Slashdot Mirror
The Science of 12-Step Programs
Hugh Pickens DOT Com writes "Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists. But there is an interesting read at National Geographic where Jarret Liotta writes that new research shows that the success of the 12-step approach may ultimately be explained through medical science and psychology. According to Marvin Seppala, chief medical officer at Hazelden and sober 37 years, attending 12-step meetings does more than give an addict warm, fuzzy feelings. The unconscious neurological pull of addiction undermines healthy survival drives, causing individuals to make disastrous choices, he says. "People will regularly risk their lives—risk everything—to continue use of a substance." Addicts don't want to engage in these behaviors, but they can't control themselves. "The only way to truly treat it is with something more powerful," like the 12 steps, that can change patterns in the brain. Philip Flores, author of Addiction as an Attachment Disorder, says the human need for social interaction is a physiological one, linked to the well-being of the nervous system. When someone becomes addicted, Flores says, mechanisms for healthy attachment are "hijacked," resulting in dependence on addictive substances or behaviors. Some believe that addicts, even before their disease kicks in, struggle with knowing how to form emotional bonds that connect them to other people. Co-occurring disorders, such as depression and anxiety, make it even harder to build those essential emotional attachments. "We, as social mammals, cannot regulate our central nervous systems by ourselves," Flores says. "We need other people to do that.""
I would suspect that programs such as these do work, because they provide a means of seeking help, support and resisting temptation, instead of having no direction to go but down.
Donte Alistair Anderson Roberts - hi son!
Karma: Chameleon
in order to get back to the healthy, socially expected addiction to people. Makes sense.
had to quit it due to pancreatitis. fuck twelve steps, fuck the AA, fuck the higher power, fuck the addiction treatment industry.
you see what's wrong with for example the AA 12 steps? 8 of the steps are "whee I'm a christian now and can't be judged for raping my cousin" and the rest are pretty much "It's not my fault I am/was an asshole". it's bullshit.
not fucking one of the steps is to ACTUALLY STOP DRINKING! and half of the steps are practically just setting up that it's not their fault if they drink!
here's my two step program.
1) stop drinking.
2) try to fill the time with something to make things feel as fun as when drinking.
step two is hard, because, hey, drinking is highly enjoyable.
(* due to having stopped drinking, I find myself unable to stop posting obnoxious poorly spelled comments to slashdot, but hey, it works. btw if you drink, don't be an asshole. AA is geared for people who are so big assholes they can't even go to the corner shop sober because they know they're such dicks when they drink, which makes for a sorry loop).
world was created 5 seconds before this post as it is.
We, as social mammals, cannot regulate our central nervous systems by ourselves. We need other people to do that.
Maybe you can't.
It's been said in the comments on the NGS web site, but it's worth repeating here: The article starts from the presumption that 12 step programs are effective, based on the fact that they are popular. The actual science on twelve step programs says something else entirely.
http://www.nytimes.com/2006/07/25/health/25drin.html?_r=1&
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032.pub2/abstract
Coming up with a "scientific explanation" for how AA "works" without any demonstration that it actually DOES work seems like a load of horseshit, not to put too fine a point on it.
If there's anyone who wants to quit but doesn't like AA for whatever reason, I can recommend Naltrexone and the "Sinclair Method".
The problem with 12 step programs isn't the people who they work for, the problem is that so often they are presented as the only option. Not everyone who has ever used any addictive substance has no control over themselves.Some people used them for different reasons, and those people are often forcefully pushed into these 12 step programs right along side the people who need them.
Most schools are trying to come to terms with the fact that people learn differently, when will treatment programs come to terms with the fact that people recover differently?
"Addicts don't want to engage in these behaviors, but they can't control themselves"
Nonsense. Read 'Addiction is a choice' and 'The myth of addiction'.
There is no such thing as 'addiction'. Every so-called 'addict' CHOOSES to engage in whatever behaviour they are doing, which is called an 'addiction'. Alcohol doesn't force you to pick up a bottle, doesn't move your arms for you, etc.
People take drugs because they are UNHAPPY, and if they stop taking those drugs, their real feelings come to the surface, which they have been trying to avoid all their lives, and they will do anything to continue avoiding them. That is all there is to it.
Given the choice between those two options, I'd pick the 12-step program every time.
Be honest, read those 12 steps. They basically consist of "I'm not guilty, I'm not to blame, I can't help it, I'm powerless, someone else should do it".
BULLSHIT!
That's just a justification. It helps people to quit something that helps them forget if they don't have to carry the weight of what "wrongs" they did, sure, but that doesn't take 12 steps. That just takes the simple step from being an asshole to others and feeling bad about it to generally being a self righteous asshole and feeling good about it. Sure, religion is a great way to take that step, but anything that gives you the "holier than thou" attitude will do.
Or you could simply accept that you did something wrong in the past, grow a pair and turn over a new page. Find something meaningful in your life to fill the void that alcohol took (and no, religion certainly isn't meaningful). Preferably it could be something that helps you manage the "wrongs" you did as your drinking self. Charity work works wonders here. Don't preach to others on the sins of alcohol, that only drags them down and actually keeps them from getting rid of (think back, what would you have done during your alcohol filled days when someone puts you down?).
On the surface, 12stepping does the same. In fact, though, it never acknowledges that YOU and YOU ALONE are responsible for whether or not you drink. Not some "higher power" and you certainly are not "powerless to stop". That's prime grade bullcrap. You and you alone are responsible for your life and what you do. And you and you alone can pull yourself out of the gutter. Friends can be a boon here, whether fellow sufferers are is debatable if you ask me. But in the end, it's your choice.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
"attending 12-step meetings does more than give an addict warm, fuzzy feelings."
"the human need for social interaction is a physiological one"
I'm sure there's some scientific value in quantifying the effect, but that's what people mean by "warm, fuzzy feelings" - it wasn't a mystery.
I am a strong advocate of whatever works.
It doesn't matter who is right or if its the best way or stupid or God or placebo effect. I think the issue is that human beings effect one another and that people with problems of any kind do have an affect on the people around them. These problems may be the result of their experience of the people around them. Whether or not addiction is a choice or a disease or a spiritual or a social disorder really does not matter. What matters is that those who may be afflicted with this dilemma attempt to engage with society in a way that will help to resolve behavior that is inevitably harmful to the self and to the people around them. I don't mean to judge others, each individual can make that determination for themselves. But if it seems that there is wreckage and damage to themselves and to others, and if it is difficult to ascertain how to get a handle on the situation, then its a pretty good bet that engaging with other human beings might be a good starting place.
While it is also true that 12 step programs derive from a spiritual, albeit even Christian flavored template, that in no way limits an individuals personal approach or beliefs. Its just a social venue in which to engage with fellow addicts. And yes there are all kinds of people out there, from the weird to the mundane. Some with "fight club" agendas and some working on a date for Saturday night. Many are addicted to 12 step groups and some are stoned and court mandated to attend. Whatever. It doesn't matter. Its like the rest of the world - there are all kinds. But if you try to do SOMETHING, try to engage with others in a way conducive to new behavior, or another perspective, then its a good place to start.
Why a 12 step? Because its all around, in pretty much every town in the western world. It is anonymous. It is inclusive of anyone who can just be present and listen. It costs nothing. You can leave at any time. If you don't like the kooks or freaks or holy rollers or drunks then just go and find a group that is normal like you. Or blow it off. Nobody will stand in your way. Just know that it is available to you, even if its not particularly useful or interesting to you, it remains an option. And the possibilities are as varied as the human beings that comprise our world. Some are even Scientologists lurking in narc-anon.
Like most things you get out of it what you put into it. If you spend more time drinking you'll spend more time dealing with those consequences, whatever they are. For some, it just means better wine, for others its a DUI or health concerns or anything else you can imagine. If you spend a lot of times doing something else instead, then you will get other results. It may not make you happy or solve your problems, but it will take time away from drinking or gambling or eating a gallon of ice cream or it doesn't matter what else.
My point is perhaps best stated by the immortal Tom Leher. He once said,
"Life is like a sewer.... What you get out of it depends on what you put into it"
And as with most things that goes for the 12 or 13 steps as well. Let the farce be with you.
My father managed to get out of several decades of drug and alcohol abuse (and criminality) via the 12 step. He got an education in treating addicts and now work since a number of years treating others with the 12 step. It works (but that's not news).
