorder, Major Depression, etc?"

The same can be said about many violent criminals as well, but we do not generally characterize criminal behavior as stemming from a disease. Rather, we say the criminal has made bad choices and is responsible for them.

Why should the addict be any different?

To disease or not to disease... - - Feb 5th 2010

“If addiction is not a disease then why do some people drink, never develop a problem and and never need any type of treatment while others drink a quart of vodka daily along with cans of beer and wine and can never seem to get enough.

“If addiction is not a disease, why is the brain altered? If addiction is not a disease why do the profiles of vast numbers of addicts include childhood sexual and physical abuse, Attention Deificit Hyperactivity Disorder, Major Depression, etc?”

Why do some people lie and some don’t? Why do some people steal and some don’t? Why do some people abuse and some don’t? Why do some people smoke and some don’t? Why do some people cheat on their spouses and some don’t? Why do some people compulsively spend money and some don’t. And so on. Everyone has challenges – even those who are so seemingly “well packaged”. The only thing that makes addiction stand out is the tragic turns a person’s life can take – physically and otherwise and yes, because the brain is altered, once alcohol or drugs are introduced. However, that does not change the premise of why one looks to alcohol or drugs? If the pain of one’s past did not exist, than the need or compulsion for a person to find relief from that pain through alcohol or drugs would not exist, and addiction would not be an issue. Isn’t that a powerful indication that it is not a disease, but rather a means to cope in the absence of knowing an alternate and healthier means to cope? Doesn’t referring to it as a disease wipe out or camouflage the genuine source of it? Doesn’t it invalidate the very thing which they need to and are entitled to discover – that whatever happened to them is NOT their fault? That there is a reason for those feelings and their attempt to find relief from those feelings is perfectly understandable – despite how terribly it has affected them?

The profiles of addicts which include childhood sexual and physical abuse is evidence of what I am suggesting here. The abuse is what compels a person to seek relief from that pain and in the absence of having the skills and tools to otherwise cope, they find relief through drugs and alcohol. Is that not a valid indication that it is the abuse which is what specifically requires resolution and to classify the symptom (addiction) as a disease removes the determinability of one’s circumstances. Addiction is merely the evidence to something far more significant. Placing the emphasis on the evidence and falsely identifying the evidence as something entirely separate, such as a disease, leads a person away from the very understanding required to fully recover. Convincing an addict who was sexually abused that he is diseased seems to be somewhat cruel to me. It insinuates that there is something fundamentally wrong with him in the face of him deserving to discover that there is not anything fundamentally wrong with him. Being sexually abused will leave a person feeling guilt, shame and as if it was his fault and that there is something wrong with him. The answer lies in becoming free from that false impression and not confirming it, by accusing him of being diseased.

Flexibilty and pragmatism - - Feb 5th 2010

Flexibilty and pragmatism. And, deal with the whole person. This matter is not not like treating a physical disease that has a proven course of treatment. We are not at that point, and we may never be at that point.

Putting into practice the ideas of flexiblity and pragmatism and dealing with the whole person means that the helping person knows and understands different approaches. And, I am reminded of the principle of 'do no harm'.

Response To Mr. AA on The Subject Or Moral Psychology - MeMay - Feb 5th 2010

Mr. AA. I will have to dust off my copy of the Big Book and take a look at the exact quote of Bill's. I should have opened it up and took a look before I quoted his words. But I do think there is a passage in the book where he states this, or something very similar. I will let you know what I find. But, I would still like to touch on this subject for a moment for I believe this is extremely important. You wrote,,,,,, Although I do not have my Big Book with me, I believe the quote was closer to: "If good morals were all that we needed, then most of us would have stopped drinking long ago.",,,,,,,,,Ok. So, even if this was what Bill wrote my point still stands. Why are the steps about morality if a set of good morals will do alcoholics no good? MeMay

Addiction As You Understand It - Looking for a Name - Feb 5th 2010

Addiction speaks to our core views about what it means to be a human being - perhaps one of the reasons why the debate on its true nature gets so personal and so heated.

Different strategies work for different people. The notion of addiction as a ______(fill-in-the-blank) might be a lifesaver to one person and a death sentence to another. So why not let a person who is honestly trying to change choose their own understanding of addiction. (Sound familiar?) Let the moralist approach it as a sin. Let the rationalist view it as a a choice. Let others view it as a disease. Whatever works to propel themselves forward should be honored and supported.

Using this approach as an AA sponsor has worked quite well for a long time: I present the aspirant with a variety of ways to understand what is happening to them and let them choose the most empowering. We then adjust their Step-Work accordingly. More than just pragmatism, such flexibility may be closer to the real truth: addiction can alternately appear to manifest as a choice, sin, disease, and many other phenomena - cunning, baffling, and changeable.

The honest wing of the medical establishment will listen if we challenge them in such a way that honors their efforts. I recently presented these ideas to the CEO and COO to a top (but typical) American rehab, finishing with this statement: "When we try to force another human being to accept a characterization of their condition that is at odds with their deepest values, we perform a cruelty that may be worse than the addiction itself." They were genuinely embarassed, but remained open to me showing them how such a shift in practice can occur without incurring insurance liability.

When I first try to "understand rather than be understood" I am always stunned by the willingness of others to listen to a new idea.

Not A Disease - Allan N. Schwartz, PhD - Feb 5th 2010

If addiction is not a disease then why do some people drink, never develop a problem and and never need any type of treatment while others drink a quart of vodka daily along with cans of beer and wine and can never seem to get enough.

If addiction is not a disease, why is the brain altered? If addiction is not a disease why do the profiles of vast numbers of addicts include childhood sexual and physical abuse, Attention Deificit Hyperactivity Disorder, Major Depression, etc?

My point is that people are not responsible for becoming addicted. But, yes, they are responsible for getting into treatment and recovering.

Note: It is good to have this discussion in a way that is free of sarcasm and bitterness.

Allan

two edged sword - - Feb 5th 2010

This idea of choice is a two edged sword. It is, at the same time, empowering and inculpating. To say that one has a choice means that a person can liberate himself from an affliction. That is the good part. This is where the help comes in: "You do not have to drink any more." There are better choices that you can make. It does not have to be this way. This empowerment may not be an easy road. For those who are truly afflicted - not 'merely drinking too much ' - but those with mental illness and a life history of pain and struggle [ as so many are] - it can be very hard.

It is not much easier for those trying to help those afflicted. How do I help? It can be a tough call.