Seeing this pretty close and talking to my father about many details, I can state this with absolute certainty that it is 100% exactly the same as any "mind-controlling" cult, but for a different purpose. It works the same, looks the same, everything - and it even has a lot of "god" in it, although many people choose to interpret that in other ways. Especially it is formed to teach you that you are powerless and must trust whatever higher power. It turns the addicts into addicts for meetings instead of drugs.
I have many many problems with the treatment as it is done today, especially since it forms a life-long dependency on something new (this is the trick!) instead of the drug, and the breaking down of the mind. But, on the other hand, it's better than the alternative. I just can't help thinking that there must be a better way than switch addiction for addiction. My father disagrees, of course, simply because for him, this is not how he views it, he sees himself as free from addiction, but he gets all jittery if he can't go to a meeting for a few days...
If we are gonna reprogram humans (it's similar to NLP?), I'm sure it would be possible to reprogram them in a better way than this.
AA's own internal figures show that only 5% of people who start AA are not drinking one year later.
The spontaneous remission rate is also 5%.
So the ones who are stopping were going to stop anyway (and kudos to them).
But what about the 95% who don't stop? Other studies show that when groups of alcoholics were randomly assigned to court ordered AA, no treatment, or a therapy program, the AA group was FIVE TIMES as likely to engage in subsequent episodes of severe binge drinking as the no treatment group, and nine times more likely than the therapy group.
Here's a sampler:
http://www.thefix.com/content/the-real-statistics-of-aa7301
http://www.orange-papers.org/orange-effectiveness.html
http://www.youtube.com/watch?v=Z0DSEdLCAUg
I think before we start analyzing why 12 step programs work, maybe we should determine if they work. While everyone just assumes 12 step programs are the answers, there is very little scientific evidence and studies on whether they work better than anything else. It is a hard subject to study, but I think something that should be done since the state is sentencing people to 12 step programs. Before we force people to go into programs (especially one that force people to accept that there is a "higher power") I think there should be strong studies done to show that these programs work better than other programs or at least better than a person just deciding to stop.
"Information wants to be expensive" - Stewart Brand, the same guy who said "Information wants to be free"
It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
There is a lot of evidence to suggest that 12-step programs are nothing more than window-dressing. That they take credit for spontaneous remission - the percentage of people who just quit on their own.
For example, alcoholics have a spontaneous remission rate of roughly 5% - so if an AA program has a 5% success rate (including the people who give up on the program - the AA people don't like to count them) then AA is just a no-op.
Here's one of many analyses making the argument that 12-steppers are just bad at math.
http://www.orange-papers.org/orange-effectiveness.html
When information is power, privacy is freedom.
https://yourlogicalfallacyis.com/begging-the-question
It cannot make sense until we have re-established purely materialistic explanations for every phenomenon.
This is a crucial aspect of achieving a fully deterministic, freewill-free model for human behavior.
Only then can humans become fungible with sheep in the eyes of SkyNet.
The eugenics applications alone of this effort are staggering.
Get thee glass eyes, and, like a scurvy politician, seem to see things thou dost not.--King Lear
My AA story...
In college, I attended an AA meeting as a requirement for a Psychology class. I wan't an alcoholic or even on the path to alcoholism; I just needed to fulfill the requirement and "attend an AA meeting" was the easiest way to do that.
The first thing I noticed was that all the people in the meeeting (there were maybe 40 attendees) had replaced alcohol with coffee and cigarettes. The second thing was that all of these people seemed to care about each other. A lot. It wasn't anything explicit or obvious; it just seemed to radiate from everybody and it generated this vibe that was incredibly warm and fuzzy. I didn't announce why I was there, so unless they asked me the other attendees just treated me like another anonymous alcoholic. And they treated me like I was their son or their brother. It felt really, really comfortable and nice. At one point, I actually thought to myself "it's too bad I'm not an alcoholic, because it would be great to hang out with these people every week."
I left that meeting on an emotional high. The only way I can describe it is that it was like finding out you had a whole branch of your family that been searching for you for years, and now you've been reunited and your new family just accepts you with -- not just open arms -- but with a tangible joy that you've finally joined them. It was awesome! And then I got about 50 feet out the door and said to myself "You just got hooked by a cult!"
I was shocked because I had always assumed that I was 100% absolutely immune to cults. I had read stories about people who were brainwashed into joining them and thought that I -- with my intelligence and my skepticism and my stable family life -- could never fall for something like that. But I had only been there for two hours and they had hooked me. Had I been less intelligent or cynical or more lonely maybe I wouldn't ever have realized what was happening.
But more importantly (at least for the report I had to write for my Psychology class), I understood how AA works. It's a cult. A brain-washing, mind-controlling cult that uses the same psychological techniques as Jim Jones or Heaven's Gate to control people, and then uses that control to help them conquer their addiction demons. It's atomic fission harnessed to light up a city rather than to destroy it. And it works because we're social animals and our brains normally respond to social cues at a level far beneath our concious thought. Unless we're actively guarding against it, we can all be manipulated this way. Even you.
Please note, I'm not in any way claiming that AA is bad or that they use social power to do anything other than try to help people. People's need for social interaction is just a fact, and AA uses this knowledge as the starting point to help people stop drinking. Knowing that you have several dozen people who care about you, who would be disappointed if you had a relapse, who look to you as an example of success, or who would be happy to talk to you if you just need help resisting the urge; that knowledge might make the difference between you giving in to your addiction and you staying sober for another day. That's a good thing and if AA works for somebody then that's great.
So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.
Yep.
Most other activities, you can "give them up". But get involved for real with a program like AA? "Forever is a long time"!
"Sober 37 years"?! So let's say he started the program at 30, and now he's 67? Do some math people then re-apply the context!
"Oh yeah, I did some stuff back in 1973..." So? Didn't everyone? But a program like AA makes sure you can never forget it and move on!
And that's without even getting started on the Christian angle!
My first Journal Entry ever, in 8 years! http://slashdot.org/journal/365947/aphelion-scifi-fantasy-horror-poetry-webzine
Doug Stanhope - AA Is A Poorly Constructed Cult and Doesn't Work
http://www.youtube.com/watch?v=4txNz25Ht9o
I understood how AA works. It's a cult. A brain-washing, mind-controlling cult that uses the same psychological techniques as Jim Jones or Heaven's Gate to control people ... So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.
"Cult" is a very imprecise term. By your broad definition, your family is also a cult (you're the one who likened the meeting to a family reunion). For that matter, our entire society (and I suspect all societies) are cults by that definition. Families and societies are extremely strong means of controlling people.
"Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists.
12 step programs do not claim to cure anything. If an alcoholic enters AA, even if they refrain from alcohol for years, they are still an alcholic. Nothing is cured, they have only developed ways to deal with the alcoholism. Same is true for other addicitons treated through 12 step programs.
Maybe if scientists viewed 12 step programs as behavior modification programs, they wouldn't be so perplexed.
AAs success rate varies between 5 and 8 percent, about the same success rate you'd expect from no treatment.
If you can't beat the control group then it's junk science at best to try and derive meaningful conclusions from the few success stories and lends undeserved credibility to a program that is a massive statistical failure by almost any measure that means anything.
That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
I had thought there was pretty conclusive evidence that 12-step programs didn't work?
http://www.orange-papers.org/orange-effectiveness.html.
---
My source is not better, just different. We need some real authoratitive research into "does this work", before "why does this work".
20 characters max for the password? How will I use my favorite poems as passwords?
There was an AA meeting group in the civic center I volunteered at. A loved one and friend of mine also attended AA meetings.
Though I am an atheist without a drinking problem I helped set up and clean up, and became tangentially involved with 12 step programs over the years.
One major compulsion to attend AA and other 12 step addiction programs, especially for teen and young adult members, is the unwritten "13th Step": Sex and/or relapse into addiction with other members. Some have related to me that they were introduced to hard drugs or "milder" drugs like cigarettes and caffeine via AA... When I asked if trading one vice for another wasn't just as bad (smoking packs of cigarettes a day is very bad and severely addictive), "One addiction at a time," they would say. One need only look at the coffee expenses nearly all AA meetings have to realize the effectiveness at combating addictions are quite subjective... A cyberneticist might even say: They have changed from sating their tendency via physiological addiction into sociological addictions, either can be severely harmful; Please enjoy addictions responsibly; Everything flows, moderation is the key.