Love your disclaimer, Mr. AA - Mona Lisa - Feb 5th 2010

I just crack up every time I see that disclaimer!!!!

not a disease - - Feb 5th 2010

‘Similarly, the old view of addictions was that the addiction was the fault of the person who became addicted. They were blamed for the addiction because they had poor morals, weak character, etc. We now know that was and is false.”

I agree that this was and is false. However, so too is the notion that it is a disease. You say yourself that it is identified as a disease so the focus is shifted from blame to treatment. Why is it necessary to falsely identify something as a disease just to shift the focus or to remove the blame? That is a manipulation and a pretense. Is compassion and understanding so foreign to the treatment industry that it is not even a consideration? Why not call it what it is with compassion and understanding that the addict has not yet understood it for what it is? It is a choice and the person responsible for making that choice is the addict. And just as your grandmother should have done with you, it can be explained that fault and blame does not enter into the equation and serves absolutely no positive purpose. No disrespect toward your grandmother, but it is safe to say that laying someone on a guilt trip or laying blame isn’t the most healing or enlightened approach, but neither is denying a person the truth that ultimately, it is a choice which he will need to take responsibility for AND which becomes something to be grateful for and proud of. The choice – much like all positive and empowered choices, will transform into a sense of accomplishment for making a choice today that seemed impossible to make yesterday. Discovering why it is not recognized as a choice by the addict is the key. What is it that he convinces himself he cannot endure or tolerate without the alcohol? Whether the treatment industry attempts to blame him or spare him from blame does not change the fact the he will feel shame and guilt. That has to be addressed and replaced with understanding and then new ways to face life need to be experienced.

I wholeheartedly believe that although the intentions of identifying addiction as a disease may have been good and honorable, it backfired and continues to backfire and work against the addicts and the treatment industry every single day. It places the ability for behaviors within the addict to be a result of some separate force or something beyond his ability to cope with or manage. He falsely becomes a victim of his disease, rather than someone who is in charge of his own life. Someone who is not in charge of his own life, even when sober, is not living his life to the fullest extent that he is able to or in a way that it is intended to be. While he may not be in charge of his life while drinking, he has it within his potential to be in charge of his life and therefore choose not to drink. Teaching that is consistent with genuine recovery.

“However, if I am choosing to drink and drive I am responsible and to blame, but, many things happened to me that caused me to become an alcoholic that were not my fault.”

Your above statement can be applied to every single behavior known to man – lying, stealing, cheating, promiscuity, physical abuse, mental abuse, sexual abuse/ rape, infidelity, bullying – just to name a few. Are we going to deny the entire or the majority of the human race the enlightenment and the chance to become responsible so they are able to make better choices and become more fulfilled? Are we going to interfere with a person’s ability to change and grow by pretending that he is diseased rather than simply a human being with a natural potential to get better and better throughout his lifetime? Being responsible and making choices is positive and is something to feel empowered by and grateful for. If viewed and implemented properly, it actually eliminates guilt and shame or fault and blame. It does not induce any of those things.

The Spiritual Kindergarten - Mr. AA - Feb 4th 2010

BUT THE CHOICE IS STILL WITHIN THE PERSON...It is not bestowed by God. Mona Lisa

Thanks for your post.

AA's third group, which was started by Clarence S. in Cleveland, emphasized that God created humans with a seed cure (1) for alcoholism laying dormant within the person, and all that the alcoholic had to do to activate the seed cure was to surrender to Jesus Christ.

Although such a theology sounds a little sneaky to any critical thinker, there is a long history of AA'ers following Bill Wilson's credo: "We are only operating a spiritual kindergarten in which people are enabled to get over drinking and find the grace to go on living to a better effect. Each man's theology has to be his own quest, his own affair." (2)

(1) See headlines from issues of the Cleveland Plain Dealer, "Alcoholics Cured by God."

(2) As Bill Sees It #95.

[Disclaimer: The opinions expressed here do not represent the opinions of AA, nor do they represent the opinions of Mr. AA; they represent Mr. AA's opinion about what he thinks is AA's opinion]

Mr. AA

To Mike - From Mindful Sheep - Feb 4th 2010

Didn't think it would take you very long \-;

FYI, there is now only one person speaking - the one responsible for all the creative material.

Someday I will tell you the whole story - an intriguing tale of copyright infringement, violation of confidentiality agreement, and attempted identity theft.

Allan, You Are Wrong - MeMay - Feb 4th 2010
Allan. Your comparison of the cancer patient's treatment and the alcoholic's treatment is way off. It is true that the person with cancer is responsible for their treatment just like the alcoholic is responsible for their's as well. But what you fail to see is that the cancer patient can follow their treatment to a T and have no guarantee that they will recover. They can go to their radiation treatments and take all medicine prescribed and still not have a guarantee that they will live. Now, what about the alcoholic? Well, it is pretty simple, 'Just stop drinking alcohol.' Life spared! Do you see what I mean? Mike

Moral Psychology - Mr. AA - Feb 4th 2010

One thing that has always struck me as odd is how Bill Wilson states in the Big Book how "No set of good morals can stop our destructive drinking." If this is true why are the 12 steps all about morality? MeMay

Although I do not have my Big Book with me, I believe the quote was closer to: "If good morals were all that we needed, then most of us would have stopped drinking long ago."

A key as to what Bill Wilson may have meant can be found in "The Doctor's Opinion": (paraphrasing) although most doctors of the time realized long ago that only a "moral psychology" could save the alcoholic, "its application presented problems."

A systematic surrender, self-examination, confession, and restitution is the missing "application" - rather than just a general sense of trying to become a better person by not drinking. And the emphasis on self-examination is there, of course, only because alcoholics as a class are not used to such self-inquiry.

Disclaimer: The opinions expressed here do not represent the opinions of AA, nor do they represent the opinions of Mr. AA; they represent Mr. AA's opinion about what he thinks is AA's opinion.

Mr. AA

More on choice - Mona Lisa - Feb 4th 2010

Viewing addiction as a disease shifts the focus from fault to treatment and prevention.

Maybe, but it's a double-edged sword. True, the view of addiction as a disease does absolve the addict of blame, which should, theoretically, increase the willingness of the addict to recognize his or her problem and do something about it.

But it also suggests that the addict is helpless in the face of his so-called disease, just as one would be with, for example, cancer. It suggests that individual behavior, thoughts, actions, motivation, etc., have nothing to do with the situation.

If I had cancer, I could not choose to not have it. I could not say, "OK, I'm not going to have cancer anymore"--well, I suppose I could, but it wouldn't work. However, with an addiction, I can, and in fact did, say "OK, I'm not going to drink anymore" and, following an initial period of cravings, withdrawal, and other unpleasantness--rid myself of the condition.

Also, I want to say that I agree with Dr. Dombeck to the extent that I don't think the issue of choice is black and white. Although a person may have a choice, his or her ability to exercise that choice depends upon a number of factors, including his or her social environment, belief system, resources, mental health, etc. BUT THE CHOICE IS STILL WITHIN THE PERSON. It does not reside in the medical community. It is not bestowed by God.

Frankly, even in AA, they know this. It is fairly commonly stated in AA that "this problem is not for those who NEED it, it is for those who WANT it." And indeed, it is the wanting that makes the difference--it is the desire to exercise the choice that leads to abstinence.

here, here, Memay - Mike - Feb 4th 2010

I agree with your logic...of course the steps are all about morality. Herr Bachman would have had it no other way.

Addiction Is A Chosen Lifestyle - MeMay - Feb 4th 2010

I agree 110% with Mona Lisa on this. Addiction is a choice. It also is a chosen lifestyle and a chosen set of beliefs and world views. One thing that has always struck me as odd is how Bill Wilson states in the Big Book how "No set of good morals can stop our destructive drinking." If this is true why are the 12 steps all about morality? MeMay

Degrees of Freedom - Mark Dombeck, Ph.D. - Feb 4th 2010

All,

There is a concept (I forget where I learned it but I think maybe it was from statistics) called "Degrees of Freedom" which may help people here to see this issue of "choice" in a less black and white way.

The way I understand the argument happening here, there is this strong sense that AA encourages people to see addiction as a non-choice, meaning that people are helpless and utterly incapable of helping themselves. Understandably, people here who are proud of their emancipation from AA want to disclaim that statement of utter helplessness. From their own life examples, they know they are not helpless to stop drinking on their own, and from that they arrive at a position opposite from the AA "utter helplessness" position, which is that addiction is "totally a choice".

There is a middle position. It is possible for people to have a choice over what they will do with regards to their drug or alcohol use, AND AT THE SAME TIME also be constrained by forces (such as cravings, poor-self-concept, genetic factors, etc.) which make it far harder for them to make a choice other than to have another drink. When this is the case, we say that these people have restricted degrees of freedom over their behavior. They certainly do still have a choice to do or not to do, but their choice to not do is more expensive for them than it would be for someone who was not similarly constrained by cravings, genetic factors, etc.

Does this make sense? It is not an either/or situation here, total choice or no choice. It's really a range of abilities to make choices.

Mark

You honestly believe being responsible is a "fault"? - Allan N. Schwartz, PhD - Feb 4th 2010

As my late maternal Grandma would say, "Oy Vay." The reason for the Oy Vay is that, hard as I try to clarify, you continue to cloud things up. Why is that?

Going back to that same late Grandma, a little story from my childhood. If I did not wear my hat when I went outside and I caught a cold, I was told I was to blame because I chose not to wear my hat. It was, in her mind, a simple connection: No hat, Cold Virus, and that was it. It was my fault.

Similarly, the old view of addictions was that the addiction was the fault of the person who became addicted. They were blamed for the addiction because they had poor morals, weak character, etc. We now know that was and is false.

Viewing addiction as a disease shifts the focus from fault to treatment and prevention. The individual is not blamed for their addiction.

Responsibility: Once addicted, it is the responsibilty of the person to get treatment. The nature of this disease called addiction is such that people often do not want treatment and do not believe they need treatment. If they live long enough, they may reach the point where they do want treatment.

There is nothing wrong with the word "responsibilty." However, it can be used in different ways and with different meanings:

1. If the Judge in court rules that I am responsible for a traffic accident and the resulting injuries to others, then, I am to blame.

2. If I caused the accident because I was driving while intoxicated then I am responsible and to blame for the accident and can face the loss of my license and even face a prison term.

3. However, if I am choosing to drink and drive I am responsible and to blame, but, many things happened to me that caused me to become an alcoholic that were not my fault.

If someone gets cancer, it is not their fault. They are not responsble for getting cancer. Even those who never smoked a day in their lives can get and die of lung cancer.

However, I am responsible for getting help for the treatment for that cancer. I have to be and should be a responsible person.

It was not my fault that I caught cold. Other kids in school, sneezing and coughing all around me caused me to catch the virus, not my hat or lack of.

See what I mean?

Allan

Is addiction a choice? - Mona Lisa - Feb 4th 2010

If the use of drugs and alcohol were not, at some level, chosen behaviors, then no one would ever quit an addiction.

In saying this, I in no way mean to blame the addict for his or her situation. Blame is a useless and destructive concept when it comes to addiction. I am simply saying that addicts do have the power to choose to stop using the addictive substance.

I will use my own personal experience as an example. I was addicted to alcohol for over 2 decades and honestly believed that I could not quit, that I "had to" drink. But then one day, following an extremely ugly incident, I decided that I had had enough. I decided I would never drink again, no matter what. And I never have--it's been well over a decade now, and I intend to remain abstinent from alcohol for the rest of my life.

When I was in AA, I was told that my sobriety was a "gift from God", who "granted me a daily reprieve from my alcoholism, contingent on the maintenance of my spiritual condition".

But is perfectly clear to me that I made a choice that day and that I had the power to do so. Even though I was absolutely addicted to alcohol, I had the choice to quit, and I am abstinent today because I made that choice.

If not a choice, than what is it? - - Feb 4th 2010

If addiction is not a choice then what is it that occurs when a person who is presented with two options does in the face of those options – regardless of which option it is? For example, if an addict gets a phone call from two different friends and friend # 1 invites him out to drink and friend #2 invites him to go bowling, or to a movie, or to a meeting? If not a choice, what is it that occurs within that individual which “positions” him to engage himself with friend #1 or friend #2? Seriously, what does one call it if it is not a choice? One cannot claim that recovery is a choice if addiction isn’t a choice. That seems obvious. If recovery is a choice it would have to be acknowledged that an addict can participate in some sort of recovery or participate in some sort of drinking. Going to a meeting or participating in some other activity reflective of recovery is NOT drinking. If it is not a choice, then what is it?