I can believe that addictive personalties may favor a certain substance or habitual activity above others (drug of choice), but I can also acknowledge that there is no such binary as "AA works" -- It's more like: AA has some success and a lot of failures: Success more likely only if you've "Hit Rock Bottom" first however, which I find quite ridiculous. Either it does or doesn't work, the belief in AA that a cathartic event that nearly destroys a person be practically a prerequisite for recovery is dangerous, reckless, and foolish -- Not based in empirical study, for certain; Only anecdote.
There was a teen 12 step program my friend was in, "Lifeway", and "PDAP", before that. These were largely modeled after AA's 12 steps, but Lifeway mushed the "you believe in a higher power" in with some other step so that it could squeeze in a step about abandoning your friends since they will cause you to fall back into addiction again... Even abandoning me because I wasn't "a winner" in life enough to help my friend "work a program". This is a common cult tactic.
The safety net gone, when my friend could not "work a program" due to being as atheist and thus incompatible with the "higher power" step, my friend's parents (upon advice from the parent meetings they attended) kicked my friend out of the house. They said the other families wouldn't let them stay with them, even though such was the apparent practice, and instead they were shown, "Tough Love". My friend became a 16 year old homeless person and flunked out of high school. My friend said they still attended the meetings, because they were too ashamed and afraid to contact an old friend like me -- they said that if the group, family, or "sponsor" found out about the contact it could mean prolonging the homelessness. Though they had been without drugs while failing to "work a program" for over a year, they started using drugs again once on the street... Of course! That was my friend's first encounter with harder drugs... This before the 3rd step of the program could even be attempted, they said.
AA and other 12 step programs do not provide the housing aspect a teenage kid requires to survive, so they were of no help, "Keep coming back, it works if you work it," is the literally ignorant motto. After months of homelessness and abject prostration before the parents of Lifeway my friend was allowed to stay with another family, but not their own family; It was more "Tough Love" they said. I saw my friend with the new family around town and was quite puzzled because they'd never hung out before, and I was given the cold shoulder when I tried to say Hi.
Later, my friend had said they had to earn back the right to live in their home, and couldn't take any chances... Meanwhile they were instructed to attend "outpatient" meetings, which my friend described as exp
Okay. First of all, there's no (official) 'Christian' angle in 12-step programs. The higher power is nothing more than a technique for letting go of trying to control things yourself. For lots of people, the 'higher power' is the group (no God required). And the purpose of it all is to give you enough breathing room to actually take a hard look at your behavior and learn that it (literally) won't kill you (or anybody else) to approach life honestly. The rest of it is all trappings to keep you occupied until that realization truly takes hold. Sure, there are plenty of people who go to AA because someone else 'makes them'. And it doesn't work for those people. There are also plenty of people for whom the program becomes a way of life (with good and bad aspects - not least is the desire of those who were genuinely helped to help others deal with their problem). And some people grow away from the day-to-day aspects and carry on with their lives, applying the lessons they learned in AA.
So why not shut the fuck up when you're ignorant about something instead of getting all superior and condescending.
Posted from my Android phone. Oh, I can change this? There, that's better...
Beware methadone overdose. Quoting from that page: "it stays in the body longer than other drugs". I've also heard that it stays in the body after it has stopped working, so you want more...leading, potentially, to overdoses. WA state pushes methadone (as it is cheaper) and has killed a bunch of people as a result.
I come here for the love
this article cites a few studies on dopamine receptors and fucking brain waves, and tries to link those with 12 step programs, does a bad job of it, and does not cite any study of the actual success rate of AA vs quitting cold turkey. Probably because those studies show that AA has at best, no effect on relapse rates for addiction. and AA isnt grassroots. its sneaky religious indoctrination that judges can order alcoholics to attend in lieu of time in jail. and thats probably unconstitutional.
Bring up Jesus in an AA meeting and you are liable to be chastised. AA is a spiritual program, not a religious program. AA isn't about "stuff" one did, it's about not drinking, maybe so you don't do more "stuff".
Further, about 40 percent of AA members drop out during the first year (although some may return), raising the possibility that the people who remain may be the ones who are most motivated to improve.
It sounds like those same people would have been just as successful at SOS or any other group that would support them in their goal of quitting drinking. Maybe, those same people would have quite without AA or any help because they were so motivated.
What needs to be done is take two groups of highly motivated people - one in AA and the other on their own - and see what happens.
Again, we're back to a self selection group.
...purely materialistic explanations for every phenomenon.
In my business, it's called troubleshooting. Find the problem and fix it.
The only faith required is the belief that you can do it. - Mark 10:52
“He’s not deformed, he’s just drunk!”
That study wasn't a RCT.
Everyone who goes and stays at AA are a self-selected group. A judge may sentence them to it, but to stay required commitment to stop. No randomization; therefore not very valid.
First of all, there's no (official) 'Christian' angle in 12-step programs. The higher power is nothing more than a technique for letting go of trying to control things yourself.
I refer you to steps 2, 3, 5, 6, 7 and 11 all of which explicitly invoke a diety of some kind. Claims that the twelve steps do not involve religion hard to swallow and frankly a bit disingenuous. It's pretty hard to buy the claim that those steps collectively are somehow independent of christian teachings. Those steps collectively are little different in function from confession in the christian tradition. Furthermore the founders of the twelve step programs themselves come from a christian tradition.
If 12 step programs clearly worked I would have little problem with that fact. If some prayer genuinely helps someone get their life together and stop drinking, who am I to judge? Anything that helps without harming others is fine with me. The problem is that it is not at all clear if they are actually effective. Some evidence points towards them being helpful for some people, much indicates that they provide little benefit and in occasional cases might have actually proved harmful. It's hard to study their effectiveness because the nature of twelve step programs tends to be secretive and there are other problems such as lack of a control group. The evidence supporting AA as an effective treatment is scientifically quite weak. Most evidence seems to show that at best it has a success rate barely better than those who do not take the program. I have a problem with the notion of prescribing religion as a treatment regimen in light of the fact that there is no compelling evidence that it actually has the desired outcome.
The difference is that an alcoholic would drink themselves to death despite pancreatitis.
NO. An alcoholic would WANT to continue drinking but whether or not they actually do so is a separate matter. Addiction is about the urge. Some can conquer the urge, some ultimately cannot.
You had a need to stop, you did stop. That proves you are not an alcoholic.
Which shows you do not understand addiction. If the person stops but the urge remains then they ARE an alcoholic whether or not they ever drink again. For some the urge is too difficult to overcome. I have an employee who is an alcoholic. A condition of his employment was that he stay sober but he always has the urge to drink. He's had a rough life due to his drinking - he was almost unemployable, lost his drivers license, lost a marriage, etc. Now to my knowledge he hasn't had a drink in several years (and has taken the tests to prove it) but the urge is always there. He IS an alcoholic whether or not he actually drinks another drop.
And they are all giving power to a higher power because the addicted can't stop themselves. So having an imaginary friend who's always there looking over your shoulder gives you some accountability when you'd otherwise have none.
All of which is fine in theory. In reality the scientific evidence is very thin regarding whether twelve step programs actually are effective. There has never been a study which conclusively proved that twelve step programs significantly increase sobriety. Admittedly it is a hard thing to study but what evidence there is indicates that "giving in to a higher power" isn't likely to be more effective than the alternatives available.
It doesn't matter who is right or if its the best way or stupid or God or placebo effect.
If it is the placebo effect then by definition the treatment is ineffective. In principle I agree with you. It something works then keep with it. The problem is that there is very poor evidence supporting the effectiveness of AA or other twelve step programs. If someone can show me a study that *definitively* says "yep, AA helps 10% more people than a control group" or then I will say go ahead with AA and try to figure out who it helps best. I'm even willing to go along with AA continuing while they do such studies since it is mostly harmless from what I can tell. But if AA is shown to be no more effective than a placebo then by definition it is a pointless endeavor and we should look for alternatives. As things stand AA has a much better reputation than the available evidence supports. It's certainly not a proven means of achieving sobriety.
True, AA isn't generally "warm and fuzzy". NA is more warm and fuzzy, more of a "support" group.