I personally think that is an impossible question to accurately answer because it is a choice. That doesn’t mean that an addict sees it as a choice. That is the problem. However, enlightening him to recognize it as a choice is the only honest, empowering, and effective approach, not further denying him of that choice. We all learn in time to be better people, to increase our awareness and to assume new responsibilities based on that new awareness. That is part of life and part of evolution and part of being human. There is no blame or fault in that. Being responsible for something today which you were not aware of yesterday is something to celebrate – not cast blame onto or feel guilty about. Addicts are as human as anyone else. There is no reason for an addict to feel “blame” for something he was unaware of at any given time. That doesn’t mean you deny him of that awareness today or exclude him from recognizing his own choices.

Recognizing an addict as having choices can include having great compassion and understanding for him. In fact, it is more respectful and loving of a person to recognize that the addict has choices than it is to deny him something which is so basic to all of us - as if he is deficient in something so fundamental to being human.

choice in name only - - Feb 4th 2010

Addiction may be a choice in name only -- more apparent than real. That is one reason why it is, at times, hard to get shut of. This, I think, is where mental illness comes in. Many of those with an addiction are: depressed, anxious, compulsive, socially phobic, have a personality disorder, etc.

You honestly believe being responsible is a "fault"? - - Feb 4th 2010

“You clearly stated that addiction is a choice. The direct and straightforward implication of "choice" is that an addicted person chose to be addicted and is to blame. You use the word "responsibility." Responsibility implies blame. These terms all fall under the same category.”

That is an odd association of the words “responsibility” and “blame”. Do you choose to be a responsible doctor? A responsible man? Where is the blame in that? Based on your concept of “choice”, I can understand one’s hesitancy to view addiction as such. In fact, based on your concept, I can understand one’s hesitancy to view any self-denying behavior as a choice. Perhaps that is why there are so many false diseases attributed to behaviors which would benefit those "afflicted" if ultimately they recognized such behaviors as a choice. I pray that the proposed powerlessness and the diseasing of every challenging behavior is more recognized for what it is – false and crippling.

One can choose to be abusive to his child or one can choose to be responsible for his issues which compel him to be abusive – such as being abused himself as a child. The choice may not feel like an easy one, but it is a choice nonetheless. He has the ability to confront and resolve his issues and choose to be a good parent, rather than an abusive one. Same thing applies to addiction – even giving proper consideration to the genetic, environmental, and emotional tendencies, the choice to resolve such issues is the ONLY way out. If you don’t believe that, than even AA can’t help because anyone who abstains from alcohol/drugs is making a choice - even going to AA requires a choice, regardless of how they convince you otherwise once you get there. Recognizing and being responsible for choices is the only possible path to recovery from anything. To deny that is absurd and certainly not helpful to anyone.

Mindful Sheep - Mike - Feb 4th 2010

You are beginning to challenge us - extravagantly. \-;

Blameworthy - Allan N. Schwartz, PhD - Feb 4th 2010

Hello Anonymous,

You clearly stated that addiction is a choice. The direct and straightforward implication of "choice" is that an addicted person chose to be addicted and is to blame. You use the word "responsibility." Responsibility implies blame. These terms all fall under the same category.

Dr. Schwartz

Independent Thinking in AA - Mindful Sheep - Feb 4th 2010

Aren't you forgetting that independent thinking is in "fact", stinkin thinkin?

Not where I come from!

One of the most popular cliches in the area in which I sobered up was this: "Half of everything you hear in an AA meeting is wrong - your job is to figure out which half." (That was a long time ago; the errant "half" might be up to 90% now.)

I was, in fact, encouraged to think for myself when I came into the Program because I surrounded myself with those people in AA who would encourage such discourse and ignored the "stinkin thinkin" contingent.

In Ernest Kurtz's Phd dissertation - which eventually became the AA history called NOT-GOD - the author does a reasonable job showing how AA has always been composed of conflicting elements which he calls "liberal humanism" and "evangelical pietism." Both together create the living contradiction that is AA, and both need each other to fuel the creative tension that leads to growth.

With all due respect to any poster here (how about that for some back-shuffling?), I will admit that the discussion is severely hampered by a lack of AA advocates who can intelligently discuss the issues without resource to mind-numbing rhetoric or emotional sabotage.

Where are these fine examples of the best AA has to offer? They don't go to meetings anymore! But they also have not become AA detractors: they look back fondly at a Program and a Fellowship that served its purpose at the time. (See Bill Wilson's last address before Congress on this) Sadly, this may now be why the "errant half" keeps rising. (see Gresham's Law and Alcoholics Anonymous by Tom P.)

To the mindless sheep - - Feb 4th 2010

"Really? So it is not possible for an independent thinker to listen to what AA has to say and after serious consideration, freely decide to adopt it as their "truth"? (I actually thought that was a form of what we call "learning.")"

Aren't you forgetting that independent thinking is in "fact", stinkin thinkin?

to mindless sheep - Mike - Feb 4th 2010

And for any former AA member-turned-detractor who actually believes that they have freed themselves from AA conditioning: simple reaction against a falsehood is not, by definition, the truth.

I guess the truth can be relative.

That notwithstanding, I have my experiences.

http://www.outofsteps.net

not a mindless sheep - - Feb 4th 2010

I am not a mindless sheep. I will repeat: people have the right and responsiblity to decide for them selves. Investigate all your options. It is on line: AA; LifeRing; SOS; WFS; Moderation Management; SMART Recovery; Rational Recovery. Read their web sites. Go to other web sites concerning substance abuse, and read about them. Decide what you are going to do. Then, set about doing it with motivation and determination.

Do not sell yourself short; and, do not allow anyone else to sell you short. Determine what is right -- then, go ahead.

To the Great Independent Thinker - From a Mindless Sheep - Feb 4th 2010

"Those of you who defend AA and its principles may speak with conviction, but you are not speaking your own truth – you are speaking Bill W’s."

Really? So it is not possible for an independent thinker to listen to what AA has to say and after serious consideration, freely decide to adopt it as their "truth"? (I actually thought that was a form of what we call "learning.")

Oh Great One, do you really believe your "facts" come to you independent of any agenda, background conditioning, or information outside your personal experience? There is nothing original in anything you have to say in your posts. I suggest you read some David Hume or J. Krishnamurti regarding the oxymoron, "free thought."

And for any former AA member-turned-detractor who actually believes that they have freed themselves from AA conditioning: simple reaction against a falsehood is not, by definition, the truth. Almost 4 years after this thread started, we recycle the same polarized ideas with no progress made on a synthesis that would liberate both sides from their tiresome certainty.

Blameworthy is your word, not my own - - Feb 3rd 2010

"No addiction is not simple and those who are addicted are not blameworthy."

Dr. Schwartz

The word "blame" was never mentioned or insinuated, Dr. Schwartz. It was imagined in your own mind - just as is you alleged neutrality on the subject and just as your inaccurate assessment of my posting in the wrong section. Scroll down and you will see for yourself.

There is a vast difference between blame and responsibility. Responsibility is a positive, fulfilling and empowering thing.

I maintain that addiction far more simple than it is made out to be and that AA and 12 step continues to transform it from something that can be permanently resolved into something that is beyond a person's inherent power and abilities.

Talk About Lopsided - - Feb 3rd 2010

Hello Anonymous,

I feel compelled to point out a very obvious fact: You chose to discuss the "Lopsided" issue in the wrong forum. The article you are quoting is separate from that of Dr. Dombeck's. Why did you post here instead of where I wrote the post?

Second, I notice that you completely disregard my appeal for a respectful and dignified discussion and return to the old vitriolic tone.

Third, Addiction is not a matter of choice and is not simple. For example, large numbers of those with severe alcohol problems have histories of having been sexually and physically abused, and have long histories of alcohol abuse running through their family histories. This reflects a very complex interplay between genetics and environment as involved factors in alcohol addiction. None of this even begins to touch upon the human brain.

No addiction is not simple and those who are addicted are not blameworthy.

Dr. Schwartz

Joe and Homework - Allan N. Schwartz, PhD - Feb 3rd 2010

Hi Joe,

This is the other doctor here: Dr. Schwartz. Speaking only for myself and not Dr. Dombeck, I have done my homework, except for dating someone from AA, but I have other very close relationships, and have found that AA participants find attendance helpful. However, these are people who have no serious mental illnesses, are in or have been in individual psychotherapy and drug treatment programs, and tell me that they find atteding these meetings helpful and supportive.

One more caveat that I have found with many AA people I have met: Regardless of the Big Book and the procedure at meetings, these people take what they want and reject the rest of it, including religion, spirituality and any other concepts with which they do not agree.

Dr. Schwartz

You haven't Done your Homework Doc.. - Joe - Feb 2nd 2010

"AA seems to have its place for people who are seeking some help with drinking. Relapse is built into this disease and therefore, there is a high rate of failure. However, there is evidence that with psychotherapy and other real treatments, AA is a good adjunct support system."

With all due respect, you have not done your homework enough to know what actually goes on within AA. You state you do not support or detract, but you make the above comment that is IN FACT an endorsment of AA. You as a Doctor and persumably licensed to practice as such are basically saying here you support AA and the unlicensed practice of medcine and/or therapy.

AA ...IS NOT... just a meet and greet place for support it, AA, through it's Books, and "Sponsors" attempt to TREAT the disease.

I KNOW. I went out with a person in AA.

I KNOW. I have inquired of AA and posed questions to them.

I KNOW. I have experienced their Sponsors.

I KNOW. I have their materials.

....Do you Doctor?

Talk about lopsided - - Feb 2nd 2010

"Once again I am very concerned that those of you who are anti AA present your views in ways that are so strenuous that you do not tolerate the view points of others, especially those who disagree. What is more, you seem to be convinced that your anti AA opinions are actual facts".

It is mighty bold of for person who is aligned with AA – openly aligned or otherwise – to reprimand a non-aa supporter and accuse him of stating a fact in the face of him merely speaking his truth. You might as well come out and say, “For all who view AA in a manner which is consistent with my viewpoints – then be free to state your position – For all who view AA in a manner which is INconsistent with how I view it, then how dare you speak with conviction.”

People who think independently of AA and disapprove of its message and its claims are often treated as if they somehow misinterpreted its message or just had a bad experience or went to the wrong meeting – or are not enlightened enough to “get it” – or anything at all to divert attention from the FACT that we are simply, fundamentally, and entirely incompatible with AA and its 12 steps. If someone were to acknowledge that a person may be incompatible with AA then they would be forced to truly recognize and acknowledge that AA has limitations and its principles and practices are not universal. It is easier and more convenient to falsely determine that the limitations belong to the people who reject AA. Subsequently, people – especially people who claim to help others with issues of addiction – are off the hook from having to put effort or thought into something other than spew the beliefs of AA/12 steps.

Luckily, I do not live by the standards of another. Therefore, I feel free to pass on certain facts that I live by:

1. Alcoholism is not a disease. It is a choice.

2. People are not powerless over alcohol. In FACT, people’s inherent strength and genuine power to overcome such struggles are contingent upon the recognition of that fact.

3. Addiction is not as complex as people have made it out to be. In part, AA and 12 step based treatment centers have falsely attributed complexities to addiction that simply do not exist. They have made things worse for many people. The depths of a person’s suffering and the fact that many have died and will die from addiction makes it tragic – no doubt – but the symptoms of alcoholism do not alter the premise of it. It is what it is. And oddly to people’s dismay, it is a choice. Being compassionate and mindful toward one’s underlying pain and issues which compel a person to make self-destructive and shame inducing choices as a means to inspire and motivate them to make better choices - to empower - is where true resolution lies. Convincing a person he is powerless or diseased is futile, counter-productive and wrong.

When the big book stops getting quoted as fact and nonsensical slogans stop getting tossed around as fact and mental health professionals stop blindly accepting AA and 12 steps as fact and when people are no longer told, as a matter of fact, that they will die if they don’t follow the program of AA, then perhaps a forum more accepting of individual truths will entice me to soften my approach. Who knows? In the meantime, to anyone who has a problem with my beliefs being expressed with strength and conviction – don’t knock it until you try it. Those of you who defend AA and its principles may speak with conviction, but you are not speaking your own truth – you are speaking Bill W’s. And that is as tragic as addiction.

Lopsided? - Abbadun - Feb 2nd 2010

Hi Allen

You are right that AA is not a cure all for addiction. Unfortunately too many addiction and healthcare professionals operate and advise as if AA was the only cure for alcoholism.

I have read too many progress reports about clients sent to probation officers that are negative based primarily on the fact that the client wanted to try something else than AA and AA's brand of spirituality.