At many AA groups, they'll not do the "everything's okay" bullshit. They'll tell you it's NOT okay to get drunk and punch your wife, then take your kids for a ride at 110 MPH. Did that hurt your feelings? That's okay. I care enough about you that I'd rather save your life than have you like me.
* there are tens of thousands of AA groups, who have held millions of meetings. Anything I say about AA in general may not apply to a particular meeting.
Since there are tens of thousands of groups that are all different, I can't say that anything in particular is true of every group, but the book "Alcoholics Anonymous" tells us what it's designed to be. The book is abundantly clear. Drinking can be replaced by service to others. As I write this, I'm caring for a severely autistic young man while his parents are in church, instead of getting drunk with my brother. Here with me is my beautiful wife, who wouldn't have married me if I were still living like I used to. It works for me.
While I am definitely not a 12 step advocate, your comment reflects an ignorance of the program. Step 1 as laid out in the big book (not the one liner, the whole enchilada) makes it clear that not drinking and staying stopped is key and that the remaining steps, when taken as a whole, are a means to that end. In other words, no single step is stop drinking and stay stopped just as no single step of fixing a car is 1) fix the car.
Please leave arguments against AA to those of us who actually understand the program, as people like you merely give them ammunition.
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
If you can't beat the control group then it's junk science
It's junk science to pretend that a randomly chosen group is a meaningful control group when studying something like this. The key issue is explained here and here.
limitations are widely acknowledged in obtaining acceptable data due to the difficulty in applying experimental controls to clinical analyses of AA, such as adequate placebo control
It's a notorious problem with studying the efficacy of psychological treatments. In many cases the whole issue is ignored so someone can claim to study it in a meaningful way and get more grant money.
Doug Stanhope on Dr. Drew
FYI wiki is not a source, it's some random person's posting on the internet, just like this is.
Anyway, many leaders in my city, the most respected members of the community, are former "habitual offenders" , drunks and crack addicts who had no respect for themselves, much less the respect of others. I myself used to live under tarp behind the Target store.
Now people act like I'm doing great things, helping
those in need. They call me "a blessing". It is I who is blessed. I don't help others because I'm any kind of saint, far from it. I do what I do because a) it's fun and b) I've discovered that I can either help the homeless guy, or become the homeless guy. For some of us it's like that. So my choice is between having fun being helpful, or having hep C being homeless. It doesn't take a saint to figure out which sounds better.
What happened to me, and hundreds of my friends who have had the same experience? We followed the steps of AA, even the hard ones. Each of our case studies shows that doing the AA system changes lives in a radical, amazing way.
What the survey studies will show you is that telling someone to go to a meeting and hear about AA doesn't make them sober, anymore than telling someone to visit a law school makes them a lawyer. That's what was tested in all of the studies I've seen that concluded "AA doesn't work so well" - they looked at people who were told to go hear about AA. 30% of those people didn't even go into the meeting to find out about AA, they skipped it or sat on the front porch chatting because they had no interest in getting sober.
The reasonable conclusion is "telling someone to find out about AA doesn't work. Actually doing the AA program does work."
The article you linked opened with Lindsay Lohan being court ordered visit a rehab.
Let me ask you this -
If she were ordered to visit a law school a couple times, do you think that would make her a lawyer? Of course not. So that means law schools don't work?
What if she were ordered to visit NASA? Would she become an astronaut? Probably not. I guess NASA doesn't work.
Ordering a person to visit a place doesn't cause them to change their lives.
Law school works - people who really want to be lawyers can go there, work hard, and become a lawyer. AA works the same - addicts who really want to be sober can go there, work hard, and become sober.
I tried AA, never worked very well for me. And yes, it was the religious aspect of it that really made it not work for me. I'm an atheist. I tried a lot of things honestly, to stop drinking. I knew very early on it was a serious issue for me.
What did it for me? I finally told myself (and still believe it) that if I drink one more time, it will kill me.
Haven't touched the stuff since.
It's Bullshit. No science involved at all. Ask Penn & Teller.
When you lose your license to practice law behind drinking, but feel compelled to drink again the next day, you start to suspect there may be a problem. A year later, when you lose your wife and kids to drinking despite doing all you can to try to stop, you suspect it might be serious. Two years later, when you find yourself in the bar after your dialysis appointment, you KNOW you're screwed. Nobody has to tell you that. At AA you'll find people who tell you "yes, I was just as powerless, I found myself in the same situations."
If you personally haven't been through that, I'm sure it's hard to comprehend. The fact is, for a real alcoholic, it's like diabetes - it'll always be part of your makeup, though it can be controlled with daily vigilance. That's fundamentally different from someone who simply has a sugar crash from eating too many sweets, or a hangover from too many drinks.
You say that you suspect that they work. But there is no data to support that. In fact, most 12 steppers fail, and the success rate for 12 steppers is as low as the success rate for people just deciding to quit without using the 12 step program. Penn and Teller did an episode of their show "Bullshit" that talked about 12 step programs and gave some interesting data on its success. I'll suggest that you may want to see it before telling more people why you think 12 step programs work. They do not. You can usually find copyright infringing episodes of this show on You Tube. This supposed report is just more Bullshit.
I'm an American. I love this country and the freedoms that we used to have.
The reason the method hasn't changed much is because AA isn't an arm of the court. They have no interest in getting people who were forced to go there to do anything.
If courts ordered people to visit a law school, and those people didn't become lawyers, would the schools change their teaching methods? AA has a method that alcoholics can use to stop, but it's not easy. That's not of interest to someone who doesn't even want to be there. It's very useful for someone who is dying to stop - literally.
Maybe whatever temperance organization is trying to convince people to stop drinking will change THEIR methods. That's not AA's purpose.
The article is propaganda, plain and simple. In the first few sentences the author is already using words like “success” and “a miracle” to describe 12-step programs. I was interested in the article at first because the headline seemed to promise coverage of a genuine scientific assessment into the efficacy of the 12-step approach, something that is badly needed here in the USA where the 12-steps are frequently treated as The One True Religion by the established addiction treatment community. But the piece is just fluff, apparently written by a true believer who seems only interested in research aimed at retroactively determining just how 12-step programs accomplish such great things... The greatness is just assumed to already be a settled matter. The fact that AA and especially NA don’t work for the overwhelming majority of addicts is something that is just glossed over.
And that’s really too bad, because AFAIK most studies find only marginally better outcomes when evaluating 12-step program performance, on the order of a couple of percentage points when compared with alternative treatment methods, particularly over the long term where the numbers are barely statistically significant. The sad fact is that something like 99% of the addicts who walk in to a NA meeting for the first time will relapse in a matter of weeks or even days, and often just hours. As for the long term outlook, there are studies showing no measurable difference in sobriety levels after 5 years of NA versus no treatment at all. Even when the 12-step rules are scrupulously adhered to and all meetings are faithfully attended by the recovering addict, it remains a method of dealing with addiction that works only for very, very few people, although admittedly when it does work it can be a godsend. The question that needs to be asked in the USA, a country still obsessed with the patently un-winnable War On Drugs, is this: why is a program with such abysmal success rates still considered the gold standard in addiction therapy by treatment providers? Too bad you won‘t find any such question in the article.
Other social groups (where "social" means 2+ humans) utilize the same mechanisms that work for cults.
In other words, many groups (like political parties, organized religion, sports fans, various work teams, boy scouts, girl scouts,
Some of the groups hack the human bios in a way that causes more damage than others.
*shrug* If people are lucky, they are raised around the less-damaging groups.
Your surprise at being affected is actually very interesting: I take that to show how just how fundamental the human bios is to people; usually people don't think about "breathing" or "seeing" - lots of neural hardware just works to make those processes happen. Why should social dynamics (my "bios" metaphor) be any more obvious, or have any less neural hardware, than other processes?
My AA story... ...
In college, I attended an AA meeting as a requirement for a Psychology class. I wan't an alcoholic or even on the path to alcoholism; I just needed to fulfill the requirement and "attend an AA meeting" was the easiest way to do that.
I left that meeting on an emotional high. The only way I can describe it is that it was like finding out you had a whole branch of your family that been searching for you for years, and now you've been reunited and your new family just accepts you with -- not just open arms -- but with a tangible joy that you've finally joined them. It was awesome! And then I got about 50 feet out the door and said to myself "You just got hooked by a cult!"