If funding sources like SAMHSA believes that there are many roads to recovery shouldn't more professionals operate if that is so?

mental state - - Feb 2nd 2010

If what has been said here recently indicates that the mental state of the person has lot to do with getting shut of addiction/alcohol abuse, I agree. I think that mental state , up to an including mental illness, has a lot to do with it. This mental state may, in fact, be controlling. It is often true that drinking too much is 'simply' drinking too much; but, not always. people with a personality disorder may drink too much; people who are depressed, bi polar, anxious, etc, may drink too much. It seems to me that both have to be addressed. I think that the professionals should deal with how both are addressed.

Lopsided? - Allan N. Schwartz, PhD - Feb 1st 2010

Hi Mike,

Good points, all of them, but they do not mean that AA is "a religion," nor does it mean that AA "is a cult."

Regardless of what the Big Book states, the nature and intensity of an individual's mental illness often determines their ability to recover from addiction, unfortunately. AA will not free them from their mental illness because it is not a psychotherapy program and it will not free them from their addiction because they are not a treatment program. There are programs, both psychiatric and recovery, that are treatment programs for the mentally ill.

I know about the Big Book but, it is like the Bible and the Constitution: Open to Interpretation.

For the average person with alcohol addiction problems, AA seems to provide support and even relief to some depression that comes from social isolation.

You and others are correct though: it is not a cure all for alcohol addiction.

Allan N. Schwartz, PhD

Lopsided? - Mike - Feb 1st 2010

In addition, whatever your complaints about AA are and whatever unfortunate experiences you had there, I do not view AA as a cult nor do I view it as a religion. It is simply and only a support resource or fellowship for people who are looking for help with their drinking problems. Itself, AA is not a treatment program although there are now many treatment programs that have adopted 12 step type philosophies.

Dr. Schwartz,

Yes, the AA preamble when taken alone does sounds quite harmless. However, many, many groups also read the introduction to the Big Book chapter called "How it Works" at the beginning of their meetings. This chapter outlines the actual program that gets touted in the fellowship. Here are the opening paragraphs:

Alcoholics Anonymous - How it works

RARELY HAVE we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way. They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty. Their chances are less than average. There are those, too, who suffer from grave emotional and mental disorders, but many of them do recover if they have the capacity to be honest.

Our stories disclose in a general way what we used to be like, what happened, and what we are like now. If you have decided that you want what we have and are willing to go to any length to get it - then you are ready to take certain steps.

At some of these we balked. We thought that we could find an easier, softer way. But we could not. With all earnestness at our command, we beg of you to be fearless and thorough from the very start. Some of us have tried to hold on to our old ideas and the result was nil until we let go absolutely.

Remember that we deal with alcohol - cunning, baffling, powerful! Without help it is too much for us. But there is One who has all power - that One is God. May you find him now.

Half measures availed us nothing. We stood at the turning point. We asked His protection and care with complete abandon.

Here are the steps we took, which are suggested as a program of recovery: [steps follow]

Some points of interest from the preceding, Dr. Schwartz:

1. The program claims that emotionally and mentally ill people can recover if they get honest. This sounds like faith healing, and is cultish.

2. "Going to any length" is also cultish. It sets up a power structure for groups.

3. "that one is God. May you find Him now". This is religious.

4. "Here are the steps we took....". This outlines a treatment program.

Mike

Lopsided - Allan N. Schwartz, PhD - Feb 1st 2010

Once again I am very concerned that those of you who are anti AA present your views in ways that are so strenuous that you do not tolerate the view points of others, especially those who disagree. What is more, you seem to be convinced that your anti AA opinions are actual facts.

I will state again as I have stated before that this site tolerates diverse points of view. In addition, whatever your complaints about AA are and whatever unfortunate experiences you had there, I do not view AA as a cult nor do I view it as a religion. It is simply and only a support resource or fellowship for people who are looking for help with their drinking problems. Itself, AA is not a treatment program although there are now many treatment programs that have adopted 12 step type philosophies.

From my perspective, the problem is not AA or 12 step programs but the complex nature of alcohol and drug addiction.

Lastly, to those of you who insist that I support or advocate AA, I must say, that is not an insult but the truth is I am neither a believer nor a detractor. AA seems to have its place for people who are seeking some help with drinking. Relapse is built into this disease and therefore, there is a high rate of failure. However, there is evidence that with psychotherapy and other real treatments, AA is a good adjunct support system.

Dr. Schwartz

12 Step Programs (CoDA) - MM - Feb 1st 2010

"I'm not a psychologist, but I would say some of the members there, mostly women were narcissist/histrionics who loved talking about themselves." MM

A fascinating observation, in that in my experience when the number of women in a mixed meeting increases to about 50% the amount of "boys will be boys" behavior slows to almost zero.

Thanks for the reply! The meetings I attended is 90% women and according to my therapist, some don't like men for justified reasons. As a male, what is the benefit of going to a support group with type of culture? Most new males that attend don't last long. Maybe a month. I think it is hard for men to open up in front of a group of women with their intermost feelings for fear of being seen as a weak wussy. I also wonder how many members have been misdiagnosed with "Codependency", when they actually have a personality disorder. There aren't any checks and balances with these 12 step programs. MM

don' - Mike - Feb 1st 2010

I think ML's going to graduate school is indeed a very good step. She will have, in stark contrast to most AA sponsors/gurus, some formal training in the addiction field.

I don't hold any illusions about my blog having any influence on AA. I'm not sure that is even my intent. I just want to share my experiences/insights into the program. Most old-timers quietly fade away from the program, I'm leaving behind some anecdotes.

http://outofsteps.net/

Thinning the Herd - I don't care what you think - Feb 1st 2010

Regarding Beth's story, any person who would stop taking their meds because they listened to an AA sponsor instead of their doctor deserves to die for being terminally stupid.

Oh yea, I said it. Somebody has to: I have yet to hear on this site a specific action plan by anyone on how they intend to change the industry (or AA) that they so cavalierly dismiss. ( I gave mine in a past post, which was, of course, predictably ingored by the room.)

Mike, Mona Lisa, JR - feel free to weigh in. Setting up a blog, going to graduate school and becoming part of the problem, or retiring from the discussion are not acceptable answers.

If lives were not at stake, the hypocrisy on this site would be laughable.

To POO - Mona Lisa - Jan 30th 2010

I'm glad you are not trying to impugn my integrity. That would be quite misplaced, particularly since I am essentially retooling my entire life to work toward systemic change in this area.

But I don't think people have to go as far as I am going in order to make a difference. I regard whatever actions people are able to take as positive, not pointless. From the folks who still go to meetings and try to add some sanity to the mix, to the people who write comments in forums and on amazon.com and in letters to the editor, to the researchers who keep on piling up the evidence, to the mental health professionals who are increasingly moving away from recommending "treatment as usual"...we all do what we can.

AA, Sponsors, and the naked Truth - Joe - Jan 30th 2010

I experienced AA sponsors lying to the girl I was seeing. Of course what I had to say made no difference. They lie, she lied, period. If being an Alcoholic is a disease then AA is attempting to treat a disease and acting like a doctor, or should I say practicing medicine or psychiartitry without a license.

See here:

http://answers.yahoo.com/question/index?qid=20081231143714AAArWUu

and

http://www.sophieparish.blogspot.com/

to MM - - Jan 30th 2010

"I'm not a psychologist, but I would say some of the members there, mostly women were narcissist/histrionics who loved talking about themselves."

A fascinating observation, in that in my experience when the number of women in a mixed meeting increases to about 50% the amount of "boys will be boys" behavior slows to almost zero.

to Mcgowdog - - Jan 30th 2010

Dial the smugness back just a tad. You should fire your website designer (it is a real mess my friend) and realize that I was speaking more to the weakness of the player-haters than to the strength of any of the players.

To Mike and Mona Lisa - POO - Jan 29th 2010

Thanks so much for your replies.

To Mike: Your point about making the hosts of AA meetings accountable sounds like an excellent strategy. However, someone has to actually DO that.

To Mona Lisa: Never meant to impune your integrity. However, I have read dozens of your posts (including the ones on amazon.com) without once hearing about what you are actually DOING.

POO

12 step programs - MM - Jan 29th 2010

To comment on AA or any other 12 step program. My therapist would not take no for an answer when I was told I needed CoDA. Attended meetings for 6 months and found that most people there were more co-dependant than myself, and concluded there was no one there to consider as my sponser. There was also an inner circle that would not give you the time of day. This is support? I'm not a pshycologist, but I would say some of the members there, mostly women were narcissist/histrionics who loved talking about themselves. I got nothing out of the meetings but drama.

to POO - Mike - Jan 29th 2010

I'm no lawyer, buy I don't think AAWS could easily be connected to the bad behavior at meetings in regards to Rx advice. There is an AA pamphlet on Rx use that states a doctor should always be consulted. This would be the fallback for AAWS if they were taken to court.

What I do think is possible is that the facilities that host meetings can be held responsible for any predatory behavior that happens on site. Most churches, especially the Catholic, are very wary of having predators in their midst. The simple questions that can be addressed to churches that host AA are: Do you know if the groups you are hosting are safe places for the vulnerable? Is there a sex offender policy in place? Are minors allowed at the meetings?

My guess is that most churches would send a group packing if it could not show that solid safety policies are in place. If the banning of AA meeting from churches caught on then the donations back to NY would steadily diminish. You get the picture.

Mike

Talking rather than doing: not exactly.... - Mona Lisa - Jan 29th 2010

With all due respect, I am far from guilty on the "talking, not doing" front. All you see here is what I write about AA. What you do not see is that I've become a SMART Recovery volunteer and am studying for a master's degree in social work so that I have the ability to work first-hand with addicts utilizing evidence-based approaches, and to better advocate for change in the treatment delivery system.

A Question of Balance - - Jan 29th 2010

As much as I disagree with McGowdog on almost all issues AA, the sarcasm is well placed here. As the site gets more and more lopsided, the detractors start to look as cultish as the community they criticize.

I have been to many AA meetings where the behavior is so rigidly controlled that a code-of-conduct is read beforehand - usually including a ban on even the mildest profanity (which, unfortunately, cuts my repertoire in half)

mcgowdog's blog - - Jan 29th 2010

mcgowdog's blog Enjoy: http://mcgowdog.blogspot.com/

we grab you - McGowdog - Jan 29th 2010

In the AA cult, we grab you, shave your head, hold you down and pour booze down your throat (Waterboarding with booze) then we send you out to the airport to sell flowers.

When we get through with you, you will never want to drink again.

If you try to leave we will kill your family and cut off your ears.

The Revolution Will Not Be Televised - Portal Of Opportunity - Jan 29th 2010

I listen with sadness over those who have been hurt by AA, and applaud those who spread that message with such eloquence. What I do not, however, hear on this site is solutions. For example, some time ago a frequent poster ( I think it was you Mike) made the on-target observation that it would take a good lawyer with the right case to break through the AAWS stonewalling.

Well, I have heard several scenarios on this site—particularly the ones with sponsors telling their prospects to stop taking meds—that any New York Law Firm itching to find a provocative way to spend its 10% pro-bono work would salivate over. Are you telling me that no one who has been hurt by AA is connected to a heavy-hitter in the legal profession?

Even without the pro-bono work, how about founding an "AA Victim Defense League" and start taking donations—it would take about 10 million to bury AAWS in a court battle. Impossible? Not for an Erin Brokovich! (What does your schedule look like Mona Lisa? ;)

My purpose here is not to judge, as I am one of you, but perhaps to point out an irony: even those of us who have seen the light regarding AA still share an insidious trait with those we left behind in the rooms - we find it easier to talk than to do.

(And in case anyone is wondering what I am doing, I have since 1991 spent all my free time acting as an outside consultant in my professional area of expertise for AA groups, addiction rehabs, and high schools & religious groups with drug problems. Am I making a difference? Who knows.)

POO

safety in meetings - - Jan 28th 2010

I just wanted to point out that there is a safety concern in meetings as well. Because of the tradition that allows anyone into the rooms, psycopaths, murders, rapists, stalkers, and so on come into the meetings and there is nothing anyone can do about it. As well, bursts of anger, fights, and violent rage are not uncommon and become triggors for people who have experianced similar abuse in the past. There is no behavioural guidelines and unfortunitly it is more then often the women who are left vulnerable and targets for preditors. Because of the lack of safety measures I no longer attend meetings and find it difficult to refer other people. The tradition of absolute conclusion must be updated to reflect the dangers ond social realities of the 21st century

To coribabs - Mona Lisa - Jan 28th 2010

Is there a place where I can go to report his sponsor for giving such destructive advice when he is not supposed to give advice?

No, there is not. And that is EXACTLY the point I have made, probably ad nauseum in the minds of some. But I'll repeat it. There is no mechanism in AA to address abuse. There is no one to complain to. No one who will do anything, anyway.