I was shocked because I had always assumed that I was 100% absolutely immune to cults. I had read stories about people who were brainwashed into joining them and thought that I -- with my intelligence and my skepticism and my stable family life -- could never fall for something like that. But I had only been there for two hours and they had hooked me. Had I been less intelligent or cynical or more lonely maybe I wouldn't ever have realized what was happening.
So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.
Any basic research will show that there is a >90% relapse rate for AA and NA participants. The relapse rate is about the same for self-recovery and almost any non-medical program.
The only ones who talk about the "success" of AA are those who have financial reasons or religious reasons to promote it.
Article X: The powers not delegated... by the Constitution...are reserved...to the people
It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
Quite glib; your implied point is "it" is worthless because it just swaps addictions.
I haven't seen a definition of addiction yet, so I'll suggest this:
Someone is addicted if they repeatedly make damage-causing choices, to the point where normal life is unsustainable (e.g. cant hold a job, arrested, or maybe death).
Now instead of a question of "Addiction" it becomes a question of Sustainability: how long can somebody carry on?
Some people carry on for a full lifetime with whatever. No problem, I'd say they're not addicted.
Other people have trouble sustaining after a while.
As for "trading one addiction for another", think of it as damage control.
Different behaviors have different time frames to their consequences.
Some things, like meth or heroin, can lead to severe consequences quickly (think Trainspotting).
Alcohol tends to be longer-term maintainable; often drinkers can sustain for years, possibly even decades. Eventually health issues (like liver damage, possibly fatal), judgement issues (drunk driving, possibly fatal), and other "consequences" (getting fired, divorced, passing out in risky situations) tend to make life unsustainable.
Marijuana is perhaps more sustainable than alcohol and other drugs.
Now, let's talk about some of the other "addictions" that you're concerned about.
Coffee? (Oh noes, they iz addixted to caffeen!!) WTF! Coffee is arguably completely sustainable, it doesn't cause damage to the user or to others.
Cigarettes? *shrug* I don't know about that one but damage-wise, but it is probably safer for somebody to smoke than to routinely make poor decisions because they're blackout drunk.
Sex? (Oh noes, they are sleepn roundz!) This is pretty sustainable; arguably healthier than lots of alcohol / chemical "entertainment" options. Do actually you have a problem with people engaging in sex?
Look... whatever behavior you're thinking about, try thinking of it in terms of sustainability. Maybe some of these things are "just" substitute addictions"... but is that really so bad?
There is a lot of logic in taking people who have broken self control mechanisms and telling them that they need to rely on some external source of judgment. Fine. When they craving for a drink, teach them to call a sponsor or other group member to talk me down. Because their brain is too broken to make correct decisions in this area. But that should be the end of it. If this becomes a foot in the door to sell a story of some invisible guy up in the sky who is all powerful, well they may not be that screwed up. And attempting to make this sales pitch is often caught, even by people lacking excellent judgment as a con. Eventually, they see through the BS and reject not only the imaginary guy with the beard, but the useful support structure keeping them away from abusing substances.
Have gnu, will travel.
It cannot make sense until we have re-established purely materialistic explanations for every phenomenon.
Nearly every human society has some kind of religion or "spiritualism". We would not have evolved such a strong propensity to believe in the super-natural if those beliefs didn't provide a competitive advantage for individuals or groups of related individuals. Of course there is no evidence that the beliefs have to be "true" in order to "work".
I think it's tragic when quacks try to justify medicalizing economics and it gets passed off as science. It's utter horsesh*t. Love is not an adult human need. Case closed.
Its a cult the same way every social support group in history is a cult, inclluding christianity, buddhism, fraternities, etc. The key to a cult is when it states explicitly that it is the only way to to X, and that all others will fail, and that you need to devote your life to them. Its definitely true that some AA/NA members feel that way, and that some meetings may devolve to that point, but the literature is not exclusive, they dont say they are the only way, they dont condemn any other supports people find (including the lesser evils of cigarettes and coffee, which a strict anti drug cult would likely forbid). The good feeling in groups can be very compelling, any Large Group Experience will do this, including a good rock concert. The antidote to that becoming a crutch is wisdom, and building as many unconditional relationships as possible, and internalizing all the supportive externalities when possible. eventually, if ones self identification with a higher power can be internalized, then you have healed yourself, even if your language around it makes the power "not" you. the feeling state of having a divine source within oneself is IT. get there, the rest is icing on the cake. AA is a more progressive model than many church settings, more democratic. its been modified to include codependency, be more supportive to women, and even modified to allow victims of religious cults to relate to it better. They say "it works if you work", but its also true that "it changes if you change it". bottom line: any time people are focussed on trying to recognize their own divine nature, there will be setbacks and pitfalls, but the journey will prove rewarding.
"We would not have evolved such a strong propensity" is, itself, a powerful faith-claim.
Get thee glass eyes, and, like a scurvy politician, seem to see things thou dost not.--King Lear
And so there were random data losses back in the days of the dishwasher-sized storage unit with the huge, removable platters.
As long as the scope of inquiry was the data system itself, the cause was mysterious. Random.
Then, somebody was working late when the cleaning crew came in, sporting a huge, unshielded vacuum cleaner.
Moral of the story: keep a weather eye on the guy trying to limit the scope of inquiry.
Get thee glass eyes, and, like a scurvy politician, seem to see things thou dost not.--King Lear
http://en.wikipedia.org/wiki/Rat_Park
---
Rat Park was a study into drug addiction conducted in the late 1970s (and published in 1980), by Canadian psychologist Bruce K. Alexander and his colleagues at Simon Fraser University in British Columbia, Canada.
Alexander's hypothesis was that drugs do not cause addiction, and that the apparent addiction to opiate drugs commonly observed in laboratory rats exposed to it is attributable to their living conditions, and not to any addictive property of the drug itself.[1] He told the Canadian Senate in 2001 that prior experiments in which laboratory rats were kept isolated in cramped metal cages, tethered to a self-injection apparatus, show only that "severely distressed animals, like severely distressed people, will relieve their distress pharmacologically if they can."[2]
To test his hypothesis, Alexander built Rat Park, an 8.8 m2 (95 sq ft) housing colony, 200 times the square footage of a standard laboratory cage. There were 16 -- 20 rats of both sexes in residence, an abundance of food, balls and wheels for play, and enough space for mating and raising litters.[3]:166 The results of the experiment appeared to support his hypothesis. Rats who had been forced to consume morphine hydrochloride for 57 consecutive days were brought to Rat Park and given a choice between plain tap water and water laced with morphine. For the most part, they chose the plain water. "Nothing that we tried," Alexander wrote, "... produced anything that looked like addiction in rats that were housed in a reasonably normal environment."[1] Control groups of rats isolated in small cages consumed much more morphine in this and several subsequent experiments.
The two major science journals, Science and Nature, rejected Alexander, Coambs, and Hadaway's first paper, which appeared instead in Psychopharmacology, a respectable but much smaller journal in 1978. The paper's publication initially attracted no response.[4] Within a few years, Simon Fraser University withdrew Rat Park's funding.[5]
----
Although other addictive paths in the brain may work differently than morphine, a limit of that study...
Other ideas about addiction as a "pleasure trap" relating to "supernormal stimuli":
http://www.drfuhrman.com/library/article16.aspx
http://www.amazon.com/Supernormal-Stimuli-Overran-Evolutionary-Purpose/dp/B0057DC3VY
And the challenge of addiction may only get worse:
http://www.paulgraham.com/addiction.html
Unless we rethink our daily physical, nutritional, and social interactions:
http://www.bluezones.com/
Glad you found a way to get on an upward spiral of improving health.
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
Step 3: "Made a decision to turn our will and our lives over to the care of God as we understood Him."
Ok, we got it. You chose to ignore most of the references to "God" in the official 12-steps. There are four references, by the way.
You have made the common mistake of associating religion and spirituality. While there is some overlap among the set of people who are religious and those who are spiritual, the two have almost zero to do with each other. If you don't understand the difference then here is a saying that should drive it home: "No war was ever fought in the name of spirituality". Any time you believe that other people are somehow less than you (e.g. will go to live with Satan) if they don't believe the same things you do, you are not being spiritual at all. Many orders of magnitude more so if you think it is OK to kill them because they don't believe what you believe. Ergo, almost all religions are essentially anti-spiritual at their foundation. Two notable exceptions are Buddhism and Wicca.