AA does have a General Service Office. And this office has spent hundreds of thousands of dollars of AA member contributions enforcing AA's trademark rights (at one point actually succeeding in sending an AA member to a Mexican jail for selling a Spanish translation of the Big Book). You'd think a powerful, central body like the GSO would show an interest in creating some sort of method--anything!--aimed at preventing the worst abuses (things like sponsors ordering sponsees off psych meds). Case in point: the Midtown Group (underaged girls used for sex and ordered off meds). The very same GSO that was fully capable of suing to protect its trademark, the very same body that took in over $15.5 million in 2008, that very same body, when asked about this hideous abuse, had no comment. No comment.

I know this doesn't help you with your situation, coribabs. For that, I've found cult deprogramming resources helpful. Here is a site with some general information:

http://people.howstuffworks.com/cult6.htm

Sponsor against medication - coribabs - Jan 27th 2010

My husband of 16 years is a recovering alchoholic and was taking medication for bi-polar. During a terrible manic episode, his sponsor and I had a terrible arguement about how he does not believe in medication and that my husband can do without. My husbands sponsor turned my husband against me, saying that it would kill him if I take him to the doctor and my husband listened. The sponsor encouraged my husband to file for divorce and leave our family. Since then my husband has spiraled downward, he can't work, he is almost bankrupt, he has debilitating headaches, and he is crashing hard soon. Is there a place where I can go to report his sponsor for giving such destructive advice when he is not supposed to give advice? Its like he has my husband under a spell or something, and I can't believe a spouse has no legal rights to get help for their spouse so they don't self-destruct. I am just sickened by this and feel helpless. Any advice would be welcomed, and I need it quick.

Hidden Relapses - The Time Lord - Jan 27th 2010

"Hidden relapses among the Oldtimer group...meaning that sometimes, the people the newcomers are told to emulate are actually actively addicted themselves."

Mona Lisa accurately points out what may be one of AA's ugliest secrets: hidden relapses among the oldtimers. Strangely enough, many of these relapses remain hidden precisely because some are able to dust themselves off after after an incident or two and return to continuous sobriety - in direct contradiction to the notion of the precipitous decline after one drink.

Others hidden relapsers remain actively addicted and are either able to hide it from the group or stay protected by a group blindness that dwarfs any clinical denial. Concerning both these scenarios, I once heard an oldtimer lead a morning meeting when they were clearly drunk. At a group business meeting a few days later, I asked the precisely phrased question, "What is this group's policy about people leading a meeting when they had been drinking?" The faces told the whole story: about half knew exactly who I was talking about; the other half were clueless. Both groups were, however, united on one issue - I was asked to leave the meeting and never come back.

The more I write about this stuff, the more sick to my stomach I become.

You call this "working"? - Mona Lisa - Jan 27th 2010

It is very true that the "AA oldtimer" is often a crashing social misfit in larger society. I have often thought that the real benefit of AA for such people is not sobriety, but the fact that the closed, airless, inbred environment of AA provides a place where they can be gurus and big shots merely because of their sober time.

One problem with this is that oldtimer status is lost in an instant if the oldtimer takes a drink. In the world of AA, one drink resets your sobriety date and restores you to "beginner" status. You can't lead (tell your full story at a meeting), you can't chair a meeting, you have to fire all your sponsees, and you are quite simply no longer viewed as someone to emulate. The result? Hidden relapses among the Oldtimer group...meaning that sometimes, the people the newcomers are told to emulate are actually actively addicted themselves.

Not a good system.

Beth's story - Mary - Jan 27th 2010

Mona Lisa, I was incredibly saddened by your story regarding Beth. It touches on a problem I have with the entire mental health and addiction treatment systems, people don't fit into tidy boxes of either mentally ill OR addicted. I have seen mentally ill people dumped off in AA by the mental health system for YEARS and AA members (and I am one) are not qualified to help them with their mental illness any more than religious institutions or the PTA is qualified to help them. It is sad that this happens and I don't understand it. One conclusion I have come to is that there is too much of a divide between mental health care and addiction treatment, that is anything BUT wholistic and doomed to failure. Another problem I see is that treatment centers, especially those who provide for those without financial resources, are run (at least in my area) mainly by recovering people with just a few years and very little education in the mental health area. They are willing to work for very low pay so are tapped as a resource, often for the indigent treatment facilities they "graduated" from. So many times I have sat in a meeting and listened to someone and simply known that I, as merely a recovering alcoholic, was completely unqualified to help due to mental illness that required professional health care. On the flip side I have know numerous people in AA with mental health issues who received proper health care, medication, ect... and have prospered personally by treating all of their problems. AA is a resource, when members, and even worse professional health care providers (whether professionally trained or cheap labor treatment grads), look at it as a one size fits all dumping ground for people it FAILS because it was never intended for that purpose. I have a physical problem that will require surgery soon, AA meetings won't fix that, I need medical help; mental illness is a brain that needs medical help.

Re: You call this working - Abbadun - Jan 27th 2010

I remember the funeral of a friend of mine in AA. I remember that I went into the church with the regular people, but most of the AAers stood across the street smoking like addict until the last minute then came into the church. It was so odd and sad.

In many ways AA is the sober extention of some addictive behavior. I work in a Rehab for men with no insurance. They have their health needs taken care by community health Centers. Everytime my clients venture into the neighbor of the Health Center the Neighbor Watch People would peg them as addicts (there was terrible drug scene at the time in that Neighborhood).

RE: You call this working - surferguy - Jan 26th 2010

Just wanted to say that I have witnessed the same experiences in gatherings outside of AA. But if there is an AA dance or an AA anniversary, the people of AA feel quite comfortable. But like you explained, outside the rooms the AAers are like a fish out of water. Maybe thats why so many people go to meetings every night, it cant possibly be that they are still afraid that they will drink, especially people with years of abstinence, oh wait! I mean sobriety. And on the subject of meds, ive seen people almost come to blows in the rooms over that arguement.

To MeMay - You call this "working"? - Jan 26th 2010

You may have missed my point:

"What stuns me in both cases is the inability of the AA contingent—many of whom were social stars within the Program—to relate to other human beings when they were not in their tightly controlled AA environment."

No straw men here - these were the so-called AA "winners" who were incapable of spreading the joy of living they practice within AA outside to the rest of us. I was speaking to the illusion of community within AA.