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
Yes, it is. There's lists of criteria that help you recognize cults--read the lists and then go to a couple of meetings.
Religion and cults are not bad per se. Just powerful social tools for making people do or be something other than what they are right now. Such tools can be used to do very, very bad things. But they can do good things, too.
So they're a cult. That's the point. I joined with full knowledge that these people are trying to brainwash me. Because that's what I wanted them to do. Help me reprogram my thinking because what I was doing wasn't working. I believed (yes, thats a "d' there) in it for the same reason anyone believes in anything. I chose to.
After a while, I didn't believe in it anymore. Character flaw I guess; after I'm around some BS for too long I can't believe in it anymore--even if I want to. Same thing happened when I tried a sales job. I kicked ass until it finally sunk in this was all cynical manipulation and made-up BS.
27 years later still clean and sober. AA helped me get that way. But when I was done believing I was done believing.
I go to a meeting from time to time; the fellowship is still there. But I don't believe the religion anymore. In life, if somebody asks for help, I'll share what I have experienced, and if I need help I'll ask for it. And if somebody wiser than me points out a character flaw I have, I'll take a look at it and maybe do something about it. I don't do this within AA because I don't hang out there. But I learned how to do these things in AA.
What's the point? None; I'm not trying to prove a point. Just thought somebody who'd actually been there should speak up.
"Reality is that which, when you stop believing in it, doesn't go away." - Philip K. Dick
I have many many problems with the treatment as it is done today, especially since it forms a life-long dependency on something new (this is the trick!) instead of the drug, and the breaking down of the mind. But, on the other hand, it's better than the alternative. I just can't help thinking that there must be a better way than switch addiction for addiction. My father disagrees, of course, simply because for him, this is not how he views it, he sees himself as free from addiction, but he gets all jittery if he can't go to a meeting for a few days...
If we are gonna reprogram humans (it's similar to NLP?), I'm sure it would be possible to reprogram them in a better way than this.
There is an alternative, where you build up the mind rather than tear it down. Psychologists have recently found that willpower is like a muscle that can be trained rather than something innate and static. They've been experimenting on ways to strengthen your willpower and found techniques for dealing with temptation.
Here's an in-depth talk about the methods and the results. It's had success with treating substance abuse, weight loss, and mental illness. Getting people to strengthen their willpower is a fairly new method, but if the treatments continue to see success, it will become more widespread.
That's straight bullshit. If you ever actually read the literature you would realize how absurd the claim is, and feel foolish for making it. First of all, AA is a direct derivative of The Oxford Group, which was a very Christian group indeed. Furthermore, God - with a capital G - is found over and over and over again throughout the literature. Finally, they say the Lord's Prayer (The "Our Father") at the end of most every meeting. To say that it isn't a Christian religion is just as disingenious as claiming it is the only way to stay sober, or even that it is the best / most proven way. Yes, people who don't understand the program repeat the lie that it is a spiritual, not religious, program, and that your Higher Power can be anything you want at meetings on a regular basis, but Tradition Two makes it quite clear what the official party line is: "For our group purpose there is but one ultimate authority - a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern." - [emphasis added; note the capital letters as well as the use of the singular]
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
Ordering a person to law school won't make them a lawyer, but then again ordering you to be open minded, do some research, and then accept the fact that you bought into a line of bullshit won't make you get a clue either. What's your point?
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
>. And you can't disregard people who drop out of the program or don't follow it.
In that case , law school is garbage. It doesn't work, since 99% of people don't become lawyers. Exercise most certainly does not work for improving health, because he doesn't work for people who don't exercise. Condoms don't work then, people who don't use them get pregnant.
AccoAccording to your reasoning, virtually nothing works for any purpose.
Your article claimed that because ordering Lohan to visit a rehab doesn't work, no method for getting sober works. That's silly. The far more reasonable conclusion is that ordering someone to visit a place doesn't cause them to do anything they don't want to do.
If the judge ordered her to visit a law school and she didn't become a lawyer, you would conclude that she probably didn't want to become a lawyer. At least, not enough to put forth the effort to do law school.
If the judge orders her to visit a rehab and she doesn't do anything to become sober, the most likely conclusion is that she wasn't interested in being sober. At least, not interested enough to put forth the required effort.
In neither case does her lack of interest indicate anything at all about the effectiveness of the programs offered, making the article's primary premise garbage.
12-step programs merely replace one addiction with another. The dependence on alcohol or drugs is replaced with dependence on the Invisible Hairy Thunderer in the Sky, and, more significantly, his alleged representatives here on earth. If 12-step programs are so successful in treating addiction, then why do people continue to attend meetings for decades? Any ethical clinical psychologist will tell you that her ultimate job is to render her services unnecessary by helping the patient to achieve independence. 12-step programs merely encourage a different form of co-dependence. It's manipulative and self-serving on the part of the 12-step programs' institutional leaders, and ultimately damaging to the participants. I, for one, would rather expire from alcohol-related liver failure than surrender my ability to think critically.
A) It isn't my article.
B) It makes no such claim
C) It accurately points out that AA has a "success" rate consistent with remission rates for other diseases.
D) You are so Lohan-centric that you don't seem to get that he was merely pointing out that her recent lack of success was food for thought that inspired the very informative and accurate article.
Other than that, you're spot on though! (So long as you don't count the non-sequiter that the premise is garbage, since it wasn't the premise to begin with)
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
Read The Orange Papers, and watch Penn & Teller's Bullshit: 12 Stepping".
Get your free Dropbox account with 2 GB Free storage!
If you're comparing treatments and there's a difference, sure compare patients level of compliance and report that ALSO. Nobody studies non-patients with no interest in any treatment and from that concludes that the treatment "doesn't work" though.
You could order me to go to a bar. When I didn't get drunk, you wouldn't conclude "whiskey doesn't get people drunk". You'd conclude that TELLING SOMEONE to go to a bar doesn't get them drunk, when they don't care to do so.
Condoms don't work then, people who don't use them get pregnant.
I'll use this example, since it is easier. Methods of birth control with failure rates for typical use or perfect use: Condoms (typical - 15%; perfect - 2%), "Pulling out" (typical - 18%; perfect - 4%), Plan B - levonorgestrel (typical - 12.5%; perfect - 12.5%)
Ignore anything you think you may know about birth control and any other confounding variables for the sake of argument: If you could only inform a patient about one of these methods, which would it be?
.
.
.
Answer: More people become doctors after attending medical school when compared to those who attend law school. Also acceptable: Plan B - levonorgestrel
The birth control numbers are people who were trying not to get pregnant, and used those methods, perfectly or imperfectly.
Do you have numbers for how often condoms prevent pregnancy in people who are trying to get pregnant? For people who never bought them? Of course not. Yet some people insist on using people who want to get drunk as the gauge for something designed to help someone who wants to NOT drink.
To directly answer your question, none of the above. I would not educate a fertility patient about birth control, and I wouldn't advise someone who wants to drink regarding a method of doing the opposite.
Addicts have an almost constant voice that tells them they are worthless in the absence of some evidence to the contrary. Just telling someone "look, you are worth a lot, you deserve to be happy, no matter who you choose to be!" won't work, because as adults we do not absorb conclusions directly, we draw them ourselves. Acting out (drinking, shooting up, thinking about sex ..) is an action from which we infer that we are worthwhile - we must deserve the drug. This is all going on secretly because nobody wants to face to what they see themselves as worthless sh*t. When you go to a meeting, you say "I am an addict, I acted out this long .." and you see the other people there smiling still, they are not throwing you out. From this you infer that you are worthwhile after all, you don't have to prove your worth. Hence the meetings fill the same need as the drug.
I know a lot of people with long-term sobriety who stopped going to meetings, but I keep going after 26 years. While I never drank again, looking back at my life, the happiest times in my life were the times when I was going to meetings every day and the most unhappy times was when I stopped going to meetings altogether.
This topic is pretty dead, but I'll try to clarify some last points:
The birth control example was meant to show that scientists and doctors need to consider the actual statistical outcomes of different treatments and not the ideal outcomes. The treatment option in that set with the best "real" outcome also had the worst ideal outcome, but for modern medicine the "real" results are what matter.
You never provided a reference for the study you first brought up, so arguing about it isn't really going to be productive. My guess was that the study you were mentioning would have included control groups where they informed a similar sets of people about AA, control non-AA program, a unrelated control program (e.g. a writing club), or did not inform them of any program. If this were the case, then any significant differences should be due to the program they were informed about (they should all have similar stats on people not showing up at all - the 30% you mentioned). The study you mentioned could have been a flawed study that overstated its conclusions or it could have been a perfect study, but you seem to be the only person in this discussion that has knowledge of it.
Without a well controlled (demographic or experimental) scientific study, it should not be assumed that AA is the best course of treatment for a patient.
Modern medicine should not give up when a patient is non-compliant just because it is unethical to force them into treatment. Improved treatments and ways of informing patients about them (in order to get their consent or compliance) is needed when there are problems such as this.
The AC probably meant that if you only count the successes, then your success rate will be 100%. If you exclude a set of data from one condition then you have to exclude it from the controls as well (so you can properly compare them). If all data is included when comparing different conditions, then other variables that are independent of the conditions should fall to background noise (e.g. patients dying in a plane crash or not showing up to any meeting should be the same for both conditions and not affect the end conclusion)
If you are unable to force a patient to go to a program, then the beginning of the treatment starts when you inform them and encourage them to go. A large problem with treatments starting this way is that many patients will not listen. In this case the treatment failed for the patients that did not listen.
When I'm looking for an electrical short, I don't need to check the tire pressure.
“He’s not deformed, he’s just drunk!”
My point is not that AA is the best program. Certainly in absolute terms it's helped more alcoholics, but that's beside the point.
My point is that AC's attempt to judge AA by it's ability to do something contrary to it's purpose is ridiculous. AA is very, very clear that they have no interest in convincing people to stop drinking. I could fill pages with quotes from the AA book indicating that. To say that AA doesn't convince people stop drinking is like saying socks aren't effective because they don't improve your gas mileage. No shit, that's not the purpose.
If you want to say "treatment starts when someone hears about the treatment", aspirin is rarely effective. Everybody's heard of it, and most headaches go away without taking aspirin.
The fertility analogy is really more accurate, though. AC is claiming AA doesn't work because it doesn't have much effect on people who WANT to keep drinking. That's precisely the same as claiming that condoms are ineffective because their existence doesn't stop people who WANT to have a baby.
Until you get into some new ride where they put some kind of tire pressure gadget in the hub that's gone all sideways on you.
Bluetooth. It's the new ball bearing.
Get thee glass eyes, and, like a scurvy politician, seem to see things thou dost not.--King Lear
This article makes a HUGE - assumption - that 12-steps programs, and AA, work, and work specifically better than other programs. That is highly questionable and I don't believe there's been any conclusive evidence either way. Of course, there's the question of whether AA works versus just going to some sort of social program... the article doesn't differentiate much, but it's a big question. Our knowledge of addictions and ability to treat them is in its infancy and is sadly not a priority for many... this article just proves that.
...when it purports to state the "success rate" of AA.
So you have x/y = z%, where x = people who "successfully" recovered, y = total number of people in the program and z = success rate. And you haven't defined x or y.
Obviously z is 5%, amirite?
Let's shine some reality on this. The success rate is unknowable, because:
1) You need to know how many people are in the program. There are no member rolls or lists. No registry. No tally. Not even the GSO knows. There are some meetings that the GMO doesn't even know about.
2) You need to define "success". Is success never drinking again after the first time setting foot in an AA meeting? Is it failing and trying again until something "clicks" and one can put together 1 year, 5 years, or 20 years of continuous sobriety? Is it achieving a little bit of sobriety (e.g., 2 weeks), falling off the wagon and then coming back and never giving up?
3) You need to get the number of people who achieved "success" in the program, as you've defined it in #2. Which is impossible because of #1.
Twenty-three years of sobriety through Alcoholics Anonymous, to qualify myself.
A.A. is not religious; it is meant to be "spiritual" in nature. A member of A.A. is not held to believe a certain dogma. A higher-power, of "your" choice is what's suggested. I've seen many atheists and agnostics acquire and maintain sobriety through A.A.
A.A. does not claim to be the last resort to sobriety. Some people require additional outside help; such as therapy or whatever their family doctor might suggest. Again; it is your choice to become a member or not.
A.A. is not for those who need it; it's for those who "want" it.
There is no political or religious attachment to A.A. That in itself is what makes A.A. so attractive and successful.
Good luck and I hope to meet you on the road to happy destiny.
Why does AA work? It's a dumb question, because AA actually doesn't work. The real data show that you're better off WITHOUT going to AA meetings. People have a better success rate kicking their addiction on their own. The fundamental problem is that AA works for a minority of people, but those who are in AA are those very people ... so they're convinced it works, and they push the program on everyone.
http://religionvirus.blogspot.com/2010/04/christian-shocker-god-based-aa-program.html
So a law school with a 99% dropout rate, you would still recommend to prospective lawyers choosing a law school?
I disagree with your assessment--you're using the term cult, but ignoring the negative connotations associated with it.
The 12 steps form a framework for posing social interraction. What makes it work for most people is that the addict can look to others who have navigated a similar path. Addicts help other addicts as part of the program. They do so, because they gain insights in so doing.
A better analogy than cult might be that it's like having a personal tutor in a subject you continue to fail. He makes you do some of the homework, but a good tutor will get to know you, what you're capable of, and help you apply what you are capable of doing to problem solving on your own. He doesn't do the homework for you, he helps you so you can pass the test on your own.
Many addicts fail AA because they don't have the social support. They need the addiction because it helps them cope. They may not even understand the "why" behind the addiction (imo, most addicts don't understand why... and often when they do, it isn't very compelling.) And they don't have the support of someone telling them that they're better than their addiction, and that if they conquer it that there's a better life awaiting them. So they give up.
AA is not just about creating an emotional high. It is about distilling in the addict ideas and actual tangible steps that they can work on. Unfortunately because addiction is often deeply ingrained in self-image/self-loathing, it sometimes comes across as more touchy-feely, but most people need some sort of training when it comes to emotional maturity. Over time, that's what comes of the program.
But don't discount support, it is an essential human motivator in most things we do. Imagine attempting to do anything momentous in your life without it... it just doesn't happen, unless you're oblivious to the way others motivate you and hopelessly narcissistic.
http://www.beanleafpress.com
Oh yes, wikipedia is great. Of course _I_ am one of the authors there, so GP would probably agree it's not the most reliable source, er non-source.
;) Seriously though, that IS a good summary and list of citations.
A lot of what's in wikipedia is cited. A lot isn't. Some came directly from my rear end. Overall, it's a great summary, and a great place to FIND citations
to actual sources, which you might then cite yourself.
I just wouldn't cite it, because anyone interested in viewing the the source has to go to wikipedia, see if it's cited there, find the citation, and follow it, then look to see if the cited source is reputable. Better to just cite the source. Compare these two citations from the same actual source:
"Guns are great" [wikipedia.org]
"Guns are great" [nra.org]
If NRA is the course, citing the source directly means the reader doesn't have to click ANYTHING to find out what the source is, and if they consider
that source to be credible. Citing the wikipedia citation instead obscures the actual source. For the same reason, you don't cite Britannica, you cite
the same source Britannica does.
> http://en.wikipedia.org/wiki/Reliability_of_Wikipedia [wikipedia.org]
In a discussion about not citing wikipedia or any encyclopedia, you cited wikipedia saying "wikipedia is reliable".
I'm shocked an amazed that wikipedia isn't critical of itself.
If I had more time, I'd read more of it.
Are you psychotic?
AA only has about a three percent chance of success and it sets you up to relapse with a binge making much more likely to die than other methods. For me Rational Recovery worked. Said I am not sick just not taking personal responsibility. For a more in depth debunktion of AA see the Orange Papers http://www.orange-papers.org/orange-letters290.html#iamnotastatistic http://www.orange-papers.org/
To try to explain this....
If you send alcoholics to AA, you can divide them into three groups.
One group isn't ready to stop drinking, for whatever reason. It's obviously not fair to count this against AA.
One group will stay with the program. You're apparently in this group, and AA works for you. That's great, but other people may have different experiences.
One group will want to stop drinking, but for some other reason not continue with AA. It is fair to count this against AA. These are people for whom AA didn't work for some reason. The proper population to judge how well AA works is the second and third groups together.
Suppose somebody is finding AA to be completely unhelpful, or is offended by things that go on in the meetings. Why would that person stay in AA? However, that's one person who turned to AA and AA didn't work for them.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
Agreed. Further, I think you hit an important point:
"If you send alcoholics to AA, you can divide them into three groups."
It would be wise to recognize that if you're SENDING people to AA, those are people who didn't already choose to be there,
so most of them will be in group #1, people who don't want to be there.
So if you count all of the people SENT to AA by a court or whatever, you're counting mostly people who shouldn't be counted. Not for the purpose of determining how well AA works.
Empirical evidence says roughly about 6% of those sent by court want to sober up.
6% want to sobering up, 4% do sober up. Since the purpose is to help people who want to stop, that's an 66% success rate or so
for the first attempt. (success meaning helping people achieve their goal of sobering up - not forcing the someone's goal upon them).
Another 6% will want to quit at some future time in their lives. For many of them, their exposure to AA plants a seed that gets them somewhat
sooner than they would have sobered up otherwise. When those 6% decide they want to, they know where to go.
Ps. I don't think that means there can be no effective study. To find people who want to sober up, and therefore might be helped to do so, look at people CHOSE to go to AA as opposed to people who were ordered to visit.
That's what you'd do with a fertility drug - you'd study people who were trying to get pregnant.
And your point is? The cult is a tool and you use it for good or bad just like any tool.
Thank you for posting that video. I took the time to watch it in it's entirety and feel better for having done so. I see potential for this method in my own life but the video was quite sparse on details on actual implementation. I assume that's in the book. Having been a subject of the tear down method while I was in military boot camp, I can say that while that method does produce results it quickly falls apart because you are taught to rely on your team. If you do not have outside motivation to do something or outside praise then you will just give up. I think that may be why so many have to make a lifetime commitment to places like AA. They HAVE to have thier outside support network ready to help them back up, keep them focused on the goal, and overall motivated to stay the course. The method you pointed out appears to be more focused on training yourself to only rely on yourself. Since my attempts at personal change have ended up less than stellar, I think I'll give this a try. Thanks.
I'm fairly certain Bill W was an LSD advocate and that he thought that it could treat alcoholism. I did a few years under the current way but I much prefer mental reconditioning using LSD
There has always been a large contingent within (and outside of) the AA fellowship that hoped AA would be a tool to get us heathens back into the church. The woman who introduced the founders was one such person, and there have been many throughout the history of the fellowship.
But it hasn't worked, despite the seeming evidence. It is possible, even easy, to attend meetings and practice the program without having to indulge in thinly disguised Christianity. FWIW, it's also possible to be both an Atheist and an AA member.
The often overlooked key is to let each member define what the word "God" means. Its a founding principle
"Give a woman two glasses of wine and some pad thai, and they'll agree to just about anything." the Sports Guy
Does anyone else read "Hugh Pickens" as "Butt Pickens" every time, or is it just me?
your right but drug addicts are ostracised to keep them sick this economy would collapse if people gave up drugs and addicts who suffer low self esteem which means the cops have to destroy any self esteem they may have with strip searches and public humiliation .
Not only is it not a founding principle, but tradition 2 is very explicit about this: "For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience." Your confusion comes from a misinterpretaion and lack of understanding of the Big Book on the part of many, which has grown and propogated throught the years. The section on the agnostic says it is OK to start out not believing in the One True God described in tradition 2. The idea is that you will first "believe that we believe", but ultimately this is a mere bootstrapping method. The entire purpose of the 12 steps is to get members to eventually believe in the God described in tradition 2 (see also step 12.)
Consider also that meetings end with the very Christian "Lord's Prayer." Are you really trying to tell me that they welcome members of conflicting faith? Seriously? Sure, you can be a member but you will be exposed to AA's Christian ideals, no matter how disrespectful that may be.
You'd be amazed how different the program actually is when compared to what you hear in the rooms.
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
Law school works - people who really want to be lawyers can go there, work hard, and become a lawyer. AA works the same - addicts who really want to be sober can go there, work hard, and become sober.
That is a poor argument. By that logic, my room, "the school of EVERYTHING" works. Anything I ever did right, you can do it too, if you just go to my room.
To prove that something works, you have to prove that it is better than the sugar pill. For law school, you'd have to prove that people who goest to law school has a higher chance of passing the bar than those who take the bar after only self study. To truly prove it you'd need a random sampling. This will be almost impossible because noone will participate in a double-blind way because the kinds of people who go to lawschool aren't the kinds of people who participate in double blind studies.
To prove that AA works, you'd have to prove that going to AA had a higher chance of quitting drinking for a significant period of time than just trying by yourself.
Much to our relief, we discovered we did not need to consider another's conception of God.
When, therefore, we speak to you of God, we mean your own conception of God. This applies, too, to other spiritual expressions which you find in this book. Do not let any prejudice you may have against spiritual terms deter you from honestly asking yourself what they mean to you
(emphasis mine).
I've been to many meetings (my rough estimate is 3042) and at nearly all of those we refuse to allow the Lord's prayer. The whole group exercises that tradition 2 you referred to and determines that we don't want to use it since it is tied to Christianity. We don't really give much consideration to an individual's expressed faith. (or lack thereof)
To be fair, there is wide variation across the whole of the fellowship, so as always YMMV
"Give a woman two glasses of wine and some pad thai, and they'll agree to just about anything." the Sports Guy
should've spelt "principle" properly
"Give a woman two glasses of wine and some pad thai, and they'll agree to just about anything." the Sports Guy
Actually, you are somewhat confused (prepare to be amazed?). The Twelve Steps and Twelve Traditions are the founding principles of AA. If it isn't in there then it isn't a founding principle. The fact that they contradict themselves in some of the text of the Big Book should come as no surprise to you, as they contradict themselves the way a good Open Source project releases software: "early and often".
I myself have been to more meetings than you if your estimate is correct, in at least 5 different states, and I can tell you that not saying the Lord's Prayer is almost unheard of (though quite commendable; good for your sub-sect).
I also think you misunderstand the term group as used in step 2. It was written when there were not yet thousands upon thousands of sects; there was only the one at the beginning. It would be hard to argue that they didn't mean every AA member, since at the time the group was every AA member.
The "believe what you want / conceive how you want" bit was clearly meant to keep those who were atheist, agnostic, or had their own ideas about God from leaving before they could convince them to believe in their one and true God as described in Tradition 2.
Now you are probably thinking of telling me that "the program has evolved since then." This ignores the fact that central services refuses to change with the times, and after 5 revisions they still say it has not. Since they are the central authority and others are the fringe groups, this is inaccurate. While it may be uncommon to find an AA group that adheres to the AA principles, even a majority of rogue groups doesn't change the official AA position on the matter.
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
It's OK for people that accept the AA "higher power" and "you are helpless" thing, and really needs the social opiate to replace their integrity and independence.
I think the resistance to AA you see from people has more to do with them being acutely aware that going down THAT road would be disastrous FOR THEM.
And it HAS been disastrous and destructive for MANY people.
My problem with this AA advertising piece masquerading as "science" is that ANY real line of scientific inquiry makes an honest attempt to DISPROVE IT'S OWN HYPOTHESIS AND PRESUMPTIONS.
That's how you can ALWAYS tell if something is real, honest, scientific inquiry, or just another crappy PR piece written by people with ZERO integrity.
Cults are great for people that are never going to amount to anything anyway, it gets them out of everyone else's hair. If you need that sort of thing, and accept that you're just a disposable cog in a little machine, have at it.
The article is not an endorsement of AA or any of the addition industry groups yet don't understand the vitriolic comments to bring them down. You would think they were Al Qaeda or some terrorist organization that had to be rooted from the earth by the nasty unconscionable comments. These folks have helped tens of thousands of people who need and have asked for help. I know everyone is so much smarter on slashdot than the rest of the world which justifies their position on the grassy knoll to take easy shots at passerbys. If it saves even a few ten thousand lives, keeps some families together, gives an individual strength to stand up who are we to take the shot? Really? We gotta bring them down and simultaneously take no responsibility for the lives that are impacted because we know so much better? And anyway, isn't the point of the article that there is a suggestion, a possibility, that we are connected and care for each other might be important? "We, as social mammals, cannot regulate our central nervous systems by ourselves," Flores says. "We need other people to do that."" If somebody cares, we should stand out of their way because, placebo or not, it sometimes works.